ONcology Rounds

Nov 22, 2021 at 02:54 pm by Staff

News & Updates in Cancer Care

New treatments, research, program innovations and leadership - there is a lot of exciting news both nationally and in Nashville when it comes to improving oncology care.

New AACR Report Highlights 50 Years of Progress

Last month, the American Association for Cancer Research (AACR) released the 11th edition of its annual Cancer Progress Report, which underscores how cancer research, largely supported by federal investments in the National Institutes of Health (NIH) and the National Cancer Institute (NCI), continues to drive progress for patients with cancer.

The report chronicles advances in basic, translational, and clinical cancer research; features profiles of patients who have benefited from recently approved anticancer therapeutics; includes the latest information on cancer prevention, detection, and health disparities; and outlines policy recommendations.

This year's report highlights the enormous strides in cancer research and treatment since the National Cancer Act was signed into law by President Richard Nixon on Dec. 23, 1971. This groundbreaking legislation laid the foundation for a robust and innovative cancer research community, which has contributed to decades of progress for patients in the U.S. and around the world. A few highlights include:

  • In the U.S., the overall age-adjusted cancer death rate has decreased by 31 percent from 1991 to 2018, a reduction that translates into 3.2 million lives saved. This reduction includes a record 2.4 percent decline between 2017 and 2018, the largest reduction ever seen in a single year.
  • Successful efforts to reduce smoking rates among Americans have contributed to a 41 percent decline in lung cancer-related deaths from 1991 to 2018.
  • Fueled by discoveries made over the past 50 years, molecularly targeted therapeutics and immunotherapeutics have substantially increased the five-year survival rates for patients with formerly intractable cancers, like lung cancer and metastatic melanoma.

Biden Appoints Winkfield to National Cancer Advisory Board

Dr. Karen Winkfield

President Joe Biden recently appointed Karen Winkfield, MD, PhD, to the National Cancer Advisory Board for a six-year term to help guide federal initiatives focused on cancer.

Winkfield is the executive director of the Meharry-Vanderbilt Alliance, professor of Radiation Oncology and Ingram Professor of Cancer Research at Vanderbilt University Medical Center and professor of Medicine at Meharry Medical College.

"This is such an honor because the board helps shape the activities of the National Cancer Program," said Winkfield. "For someone like me, who is focused on health equity and ensuring that everyone -- regardless of their race, ethnicity, geographical location or socioeconomic background -- has the same chance to survive cancer and survive it well, this is a golden opportunity."

She joins Scott Hiebert, PhD, professor of Biochemistry and Hortense B. Ingram Professor of Cancer Research at Vanderbilt, on the 18-member board.

Eng Named NCI Co-Chair of GI Steering Committee

Cathy Eng

Recently, Cathy Eng, MD, FACP, FASCO, was elected co-chair of the National Cancer Institute (NCI) Gastrointestinal Cancer Steering Committee, which is responsible for supervising clinical trials, including studies on neuroendocrine tumors, gastroesophageal carcinoma, rectal-anal and colon cancers, hepatocellular tumors and pancreatic cancer.

"We help evaluate and prioritize NCI-sponsored studies involving the National Clinical Trials Network for all phase 2 and phase 3 trials that have more than 100 patients involved," explained Eng, professor of Medicine, David H. Johnson Professor of Surgical and Medical Oncology and co-leader of the Gastrointestinal Cancer Research Program at Vanderbilt-Ingram Cancer Center, who began her three-year term on Aug. 23.

Tennessee Oncology, BCBST Launch Value-Based Care Initiative

In October, Tennessee Oncology and BlueCross BlueShield of Tennessee announced an innovative, value-based cancer care program designed to improve treatment coordination. Launched for BlueCross networks P, S, and L, the new initiative is touted as being one of the most comprehensive value-based arrangements for cancer care in the country.

Dr. Andrea Willis

"This program supports our members' peace of mind by enabling access to the highest-quality, patient-centered care for their condition," said Andrea Willis, MD, senior vice president and chief clinical officer for BCBST.

Developed through a comprehensive evaluation of the most effective features of other value-based cancer care programs in recent years, the program is designed to support high-quality, cost-effective health care to patients. The initiative follows BlueCross members at all phases of the cancer journey from diagnosis through treatment and follow-up, and providers earn financial incentives or penalties based on how well members' care is coordinated and documented. BlueCross and Tennessee Oncology will:

  • ensure best practices are followed in care planning and treatment,
  • analyze treatment data to make sure care guidelines are met and patients receive the right treatment at the right time, and
  • provide patient-centered care throughout the process.
  • As the clinical partner in the Oncology Medical Home, Tennessee Oncology will maintain key quality designations including the Quality Oncology Practice Initiative (QOPI) Certification awarded by the American Society of Clinical Oncology (ASCO).

Dr. Natalie Dickson

"Our commitment to innovation and patient-centered care have always been core to the culture of Tennessee Oncology," said Natalie Dickson, MD, president of Tennessee Oncology. "The current era of personalized medicine is especially encouraging for our patients and clinicians; however, affordability will continue to be a major challenge. As evidenced by this program, the role of the health plans is becoming increasingly important to enable us to fulfil our mission. This value-based care initiative will serve as a model for how clinicians and health insurers can collaborate to benefit patients."

Sarah Cannon Continues to Grow

Sarah Cannon has recently added several new physician-scientists to their renowned program.

Navneet S. Majhail, MD, MS, FASTCT, recently joined Sarah Cannon as deputy physician-in-chief of Blood Cancers for the Sarah Cannon Transplant and Cellular Therapy Network. In addition to his work at Sarah Cannon, Majhail is also serving as program medical director for the Sarah Cannon Transplant and Cellular Therapy Program at TriStar Centennial Medical Center.

Most recently, Majhail served as director of the Cleveland Clinic's Blood and Marrow Transplant Program and also served as the vice chair for the Department of Hematology and Medical Oncology and a professor of Medicine with the Cleveland Clinic Lerner College of Medicine. He is a past president of the American Society for Transplantation and Cellular Therapy (ASTCT) and has been recognized as a fellow for his contributions to the field of transplantation and cellular therapy.

Meredith Pelster, MD, MSCI, joined Sarah Cannon as an investigator for Sarah Cannon Research Institute at Tennessee Oncology, specializing in gastrointestinal cancer, as well as head and neck cancer research. Pelster received her medical degree from Vanderbilt University School of Medicine. She completed her fellowship in hematology and medical oncology at MD Anderson Cancer Center and her residency and Master of Science in Clinical Investigation at Northwestern University.

Benjamin Garmezy, MD, also joined Sarah Cannon this year as an investigator for Sarah Cannon Research Institute at Tennessee Oncology, specializing in genitourinary (GU) oncology research. In his role, Garmezy oversees investigational therapy trials for GU cancers, including prostate, kidney, and bladder cancers. He received his undergraduate degree from Amherst College and his medical degree from Baylor College of Medicine. Prior to joining Sarah Cannon, Garmezy completed his internal medicine residency at the University of Michigan and his fellowship in hematology/oncology at MD Anderson Cancer Center.

Funding Renewed for Local Partnership on Cancer Disparities

The Meharry Medical College/Vanderbilt-Ingram Cancer Center/Tennessee State University Partnership (MVTCP) recently received renewed funding for the next five years to continue long-standing collaborations to eliminate cancer health disparities.

The National Cancer Institute, a division of the National Institutes of Health, awarded the grant through the U54 Comprehensive Partnerships to Advance Cancer Health Equity (CPACHE) program. The MVTCP is the longest-standing partnership in the United States through this program, beginning its 22nd consecutive year of funding this past September.

AACR Launches Two Career Development Awards to Encourage Diversity

In mid-October, the American Association for Cancer Research announced the creation of two career development awards (CDA) to further diversity, equity, and inclusion in cancer research. One is for basic, translational, or population sciences research with recipients receiving $300,000 over three years. The second is focused on clinical cancer research with applicants invited to submit proposed projects for the opportunity to receive $375,000 over three years.

These new awards support early-career investigators from racial or ethnic groups that are underrepresented in cancer-related sciences. In coordination with the AACR's Minorities in Cancer Research (MICR) constituency group, grantees will be provided opportunities to attend professional development sessions and to engage with colleagues and potential mentors.

Applications for the two awards through Nov. 30, 2021. For more information on these and other funding opportunities, visit aacr.org/professionals/research-funding.

Ascension Celebrates 3D Mobile Mammography

At the end of October, Ascension Saint Thomas held a ribbon-cutting for the state's first 3D mammogram breast tomosynthesis bus at Green Hills Mall. The 44-foot coach is outfitted with an imaging test that combines multiple X-rays to create a three-dimensional picture of the breast.

Set to serve 26 counties in the Middle Tennessee area, the goal of the coach is to contribute to early detection and a reduction in late-stage breast cancer and breast cancer mortality by providing crucial access to screening mammography.

The new mobile mammography bus was made possible by the donors to the Ascension Saint Thomas Rutherford Foundation, The Ascension Saint Thomas Foundation, the Christy Houston Foundation, and through the Our Mission in Motion program, an Ascension Saint Thomas initiative to increase access to breast health services to underserved, uninsured, and low-income patients

VICC Trial Tests ATR Inhibitor in Difficult-to-Treat Cancers

A clinical trial recently has been launched to test a new targeted therapy in patients with advanced and difficult-to-treat cancers.

Dr. Satya Das

Satya Das, MD, MSCI, assistant professor of Medicine at Vanderbilt-Ingram Cancer Center (VICC), is the national principal investigator for the trial enrolling people with metastatic small cell lung cancer, metastatic pancreatic cancer, metastatic neuroendocrine cancer and other types of advanced solid tumors.

The phase 1 trial will evaluate a novel drug, elimusertib, in combination with standard chemotherapy. In preclinical studies, elimusertib has demonstrated tumor shrinkage. An ATR inhibitor, this promising class of new drugs target the ataxia telangiectasia mutated and Rad3-related (ATR) kinase, which is involved in DNA damage repair. The drug inhibits the growth of tumor cells by limiting their ability to repair damaged DNA. ATR inhibitors work similarly to PARP inhibitors, which have already been approved by the U.S. Food and Drug Administration for ovarian cancer and breast cancer.

"Unfortunately, PARP inhibitors have a pretty limited activity for patients with the types of cancers in this clinical trial," Das explained. "ATR is a pathway that is actually activated by single strand DNA breaks. A lot of our chemotherapies induce DNA breaks. ATR is a very commonly activated pathway, so ATR inhibitors are being tested in multiple disease sites, mostly in early phase studies. What makes elimusertib quite interesting is that in preclinical models it seems to be the most potent. It induces the most tumor shrinkage across cancer types."

Sarah Cannon Expands Collaborations

With a mission to bring cutting-edge care and clinical trials to communities across the country, Sarah Cannon has announced several additions to the network this fall.

At the end of September, Sarah Cannon announced the opening of its newest drug development unit (DDU) in collaboration with Florida Cancer Specialists & Research Institute and the University of Central Florida College of Medicine in Lake Nona, Fla. The new unit is led by Cesar Augusto Perez, MD, a recognized expert in Phase 1 oncology research. The first of its kind in Lake Nona, the DDU focuses exclusively on oncology clinical trials at the earliest phases of research and was designed to meet the specialized needs of patients seeking advanced cancer treatment options.

Also in September, Sarah Cannon Research Institute announced an expansion of their collaboration with American Oncology Network (AON) with the addition of AON partner practice Genesis Cancer and Blood Institute as a strategic research site in Arkansas. Genesis joins Hematology/Oncology Clinic in Baton Rouge, Messino Cancer Centers in Asheville, N.C., and Zangmeister Cancer Center in Columbus, Ohio as strategic research sites to enhance access to clinical trials.

Nashville General Earns Cancer Reaccreditation for 80th Consecutive Year

This year, Nashville General Hospital earned reaccreditation from the American College of Surgeons Commission on Cancer (CoC) for an 80th consecutive year, making it the second-oldest accredited cancer program in Nashville.

The CoC recognizes cancer care programs dedicated to improving survival and quality of life for cancer patients through standards that promote cancer prevention, research, education and monitoring of comprehensive quality care. To earn this accreditation, a cancer program must meet 34 CoC quality care standards, be evaluated every three years through a survey process, and maintain levels of excellence in the delivery of comprehensive patient-centered care.

"We are thrilled to receive this accreditation for the 80th consecutive year," said Joseph Webb, D.Sc., MSHA, FACHE, CEO at Nashville General Hospital. "This recognition is a significant reminder of the incredible work that our organization does to improve the quality of life for cancer patients in the Nashville community."

Mark Your Calendar

AACR Annual Meeting

April 8-13, 2022 • New Orleans

Register by Dec. 17 to take advantage of early bird rates for the American Association for Cancer Research annual meeting. For event details or to register, go online to aacr.org.

ASCO Annual Meeting

June 3-8 • Chicago

Registration opens in December for the annual meeting of the American Society of Clinical Oncology. For details or to register, go online to conferences.asco.org/am.

Ascension Saint Thomas Uses 'Hot Chemo' in Ovarian Cancer Battle

Earlier this year, a Middle Tennessee teacher became the first in the state to receive an innovative treatment known as "hot chemotherapy."

When Cheatham County elementary school teacher Melissa Barr felt some stomach pains and bloating, she wasn't overly worried. A healthy eater and yoga devotee, she brushed off any concerns, thinking it was safer to just ride it out as the first wave of the pandemic was underway. By December 2020, Barr knew she needed to seek care and was shocked to be diagnosed with stage 3 ovarian cancer.

After receiving three rounds of traditional chemotherapy, Barr became the first ovarian cancer patient in Tennessee to receive Hyperthermic Intraperitoneal Chemotherapy (HIPEC), before completing another three rounds of traditional chemotherapy. HIPEC, also known as "hot chemotherapy" because it involves heating a standard dose of chemotherapy and applying it directly to the abdomen to increase penetration of cancerous tissues, has more frequently been used by surgical oncologists to manage cancers of the abdomen. However, gynecological oncologists Jason Barnett, MD, and Michael Stany, MD, led the charge in Tennessee by employing this technique in Barr's treatment at Ascension Saint Thomas Hospital Midtown.

Today, Barr's cancer is in remission, she has returned to teaching and is enjoying life with her family and friends.

American College of Surgeons CoC Celebrates 100th Anniversary

In October, the American College of Surgeons (ACS) Commission on Cancer (CoC) launched a year-long campaign to celebrate its 100-year anniversary.

Established in 1922, the CoC is a consortium of professional organizations dedicated to establishing standards to ensure quality, multidisciplinary, and comprehensive cancer care. Since its founding, the CoC has expanded its mission to improve survival and quality of life for cancer patients through standard-setting, prevention, research, education, and the monitoring of comprehensive quality care through compliance standards, data collection, and analysis.

Over the next year, the ACS will recognize the achievements of its accredited cancer programs, member organizations, and leadership in helping to improve the quality of care for cancer patients, as well as publishing a commemorative booklet to celebrate its centennial of service.

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