By Joseph A. Sparano, MD

ECOG-ACRIN Deputy Chair, AMC Consortium Joint Strategy
and
Chief, Division of Hematology and Medical Oncology at the Icahn School of Medicine at Mount Sinai

The Mount Sinai Health System (MSHS) is an integrated healthcare system of academic and community hospitals across New York City (NYC) and its metropolitan region that provides care to a highly diverse population reflective of the surrounding community. As the sole academic partner for MSHS, the Icahn School of Medicine at Mount Sinai (ISMMS) includes 38 academic departments and 45 research, educational, and clinical institutes, and is internationally acclaimed for its excellence in research, patient care, and education across a range of specialties. With over 4,600 faculty and over 350 laboratories, the ISMMS was ranked 11th in National Institutes of Health (NIH) funding in 2025.

The Mount Sinai Tisch Cancer Center (TCC) is a National Cancer Institute (NCI)-funded Comprehensive Cancer Center, achieving comprehensive designation in 2025 under the leadership of Ramon Parsons, MD, PhD. MSHS serves one of the most socioeconomically and racially diverse communities in NYC and its metropolitan area. The MSHS and affiliates encompass sites in the four most populous boroughs of NYC (Manhattan, Queens, Brooklyn, and the Bronx), Long Island (Nassau County), and New Jersey (Bergen County), including a population of approximately 10.5 million residents.

I have served as the ECOG-ACRIN Cancer Research Group (ECOG-ACRIN) principal investigator (PI) for the TCC since I joined the ISMMS in 2021. I have previously served in many roles in ECOG-ACRIN (and before that ECOG), including as study chair of multiple clinical trials (including TAILORx), member of the Nominating Committee and Executive Committee, as AIDS Oncology Chair and Breast Committee Chair, as Group Vice-Chair, and as the inaugural PI of the NCI Community Oncology Research Program (NCORP) site at Montefiore-Einstein from 2014-2021.

I currently serve as ECOG-ACRIN Deputy Chair, AMC Consortium Joint Strategy, and have served as founding director and current co-director of the ECOG-ACRIN Young Investigator Symposium since 2001.* In my role as PI for the Consortium for Advancing the Management and Prevention of Cancer in People with HIV (AMC Consortium), I actively collaborate with ECOG-ACRIN leadership and investigators in identifying strategic partnership opportunities.** 

Since joining Mount Sinai, I have recommitted our center to making strong contributions to NCI-funded research through its National Clinical Trials Network (NCTN), and continue to encourage our faculty and hematology-oncology fellows to participate in ECOG-ACRIN activities. As testament to that, ISMSS fellows have been awarded the prestigious and highly competitive ECOG-ACRIN Paul Carbone, MD Fellowship Award for 3 of the last 5 years, including 2025 (Zarchary Avigan, MD), 2024 (Tarek Mouhieddine, MD), and 2022 (Andrew Srisuwanakorn, MD), all of whom currently hold full-time academic faculty positions at Mount Sinai, Dana-Farber Cancer Institute, and The Ohio State University Comprehensive Cancer Center, respectively.

Our network accrues about 120 patients annually in therapeutic intervention and cancer control/prevention studies. In addition, a number of our faculty have led or currently co-lead NTCN trials, including trials coordinated by ECOG-ACRIN, as summarized in the table below.

Of those, one I would like to particularly highlight is EA1241 – Extended Clinical Follow up and Biospecimen Collection for Patients Enrolled in TAILORx and RxPONDER: A Companion Protocol. This study is co-chaired by Rima Patel, MD, an assistant professor at ISMMS who I am mentoring in her first experience as an ECOG-ACRIN study chair.

Study EA1241 is currently open to accrual; if your site previously contributed to TAILORx and/or RxPONDER, I encourage you to activate the study and enroll subjects. The study seeks to collect relapse tumor specimens from patients enrolled in TAILORx (cohort 1, Recurrence Score [RS] 0-100) and RxPONDER (cohort 2, RS 0-25), as well as primary and recurrence tumor specimens if applicable from patients who participated in RxPONDER and had a RS 26-100 (cohort 3); patients who have had a recurrence and are deceased are potentially eligible for tissue submission and study credit if they had previously consented to future research. Learn more about EA1241 at ecog-acrin.org.

Plans for the TAILORx Data Hub to Study Breast Cancer Recurrence

The EA1241 study is supported in part by two separate Department of Defense Clinical Research Extension Awards that offer an opportunity to shed new light on breast cancer recurrence. One award held jointly by me, as partnering PI with W. Fraser Symmans, MD at MD Anderson Cancer Center (BC221354), and a second is held by Christina Curtis, PhD, MSc, at the Stanford Cancer Institute (BC250864). These will support spatial transcriptomics and proteomics on primary and relapse tumor specimens. The aims of both awards can be summarized as follows:

• Aim 1 will establish the TAILORx DataHub to harmonize, integrate, and mine available multi-modal data to advance biological insights and validate promising biomarkers with the goal of expediting clinical translation.
• In Aim 2, we will characterize the tumor microenvironment (TME) of estrogen receptor-positive (ER+) breast cancer at unprecedented resolution through spatial profiling of existing TAILORx tissue microarrays (TMAs) and perform analysis with an established computational framework. These data will be integrated with other modalities within the TAILORx DataHub to define TME features across the intrinsic cluster (IC) subgroups.
• In Aim 3, we will refine and evaluate a novel digital pathology tool (PATH-IC) to predict IC subtype from digitized H&E slides. Further, we will evaluate whether the spatial features defined in Aim 2 can be inferred from H&Es and improve relapse prediction. Finally, we will develop PATH-IC as a clinically deployable tool to aid relapse risk prediction for individual patients, and to enable deep insights from existing clinical cohorts where molecular testing is not feasible.

Future Vision

As we look to the future, Mount Sinai remains committed to advancing practice-changing cancer research through active participation in ECOG-ACRIN and across the NCTN. Studies such as EA1241 demonstrate the enduring value of long-term clinical trial follow-up and collaborative science, creating opportunities to better understand tumor biology, refine risk prediction, and improve outcomes for future patients. Equally important, these efforts help cultivate the next generation of clinical investigators, ensuring that innovative, patient-centered research continues to thrive across our network and throughout the broader oncology community.

*The Young Investigator Symposium is an annual event founded in 2001 by ECOG-ACRIN’s then group chair Robert L. Comis, MD and Dr. Sparano. It remains a key component of the Mentorship Program and an annual highlight of the fall group meetings. Funding for this program is provided by the ECOG Research and Education Foundation.

**The AMC Consortium is an NCI-supported clinical trials group founded in 1995. It collaboratively designs and conducts studies on hematologic malignancies, Kaposi’s sarcoma, and solid tumors, and maintains a large, ever-expanding biospecimen collection contributed by participants in consortium trials. Dr. Sparano serves as group and executive committee chair.