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SCCA Network News, Issue 8 Fall 2010

In this issue:

Annual Network Summit

This year’s Network Member Summit was focused on quality initiatives and best practices in clinical research, surgical quality, cancer survivorship, and marketing campaigns.  There were over 75 attendees with representatives from network institutions and the SCCA Consortium.

The keynote address on the future of oncology care was delivered by Dr. Fred Appelbaum, Executive Director and President of SCCA and Director of the Clinical Research Division at Fred Hutchinson Cancer Research Center.  He highlighted the importance of early detection and discussed innovative breakthroughs and the implications of immunotherapy as a therapeutic modality.

Since the summit, several initiatives have been embarked upon on including the use of the OncoRad system and Virtual Private Network  access for Network institutions.  Overall, the summit was a success.

As we start to plan for the 2011 Summit in the next couple of months, we encourage you to share thoughts and ideas that might be of interest and beneficial to everyone across the Network.  Our goal is to provide an opportunity for all network members to exchange ideas, learn from each other, and allow interactions among colleagues.  Please contact the Network Office at  (206) 288-1066 or sccanet@seattlecca.org with your suggestions.

Accruals to Network Clinical Trials

Clinical trial enrollment is becoming an integral part of accreditation for institutions and is a component of the SCCA 5-year strategic plan. One theme of the plan is increasing accrual to clinical trials by strengthening relationships with Network physicians and allowing more patients to stay in their communities for treatment.  As the plan is implemented, metrics will be collected to gauge whether progress is being made. The metric for evaluating SCCA Network progress is accrual to clinical trials offered to SCCA Network member institutions. Strategic plan metrics are reported to the SCCA Board quarterly. Future newsletters will include a table of enrollment by Network institution so we can all be aware of our progress.

Cancer clinical trials are essential for improving patient outcomes.  Unfortunately, only 3% of new cancer patients participate in clinical trials. Of approximately 60% of cancer patients who are considered for participation in clinical trials, approximately half have an appropriate clinical trial available. Approximately 50% of patients approached agree to participate.  Increasing access and enrollment to clinical trials are the main goals of the Seattle Cancer Care Alliance Network Office. We are working diligently to identify new trials for your patients, provide tools to assist with clinical trial enrollment and track the progress that we are making.

Castleman Disease Study

Multicentric Castleman Disease (MCD) is a rare, benign disorder characterized by abnormal non-cancerous growths in the lymphatic tissues in multiple sites throughout the body. Patients with MCD present with a variety of symptoms, and in its most aggressive form, MCD can also be associated with non-Hodgkin’s lymphoma.

Patients with Castleman disease have few therapeutic options. There is currently no treatment approved by the FDA or studied in a randomized controlled trial. The disease is traditionally treated with chemotherapy or more recently with monoclonal antibodies to CD20, but responses are neither universal nor durable.

In August 2010, Corey Casper, MD, MPH, associate professor of Medicine at the University of Washington and colleagues published the first data from the United States on a monoclonal antibody against interleukin-6 (siltuximab) in the Journal of Clinical Oncology. In this Phase I study of 32 patients with Castleman disease, they found that 78 percent of the 23 patients treated achieved a response and no significant toxicities were noted.

Seattle Cancer Care Alliance is now participating in a pivotal Phase II registration study of siltuximab for individuals with MCD. If you have any patients with this rare, debilitating condition, this study may present a unique opportunity for them. The primary objective of the study will be to demonstrate that the investigational medicine plus best supportive care (BSC) is better than placebo plus BSC in patients with MCD. Approximately 78 subjects from approximately 24 countries worldwide will be recruited for the study. Of note, all patients will have the opportunity to receive siltuximab (patients randomized to placebo will be “crossed-over” to the active drug for persistent signs and symptoms of MCD on best supportive care).

For more information about this study, or to refer your patient, please go to https://www.seattlecca.org/clinical-trials/castleman-NCT01024036.cfm.

Pancreas Cancer Specialty Clinic

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. 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 intraductal papillary mucinous neoplasms (IPMS), 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 www. seattlecca.org/physician-referral.cfm.

SCCA Physician Profile: Sunil R. Hingorani, MD

Director of the Pancreas Cancer Specialty Clinic

Dr. Sunil Hingorani is the director of the Pancreas Cancer Specialty Clinic at Seattle Cancer Care Alliance. He also leads a research laboratory at Fred Hutchinson Cancer Research Center that is dedicated to studying and defeating pancreas cancer.

In his years of research, several unexpected properties of pancreas cancer have emerged, including its extremely poor blood supply, which provides pancreas cancers with a very straightforward mechanism of resistance to chemotherapy. He is working now to develop strategies to target secondary characteristics of pancreas cancer in order to increase the delivery and penetration of chemotherapeutic agents.

Dr. Hingorani is a graduate of Yale University School of Medicine and received a PhD in Cellular and Molecular Physiology from Yale Graduate School of Arts and Sciences. He completed a medical oncology fellowship at Dana-Farber/Partners Cancer Care Program in Boston, Mass. and additional research training at the Massachusetts Institute of Technology in Cambridge, Mass.

Sea Mar Community Health Centers

Sea Mar Community Health Centers is one of Washington State’s largest providers of community-based, comprehensive health care, including the only Spanish-only inpatient behavioral health treatment program in the state. Sea Mar services are available in 21 medical clinics, 13 dental clinics, and 16 behavioral health and/or substance abuse treatment centers in the Puget Sound area.

At Sea Mar’s medical clinics, patient-centered and comprehensive family medical services are provided, including prenatal and OB care, well-child care, adolescent health care, family planning, geriatric, and nursing home care. Specialty services delivered on-site include OB/GYN, pediatrics, and psychiatric care.

Sea Mar clinics provide patients with their own physician and same-day access, Monday through Saturday, with appointments available for acute and chronic conditions. Family-medicine physicians and nurse practitioners work together to meet the medical needs of an assigned panel of patients.

In addition to comprehensive health services, Sea Mar offers a wide variety of nutritional, nursing and assisted-living, affordable housing, child development, cultural, and educational services.

Physician Profile: Patrick Gemperline, MD

Sea Mar Community Health Centers

Dr. Patrick Gemperline is the site supervisor for Sea Mar’s family medicine residency. As a Joint Commission on Accrediation of Healthcare Organziation (JACHO)-accredited institution, Sea Mar utilizes an on-going quality-improvement process in which residents are included. Residents selected must demonstrate academic excellence, leadership, and interest in serving Spanish-speaking, low-income, and minority populations.

Dr. Gemperline also coordinates OB training for first-year residents, and is the advanced life support obstetrics (ALSO) course director and faculty member.

Dr. Gemperline is fully committed to the mission of community health centers and is proud of Sea Mar’s philosophy to provide quality, comprehensive medical care to all people, regardless of ability to pay. He continues to see patients daily and speaks English and Spanish, enabling him to serve a burgeoning Latino population in Seattle and King County.

Dr. Gemperline completed medical school at the University of Utah in 1986, and his residency at Providence Hospital in Seattle in 1989. He volunteers regularly at the winter homeless shelter sponsored by St. Joseph’s Church. He is married, the father of three boys, and enjoys bicycling and running.

Wenatchee Valley Medical Center

Wenatchee Valley Medical Center (WVMC) was established in 1940 as a physician-owned health-care delivery system in rural Washington State. With clinics in eight locations, a 20-bed hospital/acute rehabilitation center, and a service area encompassing roughly 12,000 square miles, WVMC provides comprehensive medical and ancillary services for patients throughout the region. Its 300 physicians and mid-level providers are committed to serving patients’ needs by providing the highest quality healthcare and service in an atmosphere of concern and caring.

The Wenatchee Valley Cancer Treatment Center at WVMC offers programs in community outreach, prevention, screening, cancer diagnosis, treatment, and clinical research. Medical oncologists/hematologists provide cancer treatment, continuous follow-up care, consultations, and second opinions for cancer management. Radiation oncologists work closely with the medical oncologists, surgeons, and other physicians to coordinate optimal care for each cancer patient. WVMC has been a Seattle Cancer Care Alliance Network member since 2006.

Physician Profile: Thomas Carlson, MD

Radiation Oncologist, Wenatchee Valley Medical Center

Dr. Thomas Carlson, radiation oncologist at Wenatchee Valley Medical Center (WVMC), is committed to bringing high-quality medicine to the more rural areas of Washington State.

He has been a staunch advocate for Wenatchee Valley Cancer Treatment Center’s affiliation with Seattle Cancer Care Alliance and has worked diligently to obtain accreditation for WVMC’s cancer program from the American College of Surgeons Commission on Cancer (CoC).

In August 2010 he received an Outstanding Performance Award from the CoC for going above and beyond the scope of normal duties in serving as a liaison between the cancer program at WVMC and the CoC.