Renowned geneticist speaks at Villanova University
Dr. Olopade receives V.U. Mendel Medal
RADNOR » In the not so far off future, you will carry your genetic profile with you to help doctors key in on a proper diagnosis and treatment.
That was the assessment of Dr. Olufunmilayo Falusi Olopade, a University of Chicago researcher who was chosen by Villanova University as this year’s Mendel Medal winner in recognition of her work in developing innovative strategies for comprehensive cancer risk assessment and prevention. Olopade’s research is based on the understanding of genetic and non-genetic factors in individual patients, with a focus on women of African ancestry.
Olopade, who emigrated from Nigeria where she was already a doctor, was recruited to do a residency at Cook County Hospital in Chicago, then joined the lab of the late Dr. Janet Rawley, a prominent geneticist at the University of Chicago, as a research fellow, said Professor Jan Knepper, who introduced Olopade to an audience at Villanova on Nov. 17. In Rawley’s lab, Olopade learned a variety of skills, including “chromosome walking,” which allows scientists to map chromosomes.
Olopade, who went on to found her own laboratory at University of Chicago, discovered a key region in Chromosome 9 that is altered or deleted in many cancers, said Knepper, a missing site where tumor suppressors that stop cancers from growing should exist. While directing her lab, Olopade continued to treat patients and also became concerned about racial disparity in breast cancer survival, said Knepper.
African and African American women had less access to medical care and also contracted more aggressive tumors “that did not respond to the first line therapies typically offered to breast cancer patients,” said Knepper.
When she started with Rawley, her mentor who had also received the VU Mendel Medal, people were skeptical about the role of genetics in cancer, Olopade said. Doctors thought cancer was caused by what people ate or the environment, she said.
Starting in 1990, Olopade began to collaborate with Dr. Mary-Claire King working on how breast and ovarian cancer ran in some families. King is credited with discovering that the BRCA1 gene is linked to increased breast cancer risk.
About cancer, Olopade said, “How does it happen? When does it happen? Does it happen by chance or is it a preprogramed event?” For some individuals, scientists now know it is the latter.
Much of the data on breast cancer was from the northern hemisphere and with Caucasian subjects, she said. But women in the southern hemisphere have higher mortality rates from the disease.
She wanted to do community engaged research because “a black woman in Chicago was two times as likely to dies of breast cancer than a white woman.” If cancer is found on a mammogram and “you don’t have any way to treat it, what use is it?” she asked.
A pathologist from Nigeria who came to Olopade’s lab showed her that the breast cancer tumors they saw under the microscope did not look like tumors in textbooks. The cancer was “really different” than in Japanese or white, postmenopausal women. Olopade and her colleagues studied west breast cancer from West African women and found a high incidence in more aggressive and less easily treated cancers. In 2005, Olopade authored a study that showed significant differences between the breast cancers in Caucasian women and in women of African descent.
“If you are doing population genetics, Africa has the most diverse of all genomes,” Olopade said. “While people are 99.9 percent identical, that .1 percent…makes us really unique and different from each other,” she said. In Nigeria they did a population genetics study in 1998 to look at how genes affect the risk of cancer.
There are now genetic tests that can tell individuals if they have a higher risk for cancer. In the European population, 50 percent of breast cancer is inherited, Olopade said. But the other half is unexplained.
“All of you know about Angelina Jolie, right?” said Olopade. Jolie, an actress, had her breasts and ovaries removed after learning that she had a defective BRCA1 gene, along with close relatives who died from breast and ovarian cancer.
The discovery of that the BRCA1 and BRCA2 genes increase the risk of cancer was a major step forward. Although research among Jewish women of European descent helped with that breakthrough, it’s now known other populations also carry those defective genes, said Olopade.
And a Supreme Court ruling that genes cannot be patented allows any lab to test for those genes, so the tests are getting less expensive. Olopade mentioned a “worried well” woman from suburban Winnetka who came to her clinic and wanted to be tested for those cancer genes.
“She wrote a check for $2,500,” said Olopade. “For social justice, do I take the money? Do I not take the money when it’s not available for everybody?” However, once that woman was tested and she was positive, she told her other family members of the risk, which impressed Olopade.
“It became clear to me that I have to advocate for everybody to have genetic testing,” said Olopade. “Because it’s ethically and morally right for me to offer the test to other people…” So she is trying to get more access to genetic analysis to screen for genes that predispose a person to breast cancer for underserved populations.
In one study she did with 300 African American patients who came to the clinic in Chicago, 75 percent of the mutations that she found were in the BRCA1 or BRCA2 genes. She’s also studied done genetic studies on people in Brazil and India, as well as in Nigeria and the U.S., she said. Also, men can carry the mutation for breast cancer and pass it on to their offspring, as well as women.
“If we don’t know why people are getting breast cancer, how can we fix it?” she asked. In a recent study, researchers found that people with African ancestry were four times more likely to have more advanced breast cancer and twice as likely to get HER 2 (a more aggressive form of the disease) compared with those with European ancestry, she said.
Most of the clinical trials breast cancer therapies have been done with women of European ancestry, she said. That is only just beginning to change, with the FDA now requiring drug trials in the country where the drug will be sold.
“We know that genetics really matter,” she said. There will be more precision medicine based on sequencing the genome.
Why there isn’t there more access to “life-saving drugs?” she asked. “Only 1 percent of the world’s breast cancer patients have access to (the drug) Herceptin…In the U.S. you will only get it if you have health insurance. How many women died in Chicago because they did not have health insurance? Until the Affordable Care was passed …our neighbors on the Southside of Chicago would have HER2 breast cancer and die from it.”
In some families, generations of women have had breast and ovarian cancer, she said. A new international consortium is looking at genetic diversity and cancer risk, she said. And there are now treatments based on genetic factors.
“It’s no longer kosher
GENETICIST » PAGE 8