As you’ve probably seen, Avastin is back in the news, and while the media have asked lots of experts to weigh in, the reality is that right now we don’t yet know what these new findings really mean. Research involves doing experiments in different conditions and making observations. Eventually the data points us to an explanation of the mechanism of the drug and sometimes even some insight into how cancer works. Then clinical trials are done to help us decide whether the drug is effective and which people can benefit from taking it.

In this regard, bevacizumab (Avastin) is still a work in progress. To understand how Avastin works, you need to know that in order to grow, all cells require a blood supply to bring them oxygen and nutrients. This includes cancer cells. And because cancer cells have an inherent need to grow, they need a larger blood supply than typical cells. To get all the oxygen and nutrients they need, cancer cells secrete a protein called vascular endothelial growth factor, which stimulates more blood vessels to grow and feed them.
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When it comes to medicine, all too often we think, “Well, if a little is good for you then more must be better!” But three studies published this month alone underscore why, when it comes to our health, more may actually be more than we need.

The first study I want to tell you about was conducted by the Study of Osteoporotic Fractures Research Group, and was published in the current issue of the New England Journal of Medicine. Its focus was bone mineral density testing for older women.
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Once again we are returning to the question of whether menopausal hormone replacement therapy (HRT)increases breast cancer risk.

The recent issue of Journal of Family Planning and Health Care contains an article by two researchers who argue that the data used in the previously reported Million Women Study is too flawed to support its widely-heralded finding that HRT use increases breast cancer risk.

The Million Women Study is an observational study that found that women who used estrogen and progestin had an increased risk of developing breast cancer. It is well understood that epidemiologic studies like the Million Women Study can only prove correlations, and not cause and effect. In fact, there are several observational studies that supported the use of HRT to prevent heart disease, a finding that was not born out when randomized trials were done.
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Most people who have heard me talk know that I am focused on finding the cause of breast cancer so that we can prevent it. Many people have suggested that the answer may well be the environment. The recent Institute of Medicine Report on Breast Cancer and the Environment noted the known risk factors such as hormone replacement therapy, obesity and alcohol. But what about all the chemicals that are ubiquitous in our lives? Could they be culprits? The IOM said it couldn’t answer this question because not enough research has been done.
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I want to begin the New Year by sending a heartfelt thank you to each and every one of you who contributed to our year-end appeal. I couldn’t have imagined a better way to step into 2012 than with the show of support you provided through your generous donations totaling more than half a million dollars!

I know that many of you have watched and have been inspired by the short video message I posted talking about the Foundation’s research and our goals for 2012. If you haven’t had the opportunity to see it yet, you can view the video here.

I also want to share with you the list of New Year’s Resolutions we developed at the Foundation. If there are any you think that we should add to the list, please let me know!
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You don’t have to spend very long with a group of breast cancer survivors before you hear one of them mention chemobrain—even if it is just a throw-away line used to excuse a memory lapse. While these symptoms, such as easily becoming distracted or having difficulty remembering names and words, are all-too-familiar to many survivors, they often have been dismissed by medical professionals. But now, thanks to researchers who took these concerns seriously, we’ve got two recently published papers that clearly substantiate survivors’ experiences.
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The mornings often start with a presentation about a particular topic before the research reports.  Thursday started with a terrific presentation “Macrophages as Novel Targets for Therapy in Breast Cancer,” by Lisa Coussens, PhD, a pathologist at the University of California, San Francisco.

In order to develop cancer, you need both mutated cells and for the cells to be in a local environment, or neighborhood, that is egging them on. A lot of attention has been paid at this meeting to how cancer cells differ from normal cells and how we can develop targeted therapies that exploit that difference to kill them. Dr. Coussens’ presentation looked at one part of the neighborhood—the immune system.
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Three reports that have already been in the press are being presented today at the San Antonio Breast Cancer Symposium.

The first is the Bolero (Breast Cancer Trials of Oral Everolimus) study, which was familiar to many of us here as it was presented in November at a conference in Europe. What makes this study interesting is that it demonstrates a technique for reversing resistance to an aromatase inhibitor with the drug Everolimus, which is currently used to treat kidney cancer. Everolimus works by targeting the protein called mTor, which is thought to be involved in endocrine resistance. The additional months of progression free survival seen in this study survival may or may not be clinically relevant but it proves that this approach has merit.
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With the season of giving upon us, I want to begin by thanking you for how much you have given to me this year by supporting the Dr. Susan Love Foundation and our primary goal: finding the cause and prevention of breast cancer.

I also want to thank you for your commitment to helping me get the message out that awareness is NOT enough. We’ve now had 25 years of breast cancer awareness—and we still don’t understand the cause or ways to prevent this disease.  And the cure is NOT enough either. Not if it means surgery, chemotherapy, radiation, hormone therapy, and targeted therapy—all of which have side effects and cause long-term collateral damage to our bodies!
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As promised, here’s the first update from the San Antonio Breast Cancer Symposium.

The morning started with several studies that looked at whether adding bisphosphonates (osteoporosis drugs) to the treatment of women with metastatic breast cancer could decrease bone mets as well as improve breast cancer survival. The studies found that there is a small benefit which was most evident in women who had what the researchers called a “low estrogen environment.” (I think that means menopause whether naturally occurring or medically caused by drugs or surgery.)

A new report from the Institute of Medicine, “Breast Cancer and the Environment: A Life Course Approach” was presented to an expectant audience.  The report, pursued at the request of and funded by Komen, did not, however, have any new information or smoking gun. The IOM committee defined environment widely to include any factor other than inherited DNA. This meant that they included lifestyle changes, which ended up comprising the bulk of their recommendations.
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