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Vanderbilt-Ingram Cancer CenterVanderbilt-Ingram Cancer Center

 
Ingrid A.  Mayer

Ingrid A. Mayer, M.D., M.S.C.I.

Associate Professor of Medicine (Hematology/Oncology)
Clinical Director and Co-Leader, Breast Cancer Program
Medical Oncologist

  • Appointments
    615-322-2064
    Physicians: 1-877-936-8422
  • Clinical Trials Information
  • Other Telephone Numbers
    Vanderbilt Breast Center at One Hundred Oaks
    615-322-2064

    Office
    615-936-3831
  • Faxes
    Vanderbilt Breast Center at One Hundred Oaks Fax
    615-343-3343
    Office Fax
    615-343-7602
  • Addresses
    Vanderbilt Breast Center at One Hundred Oaks
    719 Thompson Lane, Suite 25000
    Nashville, TN 37204
    Website

    Office
    Vanderbilt-Ingram Cancer Center
    2220 Pierce Ave.
    777 Preston Building
    Nashville, TN 37232-6307
Profile

Dr. Mayer obtained her medical degree from the Federal University of Sáo Paulo, Brazil in 1993. Thereafter, she came to the United States for her post-graduate training (internship, residency, chief-residency and Hematology/ Oncology fellowship) at the University of Illinois at Chicago, between 1994 and 2001.
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Dr. Mayer obtained her medical degree from the Federal University of Sáo Paulo, Brazil in 1993. Thereafter, she came to the United States for her post-graduate training (internship, residency, chief-residency and Hematology/ Oncology fellowship) at the University of Illinois at Chicago, between 1994 and 2001. During that time, Dr. Mayer received an American Society of Clinical Oncology (ASCO) Young Investigator Award in 2001 for her research project focused on the inhibitory effects of IFN-alpha in chronic myelogenous leukemia. 

In September, 2003, Dr. Mayer was recruited to Vanderbilt University as an Assistant Professor of Medicine and member of the Breast Cancer Program of the NCI-designated Vanderbilt-Ingram Cancer Center (VICC). She successfully completed a Master of Science in Clinical Investigation (MSCI) Program at Vanderbilt University in May 2006. Since then, she displayed an impressively strong commitment to a career in patient-oriented clinical and translational research in breast cancer. Her research endeavors have been focused on 1) the identification of targetable pathways in breast cancer, 2) ErbB signaling and endocrine therapy resistance in estrogen receptor positive (ER+) breast cancers, 3) PI3K signaling and endocrine therapy resistance in ER+ breast cancers, 4) chemotherapy resistance in triple negative breast cancers, and 5) biomarker prediction of treatment response in human breast cancers. She has obtained several grants to fund her line of research, including a K23 Career Development Award, a Breast Cancer Research Foundation - American Association for Cancer Research (BCRF-AACR) Grant for Translational Breast Cancer Research, and co-leadership in 3 projects in 2 of the VICC Breast Cancer Specialized Program of Research Excellence (SPORE) Grants. 

Dr. Mayer has been a Principal Investigator on more than 50 clinical trials, spanning from phase I through phase III trials. Of these, more than 10 are investigator-initiated trials (IITs), including two large Cooperative Group phase III trials through the Eastern Cooperative Oncology Group- American College of Radiology Imaging Network (ECOG-ACRIN) and a global Stand Up to Cancer (SU2C) / Translational Breast Cancer Research Consortium (TBCRC) / Novartis trial. In view of her clinical trial experience, she was appointed Chair of the Data Safety and Monitoring Committee (VICC DSMC) in 2010.

Nationally, aside from being an active member of the ECOG-ACRIN Breast Core Committee, and the VICC representative of the National Comprehensive Cancer Network (NCCN) Breast Cancer Panel of Experts, Dr. Mayer has been highly involved with the Translational Breast Cancer Research Consortium (TBCRC), and since 2009, she was appointed co-Chair of the TBCRC Endocrine Resistance Working Group (ERWG). 

As a key component of the VICC Breast Cancer Program, Dr. Mayer has been the director of the Clinical Core of the VICC Breast Cancer SPORE and Clinical Team Leader of the Breast Cancer Program since 2008. In this capacity, Dr. Mayer oversees and coordinates the efforts of several physicians and full-time research support personnel, assisting with implementation and development of investigator-initiated, mechanism-based translational clinical trials, patient accrual, management, and monitoring of toxicity of patients on the trials. Under her leadership, the Breast Cancer Research Team is currently one of the top accruer of patients to VICC trials, and in 2014 she was appointed Co-Leader of the VICC Breast Cancer Program. 

Education
Doctor of Medicine
  • Federal University of Sao Paulo, Sao Paulo, Brazil
  • February, 1988 - December, 1993
Residency, Internal Medicine
  • University of Illinois at Chicago Affiliated Hospitals, Chicago, IL
  • July 1994 - June 1997
Chief Residency, Internal Medicine
  • University of Illinois at Chicago Affiliated Hospitals, Chicago, IL
  • July 1997 - June 1998
Fellowship, Hematology/OncologyUniversity of Illinois at Chicago Affiliated Hospitals, Chicago, IL
  • July 1998 - June 2001
Master of Science in Clinical Investigation
  • Vanderbilt University School of Medicine, Nashville, TN
  • September 2004 - September 2006
Research Description

Dr. Mayer research endeavors have been focused on 1) the identification of targetable pathways in breast cancer, 2) ErbB signaling and endocrine therapy resistance in estrogen receptor positive (ER+) breast cancers, 3) PI3K signaling and endocrine therapy resistance in ER+ breast cancers, 4) chemotherapy resistance in triple negative breast cancers, and 5) biomarker prediction of treatment response in human breast cancers.

Identification of targetable pathways in breast cancer. To enhance understanding of breast cancer biology and to elucidate molecular determinants of clinical efficacy, Dr. Mayer obtained a Vanderbilt Physician Scientist Development (VPSD) Award. The specific aims of this grant were to identify relevant tumor antigens by multidimensional liquid chromatography (LC) and tandem mass spectrometry (MS) using antibodies raised against specific peptide motifs recognized by circulating IgGs in breast cancer patients sera and to determine if these tumor antigens could be detected by immunohistochemistry in all different subsets of primary breast tumors. Preliminary results of this work led to testing of new therapeutic strategies targeting the phosphatidylinositol-3 kinase (PI3K)/Akt and correlated pathways in triple-negative, hormone-refractory and HER2-overexpressing refractory breast cancers, using biologically-based targeted agents. Initially, Dr. Mayer conducted a pilot project to determine the safety of an oral mTOR inhibitor in combination with an EGFR inhibitor in patients with metastatic breast cancer, addressing the synergism between EGFR and PI3K pathways. This study was partially funded by a Breast Cancer SPORE Pilot Project Grant. The outcome from this pilot project served as the preliminary data for her K23 Career Development Award. This grant included molecular analysis of individual breast cancers to determine how the biology of the cancer affects the response to the therapeutic agent.

ErbB signaling and endocrine therapy resistance in ER+ breast cancers. Preclinical models and some clinical observations suggest that ER+ breast cancers initially inhibited by a selective estrogen-receptor modulator (SERM) can use autocrine ErbB signaling in order to escape SERM action. This mechanism involves crosstalk between growth factor signaling and ER. Dr. Mayer obtained a Breast Cancer Research Foundation American Association for Cancer Research (BCRF-AACR) Grant for Translational Breast Cancer Research to explore if clinically combining an aromatase inhibitor with an EGFR/HER2 inhibitor would restore sensitivity to endocrine treatment in ER+/HER2+ breast cancers and would prevent the emergence of cells resistant to endocrine therapy. As a continuation of this work, funds were also obtained through the Breast Cancer Specialized Program of Research Excellence (SPORE), Project 1 to determine 1) if combined neoadjuvant breast cancer therapy with the aromatase inhibitor letrozole and the HER2 tyrosine kinase inhibitor lapatinib induces pathologic complete responses in hormone receptor-positive breast cancers that overexpress HER2 and 2) to establish biomarkers predictive of response to this therapy, 3) to determine if the post-letrozole Ki67 in hormone receptor-positive/HER2-negative tumors mirrored the recurrence score as measured by RT-PCR of 21 selected genes in formalin-fixed tumor tissue sections, and 4) to use these biomarkers to discover gene expression signatures associated with response or resistance to estrogen deprivation.

PI3K signaling and endocrine therapy resistance in ER+ breast cancers. Preclinical and a few clinical studies have already suggested that ER+/PI3K mutant tumors exhibit a lower response to antiestrogens compared to ER+/PI3K wild-type tumors. Upon recent renewal of the Breast Cancer Specialized Program of Research Excellence (SPORE), Project 1, Dr. Mayer is seeking to explore if the combination of antiestrogens with a PI3K inhibitor would be more effective against ER+/PI3K mutant

Clinical Interest

Dr. Mayer is a medical oncologist that specializes in breast cancer. Along with Dr. Ingrid Meszoely (Surgical Oncology, Breast Center Director), they fostered the creation of a Breast Cancer Multidisciplinary Clinic in 2007 at the Vanderbilt Breast Center at the Village at Vanderbilt, which allowed new patients to see a medical oncologist, a surgical oncologist and a radiation oncologist all during the same visit. As Medical Oncology director of the Breast Center, Dr. Mayer supervises the clinical operation of the Medical Oncology clinic (including the breast cancer research team operation at OHO) and is the liaison between Medical Oncology and Imaging and Surgical services at the Breast Center. Dr. Mayer attends two full days a week in the breast cancer outpatient oncology clinic, and provides day-to-day oversight of the medical oncology outpatient care at the Vanderbilt Breast Center at OHO, as Medical Oncology director. From a clinical standpoint, Dr. Mayer is regarded as one of the leading breast cancer oncologists not only at Vanderbilt but nationally. She sees breast cancer patients referred from throughout the southeastern United States and sometimes beyond. For several years now, she has annually received the Five Star Awards in the Excellence in Healthcare and has been selected as one of the "Best Doctors in America" by US News Top Doctors.

Clinical Research Description

1- Identification of targetable pathways in breast cancer. Dr. Mayer obtained a Vanderbilt Physician Scientist Development (VPSD) Award to test new therapeutic strategies targeting the phosphatidylinositol-3 kinase (PI3K)/Akt and correlated pathways in breast cancers, using biologically-based targeted agents. Initially, Dr. Mayer conducted a pilot project to determine the safety of an oral mTOR inhibitor in combination with an EGFR inhibitor in patients with metastatic breast cancer, addressing the synergism between EGFR and PI3K pathways. This study served as the preliminary data for her K23 Career Development Award. 2- ErbB signaling and endocrine therapy resistance in ER+ breast cancers. Dr. Mayer obtained a Breast Cancer Research Foundation ??? American Association for Cancer Research (BCRF-AACR) Grant for Translational Breast Cancer Research to explore if clinically combining an aromatase inhibitor with an EGFR/HER2 inhibitor would restore sensitivity to endocrine treatment in ER+/HER2+ breast cancers and would prevent the emergence of cells resistant to endocrine therapy. Funds were also obtained through the Breast Cancer Specialized Program of Research Excellence (SPORE), Project 1 to determine 1) if combined neoadjuvant breast cancer therapy with the aromatase inhibitor letrozole and the HER2 tyrosine kinase inhibitor lapatinib induces pathologic complete responses in hormone receptor-positive breast cancers that overexpress HER2 and 2) to establish biomarkers predictive of response to this therapy, 3) to determine if the post-letrozole Ki67 in hormone receptor-positive/HER2-negative tumors mirrored the recurrence score as measured by RT-PCR of 21 selected genes in formalin-fixed tumor tissue sections, and 4) to use these biomarkers to discover gene expression signatures associated with response or resistance to estrogen deprivation. 3- PI3K signaling and endocrine therapy resistance in ER+ breast cancers. Within the Breast Cancer Specialized Program of Research Excellence (SPORE), Project 1, Dr. Mayer is seeking to explore if the combination of antiestrogens with a PI3K inhibitor would be more effective against ER+/PI3K mutant breast cancers compared to the antiestrogen alone. Based on Dr. Mayer's active role in this area, she was invited to be the lead investigator in three clinical trials being run through the SU2C Dream Team Targeting PI3K in Women???s Cancers, which focuses on determining the role of PI3K pathway in breast, ovarian and endometrial cancers. 4- Chemotherapy resistance in triple-negative breast cancers (TNBC). Dr. Mayer obtained funds through the Breast Cancer Specialized Program of Research Excellence (SPORE), Project 2 to determine the degree of tumor response to neoadjuvant cisplatin, paclitaxel, and the TOR inhibitor everolimus (RAD001) versus cisplatin and paclitaxel therapy in patients with TNBC. In the context of this trial, tissues were analyzed to explore 1) if gene expression profiling could sub-classify triple negative, basal-like cancers and 2) to identify gene expression signatures, such as those of p63 and p73, which would predict sensitivity and response to neoadjuvant, preoperative therapy in TNBC. 5- Biomarker prediction of treatment response in human breast cancers. Dr. Mayer has been a key co-investigator/collaborator on over 5 NIH, DoD, or Foundation grants throughout the institution, particularly in collaboration with investigators from the Department of Chemical Biology, the Vanderbilt Imaging Sciences Division, and the Cardiology Division on grants and trials that aim to develop specific guidelines for incorporating optimized and integrated quantitative PET-MRI into appropriate clinical trials.

Publications