Bakes for Breast Cancer 2017 will support the research of Dr. Shom Goel
Although the term “physician-scientist” has become a buzzword in medical research, there are actually only a few people around who successfully combine a career in the clinic, taking care of breast cancer patients, with laboratory research. Dr Shom Goel is one such person – a breast cancer oncologist at the Dana-Farber who divides his time between the laboratory bench and the patient’s bedside. This year, we will be funding Dr. Goel and his research that addresses the important question – “Why are some breast cancers resistant to the drug treatments we use in the clinic?”
Dr Goel explained that as a clinician, he is confronted all too often with the situation wherein a patient’s breast cancer initially responds well to a drug treatment, but later becomes resistant to that treatment. Understanding why this process happens is very important – only when we understand the causes of drug resistance can we find ways to overcome it.
Dr Goel’s laboratory research is often inspired by his experiences with patients: “The clinic is where I find the problems that need to be solved”, he explained, “and the lab is where I am able to explore these problems in depth.” Dr Goel uses several sophisticated techniques in the lab, including genetically engineered mice, to mimic situations seen in patients. He is then able to perform detailed experiments to understand drug resistance. When experiments go well, the results provide new insights that can translate into new treatments for patients.
Because Dr. Goel is also a clinician, he has the potential to take promising new treatments he develops in the laboratory and move them forward in clinical trials. Initially, new drug combinations demand small clinical trials to ensure that the medications are safe. However, these often spawn larger trials, which are designed to test whether the results found in mice apply to patients too. As an example, Dr. Goel’s recent research on a type of breast cancer called “HER2-positive” breast cancer has led to the development of a clinical trial of a new drug combination which is accepting patents from across 13 different countries. “Developing new treatments in mice and then seeing encouraging results in patients is extremely gratifying”, he said.
Dr Goel’s current work is focused on understanding how breast cancers are able to “hide” from the immune system, and relates to the fast-growing field of cancer immunotherapy. Although cancers are formed from within, cancer cells are often so abnormal that our immune system recognizes them as foreign, and tries to kill them. However, cancers are smart and have developed ways to turn off the immune system – basically saying “don’t eat me”. By doing this, cancers are able to escape the immune system.
The goal of immunotherapy is to stop the ability of cancers to overrule the immune system. Indeed in certain types of cancer, immunotherapy has been very effective. However, results in breast cancer have been disappointing. Why does immunotherapy not work as well in breast cancer as it does with other cancers? What is missing from immunotherapy that can make it successful in treating breast cancer?
These are the research questions Dr Goel is currently asking in the laboratory and which we will be funding this year. In particular, he is studying a new class of drugs called CDK4/6 inhibitors with the goal of finding out if they might be effective in combination with immunotherapy for the treatment of breast cancer. If his laboratory experiments show that this is the case, he will move on to test the combination of drugs in clinical trials in patients. Ultimately, the goal is to perform large clinical trials that might lead to the approval of new drug combinations for use in patients. These combinations are designed to both prolong life of patients, and improve their quality of life.
But for now, it’s one step at a time. “Each small discovery is added to those of the year before – that is how progress is made”, said Dr. Goel.