UNC Lineberger researchers are leading next-generation clinical breast cancer trials as part of a national project using AI and other cutting-edge technologies to track tumor changes in real time, enabling doctors to more quickly adapt treatment plans in response to those changes.
The EVOLVE study, part of a $28 million project funded by the Advanced Research Projects Agency for Health, also includes colon and lung research trials led by other cancer centers. UNC Lineberger is leading the breast cancer trial in partnership with the Translational Breast Cancer Research Consortium.
For the first time, scientists will be able to apply deep-learning approaches to treatment through AI-enabled modeling using biomarkers, imaging and other tools to illuminate a tumor’s status at that point in time to help predict the next best step in treatment.
“So much of our understanding of tumor biology is based on historical specimens from sometimes years before,” said principal investigator Lisa Carey, MD, ScM, FASCO, the L. Richardson and Marilyn Jacobs Preyer Distinguished Professor for Breast Cancer Research and deputy director of clinical science at UNC Lineberger. “But we know that the biology of the cancer evolves. If you want to know how best to treat a patient today, you need to look at what the cancer looks like today.”
UNC Breast SPORE
UNC Lineberger’s major role in EVOLVE is just the latest sign of its global leadership in breast cancer research. The cancer center has continuously received Breast Cancer Specialized Program of Research Excellence (SPORE) funding from the National Cancer Institute for more than three decades, and its SPORE grant was renewed again this year.
UNC’s Breast SPORE is led by Carey, an internationally recognized breast cancer physician-researcher who was named by OncLive as one of its 2025 Giants of Cancer Care, and Chuck Perou, PhD, the May Goldman Shaw Distinguished Professor of Molecular Oncology who was the first to discover distinct cancer subtypes, including triple-negative breast cancer, a highly aggressive and difficult-to-treat form of cancer that disproportionately affects young Black women.
The SPORE grant allows UNC Lineberger’s breast cancer experts to collaborate on four primary projects:
- The Carolina Breast Cancer Study, the groundbreaking population-based study launched in 1993 to predict risk of cancer among women in North Carolina that has since grown to examine the intersection of tumor biology, treatment barriers, social determinants of health and cancer outcomes.
- Research on tumor response and resistance to the combined treatment of radiation and immunotherapy to improve therapeutic approaches.
- Continued studies of the biology of triple-negative breast cancer to develop more effective, less toxic treatments.
- CAR-T cell therapy trials that re-engineer cancer patients’ own immune cells to treat metastatic triple negative breast cancer.
“UNC’s breast cancer program has had a SPORE since the beginning. It’s a marker of research excellence, from bench to bedside,” Carey said. “UNC had amazing scientists and epidemiologists working here in the 1990s, recruited deliberately to bring in clinical and translational approaches, and then knitted everyone together. We do collaborative research better than almost anybody – that is one of Lineberger’s superpowers.”