In June 2021, clinician and researcher, Joseph A. Sparano, MD, joined The Tisch Cancer Institute as Deputy Director, where he will continue to lead clinical trials and improve treatments for breast cancer and cancers associated with HIV infection, as he has done throughout his distinguished 33-year career. Dr. Sparano was also named Chief of the Division of Hematology and Medical Oncology for the Mount Sinai Health System, and the Ezra Greenspan MD Professor in Clinical Cancer Therapeutics at the Icahn School of Medicine at Mount Sinai.
“My research is driven by addressing questions that will directly inform the care of patients I see every day,” he says. “The key to achieving scientific progress and driving personalized care for cancer patients is bringing together people with complementary skill sets—clinicians, basic scientists, informatics experts, population health researchers.” In addition to conducting research, Dr. Sparano will maintain an active clinical practice within Mount Sinai’s Dubin Breast Center.
Prior to Mount Sinai, Dr. Sparano held research and clinical leadership roles at the Albert Einstein College of Medicine-Montefiore Medical Center. While there, he led the first and largest National Cancer Institute (NCI)-funded precision medicine trial, the Trial Assigning Individualized Options for Treatment (TAILORx).
“The key to achieving scientific progress and driving personalized care for cancer patients is bringing together people with complementary skill sets—clinicians, basic scientists, informatics experts, population health researchers.”
- Joseph A. Sparano, MD
Initially developed and planned 15 years ago, TAILORx included 10,273 women with breast cancer across 1,182 sites on three continents. It was designed to test the clinical utility of the Oncotype DX 21-gene Recurrence Score, which analyses the expression pattern of genes in the tumor and provides prognostic information for risk of disease recurrence and potential benefit from chemotherapy. When early findings became available in 2015, and final results became available in 2018, the trial prompted changes in the standard of care for early stage HR positive/HER-2 negative breast cancer, sparing the use of chemotherapy in up to 70 percent of women when it would otherwise have been recommended.
Based on the results of TAILORx, the 21-gene Recurrence Score test is now routinely recommended by practice guidelines when chemotherapy is being considered in this scenario, which accounts for about one-half of all new breast cancers diagnosed annually in the United States.
Dr. Sparano also led the effort to develop RSClin, a tool that integrates the prognostic information provided by the Recurrence Score, clinical factors, such as age, and pathological factors, such as tumor size and grade. He has shown that RSClin provides greater precision in determining the true recurrence risk than Recurrence Score alone, or clinicopathologic factors alone. Dr. Sparano says RSClin “takes the guesswork” out of precisely determining recurrence risk and selecting the patients most likely to benefit from chemotherapy.
Under Dr. Sparano’s leadership as Chair of the AIDS Malignancy Consortium (AMC)—following 12 years as Vice-Chair of the Consortium—Mount Sinai has been approved as a site for the Consortium’s $111 million NCI-funded grant and will become the AMC’s home institution. The Consortium comprises a network of 42 core clinical sites in the United States, Africa, and Latin America, which researches cancers in people with HIV who live in regions with the highest burden of disease.
AMC coordinated the landmark ANCHOR trial, which established that screening for and treatment of precancerous lesions in the anal canal is effective in reducing the risk of developing anal cancer. The trial also established a new screening and treatment paradigm for this condition. Mount Sinai has a screening and treatment program for precancerous anal lesions, led by Michael M. Gaisa, MD, PhD, Professor of Medicine (Infectious Diseases), who is partnering with Dr. Sparano and AMC to test more effective screening and treatment strategies.
At Mount Sinai, Dr. Sparano will also advance his long-standing interest in addressing racial disparities in health care. He is co-investigator on an NCI-funded study to determine genetic factors associated with chemotherapy-induced neuropathy in Black women, who are at high risk for developing this condition. Neuropathy can be a permanent complication of chemotherapy, causing pain and numbness in the hands and feet.
Dr. Sparano will partner with Ramon Parsons, MD, PhD, Director of The Tisch Cancer Institute, in addressing racial disparities in cancer outcomes. They will also work on achieving Mount Sinai’s goal of becoming an NCI-designated comprehensive cancer center. In addition, he will work with Karyn A. Goodman, MD, MS, Vice Chair for Research and Quality, in expanding the clinical trials program at The Tisch Cancer Institute and bringing novel trials to other sites within the Mount Sinai Health System.