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BCRF Grantee Since


Donor Recognition

The Play for P.I.N.K. Award

Area(s) of Focus

Julie R. Gralow, MD

Jill D. Bennett Professor of Breast Cancer
University of Washington School of Medicine
Director, Breast Medical Oncology
Seattle Cancer Care Alliance
Member, Clinical Research Division,
Fred Hutchinson Cancer Center
Seattle, Washington

Current Research

BCRF has supported several Southwest Oncology Group (SWOG) initiatives led and coordinated by Dr. Gralow and colleagues. Among these is a phase III clinical trial of bisphosphonates as adjuvant therapy for primary breast cancer (S0307). This project is looking at whether bisphosphonates, drugs used to prevent or reduce bone breakdown, can be used to prevent breast cancer recurrence. The study enrolled 6,097 patients who received one of three bisphosphonates for a period of three years, and continue to be followed closely for recurrence for up to 10 years.  Analyses are ongoing, including the investigatation of various markers and pathways to see how they associate with the efficacy and toxicity of the three bisphosphonate therapies. Additional planned analyses in this cohort include identification of biomarkers to determine which patients are at increased risk of bone recurrence and a detailed analysis of osteonecrosis of the jaw (ONJ), a side effect of bisphosphonates use, to try to determine risk factors in the patients who developed ONJ.

Biopsies of bone metastases are commonly performed in breast cancer to document metastatic disease and evaluate metastatic expression of the estrogen receptor (ER) and HER2 proteins for clinical decision making. Preliminary analysis from a previous study confirmed that ER positivity is related to higher probability of bone metastasis. In a separate study, Dr. Gralow is testing a multiplex immune-based assay for measuring the ER and HER2 proteins in bone metastases to better assess optimal treatment options.       

Triple negative breast cancer (TNBC) has a poor prognosis, with early relapse and shorter survival following recurrence compared with non-TNBC. There is an unmet clinical need for more effective treatments in this group of patients.  Poly(ADP-ribose) polymerase (PARP) inhibitors are a promising class of drugs which inhibit DNA repair in cancer cells that have pre-existing DNA repair defects. Many TNBCs have DNA-repair defects which will make them sensitive to PARP inhibition. Dr. Gralow and her SWOG colleagues have conducted a phase I study that explored the safety and efficacy of combining a chemotherapy drug that causes DNA damage with a PARP inhibitor as a "double hit" to tumor cells. Based on promising results from this study, they will now initiate a larger study to determine if a PARP inhibitor can improve survival for patients with metastatic TNBC. The outcome of this project may validate a new class of therapy for TNBC, while providing insight into the mechanism of action of PARP inhibitors and identifying biomarkers that can predict response to treatment. Knowing which patients are most likely to respond to PARP inhibitors will allow doctors to individualize treatments for this patient population, improving survival and quality of life. If this trial is successful, PARP inhibitor/chemotherapy combination treatment could become available to patients with TNBC in the short-term. 


Julie R. Gralow, MD, is the Jill Bennett Endowed Professor of Breast Cancer at the University of Washington (UW) School of Medicine, Director of Breast Medical Oncology at the Seattle Cancer Care Alliance, and Member of the Clinical Research Division at Fred Hutchinson Cancer Center (FHCRC).

As a clinician-researcher, Dr. Gralow has developed and implemented numerous clinical trials that study new regimens for breast cancer prevention and treatment. She promotes exercise and a healthy diet for improving quality of life among breast cancer patients. She also has an interest in international breast cancer education. Dr. Gralow’s primary research expertise is in the field of breast cancer bone metastases and bisphosphonates (drugs that slow bone cell turnover, leading to a decreased risk of developing bone metastases).

Dr. Gralow is PI for the clinical core of the FHCRC/UW Breast Cancer Specialized Program of Research Excellence (SPORE) grant. She currently serves as an Executive Officer for SWOG overseeing breast and lung cancer efforts. She has served as an alternate member of the NCI Breast Cancer Steering Committee since its inception, and co-chaired an NCI State of the Science conference on preoperative therapy in breast cancer in 2007. She also serves as a member of the Leadership Team of the FHCRC’s application to NCI as a Network Lead Academic Participating Site (LAPS) in the National Clinical Trials Network.