Professor of Pathology
Director, Division of Anatomic Pathology
Beth Israel Deaconess Medical Center
Harvard Medical School
Co-Investigator: Nadine Tung, MD, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston
Breast cancer that develops in women with inherited mutations in the BRCA1 or BRCA2 genes comprises approximately 5% of all breast cancer and 10% of breast cancer in Ashkenazi Jewish women. Previous data suggest that women with BRCA1 mutations preferentially develop triple negative breast cancer, and a subset of women with triple negative disease without BRCA mutations would also have DNA-repair-deficient triple negative breast cancer.
Also, recent findings have raised the question whether it is more effective to treat breast cancers that develop in women with inherited BRCA1/2 mutations with cisplatin, a chemotherapy agent that does not have an extensive track record in breast cancer, rather than with standard chemotherapy (e.g., doxorubicin and cyclophosphamide, “AC”). There is reason to believe that cisplatin might be more effective since it creates breaks in the genetic material of cells, which breast cancers deficient in BRCA proteins cannot repair. Yet, data regarding the responsiveness of the breast cancers in this population to these two chemotherapy regimens is extremely limited. The aim of this project is to compare the relative effectiveness of cisplatin and standard “AC” chemotherapy in women with inherited BRCA mutations and early stage breast cancer. BRCA mutation carriers will be randomized to receive one of these two chemotherapy regimens prior to the excision of their breast cancer; response of the breast cancer to the chemotherapy will be assessed at the time of surgery. This trial, the INFORM: BRCA1/2 trial, will be conducted at Dana-Farber Harvard Cancer Center (Drs Nadine Tung, Judy Garber and Stuart Schnitt) in collaboration with several other BCRF-funded investigators at academic medical centers across the US.
The aim of this project is to compare the relative effectiveness of cisplatin and standard chemotherapy (e.g., doxorubicin and cyclophosphamide, “AC”) in women with inherited BRCA mutations and early stage breast cancer. Recent data raised the question whether it is more effective to treat breast cancers in this population with cisplatin, a chemotherapy agent not typically used to treat breast cancer. There is reason to believe that cisplatin might be more effective since it creates breaks in the genetic material of cells, which breast cancers deficient in BRCA proteins cannot repair. This trial is being conducted at Dana-Farber Harvard Cancer Center (Drs Nadine Tung, Judy Garber and Stuart Schnitt) in collaboration with several other BCRF-funded investigators. In the last six months, an additional ten patients have been enrolled and four additional academic centers have opened the trial (Yale, Cancer Institute of New Jersey, University of Colorado and Women and Infants Hospital of Rhode Island). Two additional sites should be activated imminently (Cedars Sinai, MD Anderson Cancer Center) with MSKCC and University of Pennsylvania expected to open for accrual in the near future.
Dr. Stuart Schnitt is an internationally recognized expert in breast pathology. He did his internship and residency in Anatomic and Clinical Pathology at Beth Israel Hospital in Boston followed by a fellowship in surgical pathology, also at Beth Israel Hospital. He joined the pathology staff at Beth Israel Hospital in 1984 and has spent his entire career at Beth Israel Hospital /Beth Israel-Deaconess Medical Center and Harvard Medical School. He is currently Director of the Division of Anatomic Pathology at Beth Israel Deaconess Medical Center, a consultant in pathology at Brigham and Women's Hospital and the Dana-Farber Cancer Institute, and a Professor of Pathology at Harvard Medical School. In April, 2010, Dr. Schnitt was inducted as president of the United States & Canadian Academy of Pathology (USCAP), an organization of nearly 11,000 physician pathologist members worldwide.
Dr. Schnitt has published over 240 original articles, review articles, editorials, commentaries, and book chapters, primarily in the area of breast diseases. Along with Dr. Laura Collins, in 2009 he published a breast pathology textbook entitled "Biopsy Interpretation of the Breast". He currently serves on the editorial board of 13 journals. He has received the Arthur Purdy Stout Society of Surgical Pathologists Annual Prize (1999) and the Golden Microscope Award for Resident Teaching and Mentoring at Beth Israel Deaconess Medical Center (2003). He has been cited in multiple editions of The Best Doctors in America and America's Top Doctors. In addition, he will serve as President of the United States and Canadian Academy of Pathology in 2010-2011. His research interests have focused primarily on risk factors for local recurrence in patients with invasive breast cancer and ductal carcinoma in situ treated with breast conserving therapy, benign breast disease and breast cancer risk, and stromal-epithelial interactions in breast tumor progression.