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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