University of California, San Francisco San Francisco, California
Director, Carol Franc Buck Breast Care Center Professor of Surgery and Radiology Clinical Program Leader, Breast Oncology Program Alfred A. de Lorimier Endowed Chair in General Surgery UCSF Helen Diller Family Comprehensive Cancer Center
Examining the effects of a diet promoting increased fiber consumption on the gut microbiome and biomarkers of immunity in women with newly diagnosed breast cancer.
Dietary recommendations during breast cancer care have focused on reducing fat intake and increasing fruit and vegetable consumption. Research has shown that diet influences the gut microbiome, the collection of bacteria and other microorganisms that live in our digestive tract, which is increasingly recognized as a key player in immunity and overall health. Since fiber intake plays a crucial role in shaping the gut microbiome, Dr. Esserman is focusing on the effects of a diet high in fiber on it and on blood-based markers of immunity in women with newly diagnosed breast cancer. Dr. Esserman’s prior research has looked at how immune cells in tumors influence the tumor response to immune drugs. She is now determining whether a change in the gut microbiome can enhance the immune environment of the tumor and improve the response to immune agents. This study will determine the feasibility and efficacy of increasing fiber intake during breast cancer care to boost an immune response. Building on a recent observation that an oral chemotherapy drug blocked the effectiveness of an immune checkpoint inhibitor, they will also test whether this interference is because of changes to the gut and whether a high fiber diet can overcome the interference.
The team will initiate a program where participants receive ten meals per week, recipes, snacks, and fiber supplements to provide 20-40 grams of fiber per day. Collection kits, both stool and blood, will be provided to obtain samples before and after two weeks of dietary intervention. Dr. Esserman’s team will analyze the samples to assess changes in the gut microbiomes at these two timepoints. They will also characterize changes in immunity and determine if they correlate with specific changes in the gut microbiome. The results of these studies will determine the utility of a high-fiber dietary intervention as a simple, safe, and cost-effective way to enhance immune responses and improve treatment outcomes in breast cancer patients.
Laura Esserman, MD, MBA, an internationally recognized breast surgeon, breast oncology specialist, and visionary in personalized medicine, is revolutionizing breast cancer screening and treatment throughout our nation today. Her breast cancer work spans a spectrum from basic science to public policy issues and the impact of both on the delivery of clinical care. She is a provocative thought leader calling attention to, and finding solutions for, over-diagnosis and over-treatment of breast cancer, especially of DCIS.
Since 2002, Dr. Esserman has led the I-SPY TRIALS, a ground-breaking national public-private collaboration among NCI, FDA, more than 20 cancer research centers, and major pharma and biotech companies. This trial model, which has now become an international model for translational research, is designed to shave several years and tens of millions of dollars off the drug development process. The trial paradigm is now being developed for use in other disease domains.
Additionally, Dr. Esserman led the creation of the University of California-wide Athena Breast Health Network, a learning system designed to integrate clinical care and research as it follows 150,000 women from screening through treatment and outcomes. As part of the network, she has spearheaded the development of the WISDOM study to learn how to improve breast cancer screening by testing and comparing the safety and efficacy of a personalized screening strategy informed by each woman’s breast cancer risk and preferences against the standard of annual screening.
Dr. Esserman has published more than 300 articles in peer-reviewed journals, and is regularly consulted by prestigious scientific, business, and consumer media including The New York Times, Wall Street Journal, Los Angeles Times, Health Magazine, Prevention Magazine, The Newshour, ABC World News, the NBC Nightly News, the CBS Evening News, and NPR’s Science Friday.
She was included as one of TIME Magazine’s 100 Most Influential People of 2016, and she also received the 2018 Giant of Cancer Care® in Cancer Diagnostics award.
1998
The Women's Cancer Research Fund Award
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