Months to years after cancer treatment has seemed effective, some malignancies come back -- rebounding with a vengeance and spreading to distant sites.
Understanding how and why potent treatments are rebuffed in certain breast cancers underlies a series of groundbreaking studies at Cold Spring Harbor Laboratory overseen by Dr. Mikala Egeblad, who late last week won a highly coveted $2.5 million research award from the Department of Defense.
The grant will aid in her efforts to find out why some breast cancers spread.
"This will really help in speeding it up," Egeblad, 43, said of her work and the additional scientists she will be able to bring onboard to delve deeper into a critical question: How cancers reseed themselves.
Known as the The Era of Hope Scholar Award, the grants are aimed at scientists still in their early career years. The defense department has been funding investigations through its Breast Cancer Research Program since 1992.
Four other scientists won grants out of more than 50 who applied for this year's awards.
Egeblad is exploring the phenomenon scientists call resistance, a cancer's capacity to repel chemotherapy. An estimated 40,000 people nationwide are affected annually by breast cancers that become resistant to treatment.
In her Cold Spring Harbor lab, Egeblad has found that a patient's own immune system cells known as macrophages play a key role in sending subversive signals that are used by tumor cells to spread.
Normally, macrophages -- chubby cells with a big mouth-like orifice -- are friends, not foe. They gobble up dead tumor cells and virtually any kind of debris, including infectious organisms. Picture the old Pac-Man video game that consumed dots.
But macrophages, Egeblad said, also send signals in the vast communication network of the body allowing cells to "talk" to each other.
"What we found is that when you give chemotherapy, the macrophages come in and clean up all these dead cells but they are also sending signals to the [tumor] cells that are not killed in the first round of chemo. And those signals are making it easier for the tumor to bounce back after chemo," she said.
Precisely what those signals are, no one knows. Egeblad is trying to decode them. She has developed a highly innovative microscopic technique that is allowing her to view -- in mice -- the activity of macrophages in real time.
Egeblad said she consulted with breast cancer survivors to better hone her work toward critical problems patients face.
One of the survivors, Joanne Marquardt of the West Islip Breast Cancer Coalition, said by zeroing in on resistant cancer cells, Egeblad is helping to unlock a critical mystery.
"Metastatic disease is what kills people," Marquardt said of cancer's spread. "If we can stop metastasis, then we can cut the cancer mortality rate."
"Right now we are getting much longer survival periods, but if you look at the mortality rates and statistics, most of the [cancer] mortality occurs in patients with metastatic disease."
Marquardt, a North Babylon resident, is a past consumer member of the Defense Department’s Breast Cancer Research Program. She has evaluated other researchers’ work and said she was excited to learn Egeblad, who lives in Cold Spring Harbor, had won a grant.
"Mikala is very humble," Marquardt said, but added her investigations are cutting-edge and she is a rising star among cancer researchers.