Innovative statewide UC Medical Center collaboration targets breast cancer

San Diego 30 September 2009The Moores University of California San Diego (UCSD) Cancer Center is participating in an unprecedented statewide University of California collaboration to improve care for breast cancer patients by designing and testing new approaches to research, technology and health care delivery. Named the ATHENA Breast Health Network, the groundbreaking project will initially involve 150.000 women throughout California who will be screened for breast cancer and followed for decades through the five UC medical centres. ATHENA is a University of California system-wide project supported by a $5,3 million University of California grant, and by a $4,8 million grant from the Safeway Foundation.

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Women who present for breast cancer screening at the five UC medical centres and their affiliates will be offered participation in the ATHENA Breast Health Network. All women undergoing screening and treatment will be asked to contribute information about themselves, any risk factors they have, including health status, and other related lifestyle behaviours, such as diet, tobacco and drug use, environmental factors, gynaecological history and family risk. This information will be used to help target prevention services now and in the future.

Women diagnosed with breast cancer will be offered enrollment in a "survivorship cohort" comprised of women who have been diagnosed with breast cancer. The UC system is particularly well-positioned for a project of ATHENA's magnitude because the medical centers annually screen as many as 80.000 women, and diagnose 2500 patients with breast cancer. The project is expected to generate a rich collection of data and knowledge that will shape breast cancer care in the way the renowned Framingham heart study changed the care of patients with heart disease.

"ATHENA is a model of multi-institutional collaboration and demonstrates the enormous potential in shared systems", stated John D. Stobo, MD, UC senior vice president for health sciences and services. "This is a great example demonstrating that the total of what can be accomplished by UC functioning as a system far exceeds the sum of contributions by the individual campuses. ATHENA represents an unprecedented opportunity to play a leadership role in driving critical changes in health care. The public nature of the UC institutions make them uniquely positioned to study the appropriateness and effectiveness of treatment. It also allows for the applied use of new scientific evidence, much of which has been developed in the UC medical centres, to truly change the delivery of care."

Moores UCSD Cancer Center principal investigator Barbara Parker, MD, medical director for oncology services, stated: "The ATHENA Breast Health Network at UCSD has brought together a multi-disciplinary group of physicians and investigators. By partnering in this unique collaboration, the five UC cancer centres are positioned to develop new approaches to screening, treatment, survivorship and personalized care."

In addition to the Moores UCSD Cancer Center, the centres involved in the large-scale demonstration project are host campus UC San Francisco, UC Davis, UC Los Angeles and UC Irvine. Also participating in the collaboration are the UC Berkeley School of Public Health, the Northern California Cancer Center, Quantum Leap Healthcare Collaborative, the National Cancer Institute's BIG Health Consortium and the Center for Medical Technology Policy.

"The ATHENA Breast Health Network provides a first-time opportunity for the five UC cancer centres to leverage their collective research strengths in tackling important scientific and clinical questions in breast cancer", stated Dennis Carson, MD, director of the Moores UCSD Cancer Center. "We are excited to be supporting this innovative collaboration that, to date, has the clearest potential to produce ground-breaking research that will bring us closer to a cure", stated Larree Renda, Safeway Inc. executive vice president, chief strategist and administrative officer and chair of the Safeway Foundation.

Breast cancer, the most common cancer in women, is a devastating and costly disease, striking more than 200.000 women annually and killing more than 40.000 women each year, according to the American Cancer Society. In the United States, more than $20 billion is spent annually screening and treating the disease.

"Our goal is to improve survival and reduce suffering from breast cancer, to accelerate research and compress the time to implement innovations in clinical practice", stated ATHENA principal investigator Laura Esserman, MD, MBA, professor of surgery and radiology, director of the UCSF Carol Franc Buck Breast Care Center and co-leader of the breast oncology programme at the UCSF Helen Diller Family Comprehensive Cancer Center.

The goals of the ATHENA initiative are:

  • To create common systems to integrate clinical research and care across the UC campuses to advance the science of prevention, screening, diagnosis and treatment of breast cancer.
  • To drive innovation across the UC system to deliver more effective and efficient systems for personalized and biologically targeted care, using breast cancer as a prototype.
  • To create a biospecimen repository that has broad racial and ethnic representation.
  • To reduce morbidity and mortality by gaining a molecular understanding of breast cancer and factors that fuel breast cancer risk.
  • To improve understanding of who is at risk for what kind of cancer, and whether the risk of that cancer is significant or minimal.
  • To generate the evidence for developing more effective and less toxic treatments and to drive innovation in prevention, diagnosis and treatment.
  • To provide tools to change the way patients and providers interact to prevent and manage the disease.

The science fueling personalized medicine is experiencing explosive growth. Molecular tests are now available that can analyze a breast cancer tumour and categorize the risk of breast cancer recurrence with and without treatments, according to Laura Esserman. "Giving doctors sophisticated tools to tailor treatments to the individual tumour will revolutionize care, potentially enabling thousands of women to safely forgo toxic treatments and providing those at high risk of dying from their cancer with more targeted and effective treatments", stated Laura Esserman. "Equally, if not more exciting, is the promise of molecular tools to more accurately predict the risk of getting breast cancer, which may ultimately lead to better ways to prevent the disease."

The potential rewards are significant, Laura Esserman stressed. "This project will standardize the collection of structured data from both patients and physicians so that it is computable, interoperable, and reusable, and it will integrate molecular profiling at the time of diagnosis and create an unparalleled biospecimen repository. The result will be a network that enables personalized care informed by science and that fuels the accelerated and continuous improvement in treatment options and outcomes", she stated.

"As the first California hospital-based breast programme to receive accreditation from the American College of Surgeons National Accreditation Programme of Breast Centers, the Breast Center at Moores UCSD Cancer Center provides multi-disciplinary, state-of-the-art patient care, survivorship care, clinical trials and translational research", stated Breast Center director Anne Wallace, MD. "Our strengths position us to collaborate with Athena in moving the field forward."

While the ATHENA Breast Health Network focuses on breast cancer, the tools and infrastructure developed for this project are readily transferable to other cancers and conditions. ATHENA has the potential to serve as a transformative model to drive innovation, alter the culture of research and clinical practice and ultimately change health care delivery, the researchers said.

Safeway is a Fortune 50 company and one of the largest food and drug retailers in North America based on sales. The company operates 1739 stores in the United States and Canada and had annual sales of $44,1 billion in 2008. The company's stock symbol is traded on the New York Stock Exchange. Safeway supports a broad range of charitable and community programmes and in 2008 donated more than $248 million to important causes, such as cancer research, education, hunger relief and programmes focused on assisting people with disabilities.

The Moores UCSD Cancer Center is one of the United States' 40 National Cancer Institute-designated Comprehensive Cancer Centers, combining research, clinical care and community outreach to advance the prevention, treatment and cure of cancer.


Source: University of California - San Diego

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