Genomic Studies Reveal a Tumor’s Secrets

Nikhil Wagle, MDBy Robert Levy

One day, the genome of a tumor will be as revealing as a tell-all memoir. Doctors will obtain a full report on each tumor’s genomic quirks – its vulnerabilities, defenses, survival strategies, even its history of advance and retreat. The revelations will help physicians decide which therapies, in which order and at what doses, are most likely to work.

At Dana-Farber and other centers around the world, the effort to understand tumors at such an intimate  level is well under way. Advances in DNA sequencing are enabling scientists to catalog the full extent of genomic abnormalities in many types of cancer. (The field of cancer genomics studies changes in tumor DNA.) The Profi   research project at Dana-Farber, Brigham and Women’s Hospital, and Boston Children’s Hospital has analyzed thousands of tumor tissue samples to identify the cancer-related mutations within them.

“Genomic research is key to our progress in women’s cancers,” says Eric Winer, MD, director of the Breast Oncology Program for the Susan F. Smith Center for Women’s Cancers at Dana-Farber.

Biology Influences Therapy

Breast cancer was the first solid tumor for which an understanding of the biologic features of the cancer had a major impact on therapy.  Finding that many breast cancer cells carry the estrogen receptor – an antenna for growth messages from estrogen – led to the discovery that tamoxifen and similar drugs could halt the growth of these cells by standing in estrogen’s way. For almost 40 years, tamoxifen has been a standard treatment for women whose breast cancer is fueled by estrogen.

Similarly, learning that some breast cancers have a surplus of the growth-promoting protein HER2 led to the development of agents that block HER2, most notably the drug trastuzumab (Herceptin).

“Today, diagnosing breast cancer by its molecular subtype, and selecting the appropriate targeted treatments, has become routine,” says Dr. Winer. “As we gain more insights into the molecular make-up of breast cancer, we are refining treatment even further.”

At the Susan F. Smith Center, for example, when hormone-sensitive breast tumors are removed during surgery, they’re often sent for genomic analysis by a  test called OncotypeDX. “Each tumor is assigned a score that helps us gauge how aggressive the cancer is and how likely it is to respond to chemotherapy,” says Erica Mayer, MD, MPH, a senior physician and breast oncologist in the Susan F. Smith Center. “The test helps provide assurance that chemotherapy is prescribed only for patients who are likely to benefit  from it.”

Genomic information is also opening treatment opportunities in other areas. “When breast cancer arises in women who carry mutations in the genes BRCA1 or BRCA2, the tumor cells’ capacity to repair their DNA is reduced,” says Judy Garber, MD, MPH, director of the Center for Cancer Genetics and Prevention at the Susan F. Smith Center. (Normally, BRCA1 and BRCA2 are involved in repairing damaged DNA; when they’re idled because of a mutation, DNA repair is hampered.) “If you know a tumor can’t repair DNA errors as easily, then part of your treatment strategy could be to exploit that weakness. Drugs capable of doing so include platinum- based chemotherapy agents and PARP inhibitors.”

Dana-Farber investigators were among the first to study the potential of platinum agents in breast tumors with BRCA mutations. With colleagues at Beth Israel Deaconess Medical Center, they’re leading a clinical trial of standard chemotherapy versus platinum chemotherapy in breast cancer patients who carry a BRCA mutation.

How a Tumor’s Genome Changes

Tumors evolve over time, acquiring new mutations as they grow and spread and encounter drug treatment. A newly diagnosed tumor may look markedly different, genomically speaking, from a tumor that has been wounded by multiple drug attacks.

Nikhil Wagle, MD

Nikhil Wagle, MD

Nikhil Wagle, MD, of the Breast Oncology Program at the Susan F. Smith Center, is exploring how, or if, a breast tumor’s genome changes when it becomes metastatic. In a project run by the Center for Cancer Precision Medicine (a joint effort of Dana-Farber, Brigham and Women’s Hospital, and the Broad Institute of Harvard and MIT), patients can agree to have a tumor sample analyzed when their cancer becomes metastatic or begins resisting the original drug. By comparing the genomes of these tumors with samples obtained before resistance developed, researchers hope to find explanations for drug resistance and metastasis – and provide a blueprint for new therapies.

In another project, Dr. Wagle is using social media to enlist metastatic breast cancer patients around the country to share their medical records, saliva, and tumor samples with his team. The project has a variety of research goals, including the identification of “exceptional responders” – patients who derive the greatest benefit from treatments that may not be effective for others. It has enrolled 1,500 patients in its first four months, a sizable number of whom qualify as exceptional responders. Researchers hope to learn what drives these tumors and why certain drugs are effective against them.

“We view this project as patient empowerment – a way for patients to participate in cutting-edge cancer research, no matter where they may live,” Dr. Wagle says.

Making Connections in Gynecologic Cancers

Scientists have made an impressive start in tracking the genomic irregularities in ovarian and other gynecologic cancers. They have discovered, for example, four common mutations in high-grade serous endometrial cancer.

From a molecular standpoint, gynecologic cancers are quite complex. “Every gynecologic cancer has a unique genomic composition,” Dr. Matulonis says. “High-grade serous ovarian cancers [HGSCs], for example, have few genetic mutations, but they have many copy number alterations – instances in which certain genes are deleted or amplified.”

Patterns are emerging amid the diversity. The Cancer Genome Atlas – a national effort to map the key genomic changes in several major forms of cancer – found that approximately 50 percent of HGSCs have alterations that hinder their ability to repair damaged DNA. As in breast cancer, researchers found that patients with HGSC whose tumors have mutations in the BRCA1 or BRCA2 DNA-repair genes often benefit from PARP inhibitors. Intriguingly, studies have shown that non-serous ovarian cancers, too, often have mutations in DNA-repair genes.

“The discovery of BRCA1 and BRCA2 mutations as indicators of a good response to PARP inhibitors represents one of the most important steps in personalized treatment for ovarian cancer,” Dr. Matulonis says. “As we learn more about HGSC, high-grade serous cancer of the endometrium, and triple-negative breast cancer, we’re finding they have a great deal in common at the molecular level.”

Researchers have also learned that ovarian tumors with an oversupply of the cyclin-E1 protein tend to have a poor prognosis. One reason is that, unlike other ovarian cancers, tumors with extra cycline-E1 can promptly repair the damage caused by chemo- therapy agents. They also don’t respond well to PARP inhibitors or existing targeted therapies.

Panos Konstantinopoulos, MD, PhD, of the Gynecologic Oncology Program at the Susan F. Smith Center, has received a large grant from the U.S. Department of Defense to explore three new strategies for disrupting the growth of this type of ovarian tumor. One involves drugs targeting a protein that helps cells respond to stress; another seeks to block the interaction of two key proteins in tumor cells; and the third involves molecules called microRNAs that may have a powerful anti-cancer effect when combined with other drugs.

Courtesy of Dana-Farber Cancer Institute

 

Potential New Drug for Triple-Negative Breast Cancer

Dana-Farber scientists this year identified a promising new drug for a form of breast cancer and discovered one way the disease can outmaneuver the drug. The findings, reported in the journal Nature, may lead to a more farsighted treatment strategy for breast cancers classified as “triple-negative” – one that uses drug combinations to both arrest the disease and prevent it from resisting front-line therapies. The dual approach could significantly extend patient survival times, the authors say.

Kornelia Polyak, M.D., Ph.D.

Kornelia Polyak, M.D., Ph.D.

 

“We found that a class of agents known as BET bromodomain inhibitors significantly impeded the growth of triple-negative breast cancer cells in laboratory as well as animal-model tests,” says Dana-Farber’s Kornelia Polyak, MD, PhD, the study’s co-senior author. “On the basis of these results, such inhibitors will be tested in patients with triple-negative breast cancer (TNBC) in a phase 2 study, and they’re also included in ongoing phase 1 trials.

“Even if these drugs prove successful, we know that cancer often manages to circumvent therapies and resume its growth,” Polyak says.

“By understanding the series of steps that allows TNBC cells to become resistant to BET inhibitors, we can devise approaches that use combinations of therapies to slow or prevent resistance.”

 

Courtesy of Dana-Farber Cancer Institute

 

 

Cape & Island Bakes

Just like in Boston, Boston Bakes has widespread partners throughout the North East. Our newest partnerships take us all the way to Cape Cod, Nantucket, and Martha’s Vineyard for a week of baking delicious desserts and fundraising right at the beginning of June. While our newest set of fundraising events, Cape & Island Bakes has grown relatively large in the few years it has been running, and now encompasses much of the seaside Massachusetts.

Just like in Boston, restaurants all up and down the seacoast partner with us to serve delicious desserts, such as fan favorites like Boston Creme Pie and Chocolate Chip Cookies, as well as seasonal fruit tarts, and raise money for the breast cancer research that our organization sponsors. Taking place from June 6th-12th, this years Cape & Island Bakes is as exciting as ever. This week of fundraising is even more important when taking into account that they have a 20% higher incident rate than the rest of the nation.

This year our Cape & Islands honoree is Linda Wheaton, the mother of our Director of Development and Communications, a six-year breast cancer survivor.

To see our list of partners visit here.

To donate click here.

We are also looking to highlight the stories of breast cancer survivors in the New England Area covered by Bakes for Breast Cancer! To share your story visit our page. You could be the inspiration for other people affected by breast cancer in your area.

 

Boston Bakes Rundown

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May is upon us! And with it, comes our first round of fundraising events: Boston Bakes. Boston Bakes is a whole week in May (2nd-8th) and it comprises  of restaurants, bakeries and retail partners from across the state, all involved in selling the baked goods that  will support the breast cancer research of Dr. Parsons. Dr. Parsons is seeking to revolutionize the way we treat breast cancer, and as a result improve the quality of life of patients across the country. A recipient of many awards, she is also the recipient of our research funds that were raised in 2015 and will be raised in 2016.

The event itself is a partnership amongst businesses and restaurants that have a passion for both dessert and cancer research. Some have been our partner for the full 17 years that Boston Bakes has been running, and some have only joined us this year. Boston Bakes’ scope encompasses all of the old and new, all partners in raising funds for breast cancer research. Currently there are two tracks that our partners can choose for Boston Bakes week: the 50% club or the standard club. For the standard, which is what many of our partners choose to do, is the choice of one Boston Bakes dessert, from which all the proceeds will be donated to the charity. The 50% club offers more variety, with the option to serve all of their desserts, from which 50% of the proceeds will go to Bakes for Breast Cancer. Both are a win-win for breast cancer and breast cancer research!

With over 150 partners for this years Boston Bakes events, there’s sure to be a diverse collection of dessert offerings across the state. Check them out on our Restaurants and Bakeries Page, and don’t forget to try out one of our many dessert offerings: from chocolate chip cookies to boston creme pies to berry desserts!

This is just the first round of Bakes for Breast Cancer events all across New England.
Rhode Island Bakes for Breast Cancer will take place May 8-14
Cape & Islands Bakes for Breast Cancer will take place June 6-12

For a complete list of participating establishments please visit our website.

Donations are greatly appreciated.

Donate

 

Young Investigators in Cancer Research

As you guys know, April is Cancer Control Month. So I thought I would take the time to highlight a young researcher looking for biological predispositions and responses to breast Parsons Bio Photocancer in the bodies of women: Dr. Heather Parsons. A graduate of Dartmouth College, she also received her Masters in Public Health from Johns Hopkins Bloomberg School of Public Health. After receiving her medical degree from Drexel University, she eventually completed her residency and fellowship at John Hopkins Hospital and joined Dana-Farber Cancer Institute.

Now a medical oncologist for the Dana-Farber Cancer Institute and an instructor at Harvard Medical School, Dr. Parsons is an innovative researcher focusing on the use of blood-based genomic biomarkers to understand individual women’s specific development of breast cancer and her response to treatment. Biomarkers, defined as “objective indications of medical state observed from outside the patient – which can be measured accurately and reproducibly” (National Library of Medicine), are more accurate than symptoms themselves, and will help Dr. Parsons determine exactly how much treatment is effective and necessary for each individual patient’s biological composition.

As cancer treatment stands right now, nobody really knows how much treatment is the right amount for any given patient. Many people will do as many treatments as possible, simply to do as much as they possibly can to eradicate their cancer. However, Dr. Parsons research is looking to discover whether this is actually necessary. With this research, Dr. Parsons is helping direct the course of treatment towards better care, and to help her patients live longer and better lives, not only in the United States, but potentially across the world. She has received many honors for her research and work, amongst them the Young Investigator Award from the American Society of Clinical Oncology.

Funds raised in 2015 and 2016, including those from Boston Bakes  2016, will benefit the research of Dr. Parsons, MD, MPH.

 

Trying a Video Recipe -Chocolate Almond Braid

almondbraid

Have you ever wondered how easy those video recipes really are? We’ve all seen them, a two minute long video with a delicious looking dessert recipe, but how often do we actually try them out? Well, I decided to try one of these recipes and see if reality matched the sweet image of dessert in the videos.

Tasty is the reigning authority on easy, delicious, and interesting desserts for bakers and novices alike, and so I took their Chocolate Almond Braid recipe for a whirl. It seems almost too easy and too delicious not to try. A crispy flaky pastry filled with gooey chocolate and covered in chopped almonds, it’s minimal ingredients and easy prep and baking time make it almost a no-brainer.

All you need is one sheet of puff pastry, a 3.5 oz chocolate bar, melted butter, and some chopped almonds; then bake it at 415 degrees Fahrenheit for 20-25 minutes. I followed the steps in the video closely, cutting the parts of the braid and folding them over the chocolate bar placed at the center carefully to mimic that of the video. I then covered it in a butter wash and sprinkled some almonds over the top of it. Going in to the oven, the dessert looked almost identical to the one in the video, and I was super confident that it would come out as easily as in the video. Coming out of the oven, however, was a whole other story!

The puff pastry was difficult to make stick to the chocolate when I was first folding the braid, and once it is fully baked it is deliciously flakey but the chocolate at the center isn’t gooey and stuck to the pastry itself. As well, the chocolate bar center doesn’t melt as easily as it does in the video, it gets hard and over heated in areas at the high temperature needed to bake the pastry. I used a milk chocolate bar that didn’t react well to the heat, so next time, I would recommend a different chocolate better for melting, and possibly baking for longer at a lower temp. The taste was much better than appearance in the end, proving that any pastry with melted chocolate at its center is bound to be delicious and popular. My experience with this endeavor? If you can get past the look of the pastry, it’s totally worth the experiment for a gooey and chocolatey dessert.

 

April Is Cancer Control Month

apr-cancer-month-icon
With April coming up at the end of this week, I thought I would highlight that April is in fact Cancer Control Month, as proclaimed by President Obama in 2015. In recognition of all of the researchers who dedicate their life to finding a cure for cancer in all of its form, and in dedication to those who continue to fight it, Cancer Control Month is to commemorate a battle for a future free from cancer. (Presidential Proclamation))

Breast cancer is the second leading cause of death amongst women, and is one of the most common types of cancer that affects over 246,000 new women every year, according to research by the American Cancer Society. Cancer Control Month is meant to bring public attention to the very real threat that all types of cancer, breast cancer among them, poses to the American public, and to honor the fight against cancer that many Americans face everyday.

This year’s funds will support the word of Dr. Heather Parsons, a young investigator at
Dana-Farber Cancer Institute and her work in biomarkers and treatment.

This month is meant to raise visibility for cancer research, just as our Boston, Rhode Island and Cape & Island Bakes for Breast Cancer events in the coming months do. By donating or volunteering, you can help contribute this month to research funding that is working to find a cure for cancer for a better future. Help raise awareness this month, and look out next month for our baking events in Boston, Rhode Island and the Cape & Islands, where you can get a sweet treat and help raise awareness and funding for cancer research.

 

2 Ingredient Cake

Screen Shot 2016-03-10 at 10.40.58 PM

If you love ice cream, then you’re almost always looking for new iterations of your favorite chilly dessert.

However, have you ever considered taking your favorite chocolate ice cream to the oven?

In one of Buzzfeed Tasty’s latest dessert recipes, they bring us a twist on our favorite ice creams that’s certainly going to be popular for bake sales and family gatherings alike: Ice Cream Bread. Not only is it bound to be delicious, but it’s super simple with only two ingredients.

As the video demonstrates, all you need is a pint of your favorite ice cream and 1 1/4 cups self-rising flour, melted and mixed together to create this delicious treat that anyone with a sweet tooth will certainly love. Bake it in a bread pan at 350 degrees for 40 minutes, and out pops a cake that tastes just like that pint of Ben n Jerry’s you love.

What’s great about this dessert is it’s super customizable, so you can choose literally any flavor of ice cream, and mix in whatever sprinkles or candies you want, and it’s still guaranteed to be tasty. Bring this dessert to your next fundraiser or bake sale, and it’s sure to be a hit.

 

The Stars of Tomorrow are the Young Investigators of Today!

The stars of tomorrow are the young investigators of today.

Bakes for Breast Cancer will now be funding the up and coming research of young investigators in breast cancer research.   Our Medical Advisory Board will direct the best use of our funds raised in the support of the young investigators.

Funds raised in 2015 and 2016 will benefit the research of Heather A. Parsons, MD, MPH. a young investigator at Dana-Farber Cancer Institute in Boston, Massachusetts.

Parsons Bio Photo

Heather A. Parsons, MD, MPH

We would like to introduce you to Dr. Heather Parsons and how the money that will be raised through our events in 2016 will be used.

Heather A. Parsons, MD, MPH is a medical oncologist at Dana-Farber Cancer Institute (DFCI) and Instructor of Medicine at Harvard Medical School. Dr. Parsons’ research focuses on breast cancer and the use of blood-based genomic biomarkers to understand the course of a woman’s breast cancer and response to treatment. Ultimately, she aims to develop these biomarkers to better direct existing treatments, to avoid overtreatment, and to develop new treatments to help patients live better, longer lives.

Dr. Parsons is a graduate of Dartmouth College and has a Master in Public Health from Johns Hopkins Bloomberg School of Public Health. She received her medical degree from Drexel University College of Medicine, followed by internship and residency in Internal Medicine at Johns Hopkins Hospital. She then completed a fellowship in Medical Oncology at Johns Hopkins Hospital before joining the faculty at Dana-Farber Cancer Institute. Dr. Parsons’ honors and awards include a Young Investigator Award from the American Society of Clinical Oncology. She is a member of the American Society of Clinical Oncology, the American Association for Cancer Research and the Translational Breast Cancer Research Consortium.

Please help raise more money for Dr. Parson’s research efforts in the work of developing biomarkers to better enable the treatment of breast cancer.

You can help in numerous ways! Bakes for Breast Cancer is 501(c) 3 nonprofit breast cancer organization determined to make a difference in a disease that touches so many we know, love and have loved.

Donate! Sponsor our organization! Volunteer! Participate in Boston Bakes for Breast Cancer, Rhode Island Bakes for Breast Cancer, Cape & The Islands Bakes for Breast Cancer! Enjoy a dessert for a cause during one of our Bakes for Breast Cancer weeklong events at a participating! Hold a Cooking Class in our Cooking Series! Hold a Bake Sale or an Office Bake Sale! There are many sweet ways to make a difference.

Help us do more!

 

 

Happy Valentines Day!

v day card 2016