As a gynecologist, I have cared for many courageous women battling cancer, and witnessing their struggle motivates me to identify more effective ways to prevent and treat cancer. To accomplish this, I take an interdisciplinary and methodically agnostic approach to identify breast and ovarian cancer prevention and treatment strategies that are informed by the critical intersection between clinical care and translational research. My clinical research program integrates hereditary cancer genetics and cancer screening in high-risk populations and is complemented by my productive translational research laboratory aimed at identifying new chemo-preventive drugs.
Optimizing cancer screening protocols, particularly breast cancer screening, has convincingly been shown to decrease cancer mortality. The goal of our multi-disciplinary breast cancer research group is to identify the optimal breast cancer screening protocol for high-risk women. We are conducting a prospective clinical trial testing twice-yearly breast MRI in patients with a hereditary predisposition to breast cancer. This study builds on findings we published in 2019 indicating that twice-yearly breast MRI identified early breast cancer in BRCA1 mutation carriers. The findings from this new, larger study could change national breast cancer screening guidelines.
Given the high cost and difficulty of new cancer drug development, I believe tapping into the anti-carcinogenic potential of economical and widely used drugs is an important paradigm shift in cancer research. My approach to this work is to integrate in vitro cancer biology techniques, mouse models of ovarian cancer, and human clinical data and samples to investigate the use of FDA-approved drugs for non-cancerous indications that may have anti-cancer effects.
We have evaluated the anti-cancer effects of two commonly used medications: metformin, used for diabetes; and statins, used for high cholesterol. Our laboratory-based data demonstrates a strong anti-neoplastic effect of both metformin and statins and novel molecular mechanisms of action of the drugs when used in ovarian cancer. Furthermore, in our retrospective cohort study we found that patients with ovarian cancer who used metformin had improved survival compared with patients who were not using metformin. Informed by the pre-clinical findings from the lab we are conducting a prospective randomized clinical trial to test whether metformin can prevent ovarian cancer or improve response to chemotherapy.
The Romero Laboratory has moved metformin from a retrospective hypothesis-generating query through preclinical validation to clinical testing and will continue to strive to improve cancer outcomes by identifying new preventive approaches.