Focus on IBC

January 2014     

 

The newsletter from the Inflammatory Breast Cancer Research Foundation  

Upcoming Events 


January 16, 2014 
Healthy Living After Breast Cancer Part One: Nutrition and Diet; webinar; Noon-1pm EST.
More Information

January 22, 2014
Healthy Living After Breast Cancer Part Two: Exercise and Fitness; webinar; Noon-1pm EST.
More Information

February 12, 2014
Addressing Health Disparities to Improve the Care of African-American Women Affected by Breast Cancer; webinar; Noon-1pm EST.
More Information

February 13, 2014
Paying it Forward: African-American Women Using Their Breast Cancer Experiences to Help Their Communities; webinar; Noon-1pm EST.
More Information

February 21-23, 2014

C4YW Conference for Young Women Affected by Breast Cancer; Hilton Orlando Lake Buena Vista, Orlando, FL.
More Information

March 6-8, 2014
Evidence-based Complementary & Alternative Cancer Therapies conference (Annie Appleseed Project); Embassy Suites, 1601 Belvedere Road, West Palm Beach, FL.
More Information 

Baffled or Befuddled by Medical Terms?


Here is your newsletter editor's favorite go-to resource: the National Cancer Institute's Dictionary of Cancer Terms.
 
Hypoxia: A condition in which there is a decrease in the oxygen supply to a tissue. In cancer treatment, the level of hypoxia in a tumor may help predict the response of the tumor to the treatment.

Hyperthermia (therapy): A type of treatment in which body tissue is exposed to high temperatures to damage and kill cancer cells or to make cancer cells more sensitive to the effects of radiation and certain anticancer drugs.

Angiogenesis: Blood vessel formation. Tumor angiogenesis is the growth of new blood vessels that tumors need to grow. This process is caused by the release of chemicals by the tumor and by host cells near the tumor. 

Additional SABCS Resources

A series of 15 press releases are available on the SABCS website and provide an overview of highlights from the conference.

Noted breast cancer advocate and colleague, Musa Mayer, has written two excellent pieces on specific to metastatic breast cancer.

The first is Dana Farber Cancer Institute oncologist and researcher Hal Burstein's perspective on the treatment of hormone-responsive (HR+ or also called ER+) metastatic breast cancer.

The second piece is University of North Carolina oncologist and researcher Lisa Carey's perspectives on the management of triple negative metastatic breast cancer, and the emerging research.

Newly Published IBC Research

One new addition to the IBC Research 2013 page (in addition to the 16 articles previously noted on that page) is listed below. If free full text of an article is provided, it is linked on that page. If the abstract only is provided, there is a link to the record in the PubMed database because some articles eventually provide free full text.

Yeh, E. D., et al. (2013). What radiologists need to know about diagnosis and treatment of inflammatory breast cancer: a multidisciplinary approach. Radiographics, 33(7), 2003-17.

Do you tweet? Are you on FaceBook?

Follow us on Twitter @IBCResearch.

Be sure to "LIKE"  our FaceBook page and stay connected with the Inflammatory Breast Cancer Research Foundation between newsletters. We're closing in on a goal of 1000 "LIKES"!!
Quick Links
ibc research pin
About Us
Photos of IBC
Bookmarks & Brochures
IBC In Our Own Words
Make a Donation
Newsletter Archive
ibcRF Facebook Page
KATHLEEN LIVINGSTON MEMORIAL GRANT AWARDED
by Ginny Mason, RN, BSN....Executive Director

 

photo of Kathleen Livingston
Kathleen Livingston

September 20, 2011, the Inflammatory Breast Cancer Research Foundation lost an amazing research advocate and dynamic friend. Kathleen was petite in frame but a giant when it came to her passion to end breast cancer. As her initial inflammatory breast cancer began to spread across her chest, she sought out clinical trials to try and contain the disease so she could maintain her active lifestyle. As is often the case the skin metastasis defied containment and would soon flare and Kathleen would search for yet another new treatment option, again and again.  For the 13 years until the disease took her life, Kathleen remained a strong voice for quality research and clinical trials.

The Inflammatory Breast Cancer Research Foundation has chosen to remember Kathleen's dedication and passion by funding research specifically focused on skin metastasis. In June 2013, an RFA (request for applications) went out to select researchers.  Then by early fall the applications were reviewed by our Medical Advisory Board and Board of Directors.  Finally, on Nov. 30 a recipient was chosen from the outstanding pool of applicants.   

Mark Dewhirst 

We are delighted to announce that Mark Dewhirst, DVM, PhD., of Duke University Medical Center, has been chosen to receive $50,000 to support the research, "HIF-1 driven therapeutic resistance mechanisms in chest wall recurrences of inflammatory breast cancer (IBC)." The Inflammatory Breast Cancer Research Foundation is pleased to fund this important research with the potential, if successful, to move quickly to improve patient care and outcomes.

Dr. Dewhirst's name is probably not familiar to most of our readers, so I asked him to tell us a bit more about himself and his research through the following questions.

How did you be come interested in studying breast cancer and skin metastasis specifically?

I became interested in breast cancer research for several reasons. Over the past 30 years I have been involved in two NIH -funded program project grants (led the second one for 19 years) where we studied the combination of radiation and hyperthermia to treat chest wall recurrences of breast cancer.  This disease was chosen by researchers involved in hyperthermia because there is no effective treatment for it and it is on the body surface and therefore is amenable to heating.  Although I am not a physician, I met many  of these patients over the years.  We were able to show in randomized trials that the combination of radiotherapy and hyperthermia is significantly better than radiotherapy alone for achieving local tumor control in the treated site.  However, many of these patients went on to develop metastasis to other dermal sites beyond the original treatment site.  The  failure to control the inexorable movement of these tumor cells via the lymphatics has driven me to want to understand the underlying biology of this manifestation of the disease. 

In more recent years, I worked with David Needham in the Pratt School of Engineering to develop a novel doxorubicin containing heat sensitive liposome (a nanoparticle). One of the primary objectives of this drug development was to treat women with chest wall recurrences of breast cancer.  We showed preclinically that we could deliver up to 30x more drug to a heated site without increased toxicity (in fact the drug reduced cardiotoxicity of doxorubicin).  Further, the combination therapy was able to achieve mouse cures in the very aggressive 4T1 mouse mammary carcinoma, whereas free doxorubicin had no effect on tumor growth in this tumor.  These results compelled us to work with Celsion Corporation to conduct the first-in-woman phase I trial using this drug. The paper summarizing these results is currently in review.

What has been the research focus in your lab?

My laboratory has focused on three interrelated themes: hypoxia, angiogenesis and drug transport. We have had long term interest in the underlying causes of tumor hypoxia. When I first started looking at this in the late 1970's the only persons who cared about tumor hypoxia were radiation oncologists, because hypoxia causes radiation resistance. In the early 1990s, however, Gregg Semenza at Hopkins discovered the hypoxia-inducible transcription factor, HIF-1. We now know that hypoxia has important influence on tumor angiogenesis, metastasis, metabolism and immune surveillance. As such, it is centrally important  to virtually all aspects of tumor aggressiveness.  My laboratory has played an important role in this by establishing the mechanisms that cause hypoxia and by discovering that treatments such as radiotherapy and chemotherapy drive upregulation of HIF-1.   The fundamental premise of our pilot project investigates how treatment with radiotherapy and drugs can drive tumor cell invasion, via HIF-1.  I have been fortunate to have 8 prior graduate students who have received DOD pre-doctoral fellowships to study projects related to breast cancer. These projects have included studies in tumor hypoxia, angiogenesis, drug transport and imaging of drug delivery.  

[Editor's note: To read more about Kathleen and how she was always researching and studying, learning what she could about this deadly disease and how to attack it, see the September 2011 issue of Focus on IBC. To join others who have already  made donations to fund this research grant, make a donation online or send a check or money order payable to: Inflammatory Breast Cancer Research Foundation and mail to: IBC Research Foundation, 321 High School Road NE Ste. D3, PMB 149, Bainbridge Island WA 98110. Together let's honor Kathleen through research that tackles this important and neglected problem.]

Read about all research grants awarded 2009-2013.  

News from the San Antonio Breast Cancer Symposium


Oncology clinicians, researchers, advocates and others of the breast cancer community gathered in chilly San Antonio for the Breast Cancer Symposium (SABCS), Dec. 10-14.  Often noted as the premier breast cancer meeting, the typical crowd numbered close to 8000 representing as many as 90 countries.

While the symposium actually begins on Wednesday, in recent years a series of educational sessions have been offered on Tuesday.  This year, for the first time, "Inflammatory Breast Cancer: Diagnosis, Treatment, and Biology" was featured in the 5:30 - 7:00 pm time slot.  The session was well attended and Drs. Merajver, Cristofanilli and Woodward provided good overviews of their assigned topics.  Hopefully attendees came away from the session with a better understanding of IBC as well as the progress made and challenges still ahead.

Most attendees take advantage of opportunities to network while attending the symposium. This was my 11th year to attend and I always meet with researchers to catch up on their work. Posters offer a chance to talk to young investigators about their work and encourage them to consider studying IBC. I spoke at length with a young woman about her vaccine work. I was able to have coffee with a few of our Medical Advisory Board members, check-in with some of our previous grant recipients, and set the stage for a multi-center clinical trial by facilitating conversation between institutions. A lot of important business takes place outside the actual meetings!

The symposium covers a wide variety of basic research, clinical trial data, and educational topics.  Through platform presentations, featured speakers, posters, and case discussions there are opportunities to take in more information than anyone can begin to assimilate! There were no IBC specific presentations in the general sessions this year. However there were a number of posters on various aspects of IBC research. Poster topics included 'Identification of a common genotype in 3 IBC patients,' 'mTOR & JAK2/STAT3 pathways in IBC,' 'Survival of IBC, a population study,' 'Risk factors for IBC', 'Serum biomarkers using quantitative proteomics', 'Celecoxib inhibits growth of IBC tumors,' and others.  

Beth Overmoyer with her poster "Pre-operative Phase II trial of paclitaxel, trastuzumab and pertuzumab in IBC"
This was a year of good news for those with HER2 positive breast cancer.  New analysis of the NeoALTTO trial shows pathologic complete response (pCR) to neoadjuvant chemotherapy (chemo before surgery) had a significant correlation with survival in early HER2 positive breast cancer after 4 years of follow-up.  However it's not clear if this value extends to overall survival (OS) or translates in later stage breast cancer, such as IBC.

Two studies presented data to suggest after a response to initial chemotherapy, radiotherapy and surgical removal of the breast tumor and nearby lymph nodes does not provide any additional benefit to patients with metastatic breast cancer.  This has been conventional wisdom but these data show that patients with metastatic breast cancer may not benefit from surgery and radiation after chemotherapy.  However, surgery may be needed on a case by case basis.

Another report highlighted the potential role of tumor infiltrating lymphocytes (TILs) and response to trastuzumab (Herceptin).  Studying clinical trial data investigators confirmed there was a relationship between the immune system and responses to trastuzumab.  Women with breast tumors and a high number of TILs have better outcomes with trastuzumab, contributing to pCR.  "Further validation is needed but these data suggest that trastuzumab acts not only directly on the tumor, but may help antitumor immunity" said Dr. Loi, the conference presenter.

In other news, another multicenter study, CALBG/Alliance 40603, indicated the addition of carboplatin to standard neoadjuvant chemotherapy increased pCR rates in patients with triple-negative breast cancer (TNBC).  Anthracycline and taxane based neoadjuvant chemotherapy results in a pCR in about 1/3 of patients with TNBC.  In advanced TNBC, platinum analogues are active but it's unclear if the same magnitude of benefit will be seen.  Another arm of the study included the use of bevacizumab (Avastin).  In this arm pCR rates were also increased but with significant increases in toxicity.  Sikov, who presented these data stated that "we don't have long-term results, and we don't know if increasing pCR results in a significant improvement in recurrence-free or overall survival" but carboplatin should be consider for neoadjuvant treatment in TNBC.

At the time of this writing, all SABCS resources are blocked and can be accessed only by attendees so links to the posters/abstracts cannot be provided.  Beginning January 1, 2014, SABCS On Demand will be available to non-attendees; no log-in & password will be necessary.  You can search the data base for poster/abstract information.  All SABCS on-line resources will remain available for 3 years.