Executive Summary
During 2010, the California Breast Cancer Research Program (CBCRP) funded 37 new single- and multiple year research projects that will advance scientific knowledge about breast cancer. With these new awards, we are investing almost $17 million at 18 California institutions. This annual report summarizes the studies that were completed during 2010 and lists the newly funded and ongoing studies.
Table 1. Research Projects Funded in 2010 by Subject Area
|
Number |
Amount |
Percentage of |
|
of projects |
|
Total Funding |
Community Impact of Breast Cancer |
5 |
$4,319,815 |
26% |
Etiology and Prevention |
4 |
$6,373,430 |
38% |
Detection, Prognosis and Treatment |
18 |
$4,507,438 |
27% |
Biology of the Breast Cell |
10 |
$1,671,431 |
10% |
Totals |
37 |
$16,872,114 |
100% |
Designed to push breast cancer research in new, creative directions, the CBCRP is funded primarily by a California state tax on tobacco. Breast cancer activists have played a leading role in the CBCRP from the beginning. They helped write and pass the statewide legislation that created the Program in 1993. Since then, the CBCRP has provided over $215 million for research in California to prevent, treat, and cure breast cancer.
Women with breast cancer and survivors of the disease are involved in all levels of the CBCRP’s decision making, including decisions about which projects get funded. With input from these advocates, the CBCRP has established a record for funding cutting-edge studies and jump-starting new areas of research. The Program’s goal is to fund the projects that will lead most rapidly to the end of the breast cancer epidemic.
The need is urgent. Every two hours, on average, a California woman dies of breast cancer. More than 277,000 Californians are living with the disease, and over 21,000 more will be diagnosed this year. Over the past three decades, some progress has been made. The rate at which California women got breast cancer climbed steeply from 1973-1988 and stayed near the 1988 rate for more than a decade. Since then, the breast cancer incidence rate has dropped by eight percent. Between 1988 and 2005, the breast cancer death rate in California dropped by 29 percent.
In April 2010, the U.S. President’s Cancer Panel released a ground-breaking report, Reducing Environmental Cancer Risk: What We Can Do Now. The federal panel acknowledged that environmental exposures have a substantial impact on increased cancer risk, and they issued a comprehensive call to action to reduce those risks. This landmark report indicates a rising national awareness of the health risks in environmental contaminants and the need for action at the federal, industrial, scientific, local, and individual levels. It underscores the need for the leadership the CBCRP has taken in this area for years. Prior to the release of this report, the CBCRP embarked on an undertaking to develop innovative methods to uncover the environmental causes of breast cancer, with the goal of using the findings to help shape environmental policy to protect Californians.
This report has been prepared by the University of California pursuant to Article 1 of Chapter 2 of Part 1 of Division 103 of the California Health and Safety Code, Section 104145; and the Revenue and Taxation Code Sections 30461-30462.1 and 18791-18796 amended by AB-28 Oct. 11, 2008. The following required reporting elements will be addressed in this report:
- The number and dollar amounts of research grants, including the amount allocated to indirect costs. TThe CBCRP awarded almost $17 million for 37 single- and multiple-year research projects, funded in the form of 43 grants to 18 California institutions in 2010. A complete list of newly funded grants can be found in Table 2.
- The institutions and campuses receiving grant awards. All funded grants are listed with the recipient institutions in Table 2 and in the Research Progress and Results section of this report.
- The subject of research projects. All of the investigator-initiated projects funded by the CBCRP involve key questions in one or more of the following research areas:
- Community Impact of Breast Cancer (sociocultural behavioral studies and health policy)
- Breast Cancer Causes and Prevention
- Earlier Detection, Diagnosis, and Treatment of Breast Cancer
- Basic Biology of the Breast (normal breast biology and breast cancer pathogenesis)
In 2004, the CBCRP launched the Special Research Initiatives, which involved devoting 30% of annual research funding to program-initiated research into critical but understudied questions in breast cancer. In 2010, the CBCRP decided to build on the success of this approach and is now devoting 50 percent of funding to program-initiated research in three of the most challenging and under-researched areas in breast cancer: the role of the environment in the disease; the reasons why some groups of women—based on characteristics such as ethnicity or race—bear a greater burden of breast cancer; and breast cancer prevention.
- The relationship between federal and state funding for breast cancer research.The CBCRP takes several steps to avoid duplication of funding at the individual research project level and in the Program’s research priorities. We identify and attempt to fill important gaps in knowledge about breast cancer. We review priorities yearly in light of changes in the research field, successes and failures of previous funding initiatives, and the results of previous funding. Additionally, as founding members of the International Cancer Research Portfolio and participating members of the Collaborative Summit on Breast Cancer Research, we are able to ensure that CBCRP funding complements, rather than duplicates, grants bestowed by other funding organizations.
The CBCRP’s Breast Cancer Research Council sets the Program’s funding priorities, taking into account:
- Opinions from national breast cancer experts
- Opinions from California advocates and activists, healthcare providers, public health practitioners, community leaders, biotechnology scientists, and academic researchers
- Current literature on breast cancer and current gaps in knowledge
- Comparisons with portfolios and programmatic goals of other funding agencies
- In-house evaluations of the efficacy of CBCRP grant mechanisms and topic areas in fulfilling program goals
- The relationship between each project and the overall strategy of the research program. The following ten goals are used to set overall programmatic research priorities and calls for applications.
- California Specific: Fund research that utilizes resources particular to California and/or addresses a breast cancer need that is specific, but not necessarily unique, to the burden of breast cancer in California.
- Career Development: Fund research that helps recruit, retain, and develop high-quality California-based investigators who engage in breast cancer research.
- Collaboration: Fund research that uses multidisciplinary approaches and helps foster collaboration among California scientists, clinicians, advocates, community members, patients, survivors, and others.
- Disparities: Fund research that addresses disparities, inequalities and/or underserved populations in California.
- Innovation: Fund innovative research (i.e., new drugs, new strategies, new paradigms, new applications of tested strategies in new populations and contexts).
- Non-duplicative: Fund research that complements, builds on, and/or feeds into, but does not duplicate, other research programs.
- Outcome Driven: Fund research that will improve public health outcomes (e.g., preventing breast cancer, detecting breast cancer, effective treatments, and quality of life).
- Policy: Fund research and evaluation that will have policy implications for breast cancer in California.
- Responsive: Fund research that is responsive to the perceived breast cancer research needs, opportunities, and expectations of the CBCRP as identified by scientists and the public in California.
- Translation: Fund research that is on a critical path for practical application and leads to more effective products, technologies, interventions, or policies and their application/ delivery to Californians.
TThe review of each individual grant application is also designed to ensure that the research projects funded by the CBCRP have both high scientific merit and programmatic interest. Each individual application is evaluated by external scientific review committees for specific aspects of scientific merit including, but not limited to, impact on breast cancer, innovation, feasibility, and approach. All applications of sufficient scientific merit undergo a programmatic review by our Breast Cancer Research Council for responsiveness to program priorities, including whether it fits the goals of the award type, integrates advocacy issues, and is an under-funded research question.
- A summary of research findings including discussion of promising new areas. Summaries of all of the research projects completed in 2010 are included in the body of this report. Listed below are just a few of the findings:
- Megan Schwarzman, M.D., M.P.H., at the University of California, Berkeley, and Sarah Janssen, M.D., Ph.D., M.P.H., at the Natural Resources Defense Council, developed a testing scheme for identifying chemicals that could contribute to the development or progression of breast cancer. This approach is useful for informing California’s Green Chemistry Initiative and for reforming the national policy to include toxicity tests that are relevant to the mammary gland.
- Jessica Gorman, M.P.H., at the University of California, San Diego, evaluated whether concerns about reproduction after breast cancer treatment were associated with long-term depression in women diagnosed with early stage breast cancer at age 40 or younger. Her findings suggest that reproductive concerns are associated with depression, and that young survivors would benefit from additional information and support related to reproductive issues.
- Jessica Gorman, M.P.H., at the University of California, San Diego, evaluated whether concerns about reproduction after breast cancer treatment were associated with long-term depression in women diagnosed with early stage breast cancer at age 40 or younger. Her findings suggest that reproductive concerns are associated with depression, and that young survivors would benefit from additional information and support related to reproductive issues.
- Lawrence Kushi, Sc.D., at the Kaiser Foundation Research Institute held a Mammary Gland Evaluation and Risk Assessment Workshop to develop a standard protocol for using mammary gland morphology in chemical risk assessment. This protocol will help to advance our understanding of the impact that early life exposure to chemicals that affect hormone systems can have on mammary gland development and susceptibility to cancer, and provide the scientific basis public policy experts need to develop and implement regulations that limit chemical exposures that are associated with breast cancer.
- Gaurav Sharma, Ph.D., at Sanford-Burnham Medical Research Institute developed a nanoparticle therapy that targets and delivers drugs to the tumor associated macrophages, the type of cells the comprise up to 80% of the cells in a breast tumor. These studies provide the proof-of-concept that could lead to the development of a new breast cancer treatment.
- Magnetic resonance imaging (MRI) is increasingly being used for early breast cancer detection. However, MRI is associated with many false-positive findings, leading to unnecessary biopsies. It also requires intravenous injection of a contrast agent, such as gadolinium. Rebecca Rakow-Penner, M.S., and colleagues at Stanford University have completed a pilot study determining that it is feasible to use blood oxygen level dependent (BOLD) contrast to make magnetic resonance imaging more accurate and to dispense with intravenous injections of contrast agents.\
- Shannon Sirk, Ph.D., and colleagues at the University of California, Los Angeles, investigated whether whole body breast imaging would aid in earlier and more accurate detection and diagnosis of HER2-positive tumors than the current biopsy and immuhistochemistry methods. This work has the potential to improve non-invasive detection, diagnosis, and treatment of HER2-positive breast cancer.
- Studies suggest that disruption of day-night cycles (circadian rhythms) can increase breast cancer risk and that these cycles are controlled by defined molecular pathways. Kuang-Yu Jen, M.D., Ph.D., and colleagues at the University of California, San Francisco, have demonstrated that breast cancers that have low levels of one of the circadian rhythm genes, known as Period3 (Per3), are more likely to stop responding to anti-hormone treatment than those with higher Per3
- Inclusion of women and minorities in research studies. The CBCRP funded 37 research projects in 2010. Fortythree percent (16 of 37) of the research projects that the CBCRP funded in 2010 study either women or tissues from women. The remaining 57% are laboratory studies that do not directly involve women or human tissues.
One of the 16 research projects involve tissues from women, while 15 (94%) have women as participants in the study.
Out of the 15 studies that include women:
- One hundred percent (15) include minority women in the study.
- Twenty-six percent (4) are focused on minority women.
- Thirty-three percent (3) are focused on underserved women.
The CBCRP’s activities, goals, and progress during 2010 are described in this report, along with the challenges that must be confronted in order to decrease the economic burden and human suffering caused by breast cancer in California.

