An interview with Dr. Michael Birrer
1. Diane Redington: You talked about obtaining tissue from patients. Are you in need of more additional tissue samples, because I know that there are a number of women who ask me, “How can I help? Can I send my tumor? Can we participate?” So, are you in need of tissue?
Answer, Dr. Michael Birrer: The straight and easy answer is “Absolutely!” Again, this is a tumor that is not common. So getting large collections is hard and numbers are important in this analysis. If we are analyzing small numbers of tumors, we might overestimate or underestimate a particular molecular problem. So we need fairly large numbers. More importantly, we are now evolving from having analyzed what we call formalin-fixed paraffin-embedded material. These are the tumors that are removed from the patient, they go to the path lab and they are fixed. They are extremely helpful. But there are certain assays that can only be done on fresh or frozen material. So we are really looking for that.
2. Diane Redington: How would we find that? Would you have to find a woman who is in remission and has a recurrence? Would that be the likely source of the tumor?
Answer, Dr. Michael Birrer: I think the most common source would be a patient who has suffered a recurrence, has a radiologically visible site of tumor that can be safely biopsied. We already have an IRB-approved protocol to do this, and we have done it several times. It is safe – I can’t say it is non-invasive – it is invasive – but a quick, safe procedure, which gives us enough tumor to analyze, both for the project but also for that patient. Now, an alternative approach is at the time of initial diagnosis. That is tricky though, because as you probably know, when patients are operated on, most of that material ends up in the path lab and ends up being fixed very quickly.
3. Diane Redington: Women will want to know, “What can I do to help?” They will donate money and will donate tissue. What else can we do to support this research and to find a cure?
Answer, Dr. Michael Birrer: Well, I think the first two you mention are important. This is a resource-dependent process. There is no issue about that. I think material and tissue is very important and that is not only primary tissue but recurrent tissue. We need to know what the evolution of the molecular events are in this tumor. Don’t know that yet.
I think what you’ve done with this project and with the website is equally important. Uncommon tumor. So, every woman felt she was by herself. Now you have begun to create a network and a place where people can and patients can talk about this. That’s going to be incredibly important. So, let’s say tomorrow, the science leads me to a clinical trial possibility. I need a mechanism by which we can spread the word on that. So, the website and what you are doing is so important for that.
But let’s say we can’t get a company involved or we can’t get the NCI [National Cancer Institute] interested. We need a group of ladies who are motivated to make that happen. Because there is nothing more convincing than motivated ladies.
Diane Redington: Show up at Genentech.
Dr. Michael Birrer: It works. Been there; done that.
Diane Redington: Yes, it worked with Herceptin and breast cancer.
Dr. Michael Birrer: Absolutely.
Diane Redington: Absolutely. Well, we are a bunch of motivated ladies. So, we just need to know what to do, and I think your direction and help in working with us on has just made me feel so optimistic and positive. I think we’re going to make history.
Dr. Michael Birrer: Good. I like that.
Diane Redington: That’s our challenge.
Dr. Michael Birrer: That’s the plan.
Diane Redington: That’s what we’re going to do.
Diane Redington: Well, again, I can’t thank you enough. I feel so fortunate that we were able to connect and establish this wonderful research and meet your team. You guys inspire me every day. I just can’t thank you enough.
Dr. Michael Birrer: You inspire us. That’s why we do it. Thank you.