Silvia Formenti, MD

2012-2013 BCRF Project:
(made possible by generous support from Coach)
Co-Investigator: Robert J. Schneider, PhD, NYU School of Medicine, New York

The research team led by Drs. Formenti and Schneider will undertake two studies in 2012-2013. For the first project, a growing body of evidence indicates that the primary breast cancer alters the surrounding tissue in a way that increases its ability to recur and metastasize. Drs. Formenti and Schneider introduced the concept that radiotherapy to the post-surgical tissue may reduce the inflammatory response associated with cancer surgery, as reflected by improved control of the tumor and survival among irradiated patients. Their ongoing study in breast cancer patients and in the laboratory setting has shown that malignant breast cancers, but not benign lesions, do in fact condition the surrounding breast tissue to develop factors that promote the survival of breast cancer cells and their growth, even following complete surgical removal of the tumor. These findings suggest the importance of treating the post-tumor surrounding tissues with radiation. Also, they may provide some initial explanation of the effects of radiation on the prevention of future breast cancer recurrence. Drs. Formenti and Schneider will further investigate these key findings.

In their second project, Drs. Formenti and Schneider aim to enhance the understanding of the role of selective protein synthesis in the regulation, survival, and resistance to treatment of breast cancer cells that are thought to be responsible for breast cancer metastasis and recurrence. The studies conducted in the past year are developing a novel approach that targets an area of gene regulation not previously exploited to more effectively treat advanced and metastatic breast cancer. They will continue these inquiries with the aim of developing new tools that can be used in the clinical setting.

Mid-year Progress: In their first project, Drs. Formenti and Schneider examine the concept that breast tumors alter the surrounding tissues in the breast in a way that increases their ability to recur and metastasize. Radiotherapy following tumor surgery is thought to improve breast cancer patient survival in part by reducing the ability of the surrounding tissue to maintain residual cancer cells and to become cancerous in the future. Their current research is showing that malignant breast cancers, but not benign lesions, condition the surrounding breast tissue to develop factors that promote the survival of breast cancer cells and promote their growth, even following complete surgical removal of the tumor. They continue to investigate these key observations.

In their second project, Drs. Formenti and Schneider continue to develop novel approaches and drugs that target the ability of breast cancer cells to produce proteins required for their survival and ability to spread. Their laboratory studies demonstrate that this area of research, which has not been previously exploited, provides great potential to more effectively treat advanced and metastatic breast cancer.

Bio:
Silvia Formenti, MD, was appointed in 2000 as the first Sandra and Edward H. Meyer Chairman of the new Department of Radiation Oncology. Widely respected for her work in breast and cervical cancer, Dr. Formenti joined NYU from the University of Southern California, Keck School of Medicine in Los Angeles, where she was a tenured Associate Professor of both Radiation Oncology and Medicine. She has been a member of the Advisory Board to the NYU Breast Cancer Program since 1996.

Dr. Formenti, a native of Milan, Italy, attended medical school at the Universita degli Studi di Milano. She completed residencies in internal medicine and medical oncology followed by one in radiology and radiation oncology in Milan, before coming to the States to work at USC in Dr. Malcolm Mitchell's laboratory, funded by a grant from the Italian National Research Committee (CNR). After a year in the lab she returned to the clinic as an Audrey Meyer Mars American Cancer Society Fellow and worked with Dr. Robert Lukes and Dr. Alexandra Levine on AIDS and Lymphomas. She then elected to permanently transfer to this country and completed an internship in general medicine and a residency in radiation oncology, before joining the faculty at USC.

A prolific researcher, Dr. Formenti started with a 3-year ACS career development award and is currently principal or co-principal investigator on five multi-year peer-reviewed grants with more than $ 3 million in total funding. She has devoted her research career to the study of women's malignancies, with a particular focus on underserved patients and Latina women. She has pioneered the use of concurrent chemo-radiation in the neo-adjuvant (before surgery) setting of LABC, an ideal setting to explore associations of pre-treatment tumor molecular markers with the extent of pathological response (response in the removed surgical specimen) after chemo-radiation. This research has been consistently funded by the NIH and ACS. The translational component of this research consists of several collaborations with basic scientists to identify in the laboratory which original tumor molecular tumor marker might determine response to a specific treatment. In addition, at NYU, in collaboration with Dr. Sandra Demaria she is studying how chemo-radiation induced cell-death affects patient's immunity.

Finally, funded by a grant from the Department of Defense, she is studying the role of partial breast radiation with an accelerated regimen, 5 instead of 30 fractions. She is also the P.I. in two other studies investigating the role of intensity modulated radiation therapy (IMRT) as a tool to reduce the number of radiation sessions required to treat small breast cancers.

In addition to her role as Chairman of the NYU Department of Radiation Oncology, Dr. Formenti is currently the Associate Director for Clinical Research as well as the Leader of the Breast Cancer Research Program of the NYU Cancer Institute, where she oversees the clinical and research efforts of over 30 investigators.