Counting Calories to Curb Breast Cancer

Radiation oncologist Nicole L Simone, MD

Radiation oncologist Nicole L. Simone, MD

A grim funding climate threatens scientific discovery every day across our nation. But among ever-tightening budgets and stiffening competition for grants, Nicole Simone, MD, assistant professor of radiation oncology at Jefferson, continues to thrive.

“I’m constantly writing proposals. It’s not fun, but it forces me to plan exactly where I want to go with my science — to develop concrete ideas and ways to implement them as efficiently as possible,” she says.

Perhaps the greatest testament to the promise of Simone’s work is her receipt of three prestigious awards in the past year: the Radiation Therapy Oncology Group Simon Kramer New Investigator Award, the American Society for Radiation Oncology Junior Faculty Award and the Ben Franklin-Prostate Cancer Foundation Young Investigator Award.

Currently, Simone’s top priority is leading a first-of-its-kind clinical trial evaluating calorie reduction’s impact on radiation therapy for women with breast cancer. Her studies have indicated that cutting calories from these patients’ diets could enhance radiation’s effectiveness, and Simone is excited to translate her lab discoveries to the human population.

What inspired you to study caloric intake’s connection to cancer?

Dr. Simone: Radiation stresses cells, so I’ve tested other stressors to see how they affect the body. I found that calorie restriction is a stressor that alters the molecular pathways involved in radiation therapy, so I wondered if we could use it to get a bigger bang for our radiation buck. And we did — the combination caused greater tumor shrinkage and a decrease in metastases.

What does your clinical trial involve?

Dr. Simone: Patients start by keeping a diet log so we can assess their caloric intake. We then work with Dr. Daniel Monti and his team at the Myrna Brind Center of Integrative Medicine to determine how to safely reduce that by 25 percent. Participants stay on that diet for 10 weeks while they undergo radiation. If we find that reducing calories improves their outcomes, it’s possible that dieting could become a standard, not to mention affordable, part of treatment.

Are you conducting any other research?

Dr. Simone: I’m also studying the effect of radiation on microRNA expression. MicroRNAs control translation and proteins, and I’ve been looking at how one in particular, miR-21, operates almost like an oncogene. It’s called an onco-miR and is known to be upregulated in breast cancer. If we could shut it down, maybe we can actually turn off some breast cancer genes.

Where do you see your field heading in the next several years?

Dr. Simone: I see a movement to limit toxicity in cancer therapy. Many adjuvant treatments to radiation have toxicity — and if you target different molecules with different drugs, you’re going to multiply that toxicity. But with methods like calorie restriction, we’re learning that we can turn off molecules associated with cancer in a nontoxic way, and I hope we can ultimately use this to enhance treatment safely and with minimal side effects.

What is your proudest accomplishment?

Dr. Simone: As proud as I am of my work, I’d have to say my two kids, Christina and Nicholas. They keep me busy but happy. And then as soon as they go to bed, I start writing grants again.

Reprinted from the Fall 2013 issue of the Jefferson Alumni Bulletin

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