Teresa A. Gilewski, MD

2007-2008 BCRF Project:
Co-Investigator: Philip O. Livingston, MD, Memorial Sloan-Kettering Cancer Center, New York

Vaccines that stimulate the production of antibodies and those that activate specialized immune cells called T cells have been used in laboratory models to attack cancer. Eventually, both types of vaccines may be used simultaneously to treat cancer or to prevent it from recurring.

Building on BCRF-funded research, Drs. Gilewski and Livingston have created an anti-cancer vaccine in a phase II/III clinical trial for patients who have been treated for breast cancer but who are at high risk of cancer recurrence. This vaccine is designed to stimulate the patient's immune system to produce antibodies that attack cancer cells. It contains seven components that each target a specific antigen (protein or carbohydrate) expressed on the surface of breast cancer cells. The researchers will evaluate whether the vaccine can eliminate circulating tumor cells and cancer spread, resulting in prolonged disease-free and overall survival.

Preparation of the heptavalent conjugate vaccine for the randomized phase II/III trial in high-risk patients who are free of measurable breast cancer after surgery and chemotherapy is progressing rapidly. A small trial with the final component of this vaccine sLea is currently ongoing and the full polyvalent vaccine should be completed in the fall of 2007.

Mid-Year Progress Report:
Preparation of a breast cancer vaccine containing 6 or 7 breast cancer antigens is progressing rapidly for a large randomized Phase II/III trial in high risk patients who are free of detectable breast cancer after surgery and chemotherapy. The researchers have previously tested vaccines containing 6 of these antigens, each present on most breast cancers, and shown that antibody responses against each were induced in most patients. A small trial with the final component of this vaccine sLea is currently ongoing. The full vaccine will be vialed as soon as results of the sLea trial are known and the researchers know whether to include this as the seventh antigen. The 6 or 7 antigen vaccine will then be tested in a pilot trial to confirm immunogenicity and safety. Drs. Livingston and Gilewski hope to initiate this in late 2008, to be followed by a large randomized trial to determine impact of vaccination on clinical course.

Bio:
Dr. Teresa Gilewski is a medical oncologist on the Breast Cancer Service, Department of Medicine, at Memorial Sloan-Kettering Cancer Center. Dr. Gilewski received a BS from Gannon University and a MD from Hahnemann University as part of a six-year combined BS/MD program. She then completed training in internal medicine at Northwestern Memorial Hospital followed by a fellowship in hematology/oncology at the University of Chicago.

Her current focus of research is the development of vaccines for patients with breast cancer at high risk of recurrence. In collaboration with colleagues from the immunology service, she has conducted clinical trials in patients with locally advanced or recurrent breast cancer. Several ongoing studies will evaluate different types of vaccines.

Dr. Gilewski also created the Art of Medicine lecture series at Memorial Sloan-Kettering Cancer Center. This program focuses on the humanistic aspect of medicine. She directed, produced and wrote two films: "Reflections on Illness- an Interview with Dr. Alan Houghton" and "Living Through and Beyond Breast Cancer". She is currently developing a film on "The Physician as the Patient" to be shown at the American Society of Clinical Oncology meeting in 2007.