Project Summary
Breast cancer is a devastating disease that affects large numbers of women annually; it is estimated that 1 in 8
women in the United States will be diagnosed with this disease during their lifetime. The five-year survival rate
for women diagnosed with localized or regional breast cancer is greater than 90 percent. However, the presence
of brain metastases reduces five-year survival rates to less than 10 percent. Chemotherapy treatment of brain
metastases is challenging and has yielded inferior results compared to tumors in the periphery, likely reflecting
the inability of chemotherapy to cross the blood brain barrier (BBB) and/or blood tumor barrier (BTB) at
efficacious rates. Recent studies demonstrate circadian regulation of BBB permeability; however no study has
examined whether temporal alterations in chemotherapy administration can improve the efficacy of treatment of
brain metastases. This project aims to take advantage of circadian control of BBB permeability by optimally
timing chemotherapy administration to increase anti-tumor efficacy and reduce adverse side effects of brain
metastases. Specifically, I hypothesize that circadian control of efflux transporter expression at the BBB underlies
the fluctuations in BBB/BTB permeability to chemotherapeutic agents. Permeability of two of the most commonly
prescribed chemotherapeutic drugs for breast cancer, doxorubicin (A) and paclitaxel (P), will be assessed via
phosphor autoradiography imaging by using 14C labeled chemotherapeutic drugs. Additionally, pharmacological
inhibition and genetic approaches (CRISPR) will be utilized to determine both the type and location (BBB or BTB)
of efflux transporters that underlie altered permeability. Mice harboring brain metastases of breast cancer will
receive intravenous injections of doxorubicin/cyclophosphamide cocktail or paclitaxel every 2 weeks during either
the peak or trough of BBB permeability. Anti-tumor efficacy will be assessed via bioluminescence and
immunohistochemistry. Adverse behavioral effects of chemotherapy will be assessed via multiple behavioral
tasks and sleep assessment. I predict that optimal timing of chemotherapy administration will increase anti-tumor
efficacy and minimizes adverse side effects. Indeed, preliminary data demonstrate that altering only the timing
of injection increased the amount of chemotherapy within brain metastases of breast cancer by approximately
50%. Thus, chrono-chemotherapy represents a viable and novel treatment strategy. Together, these studies will
provide essential information with a high potential for clinical relevance to better treat patients with breast cancer.
This career development training award will enable me to become an independent investigator by allowing
training in emerging techniques (i.e., CRISPR and blood-brain barrier/blood-tumor barrier biology), professional
development, grant writing, guest lab training, mentor training, and highly focused research support. To help
accomplish my goals, I have assembled a multidisciplinary mentoring team that has extensive expertise in the
fields of circadian biology, cancer, and neuroscience.