Kelly K. Hunt, MD, FACS

On behalf of the American College of Surgeons Oncology Group
Co-Investigators: Matthew J. Ellis, MD, PhD, Washington University School of Medicine, St. Louis, MO; Joseph R. Nevins, PhD, Duke University, Durham, NC, and John A. Olson, Jr., MD, PhD, Duke University, Durham, NC

Postmenopausal women with strongly ER positive stage 2 and 3 breast cancer who are at risk for a mastectomy are candidates for preoperative endocrine therapy to down stage the tumor and improve surgical outcomes. This practice is supported by randomized clinical trials that show an increased chance of breast conservation when aromatase inhibitors were utilized in this indication in comparison with tamoxifen.

In this project, the ACOSOG researchers will use tumor samples from ongoing ACOSOG clinical trial Z1031 to address why estrogen receptor positive breast cancers are not universally responsive to this approach. Specifically, they will asks if large gains in DNA segments in tumor cells called "amplicons" are associated with treatment resistance. This information will not only define which patients are suitable for preoperative endocrine therapy, but will aid in the identification of genes that are responsible for treatment failure. This may lead to the development of new treatments that increase the effectiveness of endocrine therapy through the application of targeted pharmacological agents.

Mid-Year Progress Report:
In late January, the researchers reported that analysis of ACOSOG Z1031samples has been initiated to provide an even larger number of specimens for biomarker research. Z1031 is a phase III clinical trial which is actively enrolling patients to evaluate the efficacy of neoadjuvant aromatase inhibitor (AI) for locally advanced ER + breast cancer in postmenopausal women. The trial was activated in January 2006 with a target accrual goal of 375 patients. The monthly accrual rate is meeting the targeted accrual rate and as of January 29th, 2008, 189 patients have been accrued and 116 have completed surgery. There are 252 approved sites and at the current rate of enrollment, this trial is estimated to close in June 2009. The ACOSOG researchers have now completed expression array analysis on the first 50 baseline samples and 19 post-treatment specimens. By June, they expect to have processed approximately 100 cases for DNA and RNA and to have completed analysis on over 60.

Bio:
Dr. Hunt received her medical degree with highest honors from The University of Tennessee Center for the Health Sciences, Memphis, Tennessee, in 1986. From 1986 to 1993, she fulfilled her postgraduate training at the University of California Los Angeles School of Medicine, where her positions included: resident, Department of Surgery; surgical oncology research fellow, National Institutes of Health Surgical Oncology Training Grant recipient; American Cancer Society Clinical Fellow in the Division of Surgical Oncology; assistant resident in general surgery, Department of Surgery; and chief resident in general surgery. She also served as a registrar in General and Vascular Surgery, University Hospital, Queen’s Medical Centre, Nottingham, England. From 1994 to 1996, she was a surgical oncology fellow at The M. D. Anderson Cancer Center.

Dr. Hunt joined the M. D. Anderson faculty in 1994 as junior faculty associate in the Department of Surgical Oncology. In 1996, she was promoted to Assistant Professor of Surgery, and in 2000, was named Associate Professor of Surgical Oncology and Chief, Surgical Breast Section in the Department of Surgical Oncology. In 2004, Dr. Hunt was named as Professor of Surgery. Within the Department of Surgical Oncology, Dr. Hunt also serves as the Director of the Surgical Breast Research Program. She is the Director of the weekly Breast Education Conferences. In addition to her responsibilities in the Department of Surgical Oncology, Dr. Hunt is also the Associate Medical Director of the Nellie B. Connally Breast Center and the Director of the Breast Lymphatic Mapping Working Group at The University of Texas M. D. Anderson Cancer Center.

Dr. Hunt has received numerous awards, including the American Cancer Society Clinical Fellow of the Year for two consecutive years. She holds membership in a number of institutional committees, including the Steering Committee of the Breast Cancer Research Group and the Executive Committee of the Medical Staff. Dr. Hunt has published over 240 peer-reviewed articles in journals such as Annals of Surgical Oncology, Cancer, Cancer Research, The Journal of Clinical Oncology, and Science. In addition she has published 20 invited articles, two editorials, over 200 abstracts in the past 5 years, and 24 book chapters. She has edited three books on breast cancer and one book on gene therapy. She has been an invited speaker at over 111 national and international presentations, and more than 70 other guest lectures, grand rounds, visiting professorships, and professional conferences.

Since her arrival at MD Anderson, Dr. Hunt has served as principal investigator, collaborator and co-investigator on numerous grants, contracts and funded protocols. She is the Chair of the Breast Organ Site Committee and a member of the Executive Committee of the American College of Surgeons Oncology Group; a member of the Correlative Science Committee of the Breast Cancer Intergroup of North America; and a member of the Scientific Program Committee of the Society of Surgical Oncology. Her primary research interests are gene therapy and tumor suppressor genes, and her clinical interests include breast conservation, sentinel lymph node biopsy, and skin-sparing mastectomy.