{"id":2449,"date":"2021-11-15T23:00:20","date_gmt":"2021-11-15T23:00:20","guid":{"rendered":"https:\/\/magazines.uthscsa.edu\/schools\/?p=2449"},"modified":"2021-11-17T17:57:27","modified_gmt":"2021-11-17T17:57:27","slug":"winning-the-war-against-breast-cancer-one-battle-at-a-time","status":"publish","type":"post","link":"https:\/\/magazines.uthscsa.edu\/schools\/2021\/11\/15\/winning-the-war-against-breast-cancer-one-battle-at-a-time\/","title":{"rendered":"Winning the War Against Breast Cancer: One Battle at a Time"},"content":{"rendered":"
By Michael Seringer<\/p>\n
Breast cancer is not one disease, but many.<\/p>\nVirginia Kakalmani, MD, DSc, well-known physician-scientist and chair of Breast Cancer Research at the Mays Cancer Center, is performing clinical trials to repurpose FDA-approved drugs believed to have cancer-fighting potential.<\/figcaption><\/figure>\n
\u201cToday we understand that breast cancer is definitely not one disease, but breast cancer is not three or four diseases, either,\u201d said Virginia G. Kaklamani, MD, DSc, well-known physician-scientist and chair of Breast Cancer Research at the Mays Cancer Center, home to UT Health San Antonio MD Anderson Cancer Center. \u201cIt\u2019s probably 10 to 12 different diseases, and by looking at the gene makeup of these specific breast cancers we are able to use targeted therapies that individualize treatment.\u201d<\/p>\n
Many drugs are discarded that may help one type of breast cancer, but not the majority. Defining the weaknesses of each type of breast cancer and then targeting those specific weaknesses is crucial to finding new treatments for this cancer. Investigators at UT Health San Antonio are finding that these newly discovered weaknesses specific to distinct forms of breast cancer can be targeted using repurposed drugs. These are drugs that are used for other diseases but have either never been tested in breast cancer or been tested and rejected, because the majority of breast cancer types did not respond.<\/p>\n
For example, Dr. Kaklamani and Kimi Kong, PhD, associate professor of medicine, have found that drugs currently used to prevent rejection of transplanted organs can target inherited breast cancer, which represents only about 5 percent of all breast cancer. They have started a clinical trial testing this new therapy in this type of breast cancer.<\/p>\n
David Gius, MD, PhD, assistant dean for research, has found another. \u201cWomen with a breast cancer type termed luminal B that have failed therapy have no hope,\u201d he said. \u201cHowever, these cancers require superoxide dismutase, which can be targeted by a drug used to treat other diseases.\u201d<\/p>\n
Such therapies targeted to the distinct forms of breast cancer are the future of breast cancer treatment, Dr. Kaklamani believes. Each of these forms of breast cancer arose from distinct mechanisms, so it seems obvious that they would need distinct therapies. Yet this concept is a recent development, although it has its roots in the breast cancer research team at UT Health San Antonio.<\/p>\nDavid Gius, MD, PhD, associate director for translational research at the Mays Cancer Center and assistant dean for research for the Long School of Medicine at UT Health San Antonio, was recently recruited to San Antonio with a $6 million senior investigator grant from the Cancer Prevention and Research Institute\u00a0of Texas.<\/figcaption><\/figure>\n
Individualizing Breast Cancer Treatment<\/h3>\n
This concept that distinct types of breast cancer require distinct therapies was built on work pioneered by William L. McGuire, MD, and many others who helped target cancer treatment to the individual patient. New targeting discoveries will provide clinicians with even more customized treatment plans and improved outcomes. Researchers with the Joe R. and Teresa Lozano Long School of Medicine are interested in the genetic evolution of tumors. They plan on matching interventions to the tumor\u2019s change in order to improve treatment options. This research is just one example of personalized medicine designed to better target treatment.<\/p>\n
A headline in The New York Times once heralded UT Health San Antonio\u2019s work in measuring progesterone receptors as a \u201cclue to breast cancer odds.\u201d In reality, Dr. McGuire, pioneering breast cancer researcher and the first chief of oncology at UT Health San Antonio, was on to something much more radical. Dr. McGuire\u2019s research took significant steps in targeting hormonal therapies to individual patients who expressed the estrogen and progesterone receptors\u2014an idea that would come to define breast cancer treatment, improving the odds for everyone. This was the first example of individualizing therapy for each patient.<\/p>\n
Dr. McGuire\u2019s energy and attention to quality clinical trial design allowed him to quickly confirm the consequential role estrogen receptors play in predicting outcomes, a landmark research discovery made by Elwood Jensen, PhD. Dr. McGuire quickly recruited a cohort of more than 100 breast cancer patients in San Antonio. His research ultimately proved Dr. Jensen\u2019s basic science, improved breast cancer treatment and distinguished UT Health San Antonio as a leading center in breast cancer research.<\/p>\n
San Antonio\u2014Synonymous\u00a0with Breast Cancer Research<\/h3>\nCharles A. Coltman Jr., MD, oncology trailblazer and co-founder of the San Antonio Breast Cancer Symposium, served as medical director of the Cancer Therapy & Research Center, which is now known as the Mays Cancer Center, home to UT Health San Antonio MD Anderson Cancer Center.<\/figcaption><\/figure>\n
In 1978, Dr. McGuire and Charles Coltman Jr., MD, medical director of the Cancer Therapy & Research Center (now UT Health\u2019s Mays Cancer Center), organized a small group of oncologists for a one-day meeting at a local hotel. Propelled by Dr. Coltman\u2019s and Dr. McGuire\u2019s determined leadership, this gathering of physicians was the first meeting of what is now the largest, most significant breast cancer symposium in the world, the San Antonio Breast Cancer Symposium.<\/p>\n
The opportunity to be involved with the San Antonio Breast Cancer Symposium was one of the reasons Dr. Kaklamani decided to come to UT Health San Antonio from Northwestern University.<\/p>\n
\u201cIt is the largest breast cancer symposium in the world. We have over 8,000 attendees coming from all over, every year,\u201d said Dr. Kaklamani, professor of medicine in the Division of Hematology\/Oncology at UT Health San Antonio. \u201cAll of the new research in breast cancer comes through this symposium.\u201d<\/p>\n
Decades after its founding, the symposium continues to bring together basic and clinical research, with the goal of accelerating both. Dr. McGuire foresaw the benefit of getting researchers in both the clinic and the lab to understand what each group was doing. It was translational research in practice before the term became popular. The symposium\u2019s spirit of collegiality and collaboration was an extension of the culture being built at UT Health San Antonio.<\/p>\n
Patrick Sung, DPhil, world-acclaimed biochemist and associate dean for research for the Long School of Medicine at UT Health San Antonio, believes the institution has a long trajectory of future growth because of its cooperative culture. Dr. Sung received the prestigious National Cancer Institute Outstanding Investigator Award and Recruitment of Established Investigators Award from the Cancer Prevention and Research Institute of Texas in 2019 and fosters\u00a0a collaborative ethic in his lab.<\/p>\n
\u201cCulture is key,\u201d said Dr. Sung, the Robert A. Welch Distinguished Chair in Chemistry and co-leader of Cancer Development and Progression at the Mays Cancer Center. \u201cFor a place to rise and be productive, it must be collegial and collaborative. Now, my best collaborators are in the same building.\u201d<\/p>\n
The culture at UT Health San Antonio is a selling point when recruiting researchers and patients, said Dr. Gius, associate director for translational research at the Mays Cancer Center, and a recipient of the Recruitment of Established Investigators Award from the Cancer Prevention and Research Institute of Texas.<\/p>\n
\u201cUT Health San Antonio has a long history of being a cooperative and collaborative institution where investigators really do want to work together,\u201d he said. \u201cThat makes it fun.\u201d<\/p>\n
Dr. McGuire\u2019s rule to never create obstacles between basic and clinical research is still followed at UT Health San Antonio and helps to foster a close working relationship between the lab and the clinic. Collaboration accelerates discovery, resulting in the ability of breast cancer patients to access more sophisticated, targeted therapeutic options more quickly.<\/p>\n
The Next Ten Years<\/h3>\n
Dr. Sung believes the next decade will yield major discoveries in cancer research. His lab focuses on DNA repair mechanisms, a better understanding of which may yield more effective treatments. His lab hopes to identify new targets and develop precise genomic therapies.<\/p>\nPatrick Sung, DPhil, world-acclaimed biochemist and associate dean for research for the Long School of Medicine at UT Health San Antonio, and his research team are developing therapies for breast cancer caused by DNA repair defects.<\/figcaption><\/figure>\n
\u201cResearch into the repair of these DNA double-strand breaks will give us a better understanding of how to manipulate the pathway for therapeutic gains,\u201d Dr. Sung said. \u201cThis could be applicable across tumors and would help with drug resistance by shutting down the tumor\u2019s ability to repair itself.\u201d<\/p>\n
\u201cAs you look at the next ten years what we are going to be seeing is a lot more targeted approaches based on the genomic makeup of the tumor and that genomic makeup actually changes over time,\u201d Dr. Kaklamani said. \u201cInstead of just looking at one time point, we are going to be looking at different time points and adjusting our treatments over time to fit how the cancer is evolving.\u201d<\/p>\n
Dr. Kaklamani believes there is much work to be done in the early detection and prevention of breast cancer. She said community efforts must engage underserved patients and health care providers must promote breast cancer screenings to the broader community. Early detection reduces health care inequalities, she noted.<\/p>\n
\u201cAround 60 percent of our patients are Hispanic, and about 60 percent of this population is underserved, and this comes with its own challenges. We know from many, many studies that patients that have a low socioeconomic status have worse outcomes,\u201d Dr. Kaklamani said.<\/p>\n
Along with reaching out to underserved communities to address inequalities in breast cancer treatment, UT Health San Antonio is promoting prevention through early detection. Educating women on preventing breast cancer is key to reducing health inequality and saving lives.<\/p>\n
An effective prevention plan starts with identifying individuals who have a high risk for breast cancer, Dr. Kaklamani said. Once they know their breast cancer risk, patients can make more informed decisions regarding preventative therapies.<\/p>\n
Investments made in UT Health San Antonio\u2019s cancer genetics program help identify women at high risk. Genetic counselors then educate patients and provide personalized prevention strategies. This program reduces costs by preventing much more expensive treatment options required when breast cancer is detected later, Dr. Kaklamani said.<\/p>\n
This approach is improving patients\u2019 odds of surviving breast cancer. It is just one of many efforts at UT Health San Antonio that brings together basic science and clinical research to propel discovery\u2014a fitting legacy to Dr. William L. McGuire.<\/p>\n","protected":false},"excerpt":{"rendered":"
Researchers at UT Health San Antonio know that breast cancer is not one disease but many. Scientists are studying the genetic makeup of specific breast cancers to create targeted therapies that individualize treatment. <\/p>\n","protected":false},"author":43,"featured_media":2482,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[11,12],"magazine":[22],"issue-year":[47],"featured-story":[37],"class_list":["post-2449","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-patient-care","category-research","magazine-future","issue-year-47","featured-story-landing-page"],"yoast_head":"\n
Winning the War Against Breast Cancer: One Battle at a Time - Magazines of the Schools at UT Health San Antonio<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/magazines.uthscsa.edu\/schools\/2021\/11\/15\/winning-the-war-against-breast-cancer-one-battle-at-a-time\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Winning the War Against Breast Cancer: One Battle at a Time - Magazines of the Schools at UT Health San Antonio\" \/>\n<meta property=\"og:description\" content=\"Researchers at UT Health San Antonio know that breast cancer is not one disease but many. 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