What is a Center of Excellence?

As the science of breast cancer evolves, it becomes more complex: breast cancer is now thought to be at least five different diseases. Consequently, the traditional way of funding the individual scientist working alone in a laboratory, or in a single institution, is increasingly less effective. The Department of Defense Breast Cancer Research Program developed the Center of Excellence grant to enable leading experts from different institutions and fields of study to work together to solve complex problems in breast cancer research. Basic scientists, who research cell lines and animals such as mice, and translational scientists, who adapt the findings of basic science for human use, join with a range of clinical researchers including oncologists, pathologists, surgeons and radiation oncologists to answer questions that could not be answered alone.

An especially important feature of the Center of Excellence Department of Defense grant is the emphasis placed on the partnership between scientists and breast cancer advocates. The presence of women with breast cancer in a Center of Excellence is a constant reminder to the scientists of the urgency of their work. Advocates ensure that the Center of Excellence stays focused on results that will be meaningful to women with breast cancer.

Why a Center of Excellence for breast cancer brain metastases?

Treatment for brain metastases of breast cancer is an unmet medical need. While advances have been made in the treatment of early breast cancer, and there have been modest steps forward in controlling distant metastases in organs other than the brain, almost no progress has been made in the treatment, prevention, or eradication of metastases to the brain. Surgery and radiation, the mainstays of treatment, have remained unchanged for decades. The blood-brain barrier, meant to keep toxins, infections and viruses from getting into the brain, also serves as a barrier to many breast cancer therapies such as chemotherapy and Herceptin, preventing them from getting into the brain. Once in the brain, drugs also have difficulty penetrating a second barrier around the metastases called the blood-tumor barrier. The urgency of this problem is obvious. Women whose lives are being extended by chemotherapy and targeted therapies such as Herceptin are now more likely to die of brain metastases. Researchers estimate that as many as a quarter to a third of women with metastatic breast cancer will have to face brain metastases at some stage of their disease.

It is clear that experts on the blood-brain barrier and drug delivery systems, as well as neurologists, neuropathologists, neuropsychologists, neurosurgeons and radiation oncologists need to collaborate with cancer researchers and oncologists to make significant progress in the treatment of brain metastases

What are the goals of our Center of Excellence?

1. To create the first community of breast cancer researchers and advocates dedicated to this important problem. This includes providing the infrastructure for basic and clinical research. We intend to test in animals new candidate drugs for the prevention and treatment of brain metastases.
2. To analyze tissue from breast cancer brain metastases in order to identify important targets for new drugs that treat, prevent, or eradicate breast cancer brain metastases.
3. To analyze primary tumors (tumors in the breast) from patients who did and did not get brain metastases to be able to identify who is at high risk of their breast cancer spreading to the brain.
4. To develop animal models (usually mice and rats) with brain metastases similar to humans with brain metastases in order to screen new drugs for efficacy and toxicity.
5. To analyze matched pairs of tumor tissues, comparing tissue from breast primary tumors with tumor tissue from brain metastases to determine if and how primary tumors differ from brain metastases.
6. To develop ways to deliver anticancer drugs through the blood-brain barrier and the blood-tumor barrier into brain metastases at an effective dose.