ATYPICAL RESPONDERS LANDSCAPE REVIEW ∙ OCTOBER, 2017 9 TheBroadInstitute’s MBCProject.In addition to playing a role in the NCI initiative above, the Broad Institute has launched a separate endeavor called the MBC Project, which is recruiting patients in a democratized, direct-to-patient approach instead of the traditional approach of working through clinics and institutions. This approach mirrors Dr. Susan Love’s Army of Women project launched in 2008 that recruited 375,000 healthy women, breast cancer survivors, and patients with metastatic disease. The MBC Project seeks to enroll any patient with MBC, including typically and atypically responding patients, to better understand the underlying reasons for their response to treatment. Exceptional responders, rapid progressors, and exceptional survivors present among the population of MBC patients will be identified and studied. The MBC Project is explicitly studying atypical quantitative responses, atypical duration of response, atypical resistance, and long-term survival. MBC Project study participants are asked to submit a questionnaire and provide tumor, saliva, and potentially blood samples. The resulting genomic and medical data will be de-identified before being made available to other researchers. Key strengths of this study are that the criteria defining atypical responders are quantifiable, that tumor mutations will be compared with germline information, and that the resulting data will be made available to other researchers. However, this study does not appear to take into account lifestyle and other factors that may contribute to an unusually favorable therapeutic response. The MBC Project defines exceptional responders as follows: 1) For patients with estrogen receptor (ER)+/human epidermal growth factor receptor 2 (HER2)− disease or HER2+ MBC: • Duration with metastatic disease (overall survival), >10 years, OR • Duration on any one therapy (progression-free survival (PFS)), >3 years, OR • Any exceptional response to therapy (CR or near CR), as determined by the investigators after review of the answers to the screening questions, OR • Any other clinical scenario that the investigators believe constitutes an extraordinary response/outcome 2) For patients with triple negative MBC (TNBC): • Duration with metastatic disease (overall survival), >5 years, OR • Duration on any one therapy (PFS), >2 years, OR • Any exceptional response to therapy (CR or near CR), as determined by the investigators after review of the answers to the screening questions, OR • Any other clinical scenario that the investigators believe constitutes an extraordinary response/outcome [3].