January 2006

Olufunmilayo Olopade, MD, FACP, is among 25 individuals nationwide to be selected by the John D. and Catherine T. MacArthur Foundation as a 2005 MacArthur Fellow. Dubbed the “genius grant,” the five-year, $500,000 unrestricted award provides recipients support to pursue their work without stipulations or reporting requirements, allowing them “the unfettered opportunity to explore, create, and contribute,” says Jonathan F. Fanton, President of the MacArthur Foundation.

Dr. Olopade was honored for her groundbreaking work in the field of breast cancer genetics, and for her effective translation of research results to the treatment of African and African American women with breast cancer. Her early research identified a tumor suppressor locus on the short arm of the 9th chromosome, and her recent work has sought to explore the molecular mechanisms responsible for the development of breast cancer in women of African heritage.

“Aggressive, estrogen receptor-negative breast cancer seems to be prevalent among women of African ancestry,” Dr. Olopade explains. “You hear a lot in this country about disparities in outcomes, and that black women are more likely to die from breast cancer. We want to understand the biology of that and to develop more effective treatments to cure these women.”

It is her clinical experiences and interactions with the women themselves that drives much of Dr. Olopade’s research. “I am a clinician, and my patients who have breast cancer are the ones who motivate me to go into the lab to discover why anyone develops breast cancer,” she says. “When I learn about the genetic things that happen in the laboratory, I come back and see if, in fact, my patients have these mutations. As a physician scientist, I feel as if I’m straddling both worlds, and I have a vision of translating these huge scientific advances that are upon us into practice.”

Funds from the MacArthur grant will greatly assist Dr. Olopade in her efforts to realize this vision. “I’m going to stay the course and continue the focus of our work,” she says. Her current research examines and compares the molecular characteristics of women with breast cancer of African descent living in America with women with breast cancer in Nigeria. Patients in both populations are at a higher risk of a more aggressive type of breast cancer that is resistant to treatment, and they are also more likely to be diagnosed at a younger age than their Caucasian counterparts.

The first arm of the study consists of African American women with breast cancer living in 15 neighborhoods on Chicago’s south side; the second arm consists of patients with breast cancer living in Ibadan, Nigeria. “There is a cohort of African American families in which we’ve identified mutations in BRCA1 and BRCA2,” says Dr. Olopade. “We’ve extended our research to look at women in Africa with early onset breast cancer,” she continues, noting that the same mutations are present in premenopausal patients in Nigeria. “By doing comparative work between women with breast cancer in Africa and women on a totally different continent - young women in America - we will be able to sort out the contribution of genetics and environment to early onset breast cancer.”

With a better understanding of the genetics of breast cancer in these women, Dr. Olopade is hopeful that it will be possible to develop new treatments for them. She is inspired by recent trials that have demonstrated the efficacy of herceptin in patients with HER2-positive breast cancer. “With herceptin, we understood that HER2/neu was amplified, and people went to work to find drugs to treat HER2-positive breast cancer,” she says. The identification of BRCA1 and BRCA2 mutations in women of African ancestry provides a similar therapeutic target. “Treatment can now be individualized,” she says, “and it will be based on the genetics of the person in whom the cancer developed and on the genetics of the cancer itself.”

As a clinician, Dr. Olopade is committed to finding and testing improved methods for the prediction, prevention, and early detection of cancer in moderate and high-risk populations. She is the Founding Director of the Center for Clinical Cancer Genetics at the University of Chicago, where she oversees a multidisciplinary clinical program that provides free access to genetic testing services for high-risk individuals.

Discussing the decision to create the program, Dr. Olopade recalls, “I was looking for a way as an oncologist to figure out how we could do better in terms of curing more individuals with cancer. I was motivated thinking about how people who were treating cardiovascular disease had done a much better job of educating the public about the risk factors for the disease. In oncology, we were so far behind. So we started a cancer risk clinic in 1992. What we wanted was to have people come in and ask what they could do to lower their risk of cancer.”

Early detection is another key component of Dr. Olopade’s clinical care agenda. “We are hoping to affect policy changes so that there are different screening strategies for women at risk of early onset breast cancer,” she says. “Obviously, those women are not going to benefit from waiting until they are 40 to get a mammogram. That is the larger public policy, but it is not going to work for women who have a high risk of aggressive, estrogen receptor-negative breast cancer.”

In addition to influencing public attitudes about cancer screening and prevention, Dr. Olopade strives to educate oncologists about the need for more interaction between the research and clinical spheres. “Early on in my career, I devoted myself to studying in the laboratory, and now I understand the language of the scientific discovery process,” she says. “As a physician, I understand the issues my patients face and that motivates me to be a better scientist. It’s not easy but it’s doable, and for the [oncology] workforce of the future, we are going to need more people who are scientifically trained who can bridge the gaps between the laboratory and the clinic.”

An ASCO member since 1991, Dr. Olopade is grateful for the opportunity to contribute to the evolving dialogue about cancer genetics that the Society has afforded her. “ASCO has really led the effort to educate oncologists and the public about cancer genetics, and I was fortunate to be the Chair of a task force on that subject,” she says. “The Society has given me a national platform to advocate for risk assessment, to encourage oncologists to take their patients’ family histories, and to promote preventive measures for patients. ASCO was really ahead of the pack in giving me that opportunity.”