Olufunmilayo (Funmi) I. Olopade, MD, FACP

Identifying ways to ensure that underserved women in Nigeria at high risk of breast cancer receive quality preventive screening and treatment.

Impact

Women of African descent are more likely to be diagnosed with aggressive breast cancers, and at a younger age, than white women. They are also more likely to die from their disease. Differences in tumor biology, genomics, and health care delivery patterns all contribute to this breast cancer mortality gap. Those living in low-resource communities have limited access to screening or genetic testing, compounding the challenges clinicians face in reducing these deaths. Dr. Olopade is unraveling the root causes of the disparities in breast cancer outcomes. With the support of BCRF, Dr. Olopade has established robust clinical trials infrastructure and increased the capacity of oncologists in Nigeria to perform clinical trials. These efforts led to the opening of the first cancer risk clinic in Nigeria. Her team has also been studying the genomic landscape of breast cancer to identify biomarkers that can predict either at diagnosis or before recurrence, which patients will progress. Through their work, Dr. Olopade and her colleagues can offer women in Nigeria biomarker-informed clinical trials and increased access to quality diagnostic tools and optimal treatments. Their work will further strengthen the country’s capacity to address and respond to emerging cancer care needs and provide valuable insights to decrease the burden of breast cancer in Nigeria and other low-resourced communities globally.

Progress Thus Far

Dr. Olopade’s genetic epidemiology studies have advanced our understanding of the burden of breast cancer among young women, especially those with BRCA-associated breast cancers. Her team found a high prevalence of mutations in the BRCA1 and BRCA2 genes among women with breast cancer in Uganda, Cameroon, and Nigeria. The mutation frequency suggests a significant burden of heritable risk factors across these sub-Saharan African countries. Dr. Olopade and her team are steadily expanding the translational research platform they have developed to other sites across Nigeria. Through their efforts, the first ever oncology clinical trial (ARETTA 1.0) conducted in Sub Saharan Africa met its accrual goal. ARETTA 1.0, a phase 2 trial, was carried out across four university hospitals in Nigeria and tested neoadjuvant treatment with chemotherapy (docetaxel/Taxotere®) and HER2-targeted therapy (trastuzumab/Herceptin®) in locally advanced, non-metastatic HER2-positive breast cancer. The study concluded that the combination was effective in the neoadjuvant setting for this unique demographic and with manageable toxicity and no symptomatic cardiotoxicity. While Herceptin has been on the list of WHO essential medicines, countries have not prioritized its use for treating breast cancer and access to clinical trial has not been equitable. Dr. Olopade’s research and pragmatic approach has broken this trend, paving the way for future patient-centric trials in populations from diverse settings.

What’s next

A new clinical trial will be launched in the next year to test whether dual HER2 blockade with Herceptin® and Perjeta® can improve responses in these patients. Dr. Olopade and her colleagues will leverage cutting-edge tools such as digital pathology, deep-learning, and liquid biopsy to develop imaging biomarkers to predict response to neoadjuvant therapy, understand mechanisms of resistance, and optimize therapy outcomes.