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SCCA Network News, Issue 14 Spring 2012

In this issue:

Detecting and preventing lung cancer

The Lung Cancer Early Detection & Prevention Clinic (LCED & PC) at Seattle Cancer Care Alliance is dedicated to diagnosing lung cancer early and reducing the risk for lung cancer. If you have diagnosed a patient with abnormalities suspicious for lung cancer (such as lung nodules, mass, adenopathy, etc.), consider referring them to the LCED & PC.

Patients will be evaluated by a team that includes pulmonologists and chest radiologists who are dedicated to detecting lung cancer at its earliest stages. We use the latest outpatient-based, minimally invasive technology, such as bronchoscopy, endobronchial ultrasound (EBUS), guided transbronchial needle biopsies (TBNA), and fluoroscopy or CT-guided needle biopsies to make rapid, safe diagnoses. Patients found to have lung cancer will be staged with EBUS as well.

If necessary, your patients have access to outstanding thoracic surgeons at UW Medical Center and lung cancer oncologists here at SCCA, as well as the latest clinical trials in lung cancer therapy. To schedule an appointment with the LCED & PC, call (206) 288-7222. More information can be found online at www.seattlecca.org/lung-cancer-early-detection-clinic.cfm.
 

Early assessment of response to ovarian cancer

Positron Emission Tomography (PET) is an imaging tool helpful in understanding tumor response to therapy. In this study, University of Washington professor of radiology Dr. Joseph Rajendran will investigate the ability of PET imaging to predict which women with ovarian or peritoneal cancer will respond to treatment.

Study Purpose

PET scans involve injecting tiny amounts of 18F-fluorodeoxyglucose (FDG), a form of glucose (blood sugar), that has been made radioactive so the PET camera can see it. Because cancer cells take up more blood sugar than normal cells do, PET scans can distinguish cancer tissue from normal tissue. In a standard clinical PET scan, cancer glucose uptake is determined statically, by measuring the total amount of FDG in the tumor one hour after injection. Alternatively, cancer glucose uptake can be assessed dynamically, by measuring FDG appearance in a tumor immediately after injection and tracking it for the first 45 minutes. Dynamic FDG uptake has the potential to provide information different from that revealed by a standard static clinical FDG scan. In this study, both techniques will be used.

The purpose of this study is to determine whether static and dynamic measures of FDG uptake obtained early on in the course of chemotherapy can predict who will respond to chemotherapy, how long until disease recurs, and whether FDG uptake is associated with specific biomarkers of tumor aggressiveness. Many of these biomarkers may themselves be targets for novel therapeutic agents and in the future may provide novel therapies for ovarian cancer.

Eligibility Criteria

Women 18 years and older who have an untreated, newly diagnosed stage IIIc or IV ovarian cancer or peritoneal cancer and:

  • have cytology- or biopsy-proven disease
  • are a candidate for neoadjuvant chemotherapy
  • are capable of lying still for the PET imaging procedure
  • are not pregnant
  • weigh under 350 pounds and
  • can be referred to the SCCA Gynecologic Oncology Clinic for assessment of eligibility.

Research Study Details

Prior to chemotherapy cycle 1, participating patients will undergo a whole-body FDG-PET scan during a three-hour visit to University of Washington Medical Center (UWMC). This PET scan will provide baseline information about the patient’s cancer, and may potentially benefit both the patient and her clinician as the results of this pre-therapy PET scan will be provided to the treating clinician. About three weeks after finishing chemotherapy cycle 3, participating patients will return to UWMC for a second three-hour visit and FDG-PET scan. A third scan, if considered, will be done during the middle of therapy. There is no cost to the patient; the study picks up all PET scan-related costs. There are no additional follow-up visits. The patient’s treatment will not be affected by participation in this study. These visits can be combined with other appointments to make it more convenient for the patient.

Interested patients will need to be evaluated for eligibility at the SCCA Gynecologic Oncology Clinic, however, cancer treatments can occur at any facility.

To inquire about enrolling, contact study coordinator Ann Wilson at aejw@u.washington.edu or (206) 598-2383. For more information, visit www.seattlecca.org/clinical-trials/gyncancer-FHCRC-7009.cfm.

New GI study open for accruals

Under the guidance of Sam Whiting, MD, PhD a double-blind, multicenter Phase II study of mFOLFOX6 chemotherapy plus an investigational agent, ramucirumab, (versus mFOLFOX6 with placebo) is now accruing patients who have advanced adenocarcinoma of the esophagus, gastroesophageal junction, or stomach.

Eligibility Criteria

Patients eligible for this study have:

  • histologic or cytologic confirmation of adenocarcinoma of the esophagus, GE junction or stomach
  • metastatic or locally advanced, unresectable disease • measurable or nonmeasurable disease
  • ECOG performance status of 0 or 1
  • adequate organ function.

Exclusion Criteria

Patients who have received prior first-line systemic therapy for advanced/ unresectable and/or metastatic disease (prior adjuvant or neoadjuvant therapy is permitted), are not eligible.

Progressive disease < 12 months after completing oxaliplatin treatment if given previously in the peri-operative (adjuvant or neoadjuvant) setting

  • Prior therapy with an antiangiogenic agent (including but not limited to ramucirumab, bevacizumab, sunitinib or sorafenib)
  • Radiation therapy within 14 days prior to randomization
  • Known brain or leptomeningeal metastases.


Eligible patients will receive treatment every two weeks until their disease progresses or a decision is made to discontinue treatment for other reasons. Lilly has approval from the FDA to obtain and provide supplies of leucovorin, 5FU or oxaliplatin if a participating institution is unable to obtain supplies through normal channels.

To enroll a patient or if you have any questions, contact SCCA’s clinical research office at sccanetresearch@seattlecca.org or (888) 201-0060.

Columbia Basin Hematology & Oncology

In 1998, Thomas A. Rado, MD, and Ruben D. Sierra, MD combined their practices to form Columbia Basin Hematology & Oncology (CBHO), which has served the needs of people with cancer and blood diseases in the Tri-Cities area for the past 14 years. CBHO uses a team approach to patient care. Their physicians direct all care and work closely with nurse practitioners, registered nurses, medical assistants, and the administrative staff to ensure that each patient receives high quality, personal care based on evidence-based treatment and research protocols.

For several years, CBHO physicians have participated in clinical trials in order to bring the latest developments in treatment to benefit people living in the Columbia Basin area.

CBHO collaborates with SWOG and numerous additional pharmaceutical companies for clinical trials allowing even more choices for treatment for major solid tumor and hematological cancers.

The practice continues to grow with referrals from local and surrounding community physicians. CBHO moved into a new 14,000 square-foot building with 16 exam rooms and 22 chemotherapy rooms in March 2009. 

For more information, visit www.cbho.org.

Thomas A. Rado, MD, PhD

Columbia Basin Hematology & Oncology

Thomas A. Rado, MD, PhD has a long history of academic and professional excellence and quality leadership. He moved to the Tri-Cities area of Washington in 1995 and practiced in Richland until 1998, when he and Ruben Sierra, MD merged their individual practices to form Columbia Basin Hematology & Oncology.

Rado earned his doctorate in biology from Wesleyan University in Middletown, Conn. in 1970 and went on to study medicine at the University of Arkansas. He completed Fellowship training in hematology and oncology at Yale University and was a professor of oncology at the University of Alabama at Birmingham when he left academic medicine to practice in the Tri-Cities.

Throughout his years of medical service, Rado received many awards and honors, including the American Cancer Society Career Development Award, Swebilus Foundation Cancer Research Award, and the National Research Service Award from the National Cancer Institute.

Wenatchee Valley Medical Center

Wenatchee Valley Medical Center (WVMC), established in 1940, is a large physician-owned, multi-specialty clinic. Their nearly 300 physicians and advanced practice clinicians cover a service area encompassing roughly 12,000 square miles, with clinics in eight communities across North Central Washington and the Columbia Basin. WVMC has been a Seattle Cancer Care Alliance Network member since 2006.

The Cancer Program at WVMC offers a full range of medical services along with a multidisciplinary team approach to patient care. They provide prevention, screening, cancer diagnosis, treatment, clinical research, and community outreach with state-of-the art care in branch offices in Moses Lake and Omak.

In 2011, the Cancer Program was reaccredited by the Commission on Cancer and received the ACR accreditation for breast MRI. The survivorship and clinical research programs continue to grow. Additionally, WVMC developed a cancer survivorship rehab program and began an inpatient palliative care consult service. In addition, their radiation and medical oncology services are consistently ranked at the top of Press Ganey patient satisfaction surveys.

For more information, visit www.wvmedical.com.

Thomas B. Tucker, MD

Wenatchee Valley Medical Center

Thomas B. Tucker, MD, is a board-certified oncologist at Wenatchee Valley Medical Center (WVMC). He treats all forms of cancer in adults and has a strong desire to help terminal patients live longer and more comfortably.

Prior to joining WVMC, Tucker practiced for 20 years in Austin, Texas, where he performed the first autologous stem cell transplants for cancer in the region. One of the appeals of relocating to the Wenatchee Valley was the medical center’s tight-knit relationships with other health care organizations. According to Tucker, he was “particularly impressed by the affiliation with Seattle Cancer Care Alliance.”

Tucker received his medical degree from the University of Texas Southwestern Medical School in Dallas. Subsequently, he completed an internship and residency at the University of Texas Health Science Center in San Antonio, followed by a fellowship in hematology and oncology at Boston University Medical Center.