HOUSTON -- (August 29, 2008) -- The response to insulin-like growth factor 1 (IGF-I) in breast cancer cells predicts an aggressive tumor that is less likely to respond to treatment, said researchers at Baylor College of Medicine in a report that appears in the current issue of the Journal of Clinical Oncology. The finding gives impetus to the movement to tailor cancer treatments to attributes of the various tumors.

"These findings come at a critical time," said Dr. Adrian Lee, associate professor in the Lester and Sue Smith Breast Center at BCM. "Our goal is to identify biomarkers that will help predict which patients will respond to therapy against insulin-like growth factor. Several inhibitors of the IGF pathway are in patient studies right now. There's a large movement to understand which patients will respond to these drugs. This is a step toward that goal."

Growth factor response

In this study, Lee and his colleagues stimulated breast cancer cells with IGF-I in the laboratory and defined how more than 800 genes in the cells responded to the growth factor. They then examined samples of patient breast tumors with this "gene signature" and correlated the gene signatures with the fate of the patients.

"We have technology now to allow us to globally assess what IGF is doing in breast cancer at the whole gene expression level," said Lee. "This is one of the first studies to do that. We know that IGF is bad in cancer, but now we can globally understand it in a more comprehensive manner. It could lead to finding biomarkers for patients response" to breast cancer treatments.

"We found that IGF-I is a major regulator of cell growth and cell survival," said Lee. "It also regulates DNA repair."

Implications for treatment

This has major implications for anti-cancer treatments that seek to cause DNA damage and tumor cell death.

"If you have something regulating DNA repair, you want that turned off," said Lee.

They found that tumors in which IGF (insulin-like growth factor) affected the way in which genes were activated or translated into messages were more aggressive and more likely to grow. They also found that the effect of IGF was independent of whether the tumor was affected by estrogen or not.

"This is very important," said Lee. "Once patients are resistant to hormone treatment (as with tamoxifen), their treatment options are limited. A treatment that inhibited receptors for IGF might give them another option."

Currently, the Breast Center is studying the effects of an IGF receptor antibody combined with a drug called exemestane (Aromasin® or an aromatase inhibitor that blocks estrogen production) in postmenopausal women. One group of women take the combination and the other takes exemestane.

Bioinformatics – the ability to analyze large amounts of data – proved key to the study, said Lee. In fact, the first author, Dr. Chad J. Creighton of BCM, is a bioinformatician, said Lee.

Others who took part in this research include Angelo Casa, ZaWaunyka Lazard, Shixia Huang, Anna Tsimelzon, Susan G. Hilsenbeck and C. Kent Osborne, all of BCM.

Funding for this work came from the National Institutes of Health and the Baylor College of Medicine / AstraZeneca Alliance.

The full article is available at http://jco.ascopubs.org/.

For more science news from Baylor College of Medicine, visit www.bcm.edu/fromthelab.

HOUSTON -- (August 29, 2008) -- A public-private partnership will enable the Baylor International Pediatric AIDS Initiative (BIPAI) to significantly expand its network of centers of excellence in Sub-Saharan Africa by building two clinics in Tanzania, a country hit hard by HIV/AIDS.

The United States President's Emergency Plan for AIDS Relief (PEPFAR) announced today a grant award to BIPAI of $22.5 million over five years to support the operations of the two centers of excellence and associated satellite clinic facilities.

His Excellency Mr. Jakaya Kikwete, president of the United Republic of Tanzania, participated in the announcement in Washington D.C. The Tanzanian government is working in partnership with BIPAI to establish the two centers in Mbeya and Mwanza and to ensure their integration into existing public health programs. It is expected that the centers will provide care directly to at least 15,000 children. Another 4,400 children will receive care in associated satellite facilities.

BIPAI is based at Baylor College of Medicine (BCM) and Texas Children's Hospital in Houston. It has secured additional funding totaling more than $6 million for the Tanzania program from several private donors, including Abbott Fund, the Bristol-Myers Squibb Foundation, Jan and Dan Duncan and the Sisters of Charity of the Incarnate Word.

The new centers of excellence in Tanzania will be the seventh and eighth established by BIPAI in Africa. Dr. Mark Kline, president of BIPAI, said the large country in East Africa is home to about 1.4 million people with HIV/AIDS. Currently, there are few resources for the care and treatment of HIV-infected children.

"We are thrilled to partner with the government of Tanzania in the establishment of these new children's centers of excellence. We are deeply grateful to PEPFAR and to the U.S. Agency for International Development and Centers for Disease Control and Prevention teams for all of their support, as well as to the generous private donors that made all of this possible," said Kline, also professor of pediatrics at BCM and chief of retrovirology at Texas Children's.

This is the first time BIPAI has located two centers of excellence in one country. Other African centers are located in Botswana, Malawi, Uganda, Lesotho, Burkina Faso and Swaziland. Satellite clinics and outreach programs also have been established by BIPAI in each country to maximize the reach and impact of the centers of excellence. The first BIPAI center of excellence was established in Constanta, Romania in 2001.

The centers of excellence provide comprehensive pediatric and family-centered HIV/AIDS care and treatment. BIPAI provides ongoing support to each center, including health professional training and strengthening of health systems. Relationships will be established between existing BIPAI centers of excellence in Kampala, Uganda and Lilongwe, Malawi, and the new centers in Mwanza and Mbeya, for purposes of supporting the implementation of all clinical programs.

Each BIPAI center of excellence is staffed predominantly by local health professionals, supplemented as needed by American physicians from BIPAI's Pediatric AIDS Corps, jointly supported by BCM and Bristol-Myers Squibb. Sixty Pediatric AIDS Corps physicians currently are assigned to seven countries in Africa.

Abbott Fund is contributing $2.65 million to BIPAI's program in Tanzania, which will be used to support construction and initial operations of the center in Mbeya. The Bristol-Myers Squibb Foundation is committing $2 million to the program, to be used for construction of the center in Mwanza. Both foundations are long-time supporters of BIPAI's programs for HIV-infected children across Africa and around the world.

"The clinic fulfills a critical need in Tanzania, where the Abbott Fund has been working in partnership with the government for more than a decade to improve health care, not only for people with HIV, but also for those with other chronic health issues," said Catherine V. Babington, president, the Abbott Fund. "The construction of the first pediatric clinic in Tanzania with our longstanding partner, BIPAI, marks another critical step in the Abbott Fund's ongoing commitment to addressing the health of children with HIV."

"The Bristol-Myers Squibb Foundation's Secure the Future program and its successful pediatric initiative with the Baylor College of Medicine and Texas Children's Hospital is grounded in the concept of public-private partnership," said John Damonti, president of the Bristol-Myers Squibb Foundation. "This new commitment from the United States Government to enhance pediatric care and support of children in partnership with the government of Tanzania and BIPAI will leverage and multiply the impact of the private sector support."

The two new centers of excellence will be affiliated with and located on the campuses of the Bugando Medical Centre in Mwanza and the Mbeya Referral Hospital in Mbeya.

The Mwanza region has a population of nearly 3 million and a 7.2 percent HIV prevalence rate. The Mbeya region has a population of over 2 million, and an HIV prevalence rate of 13.5 percent.

Houstonians Jan and Dan Duncan and the Houston-based Sisters of Charity of the Incarnate Word are providing substantial financial support for the establishment of the BIPAI program in Tanzania. Their gifts helped make possible the public-private partnership with PEPFAR and the U.S. government.

Jan and Dan Duncan are generous supporters of many programs at BCM and Texas Children's Hospital.

"Dan and I are so happy for the many children who will be helped by these two new children's centers in Tanzania," said Jan Duncan. "I attended a presentation Mark Kline gave in Houston last year and was very impressed with the impact of the program. What a blessing the new clinics will be in the lives of so many."

The Sisters of Charity of the Incarnate Word were among the very first supporters of BIPAI almost ten years ago.

"It is a privilege to partner with BIPAI and Dr. Kline to bring compassionate, life-saving care and treatment to the most vulnerable population fighting HIV/AIDS, the children," said a spokesperson for the Sisters of Charity of the Incarnate Word. "The expansion of this program into Tanzania and the significant commitment announced today is a turning point for the children - and future - of Tanzania."

BIPAI's two home institutions, BCM and Texas Children's Hospital, are each contributing financially and in faculty and staff support for the project. Texas Children's has pledged $600,000 to the project and BCM, $150,000.

"As a result of Dr. Mark Kline's leadership and dedication, BIPAI at Texas Children's Hospital has grown immensely with one AIDS clinic in Romania, six in Africa and additional clinics under construction in Tanzania," said Mark A. Wallace, president and CEO of Texas Children's. "Dr. Kline and his team have trained and placed health professionals and treated a larger number of HIV-infected children than any other organization in the world. We are extremely proud to be a part of this unparalleled initiative and confident Dr. Kline's tireless efforts will continue to heal sick children across the world."

"The new program in Tanzania is a natural expansion of our global network of centers of excellence. Through the expertise of the outstanding BIPAI team, including Pediatric AIDS Corps physicians, these clinics will offer state-of-the-art care to children and their families," said BCM President Dr. Peter G. Traber. "We are immensely proud of the work of this dedicated team of people who continue to prove that a difference can be made in the world by a commitment to excellence."

An initial complement of five BIPAI physicians and additional support staff will begin clinical activities in Mwanza and Mbeya by Oct. 1. Until the centers of excellence are built and opened, they will work out of transitional facilities at Bugando Medical Centre and Mbeya Referral Hospital. Construction on the centers of excellence will begin in December, with opening anticipated in December 2009.

Related links

• www.securethefuture.com
• www.abbottglobalcare.org

HOUSTON -- (August 28, 2008) -- Students studying to become doctors at Baylor College of Medicine will now have the opportunity to broaden their approach to patient care by earning a Master of Public Health degree from The University of Texas School of Public Health. The two institutions will offer the M.D./M.P.H. dual degree program, effective Sept. 1.

"It is a tremendous opportunity for both institutions to work with excellent students who want to further develop their approach to medicine and public health and want to have an impact at the community or population-level, whether that is local, national or international," said Cynthia Chappell, Ph.D., professor and senior associate dean for academic affairs at the UT School of Public Health.

"This joint degree program will allow interested students to further their career path in both medicine and public health. BCM is enthusiastic about this new educational opportunity for its medical students." said Dr. Stephen Greenberg, senior vice president and dean of medical education at BCM.

Five-year program

During the five-year program, participants will work toward their medical degree at BCM while integrating public health training into their coursework. That training will include at least 33 credit hours from courses at the UT School of Public Health, plus an internship at a public health organization and a master's thesis. The M.P.H. degree program will require that students acquire skills and knowledge in five core public health disciplines, including social and behavioral sciences, biostatistics, environmental health sciences, epidemiology, and health services administration.

"Public health training can better prepare these students for many of the issues they will be facing in medicine," Chappell said. "For example, with elderly patients, it isn't enough just to treat their bodies. You need to know where they live, their family situation and so many other pieces of information that impact their health well beyond the aspects of medicine."

Opportunities here and abroad

Chappell said the dual degree program would be ideal for medical students who are interested in pursuing careers in international health, aging and/or multicultural health. "We plan to identify outlets for the students to experience the practice of medicine and public health in a community setting," Chappell said. "That may be in Africa or here in our own backyard."

Already, a half-dozen students who began classes in August at Baylor College of Medicine have expressed interest in the dual degree program with the UT School of Public Health. Chappell said they hope to enroll between 12 and 15 students per year.

The UT School of Public Health offers a similar dual degree program with The University of Texas Health Science Center at San Antonio and it is currently in the process of revamping its M.D./M.P.H. program with The University of Texas Medical School at Houston.

HOUSTON -- (August 25, 2008) -- The 10th Anniversary Nicholas Alexander Higgins Memorial Golf Tournament benefitting pediatric and congenital cardiology research and care will tee off Sept. 20 at the Wildcat Golf Club at 12000 Almeda Road.

Funds raised will support the Texas Adult Congenital Heart Clinic at Baylor College of Medicine, Texas Children's Heart Center and the Covenant House.

Dr. Wayne Franklin, assistant professor of medicine and pediatrics at BCM and medical director of the Texas Adult Congenital Heart Clinic, said the support is greatly needed.

"Since treatment for congenital heart disease has improved, so has the survival rate. Thus, more children are entering adulthood and facing new health challenges," Franklin said. "Sometimes, as they grow, they develop adult health problems that are often beyond the comfort level of their pediatric specialists. These patients need health professionals who can help them deal with adult issues as well as their heart problems." He notes that congenital heart disease occurs in about eight in every 1,000 births each year in the United States and that heart defects are the most common type of birth defect. This means that there are a growing number of adults with congenital heart defects as well.

Support from the Higgins family allowed the Texas Adult Congenital Heart Clinic to add its first full-time fellow to the team, which resulted in more patient-doctor time and added another doctor trained in caring for patients.

The Nicholas Alexander Higgins Memorial Golf Tournament was started by the Higgins family to celebrate the life and memory of their son Nicholas, who died at the age of 12 from a congenital heart defect.

Registration is open until the end of August. Dinner and an awards program will be held at 2 p.m. For more information contact Junior and Pauline Higgins at 713-521-3409 or http://www.tournevents.com/TCH2008/.