As researchers continue to seek promising new breast cancer treatments for patients, they are now shifting their focus from a standardized, “one-size-fits-all” approach to a more individualized practice known as precision medicine. Precision medicine, also called personalized medicine, takes multiple variables into account, including a person’s genes, lifestyle habits and environment to guide decisions to prevent, detect, diagnose and treat breast cancer.
Precision medicine is the research focus of Komen’s newest Scientific Advisory Board member Adrian Lee, Ph.D., who also serves as Director of the Institute for Precision Medicine, Professor of Pharmacology & Chemical Biology, and Professor of Human Genetics at the University of Pittsburgh. Dr. Lee and his team study the molecular basis of breast cancer development and resistance to therapy. Their goal is to refine precision medicine and improve outcomes for breast cancer patients.
Dr. Lee has studied breast cancer for the past 30 years, and while it has not been cured in this time, he observes, “We’ve made great progress, and I’m very fortunate to be doing a job where I’m passionate about the disease I’m working on.”
“Pretty much every advance that we have in breast cancer has come from research – every single advance. None of this happened by luck.”
Precision medicine has already helped scientists gain a better understanding about the complexity of breast cancer. For example, researchers now know that breast cancer is not just about the biology of a single cancer cell or how it is driven by an individual gene or pathway; it is a full, complex system of interactions.
“That fundamentally changed how I do research and I think how many others are doing it now,” says Dr. Lee. “At UPMC Hillman Cancer Center, we have great access through our clinicians to tissues and to our patients, so we’re trying to really understand the disease that women and men have. I’ve been very focused on precision medicine, the idea that if we can find the right targeted therapy with the right drug at the right time, this will be good (for patients).”
This focus on precision medicine has fueled the need for more accurate tumor models for lab research. What started as breast cancer cells grown on a plastic dish has evolved into more accurate 3D tumor models called “organoids” made from patient tissue samples. These lab-grown organoids provide researchers an opportunity to study tumor behavior, characteristics and response to treatment outside of a human model.
“I think most people believe these will be a transformative model,” says Dr. Lee. “This will be the next wave of not just breast cancer research, but all research will likely be transformed by these organoids.”
Organoids are also the focus of Dr. Lee’s Komen-funded research, where he and his team are building a shareable resource of patient-derived organoids to serve as a living biobank for the research community. One focus of this research is to collect an extensive assortment of organoids from patients of various ancestries, breast cancer subtypes and stages. By making this biobank available to the broader research community, Dr. Lee hopes to provide future researchers with breast cancer samples that better reflect the diversity of the patient population.
“It’s important to understand the diversity of individuals and the diversity of their tumors, and we are trying to increase representation of patient-derived organoids from men and women who are underrepresented in science and medicine,” he says. “We focus on rare subtypes of breast cancer, as well. If we don’t increase representation of those (in our biobank), we will never have enough.”
There are other promising developments on the horizon that come from precision medicine. Liquid biopsies that were once used in later stages of breast cancer are now being used more for early detection, a capability that Dr. Lee calls the “holy grail” that could dramatically change outcomes for patients. He predicts breast cancer screenings may someday be possible through yearly blood tests.
Dr. Lee’s lab is also investigating variations in the DNA sequence of a cell known as “point mutations” and how they influence a tumor’s resistance to endocrine therapy (hormone therapy). These – and other advances in precision medicine – could dramatically change outcomes for patients and save lives.
Mentoring the Next Generation of Leaders Through Komen’s Scientific Advisory Board
Dr. Lee was recently appointed to Komen’s Scientific Advisory Board and is inspired by his own experience as an early career researcher to give back to the community that helped him at the beginning of his career.
“Komen really started my career,” he says. “My first grant was a Komen grant that got my lab started, and when you’re starting a lab, it’s the hardest of times to hire people, get grants and generate income, so I remain indebted to Komen for that.”
Since then, Dr. Lee has served as an advisor or board member for Komen every year of his career. “To be on the Scientific Advisory Board is one of the highest honors, and I’m honored to serve among peers whom I respect,” he says. “I’m excited to see Komen’s practice-changing goals and I’m happy to advise and help in those areas.”
Dr. Lee is happy to be at the point in his career where he can offer support and guidance to Komen-funded researchers, including the next generation of emerging leaders in breast cancer research. “I’m excited to help move the science forward, which I think will be important for patients,” he says. “Pretty much every advance that we have in breast cancer has come from research – every single advance. None of this happened by luck.”
