Richard R. Love, MD, MS

2009-2010 BCRF Project:
Each year 500,000 poor young women in Asia develop breast cancer which is sensitive to hormone change; the majority of these women experience spread of their cancers to other parts of their bodies at diagnosis or soon thereafter. Dr. Love's team is conducting a clinical trial investigating a way to use a known effective combined hormonal treatment for these women to potentially greater benefit, focusing in particular on women in Bangladesh a very poor country. They hope to get to 350 women, in order to rigorously test their hypothesis, that they can extend these women's lives by an average of a year by changing the time of the ovarian surgery to be in the second half of the menstrual cycle; by early June 2009 accrual was at 189 patients; the trial is open at centers in 7 Asian and 2 African countries.

This ground-breaking (in its focus on surgery timing) clinical trial continues to accrue patients well, all in low-income countries. Many women in the trial are having very useful remissions of their often locally-very- advanced disease, which experience is unusual in the study sites. This trial - now with over half the planned total cases already accrued - is meeting important scientific, educational, humanitarian, and medical diplomacy goals. Major challenges in breast cancer are maximizing the benefits and minimizing the risks of specific useful therapies. Different genetic backgrounds and medical circumstances among populations offer opportunities to answer critical therapeutic questions efficiently and rigorously.

In the coming year, Dr. Love will work in three areas. He will: begin a study of the impact of tamoxifen on cognitive function; collect DNA and blood samples from all 740 Vietnamese and Filipino women in an adjuvant therapy study, for assessment of tamoxifen metabolizing enzyme genotypes and blood drug and metabolite concentrations; and continue accrual to a phase III study investigating the timing of surgical oophorectomy for treatment of metastatic hormone receptor positive breast cancer.

Mid-Year Progress Report:
Major challenges in breast cancer are maximizing the benefits and minimizing the risks of specific useful therapies. Different genetic backgrounds and medical circumstances among populations offer opportunities to answer critical therapeutic questions efficiently and rigorously. Various logistical issues have delayed the Love team in getting the first of their proposed studies on cognitive functioning active. The second study collecting DNA and plasma specimens for a big tamoxifen pharmacogenomic study is progressing well and Dr. Love anticipates that he will have all specimens (about 640 in total) collected by mid-2010. The third study, a phase III trial of the timing of surgical oophorectomy in women with metastatic hormone receptor positive breast cancer, was reviewed in detail by an independent international data and safety monitoring committee in December 2009, and judged to be progressing well.

Bio:
Dr. Richard R. Love, Scientific Director of the International Breast Cancer Research Foundation (IBCRF), is a professor of Internal Medicine in Hematology/Oncology, a professor of Public Health in Epidemiology and Biometrics, and director of International Oncology at the Ohio State University Comprehensive Cancer Center in Columbus, Ohio.

He has been an advisor to the National Institute of Oncology in Rabat, Morocco, the National Cancer Institute in Hanoi, Vietnam, and the Cancer Research Center of Hawaii in Honolulu.

Dr. Love has been funded as an independent researcher by the United States National Institutes of Health for many years, and since 2003, by The Breast Cancer Research Foundation of New York. He has published over 150 peer-reviewed scientific papers. His first important contribution was in demonstrating for the first time that certain hormones could act as SERMS (selective estrogen receptor modulators) in human beings; this means that a hormone could have estrogen-like effects in some tissues of the body and anti-estrogenic effects in other tissues. With initial funding from IBCRF, he then conducted the definitive clinical trial demonstrating that surgical oophorectomy (removal of ovaries) plus Tamoxifen is an effective, safe and cost-effective adjuvant treatment for breast cancer in developing countries. This treatment is now a worldwide standard of care.

Dr. Love suggested that the timing of surgical oophorectomy in the luteal phase (second half) of the menstrual cycle could offer remarkably greater benefits from this procedure and together with Dr. John Niederhuber, current director of the United States National Cancer Institute, has posited a "progesterone trigger hypothesis" to explain this observation. Working through IBCRF, Dr. Love currently collaborates with leading cancer research physicians in the US, Canada, Philippines, China, Vietnam, Indonesia, Malaysia, Morocco, India, Bangladesh, and Nigeria.

In 2009, Dr. Love was selected to join 25 experts in global health research who advocate for greater U.S. investment in global health research in Research!America’s Paul G. Rogers Society for Global Health Research in a united effort to build a national conversation around the value and importance of U.S. funded global heath research. Dr. Love and the other top global health researchers of 2009 were selected by an advisory council comprised of renowned leaders in science, public policy and communications, including four Nobel Laureates. Together they meet with their policymakers to make the case for an increased U.S. investment in global health research through the examples of their own research.