How can we craft precision treatments for individual patients?
Breast cancer is not a single disease but a cluster of diseases, each with its own characteristics that allow it to survive despite surgery and chemotherapy. While advances have helped us understand the nuances of each sub-type, standard treatments are an imprecise approach at a time when precision is demanded.
To improve results, therapies need to address the unique traits of the tumor—and the woman it has invaded. Instead of the one-size-fits all approach that’s been relied on for decades, this approach analyzes individual variables in genes, environment, and lifestyle when crafting prevention and treatment strategies.
At the Vera Bradley Foundation Center for Breast Cancer Research, we call it “Monogrammed Medicine.”
Jenny Larner Brown is a five-year triple negative breast cancer survivor. She’s been in complete remission since participating in a first-in-human clinical trial targeting TNBC’s most active genes.
Called “Whac-a-Mole” after the popular arcade game, the trial tested a two-drug knockout combination therapy. TNBC is tricky to treat because when one chemotherapy drug knocks out the cancer, another genetic pathway “pops up” allowing the cancer to persist, just like those pestilent moles in the game.
She’s now taking trips with her family and friends, hiking sections of the Appalachian Trail, pursuing a master’s degree, and savoring every moment because of this Vera Bradley Foundation Center-funded research conducted by the Monogrammed Medicine team.
The better we can understand how that happened for her—what is unique about Jenny, her tumor and this therapy—the closer we get to being able to replicate it and get that response for others.
Kathy Miller, MD — Principal investigator, “Whac-a-Mole” clinical trial
Vera Bradley Professor of Oncology Bryan Schneider, MD, working with collaborator Milan Radovich, PhD, recently discovered how to predict which women with triple negative breast cancer (TNBC) are likely to remain disease-free after initial chemotherapy and surgery. TNBC is aggressive and deadly when it recurs.
Their discovery led to a clinical trial, with data presented in December 2020 and published in July in the prestigious journal, JAMA Oncology.
Now, Dr. Schneider is leading the next national clinical trial—dubbed PERSEVERE—to better understand personalized cancer treatment combinations.
Todd Skaar, PhD, discovered a way to identify breast cancer patients who are most likely to experience a very toxic side effect of a common chemotherapy.
This genetic marker will soon be published and the information will be included in patient profiles that physicians utilize to determine the most effective and tolerable treatments for women with breast cancer. This will allow caregivers throughout the U.S. to modify dosage or select a less toxic drug if possible.
Monogrammed Medicine—the signature program of the Vera Bradley Foundation Center—has provided the funding to identify multiple genes that determine how effective and tolerable breast cancer drugs will be for individual patients.
It has also facilitated the development of genetic tests that can be used to identify the best supportive care drugs to help patients manage the symptoms caused by the diagnosis and treatment of breast cancer.
One million breast cancer patients worldwide are well aware of their Oncotype DX score, a test that has roots in the Vera Bradley Foundation Center.
Breast tumors with the estrogen receptor are routinely analyzed with this test that determines genes driving the cancer and the level of tumor aggressiveness. Of the one million women worldwide who have been tested, half of them have been able to reduce chemotherapy by half and be successfully treated.
Sunil Bavde, MD, was the lead pathologist of the national study—known as TAILORx—to demonstrate the effectiveness of the test in predicting who needed chemotherapy and how much was needed. George Sledge, MD, was the principal member of the research team when the study began, and Kathy Miller, MD, played a major role in reporting the results.
The Vera Bradley Foundation Center doesn't shy away from problems and doesn't shy away from the tough cancers.
Kathy Miller, MD — World-renowned breast cancer clinical trial expert
One of the world’s foremost experts in breast cancer epigenetics is part of the Vera Bradley Foundation Center team—and his work is now part of a prestigious Specialized Programs of Research Excellence (SPORE) grant from the National Cancer Institute.
Kenneth Nephew, PhD, along with colleague Kathy Miller, MD, and a collaborator at the University of Maryland are studying the impact of epigenetic therapy on cancers driven by BRCAness, a major cancer-related vulnerability.
Patients who inherit mutations in the BRCA1 or BRCA2 genes are at higher risk for breast and ovarian cancers. While approved therapies exist for these patient populations, those therapies won’t work for women diagnosed with triple negative breast cancer or ovarian cancer with BRCAness—a defect in the DNA repair process that imitates BRCA mutations, even though the gene is intact.
Dr. Nephew’s research could offer a treatment approach for both BRCA mutant and intact cancers.
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Vera Bradley Foundation Center for Breast Cancer Research
535 Barnhill Drive
Indianapolis, IN 46202
