Out from the shadows
At least among the general public, biostatisticians have traditionally been the unsung heroes of cancer research, rarely accorded the recognition and fanfare given to front-line scientists. At Dana-Farber and elsewhere, however, they are indispensable partners in the study of cancer and related diseases, in the clinic as well as the laboratory. Biostatistical experts work with researchers to design studies, monitor progress, and interpret results. They help investigators determine, for instance, how many patients should be included in a study of a new cancer drug's effectiveness, which laboratory animals are best suited for experiments on shutting down key genes, or what type of computer program is needed to handle experimental data.
Biostatistician Richard Gelber, PhD, (center) collaborates with Virginia Dalton, RN, and Lewis Silverman, MD, on clinical trials for acute lymphoblastic leukemia.
The advent of powerful new research tools in medicine has only increased the need for skilled biostatisticians. This is certainly true in the burgeoning field of microarray technology, where these experts help interpret grids showing the activity of thousands of genes. It is also evident in the creation of two new subfields: bioinformatics, which relates experimental data to that derived from mathematical models, and computational biology, which constructs electronic simulations of life processes.
In each of these areas, DFCI's Biostatistical Science Department has been a pioneer, as befits one of the largest and most respected units of its type based at a U.S. cancer center. But that wasn't always the case. Thirty years ago, the department didn't even exist.
Recognizing the handicap this presented to DFCI scientists, the Institute's then-Physician-in-Chief Emil "Tom" Frei III, MD, did not so much create a biostatistics department as import one. In 1977, he contacted his longtime friend and colleague Marvin Zelen, PhD, a professor of statistics at the State University of New York (SUNY) at Buffalo, to see if he'd be interested in joining Dana-Farber. Zelen agreed and brought with him virtually his entire department: 12 faculty members, sizable funding, and even a minicomputer — a great rarity in those days.
Marvin Zelen, PhD
"Tom Frei felt the Institute [then known as the Sidney Farber Cancer Center] should have a first-class biostatistics group," recalls Zelen, who served as department chairman until 1999 and maintains a DFCI appointment. "Our coming here gave the Institute an immediate pre-eminence in the field."
The change had an almost instant impact on the way research was conducted at the Institute. Zelen and his team developed a database-management system — one of the first anywhere — to create a formal system for processing clinical information. And they built a database for collecting and organizing research results that "put us half a decade ahead of everyone else," Zelen remarks.
With the SUNY department's move from Buffalo to Boston, Dana-Farber inherited what had been one of its main roles: serving as the statistical center for national and international cancer research groups. Studies run by these units often involve hundreds of doctors and thousands of patients, and the task of gathering, standardizing, and analyzing their results calls not only for massive computing power, but also the highest level of biostatistical skill. Two of the best known of these projects are the Eastern Cooperative Oncology Group, a consortium of some 350 hospitals and treatment centers with a database of more than 100,000 cancer cases, and the International Breast Cancer Study Group, a collection of institutions on four continents that has carried out clinical studies on the timing and duration of chemotherapy and the value of hormone therapy for breast cancer.
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