Pitt research could slow triple-negative breast cancer

| Sunday, Sept. 30, 2012, 12:05 a.m.

Cell research at the University of Pittsburgh Cancer Institute could slow an especially virulent form of breast cancer that disproportionately strikes black and younger women, an institute leader said.

The development in treating triple-negative cases, from the Pitt Women's Cancer Research Center in Oakland, ranks with other ground-breaking advancements since the 1960s that have made Pittsburgh a core for breast-cancer research.

Pitt graduate Dr. Bernard Fisher reported in 1985 that lumpectomy and radiation treatments can be as effective as more radical and disfiguring mastectomies. He helped establish the National Surgical Adjuvant Breast and Bowel Project, or NSABP, a North Side-based research consortium at the top of its field.

“I think when you have a pioneer like that, it tends to bring others here,” said Adrian Lee, a pharmacology professor and director at the Pitt center. He said its focus on triple-negative cases — found in nearly a third of black women with breast cancer — may lead to clinical trials within a year or two.

Mortality rates for triple-negative breast cancer can be double those for more common breast cancers. That type of cancer can appear twice as often in black women as in other patients, according to the nonprofit Susan G. Komen for the Cure.

Unlike slower-spreading cancers, triple-negative cases don't respond well to conventional hormone therapies, Lee said. The researchers found a cell-growth regulator that, when blocked, can impair triple-negatives.

That approach, paired with chemotherapy, can “completely shrink tumors until they disappear” in rodents, Lee said.

Another center study is investigating how genetic subtleties might affect responses to treatment in triple-negative cases. Lee expects genetics, specialized treatments and cross-disciplinary collaboration to play increasingly prominent roles in research.

“Getting the physician to speak to the basic scientist is probably the most critical part, because we can educate each other and then try to solve the problem,” he said.

At the NSABP, researchers are trying to limit the scope of breast surgery, said associate chairman Dr. D. L. Wickerham, chief of cancer genetics and prevention at Allegheny General Hospital.

“Our focus at the moment is increasingly on chemotherapy prior to the operation, which — if it's exceedingly beneficial — can avoid the necessity of an operation altogether,” Wickerham said. He said research is moving toward breast cancer prevention.

NSABP trials led to such widespread approaches as blends of chemotherapy and tamoxifen, a popular hormonal treatment. Average five-year survival rates rose to the 90-percent range for U.S. patients, up from the mid-1970s four decades ago.

“I think all women — and black women are no exception — really fear the diagnosis of breast cancer,” said Dr. Nancy E. Davidson, director of the University of Pittsburgh Cancer Institute and the UPMC Cancer Center. “But it's important for us to remember that we've made a lot of headway with breast cancer and its treatment over the past couple decades.”

Davidson emphasized the need for diverse participation in clinical trials, which test the usefulness of possible treatments. Patients can learn more by talking to their doctors.

“Education is key,” said Valerie Rochester, program director at the Black Women's Health Imperative in Washington. “We need to have a better understanding of why black women, especially younger black women, are affected so often.”

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