Fall 2005 Newsletter:
A New Way in Cancer Research.

Stanford J. Goldblatt
Vice President
The Cancer Research Foundation

In our Spring, 2005, newsletter, we asked Dr. Michelle Le Beau, the director of the University of Chicago Cancer Research Center, to tell us about the new University program to restructure, transform and energize cancer research. The UCCRC, the University's Biological Sciences Division and its Hospitals have embarked on a bold collaborative effort to increase the number of cancer scientists and provide state-of-the- art physical space for their work.

One new building for inter-disciplinary research will promote basic scientists and physicists working together along with specialists in biochemistry, organic chemistry, physiology, pathology, pharmacology, genetics and medicine, all collaborating in the battle against cancer. A second interdisciplinary facility will house three floors of state-of-the-art laboratories of cancer scientists. In these two new buildings, which are connected by a walkway, the University is creating a critical mass of cancer programs to stimulate discovery.

We, the Cancer Research Foundation, want to be a part of this endeavor, and, to that end, we have made a gift of $1.5 million to the University of Chicago to support a new program in Gastrointestinal Cancer Prevention and Control. Stanford J. Goldblatt, CRF vice president, describes what we will support: A New Way in Cancer Research.

“A new area of cancer research, in fact a new way of thinking about cancer research is fast developing.

“The classical goal in cancer genetics of finding a specific genetic abnormality and identifying a high probability correlation between the existence of the abnormality and the occurrence of a specific cancer in specific patients has been reached. In some of these cases it is possible to attack the specific abnormality and cure existing cancers. The process of finding high correlation situations has been slow and has underlined the fact that there are many different kinds of cancers and one to one relationships between genetic abnormality and cancer is fairly rare.

“It seems that the 'cause and effect' of many cancers is too complex to be amenable to such a straightforward 'classical' resolution. At the same time, while some cancers do not seem to closely correlate with any specific abnormality, they do have some statistically positive correlation with certain relatively more common genetic abnormalities. Because of this correlation, people with the relevant genetic abnormality are not necessarily going to get cancer but they are more likely to develop cancers than people without it. Presumably, if a form of cancer is relatively common, it makes sense for people with a correlated abnormality to be screened for the cancer sooner and more often than others, particularly for cancers where early intervention can have demonstrable improved health outcomes.

“The scientific core of this new approach starts with the identification of specific genetic abnormalities but then involves (i) finding lower level yet statistically significant correlations between such abnormalities and certain cancers and (ii) finding a way to identify the persons with these abnormalities. Because the correlations are lower than in the 'classical' model, much larger samples of both abnormalities and cancers and much more sophisticated statistical methods are needed for both additional ends of this research. “If, as appears to be the case, many cancers are the result of a multiplicity of causes interacting with one another, the new approach may be the only realistic way to identify a connection between genetic abnormality and cancer.

“Gastrointestinal (GI) cancer appears to be perhaps the best possible area in which to validate this new approach to cancer research because it appears that there are several known genetic abnormalities that present lower, but still statistically significant correlations with several relatively common GI cancers. Because the cancers are fairly common, there are large samples of data available relating to these GI cancers and relatively easy methods of obtaining more data. Further, because of the availability of colonoscopy and the fact that the existence of colonic polyps almost always precedes the occurrence of GI cancer, early intervention before cancer occurs in higher risk populations can not only predict cancer but can actually prevent cancer from occurring. Thus, there is likely more reason for screening higher risk populations for GI cancer than there is for other relatively common cancers.

“The Cancer Research Foundation will support gastrointestinal cancer research at the University of Chicago, one of the best possible places in the world to support this new kind of research in GI cancer. Its large GI program has generated and will continue to generate a very large amount of relevant data. In addition, this program participates in virtually all national data collection programs. Dr. Nathan Ellis, a national leader in this new field, has been recruited and will focus his attention on GI cancers. Dr. Ellis said that central to his decision to come here was the U of C ability in statistics, as applied to issues in genetics, crucial to success.

“The University of Chicago is uniquely capable in dealing with one of the most frustrating aspects of this new field of research: bringing together faculty members from different departments and different disciplines.

Success in the analysis and dealing with large data sets and large populations at risk cannot be attained without the collaboration among several disciplines, some of which, e.g., populational statistics, are not traditionally thought of as central in the world of medical research.

“The success of this program could enable its replication for several other areas of cancer, e.g., breast cancer, and for several other diseases. It could also provide the base for a whole host of new public policy and ethics investigations relating to the uses of the information that will be forthcoming.”