Intended to add another important element to their current project, Neuhausen and Ziv are the principal investigators of the newly funded study, "Improving Precision Medicine for Breast Cancer in Latinas: A Multi-Tiered Approach." They and a host of other collaborators from City of Hope, UC San Francisco, UC Davis and Stanford University will spend three years on the project.
"Our R01 grant from the National Institutes of Health is called ‘Germline and Tumor Genomic Analyses of Breast Cancer in Latinas.’ Using a combined germline/somatic genomics approach, our goal is to identify additional breast cancer predisposition genes — genes that show moderate to high increased risk of developing breast cancer, as much as a 10-fold risk increase," Neuhausen, The Morris & Horowitz Families Professor in Cancer Etiology & Outcomes Research and director of the Division of Biomarkers of Early Detection and Prevention in the Department of Population Sciences, Beckman Research Institute at City of Hope, explained.
“We've been looking at germline and somatic genomics of breast cancer in Latinas," she said. With the R01 grant in its last year, "it was a natural progression that we would apply for this CIAPM grant, because it would provide us with additional resources to obtain the needed knowledge for precision genomics in Latina women. Precision medicine has the potential to revolutionize prevention and treatment approaches. However, if there are insufficient data on particular populations, it may exacerbate existing disparities. This is the current situation in Latinas,” Neuhausen said.
The recently awarded CIAPM grant was garnered among a competitive environment for California researchers; with 27 applicants, only three were awarded to researchers, whose work must be done in the state.
The group's research is vital, for Latinas are a woefully underrepresented group in genomic studies of breast cancer. "In The Cancer Genome Atlas (TCGA) for breast cancer, Latinas are totally underrepresented, with only 36 out of about 1,100 tumors," Neuhausen pointed out. "That means only 3% are Latina. African Americans and Asians are also underrepresented. Right now, each of those non-Caucasian groups is finally being studied in more depth.”
So far, Neuhausen and her colleagues have succeeded in obtaining genetic samples from 4,500 cases and 4,500 controls. The new three-year grant is going to allow them to enroll another 2,500 cases and obtain another 2,500 controls. Those much-increased numbers of Latinas will allow the researchers to "fill the knowledge gap to obtain more precise estimates of risk of developing breast cancer" and then be able to help physicians understand how to determine risk assessment for their Latina patients.
Right now, the majority of the data from TCGA and other sources is based on European women, so the end goal of the research team is to "fill this knowledge gap" in order to help Latinas. "With the precision genomic approaches we are using in our studies, we can have more precise estimates of risk and the variants specific to Latinas," Neuhausen said.
"That means we will be able to provide better cancer risk assessment to Latina women, so that they can start mammographic screening and prevention at an appropriate age. By also providing education and navigation on hereditary cancer risk through promotoras in the community, we hope to increase utilization of genetic testing in Latinas,” she said. “In addition, for prognosis and targeted treatments, we will develop a comprehensive portrait of mutations in breast tumors in Latinas and its relationship to treatment outcomes; it is not known whether the spectrum of breast tumor mutations in Latinas is the same as in women of European ancestry."
The California Initiative to Advance Precision Medicine grant was awarded in February 2019, meaning Neuhausen and her associates will be working on the project until 2021.
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