Cancer Care: The Next Generation

Dr. Gail Roboz on ABC talks about “taking a chance on something new.” [go]

 

 

 

 

 


Treatment of minimal residual disease in AML patients

 

Gail Roboz, MD from Weill Cornell Medicine discusses minimal residual disease (MRD) found in acute myeloid leukemia (AML) patients. According to Dr Roboz the biology of the remaining leukemia cells may not be similar to the bulk disease that was eliminated with initial therapy. Currently there are efforts to characterize and quantify the remaining cells, with the hopes to determine whether existing or novel treatments can be used to lower their number to below the threshold level required for stem cell transplants. Furthermore, stem cell transplants are dramatically less effective if there is minimal residual disease detected so any therapy to reduce these cells may confer an advantage. Recorded at the 2016 Annual Meeting of the British Society of Haematology (BSH) and International Society of Hematology (ISH), in Glasgow, Scotland.

Original story posted to Video Journal of Hematological Oncology [go]


Not just a shot in the dark

Friday, July 1, 2016

In many ways, it’s a science success story: 8-year-old boy with a rare form of brain cancer is treated by one of the world’s leading experts in the disease, who collaborates with a pioneering precision medicine institute to sequence his cancer and create a first-of-its-kind tumor model replica in the lab, allowing for further analysis and treatment testing without risk of harm to the child.

Upon analysis, the physician-scientist discovers a mutation previously not known to be linked to that type of cancer — and it happens to be in the protein that his colleague has spent a career studying. He contacts the colleague to ask if there is a drug to target the protein, and it arrives the next day. Applied to the tumor model, the drug effectively kills 80-90 percent of the diseased cells.

If only the story ended there.

Unfortunately, although the drug has been approved by the FDA, it cannot be used on the young patient because it has never been tested in children, and the pharmaceutical company controlling the drug is not willing to take the risk.

“We now start the gymnastics of trying to get permission from the FDA based on compassionate use,” said Jeffrey Greenfield, M.D., Ph.D. “We’ve done it before, and it takes anywhere from 3-6 months. This boy doesn’t have 3-6 months.”

Greenfield, a neurosurgeon at Weill Cornell Medicine and NewYork-Presbyterian, shared the anecdote at a special event held at Weill Cornell Medicine on June 29, one of 270 across the United States convened by Vice President Joe Biden in tandem with a national summit at Howard University in Washington, DC

Biden invited regional participants to discuss the goals of the “Cancer Moonshot” mission, announced in January by President Barack Obama as a way to accelerate cancer research, foster data sharing and collaboration, and improve patient access to care — all on a five-year timeline.

Greenfield said his story summed up some of the challenges the nation will face in trying to achieve such an ambitious goal.

“The promise of precision medicine, which is enormous and which we have all bought into, doesn’t deliver in this case,” Greenfield said. “We’ve done all the work that we’ve promised to do, and we still have hurdles. The science is great, the medicine is great, but we’ve got to figure out a way to bridge the chasm between academia, pharma and clinic.”

The future is now

Rohan Ramakrishna, M.D., and Gail Roboz, M.D., at the NYC regional Cancer Moonshot Summit at Weill Cornell Medicine
Rohan Ramakrishna, M.D., and Gail Roboz, M.D.. Photo: Ira Fox

Greenfield was joined at the event by more than a dozen other distinguished researchers and physicians, as well as a standing-room only crowd of around 100.

Participants heard that in many ways, the future of medicine is already here. Silvia Formenti, M.D., discussed how she uses radiation therapy to turn patients’ own tumors into internal “vaccines,” and Ching Tung, Ph.D., director of the Molecular Imaging Innovations Institute described new ways of “seeing” cancer.

Neurosurgeon Mark Souweidane, M.D., spoke about the importance of developing new forms of drug delivery and working with industry to be able to integrate research and technology into the operating room. His colleagues Susan Pannullo, M.D., and Michael Kaplitt, M.D., Ph.D., explained stereotactic radiosurgery and the use of ultrasound technology to poke holes in the blood-brain barrier.

“These are ways we can use novel non-invasive technologies that will put us as surgeons out of business, unfortunately, but will help heal the world,” Kaplitt said.

Gail Roboz, M.D., director of the Weill Cornell Leukemia Program, described immunotherapy, and in particular the use of CAR-T cells as an emerging therapy.

“The idea isn’t new, “Roboz said. “What’s new is that we can actually do it, we are able to finally do things that were Jetsons level before.”

“In 2016, we are at an amazing inflection point in cancer therapy,” added neurosurgeon Rohan Ramakrishna, M.D. “It’s one thing to say you want to accomplish big change in five years, it’s another to be able to do that.”

But he added that the time it takes to get discoveries from bench to bedside is still too long. We need to innovate, Ramakrishna said, and we need to incentivize high-risk research.

To read the full story [go]


Some Pediatric Regimens Can Be Successful in Adults With ALL

When Jody Winsick-Soluri was diagnosed with acute lymphoblastic leukemia (ALL), she found out she had a chromosomal abnormality, the Philadelphia chromosome, which made her prospects bleak.

“I was bleeding out; they said I might only have 24 hours to live,” Winsick-Soluri remembers. Now, after many rounds of chemotherapy, total body irradiation, two bone marrow transplants and seven years, Winsick Soluri takes a targeted drug — Sprycel (dasatinib) — that blocks a protein leukemia cells need to proliferate. “Now, I’m four-and-a-half years out from the last transplant,” the New Jersey mother of four says. “More people with ALL are staying alive a lot longer.”

See the original article posted on March 16, 2016


What to Expect When You’re Expecting MDS

Dr. Ritchie provides and in-depth look at what it takes to diagnose MDS. For more information visit crushdmds.org.


Dr. Desai – Treatment for Intermediate & High Risk MDS

Dr. Desai discusses approved treatments for intermediate and high risk MDS. For more information visit crushmds.org.


Six Top Medical Institutions Launch Research Alliance Program to ‘CRUSH MDS’, a Rare Form of Blood Cancer

Joint Effort Expands Experts’ Capacity to Develop Treatments, Find a Cure

crush_mds_logoEx-marine Kevin Chambers had always been a strong and powerfully built man. The retired 66-year-old Vietnam War veteran used to work as a professional bodyguard in New York City, providing personal security for major celebrities like Michael Jackson, James Cagney and Barbra Streisand. Last year, Chambers needed a wheelchair and a walker just to get around. 

“I got sick in 2014 and felt so strange and weak in so many ways,” said Chambers. After being initially diagnosed with severe anemia along with two other conditions, later test results showed he had atypical myelodysplastic syndrome (MDS), a life-threatening bone marrow failure disease. Thanks to his daughter, an editor at ABC’s Good Morning America, Chambers was referred to Dr. Gail Roboz, the specialist who treated the show’s co-anchor Robin Roberts for MDS.

Roboz is with the Weill Medical College of Cornell University, one of the six preeminent institutions that form the MDS Clinical Research Consortium (MDS CRC). The others include the Cleveland Clinic Taussig Cancer Institute, the Dana-Farber Cancer Center in Boston, MD Anderson Cancer Center in Houston, H. Lee Moffitt Cancer Center and Research Institute in Tampa, and the Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins in Baltimore.

The MDS CRC was created with a grant from the Edward P. Evans Foundation. Suffering from MDS himself, philanthropist Evans was determined to speed up drug development by minimizing excessive “red tape” in clinical research. The CRC is the first collaboration of its kind, and its investigators lead unique, high-quality clinical and laboratory studies aimed at improving the lives of MDS patients. It recently launched a website with a public initiative called the Clinical Repository to Understand, Study and Heal Myelodysplastic Syndromes, otherwise known as CRUSH!!MDS.

The consortium works to accelerate and amplify the research conducted at these leading cancer centers. The beneficiaries are patients like Kevin Chambers, who Dr. Roboz quickly involved in a clinical trial. With careful monitoring of his blood cell counts and reactions to drugs, she was able to customize his care with precision treatments that were regularly adjusted based on his progress.

One year later, Chambers is walking again and his strength has vastly improved. He used to need a blood transfusion every two weeks. Now his transfusions are five weeks apart. He jokes that when he has enough blood, he doesn’t even need to nap. “I work very closely with Dr. Roboz and, if I don’t follow what she says, she kind of gives me hell by thanking me for my medical opinion.” That toughness combined with constant attention to the clinical data is how the specialists CRUSH MDS. For more information visit crushmds.org.

Press release originally posted on AAMDS March 2, 2016