Megan Kruse, MD

Associate Staff
Hematology and Medical Oncology
Cleveland Clinic
Developmental Therapeutics Program
Case Comprehensive Cancer Center

Throughout my clinical fellowship training in hematology and medical oncology, I sought to develop a broad understanding of the pathophysiology underlying breast cancer and how these pathways inform the current approach to treatment. My long-term research interests center on developing clinical trials involving novel therapeutic approaches for triple-negative breast cancer and invasive lobular carcinoma of the breast. I was involved in the development of a protocol for a phase II clinical trial studying a novel antibody drug conjugate targeting the folate receptor alpha pathway for patients with metastatic triple-negative breast cancer. This protocol was developed at the ASCO/AACR Methods in Clinical Cancer Research Workshop in July 2016. During this workshop, I broadened my knowledge of clinical trial design with a focus on feasibility and statistical analysis. Participating in these types of projects as a clinical trainee under the mentorship of Jame Abraham MD provided the groundwork for my successful participation future research endeavors.

During my time as junior faculty, I have been working to develop a research program centered on hormone sensitive breast cancer, particularly lobular breast cancer. This interested started with the development of a pilot study investigating HSD3B1 genotype frequencies in postmenopausal women with breast cancer at Cleveland Clinic. We hypothesize that increased adrenal-derived peripheral estrogen conversion will predispose women with homozygous HSD3B1(1245C) variant genotype to a higher risk of developing estrogen-dependent breast cancer. This work has formed the foundation for a Department of Defense grant proposal and an investigator initiated protocol at Cleveland Clinic assessing clinical outcomes with endocrine therapy/CDK 4/6 inhibition for metastatic hormone receptor positive, HER2 negative patients with and without the homozygous HSD3B1(1245C) variant genotype. This work may have clinical application to both the metastatic and early stage breast cancer settings should we find that patients with the variant genotype have predisposition to hormone sensitive breast cancer or differential responsiveness to endocrine based treatments.

Most recently, I have been involved in investigation of the immune micro-environment for lobular breast cancers and hope that this work may open an avenue for consideration of immune checkpoint inhibitor therapy use in this disease space. I was also appointed as the NRG representative to the NCI breast immune-oncology task force which will allow me to better understand the spectrum of immuno-oncology trials being developed for breast cancer and have impact on the design of these trials moving forward.