Victoria Seewaldt, MD, professor of medicine (Medical Oncology) and director of the Breast Cancer Prevention Program at the Women’s Wellness Clinic, received a National Institutes of Health R01 grant for a study called Targeted Chemoprevention of Breast Cancer: From the Bench to Clinical Testing.
The grant, which has grown out of collaboration between Duke University and CAARE Inc., a Durham-based nonprofit that provides healthcare to low-income community members, will look at precancer signaling and pathways associated with invasive triple-negative breast cancer and propose specific interventions to turn off those pathways before the disease begins its aggressive assault on premenopausal women.
“We used to think of breast cancer as going through specific stages,” said Seewaldt. “It was assumed that it would take many years for precancerous cells to develop into a tumor. “
But, Seewaldt said, women with aggressive cancer often see rapid development of cancer within 12 months. For these women, diligent screening is needed to catch the disease in time for treatment. Now Seewaldt and her co-investigators are looking to identify the biological origins of aggressive triple-negative breast cancer.
“We want to know if the bad nature of aggressive cancer lives in cells ahead of time,” said Seewaldt. “If it does, we can find and target the pathway.”
[quote]The goal here is to provide breast cancer prevention that helps to improve the health of the whole woman and is affordable[/quote] Triple-negative breast cancer means that the cancer tests are negative for estrogen, progesterone and HER2 receptors, so hormonal therapies and treatments targeting those receptors don’t work. Between 10 and 20 percent of breast cancers are triple-negative, and finding a cost-efficient treatment or prevention strategy for women susceptible to this type of cancer is an ongoing struggle for researchers.
Seewaldt said her current work looks at the biology of high-risk networks, including the insulin and IL-6 signaling pathways, which are activated in women with aggressive breast cancer. These are the same pathways and high-risk networks linked to obesity. She identified these pathways after using random periareolar fine needle aspiration to collect a number of atypical cells from the breasts of women with aggressive breast cancer. Subsequent glucose testing among these women showed insulin resistance.
“Every time they eat they are activating aggressive cancer pathways,” said Seewaldt. “For these women, lowering insulin means lowering glucose.” And lowering glucose may help deactivate the pathways that lead to aggressive cancer.
To access and regulate the insulin pathway, Seewaldt’s study will use Metformin, an older diabetes medication that controls the amount of glucose in the blood. It’s the opposite of narrowly targeted, expensive cancer drugs, but Seewaldt said Metformin makes sense for Durham’s predominately African-American patient population.
“The goal here is to provide breast cancer prevention that helps to improve the health of the whole woman and is affordable,” said Seewaldt. “Expensive drugs would not be widely available for members after the trial.”
Seewaldt also said Metformin, which costs $4 per month, is a socially acceptable medicine because many people recognize it from diabetes treatments.
This grant was funded under the new NIH review system. Dr. Seewaldt said that she worked with NIH program officials to assist them in presenting the grant to Dr. Harold Varmus for review.
“This was a nerve-wracking and long process. I am very grateful to be funded.” said Seewaldt. “I am also happy to help anyone who with going through this process.”
Studies of signaling pathways that are activated during breast cancer initiation are ongoing. Seewaldt anticipates that the metformin prevention trial will star within the next year.
But, Seewaldt said, women with aggressive cancer often see rapid development of cancer within 12 months. For these women, diligent screening is needed to catch the disease in time for treatment. Now Seewaldt and her co-investigators are looking to identify the biological origins of aggressive triple-negative breast cancer.
“We want to know if the bad nature of aggressive cancer lives in cells ahead of time,” said Seewaldt. “If it does, we can find and target the pathway.”
[quote]The goal here is to provide breast cancer prevention that helps to improve the health of the whole woman and is affordable[/quote] Triple-negative breast cancer means that the cancer tests are negative for estrogen, progesterone and HER2 receptors, so hormonal therapies and treatments targeting those receptors don’t work. Between 10 and 20 percent of breast cancers are triple-negative, and finding a cost-efficient treatment or prevention strategy for women susceptible to this type of cancer is an ongoing struggle for researchers.
Seewaldt said her current work looks at the biology of high-risk networks, including the insulin and IL-6 signaling pathways, which are activated in women with aggressive breast cancer. These are the same pathways and high-risk networks linked to obesity. She identified these pathways after using random periareolar fine needle aspiration to collect a number of atypical cells from the breasts of women with aggressive breast cancer. Subsequent glucose testing among these women showed insulin resistance.
“Every time they eat they are activating aggressive cancer pathways,” said Seewaldt. “For these women, lowering insulin means lowering glucose.” And lowering glucose may help deactivate the pathways that lead to aggressive cancer.
To access and regulate the insulin pathway, Seewaldt’s study will use Metformin, an older diabetes medication that controls the amount of glucose in the blood. It’s the opposite of narrowly targeted, expensive cancer drugs, but Seewaldt said Metformin makes sense for Durham’s predominately African-American patient population.
“The goal here is to provide breast cancer prevention that helps to improve the health of the whole woman and is affordable,” said Seewaldt. “Expensive drugs would not be widely available for members after the trial.”
Seewaldt also said Metformin, which costs $4 per month, is a socially acceptable medicine because many people recognize it from diabetes treatments.
This grant was funded under the new NIH review system. Dr. Seewaldt said that she worked with NIH program officials to assist them in presenting the grant to Dr. Harold Varmus for review.
“This was a nerve-wracking and long process. I am very grateful to be funded.” said Seewaldt. “I am also happy to help anyone who with going through this process.”
Studies of signaling pathways that are activated during breast cancer initiation are ongoing. Seewaldt anticipates that the metformin prevention trial will star within the next year.