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Issue 18

Survivorship Program -- Good For Your Patients

Each year, more people benefit from early detection and effective medical treatments for cancer. Approximately 66 percent of adult cancer patients and 80 percent of childhood cancer patients are expected to live at least five years after diagnosis. As of January 1, 2006, there were an estimated 11.4 million cancer survivors in the United States, which is expected to increase to nearly 20 million by 2020.

The Fred Hutchinson Cancer Research Center Survivorship Program at Seattle Cancer Care Alliance is one of only eight LIVESTRONG Survivorship Centers in the nation and the only one in the Pacific Northwest. The Survivorship Program is open to all cancer survivors, regardless of where they received their original treatment. The program provides clinical care and patient education to cancer survivors at Seattle Cancer Care Alliance and includes:

  • A thorough screening and health evaluation program for survivors of bone marrow transplantation has been in place for more than 30 years – longer than any other in the world. In recognition of the Center’s strong history of cancer research, specialized oncology programs, and long-term care of bone marrow transplant patients, the LIVESTRONG Foundation awarded a grant to the Hutchinson Center to create the Fred Hutchinson Cancer Research Center Survivorship Program at SCCA; part of the LIVESTRONG Survivorship Center of Excellence Network.
  • A Treatment Summary (lists therapy and medical information related to the patient’s diagnosis and any potential long-term problems)
  • A Survivorship Care Plan (tests results, support services, and dates of treatment) A copy of the Treatment Summary and the Survivorship Care Plan are also sent to the patient’s
    medical oncologist and primary care provider.

Follow-up care may consist of recommended health and wellness screenings, monitoring for long-term effects of treatment, therapy for possible psychological effects, recommended lifestyle changes, and a list of local resources. “We serve as a bridge from the oncologist to the primary care physician,” says K. Scott Baker, MD, director of the Survivorship Program. “Our specialized knowledge of the short- and long-term concerns from having cancer allows us to red-flag any possible issues that may arise down the road. As a result we can let primary care physicians know what to look and test for in the future.”

The Survivorship Program hosts educational events for survivors and medical educational events for primary care physicians, mid-level providers, and ancillary health-care professionals involved in the management of cancer survivors so they have the latest information surrounding cancer survivorship issues.

This program offers current survivors the opportunity to shape a path to wellness for their own health, and works to benefit future survivors though research.

Learn more about the Survivorship Program

Contact the Fred Hutchinson Cancer Research Center Survivorship Program at Seattle Cancer Care Alliance at (866) 543-4272, or e-mail survivor@fhcrc.org. On the web at www.seattlecca.org/fredhutchinson-cancer-survivorship-program.cfm.

 

New clinical trials database launched

Seattle Cancer Care Alliance is a world-class cancer treatment center and home to over 200 promising new treatments being offered in clinical trials. SCCA launched a new web database listing all of these clinical trials in an effort to assist referring providers as they navigate through the trials and ultimately refer their patients to them.

“This is a big advancement for our trial coordinators that has taken over a year by several dedicated individuals to bring to fruition,” says Dr. Marc Stewart, medical director of SCCA. “New treatments can only come from clinical trials. The more patients we can enroll in trials, the quicker we can find the best treatments for these diseases.”

Visit www.seattlecca.org/clinicaltrials.

To find an appropriate trial for a patient, browse through the disease sections. You can refer a patient by sending an electronic referral form (click the Refer Patient button on the trial page) or call SCCA at (800) 804-8824. If you have any questions or comments about this site, contact Tove Thompson at tovethom@seattlecca.org or (206) 288-1233.

Dedicated Team is best practice for pancreas cancer care SCCA’s Pancreas Cancer Specialty

Clinic (PCSC) hopes to define a new standard of care for pancreas cancer while minimizing the obstacles that patients and their families may encounter in navigating a complex medical system. The PCSC is comprised of a dedicated team that includes four surgeons, Venu Paillarisetty, Gary Mann, James Park, and David Byrd; four medical oncologists, Sunil Hingorani, Sam Whiting, Vena Shankaran, and Tony Back; and radiation oncologist Wui-Jin Koh, as well as dedicated nurses, symptom management and pain specialists, nutritionists, physical therapists, social workers, and radiologists, all devoted to the clinic’s mission.

“Our program is unique,” says Dr. David Byrd, chief of surgical oncology at the University of Washington and associate director of surgery at SCCA. “I’m fairly certain there’s not a program like it in the country.” At the PCSC, a variety of conditions including those that are pre-cancerous, high-risk, cystic neoplasms, and IPMS – intraductal papillary mucinous neoplasms, are seen as well as malignant and islet cell tumors. 

“We provide complete evaluation and management strategies for all aspects of the disease, including relief systems and supportive strategies,” Byrd says. To refer your patient to the PCSC, call (206) 288-7222, or visit http://www.seattlecca.org/physician-referral.cfm.

New linear accelerator at SCCA

SCCA has a new linear accelerator that replaces an older machine for providing more targeted radiation therapy to treat solid tumors. The $2.5 million, Swedish-made Elekta Infinity, in addition to the microlead collimator system, will be used for extracranial stereotactic radiosurgery on tumors that are in critical anatomic locations or have received prior radiation. Volumetric modulated arc therapy (VMAT), a method of radiation treatment delivery, allows for the radiation dose intensity to be varied through the body by delivering the desired dose to the tumor with the potential for greater sparing of nearby normal tissue. Radiation also is delivered more quickly in a continual movement of gantry, collimator, and multi-leaf collimation.

New clinical trials lead to better treatments

Several new AML clinical trials are open at SCCA. After each trial description you’ll find a contact for enrollment and/or more information. This list is for Newly Diagnosed AML patients only, but there are many trials open to relapsed AML patients, too. Visit our new clinical trials web site for a complete list of leukemia trials.  

Newly-Diagnosed AML Patients

Age < 60

Clofarabine+ ara-C (2 g/m2 daily X 5) G CSF (GCLAC)
We observed a 46% CR rate in relapsed or refractory AML with GCLAC. This trial is open to untreated patients. We are obtaining our supply of clofarabine free of charge from Genzyme. Contact Pam Becker, MD; pbecker@uw.edu.

3+7 + plerixafor (UW 09011)
Plerixafor, a CXCR4 antagonist, blocks the CXCR4-mediated interaction between AML blasts and marrow stroma. This interaction appears to protect the blasts from chemotherapy-induced apoptosis. Patients are eligible if they have de novo AML. Contact Pam Becker, MD; pbecker@uw.edu.

Age > 60

Abnormal karyotype Bendamustine + gemtuzumab ozogamicin (GO)
Cloretazine has activity in older patients with untreated AML, but alkylating agents remain relatively unexplored in this population. Bendamustine has activity in relapsed AML, and data from both SWOG and MRC network in the UK suggest that GO can add to the effectiveness of other chemotherapeutic agents. This is a phase 1-2 trial in which, to be considered for further study a dose must meet both efficacy and toxicity standards. Benadmustine is supplied free of charge by Cephalon. Contact Jack Lionberger, MD; jlionber@fhcrc.org or John Pagel, MD; jpagel@fhcrc.org.

Decitabine followed by 3+7
Although 3+7 has limited activity in the frequently seen older patients with “monosomal” or “complex” karyotypes (CR rate about 25%), some data suggest decitabine may be more effective, although still suboptimal, in such patients. Furthermore decitabine-induced hypomethylation may increase sensitivity of AML blasts to 3+7. To explore this possibility this trial administers 3+7 two weeks after initiating a five-day course of decitabine. Contact Derek Stirewalt; dstirewa@fhcrc.org.

Melanoma Trials

One of the toughest diseases to treat and beat is melanoma. Check our web site for a complete list of melanoma trials.

A few to consider for newly diagnosed patients include:

ABI-007 vs Dacarbazine for Metastatic Melanoma (CA033)

An Open-Label, Multicenter, Phase III Trial of ABI-007 vs Dacarbazine in Previously Untreated Patients With Metastatic Malignant Melanoma. Contact Shailender Bhatia, MD, (206) 288-7370

Tasisulam vs Paclitaxel for Metastatic Melanoma (H8K-MCJZAO)
A Randomized Phase 3 Study of Tasisulam Administered as an Intravenous Infusion on Day 1 of a 28-Day Cycle vs. Paclitaxel as Second-Line Treatment in Patients With Metastatic Melanoma. Contact Kim Margolin, MD, (206) 288-7370.

RO5185426 vs Dacarbazine for Untreated Metastatic Melanoma (RO5185426)

A Randomized, Openlabel, Controlled, Multicenter, Global Study on Progressionfree and Overall Survival in Previously Untreated Patients with Unresectable Stage IIIC or Stage IV Melanoma With V600E BRAF Mutation Receiving RO5185426 or Dacarbazine. Contact Kim Margolin, MD., (206) 288-7370.

New trial open to help patients with gliomas

University of Washington Medical Center is the first center in the WWAMI region to be approved by the United States Food and Drug Administration (FDA) to use an experimental drug called 5-aminolevunilic acid (5-ALA) to help locate brain tumors intraoperatively using fluorescent light.

Although this drug has been used to destroy cancer cells with photodynamic therapy for the last 30 years, UW Medical Center is one of only a few hospitals in the country that are currently exploring the safety and efficacy of this oral compound to improve surgery for malignant gliomas. Following large, randomized, prospective studies in Europe, several European countries have already approved, and are currently using, 5-ALA for improved glioma surgery.

Glioma incidence is rising in the United States. An estimated 12,000 people die each year from this tumor. These high-grade gliomas are often fast-growing, so improved treatment options are critical. Because gliomas lack easily identifiable margins, 5-ALA provides the neurosurgeon with an important option that potentially enables better identification of this invasive tumor. Compared to normal tissue, 5-ALA is metabolized by high-grade gliomas to a fluorescent compound called a “photoporphyrin,” a structure similar to that of chlorophyll found in plants. Tumors that absorb this compound fluoresce with UV light exposure, using a specially modified surgical microscope that contains a UV light bulb enabling the neurosurgeon to see the glowing tumor tissue and help guide excision of the tumor.

UW Medical Center will be using 5-ALA in surgeries beginning this summer. For more information about this trial, contact Daniel Silbergeld, MD of Neurological Surgery, by calling his nurse, Laurie Lee at (206) 598-9449.
 

Related Documents:

07-20-2010 SCC398_Leading_Edge_FNL2.pdf (4076kb)
View and print this issue of The Leading Edge in PDF format.

Adult Bone Marrow Transplant News

The SCCA Adult Bone Marrow Transplant News is a publication presenting the latest information on bone marrow transplant research at SCCA, providing up-to-date information for all health care professionals caring for transplant patients.

Pediatric Bone Marrow Transplant News

Read about important outcomes research at the Hutchinson Center that may benefit your patients.

Clinical Trials Monthly

Each issue of Clinical Trials Monthly highlights several of the more than 200 clinical trials that are currently recruiting patients at SCCA.

The Leading Edge Newsletter

Each quarterly Leading Edge newsletter will highlight a new topic to give you the latest news on leading-edge therapies that SCCA physicians are offering.