August 21, 2009

Pioneer Personalizes Breast Cancer Treatment

Laura van ’t Veer and Laura Esserman

Laura van ’t Veer, PhD, has changed the way physicians look at breast cancer. Tumors differ from each other genetically. And thanks to van ’t Veer’s pioneering vision, oncologists now use a new generation of genetic tests to help make treatment decisions. Fewer women with low-risk breast cancer are being treated unnecessarily with drugs that may have side effects. More women with high-risk disease are receiving appropriate, aggressive therapy. Van ’t Veer led the bench-to-bedside development of the MammaPrint, a lab test on a chip. It detects patterns of gene activity in samples prepared from breast tumors. The various patterns of gene activity detected by the MammaPrint indicate a better or worse likelihood of breast cancer’s returning despite surgery. Research shows that for early-stage breast cancer, the MammaPrint is a more accurate gauge of breast cancer prognosis than previously established measures. Van ’t Veer was determined to see that her research did not languish in a lab. To make sure that MammaPrint reached the clinic, she started her own company. Now, in collaboration with researchers and physicians at UCSF, van ’t Veer sees new opportunities to develop additional clinical applications to benefit breast cancer patients, based on new knowledge of genetic abnormalities and molecular markers in cancer. Van ’t Veer, who chairs the Division of Diagnostic Oncology at the Netherlands Cancer Institute, originally came to UCSF in 2003 at the invitation of patient advocates to speak at an Avon Foundation breast cancer symposium. During her first UCSF visit, van ’t Veer established key connections with leaders of the Cancer Center’s Breast Oncology Program, Joe Gray, PhD, and Laura Esserman, MD. Like van ’t Veer, Gray is a leader in developing techniques widely used to probe genes. Esserman leads clinical trials that aim to quickly evaluate the effectiveness of treatments for individual patients prior to surgery. Van ’t Veer now has chosen UCSF for a research sabbatical – prized time when dedicated researchers can work free of competing administrative duties. She is collaborating with Gray to look for genetic patterns in tumors that can help predict the combinations of standard or experimental drugs that may best target each tumor. Van ’t Veer also is collaborating with Esserman to prepare the next phase of a major, unique clinical trial. During the course of the study, knowledge of how early genetic and imaging measurements are associated with treatment responses will be used to direct patients to the treatments that are predicted to work best for them individually. “The breast cancer program is a good instrument for integrating basic research with patients’ needs, and with the capability to evaluate new clinical approaches,” van ’t Veer says. For her, that makes UCSF a home away from home. The UCSF Carol Franc Buck Breast Care Center provides specialized services, including individual counseling as well as support groups that focus on every stage that you and your family may experience. For information about services or appointments, call 415/353-7070 or visit ucsfbreastcarecenter.org. Source: Cancer Report, Summer 2009 Photo by Susan Merrell

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