Magee-Womens Research Institute & Foundation

‘Breast cancer is our passion:’ Husband and wife deliver a one-two scientific punch

Steffi Oesterreich and her husband, Adrian Lee, had an ironclad rule when their daughters were young: All talk of breast cancer stopped once the kids were in the car.

It wasn’t easy to enforce. Both Oesterreich, whose expertise lies in the hormone response in breast cancer, and Lee, who studies growth factor signaling, are among the premier scientists in their respective fields. In fact, both are Komen Scholars – an elite international group of 51 men and women who have made a significant impact on breast cancer research. To have two at a single institution is highly unusual; for them to be married is unprecedented.

“We live and breathe breast cancer,” Steffi says, “because …”

“… it’s our passion,” Adrian finishes.

The couple met in San Antonio in 1992. Both had earned their degrees in Europe (Oesterreich is German, and Lee is British), but ended up in Texas to work at what was then considered the epicenter of breast cancer research, a multi-disciplinary group headed by the late Dr. William McGuire at the University of Texas Health Science Center.

They arrived in Pittsburgh in 2010, lured by the size of UPMC Magee-Womens Hospital, the strengths of the UPMC Hillman Cancer Center, and the overall breadth of the research. A large clinical program and sizeable tissue bank meant they would already have a good foundation on which to build their respective labs.

“That excited us because we didn’t need to build things from scratch,” Adrian explains. “There was already this baseline. We [only] needed to shepherd the research together and give it a home and a vision and a plan.”

Having interviewed up and down the east and west coasts, they were not even sure where Pittsburgh was. But they fell in love with the city’s down-to-earth, low-key atmosphere; its architecture and neighborhoods reminded them of Europe. It was the perfect size: large enough and sophisticated enough to offer plenty of scientific collaboration opportunities, yet not so large that labs disregarded the need to work together.

“We were amazed by the potential,” Adrian says.

The couple are part of the Women’s Cancer Research Center, a collaboration between Magee-Womens Research Institute and UPMC Hillman Cancer Center. Their labs are located at MWRI. Oesterreich also studies invasive lobular breast cancer, while Lee’s focus includes genomics and personalized medicine.

With Magee’s substantial patient volume – the hospital sees roughly 1,400 new breast cancer cases each year – “you can really do meaningful research,” Steffi says. “You have the critical mass to get something done.”

Pittsburgh is also unique in that patients tend not to migrate out of the region as often as they do in other metropolitan areas, making longitudinal studies more feasible.

For 10 to 15 years, Adrian and Steffi operated independently of one another, working hard to maintain their own labs and establish their own research identities. But in 2018, now that both have enjoyed success in their respective fields, they were able to merge their labs and collaborate very closely on all of their projects. They also share a philosophy that emphasizes credit for students, postdocs, and technicians who are the life’s blood of the lab.

Adrian’s work involves mining big data and sequencing breast cancer genomes. Steffi was leading a study searching for genes involved in the action of the estrogen receptor, a protein that controls the body’s estrogen response.

If a breast cancer cell has estrogen receptors, it means the estrogen hormone that a woman’s body produces may be signaling those cancer cells to grow. This describes about 70 percent of all breast cancers. By blocking the woman’s body from producing estrogen, doctors can treat the cancer.

But in about 30 percent of women with this form of breast cancer, the receptor protein mutates, allowing cancer cells to circumvent the treatment and continue growing.

Through genetic sequencing, Steffi found that a gene that allows these mutations to occur happens to be one of the same ones that Adrian’s lab studies.

“This is not manufactured; this is pure coincidence,” Adrian notes.

The two hope their collaborations will lead to more precise predictions of the development of breast cancer, as well as providing better targets for the development of therapeutic drugs.

“One of the things we now know is that breast cancers evolve over time; they change over time. And that’s why we have so much trouble treating it,” Adrian explains. “It’s not like a weed – you kill it, it goes away. Cancer sometimes comes back as a different weed next time, you’ve got to use a different drug to kill it. With sequencing, we can now track how the cancer evolves and evades drugs over time.”

As sequencing becomes less expensive, scientists can do more, using additional data sets to create predictive models. “The ultimate goal is to predict the future -- just like Amazon predicts what you want to buy,” Adrian says.

They are also one of the leading research group in the United States that is studying lobular breast cancer, an understudied subtype of the disease. Their team, headed by collaborating clinicians from UPMC (Drs. Priscilla McAuliffe and Rachel Jankowitz), is conducting the first-ever clinical trial in lobular breast cancer, and Steffi chaired the organization of the first symposium on the topic in 2016. Steffi serves as the Scientific Advisory Board chair for the Lobular Breast Cancer Alliance, a small but growing advocacy group.

Now that their two daughters are grown, they’ve relaxed their rule about talking shop at home. In fact, they talk about it all the time – in the car, over dinner, or while fishing, one of their favorite pastimes. The two are also avid fans of Pittsburgh’s sports teams.

“Breast cancer isn’t just our profession, it’s our hobby. We talk about it probably 80 percent of the time,” Adrian says.

He believes that being so immersed in their life’s work, and having full access to a world-renowned and completely trusted colleague as a sounding board, has made them both better scientists.

“It really gives us the opportunity to throw ideas off each other before we present to a large audience,” he says. And the critique can be brutal, occasionally prompting marital arguments, laughs Steffi. But that’s how they know the feedback is honest.

Gone are the days when they pored over their laptops at their daughters’ swim meets, furiously writing grants. Now they apply their collective knowledge to the disease, pulling together a deep understanding of its molecular, clinical, and epidemiological aspects, acting like a hub that puts pieces of the puzzle together, Steffi explains.

“Our main goal was always to do translational research which was clinically meaningful. But I think now this has become more important than ever,” she says. The couple, who recently celebrated their 25^th wedding anniversary, hope to one day see their work translated into a treatment trial.

“That is the holy grail,” Steffi says. “All we want is to make progress as fast as possible … All we care about is curing breast cancer.”