# Optimal BET inhibitor combination therapies in triple negative breast cancer

> **NIH NIH F30** · HARVARD MEDICAL SCHOOL · 2020 · $50,520

## Abstract

PROJECT SUMMARY
Triple negative breast cancer (TNBC) is a major subtype of breast cancer that is associated with generally poor
outcome, younger age at diagnosis, and worse prognosis than other subtypes. It currently has no options for
targeted therapy, and chemotherapy remains the only pharmacologic option; thus, better treatments are
urgently needed. We recently demonstrated the potential of a class of epigenetic targeted agents, BET
inhibitors, as a promising new therapy in TNBC. However, the rapid development of resistance necessitates
further study to determine how to effectively administer these drugs and to prevent resistance. Treatment with
the prototypical BET inhibitor, JQ1, is known to induce phenotypic changes in cellular state, which may
mediate resistance. The high degree of intratumor heterogeneity in TNBC may also contribute to development
of resistance and treatment failure. Therefore, a better understanding is needed of how tumor populations are
affected by the selective pressures of treatment. Furthermore, effective combination therapies must be
developed and their administrations optimized in order achieve a more durable response. I hypothesize that
double and triple combination therapies with paclitaxel chemotherapy and PD-L1 immunotherapy, as well as
the order in which combinations are administered, will have an effect on treatment efficacy and tumor
evolution. In Aim 1, I will investigate population dynamics in response to JQ1 combination therapy with
paclitaxel, using TNBC cell lines barcoded with a high-complexity DNA library to track individual subclones
during treatment, both in culture and in xenografts in immunodeficient mice. In Aim 2, I will investigate optimal
administration of JQ1 with paclitaxel by testing concomitant and sequential therapy in both orders in xenografts
with barcoded cells, in order to assess differences in population dynamics between treatment schedules and
differences in cellular response with single cell RNA-seq. I will then use EvoSeq, a method to isolate cells from
within a population with barcode-level specificity, to retrieve cells with differentially selected barcodes between
treatment schedules and examine whether they are predisposed to resistance and whether pretreatment with
one drug alters sensitivity to the second drug. In Aim 3, I will characterize changes in heterogeneity that result
from the triple combination of JQ1, paclitaxel, and anti-PD-L1 antibody, after testing all single agents, double
combinations, and triple combination in MMTV-PyMT cells in immunocompetent mice. The results of this study
will lead to a deeper understanding of how intratumor heterogeneity modifies treatment response and establish
how to optimally combine BET inhibitors. This research will also have direct translational impact in informing
the rational design of clinical trials and, if successful, would lead to improved survival for patients with TNBC.

## Key facts

- **NIH application ID:** 9850947
- **Project number:** 5F30CA228208-03
- **Recipient organization:** HARVARD MEDICAL SCHOOL
- **Principal Investigator:** Jennifer Yawei Ge
- **Activity code:** F30 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $50,520
- **Award type:** 5
- **Project period:** 2018-03-01 → 2021-07-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9850947

## Citation

> US National Institutes of Health, RePORTER application 9850947, Optimal BET inhibitor combination therapies in triple negative breast cancer (5F30CA228208-03). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/9850947. Licensed CC0.

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