May 14, 2020

At the intersection of breast and gynecologic cancers: Dr. Elisavet Paplomata

Madison, Wis. — Although gynecologic cancers are less common than breast cancer, the treatment of these cancers can be more challenging due to lack of effective screening and subsequent diagnosis at an advanced stage.

New UW Carbone Cancer Center member Elisavet Paplomata, MD, an assistant professor in the Department of Medicine, brings extensive clinical research experience in studying both breast and gynecologic cancers to UW-Madison. Her work focuses on finding new drug treatment options for women diagnosed with these diseases.

“This is more like a female malignancy focus, which I really enjoy doing,” Paplomata said.

Paplomata was a resident in obstetrics and gynecology in Greece when she decided to devote her life and career to the treatment of patients with cancer. When the time came to choose how to finish her medical training, she opted for a fellowship in hematology and oncology.

“With cancer patients I was seeing in the clinic, I made a difference,” Paplomata said. “The oncology drugs like chemotherapy, the science behind it, the interaction with the patient — this is what drew me, and I decided to do medical oncology.”

Paplomata completed her fellowship, which included preclinical and clinical breast cancer research, at Emory University in Atlanta, alongside Ruth O’Regan, MD who directed the breast cancer center there at the time. The two are now reunited at UW Carbone and are both faculty members in the division of hematology and medical oncology.

Paplomata, who joined UW earlier this year, now wants to concentrate on cooperative group study development that allows for researchers from hospitals and universities across the country to connect and develop new cancer treatments. For example, at Emory University she was the institution’s primary investigator in a phase II clinical trial for advanced breast cancer that recently reported better outcomes for people with metastatic HER2-positive breast cancer when they were treated with a drug inhibiting the HER2 receptor, in addition to other targeted drugs and chemotherapy.

“My goal in coming to UW was to bring this clinical research experience and try to focus a bit more in gynecologic cancers,” Paplomata said.

Breast and gynecologic cancers have a lot in common from an oncologist’s perspective, according to Paplomata. Although the BRCA1 and BRCA2 genes are more often associated with breast cancer, mutations in these genes can also increase an individual’s risk for ovarian cancer. Some types of treatments like hormone therapy are also often used in breast and uterine cancers.

“I do find that by having experience in one, it helps me find research ideas in the other types of cancers,” Paplomata said.

Paplomata also said that being in Madison also brings new opportunities for collaboration with other researchers and clinicians at multiple institutions through the Big Ten Cancer Research Consortium, which brings together the 14 cancer centers from the Big Ten universities.

“The Big Ten Consortium is a great platform to introduce clinical trials for new drug treatments — especially if it’s not a huge pharmaceutical industry trial,” Paplomata said.

Paplomata is also interested in testing whether some therapies often used in breast cancers, like drugs targeting cell division, might be effective in uterine cancers. By using knowledge from one disease and applying it to another that might share similar biologic properties, people might be able to receive new and better treatment options for their specific cancer case.

Additionally, whereas mammography can help identify breast cancers earlier when more expansive treatment options increase the chance for a cure, gynecologic cancers do not have an equivalent screening tool. The symptoms for gynecologic cancers can also often go unnoticed for a long time. As a result, ovarian cancer, for example, is typically diagnosed at a later stage.

“Most patients are found with an advanced stage cancer, and that makes treatment harder,” Paplomata said.

Many people with ovarian cancer also later develop resistance to platinum therapy — a common first-line chemotherapeutic agent. Various clinical trials are trying to address that treatment gap, and Paplomata is eager to get more clinical trials open again.

“There are several mechanisms of resistance we do not understand, and if we can understand those, we will find the patients who need to be treated one way versus another,” she said.