Tatiana Prowell | |
---|---|
Born | Atlanta, Georgia, USA |
Spouse | Todd Gleeson (m. 2002) |
Children | 3 |
Academic background | |
Education | B.A., literature and language, 1994, Bard College M.D., 1999, Johns Hopkins University School of Medicine |
Academic work | |
Institutions | Johns Hopkins University School of Medicine |
Tatiana Michelle Prowell is an American medical oncologist specializing in breast cancer. She is an Associate Professor of Oncology at Johns Hopkins School of Medicine and Breast Cancer Scientific Liaison at the U.S. Food &Drug Administration.
Prowell grew up in Atlanta,Georgia, [1] [2] Her father was a federal employee working for the U.S. Geological Survey and her mother a homemaker. [3] She attended Parkview High School for her secondary school education. [4]
Prowell completed a Bachelor of Arts degree in literature at Bard College,where she was encouraged by her academic advisor,Clark Rodewald,to pursue a medical career. After a year working with Nobel Laureate D. Carleton Gajdusek in his NIH Laboratory of Central Nervous System Studies,where she conducted basic science research in spongiform encephalopathies and served as the editor of several years of Gajdusek's personal diaries housed in the National Library of Medicine,she was accepted into the Johns Hopkins School of Medicine. She graduated in 1999 with a medical degree and election to the Phi Beta Kappa and Alpha Omega Alpha honor societies. [5]
Prowell completed an internal medicine residency in the Osler Housestaff Training Program and medical oncology fellowship at the Sidney Kimmel Comprehensive Cancer Center,both at Johns Hopkins. In 2006,Prowell was recruited by Richard Pazdur to the U.S. Food &Drug Administration (FDA). [3] She has held joint appointments since that time at Johns Hopkins University School of Medicine where she is an Associate Professor of Oncology and at the FDA where she serves as Breast Cancer Scientific Liaison. [6]
In 2012,Prowell and Pazdur co-published new FDA guidelines which would allow non-approved drugs to be tested on highly aggressive types of breast cancer before women underwent surgery,with the disappearance of all cancer after treatment in the pathological specimen,known as pathological compete response,to be used as a potential basis for regulatory approval. [7] She played a key role in developing FDA’s policy on accelerated approval using pathological complete response as a novel regulatory endpoint in the neoadjuvant high-risk breast cancer setting. [8] [9] Similar policies were subsequently adopted by other global regulatory agencies. [10] Relevant articles include "Residual Disease after Neoadjuvant Therapy —Developing Drugs for High-Risk Early Breast Cancer" [11] and "Pathological Complete Response and Accelerated Drug Approval in Early Breast Cancer". [12]
In 2014,Prowell began advocating for routine inclusion of male patients with breast cancer in clinical trials. [13] By 2021,the FDA reported that the majority of breast cancer clinical trials now permit male patients to enroll and that recent drug approvals in breast cancer have been granted regardless of sex. [14]
Prowell was appointed in 2016 by Elizabeth Jaffee to the Biden Cancer Moonshot Blue Ribbon Panel Cancer Immunology Working Group. [15]
In 2017,Prowell and colleagues called for further modernization of eligibility criteria to improve patient access to clinical trials of investigational cancer treatments and to ensure that enrolled populations are representative of patients likely to receive these treatments in the postmarket setting. [16] [17] Prowell has been a particular advocate for inclusion of patients with brain metastases in clinical trials given the prevalence of the condition and their high degree of unmet medical need. [18] NCI Cancer Therapy Evaluation Program (CTEP) subsequently announced that the updated eligibility criteria were mandatory for use in all CTEP-sponsored clinical trials. [19] Following widespread adoption of these criteria,multiple drugs have demonstrated effectiveness against brain metastases. [20] [21] [22]
Prowell and Don Dizon have called upon the field of medicine to abandon language that dehumanizes patients. [23] While serving as Chair of the American Society of Clinical Oncology's 2020 Annual Meeting Education Committee,Prowell co-authored The Language of Respect document intended to address these issues as well as mitigate unconscious gender and racial bias in speaker introductions at conferences. [24] [25] [26] [27] [28] By 2022,the Language of Respect guidelines had been translated into five languages and adapted for use by 17 professional societies. [29] [30]
Prowell rose to prominence on Twitter during the COVID-19 pandemic as a reliable source of medical news and public health commentary. [31] In March 2020,she tweeted seeking a convalescent plasma donor for a physician family member who was critically ill with COVID-19. The tweet led to an outpouring of messages from thousands of prospective convalescent plasma donors,as well as others also seeking plasma for their own family members. Prowell worked to connect potential donors and recipients to donation centers throughout the U.S. before the U.S. Food and Drug Administration and the American Red Cross set up a convalescent plasma donation program. [32] By April 10,2020, The Atlantic journalist Sarah Zhang reported that 20,000 potential donors reached out to Mount Sinai Hospital. [33] Prowell's tweet and subsequent efforts earned her a Webby Special Achievement in May 2020 for "her use of the Internet to organize a blood drive and to inspire COVID-19 survivors to donate their plasma to those still in the fight to recover." [34]
In December 2020,Angela Weyand and Prowell co-founded Healthcare Workers Vs. Hunger,a volunteer-led,weeklong annual contest between teams of health care workers on Twitter (#HCWvsHunger) to address food insecurity during the COVID-19 pandemic and improve the morale of healthcare workers. [35] As of December 2023,HCWvsHunger had raised more than 2.3 million dollars for food banks and hunger organizations. [36]
Prowell was the recipient of an American Society of Clinical Oncology Young Investigator Award and two Pearl M. Stetler awards for women in medicine. [37] In 2019, she received the John and Samuel Bard Award in Science or Medicine for her contributions to the field of oncology. [38] Prowell was also recognized as one of the 100 Influential Women in Oncology by OncoDaily. [39]
In 2004 she married Todd Gleeson, an HIV specialist. [40]
Small-cell carcinoma is a type of highly malignant cancer that most commonly arises within the lung, although it can occasionally arise in other body sites, such as the cervix, prostate, and gastrointestinal tract. Compared to non-small cell carcinoma, small cell carcinoma is more aggressive, with a shorter doubling time, higher growth fraction, and earlier development of metastases.
Pemetrexed, sold under the brand name Alimta among others, is a chemotherapy medication for the treatment of pleural mesothelioma and non-small cell lung cancer (NSCLC).
Adjuvant therapy, also known as adjunct therapy, adjuvant care, or augmentation therapy, is a therapy that is given in addition to the primary or initial therapy to maximize its effectiveness. The surgeries and complex treatment regimens used in cancer therapy have led the term to be used mainly to describe adjuvant cancer treatments. An example of such adjuvant therapy is the additional treatment usually given after surgery where all detectable disease has been removed, but where there remains a statistical risk of relapse due to the presence of undetected disease. If known disease is left behind following surgery, then further treatment is not technically adjuvant.
MammaPrint is a prognostic and predictive diagnostic test for early stage breast cancer patients that assess the risk that a tumor will metastasize to other parts of the body. It gives a binary result, high-risk or low-risk classification, and helps physicians determine whether or not a patient will benefit from chemotherapy. Women with a low risk result can safely forego chemotherapy without decreasing likelihood of disease free survival. MammaPrint is part of the personalized medicine portfolio marketed by Agendia.
Pertuzumab, sold under the brand name Perjeta, is a monoclonal antibody used in combination with trastuzumab and docetaxel for the treatment of metastatic HER2-positive breast cancer; it also used in the same combination as a neoadjuvant in early HER2-positive breast cancer.
Triple-negative breast cancer (TNBC) is any breast cancer that either lacks or shows low levels of estrogen receptor (ER), progesterone receptor (PR) and human epidermal growth factor receptor 2 (HER2) overexpression and/or gene amplification. Triple-negative is sometimes used as a surrogate term for basal-like.
Breast cancer classification divides breast cancer into categories according to different schemes criteria and serving a different purpose. The major categories are the histopathological type, the grade of the tumor, the stage of the tumor, and the expression of proteins and genes. As knowledge of cancer cell biology develops these classifications are updated.
Metastatic breast cancer, also referred to as metastases, advanced breast cancer, secondary tumors, secondaries or stage IV breast cancer, is a stage of breast cancer where the breast cancer cells have spread to distant sites beyond the axillary lymph nodes. There is no cure for metastatic breast cancer; there is no stage after IV.
Olaparib, sold under the brand name Lynparza, is a medication for the maintenance treatment of BRCA-mutated advanced ovarian cancer in adults. It is a PARP inhibitor, inhibiting poly ADP ribose polymerase (PARP), an enzyme involved in DNA repair. It acts against cancers in people with hereditary BRCA1 or BRCA2 mutations, which include some ovarian, breast, and prostate cancers.
Lenvatinib, sold under the brand name Lenvima among others, is an anti-cancer medication for the treatment of certain kinds of thyroid cancer and for other cancers as well. It was developed by Eisai Co. and acts as a multiple kinase inhibitor against the VEGFR1, VEGFR2 and VEGFR3 kinases.
Veliparib (ABT-888) is a potential anti-cancer drug acting as a PARP inhibitor. It kills cancer cells by blocking a protein called PARP, thereby preventing the repair of DNA or genetic damage in cancer cells and possibly making them more susceptible to anticancer treatments. Veliparib may make whole brain radiation treatment work more effectively against brain metastases from NSCLC. It has been shown to potentiate the effects of many chemotherapeutics, and as such has been part of many combination clinical trials.
Trastuzumab emtansine, sold under the brand name Kadcyla, is an antibody-drug conjugate consisting of the humanized monoclonal antibody trastuzumab (Herceptin) covalently linked to the cytotoxic agent DM1. Trastuzumab alone stops growth of cancer cells by binding to the HER2 receptor, whereas trastuzumab emtansine undergoes receptor-mediated internalization into cells, is catabolized in lysosomes where DM1-containing catabolites are released and subsequently bind tubulin to cause mitotic arrest and cell death. Trastuzumab binding to HER2 prevents homodimerization or heterodimerization (HER2/HER3) of the receptor, ultimately inhibiting the activation of MAPK and PI3K/AKT cellular signalling pathways. Because the monoclonal antibody targets HER2, and HER2 is only over-expressed in cancer cells, the conjugate delivers the cytotoxic agent DM1 specifically to tumor cells. The conjugate is abbreviated T-DM1.
Temozolomide, sold under the brand name Temodar among others, is an anticancer medication used to treat brain tumors such as glioblastoma and anaplastic astrocytoma. It is taken by mouth or via intravenous infusion.
Nivolumab, sold under the brand name Opdivo, is an anti-cancer medication used to treat a number of types of cancer. This includes melanoma, lung cancer, malignant pleural mesothelioma, renal cell carcinoma, Hodgkin lymphoma, head and neck cancer, urothelial carcinoma, colon cancer, esophageal squamous cell carcinoma, liver cancer, gastric cancer, and esophageal or gastroesophageal junction cancer. It is administered intravenously.
Pembrolizumab, sold under the brand name Keytruda, is a humanized antibody used in cancer immunotherapy that treats melanoma, lung cancer, head and neck cancer, Hodgkin lymphoma, stomach cancer, cervical cancer, and certain types of breast cancer. It is administered by slow intravenous injection.
Atezolizumab, sold under the brand name Tecentriq among others, is a monoclonal antibody medication used to treat urothelial carcinoma, non-small cell lung cancer (NSCLC), small cell lung cancer (SCLC), hepatocellular carcinoma and alveolar soft part sarcoma, but discontinued for use in triple-negative breast cancer (TNBC). It is a fully humanized, engineered monoclonal antibody of IgG1 isotype against the protein programmed cell death-ligand 1 (PD-L1).
Abemaciclib, sold under the brand name Verzenio among others, is a medication for the treatment of advanced or metastatic breast cancers. It was developed by Eli Lilly and it acts as a CDK inhibitor selective for CDK4 and CDK6.
Tucatinib, sold under the brand name Tukysa, is an anticancer medication used for the treatment of HER2-positive breast cancer. It is a small molecule inhibitor of HER2. It was developed by Array BioPharma and licensed to Cascadian Therapeutics.
Trastuzumab/hyaluronidase, sold under the brand name Herceptin SC among others, is a fixed-dose combination medication for the treatment of HER2-overexpressing breast cancer in adults. It is a combination of trastuzumab and hyaluronidase.
Nancy Lin is an American oncologist who works at the Dana-Farber Cancer Institute and is an Associate Professor of Medicine at Harvard Medical School. Her research considers new diagnostic strategies and treatment pathways for HER2 positive breast cancer.