Kathy Miller is the kind of physician and scientist a cancerpatient dreams of--warm, devoted, and passionate about her research, which centers on halting the spread of breast cancer tumors.
Miller's expertise in treating breast cancer was internationalnews in 1999, when she diagnosed and treated Dr. Jerri Nielsen,the American physician at the South Pole who discovered a lumpin her breast but could not be evacuated for treatment becauseof the harsh polar winter. Miller treated Nielsen through videoconferencing,until weather conditions allowed Nielsen to be transported tothe Indiana University Cancer Center in Indianapolis.
In the United States, more than 200,000 women will be diagnosedwith breast cancer in 2005, with an estimated 40,000 deaths,according to the National Cancer Institute ( NCI ). But thisyear, Miller, an assistant professor of medicine at the IU Schoolof Medicine, is making world news again with surprising discoveriesabout effective new breast cancer drugs.
One of Miller's major research efforts is the study of an antibodyknown as Avastin ä (made by Genentech), a drug that worksby choking off a tumor's blood supply. In April, the NCI announcedpreliminary results from a large clinical trial for which Milleris the principal investigator. The study showed that for womenwith previously untreated recurrent or metastatic breast cancer,Avastin--in combination with standard chemotherapy--prolongedthe time that patients survived without their cancers gettingworse. In the three-year trial, the Avastin-chemotherapy combinationdelayed the worsening of the cancer by an average of four months,compared to patients who received chemotherapy alone. For womenwith advanced disease, Miller says, this is a “major advance.”
In May, Miller announced more impressive results from a smallclinical trial of an experimental drug compound called Sutent(made by Pfizer). The drug inhibits multiple growth factors simultaneously,halting the development of blood vessels and cell reproduction.In the trial, which Miller also led, Sutent stopped the progressionof breast cancer or shrank tumors by half in about 14 percentof participants with advanced breast cancer. Again, for womenwith advanced disease, the early Sutent results are “very encouraging,” Millersays.
The month of May also brought news that the breast cancer drugHerceptin, in combination with chemotherapy, cut cancer recurrenceby 52 percent for patients with HER-2-positive breast cancer,a particularly aggressive and resistant form of the disease.About one in five women have breast cancer caused by the over-productionof the protein HER-2, which is found on the surface of cancercells. Miller and colleagues participated in the very large nationalclinical trials for Herceptin. She calls the study's results “astounding.”
“Adding Herceptin to chemotherapy decreased recurrences by half,over and above what you get with chemotherapy alone,” Millersaid recently on the IU School of Medicine's radio show, SoundMedicine (for which she is a co-host). “This takes oneof the most aggressive forms of breast cancer and makes it oneof the easiest and most successful forms of breast cancer totreat based purely on using this drug earlier in the course ofthe disease.”
For more about Miller, see medicine.iupui.edu/faculty/showme.asp?id=2348 or soundmedicine.iu.edu/
