Lalage M. Wakefield, D.Phil.

Lalage M. Wakefield, D.Phil.
Senior Investigator
Head, Cancer Biology of TGF-beta Section

Dr. Wakefield is a leading investigator in the complex cancer biology of the TGF-beta pathway, with a particular focus on breast cancer. Her preclinical studies contributed to the development of anti-TGF-beta therapeutics in oncology, some of which have advanced to early clinical trials. Her current research program uses innovative imaging, genomic and animal modeling methods to address the role of TGF-betas in regulating cancer stem cells, elucidate mechanisms underlying the dual role of TGF-beta in cancer, and develop and exploit preclinical models to support the clinical development of TGF-beta antagonists.

Areas of Expertise

1) TGF-beta, 2) breast cancer, 3) metastasis, 4) mouse models, 5) targeted therapy,
6) cancer stem cells

Contact Info

Lalage M. Wakefield, D.Phil.
Center for Cancer Research
National Cancer Institute
Building 37, Room 4032A
Bethesda, MD 20892-4255
Ph: 240-760-6808

Transforming Growth Factor-βs and Cancer Stem Cells in Breast Cancer Progression

Transforming growth factor-βs (TGF-βs) play central roles in adult homeostasis and response to injury.  Consequently, dysregulation of this pathway is associated with many disease states, including cancer.  In epithelial cancers the prevailing hypothesis is that TGF-βs have tumor suppressor activity early in the carcinogenic process, but that in the later stages, tumor suppressor activity is lost and pro-oncogenic activities come to dominate.  TGF-β pathway antagonists are in early phase clinical oncology trials, so understanding the complex dual role of TGF-β will be critical to the safe and effective development of these agents.  Our two-part research program applies a multifaceted approach to address this problem.

Probing the dual role of TGF-β in breast cancer  The major goal of this part of the program is to understand the positive and negative effects of TGF-β that are targeted towards the cancer cell itself, and how these change with disease progression.  Currently we have a strong focus on the cancer stem cell subpopulation, which is responsible for initiating and sustaining the tumor, and driving cancer recurrence when therapeutic approaches fail.  We work with xenograft and genetically engineered mouse models of breast cancer progression, and we apply integrated genomic, biologic and imaging approaches to identify the effects of TGF-β on the cancer stem cells and their more differentiated offspring.  One mechanistic goal is to identify key components that influence the net output of the TGF-β signal (tumor suppressive vs tumor promoting).  An important recent advance is our development of a novel fluorescent stem cell reporter which allows us to visualize the cancer stem cell in its native habitat, with all the contextual cues intact.   We now have the tools to build a dynamic picture of cancer stem cell fate and phenotypic plasticity in real-time through functional imaging in vivo and in 3D models in vitro.  Understanding how TGF-β modulates cancer stem cell dynamics during breast cancer progression should give new insights into how to target this therapy-resistant tumor cell subpopulation.

Targeting the TGF-β pathway to suppress metastasis  Many advanced human tumors show elevated TGF-β expression, which correlates with poor prognosis.  We and others previously made the surprising finding that antagonizing TGF-β in mouse models could suppress metastasis without the expected deleterious effects on normal homeostasis and early tumorigenesis.  As a result, anti-TGF-β therapeutics are now in early phase clinical oncology trials.   In this part of the program we use mouse models of metastatic breast cancer to elucidate mechanisms and support the clinical development of these agents.  We have previously shown that the therapeutic efficacy of anti-β-beta antibodies involves multiple small effects on many different cellular compartments (“death by a thousand cuts”), with most of the efficacy dependent on reactivation or unmasking of effective anti-tumor immunity.   Using an expanded panel of models, we find heterogeneous responses to TGF-β antagonists, with a minority of models showing undesirable adverse responses.  Work is ongoing to investigate mechanisms and develop predictive biomarkers for patient selection, as well as to improve efficacy through rational combinations with other therapeutics.

Our collaborators include John Condeelis, Albert Einstein College of Medicine; Caroline Hill, Cancer Research UK; Sushil Rane, NIDDK; Maxwell Lee, NCI; Kent Hunter, NCI

Scientific focus areas:

Cancer Biology, Cell Biology, Molecular Biology and Biochemistry, Stem Cell Biology


NIH Scientific Focus Areas:
Cancer Biology, Cell Biology, Molecular Biology and Biochemistry, Stem Cell Biology
  1. Yang YA, Dukhanina O, Tang B, Mamura M, Letterio JJ, MacGregor J, Patel SC, Khozin S, Liu ZY, Green J, Anver MR, Merlino G, Wakefield LM.
    J. Clin. Invest. 109: 1607-15, 2002. [ Journal Article ]
  2. Tang B, Vu M, Booker T, Santner SJ, Miller FR, Anver MR, Wakefield LM.
    J. Clin. Invest. 112: 1116-24, 2003. [ Journal Article ]
  3. Nam JS, Terabe M, Mamura M, Kang MJ, Chae H, Stuelten C, Kohn E, Tang B, Sabzevari H, Anver MR, Lawrence S, Danielpour D, Lonning S, Berzofsky JA, Wakefield LM.
    Cancer Res. 68: 3835-43, 2008. [ Journal Article ]
  4. Sato M, Kadota M, Tang B, Shan M, Weng J, Welsh MA, Flanders KC, Michalowski AM, Yang HH, Clifford RJ, Lee M, and Wakefield LM.
    Breast Cancer Res. 16: R57, 2014. [ Journal Article ]
  5. Tang B, Raviv A, Esposito D, Daniel C, Nghiem B-T, Garfield S, Lim L, Mannan P, Robles AI, Smith WI, Zimmerberg J, Ravin R, and Wakefield LM.
    Stem Cell Reports. 4: 155-169, 2015. [ Journal Article ]

Dr. Wakefield obtained her BA and D.Phil. degrees in Biochemistry at the University of Oxford, England. In 1983, she joined the Laboratory of Chemoprevention at the NCI to work with Drs. Michael Sporn and Anita Roberts on the newly-discovered TGF-beta proteins and their relation to carcinogenesis. Dr. Wakefield was tenured in 1989, and now heads the Cancer Biology of TGF-beta Section in the Laboratory of Cancer Biology and Genetics. She received the NCI Outstanding Mentor Award in 2001 and 2016, and the WSA Mentoring and Leadership Award in 2013.

Name Position
Daniel Grun Ph.D. Postdoctoral Fellow (CRTA)
Nellie Moshkovich Ph.D. Postdoctoral Fellow (CRTA)
Binwu Tang, Ph.D. Staff Scientist
Alex Man Lai Wu Ph.D. Postdoctoral Fellow (Visiting)
Yuan Yang M.D., Ph.D. Research Biologist