University of Melbourne Melbourne, Australia
Professor, Department of Oncology Clinical Lead, Breast Medical Oncology Peter MacCallum Cancer Center
Improving accuracy of predicting breast cancer risk and enhancing our understanding of preventative therapy.
Analysis of biobanked samples—blood, tissue, and clinical data from consenting patients—is critical for cancer research. Mountains of data can be gleaned from biobanks, and Drs. Cuzick and Francis and their teams are pioneers in leveraging the biobanked data to expand our understanding of breast cancer prevention. The High-Risk Breast Cancer Bio-bank (HRBCBB) was established with biospecimens and mammograms from women in the IBIS-I, IBIS-II, IBIS-II DCIS, and LATER clinical trials. Through the years, additional biospecimen from clinical treatment trials in early breast cancer (NeoGem, ELIMINATE, NeoN, CHARIOT, EXPERT) or metastatic breast cancer (DIAmOND, CAPTURE) and the UK/ANZ DCIS trial have been collected and added to the HRBCBB Bio-bank. Studies from these valuable resources may assist with the development of personalized treatments.
Recent analysis of samples from the IBIS-II trial has revealed that higher estradiol levels are associated with higher cancer risk, but also greater benefit from the hormone therapy anastrozole. They demonstrated from samples from the SOFT trial that risk of recurrence scores based on the PAM50 assay, which provides cancer subtyping and risk profiling in postmenopausal women, did not predict benefit of ovarian function suppression treatment in premenopausal patients with hormone receptor (HR)-positive breast cancer.
Prevention research is a long-term game as it takes many years of follow-up to ensure that preventive measures are effective. In the coming year, the team will analyze digitized images from the UK/ANZ DCIS trial using AI to identify treatment resistance and recurrence signatures. They will develop prognostic models that incorporate these signatures and publish recent findings showing infiltrating immune cells in ductal carcinoma in situ are associated with greater recurrence risk but also greater radiotherapy benefit.
Dr. Prudence Francis is Clinical Head of Breast Medical Oncology at Peter MacCallum Cancer Centre in Melbourne, Australia. She received her medical degree from the University of Melbourne and completed Medical Oncology training at Memorial Sloan-Kettering Cancer Center in New York, where she spent 4 years. Since returning to Australia, she focused her research on breast cancer randomized clinical trials (i.e. BIG 2-98, SOFT) with prospective tissue collection to facilitate translational research. She chairs the Steering Committee for the SOFT and TEXT trials which have led to changes in adjuvant endocrine therapy recommendations for young women with hormone receptor-positive breast cancer.
Dr. Francis is Chair of the Scientific Advisory Committee of Breast Cancer Trials Australia & New Zealand (BCT-ANZ) which has been conducting clinical trials since 1978. The multidisciplinary group has enrolled more than 15,000 women in national and international clinical trials across the disease spectrum from breast cancer prevention, DCIS, early-stage disease, and neoadjuvant therapy, through to advanced breast cancer trials. The group trials variously involve escalation or de-escalation strategies, with an emphasis on biobanking, and quality of life assessment.
Dr. Francis is a member of the St. Gallen International Expert Consensus Panel on the Primary Therapy of Early Breast Cancer, and the Advanced Breast Cancer (ABC) International Consensus Panel. She is a member of the Scientific Committee of the International Breast Cancer Study Group (IBCSG) and a member of the Breast International Group (BIG). In 2015, she was awarded the Medical Oncology Group of Australia Cancer Achievement Award.
2018
The Delta Air Lines Award
Queen Mary University of London London, United Kingdom
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