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Mechanisms of Cancer Growth,
Physical Sciences and Invasion
BOP Advocacy Commentary
October 11, 2010
Susan Samson
Overview
 Challenge of Genomics and Personalized Medicine:
Implications for Theories of Physical Sciences and Invasion
 Framing Research Issues and Strategic Priorities:
Single Intrinsic vs Inclusive Integrated Cell Dynamics
 Asking Critical Questions: Can We Rethink Disruptive
Innovation?
 Transdisciplinary Engagement: Approaches for Engaging
Advocates in Physical Sciences Research
 Summary: Components Essential to Successful Science
Advocacy Collaboration
Challenge of Genomics and Personalized
Medicine
Despite the enormous effort and the incredible successes
of omics effort, biomarker development, and targeted
therapy….

Vast groups of women with breast cancer are still being
overtreated

Clinical interventions are either not changing or are slowly
the changing the survival outcome of many others

African American women die so often from breast
cancer…even if their cancer is caught early and treated
aggressivey

What we call progress isn’t really progress for all
Framing Research Issues and Strategic
Priorities
Barriers to progress include limited understanding of….
 Oncogenic resistance
 The extent to which single intrinsic cell and inclusive
integrative cell dynamics contribute to cancer growth
 How progress from dysplasia to full malignancy is reflected
in physical properties across the tumor tissue
 How the relationship between molecular processes and cell
growth on a per cell basis occur
Old Paradigm: discussions abound about cell centered (intrinsic)
changes, genetic modifications, epigenetic changes and
mechanical modifications etc.
New Paradigm : emphasis is on the community issue and the
complex tissue microenvironment
Bottom Line
The characterization of tumor response is the key issue…

Joe emphasizes the importance of both single intrinsic and large cell
populations, growth kinetics, systems biology, and cell surface protein
expression

Valerie emphasizes the importance of the tumor microenvironment and
mechanistic issues…. how the rigidity or plasticity of cells relate to the cellular
properties of growth, or how the intracellular properties of cancer cells might
behave.
Despite these apparent differences in focus, they both share the
following important advocacy message …

We need to change things... new comprehensive approaches are essential if
we are to improve our understanding of mechanisms of cancer growth and
emerging targeted therapies for metastatic breast cancer.
Asking Critical Questions
 Is a single intrinsic cell perspective, often the hallmark of
personalized medicine, shifting for researchers?
 If so, what implications will this have for clinical
application?
 Will the explanatory power of complex cell
dynamics become an alternative framework to single cell
personalized medicine approaches for understanding the
physical laws and principles that shape and govern our
understanding of breast cancer behavior and cancer
growth?
New Paradigms: New Tools
Advances in understanding breast cancer growth
requires not only new ways of thinking about
cancer behavior and innovative research, but also new tools
for conducting the research and new collaborative models.

Bay Area PS-OC scientific teams are coming up with new revolutionary
ways to de-convolute complexity as they identify, study, and treat
cancer.
 Bay Area PS-OC scientific teams are coming up with new imaging
modalities and new methods to measure mechanisms of cancer
growth.
 Bay Area PS-OC scientific teams are involving advocates in their
unique initiatives designed as a systematic convergence of the physical
sciences with cancer biology.
What Is the Role of the Research
Advocate?
Advocates represent the "patient" and her needs
hopes and desires for a speedier translation to the
clinic
Although there are many types of advocacy
engagements (i.e., educational, political, community
outreach, fundraising, support, research), the term
advocate is used to define representatives who
advocate on behalf of the patient by gaining a seat at
the research table and ensuring that patients are
placed at the center of these conversations.
Advocacy Influences: Transforming
Research Design, Practice, and Policy



Design
 Adaptive Trials and Bayesian statistics--clean versus
pragmatic design
Conduct
 Evidence based practices--distinguishing hope from
hype
 FDA initiatives—driving change
 Patient centered priorities--improving communication
dissemination and consent practices
Policy
 Conflict of interest –mediating issues
 Transparency--shifting ethical priorities for access to
and support of clinical trials
The Paradigm Shift
Transdisciplinary Engagement
 Going Forward
Synergies Of
Interest
Disruptive
Innovation Transdisciplinary
Thorny
Issues
Areas of Focus
Knowledge
Engagement
Metrics And
Measures
Capacity
Building
Example: Future Goals
Forging Synergies of Interest
Support the conduct of precision
based, patient centered, ethically
responsible research
Bring attention to the
emergence and behavior of
cancer based on a unifying
physical sciences-based thematic
approach
Seek opportunities for
partnering to accelerate the pace
of scientific discovery and
technical advances.
Advocate for high impact
science which puts emphasis on
understanding the mechanisms of
tumor aggressiveness
Advocate for inclusive
integrated cell dynamics,
biomarker discovery, novel
methods for clinical detection,
new mammography imaging
modalities, and the translation of
discoveries into new interventions
Priority Areas of Advocate
Engagement
 Program Planning and Development
 Working with the scientists and clinicians to help vet hypothesis, establish
project agenda, and address issues surrounding physical sciences goals
 Education and Outreach
 Leveraging new internet technology and collaboration models to capitalize
on information dissemination and communication
 Reconfiguring consumer expectations regarding evolutionary biology
thinking and the clinical applicability of complex systems biology platforms
 Communicating the implications of the tumor microenvironment, metastatic
colonization, and “target and control” paradigms in the war against cancer
 Advocate Mentor Program
 Training the next generation of professionals, and specifically engaging
advocates in cross sector collaborations with scientists, clinicians, and
industry to map out the IMPACT awards for students and post –docs
.
Components to Successful Science
Advocacy Collaboration

Organizational infrastructure/transformation that
addresses the integration of advocates into
research culture

Front end inclusion of advocates in program
planning and research design

Predictable rewards recognition structure for
advocacy engagement

More pervasive focus on democratizing science
and disseminating information to the public