Nadine M. Tung, MD
Director, Cancer Risk Evaluation Program
2012-2013 BCRF Project:
(made possible with generous support from The Housewares Charity Foundation)
Beth Israel Deaconess Medical Center
Associate Professor of Medicine
Harvard Medical School
Co-Investigator: Stuart Schnitt, MD, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston
Breast cancer that develops in women with inherited mutations in the BRCA1 or BRCA2 genes comprises approximately 5% of all breast cancer and 10% of breast cancer in Ashkenazi Jewish women. Previous data suggest that women with BRCA1 mutations preferentially develop triple negative breast cancer, and a subset of women with triple negative disease without BRCA mutations would also have DNA-repair-deficient triple negative breast cancer. As a result, with BCRF support, Drs. Tung and Schnitt conducted the first neoadjuvant ("pre-operative") trials using cisplatin, which is platinum-containing chemotherapy, in women with triple negative breast cancer. They tested cisplatin because data had demonstrated the agent to be especially effective on BRCA1 deficient triple negative breast cancer cells. Based on that data, Drs. Tung and Schnitt have partnered with other BCRF grantees in 2011-2012 to conduct a multi-institutional clinical trial to determine whether BRCA-associated breast cancers are more effectively treated with cisplatin, an agent that targets defects in DNA repair, than with standard chemotherapy. During the last year, they have completed writing the protocol to evaluate whether preoperative cisplatin chemotherapy is superior to standard chemotherapy in women with inherited BRCA1 mutations and newly diagnosed breast cancer. This trial is known as the INFORM: BRCA1/2 trial. In addition, Drs. Tung and Schnitt have established the necessary relationships with several academic centers across the country that will participate in the trial. The protocol is now being reviewed by the Scientific Review Committee and Institutional Review Board at Dana-Farber Harvard Cancer Center. It is anticipated that the trial will open for enrollment in a few months.
In addition, Drs. Tung and Schnitt have also completed collecting clinical information on women with triple negative breast cancer to evaluate whether those with an inherited BRCA1 mutation have a different prognosis than women without a mutation. They are currently also evaluating whether certain features of the pathology of triple negative breast cancers can predict a better or worse prognosis.
Mid-year Progress: During the previous six months, the protocol to evaluate whether preoperative cisplatin chemotherapy is superior to standard chemotherapy in women with inherited BRCA mutations and newly diagnosed breast cancer has been approved by the Institutional Review Board of the Dana-Farber Harvard Cancer Center and has opened to accrual at the Beth Israel Deaconess Medical Center and Dana-Farber Cancer Institute. This trial is known as the INFORM: BRCA1/2 trial. The first two patients have been enrolled. In addition, several collaborating academic centers across the country are in the process of opening the trial.
Drs. Tung and Schnitt have also begun analysis of the data collected on 264 women with triple negative breast cancer to evaluate whether those with an inherited BRCA1 mutation have a different prognosis than women without a mutation and whether brain metastases are more common in these women.
Dr. Tung is the Director of the Cancer Risk Evaluation Program at Beth Israel Deaconess Medical Center. She earned her undergraduate degree at Princeton University and attended Harvard Medical School. Dr. Tung is an active member of the Dana Farber/ Harvard Cancer Center, the American Society of Clinical Oncology (ASCO), and the Eastern Cooperative Oncology Group (ECOG). She is an attending physician in medical oncology at Beth Israel Deaconess Medical Center, and an Assistant Professor of Medicine at Harvard Medical School.
Her research focuses on genetic causes of cancer as well as effective strategies for cancer prevention and treatment. Much of her research has focused on women with BRCA1 and BRCA2 mutations, studying the factors which influence cancer development in these women and the optimal way to treat their cancers. She completed her internship, residency and fellowship in hematology-oncology at Beth Israel Hospital in Boston before joining the staff in 1990 as an attending physician.