In 1993, when Evelyn H. Lauder founded the Breast Cancer Research Foundation with her friend Dr. Larry Norton, breast cancer screening, treatment, and research was still very limited. Mrs. Lauder, who had been diagnosed with early-stage breast cancer, and Dr. Norton conceived an organization that would bolster the best and the brightest minds in breast cancer research and give them the steady funding and freedom to pursue their out-of-the-box ideas and collaborate across institutions.
Mrs. Lauder was steadfastly dedicated to eradicating breast cancer until her untimely passing 10 years ago on November 12—but her legacy lives on today in BCRF’s progress. On this anniversary, we reflect on the incredible, lifesaving research gains BCRF has made against breast cancer over the last decade that are a testament to Mrs. Lauder’s pioneering vision.
Research is uncovering more about this disease every year. BCRF investigators have been part of every breakthrough in breast cancer research over the last decade—and since our founding in 1993.
Personalizing Care and Risk Assessment
Advances in precision medicine over the last 10 years have been life-changing for many breast cancer patients. We have made significant leaps forward to ensure that the right patients are receiving the right, effective treatments. BCRF was at the forefront of these breakthroughs by helping fund the foundational biology that led to the development of these targeted therapies. The Foundation also supported the first-ever clinical trials to codify, exactly, which women with estrogen receptor (ER)–positive, HER2-negative breast cancer benefitted from chemotherapy, and which can be treated with hormone therapy alone: TAILORx and RxPONDER.
Results from the largest-of-its-kind TAILORx trial, first reported in 2018, showed that 70 percent of women with early-stage, ER-positive breast cancer with a moderate chance of recurrence (based on their OncotypeDx® test scores) could avoid chemotherapy and be effectively treated with anti-estrogen therapies. The groundbreaking RxPONDER trial expanded on TAILORx and examined women whose ER-positive breast cancer that had spread to up to three lymph nodes. The results, reported in 2020, found that postmenopausal women with this subtype of breast cancer and a low to moderate recurrence score received no added benefit from chemotherapy, while premenopausal women did.
Together, these BCRF-supported studies had immediate, enormous impacts and represented huge gains in effective precision care. They assured tens of thousands of women that they could safely avoid chemotherapy and gave those undergoing chemotherapy confidence that their treatment would be beneficial.
Our knowledge regarding breast cancer risk has also expanded by leaps and bounds over the last decade. BCRF investigators and others have discovered 10 breast cancer predisposition genes beyond BRCA1 and BRCA2, and we are just beginning to understand the role all of these genes play in breast cancer risk.
In addition to helping uncover and further study breast cancer predisposition genes, BCRF researchers have successfully improved and expanded genetic testing in high-risk groups (as in the New York Breast Cancer Study and the Middle Eastern Breast Cancer Study) and have brought us closer to understanding the prevalence of gene mutations in all women. Just this year, researchers published results from the BCRF-backed CARRIERS study involving more than 64,000 people (about half women with breast cancer and half unaffected). CARRIERS represented the first comprehensive study to examine the prevalence of inherited mutations in both women with a personal or family history of the disease, as well as those with no family history.
More studies are ongoing to bring us closer to understanding the prevalence and breast cancer risk associated with single gene mutations or several gene mutations (called polygenic risk). This research will ultimately give doctors tools to arm women with potentially lifesaving information.
Advancing Immunotherapy for Breast Cancer
Immunotherapy harnesses the power of a person’s immune system to attack cancer cells and has been successful in treating melanoma lung cancer, and more. While immunotherapy has been less successful in breast cancer, it still holds enormous promise. In the last decade, there has been an explosion of research unveiling potential ways to make immunotherapy effective. Major discoveries in immune-targeted therapies have heralded a new era of cancer immunotherapy, and BCRF researchers are leading the charge to investigate its potential use in breast cancer.
More than a dozen BCRF investigators have advanced research that supported FDA approvals of novel immunotherapy agents to treat breast cancer, including triple-negative and HER2-positive diseases and those at later, metastatic stages. In addition to backing the development and testing of immunotherapy agents, BCRF-funded projects are ongoing to test breast cancer vaccines for TNBC and preventing breast cancer recurrence. Collectively, these results have propelled us through a decade of improved immune treatments for breast cancer and this momentum will continue into the next.
Tackling Metastatic Breast Cancer
Over the last 10 years, BCRF has become the largest private funder of metastatic breast cancer (MBC) research in the world and currently dedicates 40 percent of its total investment to this critical area of study. BCRF investigators are exploring many aspects of MBC: understanding its basic biology, identifying targeted treatments, addressing the disparities in Black women’s outcomes, and improving the quality of life for those with stage 4.
Fueled by an incredible outpouring of generosity following Mrs. Lauder’s death, BCRF launched the Evelyn H. Lauder Founder’s Fund for Metastatic Breast Cancer Research in 2013. The flagship programs of Founder’s Fund, AURORA EU and AURORA US, represent a tremendous logistical effort and a valuable resource to support the next generation of research into novel strategies to treat this devastating disease. The AURORA projects have already yielded new insights, and ongoing studies will undoubtedly reveal more to inform treatment decisions and save lives.
MBC remains the biggest challenge in breast cancer, but over the last decade, research has accelerated at unprecedented speed to give women and men not only new treatments to prolong their lives, but also, importantly, hope. In addition to the six immunotherapy drugs that have been FDA approved for MBC treatment, the agency greenlit the first small molecule HER2 inhibitor in 2017 as well as two additional HER2-targeted drugs. The clinical findings of several BCRF investigators and others further expanded treatment options, leading the FDA to approve several drugs, including the first CDK4/6, P13, and PARP inhibitors for treatment of MBC and TNBC-associated BRCA mutations. Notably, investigators also determined which specific subtype of breast cancer would benefit from each treatment option—further shaping precision therapy. Learn more about these treatment options for MBC here.
Researchers have recently started to crack another difficult puzzle in MBC research. As many as half of those diagnosed with HER2-positive MBC will see their cancer spread to the brain. Though brain metastases are rare, they are exceedingly difficult to treat because many drugs cannot penetrate the brain, so people with “brain mets” experience worse outcomes. Clinical findings from eight BCRF researchers and BCRF-funded studies led the FDA to approve the first-ever drug demonstrated to be effective for breast cancer brain mets in 2020.
In addition to more MBC treatments, research is revealing that some metastases can even be prevented. These game-changing results have been made possible through sustained and steady support for research; research that, through the last decade, has yielded unprecedented and substantial advancements that bring us closer to Mrs. Lauder’s vision of a world where no one dies from breast cancer.
Since Mrs. Lauder’s passing, BCRF has continued to champion her vision of a Foundation that supports and convenes the brightest minds in breast cancer research. Today, BCRF stands as the preeminent breast cancer research organization in the world—one that backs cutting-edge research and fosters collaboration. In keeping with Mrs. Lauder’s original mission, BCRF funds researchers, not projects. Our model fosters out-of-the-box ideas and enables researchers to nimbly follow new developments.
The Foundation has grown to become the world’s largest private funder of breast cancer research—one that now supports 250 scientists in 14 countries today compared to 145 grantees in 10 countries in 2011 (and just eight grantees in 1994). We’ve steadily scaled up our research program to fulfill Mrs. Lauder’s vision of a breast cancer–free world. Today, BCRF also ranks as the highest-rated breast cancer organization in the U.S.
Over the last decade, BCRF has cultivated a team of staff scientists to lead its grants program. These team members have the perspective of trained scientists—allowing them to help shape the research program and translate BCRF’s scientific discovery into real-world impact. BCRF has also cultivated and established partnerships with other nonprofit organizations, industries, and advocates to drive the field forward.
Advancing precision medicine is a common thread that runs deeply through BCRF-funded projects. Precision medicine is built on the premise that treatment is specific to an individual and the molecular and cellular (genes and proteins) profile of their breast cancer. To be fully realized, we must advance research to uncover biomarkers; personalize risk assessment, risk reduction strategies, and screening; and develop targeted therapies.
Biomarkers (specific genes, proteins, and other measurable factors) can potentially be exploited to help doctors decide on a course of action during treatment. For example, researchers are searching for novel biomarkers at different stages of diagnosis and developing innovative techniques to identify them from core needle biopsies, a less-invasive alternative to surgical biopsies for patients. The goal: To use small samples retrieved during this procedure for proteogenomic analysis (DNA, RNA, and proteins) to guide doctors—and bring to the clinic what could previously only be done in a laboratory research setting.
Liquid biopsy is a class of blood-based tests that give researchers the ability to look at the unique characteristics of a cancer cell quickly—and without a surgical procedure. These blood-draws can also be done more frequently, giving doctors the opportunity to follow how a cancer is changing and how someone is responding to treatment in real time. DNA blood tests might help us diagnose cancers of all types earlier, and even aid in cancer prevention. As with many discoveries that have improved breast cancer care, BCRF has backed the development and application of liquid biopsy by funding innovators who have moved the field forward. BCRF researchers are also exploiting another key discovery to further support the utility of liquid biopsy: that analysis of circulating tumor DNA and cell-free DNA isolated from liquid biopsies are as accurate as physical tumor biopsies in identifying genetic alterations. Collectively, these efforts are revolutionizing breast cancer diagnostics, surveillance, and care.
Precision medicine encompasses prevention, as well. We know that early detection saves lives. BCRF is committed to improving screening technologies that detect breast cancer early and powering research that personalizes surveillance. Our researchers are also delving into artificial intelligence to enhance current screening analyses, as well as examining new screening techniques, such as contrast-enhanced spectral mammography. Ultimately, these tools will guide future risk-based screening guidelines.
Additionally, investigators are developing mathematical models and tools that can be used to interpret many kinds and vast quantities of data. These tools will help us gain a deeper understanding of the overall picture of cancer, including areas such as disease evolution and treatment response. These and other cutting-edge studies will provide a solid foundation from which advancements in precision medicine can flourish in the years to come.
In the decade since her passing, we’ve remained steadfast in our commitment to carrying on Mrs. Lauder’s legacy. It’s an exciting and important time in breast cancer research. We are on the cusp of new treatments, more personalized care and screening, and an end to the devastation of metastatic disease. And with 3.8 million breast cancer survivors in the U.S. today, we have undoubtably saved lives.
Mrs. Lauder recognized that research—and research alone—would end breast cancer, and in doing so, she helped change the entire trajectory of the disease. BCRF is a testament to Mrs. Lauder’s fierce dedication, and we are proud to carry on her extraordinary vision.
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