RESEARCH: From Bench to Bedside

 

Dr. Ann Killary, chief of the Section of Experimental Laboratory Medicine, leads a group of scientists doing gene discovery research.

 

 

Ensuring an accelerated growth of basic, translational and clinical research was one of five major initiatives identified early in the last fiscal year by M. D. Anderson's then-new president, Dr. John Mendelsohn.

 

After a number of meetings with the faculty during his first year, he began setting research goals for continuing the institution's widely recognized pace of progress against cancer. A major group of research targets focus on the new knowledge that has been gained about the molecular causes of cancer.

 

Dr. Mendelsohn explains, "During the past decade we have discovered what causes cancer. Cancer results from damage, or mutations, in the genes that control and regulate the growth of cells in our bodies. Some of this genetic damage is inherited, but most of these flaws accumulate over our lifetime as a result of exposure to carcinogenic agents and the constant wear and tear that takes place during the normal proliferation of the many billions of cells we all have. We believe cancer occurs when some of the critical growth-controlling genes in a single cell, perhaps three to five of them, have sustained genetic damage, which enables that cell to proliferate out of control."

 

The research targets that will build on this new knowledge include:

 

· Create a new Department of Human Cancer Genetics, which will aim to discover and further characterize genetic mutations that can cause cancer.

 

· Expand the molecular diagnostic capabilities in pathology to identify the specific genetic defects in individual tumor specimens from patients. This information will be matched with responses to treatment and outcomes so that researchers can correlate precise disease patterns and responses with specific genetic changes.

 

· Establish a multidisciplinary research program in molecular therapeutics to develop new treatments that target individual genetic abnormalities in cancer cells. This initiative will build on strong research already under way to correct or replace genes involved in the cancer process.

 

· Develop better approaches to genetic counseling, prevention and early detection based on new knowledge about the genetic causes of cancer.

 

Additional priority research targets for growth are:

 

· Acquire greater understanding of the molecular, biological and physiological processes that sustain life in cells and organisms.

 

· Expand health services and outcomes research on new systems that will improve cancer care and also allow better measurement of both the quality and the cost of care.

 

Basic, translational and clinical research at M. D. Anderson form a research continuum that facilitates studying problems of mutual interest to investigators. In preparing to renew the cancer center's core support grant from the National Cancer Institute, research activities at M. D. Anderson were organized into 28 specific programs, which comprise seven basic science research programs, 18 clinical research programs and three population-based research programs.

 

Basic science programs involve investigations in biochemistry and molecular biology, biomathematics, carcinogenesis, cell biology, immunology, molecular genetics and tumor biology. The clinical research programs consist of 11 disease site programs, such as those for lung cancer and breast cancer, and seven thematic group programs. The thematic groups include bone marrow transplantation, cancer drug development, gene therapy/molecular therapeutics and others. Population-based research centers on behavioral science, clinical cancer prevention and epidemiology.

 

"M. D. Anderson faculty who participate in these research programs continued over the last year to compete successfully for major federal grants and to receive private support so important to sustaining the overall research effort," says Dr. Frederick F. Becker, vice president for research, scientific director of the Tumor Institute and holder of the Hubert L. and Olive Stringer Chair in Basic Science in honor of Sally Stringer.

 

"We now have in excess of 150 grants from the National Cancer Institute, which last year was more than any other institution. Among these are 14 substantial program project grants and other major grants for interdisciplinary research that involve the majority of our faculty. The program project grant in radiation oncology dates back 35 years, while the program project grant for studying the biology of non-melanoma skin cancer growth and progression has just entered its second year," Dr. Becker says.

 

During the last year, the Office of Protocol Research coordinated and tracked more than 600 clinical trials, which compare new cancer treatments against standard therapies.

 

About 6,500 patient registrations were recorded for these studies at M. D. Anderson, which for many years has conducted the largest number of clinical trials in the country.

Dr. Leonard A. Zwelling, associate vice president for clinical and translational research, says sizeable progress was made in 1996-97 to make the entire clinical trial process more efficient. He cited these highlights:

 

· Created an office for clinical research quality assurance to audit studies and expedite problem-solving.

 

· Established an Office for Clinical Research Finance to better evaluate the cost of clinical trials and help predict total costs before a trial begins.

 

· Set up a clinical trial document online system that replaces much of the paperwork by allowing investigators to use computers to submit proposed studies, enroll patients and monitor the results.

 

Three hundred of M. D. Anderson's clinical trials were posted on a World Wide Web site (www.clinicaltrials.org), giving cancer patients everywhere timely information on the Internet. Clinical trials can be viewed by cancer type, by name of physicians directing the studies or by the treatment agents being used in the study. Industry supported studies that contain proprietary information are not posted on the Internet without permission of the sponsors.

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