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BCRF Grantee Since

1998

Donor Recognition

The ANN INC. Award

Area(s) of Focus

Laura J. Esserman, MD, MBA

Professor of Surgery and Radiology
Director, Carol Franc Buck Breast Care Center
Co-Leader, Breast Oncology Program
UCSF Helen Diller Family Comprehensive Cancer Center
University of California, San Francisco

Current Research

The communication between immune cells and tumor cells has profound effects on tumor progression, particularly in hormone receptor-negative breast tumors.  One study conducted by Dr. Esserman is aimed at bringing new immune-based diagnostic and therapeutic strategies into the clinic as a strategy to prevent progression of DCIS (ductal carcinoma in situ, a non-invasive precursor to breast cancer), as well as invasive breast cancer (IBC).  In addition to developing immunotherapeutic strategies to target the tumor immune microenvironment, Dr. Esserman’s group is also working to characterize the types of immune cells associated with hormone negative DCIS that appear to be the precursors of triple negative tumors and HER2+, hormone-negative tumors, neither of which have preventive interventions at this time. Analyzing the immune cells around tumors, Dr. Esserman developed an index score that was associated with the most aggressive disease. She will be applying a similar analysis in very high grade cancers found in women in Africa and in the US and will continue immune profiling studies in IBC and high grade DCIS. There are plans to add these newly developed immune-based strategies to standard chemotherapy in the I-SPY 2 TRIAL, for which Dr. Esserman is the lead investigator. Importantly, results from her BCRF-supported work have led to development of an assay that can directly measure changes to the immune microenvironment that can be used to monitor tumor response to immune-based therapies.

In order to understand the changes leading to cancer progression it is imperative to understand the complexity of the normal breast. In a second project Drs. Esserman and Mina Bissell and are engaged in a collaborative effort to isolate and characterize each cell type within the normal breast and in DCIS in an effort to identify patterns of similarity and differences between the diverse cell populations.

Every cell in the mammary gland is surrounded by a microenvironment, which includes neighboring cells and tissue components called extracellular matrix (ECM) that together make up the architecture of the tissue. A dynamic and reciprocal conversation exists between each cell and its microenvironment to guide the development and maintenance of healthy tissue. How the different components of breast tissue – the cells lining the ducts, the tissue architecture and ECM – interact to prevent or even promote DCIS is still not well understood. To study this question, Drs. Esserman and Bissell will use a three-dimensional culture system to study the types of colonies formed when cells from non-malignant vs. DCIS tissue are grown in specific microenvironment conditions. They will expand these studies to include estrogen receptor-negative in situ cancers for which there are no targeted therapies. These approaches may lead to a better understanding of the role of the different cellular components in normal physiology, how they give rise to DCIS and which DCIS lesions will progress into aggressive breast cancers.

Bio

Dr. Esserman is a surgeon and breast cancer oncology specialist, and is the Director of the Carol Franc Buck Breast Care Center at the University of California, San Francisco (UCSF).   In 1996, she started the Center of Excellence for Breast Cancer Care at UCSF to integrate clinical care and research, automate tools for the capture of patient and clinical data, and develop systems to tailor care to biology, patient preference, and performance.

Dr. Esserman is nationally and internationally known as a leader in the field of breast cancer and has published over 200 articles.  She served as a member of a taskforce for President Obama’s Council of Advisors on Science and Technology (PCAST) Working Group on Advancing Innovation in Drug Development and Evaluation. The group was tasked with making recommendations to the federal government about how to best support science-based innovation in the process of drug development and regulatory evaluation.

She is the Principal Investigator of the I-SPY TRIAL program, a multi-site neoadjuvant clinical trial (which includes a phase 2 and 3 trial) that has evolved into a model for translational research and innovation in clinical trial design. Dr. Esserman has recently launched a University of California-wide breast cancer initiative called the Athena Breast Health Network, a program designed to follow 150,000 women from screening through treatment and outcomes, incorporating the latest in molecular testing and web-based tools into the course of care.  Athena is in the final stages of launching a statewide demonstration project and phase 1/2 trial of personalized screening.

Latest from Laura J. Esserman

Co-Investigators