Joanne Mortimer, MD: Breast to Brain Metastases
Dr. Joanne Mortimer discusses ongoing research in breast to brain metastases being conducted at the City of Hope Comprehensive Medical Center by her colleague, Rahul Jandial, MD, PhD.
Dr. Mortimer is the Director of the Women’s Cancers Program and a Professor in the Department of Medical Oncology and Experimental Therapeutics at the City of Hope Comprehensive Medical Center.
The Group Room at the 34th Annual CTRC-AACR San Antonio Breast Cancer Symposium was made possible by support from:
VIDEO TRANSCRIPT
Selma Schimmel, Founder & CEO, Vital Options International:
Hello and welcome to the Group Room where we’re at the 34th Annual CTRC-AACR San Antonio Breast Cancer Symposium. I’m very pleased to be joined now by Doctor Joanne Mortimer, Director of Women’s Cancers Programs, Professor in the Department of Medical Oncology and Experimental Therapeutics, in the City of Hope Comprehensive Medical Center in Forte, California.
Doctor Mortimer, City of Hope does I think 60% of its research is actually generated at the City of Hope that’s not farmer related, it’s very innovative, you’re the creator of a lot of your own research.
Joanne Mortimer, MD, Director, Women’s Cancers Program, City of Hope Cancer Center:
Yes, that’s true, Selma.
Selma Schimmel:
And while I was recently there I had the opportunity to speak to one of your neurosurgeons, and knowing that our focus this year for many of our activities for our programming is centered on metastatic disease – brain mets are a particular concern and difficult for women unlike some of the other metastatic breast spreads like to the bone, let’s say, or even to the lung. And I understand at City of Hope there is an active program where there are getting metastatic tissue from the brain and I was hoping you could talk about this evolving program at the City of Hope.
Joanne Mortimer, MD:
So brain metastasis are, unfortunately, a larger problem than I think most people appreciate as we keep women alive longer and breast cancer, lung cancer, we keep patients in colon cancer, they’re more likely tumor spread to the brain and none of our drugs – or a very few of our drugs, actually – penetrate brain. And so it turns out to be a sanctuary site, so cells are up there, and if you live long enough they become large enough to cause problems. And so, City of Hope, Doctor Jandial is one of our neurosurgeons who was studying – and not only cancers that start in the brain but the more common problem, cancers that spread to the brain – and what is it about the environment of the brain that allows these cancers to either stay dormant for a period of time and then to become active, and so he has a very active program looking at tissue specimens obtained from individuals who’ve had brain metastases resected.
Selma Schimmel:
I was so stunned by the number of 200,000 brain metastases a year compared to 10,000 newly diagnosed primary brain tumors, and that figure just stops you in your tracks.
Joanne Mortimer, MD:
Yeah, it really does stop you in your tracks because it is a very, very, very common complication in individuals who live for very long periods of time. Looking at breast cancer population it’s a somewhat unique group of women who do develop brain metastases and Doctor Jandial is focusing on those individuals. Women who have triple negative breast cancer develop brain metastases commonly; it may be as high as 30% over their lifetime if they have recurrence of their disease. Her2-Positive breast cancer patients are also at an increased risk. It’s very rare for someone whose tumor is estrogen receptor positive and Her2-Negative to develop brain metastases. So there’s something about the tumor and there’s something about the environment and the brain that allows these cancer cells to grow and become apparent over time.
Selma Schimmel:
Is it possible that once you have enough tissue collection that you might then be able to proceed with research on maybe drug development? It’s so challenging because of the blood-brain barrier in being able to give chemotherapy or adequately treat brain mets.
Joanne Mortimer, MD:
The ability to get a drug into the brain is a really very challenging and a problem but it’s not totally insurmountable. There are some of the new Her2 drugs – Lapitinib and Loratinib, which is still in study – do actually cross the blood-brain barrier. But at City of Hope we actually have a stem-cell program where we actually inject stem cells into the tumors of patients who have recurrence of a primary brain cancer that started of there, and what these stem cells are engineered to do is get drugs and convert them to active drugs within the brain so we can actually treat the cancer within the brain without worrying about the blood-brain barrier. So there are very many clever ideas in order to attack those cells once they’re up there.
Selma Schimmel:
Thank you. I just wanted to talk about that a bit when we sat with the panel of advocates today that are living with metastatic disease, one of the common concerns was exactly the issues of brain metastases, and I was very happy to be able to actually say that actually City of Hope has taken a keen interest in this area.
Joanne Mortimer, MD:
Yes, thank you.
END OF VIDEO