My major research interest is the detection, characterization and possible therapeutic targeting of occult (microscopic) disease in breast cancer. Since 1999 I have established a research team to conduct collaborative efforts aimed at detection of microscopic disease in primary and metastatic disease by using established or innovative detection/enrichment technologies.

Our initial work using a novel immunomagnetic-based technology (CellSearch™) led to a pivotal trial which successfully demonstrated the detection and prognostic value of circulating tumor cells (CTCs) in the peripheral blood of patients with metastatic breast cancer (MBC). Several seminal papers resulted from this initial study that have also fostered research in other tumor types and expanded the potential implication of microscopic disease in advanced cancer. My most recent studies focus on the biological characterization of CTCs and the link with cancer stem cells and in this endeavor, my laboratory has received grant funding from the NCI (RO1) and is also collaborating with several technology companies and bench investigators. I am leading a prospective trial to address possibilities of therapeutic targeting of CTCs with the goal to improve prognosis in MBC.

I have been involved in the development of new targeted agents in metastatic disease (e.g. lapatinib and gefitinib). In particular, I lead an investigator-initiated multicenter trial that successful demonstrated the superiority of combining an EGFR-inhibitor (Gefitinib) with anastrozole in postmenopausal women with hormone-receptor positive disease starting hormonal therapy. This seminal study provided supports for a new prospective study testing another tyrosine-receptor kinase inhibitor in similar population with the expectation of changing the standard of care of these patients.

I am a strong proponent of multidisciplinary team collaborations and perhaps the most successful of such and example is our recently developed Inflammatory Breast Cancer (IBC) Research Program and Clinic. I have assembled a group of investigators from various backgrounds (e.g. clinical, laboratory, imaging epidemiology) to address this aggressive and rare form of breast cancer. As a result of this effort, we were granted the first Promise Grant from the Susan G. Komen Foundation in the amount of $7.5 millions/5 years. Our contribution and leadership to awareness and education about IBC was consolidated with the organization of the First International Conference on IBC, held in Houston on December 5-7, 2008. I am determined to continue and expand such research areas in the future in my new position and mentor young academic physicians.