Department of Pathology

Einstein-Montefiore Researchers Awarded Avon Foundation Grant

Dr. Susan Fineberg with Avon Check
Montefiore-Einstein breast pathologist Dr. Susan Fineberg receiving award from the Avon Foundation for Women at the recent Avon 39 The Walk To End Breast Cancer

 

The Avon Foundation for Women has awarded Einstein and Montefiore pathology researchers Rachel Hazan, PhD, and Susan Fineberg, MD, a $300,000 grant to facilitate their collaborative research study of triple negative breast cancer, in primary tumors as well as in the metastatic setting.  

On Sunday, October 17, Dr. Fineberg accepted an oversized check before a cheering crowd of thousands adorned in pink that gathered at Pier 84, in Manhattan, for the closing ceremony of this year’s AVON 39 The Walk to End Breast Cancer.

This year, over 3,500 enthusiastic men, women and children walked the 39 mile course over two days, raising $8.7 million to help fund breast cancer research.  Many walked in honor of loved ones they have lost to stage IV breast cancer. 

“When I said the word metastasis – boom! – thousands of people were screaming and yelling,” said Dr. Fineberg, an associate clinical professor of pathology and attending surgical pathologist specializing in diagnosing breast disease at Montefiore Medical Center.  “When people saw me walking away with that giant check they said they were so happy to see that the money that they raised is going toward improving the quality of treatment for stage IV breast cancer,” she added. “I felt humbled and inspired by the experience, to see how our work had the potential to improve the lives of so many women.”

A collaborative effort

RHazan
Dr. Rachel Hazan

 

Dr. Hazan, professor of Pathology and principal investigator, said the grant will go toward studying the role of cell cycle inhibitor P21 in triple negative breast cancer, with a focus on metastatic disease.

“Using models of breast cancer metastasis and metastatic cancer specimens from stage IV disease, we are finding out that a highly unsuspected molecule which normally inhibits tumor cell proliferation is actually playing an aggressive role in metastasis,” said Dr. Hazan, who was in China as an invited guest speaker at the Hangzhou International Conference on Precision Medicine of Cancer Diagnostic and Treatment, in Shanghai, and could not attend the Avon event. Her Einstein lab has made major strides in the last few years in understanding the underlying causes of cancer metastasis. 

Metastatic breast cancer is considered incurable and triple negative cancers have the highest incidence of metastasis because they are often resistant to chemotherapy.  Currently, there are no effective targeted treatment options.  Triple negative breast cancers account for 22 percent of the cases among black women, and 11 percent among white women.  The rates of the disease are higher than the national average in the Bronx, where there is a large population of African American women.

Dr. Hazan’s multidisciplinary research program focuses on molecular pathways governing metastatic dissemination of breast cancer. Using N-cadherin as a model for metastatic progression, her laboratory uncovered key pathways governing motility, invasion, epithelial to mesenchymal transition, tumor cell survival and cancer-stem cell evolution, all converging into a complex network of pathways leading to metastasis. In the process of investigating N-cadherin function in cancer, her lab’s research led to the discovery of novel pathways that counteract metastasis independently of N-cadherin. One such example is R-cadherin, Akt isoforms, and the cell cycle inhibitor p21CIP1, discoveries that are opening novel and exciting avenues of research.

Her studies have shown that cell lines in which the P21 was removed lost the ability to metastasize. When the p21 was restored, however, the cells again exhibit the ability to metastasize. Currently drugs under development target the molecular pathways under the control of stem cell promoting gene P21, including genes belonging to the Wnt signaling pathway.  

“By targeting these P21 associated pathways the hope is that this can disrupt the ability of the stem cell for continued self- renewal and hence inhibit metastasis,” Dr. Hazan said. Alternatively, targeting the p21/Frizzled axis could be a treatment strategy against triple negative breast cancer (TNBC).

In order to confirm that P21 expression conveys stem cell properties  in vivo, the lab will investigate  expression of P21 high grade triple negative breast cancers to determine if P21 expression correlates with development of metastatic disease as well as chemo resistance.

Dr. Fineberg will select the most appropriate tumor tissue specimens for P21 assessment as well as interpret levels of p21 expression in these tissues via immmunohistochemistry.  Her expertise in interpreting pathology of breast cancer will allow the team to correlate appropriate pathologic features of tumors with expression levels. Also lending his expertise is world renowned breast oncologist Dr. Joseph Sparano, who is vice chairman of medical oncology at Montefiore Einstein Center for Cancer Care, professor of medicine and of obstetrics and gynecology & women's health at Albert Einstein College of Medicine and associate director of clinical research at the NCI-designated Albert Einstein Cancer Center.

Dr. Joseph Sparano
Dr. Joseph Sparano

 

This scientific team is among Montefiore’s finest. Drs. Hazan, Sparano, and Fineberg have spent their entire careers focused on breast cancer research and hope their work will eventually help in the development of targeted treatment strategies for triple negative breast cancer.

“Once we can establish this clinical relationship we can look at the effect of experimental drugs targeting these pathways to determine if this results in diminished metastability,” said Dr. Hazan. “We are hoping that this might be extended to clinical trials for patients with carcinomas at high risk for metastasis and showing high P21 expression.”

Meanwhile, the Montefiore-Einstein collaboration has fostered new friendship. For the last few years, Drs. Hazan and Fineberg have met after hours at Montefiore to look over slides and new cases of triple-negative patients. They say the basic science and clinical collaboration is highly productive – but also invigorating and fun. 

Dr. Fineberg said, “Rachel says, ‘It’s more fun than going out to have a glass a wine. We love our work! ”

BOLD BUDDY Patient Navigation Grant

The Avon Foundation for Women has also awarded Alyson Moadel-Robblee, PhD, associate professor of Clinical Epidemiology, a $100,000 Patient Navigation grant for her BOLD Buddy Peer Navigation Program, which trains cancer survivor volunteers to provide peer support to newly diagnosed cancer patients. The Avon grant will help augment the program to address the unique needs of advanced stage and end-of-life breast cancer patients.


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Department of Pathology
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Email: pathology@einstein.yu.edu 

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