Julia C. Tchou, MD, PhD - Endocrine and Oncologic Surgery

As a breast cancer surgeon and a physician scientist, Dr. Julia Tchou is privileged to treat her patients with evidence-based approaches. Her priority is to translate basic and clinical research into clinically relevant practices with the goal of improving treatment strategies and eradicating morbidities and mortalities related to breast cancer.

One of our primary research interests focuses on advancing our understanding of the role of immunotherapy in the treatment of breast cancer. A growing body of evidence shows that radiotherapy can stimulate immune response and may be synergistic when used with checkpoint blockade. We have assembled a multidisciplinary team of clinicians and translational research scientists to evaluate this combination therapy using a window of opportunity clinical trial schema. The availability of tumor tissue pre- and post- treatment will provide a rare opportunity to interrogate the effects of this novel approach on tumor tissues and peripheral blood. Our proposed window-of-opportunity trial serves as an experimental platform to evaluate the role of radiotherapy in enhancing the immune response in tumors with low immunogenicity. Our study may help identify biomarkers associated with the phenotypic switch in tumors, changing from immunologically “cold” to “hot.” Our long-term goal is to demonstrate the utility of this general schema as a versatile “in vivo” drug screening assay to evaluate response to novel therapy.

In parallel to our clinical trials, Dr, Tchou's laboratory at the Parker Institute of Cancer Immunotherapy conducts preclinical studies using mouse breast tumor models to recapitulate our human studies. Our basic and translational research is focused on the interaction between the immune system and the development of breast cancer, with a current emphasis on understanding how tumors can be switched from immunologically “cold” to “hot.”

Another approach we’re taking to improve breast cancer outcomes is to use large clinical databases to address unmet clinical needs and questions. Since 2008, we’ve built a richly annotated clinical database comprising more than 14,000 patients treated within our health system. As of 2018, our database has merged with the Penn Medicine Cancer Registry and is prospectively collecting clinical data. Several themes that have emerged from studies using this cancer database are related to 1) breast cancer risk associated with metabolic syndrome; and 2) the effects of commonly prescribed medications in mitigating breast cancer risks.

We are at a critical time in medical research in which we are making groundbreaking discoveries and translating knowledge into cures. This is truly a time of celebration for our patients and their families – a time of hope.