Pamela J. Goodwin, MD, MSc, FRCP(C)

1) Dr. Goodwin and colleagues are currently working on two studies with BCRF funding. The first, Survivorship in a Long-Term Breast Cancer Cohort, has been ongoing for three years. The researchers have completed data collection for both breast cancer survivors and healthy controls, and they are currently analyzing theirdata. Because of the complex nature of the dataset, it is anticipated that this analysis will continue for at least another year. The second study is an observational study of Vitamin D in Breast Cancer in both Toronto and Los Angeles (in collaboration with Dr. Patricia Ganz). The investigators are determining the extent to which vitamin D deficiency is present in both groups of breast cancer patients, whether it is related to treatment with aromatase inhibitors (hormones commonly used to lower the risk of breast cancer recurrence) and whether a randomized trial of vitamin D supplementation in breast cancer patients is feasible. They have done all of the preliminary work to conduct this study at both centers and are currently recruiting women onto the trial - they anticipate data collection will continue to the end of 2009, with analysis in early 2010.

A commonly used diabetes drug, metformin, may be beneficial in treating breast cancer. In the coming year, Dr. Goodwin plans to study the effect of this drug on proliferation of breast cancer cells, and on biologic processes within cancer cells, in 40 women with inoperable breast cancer. The ultimate goal is to improve outcomes of women with breast cancer

Mid-Year Progress Report:
Dr. Goodwin reports on two BCRF-supported projects: The first, Survivorship in a Long-Term Breast Cancer Cohort, has been ongoing for three years, and the researchers are conducting ongoing analyses of their data. Because of the complex nature of the dataset, it is anticipated that this analysis will continue for at least another year. The second study, an observational study of Vitamin D in Breast Cancer in both Toronto and Los Angeles (in collaboration with Dr. Patricia Ganz), is designed to determine the extent to which vitamin D deficiency is present, whether it is related to treatment with aromatase inhibitors (hormones commonly used to lower the risk of breast cancer recurrence) and whether a randomized trial of vitamin D supplementation in breast cancer patients is feasible. The researchers have completed recruitment and data collection and are currently cleaning and analyzing data.

2) Co-investigator: Lois Shepherd, MDCM, FRCP(C), Queen's University, Kingston, Ontario
On behalf of the NCIC Clinical Trials Group
MA.32 is a multicenter intergroup Phase 3 randomized clinical trial that will evaluate the impact of metformin (a commonly used anti-diabetes drug) versus placebo on invasive disease-free survival in 3582 women with high risk, early stage breast cancer. Major North American co-operative clinical trials groups will participate in this study, with initiation of enrollment anticipated in early 2010. It is estimated study subjects will be enrolled over 3 years and that the primary statistical analysis will take place 3 years later. BCRF is supporting distribution of the study drug (metformin or placebo) to participating centers.

Mid-Year Progress Report:
The researchers are finalizing protocol development for a metformin intervention study in locally advanced and metastatic breast cancer. After study over the past few months, they decided to extend the study population to include not only subjects with locally advanced breast cancer but also those with metastatic breast cancer, and they now will also evaluate the effect of metformin association with chemotherapy, and enhance their planned focus on gene expression. As a result of the change in study design, the protocol that was developed for this study is under revision and the initiation of this study is delayed. The researchers now forecast that the study will activate in June or July.

Bio:
Dr. Pamela Goodwin has been actively involved in research relating to host factors in breast cancer for the past 20 years. Early in her career, she became intrigued with the possibility that lifestyle, especially obesity, might impact outcomes of women diagnosed with breast cancer. She began a program of research that focused on the role of lifestyle factors, including nutrition, exercise and related factors in the clinical course of breast cancer.

She has led a number of studies which investigate the complex interactions between body size, nutrition, exercise and physiologic mediators such as insulin, IGF-I and vitamin D, examining the impact of these factors on survival of women diagnosed with breast cancer. More recently, Dr. Goodwin has begun investigating the status of long-term breast cancer survivors and the influences of hereditary factors, vitamin D and metformin on breast cancer outcomes. She leads a large international Phase III trial (NCIC MA.32) which examines the impact of an insulin lowering drug, metformin, on breast cancer outcomes.

Dr. Goodwin is a Professor of Medicine at the University of Toronto, with cross appointments in the Department of Health Policy, Management and Evaluation and in the School of Graduate Studies. She is a Scientist in the Samuel Lunenfeld Research Institute at Mount Sinai Hospital, Director of the hospital's Marvelle Koffler Breast Center and holder of the Marvelle Koffler Chair in Breast Research. She is also Head of the Medical Oncology Breast Group at Princess Margaret Hospital.