You are here

BCRF Grantee Since

2002

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
Professor of Medical Oncology
University of Washington School of Medicine
Director, Breast Medical Oncology
Seattle Cancer Care Alliance
Associate Breast Cancer Program Head
Fred Hutchinson Cancer Research Center
Seattle, Washington

Current Research

BCRF has supported several initiatives through the NCI-designated cooperative group known as SWOG. Among these is a phase III clinical trial of bisphosphonates as adjuvant therapy for primary breast cancer (S0307). In this project, Drs. Gralow and Porter are looking at whether bisphosphonates, drugs used to prevent or reduce bone breakdown, can be used to prevent breast cancer recurrence. The study is currently examining the differences in toxicities between various bisphosphonate drugs and will include translational studies using tissues that were collected from all the patients to help predict risk of recurrence.

As co-investigators for the U.S. team of the Male Breast Cancer Study, a collaborative, international project, Drs. Gralow and Porter are building a retrospective registry of male breast cancer patients in the U.S. that includes collection of tumor tissue and other biological material. This study will provide important information regarding the biology and natural history of male breast cancer and serve as a starting point for a prospective, international registry of male breast cancer and tissue resources that can be used in future research.

Drs. Gralow and Porter’s BCRF projects also include a clinical trial that will help identify women with estrogen receptor (ER) positive breast cancers that do not need chemotherapy. The trial will use existing recurrence prediction models to determine whether there is a recurrence score cut-point for these patients, above which chemotherapy will be recommended. The goal is to reduce toxicities from unnecessary treatment.

BCRF support has enabled Drs. Gralow and Porter to create a valuable infrastructure for future research, particularly in the collection of tissue from breast cancer patients (men and women) that will be used for decades to come.

Dr. Gralow is also a lead investigator in the RxPONDER clinical trial, also conducted through SWOG. The goal of this trial is to help doctors and their breast cancer patients make better treatment decisions by using a genomic test known as the Oncotype DX® Assay. Oncotype DX® is a diagnostic test that analyzes a panel of 21 genes within a tumor to determine a recurrence score (RS) that corresponds to a likelihood of breast cancer recurrence after treatment. Patients with hormone receptor-positive breast cancer that has spread to their lymph nodes usually get both chemotherapy and hormonal therapy after surgery. But for some of these patients with low to intermediate recurrence scores on the Oncotype DX test, hormonal therapy alone may be enough. RxPONDER will measure just how much, if any, benefit these patients get from chemotherapy, while determining whether there may be a cutoff score between patients who benefit from chemotherapy and patients who do just as well with hormonal therapy alone. BCRF has generously supported the provision of the Oncotype DX® Assay since the trial’s activation in 2011.

Currently the trial is active at 477 centers in the US as well as non‐US sites including Spain, Korea, Mexico, Peru and Ireland. France is currently completing paperwork to enroll in the trial. International sites are accruing with great success and are providing valuable data on Oncotype DX and patient outcomes in diverse populations outside North America.  As of July 2014, 5,485 screens have been conducted and 2,737 patients have been randomized (with hormonal therapy alone).

The researchers are currently conducting studies to compare the clinical effectiveness and cost effectiveness of breast cancer care based on genomic tools and markers compared to existing standards of care that do not use genome‐based approaches.  As the trial progresses, the investigators believe that it will answer one of the most important scientific and clinical questions in breast oncology and could prove to be a practice‐changing trial for node‐ positive breast cancer, saving approximately $800 million annually and, more importantly, advancing clinical care towards more personalized breast cancer therapies.

Bio

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.

Co-Investigators