M. D. Anderson Receives $4 Million From Texas State Legislature To Fund Inflammatory Breast Cancer Research
Clinic, Research Program Dedicated in Memory of Morgan WelchM. D. Anderson News Release 10/25/07
The University of Texas M. D. Anderson Cancer Center announced today (Oct. 25) that it has received a $4 million appropriation from the Texas Legislature for research into a rare, aggressive and often lethal type of breast cancer, inflammatory breast cancer (IBC).
Also today, M. D. Anderson celebrated Morgan Welch, a young woman who died from IBC at the age of 24, by dedicating its facility and commitment to the disease in her memory, the Morgan Welch Inflammatory Breast Cancer Research Program and Clinic.
M. D. Anderson unveiled the IBC clinic and research program last October; both are the first of their kind in the world dedicated to IBC.
"The IBC research program and clinic offer yet another opportunity for M. D. Anderson to lead in clinically-oriented research for a hard-to-treat cancer - one hallmark of this institution," says John Mendelsohn, M.D., president of M. D. Anderson. "We must understand why this disease is so different, why it is so resistant to treatment and, ultimately, we must accelerate the development of new therapies that improve the well-being of all women who suffer from it. We are grateful to the state leaders in helping us recognize this goal for women who are in great need."
Appropriated in the most recent legislative session, M. D. Anderson will receive $2 million a year for the next two years.
M. D. Anderson has always been at the forefront of not just treating and researching cancer, but also sharing its knowledge with the world," says Lt. Gov. David Dewhurst, who took part in today's ceremonies and was instrumental in securing the funds. "It's our hope that the state's $4 million investment will provide critical infrastructure for this much-needed research program, allowing M. D. Anderson to make a difference for women with inflammatory breast cancer in Texas and beyond."
A Different Kind Of Breast Cancer
IBC is rare - representing just 1- 2% of all breast cancers diagnosed in the U.S. Unlike other breast cancers that present as a lump, IBC's symptoms are dermatological and include: redness, swelling, and warmth in the breast, skin that is reddish, purple or bruised, has ridges and/or appears pitted like an orange. Other symptoms can include burning, aching or tenderness, an increase in breast size, and/ or an inverted nipple.
A fast-growing and extremely aggressive cancer, women with IBC are more likely than other women with breast cancer to be misdiagnosed initially and ultimately diagnosed after the disease has metastasized. Before the incorporation of chemotherapy into the initial treatment of IBC, less than 5% of women survived five years. Now, 40% of women diagnosed with IBC and treated with combined modality therapy that was developed at M. D. Anderson, will live five years.
Further complicating diagnosis, the disease often cannot be detected via a mammogram, like other breast cancers. Though still under study, Positron Emission Tomography (PET) scans and magnetic resonance mamography have shown promise as imaging tools for IBC, allowing more of the disease to be seen, including lymph nodes far from the breast. PET scans also determine if there is metastatic disease at the time of diagnosis, says Massimo Cristofanilli, M.D., associate professor in M. D. Anderson's Department of Breast Medical Oncology and Director of the Morgan Welch Inflammatory Breast Cancer Research Program and Clinic.
Current treatment for IBC includes chemotherapy, surgery, radiation, targeted therapy and/or hormonal therapy when appropriate. There are no drugs approved for the specific treatment of IBC.
Morgan Welch Inflammatory Breast Cancer Research Program
"While tremendous strides have been made in the overall treatment of breast cancer, there's been very little research into this rare disease that behaves so differently than other breast cancers," says Gabriel Hortobagyi, M.D., professor and chair of M. D. Anderson's Breast Medical Oncology. "The global cancer community will stand to benefit from our comprehensive research program and what we learn about this disease. The only way to achieve better outcomes for women with the disease is to have dedicated resources, such as the funds allocated by the state legislature, for continued IBC research."
The IBC research program is multidisciplinary in scope and features clinical, epidemiology, basic research, immunobiology, translational and imaging components. Examples of specific objectives of the IBC research program include the development of:
- molecularly targeted therapies in the neoadjuvant setting for patients with newly diagnosed non-metastatic IBC and adjuvant trials that specifically target the molecular characteristics of IBC;
- a databank including serum, plasma, photos, clinical and demographic data in order to improve the clinical definition of IBC;
- hypothesis-driven research in an effort to have a better appreciation of the immune mechanisms related to the pathogenesis of IBC;
- a PET-CT protocol for patients at diagnosis and to explore the role of PET-CT in monitoring the response of therapeutic agents;
- the infrastructure for the appropriate in-vitro and in-vivo testing of novel agents and combinations that are identified as specifically significant to IBC and to identify the molecular factors that result in metastasis or drug resistance in IBC;
- tools for detection and characterization of micrometastatic disease to better identify patients at high risk of recurrence.
Ongoing IBC Research
Last December, Cristofanilli presented findings from the first multi-center and international trial ever conducted for IBC. The phase II study showed that the experimental biological agent lapatinib, an epidermal growth factor receptor and HER2neu tyrosine kinase inhibitor, successfully treats IBC patients who have EGFR and/or ER positive tumors.
"For IBC patients, these results should be very encouraging because there's now more of a dedicated research direction for a type of breast cancer that has long been ignored and misunderstood. With lapatinib, we finally have a drug on which to build effective therapy - we just have to refine the most effective way to use it," says Cristofanilli.
Follow-up clinical trials with lapatinib for IBC are ongoing and include a large Phase III trial for patients with metastatic IBC combining the drug with an antioangiogenic agent pazopanib. A second trial, to be conducted only at M. D. Anderson, will look at lapatinib and chemotherapy in the preoperative setting.
In the year since the clinic opened, M. D. Anderson has seen approximately 100 women with IBC, 75 of whom were newly diagnosed patients - more than any other institution in the world, says Cristofanilli.