User:Emily BIOL4610/sandbox

Research Pritchard is researcher with leadership and involvement in numerous studies. Her research spans a range of topics, but is mostly focused on women’s health and breast cancer therapies. Her research goals include the development of individualized patient therapies and the advancement of prognostic tests. Much of her research is focused on the role that genetic factors play in predicting disease progression and in formulating ideal treatment plans. In her quest to find the best treatment for each individual patient, she has conducted many clinical trials that have yielded findings that have changed breast cancer treatment approaches in may ways. Dr. Pritchard has been published in numerous significant journals of oncology, including The New England Journal of Medicine, Journal of the National Cancer Institute, The Journal of Clinical Oncology, The Lancet, and The Lancet Oncology. [1]

One of Pritchard’s self-proclaimed “eureka” moments was in a clinical trial concerning the use of the drug Letrozole as an adjuvant therapy in postmenopausal women who had taken tamoxifen for five years as a primary method of combatting breast cancer. Letrozole is an aromatase inhibitor that reduces estrogen production, which is necessary for tumor growth. In one study, Pritchard and her collaborators followed over 5,000 postmenopausal women that had taken tamoxifen for their breast cancer and treated them with either Letrozole or a placebo. The results were astounding. Letrozole was shown to reduce the risk of breast cancer recurrence by over 40% in the patients treated with this drug. In fact, the results were so overwhelmingly positive that the study was ended early. Additionally, it was shown to also prevent metastasis of the cancer to other regions of the body. Results from this clinical study were published in The New England Journal of Medicine in 2003, and just two short years later the therapy was approved by Health Canada.[2]  One of Pritchard’s later studies related to this type of therapy also suggested that extending treatment with an aromatase inhibitor like Letrozole to ten years has the ability to further increase the amount of patients who survive disease-free.[3]

Pritchard has made other headway in the realm of tailoring adjuvant breast cancer therapies to patients. She has postulated that women with breast cancer that also have heavy expression of the protein Her-2/neu are predisposed to respond more favorably to a certain type of chemotherapy than women who do not have the same level of expression of this same protein. It has been shown that Her-2 responds differently to anthracycline and non-anthracycline containing drugs. Topoisomerase II has been identified as the target of anthracycline drugs, and it is believed that its location in regards to the Her-2 gene on the chromosome is what allows the anthracycline drug to be as effective as it is in patients with heavy expression of that protein. Studies have shown that women with high levels of Her-2 expression have a better response to the anthracycline containing drugs[4]. Pritchard’s research suggests that the Her-2 gene could be useful as a possible predictor of the adjuvant therapy that is most effective in certain patients. The ideas and results from this study are significant because they again show the ways in which chemotherapy can be tailored to the specific patient. The goal of such tailored therapy is that patients can be spared the toxicity and side effects of drugs that they do not actually need.[5]

Some of Dr. Pritchard’s more recent research includes exploration of Oncotype DX as a prognostic tool in predicting the likelihood of breast cancer recurrence in certain patients. Oncotype DX is a genetic recurrence-scoring tool that measures expression of certain genes associated with breast cancer. A higher score indicates a higher chance of recurring cancer. One project, the TAILORx study, uses the Oncotype DX score to gauge the need for adjuvant therapy and to predict the response to such adjuvant chemotherapy treatments. Pritchard and colleagues were able to confirm Oncotype DX as a useful tool in deciding upon treatment for low scoring patients. However, Pritchard and her colleagues indicated that results are currently insufficient in regards to the predictive abilities of the test for middle scoring patients. This research is ongoing, and it is possible that data to be collected in the coming year will be sufficient to draw further conclusions about the Oncotype DX test as a predictive tool. [6][7]