August 21, 2009

UCSF Breast Cancer Specialists Lead the Way Translating Research

Laura van ’t Veer and Laura Esserman

UCSF breast cancer faculty who are leading the way in personalized medicine and translational research were featured recently at a forum hosted by noted breast surgeon Laura Esserman, MD, MBA, long-time director of UCSF’s Carol Franc Buck Breast Care Center.

The event explored a range of UCSF research initiatives—from efforts to deliver chemotherapy drugs directly to cancer cells while minimizing damage to healthy cells, to novel ways to treat Ductal Carcinoma In Situ (DCIS), a non-invasive breast cancer.

“The goal of all our work, both in research and clinical care, is to make a difference for our patients—to reduce morbidity and mortality from this disease,” Esserman said. “Translational research is all about taking discoveries from the lab to the clinic to benefit our patients.”

Esserman is working on an initiative to unite breast cancer programs on five University of California campuses, enabling physicians and researchers to share data, analysis and treatment plans, and track long-term outcomes for women across the state. The design and scale of the project, currently in the planning stages, are expected to yield significant advancements in prevention, screening, diagnosis and treatment.

“We have a fabulous team of faculty doing pioneering work right here at UCSF,” said Nancy Milliken, MD, vice dean, UCSF School of Medicine, and director, UCSF National Center of Excellence in Women’s Health. “I see immense possibilities to transform women’s health and improve women’s lives locally, nationally and internationally.”

With the planned new Women’s Specialty Hospital at Mission Bay, one of three hospitals projected to open in 2014, UCSF is expanding its commitment to serve women’s unique health needs. “With this new hospital, we will be translating 21st century science into innovative, personalized health care for women,” Milliken said.

Groundbreaking Work

The annual breakfast forum underscored the important connection between clinicians, researchers and community supporters who provide seed funding for new ventures that improve patient care. Over the past 15 years, the UCSF Breast Care Center has grown from seeing 108 patients per month to 1,400 a month today, earning a reputation for the highest-quality medical care and the integration of the latest research developments into clinical practice.

Faculty gathered at the forum shared a number of highlights in the battle against breast cancer.

Medical oncologist Hope Rugo, MD, reviewed several clinical trials focused on new approaches to both early-stage and advanced disease. The top priority is to find new hormone therapies and chemotherapy regimens that are more effective while minimizing side effects and toxicity. Of particular concern, she said, is identifying targets for “triple negative” breast cancer, which is estrogen-receptor negative, progesterone-receptor negative and HER2/neu negative and thus not responsive to standard hormone therapies or the drug Herceptin.

Breast surgeon Shelley Hwang, MD, discussed her work with DCIS, a non-invasive cancer that generally does not spread but is treated today as if it were invasive cancer. Hwang is tracking a group of women with DCIS who have elected hormone therapy alone—Tamoxifen or an aromatase inhibitor – and not lumpectomy or mastectomy surgery.

The study is showing good results, measured by Magnetic Resonance Imaging (MRI), with the area of abnormal cells “pruned back” and sometimes eliminated. The goal is to determine whether some DCIS can be managed nonsurgically, a “kinder and gentler approach,” Hwang noted.

Molecular biologist Laura van ’t Veer, PhD, who is visiting UCSF on a one-year sabbatical from the Netherlands Cancer Institute, is continuing her groundbreaking work in the molecular profiling of cancers to guide treatment decisions. Van’t Veer specializes in analyzing various genes expressed in a breast tumor to identify patterns that help discriminate between an aggressive or indolent tumor, to tailor care. She is co-founder of a Dutch company that has developed a predictive test to inform physicians and patients if a cancer is likely to recur and the potential for chemotherapy benefit.

Elly Cohen, PhD, who is program director for BreastCancerTrials.org, talked about the free, online clinical trial matching service developed by UCSF and the National Cancer Institute, with major funding support from The Safeway Foundation. The nationwide service matches women with appropriate clinical trials and links them with the closest participating research site.

Every major advance in the breast cancer field has come from clinical trials, yet only 3 percent to 5 percent of eligible women enroll, according to Cohen. Clinical trials provide women access to innovative treatments that have the potential to become the new standard of care and are the safest, most effective means to improve breast cancer care, she said.

Photo by Susan Merrell

Groundbreaking Work

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