Featured Researcher: A Cancer Research’s Ardent Quest

Dr Ines Vasconcelos’ dedicated mission to combat ovarian and breast cancer

By R.N. Sugitha Nadarajah

“I

am very passionate about what I do, and it is hard to define or even explain the passion. I began to be interested in ovarian tumors because they are very challenging,” said Dr Ines Vasconcelos, an Editorial Board member of the journal Advances in Modern Oncology Research (AMOR).

Dr Vasconcelos, who hails from Coimbra, Portugal, is currently a clinician at the Berlin Oncological Center Kurfürstendamm, Germany. Her utmost passion lies in clinical research, specifically in the field of ovarian and breast cancer, and her work has led to several publications in respected peer-reviewed journals.

“I went to the medical school in my hometown in Coimbra, Portugal,” Dr Vasconcelos told AMOR in an exclusive interview.

“The University of Coimbra was founded in 1290, being the oldest in Portugal. It relies, even today, on a body of customs founded upon ancient traditions,” she said, pointing out that the University of Coimbra’s admission process is strictly merit-based and it is one of the major science and technology hubs for applied and fundamental research in Portugal.

Upon completing her thesis in oral contraceptives and breast cancer risk, Dr Vasconcelos graduated with honours and briefly worked at Centro Hospital de Lisboa Central in Lisbon, before moving to Germany to further her studies at the Charité Universitätsmedizin Berlin.

“The Charité was founded in 1709 in anticipation of a bubonic-plague outbreak,” Dr Vasconcelos said. “It became one of the most important institutions in Germany, with more than half of the German Nobel Prize winners in medicine and physiology coming from the Charité.”

She further added, “My doctorate studies, which were awarded a magna cum laude, were about the epigenetic quantification of T lymphocytes in epithelial ovarian cancer as a marker for aggressiveness and as explanatory of tumor dissemination patterns.”

Dr Vasconcelos’ work was presented at the ASCO 2012, and in 2013 she was honoured with the Combating Breast Cancer Travel award. Since then, she has presented her works at ESMO Meetings, Saint Gallen Breast Cancer Conference, and other highly distinguished events.

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To add onto her list of achievements, Dr Vasconcelos has been invited as a speaker at the Experts Meeting on Gynecologic Oncology in San Antonio, Texas, on May 19-21 and at the International Congress of Gynocology and Obstetrics in Barcelona, Spain, on May 28-30, 2016.

Discussing about the key challenges in her field of work, Dr Vasconcelos said, “Borderline ovarian tumors have raised disproportionate controversy compared to their incidence and they have been a source of misconceptions and overtreatment. Ovarian cancer, on the other hand, presents challenging surgical treatment and lacks efficient targeted therapies.”

She added, “On the other side of the spectrum, breast cancer presents a thoroughly studied entity with exciting treatments and excellent oncologic outcomes. Breast surgery is challenging on another level—that is, obtaining optimal oncological outcome without compromising cosmetics.”

According to Dr Vasconcelos, the main challenge in ovarian cancer is to develop maintenance therapies that help patients remain in remission through the development of successful targeted immune therapies.

She also opined that, in this field, chemotherapeutic regimens have already been maximized, and thus the focus now needs to be on maintenance therapies. “In breast cancer, I personally think CNS metastasis has very limited treatment and this is something we need to work on,” said Dr Vasconcelos.

As a clinical researcher who overcame numerous obstacles in her field of work, Dr Vasconcelos said that workplace diversity and inclusivity are challenges that she often faces on a more personal level.

“Workplace diversity can ensure that there is a large pool of knowledge, skills, life experience, perspectives, and expertise. However, subtle biases often persist and lead to exclusion,” Dr Vasconcelos said.

“Often as a coping strategy, those who are different from the majority will downplay their differences and even adopt characteristics of the majority in order to fit in, but when unique employees move towards the norms of the homogeneous majority, that negates the positive impact of having diversity within the group,” she explained.

“I think this is a very pertinent issue that needs to be openly addressed,” she emphasized.

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Dr Vasconcelos’ current research interest is in fertility-sparing treatment in early-stage ovarian cancer and she looks forward to collecting and integrating existent data on early-stage G3 tumors treated with fertility-sparing surgery.

According to her, this procedure is offered at some centers but its real risk is still not known. In this situation, meta-analysis offers a powerful tool to cumulate and summarize the knowledge in this field and to identify the overall treatment effect by combining several conclusions.

“These are very exciting times in oncology research,” quipped Dr Vasconcelos, when asked for her opinion about the current trends in oncology research.

“Basket trials, which select patients based on genomics rather than site of origin or cancer type, are particularly interesting for patients with rare cancers. It avoids undertaking small and risky trials that are hard for drug companies to undertake. In the specific case of breast cancer, circulating tumor cells seem very promising,” she said.

According to Dr Vasconcelos, the recent findings have indicated that circulating tumor cells may genetically differ from the primary tumor. For instance, the primary tumor could be Her2-neu negative while the circulating tumor cells appear to be Her2-neu positive.

This will help researchers define new therapeutic concepts, particularly in the metastatic setting where the majority of patients were shown to have these cells, according to Dr Vasconcelos.

In addition, opining on the future of oncology research, Dr Vasconcelos feels that immune therapies represent the future in ovarian cancer research. “My doctorate was related to the role of effector and regulatory T-lymphocytes in ovarian cancer, so I do believe immune tolerance plays a decisive role in ovarian cancer pathology,” she said.

According to Dr Vasconcelos, PD-1 inhibitor Nivolumab, which blocks cell death in effector T-cells while simultaneously promoting apoptosis in regulatory T-cells, has shown encouraging safety and clinical efficacy.

Furthermore, she added, the successful development of adoptive T-cell therapies would be ideal and would produce a vaccine that induces T-cell immunity.

“PARP-inhibitors have been established as valid therapeutic options and have shown a synergistic action with anti-angiogenic agents through changes in oxygenation. Lastly, targeting p53 in ovarian cancer also seems an interesting approach with a phase I study on p53MVA on its way,” she concluded.

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