I am a molecular oncologist with experience in how gene expression drives several types of cancer, including leukemia, lymphoma, breast and prostate cancer. Although these sound like very different diseases, they share many underlying genetic features -- learning details about one type can reveal surprising insights about another.
I’m best known for my work on the BET bromodomain family of gene expression regulators, which are involved in many cancer types, as well as the immune system and fat tissue metabolism. Data about these connections have forced me to think about inflammation and obesity-driven cancers, including breast and prostate cancer.
I’m the past Chair of the Obesity and Cancer Section of The Obesity Society (TOS), and past Chair of TOS’s Basic Science Section. As a key opinion leader, I designed, convene and chair an annual symposium at meetings of the American Association of Immunologists, now in its 8th year, focused on immunology, obesity, metabolism and tumor microenvironment. I also serve on the National Cancer Institute’s panel of reviewers for grant applications that focus on the tumor microenvironment of many cancer types.
My lab has been investigating the role of metabolic inflammation in obesity and Type 2 diabetes as a modifier of breast tumor microenvironment. The critical pathways are not well understood, nor is metabolic disease well managed medically as a driver of metastatic breast cancer. In just-completed studies (Uncoupling obesity from breast cancer in African American women), we showed that BET bromodomain proteins are functionally critical as effectors of metabolic inflammation driving breast cancer progression. In more recent work, we integrate tumor biology, immunology, and metabolism to understand the role of metabolic inflammation in progression of estrogen receptor negative breast cancer.
Obesity, metabolic disease and inflammation are strongly associated with the development and metastasis of several cancers. These comorbid conditions are prevalent in U.S. safety net hospitals, like Boston Medical Center where I work, but consideration of metabolic diseases does not really inform the current standard of care in medical oncology. We really do not know how best to integrate the diverse information and manage these patients properly, because the clinical studies that define treatment plans were developed almost entirely in patients who were not obese or diabetic, but were metabolically healthy apart from their cancers.
My work is addressing this knowledge gap.