Oncology Rounds on Nashville Medical News

Oncology Rounds

Posted: Monday, September 12, 2011 12:16 pm

Vanderbilt-Ingram Cancer Center Announces Leadership Changes

Last month, Vanderbilt-Ingram Cancer Center (VICC) announced the promotion of two senior faculty members to leadership roles. Carlos L. Arteaga, MD, professor of Medicine and Cancer Biology and director of the Breast Cancer Program, has accepted the role of associate director for Clinical Research, and R. Daniel Beauchamp, MD, distinguished professor of Surgery and chair of the Section of Surgical Sciences, has been named to a new leadership position as deputy director of VICC.

Arteaga, who joined the Vanderbilt faculty in 1989, is also the director of the VICC Specialized Program of Research Excellence (SPORE) in Breast Cancer, which is supported by funding from the National Cancer Institute (NCI). He received his medical degree from the University of Guayaquil in Ecuador and completed his internal medicine training at Emory in Atlanta and his oncology fellowship at the University of Texas Health Sciences Center in San Antonio. His work helped pave the way for development of several oncogene-targeted drugs such as trastuzumab (Herceptin), cetuximab (Erbitux) and erlotinib (Tarceva), as well as other combinations currently in development.

Beauchamp, who previously held the position of associate director for Clinical Research, has joint appointments as professor of Cell and Developmental Biology and Cancer Biology. He received his medical degree and served a residency in general surgery at the University of Texas Medical Branch (UTMB), Galveston. He was a post-doctoral fellow and research assistant professor working with Hal Moses, MD, at Vanderbilt, before returning to UTMB as an assistant professor. He rejoined the Vanderbilt faculty in 1994. An active investigator in the field of cancer research with a highly competitive program in colon cancer investigation, Beauchamp has published more than 100 peer-reviewed articles and has had continuous funding from the National Institutes of Health for more than 20 years.

Sarah Cannon Debuts Robotic-Assisted Thoracic Oncology Surgery, Expands GI Program

This spring, thoracic oncologist Mathew Ninan, MD, performed Nashville’s first robot-assisted thoracic oncology surgery at The Sarah Cannon Cancer Center (SCCC) at Centennial Medical Center – expanding surgical cancer treatment options for patients with lung and esophageal cancer. The less invasive, advanced robot-assisted approach allows patients to avoid scars, the loss of large amounts of tissue, and reduce recovery time.

The first da Vinci SI robot-assisted thoracic procedure performed at Centennial Medical Center was a lobectomy. Nearly 70 percent of patients suffering from early stage lung cancer are candidates for robot-assisted surgery, which often results in improved lung function and lower recurrence rates.

“By utilizing the robot, we are able to take video-assisted surgery, which has been the widely accepted form of lung cancer treatment, to the next level and even further expand our candidate pool for surgical treatment of lung and the removal of thoracic tumors,” said Ninan, who has served as the local principal investigator for three international trials in thoracic oncology and consults for improved accrual and surgical participation in clinical trials nationally. “This minimally invasive procedure provides a higher rate of accuracy in tumor removal and avoids large incisions and rib removal, greatly diminishing the patient’s pain after surgery.”

In other news, SCCC is expanding its gastrointestinal oncology program at Centennial Medical Center. The multidisciplinary team specializes in the treatment of esophageal and gastric malignancies, retroperitoneal sarcomas, pancreatic carcinoma, hepatobiliary carcinomas, neuro-endocrine tumors, and colon, rectal and anal malignancies. Colon and rectal surgeon Jason Aston, MD, recently joined the leadership team, which includes medical oncologist Johanna Bendell, MD; radiation oncologist James Gray, MD; surgeon William Polk, MD; and interventional radiologist Edward Priest, MD. Aston received his medical degree from the University of Tennessee College of Medicine in Memphis. He completed his internship and residency at the University of South Florida College of Medicine and his rectal surgery fellowship at Baylor University Medical Center.

The program’s goal is to receive patients as close to initial diagnosis as possible in order to be assessed by all appropriate disciplines and be considered early on for participation in clinical trials through the center’s partnership with Sarah Cannon Research Institute. SCCC also provides patients with access to advanced radiation therapy including 3-D planning and CyberKnife Stereotactic Radiosurgery.

Pao Named Addario Lectureship Award Recipient

William Pao, MD, PhD, director of Personalized Cancer Medicine for Vanderbilt-Ingram Cancer Center (VICC), has been named the winner of the 2011 Addario Lectureship Award. The annual award from the Bonnie J. Addario Lung Cancer Foundation recognizes remarkable individuals for their work to eradicate lung cancer. According to the National Cancer Institute, an estimated 222,520 people in the United States will be diagnosed with lung cancer this year, and 157,300 individuals will die from the disease.

The Pao Laboratory at VICC performs translational research in the area of solid tumor biology, using lung cancer as a model, and hopes to develop molecularly-tailored treatment options. Pao’s research seeks to identify ways to overcome resistance to drugs currently used to treat lung cancer patients.

Vanderbilt Lung Cancer Study Suggests New Therapy Schedule for Tumors

A new lung cancer study led by Vanderbilt-Ingram Cancer Center (VICC) investigators found that some non-small cell lung cancer (NSCLC) cells grow at different rates, which may explain why some tumors become resistant to anticancer drugs faster than others. Based on the differential growth rates, the study suggests that a change in the timing and dosages of certain therapies could be effective in delaying the onset of resistance to therapy.

The study was published in the July 6 issue of Science Translational Medicine. The first author on the paper is Juliann Chmielecki, PhD, who served as a graduate student in the research laboratory of William Pao, MD, PhD.

NSCLC with mutations in the epidermal growth factor receptor (EGFR) gene respond to the tyrosine kinase inhibitor (TKI) drugs gefitinib (Iressa) and erlotinib (Tarceva). Unfortunately, every patient with metastatic NSCLC treated with these drugs eventually develops resistance to therapy, and the cancer resumes growth. Some patients respond to the drugs again after a break in therapy, but there has been no way to predict who will respond.

Since gefitinib and erlotinib were designed to target wild-type EGFR, researchers hypothesized that current drug dosing schedules might not work for patients whose tumors have mutant EGFR. To investigate this theory, the researchers developed genetically-matched pairs of cell lines that were TKI sensitive or TKI resistant to model acquired drug resistance.

“We were surprised to discover that the drug-resistant cells grew more slowly than the drug-sensitive cells,” explained Pao. “We matched these findings against the clinical data available on patient response to therapy to verify that our preclinical findings reflected the actual course of human disease.”

Using mathematical models, the researchers designed optimal dosing strategies for EGFR-mutant NSCLC. The models predicted that using high-dose pulses of erlotinib or an even more potent EGFR TKI in conjunction with a continuous low dose schedule could delay the establishment of large drug-resistant cell populations. Pao noted, “We found that it took twice as long for the cells to develop complete resistance when we used the pulsed dosing regimen with the more potent EGFR TKI. We also found a strategy to delay disease progression even after the development of resistance.”

These findings suggest that a similar strategy might be applied toward the optimization of dosing with other targeted therapies for oncogene-driven cancers. The authors note, however, that these findings must be verified in clinical trials.

Baptist Cancer Program Re-Accredited

Baptist Hospital’s cancer program was recently re-accredited with a Three-Year Accreditation with Commendation from the Commission on Cancer (CoC) of the American College of Surgeons.

Established in 1922, the CoC is a consortium of professional organizations dedicated to improving survival rates and quality of life for cancer patients through standard-setting, prevention, research, education and the monitoring of comprehensive, quality care. CoC accreditation is given only to those facilities that have voluntarily committed to providing the highest level of quality cancer care and undergo a rigorous evaluation process and review of their performance.

Vanderbilt Earns CEO Gold Standard Award for Cancer Prevention

Vanderbilt University Medical Center (VUMC), in conjunction with the Vanderbilt-Ingram Cancer Center (VICC), has been re-accredited as a CEO Cancer Gold Standard employer for 2011. The award is based on Vanderbilt’s efforts to help employees lead healthier lives, including activities that might help prevent cancer.

The CEO Roundtable on Cancer was founded in 2001 when former President George H. W. Bush challenged a group of executives to “do something bold and venturesome about cancer within your own corporate families.” The executives responded by creating the award, which is given to organizations that take concrete steps to reduce the cancer risk of employees and their families through screenings, early detection and healthy changes in lifestyle.

Saint Thomas Health Unveils My Cancer Source Website

Saint Thomas Health recently launched the website, My Cancer Source, as a way to bring better information to those who have been touched by cancer, whether they are a newly diagnosed patient, family member or patient in remission. The site provides information on how to locate cancer specialists, clinical trials, genetic counseling and cancer risk assessments, support groups, up-to-date cancer resources and the most comprehensive cancer treatments possible. In addition, users can search the website with any phrase or question and receive results tailored to their specific needs. The site can be accessed at www.MyCancerSource.com.

Vanderbilt Opens New Cancer Center in Green Hills

Vanderbilt-Ingram Cancer Center recently opened a free-standing cancer clinic in the Green Hills neighborhood to give cancer patients more options for their oncology care. The LEED-certified VICC Green Hills provides many of the same services available at the main VICC campus, including access to board-certified cancer physicians and specially trained oncology nurses and pharmacists. Lab tests are performed at the clinic, and chemotherapy drugs are prepared and administered onsite to reduce the wait for drug infusions. Patients receiving care in the Green Hills facility are also eligible for enrollment in clinical research trials available at VICC.

“We are committed to reaching out to a wider community so that we can bring our expertise and access to clinical research trials to patients in the most convenient setting possible,” said Michael Neuss, MD, chief medical officer for VICC.