Where do BCRF dollars go?

The following is the second in a series of articles describing the impact on breast cancer research and treatment that your donations to BCRF have made.

Finding the Cure

The ultimate goal of any breast cancer research is cure and prevention. As the scope of BCRF funding has expanded, we have organized our projects dedicated to "Finding the Cure" into four main areas. The first category, called Clinical Innovations, consists of studies seeking to improve currently available therapies through adjusting dosage, schedule, and combination with other forms of therapies. The second group, Staying Healthy, focuses on breast cancer survivors and includes efforts to develop clinical interventions that help minimize risk of recurrence and metastasis. Also in this group, there are several studies on natural supplements and complementary medicine that aim to alleviate the lingering side-effects from cancer treatment and to prevent the return and spread of breast cancer. The third category is Clinical Trials, which take place around the world and cover all subtypes of breast cancer. The fourth group, Path Towards Personalized Medicine, includes efforts that lay the groundwork for individualized medical care. The National Cancer Institute defines personalized medicine as "a form of medicine that uses information about a person's genes, proteins, and environment to prevent, diagnose, and treat disease." While individualizing treatment has always been a goal in medical care, scientific technology has finally caught up to make that objective more attainable than ever before. These studies, in conjunction with the group of BCRF projects dedicated to "Finding the Cause," will help us achieve the goal of eradicating breast cancer in our lifetime.

Clinical Innovations
When a woman is diagnosed with breast cancer, she and her doctors have many treatment options from which to choose. In addition to radiation and surgery, there are several types of systemic therapies (chemotherapies) and targeted therapies to consider. BCRF is funding a wide range of projects focused on Clinical Innovations that aim to maximize the benefits of the existing therapies through adjusting the dosage, frequency, combination, and/or timing of various interventions. For instance, several BCRF studies are determining how the order of interventions, such as chemotherapy preceding or following surgery and radiation, may affect patient outcome. Researchers in the Clinical Innovations group also aim to pinpoint which patients would benefit most from a specific intervention. Often, they discover that some patients should avoid an intervention altogether because the benefits gained are minimal in relation to the negative side effects. In addition, these studies include the development of tools for diagnosis and prognosis so that physicians are able to detect the disease and determine its subtype at the earliest point possible. An innovative component of these studies is on drug resistance, as the effectiveness of a drug, or another form of intervention (e.g. radiation therapy), not only seems to differ from individual to individual but also seems to decrease in effectiveness in the same person over time. BCRF grantees are trying to find out why that happens and they are developing ways to bypass resistance, making therapies effective again.

Staying Healthy
In March 2011, the National Cancer Institute and the Centers for Disease Control & Prevention reported that about one in every 20 adults (or 11.7 million) in the United States has survived cancer, including nearly one-fifth of all people over 65. While these figures herald the welcome news that more people are surviving cancer today than was the case even a few years ago, they further underscore the necessity and importance of BCRF-funded efforts in the Staying Healthy category. These studies focus on breast cancer survivors, who make up 22% of all cancer survivors in the US. While the five-year survival rate for breast cancer diagnosed at any stage is nearly 90%, BCRF investigators are focused on preventing breast cancer from recurring or spreading.

Specifically, BCRF investigators are creating new tools that can help with early identification of women at high risk of experiencing a recurrence or metastasis and new clinical interventions which can help prevent that from happening. These projects include such innovations as the use of natural supplements (e.g. omega 3 fatty acids) and the development of vaccines in breast cancer prevention. In addition, BCRF grantees are helping breast cancer survivors recover from the myriad physical and emotional challenges brought on by cancer treatment. The side effects that breast cancer survivors face include fatigue, cognitive complaints, pain, sleep disturbance, and menopausal symptoms. Projects in the Staying Healthy category bring these concerns to center stage and create new methods to address them through investigating the biological mechanisms underlying post-treatment effects.

Clinical Trials
Another important area that BCRF research contributes to is in the design and conduct of Clinical Trials. Clinical trials are voluntary patient studies on new therapies, including vaccines against metastasis and recurrence, or new ways of using existing treatments. These trials range from preliminary to advanced studies involving participants from many parts of the world. Several cooperative groups in the US, under the direction of the National Cancer Institute, and ones formed in Europe, Australia/New Zealand, Canada, Latin America, and the Middle East are conducting focused clinical trials on new drugs and/or treatment approaches, as well as the testing of biomarkers to help physicians diagnose, stage, monitor, and treat women with all stages of breast cancer.

Path Towards Personalized Medicine
The decoding of the human genome came with the promise of important biological insights that would ultimately help researchers eliminate many human diseases, including cancer. However, there are many steps to complete before scientists can directly link genetic information to a cure. BCRF efforts in the Path Towards Personalized Medicine range from profiling tumor biology with the goal of creating targeted clinical interventions based on tumor type; to examining why one population with common ancestry has higher incidences of breast cancer than another; and finally to teasing out the genetic basis, if any, of why one individual benefits more from a specific drug or therapy than another. There is much to do but there is also much to look forward to in our ability to personalize, or individualize, medicine. We are proud that BCRF investigators are leading the way for the entire breast cancer community.