Spotlight: Dr. Ruth O'Regan
This February marks the first anniversary of Ruth O'Regan, MD at the UW Carbone Cancer Center. A respected breast cancer physician, O'Regan has brought a wealth of expertise in patient care, leadership and physician training.
In addition to being Chief of the Division of Hematology/Oncology within the UW Department of Medicine, she also brings a prominent research program, studying innovative treatments for triple-negative breast cancer (TNBC; a subset of breast cancers which do not express drugable targets).
Through a brief Q&A, Dr. O'Regan reflects on her vision for her group's breast cancer research at UW Carbone Cancer Center.
Why does your research focus on TNBC?
Overall, 15-20 percent of all breast cancers are triple negative. It affects African Americans and Hispanics more than white patients, but interestingly in Wisconsin there appears to be much more TNBC that you would expect. Unlike hormone receptor positive breast cancers, TNBC can only be treated with chemotherapy, and many do not respond to treatment. TNBC is also a very heterogeneous group of cancer, with tumors being classified into one of six subtypes, meaning it will be difficult to have enough patients to put on subtype-directed clinical trials to study new treatments.
What clinical research are you doing at UW?
We're working with Vincent Cryns, MD, who has shown if you deprive TNBC of the amino acid methionine, you enhance signaling through the TRAIL pathway, which leads to cell death. We were able to find a new drug that promotes TRAIL activity. We plan to do a trial where we ask patients to restrict methionine before surgery and then see what happens to the TRAIL receptor in their tumors. We need to do more pre-clinical testing, but we also would like to know if methionine restriction in combination with a TRAIL agonist is effective in patients with metastatic TNBC.
I am also working with Murtuza Rampurwala, MD, to coordinate one of the first breast cancer trials for the Big Ten Cancer Research Consortium. This consortium will allow us to gain access to more patients with TNBC. The planned trial will look at androgen receptor positive (AR+) TNBC. We know that CDK inhibition works in combination with anti-estrogens in estrogen-receptor positive (ER+) breast cancers, so we're testing the hypothesis that CDK inhibitors will be successful in treating AR+ TNBC when combined with anti-androgens.
What pre-clinical research are you working on?
Currently we're focusing on cell signaling pathways in TNBC, specifically two proteins called IGF1R and FAK. We know that IGF1R contributes to invasive characteristics that can lead to metastasis of one subtype of TNBC, but drugs that inhibit IGF1R have not been very impressive in the clinic. We've found that FAK works through IGF1R to promote invasion in subtypes of TNBC, and have shown that inhibiting FAK decreases invasion in these TNBC. The nice thing is these FAK inhibitor agents are in development already, so it's not like we need to also do drug discovery.
One year into your tenure here, how are things going?
When you come to a new place, you know some of what is going on, but the quality of the work I've found out that people are doing here is unbelievable! There's lots of opportunity for collaboration and the breast program here has an inordinate amount of strengths. It's been a good year and I've learned a lot.