Gilda Radner Hereditary Cancer Detection Program

The Women's Cancer Research Institute's (WCRI) Gilda Radner Hereditary Cancer Detection Program is a research program offering women at highest risk for breast and ovarian cancers - those with the BRCA1 or BRCA2 gene mutation - a chance to participate in a cancer screening program aimed at early detection. The program is dedicated to finding better prevention and screening tools.

Founded in 1991, the program utilizes the expertise of a diverse team that includes physician specialists in gynecologic oncology, surgery, radiology, pathology and genetics, as well as a support team that includes a genetic counselor, research scientists, technologists and nurses. Over 1600 women have been part of the program since its inception.

The purpose of the current clinical research program is to offer women with the BRCA1 or BRCA2 gene mutation an opportunity to participate in an ovarian and breast cancer screening program, using state-of-the-art and investigational strategies aimed at early detection. The Gilda Radner Program includes an observational (IRB#4049) and intervention (IRB#1080) protocol, and participants may choose to participate in both, one or neither protocol. The observational protocol (IRB#4049) asks participants to complete a questionnaire regarding their family history, personal history and behaviors in an attempt to help us better identify modifiable risk factors (gene-environment interactions) and modifiers of gene penetrance. Questionnaires are completed at enrollment and every two years thereafter. The intervention protocol (IRB#1080) includes screening tests such as pelvic ultrasound, mammography and breast MRI as well as CA125 testing and other investigational blood tests.

The Gilda Radner Hereditary Cancer Detection Program has contributed valuable data to our understanding of ovarian and breast cancer in high-risk women, particularly biomarker data, genetic and familial factors. Our goal is to gain a better understanding of the relationship of genes and growth of specific cancers, and to learn why some mutation carriers develop breast, ovarian and other types of cancer, and why some mutation carriers do not develop cancer at all.

Currently, WCRI is participating in an international collaboration called the Consortium of Investigators of Modifiers of BRCA1/2 (CIMBA) working on genetic modifiers of cancer risk in BRCA1 and BRCA2 mutation carriers. The aim of CIMBA is to provide sufficient sample sizes to allow large scale studies that will reliably evaluate the effects of these mutations.

In addition, as more is learned about BRCA 1 and BRCA 2 mutation carriers, treatments can be developed to improve survival. For example, Cedars-Sinai is currently enrolling patients with BRCA mutations into clinical trials using PARP (Poly ADP-Ribose Polymerase) inhibitors. In cells deficient in BRCA function, inhibition of the PARP pathway can lead to elimination of the cell. This therapy has shown a 59 percent response rate in BRCA mutation patients with recurrent ovarian cancer compared to the average response rate of 20 percent on other therapies.

Cedars-Sinai is committed to discovering effective tests for detection, prevention, and treatment of breast and ovarian cancer. Ovarian cancer is the fifth-leading cause of cancer death among women and is responsible for more deaths than all other gynecologic cancers combined. Breast cancer is the leading cause of cancer in women, affecting one out of eight American women.

Every woman should understand risk factors for ovarian and breast cancer, which include:

Being female
A personal or family history of breast, ovarian, endometrial or colorectal cancer
A family history of early age (under age 50) breast cancer
Breast cancer in both breasts
Having never borne children or a first pregnancy after age 30
Early start of menses or late onset of menopause
You or someone in your family has a BRCA1 or BRCA2 gene mutation
Ashkenazi Jewish heritage or ancestry
Other dietary factors, such as excessive alcohol use

As medical knowledge advances, we will be able to better define who is at risk, how to prevent, and how to treat ovarian and breast cancers.

For more information, call the Gilda Radner Hereditary Cancer Detection Program at (310) 423-9966.