James Ingle, M.D.

Using data from unresolved cases to solve a mystery is not just a storyline for TV dramas; it's part of real-life cancer research, too. Mayo breast cancer investigator James Ingle, M.D. collected data from nearly 30 years of clinical trials and used it to develop "best practice" guidelines for the use of Tamoxifen, a drug that suppresses estrogen to prevent cancer recurrence. However, not all breast cancer patients responded to the preventive benefits of the drug. Dr. Ingle and others were puzzled by this information. However, through Dr. Ingle's foresight, a complete set of breast tumor tissue samples was archived during the late 1980s and 1990s.

These invaluable samples enabled Mathew Goetz, M.D., Matt Ames, Ph.D., Richard Weinshilboum, M.D., and Dr. Ingle to probe for genetic information that revealed the reason why some women did not benefit from Tamoxifen treatment. The Mayo team designed new studies and developed molecular technology that led to the discovery of variations in the CYP2D6 gene. This gene actually inhibits how the body metabolizes Tamoxifen in its process to suppress estrogen. Further studies indicate that CYP2D6 function is also compromised when patients are treated simultaneously with Tamoxifen and other drugs, such as antidepressants.

This scientific-medical collaboration generated powerful knowledge that has changed medical practice. Physicians are now using these findings to individualize treatments for breast cancer based on a patient's genetic makeup.