The odds are high that you know someone who has been impacted by breast cancer. The American Cancer Society estimates 287,850 women were diagnosed with breast cancer and 43,250 women died from breast cancer in 2022. Alana Welm, a University of Utah professor of oncological sciences, is working to lower that number.

”We're trying to understand more about the deadliest form of breast cancer, which is metastatic breast cancer,” Welm said. “It's about 20-30% of all breast cancers that eventually become metastatic and we don't really know which ones those are going to be.”

While there are many new treatments for metastatic breast cancer, “unfortunately, when tumors do come back, they're not curable.” In Welm’s lab, they are searching for a cure by studying tumors in mouse models and patient derived models.

“We've genetically engineered mice that develop breast cancer and we try to understand more about the metastatic stage of the disease,” she said. With these models, Welm and her lab have “identified some important proteins that we think we can target to help boost the immune response to these tumors.”

The second type of model—a patient derived model—involves receiving and studying tumors from patients that are treated at Huntsman Cancer Institute after they have surgery or other procedures. These tumors are then grown in the lab either in mice or in three dimensional cultures. “We found that these models are really our best representation of human tumors, especially because they're coming from patients that are under modern day treatment regimens. They're getting the very best care and yet sometimes their tumors are resistant to those therapies and we're trying to model that and use those models to discover new therapies.”

These patient derived models are now being used around the world in over 100 labs. “I think it would be inspiring to our patients that the models made from tumors they donated are actually being used across the whole world for breast cancer research,” Welm said. “That wouldn't be possible without PIVOT.”

Before another lab can receive one of these models to study, the University of Utah and the requesting lab must sign a contract called a Material Transfer Agreement. These agreements outline how the models can be used by the requesting lab and ensure Welm and her team don’t lose control of the models themselves.

For the vast majority of these agreements between the U and other academic partners that are facilitated by PIVOT, there’s no money involved. Instead, Welm said the “really big impact” is getting the models “in the hands of other academic researchers across the whole world.”

PIVOT and Welm also work together to get these models in the hands of any companies looking to make new drugs and treatments. “The fact that these pharmaceutical companies have chosen to use these models is just a testament to their value in hopefully advancing care for breast cancer.”

Short- and long-term impact

Welm’s work and the work of the labs using her models have the potential to impact patients on a global and personal scale.

One of the main purposes of these models is to find new therapies for breast cancer patients. “In order to do that, we have to understand more about the biology of these tumors, why they're drug resistant, why they're so aggressive,” she said. “Then by using these models to screen new drugs or new pathways, we hope to find new therapies that could be applied on the long term.”

The short-term impact of these models wasn’t anticipated when Welm started this research, and she attributed it to “some almost accidental findings.”

“When we started growing our patients’ tumors in the lab, we found that we can identify the most aggressive tumors using our assays,” Welm said. “It really prompted us to push a little harder and say, ‘Well, if we're growing this person's tumor and we know it's going to be aggressive and recur as metastatic disease, we really need to do something about that.’”

This realization led to a new functional precision medicine program at the Huntsman Cancer Institute that has a couple trials underway. Because the trials just started, Welm and her team aren’t sure what the impact will be, but she said she thinks it’s “our greatest chance at short term impact right now.”