New services for breast cancer patients and their providers

Kevin Olson
Kevin Olson, M.D., executive medical director, Providence Cancer Institute

Providence Cancer Institute – recently renamed from Providence Cancer Center to reflect the growing breadth of research and other services – has added important new services and team members to continue to meet the needs of patients with breast cancer and their providers.

As part of a growing need for services, we’ve also hired specialized breast cancer physicians and have improved coordination of breast cancer services. While we’re fortunate to have a number of physicians who do an exemplary job of addressing patients’ breast cancer needs, hiring a few additional experts helps round out our comprehensive care for patients with breast cancer.

Details about the new or expanded services include:

Inherited risk assessment and testing

With the addition of Nicoleta Voian, M.D., we expanded our genetics team to complement the Providence High-Risk Breast Cancer Clinic.  Dr. Voian is a clinical geneticist with a clinical focus on inherited cancer syndromes.  In her role, Dr. Voian works with patients and their family members to assess their potential to carry inherited genes that may predispose them to develop breast or other cancers.  She, along with our genetic counselor Aneesa Master, MS, advises patients about the risks and benefits of specialized cancer genetic testing, as well as interpretation of their test results and potential next steps in their care.

The presence of a dedicated geneticist helps us provide even more specialized knowledge related to inherited disorders.  Dr. Voian’s practice is located in the Providence Genetic Risk Assessment Clinic on the Providence Portland and Providence St. Vincent campuses.

Genomic profiling of tumors

In addition to our enhanced ability to test for inherited genetic disorders, we also have developed a comprehensive cutting-edge program to study acquired mutations in the cancer cells of our patients affected by this disease. The study of these acquired mutations is referred to as genomic testing. 

Our Providence genomics testing program is led by Carlo Bifulco, M.D., a member of our Providence Department of Pathology.  Dr. Bifulco oversees our recently acquired comprehensive testing platform that allows for rapid analysis of tumor cells and detection of  hundreds of different cancer specific mutations. The genomic profiling performed by Dr. Bifulco and his lab allows us to understand which mutations are driving cancer cell behavior and to direct specialized, personalized care plans accordingly.  Genomic profiling analysis is available and covered in many clinical scenarios today. However, our main focus at this time is to provide testing within the context of a clinical trial whenever possible. This provides a structured, data-driven context so that treatment results can be measured to help current and future patients.

TAPUR study examines cancer therapies with genomic profiles

An example of an important clinical trial in genomics available at the Providence Cancer Institute is the Targeted Agent and Profiling Utilization Registry (TAPUR) study. TAPUR is a non-randomized clinical trial that aims to describe the safety and efficacy of commercially available, targeted anticancer drugs prescribed for treatment of patients with advanced cancer with a potential genomic variant. The objective of the TAPUR study is to evaluate molecularly targeted cancer drugs and collect data on clinical outcomes. This will help us learn about additional uses of these drugs outside of indications already approved by the Food and Drug Administration.

At present, more than 100 sites across the U.S. are participating in the multi-year study, and Providence Cancer Institute is one of only two sites in the Providence system to offer this trial.  We’re just beginning our participation in the TAPUR study and have already enrolled several patients.  Ali Conlon, M.D., MPH, the current director of Providence High Risk Breast Clinic and a very active breast cancer medical oncologist, is our lead physician on the study.

Who benefits from the study?

  • Study participants get access to targeted drugs matched to the genomic profiles of their tumors.
  • Physician investigators receive assistance interpreting genomic test results and identifying appropriate treatments.
  • The cancer community learns about new uses of targeted anti-cancer drugs for patients who have exhausted current options.
  • Pharmaceutical companies get data on use of drugs for possible new cancer indications already being used in clinical practice.

Improved coordination of breast cancer services

The Providence Cancer Institute Breast Cancer Program is charged with coordinating breast cancer services provided by our institute. The program also is accountable for quality measurement and improvement of the care we provide our patients with breast cancer throughout Oregon. Program goals include expanding and improving the use of innovative support services such as our nurse navigators, social work team, embedded palliative care in our oncology practices and more.

We recently hired Kristen Massimino, M.D., a surgeon who specializes in breast cancer, to be Providence’s regional director of breast surgery in Oregon. In addition to her clinical practice at Providence St. Vincent, she will work in partnership with our excellent team of general surgeons that provides care for patients with breast cancer. As a program leader, her focus will be to improve connected care between the program and Providence Medical Group clinics.

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