report of BCRF scientific conference 2005
Now in its fourth year, BCRF's scientific Retreat provides an opportunity for all BCRF current grantees to learn about the research of their colleagues the day prior to the annual Luncheon and public Symposium. The Retreat has been made possible each year since inception by support from BCRF Advisory Board member Muriel Siebert.
"We've changed the natural history of breast cancer through better detection and treatment," said Pamela Goodwin, MD
, Professor of Medicine, Mt. Sinai Hospital, University of Toronto. Her remark as a panelist at both the Scientific Conference and the medical Symposium for the public, underscored the changes that research has brought to breast cancer, and complemented Jill Rose Awardee Dr. Patricia Ganz's
explanation of what question drives a new generation of research: "What is the impact of primary breast cancer treatments on women's health?"
Ganz, an oncologist who directs the Division of Cancer Prevention & Control Research at UCLA's Jonsson Cancer Center, where she leads the Patients and Survivors Research Program, is a respected leader in survivorship. She's pursued quality of life research since, as she said, "the days when it was really unconventional to do so." That was 20 years ago. Because of her research, clinicians may guide their patients into the post-treatment phase with greater support and appropriate expectations.
This year's retreat included presentations by five top breast cancer researchers including Ganz; Goodwin; Kathy D. Miller, MD, Associate Professor of Medicine at Indiana University in Indianapolis; C. Kent Osborne, MD, Professor and Director of the Breast Center at Baylor College of Medicine in Houston, TX, and Edith Perez, MD, Professor of Medicine at Mayo College of Medicine in Jacksonville, FL.
In the course of their presentations to their peers, the five scientists, led by Ganz's summary of the field of quality of life research, revealed important insights:
--Treatment for breast cancer has been shortened to 2-9 months over the past 20 years, but recovery often takes 2 years or more.
--Women are primarily concerned with the risk of death due to breast cancer, making them willing to undergo difficulties associated with long courses of chemotherapy.
--Breast cancer patients are resilient women. However, high-risk groups include: young women whose fertility is jeopardized by treatment, and women who lack family or social support while undergoing treatment.
--Remarkably, many patients experience a measurable positive growth as a result of their cancer, reframing life priorities.
--Incremental return to pre-cancer activities is vital in the early survivorship stage.
Goodwin explained that women's weight is an indicator of recurrence. "Overweight and obesity have proven to be adverse qualities in breast cancer," she said. Her studies have revealed that "insulin resistance syndrome" is a possible indicator that breast cancer risk and recurrence have increased. Goodwin advocates greater awareness about weight as a risk factor and changing lifestyle through food and exercise to reduce the risk.
Edith Perez described her project of tracking women taking the drug Herceptin for evidence of risk factors for cardiac disease. "There is a small but real risk," says Perez, "and now we know how to carefully monitor our strategy to include minimizing risk and study factors that may predispose patients to this risk. Additionally, we are concentrating our efforts to optimize our understanding of patients whose tumor characteristics make them most likely to benefit from treatment and redirect those who will not respond well to the drug." Perez and her colleagues made news earlier in 2005, when the National Cancer Institute released the results of two large clinical trials showing that Herceptin given with chemotherapy reduced recurrence of breast cancer in women with HER-2 positive breast cancer by 52 percent. Perez was the principal investigator for one of those trials.
Kent Osborne presented research findings describing the evolving understanding of estrogen and progesterone receptors in helping doctors decide which drugs to use for breast cancer treatment. "Measuring the level of progesterone receptors along with HER-2 receptors now may help to select which type of endocrine therapy to use in an individual patient," he noted.
Kathy Miller outlined her bioinformatics approach to understanding how an individual's genetic makeup predisposes them to success or failure with targeted drugs used to treat breast cancer--such as trastuzumab and bevacizumab. She suggested that this new information may help doctors proscribe the best possible drug for treating breast cancer as well as form the basis for developing new targeted drugs.
BCRF's retreat engaged its scientific attendees in vigorous discussion about breast cancer as a collection of diseases with increasingly manageable outcomes. "This annual gathering actually spawns new research collaborations," Larry Norton, MD, reminded the day's attendees. Dr. Norton, who introduced the presenters and moderated the session, observed that breast cancer research is revealing new insights in other areas of women's health, such as heart disease, obesity, menopause and post-menopause.