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Personalized Cancer Therapy

Date: 12/22/2009

Personalized Cancer Treatments

BIDMC's 2nd Annual Cancer Symposium

To talk about the disease of breast cancer is actually a misnomer - the number of different types of breast cancer is numerous and, in recent years, genomic technologies have revealed that individual breast tumors contain a vast number of specific molecular features that require more personalized approaches to treatment.

Focus on Targeted Breast Cancer Therapies

During BIDMC's Second Annual Cancer Symposium, held Friday November 20 at Harvard Medical School's Joseph B. Martin Conference Center, twelve leaders in the field of breast cancer research came together to share their individual discoveries as they work toward the common goal of developing targeted treatments for these many different types of breast cancer. The program was led by BIDMC Cancer Center Director Lewis Cantley, PhD, and Codirector Pier Paolo Pandolfi, MD, PhD, who shared their visions for cancer treatments of the future. Watch Pandolfi discuss the program.

Focus on the PI3K Pathway

Since BIDMC's inaugural Cancer Symposium was held just over one year ago, Cantley has been named the leader of one of five prestigious scientific "Dream Teams," groups of distinguished cancer researchers who have been awarded grants from the national coalition Stand Up To Cancer (SU2C). The Cantley Dream Team is investigating the role that PI3K mutations play in women's cancers, specifically breast cancer, ovarian cancer and endometrial cancer, with a key goal being to develop new approaches to more accurately predict which patients will respond positively to PI3K pathway inhibitor drugs, for which there are 14 agents currently entering Phase 1 clinical trials.

"The crux of both our symposium and our SU2C Dream Team is to bring together groups of scientists and clinicians to work toward a common purpose," emphasizes Cantley. Watch the video.

Cantley's laboratory first discovered the PI3K pathway in the mid-1980s and it was a long time before anyone fully understood its purpose. But over the last seven or eight years, it's become increasingly clear that PI3K plays a key role in cancers - in fact that this single molecular pathway is implicated in about 80 percent of all tumors. As Ramon Parsons, MD, PhD, Leader of the Breast Cancer Program of the Herbert Irving Columbia Cancer Center noted in his presentation, "PI3K is the most commonly mutated oncogene in breast cancer." Other work focused on this popular pathway was described by Jean Zhao, PhD, of the Dana-Farber Cancer Institute.

A Patient-Centered Approach to Research

"Let the patient teach us what's important," noted Gordon Mills, MD, PhD, in his presentation focusing on signal transduction. Professor of Breast Medical Oncology and Immunology at the University of Texas M.D. Anderson Cancer Center and a co-leader of the Cantley Dream Team, Mills is also overseeing a major project developing personalized molecular medicine.

"Cancer is a disease of genes," he notes. "Working towards a proteomic classification of breast cancer, we're beginning to develop a toolbox to see what's going on across tumors. We know that 80 percent percent of breast-cancer patients will be cured by surgery and radiation alone, but we don't know which patients this will be. We're now beginning to pull things apart in a way that looks prognostically relevant. We know, for example, that one in 10 or 15 patients will have a remarkable response - let the patients tell us why this is happening." Mills describes the concept of pharmacogenomics in this video clip.

As Dana-Farber Cancer Institute Chief of Women's Cancers Eric Winer, MD, noted in his talk on drug resistance and why it develops, "We've clearly made progress over the past 10 to 20 years, but 41,000 women died from breast cancer this past year. It's time to step on the accelerator. We need close collaborations between clinic and laboratory [to address these complicated issues.]"

The pathologist's viewpoint was reflected in a presentation by Stuart Schnitt, MD, of BIDMC's  Department of Pathology whose presentation, "Molecular Classification of Breast Cancer - Ready for Prime Time?" described features used by pathologists to categorize patients with breast cancer: (age, tumor grade, etc.) noting that with the advent of gene expression profiling, pathologists are now able to categorize breast cancer tumors with far greater precision. Watch Schnitt discuss the new information being gathered by pathologists.

Other Cancer Symposium speakers included Joe Gray, PhD, of the Lawrence Berkeley National Laboratory and the University of California, San Francisco Helen Diller Family Comprehensive Cancer Center; Johanna Joyce, PhD, of the Cancer Biology Program at Memorial Sloan Kettering Cancer Center; Senthil Muthuswamy, PhD, of the Ontario Cancer Institute and University of Toronto; and BIDMC investigators Ralph Scully, PhD, Gerburg Wulf, MD, PhD, and Roya Khosravi-Far, PhD, all of the Division of Hematology/Oncology.

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Beth Israel Deaconess Medical Center
330 Brookline Ave
Boston, MA 02215
617-667-4217
617-667-0610
research@bidmc.harvard.edu

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