Donors Fund Research on Aggressive Breast Cancer

Thanks to ongoing donor support through The Foundation for Barnes-Jewish Hospital, WashU Medicine researchers are making progress on better ways to tackle triple-negative breast cancer (TNBC).

TNBC is one of the most aggressive subtypes of invasive breast cancer. It isn’t hormone-fueled like other types of breast cancer, which makes it more challenging to treat. To date, TNBC has no targeted therapies. It also disproportionately affects Black women relative to white women. Given that TNBC is more likely to occur between routine screening mammograms, it poses an urgent need for improved prevention and early detection years before the onset.

Predicting and Preventing TNBC

With a focus on future generations, Penny Pennington and Mike Fidler established the Breast Cancer Research Innovation Fund at the Foundation in 2023 to provide seed funding for early translational research directly related to breast cancer.

The fund was behind a groundbreaking study by Shu (Joy) Jiang, PhD, a WashU Medicine associate professor in the Public Health Sciences Division, that builds on her earlier research. 

In 2008, Dr. Jiang set out to identify people on track to develop breast cancer before tumors even form by monitoring changes in breast density measured by mammograms over 10 years. The study found that breast density declined more slowly in breasts that developed cancer than those that didn’t. 

Building on that knowledge, Dr. Jiang launched a new project in 2023 to specifically identify risk factors for TNBC. Through this current project, Dr. Jiang successfully built a model to predict patient risk for developing TNBC in the next five years.  

Dr. Jiang and colleagues have moved this work forward through the development of an artificial intelligence technology that produces a five-year risk score. This summer, the technology received Breakthrough Device designation from the Food and Drug Administration, which expedites the review process to get the technology to patients faster. 

Personalized Vaccines

Early-stage funding from the Foundation also supports William Gillanders, MD, a WashU Medicine surgical oncologist, who has been pursuing breast cancer vaccines for more than a decade. 

More recently, he and S. Peter Goedegebuure, PhD, along with other WashU Medicine researchers, built on those findings to launch a clinical trial that showed promising results for patients with TNBC who received a neoantigen DNA vaccine designed to prevent recurrence of tumors. Each patient’s vaccine contained altered proteins, called neoantigens, created by their specific tumor that stimulate the patient’s immune response.

Patients in phase 1 of the clinical trial received three doses of a personalized vaccine that targeted the mutations in their specific tumors. Their immune cells were trained to recognize and attack any cells with these mutations while leaving healthy tissue alone.

After three years, 16 of 18 patients who received the vaccine remained cancer-free. In the study group of those treated with only standard treatments of chemotherapy, surgery, and radiation, only half remained cancer-free after three years.

Because of donor support through the Foundation, the research team was able to establish the capacity to design and manufacture DNA vaccines through a combination of genome sequencing, bioinformatics, and vaccine manufacture at the Biologic Therapy Core Facility at Siteman Cancer Center.

The study’s success is leading to additional studies to optimize the vaccines and explore alternative platforms, such as DNA, RNA, and others, and is paving the way for clinical trials of the next generation of vaccines. 

The collaboration among physicians creates a domino effect in terms of new discoveries—several vaccine studies for various types of cancers are now underway at Siteman Cancer Center.