Wednesday, March 3, 2004

Breast cancer
research analyzed

Annual symposium highlights advances

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By DANA DUGAN
Express Staff Writer

A flurry of medically and scientifically astute questions were fired at a panel on breast cancer research last week in Sun Valley, dismissing the notion that Q & A sessions with doctors are merely an effective way to get free advice.

Hosted by Expedition Inspiration, the Eighth Annual Laura Evans Memorial Breast Cancer Symposium was held Feb. 25 through Feb. 29. The conference is a meeting of research and clinical physicians specializing in breast cancer research.

Attending the annual Breast Cancer Symposium in Sun Valley are Drs. Julie Gralow, Max Wicha and Chris Benz. The physicians and their colleagues spent four days together in workshops sharing their unpublished work. Courtesy photo

An open forum was held in the Limelight Room of the Sun Valley Inn Thursday, Feb. 29.

Because the theme this year was "Breast Cancer: Exciting Advances in Breast Cancer Treatment," the majority of the discussions at the symposium covered drugs, efficacy, clinical trials and advances.

The news out of the symposium was promising. Clinical trials are rewarding, old drugs are being used in new ways and only 18 percent of breast cancer patients die these days.

The symposium was attended by featured speakers and members of the EI Medical Advisory Board: EI Scientific Advisor and Chair Dr. Marc Lippman of the University of Michigan Health System; Dr. Julie Gralow of the Fred Hutchinson Cancer Research Center; Dr. Angela DeMichele of the University of Pennsylvania Abramson Cancer Center; and Dr. Robert Vestal of Boise’s Clinical Pharmacology Consulting.

Other attendees included Dr. Chris Benz of the Buck Institute for Age Research; Dr. Arul Chinnaiyan of the University of Michigan; Dr. David Flockhart of the Indiana University Cancer Center; Dr. Adrian Harris of Churchill Hospital of Oxford University, England; Dr. Cliff Hudis of Memorial Sloane Kettering; Dr. Kent Osborne of Baylor College of Medicine; Dr. George Sledge of Indian University Cancer Center; Dr. Laura Van’t Veer of The Netherlands Cancer Institute and Dr. Max Wicha of the University of Michigan Comprehensive Cancer Center. Dr. Michael Press of the USC Norris Comprehensive Cancer Center was in attendance and was named as a new EI board member.

The doctors all have research specialties, including genetic, stem cell, prevention and relapse, patient as host, genomics and protonics, molecular biology, age and pharmaceuticals.

"These are wonderful meetings," Lippman said, "You get eccentric and intelligent people in a room together and things happen."

Basically, cancer cells do not die like other cells. "We want to encourage the cancer cells to jump off a cliff," Lippman said. "We are rapidly moving away from the idea that cancer is defined by where it comes from. It’ll soon be one of the least useful things to know. Instead we follow its pathways so that we can get in its face."

Ways in which researchers are gaining on cancer are by using new targeted therapies. "It’s clear breast cancer is a group that needs to be treated separately," Lippman said.

Various drugs seem to work for some people but not on others, Hudis said. "Its going to take tremendous collaboration, which is why this meeting is so important to so many of us. We have to redefine breast cancer into subtexts, and find drugs that work for the patients."

With unconcealed satisfaction, the panel revealed that the drug, Avastin, the first drug to battle cancers by blocking their blood supply, had been approved that day by the FDA for colorectal cancer. It works by shutting off new blood vessel growth. Without that blood supply, solid tumors cannot grow. It is expected that Avastin, manufactured by Genentech, can be effective when used on breast cancer patients. In June of next year the "trial may be done and we’ll know whether it works on recurrent breast cancer," Osborne said.

The importance of testing and screening were reiterated several times during the two-hour open forum. Mammograms and breast exams are considered pretty good tools, Gralow said. But MRIs and ultra sounds "should be considered. Insurance is approving this for some high risk patients."

Clinical trial patients get the best care possible and are not treated like guinea pigs. But there are not enough doctors willing to do trials either from lack of knowledge, patient ignorance or funding issues, Lippman said.

"If you’re only looking at 95 percent of an issue you’re ignoring the fraction that may be important. Why are stem cells so important? Because we can isolate these cells from the whole tumor. Through trials and revisiting drugs that have been around for years, we get better therapy and get smarter about it," he added.

For instance, researchers have learned that giving more chemotherapy doesn’t seem to work.

Instead, "If we give the right dose more often, it increases the effectiveness of the chemo," Hudis said. "Frequency and size can impact effectiveness. We learned this in dose trials where we’re tweaking the chemo."

Also it seems that tamoxifin, a widely prescribed drug that has been around for many years, doesn’t work well when used at the same time as chemotherapy. Instead, the drugs are more effective when used sequentially. The drug Aromotase is now being considered as an early stage or prevention drug for people who screen positive for the cancer gene: BRCA 1 and BRCA 2.

This gene is very uncommon, Osborne said. "The majority are just bad genes, not necessarily from parents but are often mutated genes."

All the physicians agreed that patients should ask that their doctors participate in clinical studies. Every doctor in the U.S. can participate. Only four percent of oncologists are currently participating.

"We’ll get to prevent it someday instead of just treat it," Hudis said.

 

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