Nancy U. Lin, MD

Associate Chief, Division of Breast Oncology

Dana-Farber Cancer Institute, Boston, MA, USA

Associate Professor of Medicine

Harvard Medical School, Boston, MA, USA

Global Breast Cancer Conference 2019

New Therapeutic Approaches for Patients with Breast Cancer Brain Metastases

The Problem

• Brain metastases are frequent among patients with advanced breast cancer

• Half of patients with metastatic HER2+ breast cancer

• 25-46% in patients with metastatic triple negative breast cancer

• Treatment of patients with brain metastases continues to be a significant unmet medical need

• Increasing need for effective systemic options to treat CNS disease, especially as patients live longer

• To date, no proven prevention strategies

Approaches/Targets

• HER2-targeted therapy

• Chemotherapy

• Endocrine therapy

• CDK4/6 inhibitors

• Angiogenesis inhibitors

• PARP inhibitors

• PI3K/mTOR inhibitors

• Immune checkpoint inhibitors

• Other

Biodistribution of 89Zr-trastuzumab and PETImaging of HER2-Positive Lesions in PatientsWith Metastatic Breast Cancer

EC Dijkers, et al Clinical pharmacology & Therapeutics 2010

In vivo Imaging of Trastuzumab Biodistribution in CNS

Phillips et al, Breast Ca Res Treat 2017

Dose Response Curve: Fo2-1282 tumors in CNS

Lin et al, ASCO 2017

PATRICIA trial: 6 mg/kg weekly trastuzumabStd pertuzumabPts allowed to continue prior systemic txInterim analysis

TDM1 Prolongs Survival in Mice Bearing CNS Tumors

Phillips et al, Breast Ca Res Treat 2017

c530c528

TDM1

w0

w3

w6

w9

w12

w15

Zhao laboratory, unpublished data

TDM1 Activity in CNS

• TDM1 approved 2013 for HER2+ MBC

• Patients with active brain metsexcluded from all trials

• Single case report, followed by,

• 10 pt case series:

• 3PR, 2SD>6 mo

• Median intracranial PFS 5 mo

• median OS not reached

• 39 pt case series:

• 17 PR

• Median PFS 6.1 mo

Bartsch et al, J Neurooncology 2013; Bartsch et al Clin Exp Metastasis 2015; Jacot et al, BCRT 2016

Study N Prior RT CNS ORR TTP/PFS OS

Lin et al

CCR 2009*

50 100% 20% 3.6 mo NR

Boccardo et al,

ASCO 2008

(LEAP)

138 NR 18% Median time on

study 2.8 mo

NR

Sutherland et al, Br

J Ca 2010 (LEAP)

34 94% 21% 5.1 mo NR

Metro et al, Ann

Oncol 2011

22 86% 32% 5.1 mo 11 mo

from start

of LC

Lin et al,

J Neuro-Oncol

2011*

13 100% 38% NR NR

Bachelot et al,

Lancet Oncol

2013*

45 0% 66% 5.5 mo 91% alive

at 6 mo

Lapatinib +Capecitabine for HER2+ BCBM

As a single agent, CNS ORR

to lapatinib is only ~ 6% (Lin et al, CCR 2009)

In pre-treated patients,

lapatinib-cape results in CNS

ORR 18-38%

In the upfront setting (instead

of RT), lap-cape results in CNS

ORR 66%

RTOG 1119 WBRT/SRS + lapatinib ongoing

Neratinib

• Potent, oral, irreversible-binding inhibitor of the erbB family of

receptor tyrosine kinases

– Inhibits signal transduction through EGFR, HER2, HER4

• Awaiting results of phase 3 NALA trial (lapatinib-capecitabine

vs neratinib-capecitabine)

– *Press release indicates a “positive trial”

– NALA excluded patients with active brain metastases

TBCRC 022: Neratinib + Capecitabine

% r

ed

uc

tio

n in

vo

lum

e o

f C

NS

le

sio

ns

* 6 patients did not reach first re-staging evaluation and are categorized as ‘0’

-100

-80

-60

-40

-20

0

20

40

60

80

100

Best Volumetric CNS response (n=31 evaluable pts)

Best Volumetric Response:

Cohort 3A: Lapatinib-Naive

CNS ORR = 49% (95% CI 32-66%)

Slide adapted from Freedman et al, ASCO 2017

J Clin Oncol 2019

Responses also

observed

in Cohort 3B (Lapatinib-

pre-treated), n=12

• CNS ORR =33%

(95%CI=10-65%)

Diarrhea was the most

common grade 3 toxicity

(29% in cohorts 3A/3B).

Neratinib + TDM1

Ni et al, AACR 2019

Laboratory of Jean Zhao

Patient BCBM

+Luciferase

Intracranial

injection

Evaluation

of

Anti-cancer

drugsD

F-B

M354

DF

-BM

355

Ni et al, AACR 2019

Laboratory of Jean Zhao

Neratinib for HER2+ Breast Cancer

% r

ed

uc

tio

n in

vo

lum

e o

f C

NS

le

sio

ns

* 6 patients did not reach first re-staging evaluation and are categorized as ‘0’

• Neratinib-capecitabine now listed in the NCCN Neuro-Oncology practice guidelines for treatment of HER2+ breast cancer brain mets

• Awaiting results from NALA trial to understand the role of neratinib-capecitabine in patients with progressive extracranial metastases

• TBCRC 022 is now testing the combination of TDM1 + neratinib*

• 4 cohorts, including TDM1 pre-treated patients as well as patients with and without prior radiotherapy for brain metastases

Tucatinib (ARRY-380)

Selective HER2 inhibitor (HER2 IC50 8 nM)

Less diarrhea or rash than lapatinib or neratinib

Active in pre-clinical models (including

intracranial metastases)

Active metabolite crosses BBB

Phase 1b Trial of Tucatinib + Trastuzumab

for HER2+ Brain Metastases

Months with CNS metastases prior to study registration

30 27 24 21 18 15 12 9 6 3 0

∕∕

∕

∕

∕

∕

∕

63 mo80 mo

33 mo

38 mo

43 mo

32 mo

69 mo

Months on protocol treatment

0 3 6 9 12 15 18 21 24 27 30

Arm A

Arm B

►

►►

►

Best CNS response

Partial ResponseStable Disease

Progression DiseaseNot evaluable

► Continuing Treatment

Arm A (BID) Arm B (QD)

Trast mg/Kg Arry-380mg

Dose -1A 6 300

Dose 1A 6 450

Dose 2A 6 600

Trast mg/Kg Arry-380mg

Dose -1B 6 600

Dose 1B 6 750

Dose 2B 6 900

Dose 3B 6 1200

Dose escalation

Expansion16pts at the MTD 16pts at the MTD

The inclusion of 16 pts per arm at the MTD will give under a

phase 2 selection design, an 89% probability of selecting the

best regimen if true probabilities of CBR are 10% and 30%

Selection of best

regimen

Metzger et al, SABCS 2016

Phase 1 Tucatinib + Capecitabine + Trastuzumab

Hamilton et al, SABCS 2016

Murthy, Borges, et al. Lancet Oncol 2018

ORR 61%

N=23

CNS ORR 42%

(N=12)

HER2CLIMB:

Tucatinib vs Placebo in Combination With Capecitabine &

Trastuzumab in HER2+ Breast Cancer

NCT02614794

Accrual completed 2019

HER2-Targeted TKIs

Lapatinib Neratinib Tucatinib Pyrotinib

Targets Reversible

EGFR/HER2

Irreversible

EGFR/HER2

Selective HER2 Pan-HER

Regulatory status Approved in

HER2+ MBC

(2007: with

capecitabine; 2010,

with letrozole)

Approved in

extended adjuvant

setting in HER2+

after trastuzumab

-- --

Phase of

development

-- Phase 3 NALA

Fully accrued

HER2CLIMB

Fully accrued

Phase 3 accruing

Active CNS mets

allowed in

registration trial?

NO NO YES NO

CNS activity? Yes Yes Yes Unknown

Other Approaches/Targets

• Chemotherapy

• Endocrine therapy

• CDK4/6 inhibitors

• Angiogenesis inhibitors

• PARP inhibitors

• PI3K/mTOR inhibitors

• Immune checkpoint inhibitors

Chemotherapy can be active

• Capecitabine

• Anthracyclines

• Platinum agents

• Irinotecan

Baseline ~8 months later

Novel Chemotherapeutics

• NKTR-102

• Nal-IRI

• ANG1005

• Tesetaxel

• TPI-287

• ?? Antibody drug conjugates

Etirinotecan pegol (NKTR-102)

• PET polymer conjugate with irinotecan

• Chemotherapy released after in vivo cleavage of a

biodegradable linker

• Designed to lower peak plasma concentrations and prolong

half life (37 d vs 2d)

• Improved survival in preclinical intracranial tumor model

(MDA-MB-231Br) compared with conventional irinotecan

Adkins et al, BMC Cancer 2015

TBCRC 018: Irinotecan + Iniparib

• N=37

• Restricted to TNBC

• CNS ORR = 12%

• (Including 2/4 BRCA carriers)

Rationale

Topoisomerase inhibitor

Phase 2 studies in MBC showed

systemic responses (20-30% ORR)

Used frequently in GBM

Preclinical synergy with iniparibAnders et al, CCR 2014

BEACON trial

iTT population

(n=852) (HR

0.87; p = 0.08)

Patients with History of Brain

Metastases (n=67) (HR 0.51; p

= 0.01)

NKTR-102 vs TPC

Primary endpoint = OS

Perez et al, Lancet Oncol 2015

ATTAIN TrialNCT02915744

Metastatic breast cancer

Stable/treated brain mets

Prior tx with anthra, taxane,

and capecitabine

1:1

NKTR-102

Treatment of Provider ChoiceEribulin, ixabepilone, vinorelbine, gemcitabine, paclitaxel

docetaxel, or nab-paclitaxel

Primary endpoint = Overall survival

Brain mets could have been diagnosed at any time in the past

Washout from “single modality” (ie. WBRT, SRS or surg) = 7 days

Washout from “multi modality” (i.e. WBRT + SRS, surg + SRS) = 14 days

Tesetaxel

Tesetaxel: phase 21st line MBC (extracranial mets)

Seidman et al, ASCO 2018

Activity of Tesetaxel, an Oral Taxane, Given as a Single-agent in Patients with HER2-, Hormone Receptor + (HR+) Metastatic Breast Cancer (MBC) in a Phase 2 Study

Andrew Seidman1, Lee Schwartzberg2, Vinay Gudena3, Peter Rubin4, Stew Kroll5, Joseph O’Connell5, Kevin Tang5, Joyce O’Shaughnessy6

1Memorial Sloan Kettering Cancer Center, New York, NY; 2West Cancer Center, Memphis, TN; 3Cone Health Cancer Center, Greensboro, NC; 4SMHC Cancer Care and Blood Disorders, Biddeford, ME; 5Odonate Therapeutics, Inc., San Diego, CA; 6Texas Oncology-Baylor Charles A. Sammons Cancer Center, US Oncology, Dallas, TX

•ChemotherapyregimensforpatientswithMBCthatofferrobusteffica cywhilepreserving patientqualityoflifeareneeded

•TesetaxelisanoveltaxanethatistakenorallyQ3W withalowpillburden,nohistoryofhypersensitivity reactionsandimprovedactivityagainstchemotherapy-resistanttumors

1,2

•Tesetaxel’simprovedpharmacologicpropertiesinclude:(1)highoralbioavailability;(2)highsolubility;and(3)a

long(~8-day)half-life(Table 1andFigure 1)

•Unlikepaclitaxelanddocetaxel,tesetaxelhaspotentactivityagainstP-gp-overexpressingtumorsin vivo (Figure 2)

•TOB203wasamulticenter,Phase2studyinvestigatingsingle-agenttesetaxelasfirs t-linechemotherapyfor

patientswithHER2negativeMBC

•Keyeligibilitycriteriaincluded:

–Femalesatleast18yearsofage

–Metastatichistologicallyorcytologicallyconfirm edbreastadenocarcinoma

–HER2negativedisease

–Measurabledisease(RECIST1.1)

–ECOG performancestatus0or1

•Prioradjuvantchemotherapy(includingtaxanes)wasallowed

•Tesetaxeladministeredorallyatastartingdoseof27mg/m2onDay1ofa21-daycyclewithoutanti-allergy

premedication

•Theprimaryendpointwasobjectiveresponserate(ORR)perRECIST1.1,withconfirm ation nolessthan4weeks

afterinitialresponse

•Secondaryendpointsincludeddiseasecontrolrateandprogression-freesurvival(PFS)

Thirty-eight(38)patientswithHRpositiveMBCwereenrolledandinitiatedtreatmentwithtesetaxelQ3W

•Allpatientshadmetastaticdisease,including33(87%)withvisceraldisease(Table 2)

•Twenty-six(68%)patientsreceivedpriorneoadjuvant/adjuvantchemotherapy,including20(53%)

whoreceivedataxane-containingregimen(Table 2)

•Allpatientsinitiatedtesetaxelat27mg/m2onDay1ofa21-daycycle

•Doseescalationsanddosereductionswereallowedbasedontreatmenttolerability

•Fourteen(14)patientshadadoseescalationto35mg/m2foramedianof1.5(range:1–7)cycles

–Eight(8)ofthesepatientssubsequentlyrequiredadosereductionto27mg/m2,andtheprotocol

wasamendedtoremovedoseescalations

•Ten(10)patientshadadosereductionto24mg/m2,including3patientswhohadbeenescalated;no

furtherdosereductionswererequired

•Patientsreceivedanaverageof6.7cycles,and9(24%)received11ormorecycles

Poster Board #123

Abstract 1042

Effic

a

cy Safety

Study Design

Conclusions

Enrollment and Patient Characteristics

Exposure

Effic

a

cy

References

1. Shionoyaetal,Cancer Science2003;94(5):459-66 2. Chanetal,2006EORTC-NCI-AACRMolecularTargetsandCancerTherapeuticsSymposium

3. Shanmugametal,Drug Development and Industrial Pharmacy2015;41(11):1864-1876 4. McEnteeetal,Veterinary and Comparative Oncology2003;1(2):105-112 5. Montaseri,Taxol: Solubility, Stability and Bioavailability1997 6. Bharateetal,Bioorganic & Medicinal

Chemistry Letters2015;25(7):1561-1567 7. Tanetal,British Journal of

Cancer2014;110(11):2647-54 8. Taxotere(docetaxel)prescribinglabel

9. Langetal,2012ASCOAnnualMeeting,

Journal of Clinical Oncology2012;20(15supp):2555

10. Trocketal,Journal of the NCI 1997;89(13):917-31

Copiesofthisposterobtained

throughQuickResponse

(QR)Codeareforpersonal

useonlyandmaynotbe

reproducedwithoutpermission

fromASCO®andtheauthor

ofthisposter.Pleasecontact

tob203@odonate.comwith

anyquestionsorcomments.

*DU4475

Day

40383634323028262422

Tesetaxel 12 mg/kg/day,

orally on Day 24

Docetaxel 16.7 mg/kg/day,

IV on Days 24 and 28

Paclitaxel 40 mg/kg/day,

IV on Days 24 and 28

Control

0.0

0.2

0.4

0.6

0.8

1.0

1.2

1.4

1.6

1.8

Esti

mate

d T

um

or

Vo

lum

e (

cm

3)

*DU4475

Day

40383634323028262422

Tesetaxel 12 mg/kg/day,

orally on Day 24

Docetaxel 16.7 mg/kg/day,

IV on Days 24 and 28

Paclitaxel 40 mg/kg/day,

IV on Days 24 and 28

Control

0.0

0.2

0.4

0.6

0.8

1.0

1.2

1.4

1.6

1.8

Esti

mate

d T

um

or

Vo

lum

e (

cm

3)

•Grade3adverseeventsoccurredlessfrequentlyinthe24patientsnotdoseescalated(Table 3);inthesepatients: –NeutropeniawasthemostcommonG rade3adverseevent,occurringin6(25%)patients

–Febrileneutropeniaoccurredin1(4%)patient

–Grade3neuropathyoccurredin1(4%)patient(followingCycle12)

•Therewerenoadverseeventsleadingtodeath

•Therewerenohypersensitivityreactions

•TheincidenceofGrade2alopeciawas18%

•Tesetaxel,asasingleagent,demonstratedsignifica ntantitumoractivityinpatientswithHER2negative,HRpositiveMBC

•Confirmedresponseratewas45%andwassimilarinpatientswithnopriortaxaneexposurevs.priortaxaneexposure

•NeutropeniawasthemostcommonGrade3event;febrileneutropeniawasuncommon

•Neuropathywasprimarilymild

•G rade2alopeciawas18%

•CONTESSA,amultinational,multicenter,randomized,Phase3registrationstudyoftesetaxelplusareduceddose

ofcapecitabinevs.theapproveddoseofcapecitabinealoneinpatientswithHER2negative,HRpositivelocally

advancedormetastaticbreastcancer,isongoing(2018ASCOAnnualMeetingPosterBoard#184a,Abstract

TPS1106)

•Tesetaxel’sQ3W oraldosing,lowpillburden,primarilymildneuropathyandlowrateofGrade2alopeciamay

providequality-of-lifeadvantagesforpatientswithMBC

Results

•559patientshavebeentreatedwithtesetaxelinclinicalstudies(496monotherapy;63incombinationwithcapecitabine)

•InMBC,tesetaxelhasbeenshowntohaverobustactivityinotherclinicalstudies

•WehereinpresentresultsfortheHRpositivepatientswhoreceivedtesetaxelQ3W inStudyTOB203,amulticenter

Phase2studyinvestigatingsingle-agenttesetaxelasfirs t-linechemotherapyforpatientswithHER2negativeMBC

•CONTESSA,amultinational,multicenter,randomized,Phase3registrationstudyoftesetaxelplusareduceddoseof

capecitabinevs.theapproveddoseofcapecitabinealoneinpatientswithHER2negative,HRpositivelocallyadvanced

ormetastaticbreastcancer,isongoing(2018ASCOAnnualMeetingPosterBoard#184a,AbstractTPS1106)

Table 1: Tesetaxel’s Unique Pharmacologic Properties

Table 2: Patient Characteristics

Figure 4: Tumor Change from Baseline in Target Lesions*

27

21 2017

10 96

-2

-8 -8-10

-14 -14-18 -19

-21

-27

-33

-38 -39-41 -42

-45-48

-50

-55 -56 -56-60 -61

-65-67

-72-74

-80 -81

-99

Disease progression

Stable disease

Confirmed response

*Nadir change based on sum of the diameters

-100

-80

-60

-40

-20

0

20

40

Tu

mo

r C

han

ge f

rom

Baselin

e (

%)

Figure 7: Progression-free Survival (PFS)

129630

0

20

40

60

80

100

Censored+95% CIKaplan-Meier Estimate

Time (months)

Pro

gre

ssio

n-f

ree S

urv

iva

l (%

)

Figure 1: PK Profil

e

s of Paclitaxel and Tesetaxel

Figure 2: Antitumor Activity of Paclitaxel, Docetaxel and Tesetaxel in P-gp Positive Breast Tumors* in Mice1

Figure 6: Confir

m

ed Response Rate

by Prior Taxane Exposure

Background

Table 3: Grade 3 Adverse Events Regardless of Relationship

Figure 5: Confir

m

ed Response Rate

Forest Plot

•All38enrolledpatientsareincludedintheeffica cyanalysis

•45%(95%CI:29%-62%)ofpatientsachievedaconfirm edresponse,and37%(95%CI:22%-54%)

ofpatientsachievedstabledisease(Figures 3and4)

•Theconfir

m

edresponseratewasconsistentacrosssubgroups(Figure 5)

– 4 4% (95 % C I:2 2 % -6 9% )ofpatien ts w ithn o priortaxan eexpo s ureachievedaco n firm e d

res pon s e,

com paredto

4 5 % (95 % C I:

2 3 % -6 8% )of

patients with

prior taxane

exposure

(Figures 5

and 6)

•Medianduration

of response was

10.9months

(95%CI:4.3-13.6

months),and

medianPFS

was5.4months

(95%CI:3.8-9.8

months)(Figure 7)

Figure 3: Response*

27

21 2017

10 96

-2

-8 -8-10

-14 -14-18 -19

-21

-27

-33

-38 -39-41 -42

-45-48

-50

-55 -56 -56-60 -61

-65-67

-72-74

-80 -81

-99

Disease progression

Stable disease

Confirmed response

*Nadir change based on sum of the diameters

-100

-80

-60

-40

-20

0

20

40

Tu

mo

r C

han

ge f

rom

Baselin

e (

%)

129630

0

20

40

60

80

100

Censored+95% CIKaplan-Meier Estimate

Time (months)

Pro

gre

ssio

n-f

ree S

urv

iva

l (%

)

Adverse Eventsin 2 or More Patients

27 mg/m2

(n=24)

n (%)

27 mg/m2 Escalated to 35 mg/m2

(n=14)

n (%)

Grade 3 Grade 3Grade 4 Grade 4

Mean Plasma Concentration (ng/mL) vs. Time (hours) for

Paclitaxel and Tesetaxel

Tesetaxel: CNS penetration at d14

James et al, AACR 2019

Other Approaches/Targets

• Endocrine therapy

• CDK4/6 inhibitors

• Angiogenesis inhibitors

• PARP inhibitors

• PI3K/mTOR inhibitors

• Immune checkpoint inhibitors

Abemaciclib

• One of three commercially available CDK4/6 inhibitors approved for treatment of HR+/HER2-negative, metastatic breast cancer

• Therapeutic levels in brain and CSF detected in brief-exposure studies in humans when given prior to craniotomy resection of solid tumor brain metastases

Sahebjam et al, ASCO 2016

Abemaciclib for ER+/HER2- BCBM:

Interim analysis

Efficacy Population

Patients with Response N = 23

OIRR n (%), (95% CI) 2 (8.7), (0.0, 20.2)

CR n (%) 0

PR n (%) 2 (8.7)

SD n (%) 10 (43.5)

SDc ≥ 6 months n (%) 2 (8.7)

PD or early death n (%) 8 (34.8)

CBR n (%), (95% CI) 4 (17.4), (1.9, 32.9)

Tolaney et al, ASCO 2017

Bevacizumab plus carboplatin in BCBM:Best reduction of CNS target tumor volume

Lin et al. ASCO 2013

Cohort 1: Her2 neg: bevacizumab (15 mg/kg) + carboplatin (AUC 5)

Cohort 2: Her2 pos: bevacizumab + carboplatin + trastuzumab

*Similar results for bev/cis/etop published by Lu et al, Clin Ca Res 2015

PI3K PathwayBKM+RADControl

wk 0

wk 1

wk 2

wk -1 wk 0

wk 4

wk 6

BT355

-w1w0w1w2w3w4w5w6w7w8w9w10w11w12w13w14w15w16

0

2×106

4×106

treatment time (weeks)

RO

I

BT354

0 20 40 60 80 1000

50

100

Time (days)

Pe

rce

nt su

rviv

al

control

BKM120

P value

P value summary

0.0197

*

Median survival

control

65

BKM120

87

Control

BKM+RAD

Start treatment

Stop treatment

RO

ITime (days)

Pe

rce

nt s

urv

iva

l0 50 100 150 200 250

0

50

100 Control

BKM+RAD

Time (days)

Pe

rce

nt s

urv

iva

l

0 50 100 150 200 2500

50

100 Control

BKM+RAD

HER2+

PI3K

mTOR

pS6RP

Tumorigene

sis

pAKT

p4EBP1

BKM120

RAD001

(Everolimus)

PTEN

Lapatinib

Control BKM+RAD

wk 0

wk 2

Jing Ni, Shaozhen Xie, Victor Luu Ni et al, Nat Med 2016

DFBM355

(ER+

/HER2+)

Phase II Trial of GDC-0084 + Trastuzumab

PI: Pablo Leone

What About IO-Based Approaches?• Patients with active breast cancer brain metastases

excluded from nearly all IO-based trials

• However, data for treatment efficacy in patients with brain

metastases from melanoma and NSCLC

• Limited data suggest high TILs in BCBM across subtypes

• Clinical trials ongoing in patients with breast cancer brain

metastases

CheckMate 204

Ipi + nivo for melanoma brain mets

Tawbi et al, NEJM 2018

Summary

• Brain metastases are frequent in advanced breast cancer

patients, especially in HER2+ and TNBC

• Systemic therapy can be effective

• Many agents of interest available or in clinical trials

– HER2: lapatinib, neratinib, tucatinib, TDM1

– ER+: abemaciclib, palbociclib

– Chemotherapy: capecitabine, anthracyclines, platinum, irinotecan

– Novel chemotherapeutics: NKTR-102, ANG1005, tesetaxel, etc

– Other targets: PI3K, PARP, VEGF (bevacizumab), PD1/PDL1, etc

Acknowledgements

DFCI/BWH

Eric Winer

Jean Zhao

Rachel Freedman

Ayal Aizer

Pablo Leone

Otto Metzger

Ann Partridge

Ian Krop

Sara Tolaney

Judy Garber

Melissa Hughes

Heather Parsons

Shom Goel

Romualdo Barrosso-

Sousa

Sheheryar Kabraji

Jing Ni

Daphne Haas-Kogan

Elizabeth Frank

Elizabeth Cahn

And many more…

ASCO/FOCR

Edward Kim

Marina Kozak

Suanna

Bruinooge

FDA

Tatiana Prowell

RANO

Patrick Wen

Martin van den Bent

Eudocia Lee

Ross Camidge

Kim Margolin

Susan Chang

Many many more

Oslo University Hospital

Kyrre Emblem

Funding

NCI SPORE in Breast Cancer

U.S. Department of Defense

Breast Cancer Research Foundation

Conquer Cancer Foundation

Friends of Dana-Farber

Susan G. Komen for the Cure

Avon Foundation

Pan-Mass Challenge

NCCN-Pfizer

BWH

Deborah Dillon

Keith Ligon

Sandro Santagata

Linda Bi

Ian Dunn

Shakti Ramkissoon

Institut Gustave-Roussy

Ines Vaz-Luis

MGH

Gordon Harris

Jerry Younger

Priscilla Brastianos

Elizabeth Gerstner

HSPH/Biostatistics

William Barry

Hao Guo

Rebecca Gelman

Northwestern

Priya Kumthekar

U Penn

Yun Song

UNC

Lisa Carey

Elizabeth Bullitt

Duke

Carey Anders

RECIST WG

Elizabeth DeVries

U Colorado

Diana Cittelly