Detailed Breast Cancer | Duke Center for Global Women's Health Technologies

Activating Immunity and Preventing Recurrence in Breast Cancer

image of graduate student demonstrating the injection of Ethyl Cellulose Ethanol to a small group of research collaborators

PhD Student Katriana von Windheim demonstrating Ethanol injection to collaborators

A One-Time Injectable Therapy for Safe, Local Immune Activation

We are developing a single-dose, injectable therapy that reshapes the tumor environment to trigger durable anti-cancer immunity while minimizing systemic side effects. This approach uses ethyl cellulose, a synthetic derivative of cellulose, that forms a biocompatible gel when delivered with ethanol. After injection, the formulation localizes ethanol within the tumor, enabling controlled tumor ablation, reducing tumor burden, and activating anti-tumor T cells. When combined with low-dose chemotherapy such as cyclophosphamide, this therapy suppresses pro-tumor immune cells, reduces metastatic spread, restores responsiveness to immunotherapy, and improves survival. Because the formulation is visible on ultrasound, it can be precisely delivered and is well suited for outpatient care, resource-limited settings, and use alongside existing checkpoint inhibitor therapies.

Center Director Nimmi Ramanujam observing a graduate student working in laboratory

Graduate student Sarah Mekha and GWHT Director Nimmi Ramanujam

We have developed an injectable therapeutic that synergizes with immunotherapy to reduce metastases

Metabolic Imaging to Detect Hidden Relapse Risk

We have developed a portable imaging platform that allows us to see how tumors and immune cells change the way they use energy during and after treatment. Even when cancer appears to be successfully treated, small numbers of surviving cells can remain hidden and later cause recurrence. We can use spatiotemporal imaging to identify these high-risk cells by revealing early metabolic changes in real time. Using this technology, we discovered that tumors most likely to recur shift their energy use from sugars to fats and show greater metabolic diversity—patterns that are consistent across cancer types and largely absent in treatment-responsive disease. This capability supports smarter treatment decisions, improved monitoring of therapy response, and adaptive clinical trials aimed at preventing cancer recurrence.