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BREAKTHROUGHS Ontario Cancer Institute The stories below showcase some of the many breakthroughs that occurred this year at OCI. Tamoxifen blocks the effects of the estrogen hormone. Combined Drug- Radiation Therapy Dramatically Cuts Risk of Breast Cancer Recurrence In this study, half the women received the combined treatment, and half received tamoxifen alone. Less than 1% apy offers a significant benefit. Women should continue to discuss the risks and benefits of treatment with their doctors, and make In a ground-breaking new of the women who decisions based on what multi-centre study Drs. received the combined will best work for them.” Anthony Fyles, David treatment had suffered a The study also involved McCready, and Lee Manchul relapse five years after sur- researchers from Toronto have found that the use gery, compared to almost Sunnybrook Regional of the drug tamoxifen 8% of the women who Cancer Centre (Sunnybrook combined with radiation received tamoxifen alone. and Women’s College Health therapy to treat breast Says Dr. Fyles,“We didn’t Sciences Centre), University cancer following surgery expect to see such a dra- of Toronto, and the British reduced the likelihood of matic difference, but the Columbia Cancer Agency. cancer relapse to virtually results definitely show that N Engl J Med. 2004 Sep 2; zero at five years. post-surgery radiation ther- 351(10): 963-70. 20 RESEARCH REPORT 2005
In an autoimmune disease, the immune system responds to bodily tissue the same way it would respond to an invader —with harmful consequences. Research Points to Cause of Autoimmunity Why are some people more likely to develop an autoimmune disease than others? Although many believe it may be due to a process called molecular mimicry, Dr. Pam Ohashi’s research suggests otherwise. According to the theory of molecular mimicry, people who develop autoimmune diseases such as diabetes or arthritis may have a naturally occurring protein that looks very much like a protein from a virus or bacteria. If these people ever became infected with a “look-alike” pathogen, their immune cells could be spurred to attack their normal proteins as well as the real pathogen. This results in autoimmune disease. Says Dr. Ohashi,“Our model shows for the first time that there must be a very tight bond between the infecting pathogen and the attacking immune cells before autoimmune disease can develop. It also shows that most people have genes that protect them from this process, indicating that molecular mimicry likely isn’t the cause.” Nat Med. 2004 Oct 3; 10(11): 1234-39. UHN+ PARTNERS= New Standards of Evidence- Based Care in Prostate Cancer This year a UHN researcher led an international study which pointed to a new standard of treatment for men with advanced, incurable prostate cancer. One of the many challenges in clinical trials is to enrol a sufficiently large number of patients to get definitive proof for a conclusion. In this case, PMH’s Dr. Ian Tannock led a phase III trial supported by the drug company Aventis which enlisted 43 oncologists with practices in 24 countries on six continents to test a new treatment regime for advanced prostate cancer. The two-year study involving 1,000 men has proven that a drug called docetaxel, when taken in combination with prednisone, improved survival by an average of three months when compared to the current treatment regime. It also had a greater chance of reducing pain and improving quality of life in patients with symptoms from their disease, although there was some increase in toxicity. “Overall, treatment with docetaxel resulted in many patients feeling better and living longer,” says Dr. Tannock.“It is for this reason that we’re recommending docetaxel every three weeks, with daily prednisone, as the new standard of treatment for patients with prostate cancer resistant to hormone therapy.” In this case, the international, industry-supported partnership generated new hope for men with prostate cancer. N Engl J Med. 2004 Oct 7; 351(15): 1502-12. UNIVERSITY HEALTH NETWORK 21
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