Breast CancerProjects

Here are just a few research highlights from the Breast Cancer Program.

Center of Excellence for Individualization of Therapy for Breast Cancer

George Sledge, MD, co-leader of the IU Simon Cancer Center Breast Cancer Research Program, is lead investigator for a $10 million project, the Center of Excellence for Individualization of Therapy for Breast Cancer. This project aims to improve the treatment of women with breast cancer by making it possible to match the appropriate treatment regimen to a patient’s genetic makeup - bringing closer the promise of individualized care.

The reality of breast cancer is that advanced breast cancer patients often become resistant to therapy, or were never good candidates for the therapy. Therapeutic individualization addresses this problem of declining efficacy and increasing toxicity. This project focuses on individualized therapies - developing technologies that will get the right drugs to the right patients, minimizing side effects and maximizing effectiveness of the drugs.

Sponsored by the Department of Defense (DOD), the “Center of Excellence for Individualization of Therapy for Breast Cancer” will represent multiple disciplines and institutions to accelerate and optimize research. IU Simon Cancer Center investigators include co-principal investigator Kathy Miller, MD (clinical research), Robert Hickey, PhD and Linda Malkas, PhD (proteomics), and Constantin Yiannoutsos, PhD (biostatistics). Collaborating institutions include Baylor College of Medicine, University of Oklahoma, McGill University and the Hoosier Oncology Group.

The Pharmacogenetics Project

The IU Breast Care and Research Center and IU Simon Cancer Center collaborate with the IU School of Medicine Pharmacogenetics Center, directed by David Flockhart, MD, PhD. Pharmacogenetics allows researchers to study all the many different genes that determine drug behavior in cancer. This genetic data then can be used to determine the best therapy with the least side effects for specific individuals.

IU breast cancer researchers are currently involved in The Pharmacogenetics Project funded by the national Pharmacogenetic Research Network. The project aims to study the genes that influence the behavior of an important class of drugs, the Selective Estrogen Receptor Modulators (SERMs). SERMS include tamoxifen, commonly prescribed for women with breast cancer and women at high-risk for the disease, as well as estrogen used for hormone replacement therapy (HRT). Data gathered will help determine the genetic profile of individuals most likely to respond favorably to SERMS, help researchers better develop new drugs of this type, and shed light on the current controversy related to HRT.

The Pharmacogenetics principal investigator is Dr. Flockhart, and IU co-investigators include Stephen Hall, PhD, Kathy Miller, MD, Todd Skaar, PhD, George Sledge, MD, Anna Maria Storniolo, MD, Christopher Sweeney, MBBS, and Desta Zeruesenay, PhD.

Tamoxifen Pharmacogenetics: Some Preliminary Results

About 80 percent of women who take tamoxifen get hot flashes. Because hot flashes can create discomfort, doctors may prescribe antidepressants like paroxetine to make tamoxifen more tolerable.

Although treatment recommendations have been withheld until researchers have final data, taking tamoxifen and paroxetine together may not be a good idea. In a study led by Flockhart, some women who took both drugs at the same time had substantially lower levels of a key by-product of tamoxifen—evidence that paroxetine does affect how some individuals process tamoxifen.

Friends for Life

The Friends for Life study is a collaborative effort between the IU Simon Cancer Center and the Center for Pharmacogenomics. It is supported by the Catherine Peachey Fund for Breast Cancer Survivors, the Indiana University General Clinical Research Center, and the national Pharmacogenetics Research Network. The goal of the study is to identify genes that are involved in the etiology and treatment of breast cancer.

The study involves breast cancer survivors, their friends and family and was initiated on April 16, 2005, with the collection of DNA samples from more than 850 women in one day at the Indianapolis Susan G Komen Foundation Race for the Cure. Target enrollment was 1,000 women; sisters Patricia Kersten and Diane Massa (left) were the last to give DNA samples.