University of North Carolina Chapel Hill, North Carolina
Professor, Department of Nutrition Nutrition Research Institute and Lineberger Comprehensive Cancer Center University of North Carolina Chapel Hill, North Carolina
To understand the drivers of obesity-related breast cancer and develop effective prevention interventions.
Obesity is an important risk and prognostic factor for several types of breast cancer, but relatively few studies examine whether the cancer-promoting effects of chronic obesity can be reversed. Dr. Hursting established that robust weight loss accomplished by bariatric surgery and various calorie-restricted diets can reverse obesity-associated metabolic, inflammatory, and pro-cancer effects. However, the expense and risks associated with bariatric surgery and the challenge in maintaining severe calorie restricted diets precludes the use of either method to reverse the effects of chronic obesity. These limitations combined with high obesity prevalence, create an urgent need for new ways to break obesity-breast cancer links.
Dr. Hursting and his colleagues developed an easily adopted intermittent energy restricted diet regimen. When compared to weight loss surgery, an intermittent diet was more effective for reversing the adverse effects of obesity on breast cancer. It may thus provide a more affordable and feasible alternative strategy to reduce breast cancer risk than either bariatric surgery or severe diet restriction. Importantly, both weight loss methods reprogrammed the gut microbiome—the bacteria that inhabit the intestines—to be healthier and produce fewer inflammatory metabolites. Dr. Hursting and his colleagues tested whether the pro-cancer effects of diet-induced obesity and/or the anti-cancer effects of intermittent dieting are transmitted via the gut microbiota. They found that some of the pro-cancer effects of diet-induced obesity are transmitted through the microbiome, but the anti-cancer effects of intermittent dieting are not.
Dr. Hursting is now investigating a new weight loss strategy with the goal of achieving the positive effects of weight loss on breast cancer risk. He is testing the drugs semaglutide, which is FDA approved for weight loss, and tirzepatide, which is approved for diabetes treatment and is under FDA review for weight loss. Preliminary data show that both drugs achieve the effect of reversing obesity-associated metabolic and inflammatory factors. It is unknown, however, if their benefits extend to reducing breast cancer risk. Dr. Hursting aims to determine the effects of semaglutide or tirzepatide on development and progression of ER-positive and ER-negative breast cancer on biomarkers in blood and breast tissue.
Dr. Stephen Hursting is Professor in the Department of Nutrition and the Lineberger Comprehensive Cancer Center at UNC-Chapel Hill and Professor at the UNC Nutrition Research Institute in Kannapolis, NC. He earned his PhD in nutritional biochemistry and MPH in nutritional epidemiology from the UNC-Chapel Hill, and he completed postdoctoral training in molecular carcinogenesis and cancer prevention at the National Cancer Institute (NCI). Prior to joining the UNC faculty in 2014, Dr. Hursting was Professor and Chair of the Department of Nutritional Sciences at the University of Texas at Austin and Professor of Molecular Carcinogenesis at the UT-MD Anderson Cancer Center (2005-14). He also served as Deputy Director of the NCI’s Office of Preventive Oncology and Chief of the NCI’s Nutrition and Molecular Carcinogenesis Laboratory Section (1999-2005). His research interests center on diet-gene interactions relevant to cancer prevention, particularly the molecular and metabolic mechanisms underlying obesity-breast cancer associations, and the interplay between obesity, diabetes and breast cancer risk and response to therapy. Primarily using specially engineered laboratory models of breast cancer in parallel with breast cancer prevention trials (in collaboration with Dr. Carol Fabian at the Kansas Cancer Center), he is currently focusing on the molecular and metabolic changes occurring in response to lifestyle-based (dietary and physical activity), or pharmacologic manipulation of energy metabolism and cell signaling pathways, with emphasis on the IGF-1/Akt/mTOR and Wnt signaling pathways as well as inflammation. He also has expertise in assessing diet-related serum and tissue biomarkers, including hormones/growth factors, cytokines and chemokines, and microRNA’s in tissue samples.
2003
The Lampert Foundation Award in Honor of Kinga Lampert
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