First redesigned newsletter for the newly branded Cancer Center at UCSF.

1. u From the director ~ 2 u Personalized breast treatment ~ 6
u Clinical trials pace progress ~ 3 u Targeting melanoma genes ~ 7
u Cancer research building opens ~ 4
cancer
report
Summer 2009
> Clinical Services
> Perspective When cancer runs in families
Does cancer run in your family? If you or a close family member
has been diagnosed with an early cancer – breast cancer at age
45 or younger, colon cancer at age 50 or younger, prostate cancer
at age 60 or younger, or ovarian cancer at any age – you may want
‘‘ We see ourselves as
pioneers in transformative,
to consider the services offered by the UCSF Cancer Risk Program.
Members of the Cancer Risk Program at UCSF – including genetic
interdisciplinary cancer counselors, oncologists, surgeons, clinical geneticists and primary
research and its translation care physicians – identify and counsel individuals and families at
into improved prevention, high risk for cancers caused by inherited, abnormal genes.
detection and treatment.
Frank McCormick, Director,
UCSF Helen Diller Family
’’ Counselors examine medical histories and the pattern of cancers
within the family tree. When appropriate, they offer testing for spe-
Comprehensive Cancer Center > page 2 cific genetic abnormalities called mutations. Counselors work with
family members to help them make decisions about being tested,
and to develop personal cancer screening and prevention plans. > page 5
1> cancer.ucsf.edu information, visit us at
~ For more > cancer.ucsf.edu

2. > Perspective
From the director
Today, there are more than 11 million research and medical practice. About
US cancer survivors. They are living one-quarter of UCSF’s full-time faculty
proof that science and medicine have members work in cancer research and
made real progress against this most patient care. Based on measures such
feared disease. We are making great as merit-based research funds awarded
strides in developing treatments that through the National Cancer Institute,
offer more than chemotherapy and NCI Comprehensive Cancer Center
radiation therapy. status, the success of our clinical care
programs, and the qualifications and
At the UCSF Helen Diller Family Com-
achievements of our students and resi-
prehensive Cancer Center, we see
dents, I believe the level of excellence we
ourselves as pioneers in transformative,
have achieved – and that we are com-
interdisciplinary cancer research and
mitted to building upon – is unsurpassed.
its translation into improved prevention,
detection and treatment. Twenty years ago, UCSF scientists were
awarded the Nobel Prize for showing
The Cancer Center joins together top
that cancer growth is driven by certain
scientists with exceptional medical
genes that undergo abnormal changes.
practitioners. This culture of interdisci-
Their work opened the floodgates.
plinary teamwork enables us not only
Hundreds of genes that can become
to make key discoveries, but also to
abnormal and foster tumor growth now
Frank McCormick, PhD ensure that this new knowledge leads
have been identified.
to better treatment matched to the
individual patient. We have learned that even tumors of
the same type in different patients may
Discoveries and inventions by UCSF
rely on different, abnormal genes to
faculty already have resulted in the cre-
grow and survive. Some of these ab-
ation of dozens of new companies that
normal genes are proving to be suitable
make better products available for
drug targets.
Cancer Center members are collaborat-
> Our mission ing and consulting with pharmaceutical
The UCSF Helen Diller Family Comprehensive Cancer Center is dedicated
industry partners to identify the most
to conquering cancer worldwide through innovation and education.
promising new drug candidates. These
are being clinically evaluated in patients
stricken by tumors with specific genetic
profiles. We expect that these new
partnerships will result in faster prog-
ress and greater success in making
new drugs available for clinical practice.
2 ~ cancer.ucsf.edu

3. { A Comprehensive Cancer Center }
Any cancer center can call itself compre-
hensive, but the UCSF Helen Diller Family
Comprehensive Cancer Center has earned
that designation from the National Cancer
Institute (NCI). “Comprehensive” signifies
national leadership in advancing cancer
treatment, and in research and education.
It is the highest ranking, awarded through
a rigorous evaluation with approval of
the NCI Cancer Advisory
Board appointed by the
US president. As this news-
letter goes to press, there > Clinical Trials
are 40 NCI-designated
Comprehensive Cancer
Centers nationwide, but only one in Clinical trials pace
progress against cancer
Northern California – the UCSF Helen Diller
Family Comprehensive Cancer Center. u
The percentage of people who survive five years or more fol-
lowing a cancer diagnosis has nearly doubled in the past 40
years. Millions of long-term cancer survivors living full lives
today are a testament to improved treatments. Yet hundreds
At first, some novel treatments may only of thousands still succumb to cancer each year. We still
be available to UCSF patients through have far to go.
clinical trials. Even so, by engaging fully
The development of drugs has played a key role in improv-
in the global communities of biomedical
ing cancer survival. But no new cancer drug is approved
research and health care policy, and by
for standard medical practice without first being tested
educating future generations of research-
through clinical trials in carefully selected patients.
ers and medical caregivers, we aim to
advance medical practice worldwide. Each cancer is different. Tumors rely on any of several bio-
chemical pathways – involving many genes and proteins – to
In these pages, we welcome you to
abnormally survive, grow and spread. Different tumors may
glimpse some of the continuing prog-
be vulnerable to different treatment approaches.
ress we have made in tracking down
and targeting abnormal genes in cancer, The aim is to better know the enemy – and to use the best
in preventing and diagnosing cancers, weapons against each tumor to increase the likelihood of
and in growing the ranks of cancer cancer-free survival for each patient.
survivors. u
“We are designing clinical trials at UCSF that will be more
focused and targeted,” says breast cancer oncologist Pam
Munster, MD, who also is director of early-phase clinical
Frank McCormick, PhD, Director, UCSF Helen Diller
trials for the Cancer Center.
Family Comprehensive Cancer Center
Researchers and physicians at the Cancer Center are lead-
ers in making new discoveries of distinctive tumor profiles.
They are shedding light on the ways in which these tumor > page 4
cancer.ucsf.edu ~3

4. > New Facilities
Helen Diller Family Cancer
Research Building opens
On June 2, 2009, UCSF cel- designed by noted architect
ebrated the opening of the Rafael Viñoly, the five-story
new Helen Diller Family Can- building provides a largely
cer Research Building. The open research space. At full
162,000-square-foot building build-out, it will house 46
now emerges as an integral principal investigators and
part of UCSF Mission Bay, at a total community of 475
the heart of San Francisco’s researchers and staff. Investi-
biggest urban development gators have already taken up
push since the construction residence to begin working
of Golden Gate Park. to identify cancer risks, to
UCSF Mission Bay is a far Mission Bay campus has
explore how cancers arise,
Centrally located at 3rd cry from the abandoned rail quickly become a magnet
and to develop new ideas
Street and Mission Bay yards that covered the site a for biotech development.
for cancer prevention and
Boulevard South, and few short years ago. The
treatment. Plans are also well underway
for this to become the future
> See photos of the new facilities online at cancer.ucsf.edu/diller
Clinical trials from page 3
characteristics might be optimally target- Clinical trials may represent an especial-
ed with new or existing drugs – or com- ly important opportunity for individuals
binations of drugs. Major Cancer Center with advanced cancers who no longer
research programs with this aim engage benefit from standard treatment.
dozens of scientists and physicians, as
well as collaborators from industry who Few take part
work on developing new drugs. Even so, less than 5 percent of cancer
patients nationwide participate in clini-
“We can bring together our scientists
cal trials. As a result, it takes longer to
who work on particular cancer path-
evaluate anti-tumor treatments and to Even patients on standard therapies
ways with scientists from pharmaceuti-
get the best ones into standard practice risk side effects. For drugs still under
cal companies or the National Cancer
to improve cancer outcomes for all the investigation in clinical trials, the risks
Institute who work on drugs that target
patients who might benefit. may not all be known ahead of time.
molecules in those pathways,” Munster
But no trial begins without laboratory,
says. “We want to include in clinical The reasons few participate are complex,
cellular and animal studies on the safety
trials patients who are most likely to Munster says. Some people may be
and cancer-fighting ability of the drug in
benefit – the ones with tumors that we unaware of the opportunity. In addition,
question. Clinical trial researchers and
think will be vulnerable to the treatment.” Munster says, individuals with advanced
sponsors do not begin a study without
disease tend to be too hopeful about
Patients who elect to participate in clini- prior evidence that a new drug will be
the standard of care for their condition,
cal trials have the first chance to benefit better than – or at least as good as –
and to underestimate the potential ben-
from effective new therapy. Opportuni- existing treatments for many patients. u
efits of drug candidates being evaluated
ties to receive the newest treatments
in clinical trials.
are available for patients with many
types of cancers at different stages. > To find cancer clinical trials at UCSF
Call 877/827-3222 (toll-free) or email clinicaltrials@cc.ucsf.edu
4 ~ cancer.ucsf.edu

5. Scientists at the new cancer discoveries that inform think-
research building are well ing about new ways to treat
placed to engage in collabo- all forms of the disease.
rations that will help move
Construction of the building
new discoveries into clinical
began in 2006, thanks to an
applications.
indispensable gift of $35 mil-
The new building allows lion from the Helen Diller Fam-
consolidation of research ily Foundation of the Jewish
programs in brain tumors Community Endowment Fund.
and prostate cancer, as The building is already a hive
well as in population sci- of research activity, and with
ences – a broad field that its beautiful atrium and open
includes epidemiology, design, provides an ideal
chemoprevention, screen- environment that fosters
ing, health communication, collegiality and idea sharing.
behavioral science, health
The building enhances
services, policy, surveillance
home of the first new hos- urgent and emergency care ongoing cancer research
and survivorship research.
pital to be built in the city in and pediatric ambulatory programs at UCSF Mount
It also is the new home of
decades. The 289-bed proj- care facilities, and a women’s Zion and Parnassus, greatly
scientists who make funda-
ect will include a hospital for hospital for specialty care, expanding the existing space
mental discoveries about the
adult cancer surgery patients, with a center for women dedicated to cancer research
biological causes of cancer –
a children’s hospital with and newborns. at UCSF. u
Clinical services from front cover
About 5 percent to 10 percent of cancer But BRCA mutations also increase risks associated with an 80 percent lifetime
cases are due to inherited mutations that for other cancers. Among men, muta- risk for colon cancer. Women with Lynch
run in families. Each member of such a tions confer a 16 percent to 22 percent syndrome also have an elevated risk for
family has a 50-50 chance of inheriting lifetime risk for prostate cancer, usually endometrial and ovarian cancers.
the mutation from an affected parent. occurring before age 65.
UCSF oncologists were among the first
Sadly, men diagnosed with prostate to routinely screen all newly diagnosed
Large benefit
cancer may not suspect that they carry colon cancer patients age 50 and under
“If you can identify older individuals in the
a BRCA mutation until a daughter is with a new pair of lab tests that can be
family who have had cancer at a rela-
diagnosed with advanced-stage breast used to identify tumors that are almost
tively young age, and who carry a muta-
cancer. “It’s very important for men with certainly the result of Lynch syndrome.
tion, then you can make a real difference
prostate cancer to inform their health
for their brothers, sisters and children,” Tests to detect Lynch syndrome gene
care providers about any family his-
says Beth Crawford, director of clinical mutations in carriers before they devel-
tory of breast cancer, ovarian cancer,
services for the Cancer Risk Program. op cancer also are available. If someone
prostate cancer, melanoma or pancre-
is found to carry a Lynch syndrome mu-
One set of inherited cancer genes – atic cancer – and to ask for a referral to
tation, colon cancer screening is recom-
called BRCA genes – is most closely genetic counseling,” Crawford says.
mended, starting at age 22. Physicians
associated with breast and ovarian
Inherited colon cancer most often is use colonoscopy to detect and remove
cancer. Up to 80 percent of women
due to Lynch syndrome, which arises polyps, usually before they have had a
who inherit a BRCA mutation from their
from mutations in any of three related chance to become cancerous. u
mother or father will develop breast
genes – MLH1, MSH2 and MSH6. It is
cancer at some point. Up to 60 percent
will develop ovarian cancer if they have
a mutation in BRCA1; up to 27 percent
> For more information Call 415/885-7779 or (toll-free) 877/747-5422,
if they have a mutation in BRCA2. or visit ucsfhealth.org/cancerriskprogram
cancer.ucsf.edu ~5

6. > Initiatives
Personalized breast cancer treatment
Laura van ’t Veer, PhD, has changed Van ’t Veer was determined to see that
the way physicians look at breast her research did not languish in a lab.
Laura van ’t Veer, PhD
cancer. Tumors differ from each other To make sure that MammaPrint reached
genetically. And thanks to van ’t Veer’s the clinic, she started her own company.
pioneering vision, oncologists now use
Now, in collaboration with researchers Van ’t Veer now has chosen UCSF for a
a new generation of genetic tests to
and physicians at UCSF, van ’t Veer research sabbatical – prized time when
help make treatment decisions.
sees new opportunities to develop ad- dedicated researchers can work free of
Fewer women with low-risk breast can- ditional clinical applications to benefit competing administrative duties.
cer are being treated unnecessarily with breast cancer patients, based on new
She is collaborating with Gray to look
drugs that may have side effects. More knowledge of genetic abnormalities and
for genetic patterns in tumors that can
women with high-risk disease are re- molecular markers in cancer.
help predict the combinations of stan-
ceiving appropriate, aggressive therapy.
Van ’t Veer, who chairs the Division of dard or experimental drugs that may
Diagnostic Oncology at the Netherlands best target each tumor.
Lab on a chip
Cancer Institute, originally came to
Van ’t Veer led the bench-to-bedside Van ’t Veer also is collaborating with
UCSF in 2003 at the invitation of patient
development of the MammaPrint. The Esserman to prepare the next phase of
advocates to speak at an Avon Founda-
MammaPrint is a lab test on a chip. a major, unique clinical trial. During the
tion breast cancer symposium.
It detects patterns of gene activity in course of the study, knowledge of how
samples prepared from breast tumors. early genetic and imaging measure-
More creative time
The various patterns of gene activity ments are associated with treatment re-
During her first UCSF visit, van ’t Veer
detected by the MammaPrint indicate sponses will be used to direct patients
established key connections with leaders
a better or worse likelihood of breast to the treatments that are predicted to
of the Cancer Center’s Breast Oncol-
cancer’s returning despite surgery. work best for them individually.
ogy Program, Joe Gray, PhD, and Laura
Research shows that for early-stage Esserman, MD. Like van ’t Veer, Gray is “The breast cancer program is a good
breast cancer, the MammaPrint is a a leader in developing techniques widely instrument for integrating basic research
more accurate gauge of breast cancer used to probe genes. Esserman leads with patients’ needs, and with the capa-
prognosis than previously established clinical trials that aim to quickly evaluate bility to evaluate new clinical approach-
measures. the effectiveness of treatments for indi- es,” van ’t Veer says. For her, that makes
vidual patients prior to surgery. UCSF a home away from home. u
> To reach our world-class breast care center
The UCSF Carol Franc Buck Breast Care Center provides
specialized services, including individual counseling as
well as support groups that focus on every stage that you
and your family may experience. For information about
services or appointments, call 415/353-7070 or visit
ucsfbreastcarecenter.org.
cancer.ucsf.edu

7. Adil Daud, MD, (far left) and Boris Bastian, MD,
(left) work together, applying new research
knowledge to better match patients to new
treatments for melanomas.
> Partners
Targeting melanoma genes
for treatment success
The most deadly skin cancer, melanoma, is Bastian recently identified a previously unsuspect-
becoming more common. Fortunately, a sea ed genetic abnormality that drives an aggressive
change is at hand in the development of tailored form of melanoma – one that arises within the
treatment to target these tumors. eye. Bastian and Daud now are working with
Alnylam Pharmaceuticals on a clinical trial to
Cancer Center pathologist Boris Bastian, MD,
specifically target the gene culprit with a new type
now has identified distinct genetic abnormalities
of drug. There currently is no effective standard
that distinguish different subtypes of malignant
therapy to treat this eye cancer once it spreads.
melanomas. With this new knowledge, Bastian
is leading efforts to redefine the different forms Similarly, standard therapies do little to improve
of the disease, and he has set the stage for long-term survival of advanced forms of more
the identification and testing of better targeted common melanomas. But Bastian has discov-
treatment. ered that some of these melanomas seem to
rely on an abnormal gene that should make
Bastian’s work also has made it easier to
them vulnerable to an already standard targeted
diagnose melanomas and to distinguish these
therapy, called Gleevec. Gleevec had previously
potentially deadly cancers from harmless moles.
been tried and rejected for melanoma because it
Better yet for patients, Bastian recently teamed failed in most cases.
up with Adil Daud, MD, an oncologist who treats
Now, in early studies by Bastian and others,
skin cancers exclusively. Daud has a wealth of
Gleevec again is being tried to treat patients
experience in designing and leading early-stage
with melanomas driven by this particular genetic
clinical trials of novel therapies. Daud has seen
mutation. Some patients have shown no signs
firsthand how some patients can have remark-
of any remaining cancer after treatment, dem-
able responses to new treatments, even after
onstrating the power of targeted therapy. More
standard therapies have failed them.
studies are in the works.
“We have planned a rationally based panel of
> To learn more about skin cancer clinical trials that take into account the individual
and its prevention characteristics of a given patient’s tumor, to
Visit dermatology.medschool.ucsf.edu/skincancer to match them with the appropriate drug,” Bastian
find out about melanoma, sun protection, self-exams and says. “That’s the vision.” u
our clinics.
cancer.ucsf.edu ~7

8. UCSF Helen Diller Family Comprehensive Cancer Center Nonprofit organization
Communications Unit U.S. Postage
University of California, San Francisco PAID
San Francisco, CA 94143-1297 University of California
San Francisco
ADDRESS SERVICE REQUESTED
UCSF
Helen Diller Family Comprehensive Cancer Center
Cancer Report Summer 2009
An information resource for patients, caregivers, advocates, donors,
volunteers and members of the community
> How to get in touch
Obtain our world-class care
For personal help finding a doctor, call 888/689-8273 (toll-free) or
email referral.center@ucsfmedctr.org. Assistance is available Monday
through Friday, 8 a.m. to 5 p.m.
Get support
The Ida & Joseph Friend Cancer Resource Center offers information
on treatment options, free classes, support groups and referrals to
community resources. Call 415/885-3693 or visit cancer.ucsf.edu/crc.
Find cancer clinical trial opportunities
Clinical trials are listed online at cancer.ucsf.edu/trials.
For more information, call 877/827-3222 (toll-free) or email
clinicaltrials@cc.ucsf.edu.
> Tell us what you think
This newsletter is designed to reflect your needs and interests. We want
to hear from you: The first 50 people who complete our online survey will
receive a free iTunes gift card.
To take the survey, visit bitly.com/brjn.
> cancer.ucsf.edu
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Produced by UCSF Public Affairs. Edited and written by Jeffrey Norris. Designed by Nada Salam.
Photos: Noah Berger, pp. 1, 2; Susan Merrell, p. 6; Mark Estes, p. 7
This publication is printed on New Leaf paper made with 100 percent recycled fibers,
50 percent post-consumer waste and processed chlorine-free.
8 ~ cancer.ucsf.edu
© 2009 The Regents of the University of California PR722