Researchers at Hackensack University Medical Center have received a third grant of $190,000 from the Breast Cancer Research Foundation (BCRF) to fund research exploring the link between the microbiome and the response to breast cancer therapy, including the effectiveness of treatment and side effects. This avenue of study could potentially lead to novel ways to enhance the ability of anticancer drugs to halt the growth of breast cancer as well as improve patients’ quality of life by diminishing adverse side effects.
The microbiome includes healthy bacteria as well as viruses and fungi that live in our bodies, particularly the intestines.
“We have an enormous quantity of bacteria in our intestinal tract that are living and dying, using our nutrients to survive and making biological byproducts,” explained Leslie Montgomery, MD, Chief of Breast Surgery at Hackensack University Medical Center, who is co-leading the investigations with Rena Feinman, PhD, associate member of the Center for Discovery and Innovation at Hackensack Meridian Health.
“There is enough DNA in the microbiome to call it our “second genome”. We are just starting to understand the power of having all of these organisms producing metabolites and byproducts that can potentially affect our bodies when they are absorbed.”
“The gut microbiome is a really important player and acts like an organ on its own,” added Dr. Feinman. “Recent studies have also shown that tumors also have a unique microbiome such as bacteria. We now have next-generation sequencing and state of the art technologies that allow us to profile a patient’s gut and breast tumor microbiomes.
The project, called Gut and Intratumoral Microbiome Effects on Neoadjuvant Chemotherapy-Induced Immunosurveillance in Triple Negative Breast Cancer, is analyzing the influence of a patient’s microbiome on the effectiveness of neoadjuvant chemotherapy in women with triple-negative breast cancer (TNBC) prior to their surgery. TNBC is an aggressive form of breast cancer that lacks receptors for estrogen and progesterone as well as the protein HER2, making patients with this type of breast cancer ineligible to receive treatments designed to target these proteins.
Through a clinical trial originating at the John Theurer Cancer Center, Hackensack University Medical Center and recently opened at Yale Cancer Center and Georgetown University Lombardi Comprehensive Cancer Center, women newly diagnosed with TNBC provide blood and stool samples for analysis before their chemotherapy, during their chemotherapy and again right before surgery. Tumor tissue obtained at diagnosis and during surgery will be analyzed. Patients will also complete questionnaires about chemotherapy side effects, such as diarrhea and nausea. The profiles of patients’ gut and tumor microbiomes will be correlated with their response to treatment, and incidence of side effects..
“Our work in progress suggests there are differences in the composition of the gut microbiome among breast cancer patients before treatment which may be predictive of the outcome. We have also validated the presence of tumor bacteria in biopsies,” said Dr. Feinman. “Importantly, we are studying how beneficial bacteria reinvigorate the antitumor immune response.”
“We have not yet harnessed the energy or information about the microbiome to learn how it can hurt us or help us. If we can identify a certain microbiome population that makes gastrointestinal side effects less severe or one that improves the response to chemotherapy, perhaps we can give a specific probiotic to patients to alleviate those symptoms and/or make treatment more effective,” Dr. Montgomery hypothesized. “The ultimate goal would be to assess the power of probiotics in a randomized clinical trial to determine their optimal use for improving treatment outcomes.”
“This work shows how clinicians and laboratory scientists are working together at our health network for the benefit of patients,” said Ihor Sawczuk, M.D., FACS, chief research officer and president of the Northern Region of Hackensack Meridian Health. “We aim to push the envelope, and follow where the data leads us.”
For information about enrolling in the clinical trial, please call 551-996-4381.