This article first appeared in the St. Louis Beacon, June 11, 2009 - Participants in the Susan G. Komen Race for the Cure often say they are running for their mothers, sisters and friends -– either in their memory or to celebrate them as survivors. They also, of course, are running to raise money to treat and maybe someday cure breast cancer.
In 2008, the Susan G. Komen for the Cure Foundation in St. Louis raised $3.3 million in net proceeds for that purpose. Up to 75 percent of the money stays in St. Louis in the form of grants for community programs and research.
Dr. Cynthia Ma may not get to run this Saturday, but she is one of those who is hoping to convert those dollars into tangible results for women with breast cancer. Ma is an associate professor in oncology at the Washington University School of Medicine. She has been given $192,696 for research aimed at preventing breast cancer from spreading to other parts of the body.
Her daughter's ballet recital falls on the same day as the race this year. “ I have to talk to them. ... I wonder why they have to pick the same exact day,” Ma said with a laugh.
Ma came to Washington University in 2005, and for every race, she has been out of town or in meetings.
“This is embarrassing, but somehow I'm never getting that chance,” she said.
The money comes from a special program know as the Research Affiliates Funding Trials. The program supports efforts to overcome educational, cultural, linguistic, financial and geographic barriers that keep women from participating and staying in clinical trials. An independent panel of medical professionals, breast cancer survivors and public health professionals selected Ma for the grant.
Ma became interested in breast cancer research during her hematology and oncology fellowship at the Mayo Clinic in Minnesota. She spent her last two years at the clinic studying a gene that creates estrogen.
Usually it is difficult to find time to complete research in a private practice, Ma said. After graduating from her fellowship at the Mayo Clinic, she fielded offers from both private practices and Washington University. The ability to participate in research, while still being able to see patients, was part of the reason she came to Washington University in 2005.
“When you're in a university, you have support from the institution, which is very important, and you have support from your colleagues,” Ma said.
While the research is fascinating, Ma says it is gratifying, too, working with breast cancer patients. Frequently, doctors work with patients diagnosed with breast cancer for a much longer time compared to other types of cancer.
“When you're treating patients, you make a difference in what they're disease course is,” Ma said.
She sees patients once a week at Washington University's Center for Advanced Medicine at Forest Park and Euclid avenues. When she hears patients are in the hospital, she'll sometimes stop by and visit them. There are also the occasional funerals for patients that she attends.
Ma's research focuses on a Phase I and II clinical trial that treats metastatic breast cancer, or cancer that has spread to other parts of the body. A Phase I trial identifies the optimum dosage of the drugs being used, while Phase II tests how well the drugs are working. Ma's trial, which is in Phase I, tests the effectiveness of two drugs. The drugs, IMC-A12 and Temsirolimus, should inhibit breast cancer from growing when combined. The trial is currently in its third year.
So far, the work has been promising. “In the cell culture, this works really well,” Ma said.
Phase I includes about 20 participants, and Phase II has a maximum of 50 participants. The drugs, when working together, should target a cell's growth factor pathway. The pathways can be affected by the genetic abnormalities of cancer cells, and then are stimulated to grow more than necessary. Both drugs are necessary because, if only one is used, the cell can adapt and continue growing.
If successful, the treatment would serve as another option for people with metastatic breast cancer. Current treatments include hormone therapy and chemotherapy. Hormone therapy involves adding, blocking or removing specific hormones to stop the cancer's growth. However, half of patients do not respond to this approach. Chemotherapy is also used. But it cannot target specific areas and a patient must deal with a number of side effects.
“These targeted drugs are really designed specifically to inhibit cancer cell growth,” Ma said.
Part of the trial is paid for between the National Cancer Institute and a participant's insurance. NCI covers the cost of drugs, while a participant's insurance covers most other costs, such as infusion of the drugs.
The research trials grant will cover the costs of tumor biopsies and advanced analysis that neither the NCI nor insurance companies can support. The biopsies and analysis are crucial for determining why some patients responded to treatment and why others did not.
Funding is only guaranteed for one year. However, researchers can reapply for additional funding the following year.
Outside of the lab, Ma enjoys reading -- when she can find a spare minute. “Whenever I'm not taking care of the kids, I'm doing something related to either research or things related to patient care. I cannot even tell you the number (of hours),” Ma said.
“I'm too busy -- labs and kids. Not too much time to do anything else.”
Sarah Scully, a student at the University of Missouri, is an intern with the Beacon.