Emerging Areas of Research and Treatment with Josh Neman

Researchers are constantly searching for new and better ways to treat breast cancer.  Advances over the last 40 years have increased survival and improved the quality of life for people diagnosed with breast cancer.And, right now, there are promising new treatments and targeted therapies being developed.


Dr. Neman is an Assistant Professor of Neurological Surgery, Physiology & Neuroscience and Member of the Norris Comprehensive Cancer Center at the Keck School of Medicine of USC. Dr. Neman received his doctoral degree at the UCLA David Geffen School of Medicine in neurobiology. He then went on to complete his cancer biology fellowship at the City of Hope’s Beckman Research Institute where he was a California Institute for Regenerative Medicine (CIRM) Fellow. 

Dr. Neman has published in Proceedings of the National Academy of Sciences (PNAS), Cancer Research, PLoS One, Spine, Neurosurgery, Developmental Neurobiology, Journal of Neuroscience Research, and has numerous reviews, abstracts, and book chapters to his name. He is editor of “The Choroid Plexus and Cerebral Spinal Fluid: Emerging Roles in CNS Development, Maintenance, Disease Progression” and co-editor of the “Case Files Neuroscience” textbooks. 

Dr. Neman has been the recipient of multiple research awards including from National Institutes of Health/ National Cancer Institute, CIRM, American Cancer Society, American Brain Tumor Association, STOP Cancer, METAvivor, Susan G Komen Breast Cancer Foundation, and Department of Defense.

Dr. Neman is strong supporter of involving the community in his basic and translational laboratory—this involves engaging with patients, patient advocates, and their families’. Along with the American Brain Tumor Association, he currently organizes annual Brain Tumor 5K walk and education day at the University of Southern California’s campus.  Furthermore, he serves on the Board of Directors of Susan G Komen LA County.


Adam: [00:00] Researchers are constantly searching for new and better ways to treat breast cancer. Advances over the last forty years have increased survival and improve the quality of life for people diagnosed with breast cancer, and right now there are promising new treatments and targeted therapies being developed. To tell us more about the emerging areas of breast cancer treatment I have on the show with us, Dr. Josh Neman. Dr. Neman, welcome to the show. 

Dr. Neman: [00:23] Thanks for having me. Thanks a lot. 

Adam: [00:25] I appreciate you joining us. Just give us a little bit more background about yourself and sort of how you got into this field? 

[00:32] Yeah, so I’m an assistant professor of neurosurgery, USC Keck School of Medicine in Los Angeles. My background is actually neuroscience and brain tumors, and the reason I got into breast cancer research is because we are having more patients and women who are being diagnosed with breast cancers that go to the brain and so it is a necessary part of research and clinic that we need to be focused on. 

Adam: [01:02] I love that, I love that. It’s fascinating that you sort of made that leap over into breast cancer research for that reason, but I love what you’re doing with that. And so let’s just talk a little bit about metastatic disease, so what is metastatic disease and why study it? 

Dr. Neman: [01:17] Yeah, so I started off by telling about brain tumors and so when people think about it, and I’ll put it in the context of brain tumors as an example. So metastatic disease is when cancers leave their original site and so what that means in the case of breast cancer, which is not obvious to a lot of people, and I’m just going to put this forward to level the definition is in a case of breast cancer, a woman will never die of her disease in her breast. Okay. Metastatic disease means when that breast cancer, actual cells leave the breast and they go through the pipeline of the body, so through blood vessels and they land in other organs. 

[01:59] So as an example for brain something that we study and so when a woman gets a breast to brain metastasis, it’s not that the brain now has a brain tumor like a John McCain or a Ted Kennedy brain tumor. It’s actually breast cancer cells that have gone up to the brain and so when colleagues, neurosurgeons, when they take out or they go into the OR, it’s literally breast tissue growing and surrounded by the brain and so that’s what metastatic disease means and that is the culprit or the monster that we have to get after. 

Adam: [02:35] Wow, that’s fascinating. I’ve never really thought of it that way, it’s continuing to be breast tissue forming in other parts of the body. That’s really fascinating. 

Dr. Neman: [02:42] Right, right and if you think about it right now we have about two hundred and fifty- two hundred and sixty thousand new breast cancer diagnoses per year and almost, we have about a hundred and fifty thousand women living with metastatic disease. And unfortunately out of those, about forty thousand will succumb to that and the five-year survival rates for metastatic diseases is about 20%. And so we really need to go after that monster. 

Adam: [03:17] That’s a really good reason to study that so I love that you’re doing that. So walk me through a little bit, how did the Komen Career Catalyst Award help propel your research in the breast cancer and brain metastasis? 

Dr. Neman: [03:31] Yeah, so after I finished my fellowship at City of Hope in LA in my first year in faculty Komen was the first foundation that gave me this three year grant and it was literally ignited my career and I mean for many reasons besides the financial support, with the Komen name, it really helped spring my laboratory into fruition. And Komen community it’s very special and they believed that metastatic disease especially breast to brain is something that we need to go after.

Adam: [04:20] Yeah, that’s smart. I love that and then since the Career Catalyst Award, what specific Komen activities have you continued to participate in? 

Dr. Neman: [04:28] Yeah, so my mantra always has been to ‘pay it forward’ and because of that Career Catalyst Award, it wasn’t the fact that I just wanted to get the award three, four years and then say “Thank you so much” and then onto the next thing. I really believe in giving back and so last year I became part of the board of directors of Susan Komen LA County and I’m one of the only scientists that sits on the board and I’ve been able to through my knowledge, contribute that way back to the community and not just to LA, but just to breast cancer patients through the foundation. 

Adam: [05:15] I love that.

Dr. Neman: [05:17] So it’s not just the amazing funding source that we get as scientists, but now it’s a continuing saga of building upon that, and paying it forward. 

Adam: [05:26] I love that. So what are some of the emerging areas of treatment for the most aggressive and deadly breast cancers like stage four breast cancer or metastatic breast cancer?

Dr. Neman: [05:36] Right, so one of the emerging or it’s here actually is immunotherapy and so immunotherapy is re-harnessing our own body’s immune system, which has sort of gone to sleep, and cancers allergy I always love to give is, is cancer specifically breast cancer it’s like the wolf in sheep’s clothing. They mask themselves. The body can’t detect or they tell the body, “Hey, I’m one of the normal guys, don’t come after me and take me out.” And that’s exactly with the immune system is that the immune system is sort of turned away normally in cancer and we’ve been able to re-engage through immunotherapy and reawaken the immune system and say, “Hey, those guys actually are not good, go after them.” And so when you hear terms, for example, checkpoint inhibitors, Car T cells, these are all the different techniques of getting our normal white blood cells to wake up and go after the tumor cells. 

[06:44] And that is the leading edge of cancer treatment right now because it’s very personalized. It’s not just conventional chemotherapy, which is conventional chemotherapy is, and I’m sure everyone’s heard of this. It’s like throwing an atomic bomb on an anthill. It’s just collateral damage and so we’re getting a step closer to treating the cancer itself with really trying to minimize that off-target effect. And so as an example of an immunotherapy, which actually is going on, it just got approved, which I was part of the pre-clinical trials is out of City of Hope is using Car T cells to directly engage breast cancer that have gone to the brain and so was something I’m proud of that I was part of, and it just got approved about a month ago to go into clinical trials for patients.

Adam: [07:39] Wow, man sounds like you’re doing some really innovative and cutting edge work and that’s fantastic and it’s great for the whole community at large. 

Dr. Neman: [07:48] Yeah, I agree and we still have a long way to go, but just taking little steps at a time and being part of the Komen board, which we initiated several years ago even before I got there, but I’m helping to grow it and this is Susan G Komen LA County is, we have a metastatic breast cancer conference coming up in January 4th of 2020 and it’s being held in LA at City of Hope. And if your audience wants to know more about it, just please go to Komen LA County and see what the program is and I’m part of the scientific committee that is putting together this one day program, which is very geared towards patients and understanding metastatic disease. 

Adam: [08:32] Oh, I love that man and I assume also it’d be open to those that are supporting patients with metastatic breast cancer.

Dr. Neman: [08:38] Oh 100% patient, family members, and caregivers.

Adam: [08:42] I love that.

Dr. Neman: [08:42] And we have specific programs for each of those cohorts. 

Adam: [08:46] Okay. All right, well thanks for sharing that with us. I hope you get a big turnout. 

Dr. Neman: [08:51] Yeah, sounds good. Thanks for allowing me to throw that in there. 

Adam: [08:54] Of course, of course, that’s great. So Dr. Neman, thanks so much for the work that you’re doing both on the research side, on the leadership side, on the board, all the work that you’re doing in this area is really impactful and meaningful and really appreciate you joining me on the show. 

Dr. Neman: [09:10] Yeah, of course anytime.


Intro and outro music is City Sunshine by Kevin MacLeod.  Ad music is Blue Skies by Silent Partner.  The Real Pink podcast is hosted by Adam Walker, produced by Shannon Evanchec and owned by Susan G. Komen.