Program Head, Divisions of Human Biology and Public Health Sciences
Fred Hutchinson Cancer Research Center
BCRF has supported several SWOG initiatives led and coordinated by Drs. Gralow and Porter. Among these endeavors are a phase III clinical trial of bisphosphonates as adjuvant therapy for primary breast cancer (S0307), the SWOG tissue microarray resource, the clinical and biological characterization of male breast cancer, and predictors of bone metastases. These projects will remain the focus of BCRF-supported studies in 2013-2014.
Impact of Bisphosphonates on Bone Quality The S0307 clinical trial, called AZURE, continues to follow-up and monitor volunteers. All 6,097 patients have been followed for at least one year, and no patients remain in the monthly dosing portion of the zoledronic therapy. These patients will be followed closely for recurrence for up to ten years. A recent presentation of this clinical trial findings occurred at the San Antonio Breast Cancer Symposium in December 2010. The conclusion, with the combined evidence of other trials, regarding whether adjuvant bisphosphonates reduce recurrence or death due to breast cancer and in which patient populations, remains unclear, and further study is warranted. S0307 will continue as planned.
Predictors of Bone Metastases In the predictors of bone metastases study, 93 patients with distant recurrence have been identified, and tissue microarrays of 80 patients and slides from 13 patients have been created using their specimens. Clinical/pathological information has been finalized, and initial lab work was performed with related data finalized. Further lab work is pending from collaborators at Amgen. Preliminary analysis of the data set confirmed that ER positivity is related to higher probability of bone metastasis. A selection of matched controls from a related study is pending. Further tests are still being conducted with data yet to be analyzed and finalized.
Male Breast Cancer Study Due to the rarity of the male breast cancer, international cooperation is necessary to undertake relevant projects with potential clinical impact. With BCRF support, the Male Breast Cancer International Registration and Biologic Characterization Program has been launched, as a joint effort between the Breast International Group (BIG) and the North American Breast Cancer Groups (NABCG) and coordinated by the European Organization for the Research and Treatment of Cancer (EORTC). In the first part of this program, clinical data and tumor samples from male BC cases treated in the last 20 years are being collected. Patients are accruing rapidly, with about 1600 patients registered, which makes this study the largest series of male breast cancer cases ever investigated. The pathology analysis of these tumor samples in the central labs has begun and will lead to a better understanding of the biological characteristics of this disease and to the identification of important potential prognostic (indicative of the good or bad outcome of the disease) and predictive (indicative of probability of response to certain therapies) markers. In 2013-2014, this international team plans to launch the second part of this program, a prospective registry, and will continue negotiations for the third part, a prospective clinical trial.
The accrual closed early September 2013 and 1,800 patients have been registered. This is the largest series of male breast cancer ever studied. The pathology analysis of these tumor samples in the central labs is ongoing and will lead to a better understanding of the biological characteristics of this disease and to the identification of important potential prognostic (indicative of the good or bad outcome of the disease) and predictive (indicative of probability of response to certain therapies) markers. A 1st presentation of these data is expected during the 9th European Breast Cancer Conference, in Glasgow, Scotland, in March 2014. The second part of this program, a prospective registry, has just been launched (first patients are expected in February 2014) and negotiations are ongoing for the third part, a prospective clinical trial.
Dr. Porter obtained her medical degree in 1987 from the University of New Mexico and completed her residency in Pathology at the University of Washington where she was a recipient of the American Cancer Society Clinical Oncology Fellowship. She joined the FHCRC in 1993. Her lab focuses on identifying and understanding the molecular events associated with initiation and progression of human cancer, particularly the role of abnormal cell cycle control. In collaboration with epidemiologists and basic science researchers at the FHCRC, studies in the Porter lab identified the loss of cell cycle inhibitor p27 as an important indicator of poor prognosis in breast cancer. Investigations are underway to evaluate the relationship of p27 loss, along with abnormalities in other cell cycle regulators, with response or failure to specific chemotherapeutic agents.
As head of the multi-institutional Breast Cancer Program centered at the FHCRC, Dr. Porter leads a dynamic group of basic scientists, epidemiologists, surgeons, oncologists and pathologists dedicated to reducing the incidence and subsequent mortality of breast cancer. Projects by members of the program range from mapping mutations that contribute to cancer risk to evaluating life-style factors and potential interventions. Dr. Porter joined the Southwest Oncology Group in 2000 and is working actively with the Breast Committee, led by Dr. Robert Livingston, to take advantage of new technologic developments that will broaden the scope of clinical research questions that can be asked and answered in the clinical trials setting.