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Issue 14

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In this issue of The Leading Edge, read about

  • Leading-Edge Prostate Cancer Treatments--Basic Scientists Partner with Clinical Researchers
    Seattle Cancer Care Alliance and its parent organizations, Fred Hutchinson Cancer Research Center and UW Medicine, are working with other renowned cancer centers from around the nation to advance innovative new treatments for prostate cancer.
     

  • Advancements in Lung and Brain Tumor Treatments
    At SCCA, doctors are actively exploring new surgical techniques and better methods of radiotherapy and chemotherapy. New targeted agents are being developed that interfere with signals within the cancer cell that drive cell division or cell invasion. Since cancers cannot grow without a supply of nutrients and oxygen from blood circulation, new drugs are being developed to interfere with the blood supply of a cancer. This approach is called anti-angiogenesis.
     
  • New & Ongoing Acute Myeloid Leukemia Trials
    Several acute myeloid leukemia (AML) trials are available for appropriate patients.
    • Lenalidomide for patients with deletion of the long arm of chromosome 5 (del 5q).
    • Obatoclax for MDS and AML
    • Pre-relapse trial using a sensitive technology that uses flow cytometry to detect minimal residual disease in patients who are ostensibly in remission.

Educational Opportunities

  • Fourth Annual Oncology Congress Conference
    DATE: Thursday – Sunday, Sept. 25 – 28, 2008
    LOCATION: Hilton San Francisco, San Francisco, California
  • Pediatric Moving Beyond Cancer to Wellness 2008 Symposium
    DATE: Saturday, Oct. 18, 2008, 8 a.m. registration; Event 9 a.m. – 1:30 p.m.
    LOCATION: Seattle Children’s
  • Solid Tumor Oncology: Personalized Medicine and Targeted Cancer Therapy
    DATE: Thursday – Friday, Feb. 26 – 27, 2009
    LOCATION: Bell Harbor Conference Center, Seattle

To Refer a Patient, call the SCCA Intake Office at (206) 288-1024.
 

 

Leading-Edge Prostate Cancer Treatments
 

Basic Scientists Partner with Clinical Researchers

 

Seattle Cancer Care Alliance and its parent organizations, Fred Hutchinson Cancer Research Center and UW Medicine, are working with other renowned cancer centers from around the nation to advance innovative new treatments for prostate cancer.

 

Under the leadership of Dr. Celestia (Tia) S. Higano, UW Medicine was awarded a two-year infrastructure grant to become a member of the Department of Defense Prostate Cancer Clinical Trials Consortium. Other members of this consortium include Memorial Sloan-Kettering Cancer Center, Dana-Farber/ Harvard Cancer Center, Johns Hopkins Prostate Cancer Program, Oregon Health and Science University, University of California San Francisco, University of Michigan, M.D. Anderson Cancer Center, University of Wisconsin, and Duke Comprehensive Cancer Center. (See the consortium web site at www.mskcc.org/mskcc/html/64573.cfm).

 

According to Dr. Higano, participation in the consortium brings many benefits to the region. “Our patients have access to several new agents that look very promising, including a novel antiandrogen called MDV 3100, and abiraterone, a new hormonal agent that targets adrenal androgen production,” she says. “These agents are available only in a limited number of sites across the country and we are privileged to have access to these drugs.”

 

UW Medicine led the “first-in-man” study of IMC-A12 (insulin-like growth factor I receptor inhibitor) and brought this agent into the consortium for single agent phase II testing. “This trial was completed in record time,” Higano says, “and a randomized phase II second-line chemotherapy trial with mitoxantrone in combination with either IMC-A12 or IMC-1121B (VEGFRII inhibitor) is about to open this summer.”

 

Higano leads the overall prostate cancer clinical research program, a team effort of dedicated faculty members including Drs. Evan Yu and Bruce Montgomery. The prostate cancer research program is supported by an experienced staff that gives patients individual attention as they travel through a clinical trial. Drs. Peter Nelson and Janet Stanford, both based at Fred Hutchinson Cancer Research Center, are Principal Investigators for the Pacific NW Prostate Cancer SPORE (Specialized Programs of Research Excellence). They lead the scientific research priorities at Hutchinson Center and interact closely with the clinical team.

 

“It is the combination of outstanding scientific and clinical research at our institutions that sets us apart locally and nationally in the realm of prostate cancer,” Higano says. “We believe that teaming up with scientific and clinical powerhouses of researchers around the country is the best way to make rapid progress in treatments for prostate cancer patients.”

 

For information about prostate cancer clinical trials being conducted at Seattle Cancer Care Alliance, visit www.seattlecca.org or call (206) 288-SCCA (7222). For more information about the prostate cancer research program visit  http://depts.washington.edu/guoncres/.


Advancements in Lung and Brain Tumor Treatments


At SCCA, doctors are actively exploring new surgical techniques, better methods of surgery, radiotherapy, and chemotherapy. New targeted agents are being developed that interfere with signals within the cancer cell that drive cell division or cell invasion.


Since cancers cannot grow without a supply of nutrients and oxygen from blood circulation, new drugs are being developed to interfere with the blood supply of a cancer. This approach is called anti-angiogenesis.

 

UW Protocol 6137: A Phase II Study of Intermittent Gleevec (imatinib) and Weekly Paclitaxel in Patients Aged 70 or Older with Non-small Cell Lung Cancer.
 

Combination chemotherapy has not shown superiority over single agent therapy in patients above age 70. By adding imatinib we are hoping to increase the efficacy of weekly paclitaxel without substantially adding to toxicities.

 

Patients are treated with weekly paclitaxel on days 3, 10, and 17 of each week cycle. Each paclitaxel administration is bracketed by 4 days of imatinib, 600 mg daily given on days 1–4, 8–11, 15–18. Imatinib is provided free-of-charge.

 

Criteria for this Phase II Study
Patients with ECOG PS 0-2 who are not candidates for combination chemotherapy. For more information and assistance reviewing patient eligibility, call the PSOC office at Fred Hutchinson Cancer Research Center (206) 667-5152.

 

Principal Investigator: Renato G. Martins, MD, MPH, Medical Director, Thoracic/Head and Neck Medical Oncology Associate Professor, University of Washington

 

20070056 Phase II/III Randomized Study of CDX-110 with Radiation and  Temozolomide in Patients with Newly Diagnosed Glioblastoma Multiforme

 

Multi-institutional peptide vaccine trial for newly diagnosed glioblastoma tumors will be built on top of the standard treatment of radiation and Temodar® followed by the vaccine.

 

“We need to identify patients as early as possible,” says Marc Chamberlain, MD, Chief, UW Div. of Neuro- Oncology, “after surgery but before treatment starts, ideally.”


Tumor biopsies post-surgery will look for the protein EGFRviii, the target for this new vaccine in order to be eligible for this trial. Other criteria include

  • Adults 18 years and older
  • Complete resection
  • Good performance

Once a patient is determined eligible, treatment will consist of radiation and Temodar for six to seven weeks followed by the vaccine and post-radiation Temodar every four weeks, for about a year. This is a randomized trial. While all patients will receive standard treatment of radiation and Temodar, 65 percent of the patients will receive the vaccine and post-radiation Temodar and the remaining patients will receive post-radiation Temodar only. Seattle Cancer Care Alliance is the only institution in the Pacific Northwest participating in this national trial.

 

TM601 – Chlorotoxin – Israeli Scorpion Venom and Recurrent Glioblastoma

 

This is a small Phase I trial, with only three institutions participating, to study the anti-angiogenic agent, chlorotoxin. Like Avastin for breast cancer, this is a targeted therapy to tumor vasculature and recurrent glioblastoma. Of all cancers, this type of tumor is the most vascularized. The treatment regimen is a four-week cycle of outpatient infusions (three weekly treatments, one-week break), which will last six months.

Before the treatment begins, the patient will receive an imaging dose with a radioisotope for a brain and body SPECT scan (single photon emission computed tomography). This is a nuclear medicine tomographic imaging technique that uses gamma rays to provide true 3D image. “We will enrich people with a positive screen to identify that the target is present,” Chamberlain says. In addition to standard brain MRI scans to assess response to the treatment, the trial also includes blood flow (perfusion) MRI scans.

 

Criteria for this single-arm trial

  • Adults 18 years and older
  • Recurrence following Temodar and radiation therapy
  • At least three weeks post-surgery
  • Good performance

PTK787 – Valatinib


For recurrent meningiomas (cancer of the brain covering), this Phase II trial is looking at the efficacy, not toxicity, of this targeted, multi-functional tyrosine kinase inhibitor. Valatinib, taken daily by mouth, hits several tyrosine kinase proteins and inhibits them, shutting down the signal processes for tumor growth. This drug targets the VEGF receptor, similar to Tarceva for lung cancer. For more information about these and other brain tumor clinical trials, contact Sandra Johnston, PhD, RN Data Manager/Informatics at (206) 616-7117 or Lisa Mandell, RN, JD Research Nurse at (206) 616-8967. A list of studies for neuro-oncology can be found at: http://staff.washington.edu/stonesk/.

 

Seattle Cancer Care Alliance now has a service specifically dedicated to caring for leukemia inpatients at UW Medical Center, thanks in part to Stephen H. Petersdorf, MD, oncologist at SCCA and associate professor at UW Medicine. This service will be staffed by attending physicians whose primary interests include leukemia, and who have a wealth of experience in the management of this disease.

 

New & Ongoing AML Trials

 

These acute myeloid leukemia (AML) trials are available for appropriate patients:


Lenalidomide for patients with deletion of the long arm of chromosome 5 (del 5q).
 

Lenalidomide reduces red cell transfusion needs, eliminates cells carrying the del 5q, and may prolong survival in two thirds of patients with low-risk MDS and del 5q, a disease that is closely related to AML. The lenalidomide AML trial will see whether lenalidomide is similarly effective in patients with AML and del 5q; such patients traditionally have had a very poor prognosis when given standard therapy (three days of idarubicin and seven days of cytarabine).

 

Obatoclax for MDS and AML


Older patients routinely fare poorly when given standard therapy. An upcoming clinical trial (chaired locally by Derek Stirewalt, MD) will look at obatoclax, a pan-BCL2 family inhibitor, that has shown activity in myelodysplastic syndromes (MDS), has produced complete remission in patients with AML, and deletion of the long arm of chromosome 11q, another poor prognosis group. The obatoclax trial will be open for patients aged 70 and above and is anticipated to be less toxic than Leukemia Service & Trials News standard therapy in these patients.

 

Pre-Relapse Trial


“The great majority of patients with AML who enter complete remission will relapse,” says Elihu Estey, MD, professor in the Division of Hematology, and Member at Fred Hutchinson Cancer Research Center. “It would be desirable if impending relapse could be detected before becoming overt, thus allowing therapy to be changed.”

 

Brent Wood, MD, hematopathologist at SCCA, has pioneered development of very sensitive technology that uses flow cytometry to detect minimal residual disease (MRD) in patients who are ostensibly in remission. This led to an upcoming study (chair Pam Becker, MD) in which patients who are in remission by standard criteria (but in whom flow cytometry detects MRD despite administration of standard therapy) will receive clofarabine cytarabine and GCSF, a regimen that seems quite active in patients with relapsed AML and may be more effective when used before relapse occurs.

 

“We hope changing treatment before frank relapse will improve survival,” Estey says.

 

For more information about these and other leukemia clinical trials, contact Elihu Estey, MD, or Fred Appelbaum, MD, at (206) 288-SCCA (7222)

 


EDUCATIONAL OPPORTUNITIES

 

Fourth Annual Oncology Congress Conference
DATE: Thursday – Sunday, Sept. 25 – 28, 2008
LOCATION: Hilton San Francisco, San Francisco, California

 

Developed for the U.S.-based practicing oncologist, the Oncology Congress leads in delivering knowledge, tools, and insight into the best practices that leaders in cancer prevention, diagnosis, and treatment need to improve patient care. As one of Oncology Congress’ partnering cancer centers, there is a discounted registration rate for our referring providers. Please contact the SCCA Network Office at sccanet@seattlecca.org for the priority code.

For more information, visit www. oncologycongress.com.

 

Pediatric Moving Beyond Cancer to Wellness 2008 Symposium
DATE:
Saturday, Oct. 18, 2008, 8 a.m. registration; Event 9 a.m. – 1:30 p.m.
LOCATION: Seattle Children’s

 

The Fred Hutchinson Cancer Research Center Survivorship Program and Seattle Children’s will host its first annual pediatric Moving Beyond Cancer to Wellness educational event.

 

Keynote Speakers: Heidi Adams, founder of Planet Cancer, and Jake Seliger, graduate student, osteosarcoma survivor. Breakout sessions will be led by experts in the fields of nutrition, complementary and alternative medicine, exercise, relationships and dating, insurance rights, emotional adaptation, and late effects from cancer treatment.

 

REGISTRATION: FREE and open to the public; however, space is limited and registration is required. To register, call (206) 667-5262 or e-mail survivor@fhcrc.org.

 

Free parking on the day of the event will be available in the Giraffe and Whale parking lots.

 

Solid Tumor Oncology: Personalized Medicine and Targeted Cancer Therapy
DATE:
Thursday – Friday, Feb. 26 – 27, 2009
LOCATION: Bell Harbor Conference Center, Seattle

 

Designed for medical, surgical, and radiation oncologists, radiologists, and pathologists as well as ancillary healthcare professionals involved in solid tumor research and care, or those interested in learning and discussing the latest findings in solid tumor medicine. This conference is an in-depth, cross-disciplinary review in which leading experts will present the latest updates and clinical recommendations in solid tumor diagnosis, treatment, and care. For more information, contact Ksenia Koon at koon@seattlecca.org or (206) 288-6969.

 

Resources
 

How do I refer a patient?


Call our Intake Office at 206-288-1024.

  • General Oncology patient case discussions will be transferred to the appropriate Patient Care Coordinator.
  • Marrow or Stem Cell Transplant patient referral cases will be transferred to the Clinical Coordinator. We will review the case with you to determine if it would be beneficial for the patient to come to SCCA for treatment.

What happens after referral?


SCCA is committed to ongoing communications with referring physicians to maintain seamless patient care. UW Medicine offers a secure electronic connection through U-Link to give you instant access to your patient’s information and updated records while at SCCA. Contact the Physician Liaison Program at (206) 598-4972 to sign up. Current users may access U-link at: http://uwmedicine.washington.edu/patient-care/referrals/pages/u-link.aspx

 

Just want to consult with a specialist at SCCA?
 

Use the MEDCON Consultation service to consult with UW physicians who practice at SCCA. Call (206) 543-5300 in the Seattle area or toll-free (800) 326-5300. The consultation is free.

 

 

Survivorship Program
 

Fred Hutchinson Cancer Research Center’s Survivorship Program provides clinical care, patient education, and research opportunities to patients who have survived cancer and are not in active cancer treatment or are in long-term therapy to prevent recurrence.

 

Services are provided through the Hutchinson Center and SCCA, and are supported by the Lance Armstrong Foundation. Survivorship program patients receive thorough screenings and health evaluations by our health-care team, a Survivorship Care Plan that lists therapy and medical information related to the patient’s diagnosis and any possible long-term problems, and recommendations for patients and their health-care providers to ensure that patients stay as healthy and informed as possible.

 

Contact the Survivorship Program at (866) 543-4272 for more information.


 


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.