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SCCA Network News, Issue 3 Summer 2009

In this issue:

Networking Works

Welcome to summer!

We are halfway through 2009 and we have plenty of activities, information, and progress to share with you in this newsletter. Featured members in this issue are Clinic Cancer Care, Great Falls (Montana) and Wenatchee Valley Medical Center (Washington). Both clinics are physician-owned and became members of the SCCA Network Program in 2006.

Welcome to Overlake Hospital in Bellevue, the newest member to the SCCA Network. We are thrilled to have them join us after a long and rigorous evaluation. As with all Network members, we look forward to a fruitful relationship with Overlake that will be mutually beneficial to the program and especially to our patients.

Improved Referral Process

Earlier this year we improved our referral system with Network members. The goal was to make processes and access to SCCA and University of Washington Medical Center (UWMC) easier. To start with, we made enhancements to the Patient Referral Form, providing specialty consult areas for Network physicians to request medical oncology, radiation oncology, or surgical oncology referrals. Physicians may also indicate the disease site on this form, including referrals for bone marrow/stem cell transplantation and specific clinical trials. A referring physician signature line has also been added to the bottom of the form, which is now accepted by the UWMC Intake office in the event that the patient needs to be admitted. This has eliminated the need for an additional referral form for UWMC.

UWMC has also worked to improve our joint referral processes by adding a new position within their Physician Liaison office. This person will oversee the referral system and help mediate difficulties in scheduling appointments and physician communications.

Summit Update

In June, the 2nd Annual Network Members Summit took place on the Fred Hutchinson Cancer Research Center campus. We were pleased to see that every SCCA Network Member was represented with administrators and clinicians.

For a total of 64 attendees, there was excellent interaction between clinical researchers from SCCA and physicians from the SCCA Network member institutions.

Dr. Corey Casper delivered the keynote address: “Infections as a Cause and Consequence of Cancer: Improving the Quality of Cancer Through Efficient and Effective Infection Control and Treatment,” which was well received by all.

Several Network sites made presentations on their Clinical Research Programs including, MultiCare (Richard Shine), Providence Alaska Medical Center (Wanda Katinszky), and Wenatchee Valley Medical Center (Mitch Garrison, MD).

Many thanks for sharing the successes and challenges of conducting research at your institutions; it was informative and educational to all.

Patients Needed for Triple Negative Breast Cancer Protocol

Breast cancer is usually subdivided based on the presence, or lack of, three “receptors” known to fuel most breast cancers: estrogen receptors, progesterone receptors, and human epidermal growth factor receptor 2 (HER2). The most successful treatments for breast cancer target these receptors, but 10 to 15 percent of women develop “triple negative” (ER negative, PR negative, and HER2 non-overexpressing) breast cancers that lack these targets. These patients with triple negative phenotype of breast cancer have an aggressive disease for which successful therapy remains illusive and outcomes are often poor with standard chemotherapy.

Jennifer Specht, MD medical oncologist at Seattle Cancer Care Alliance, is the principal investigator for a phase II study of triple negative metastatic breast cancer that will evaluate the efficacy and safety of induction chemotherapy with nab-paclitaxel (Abraxane) and bevacizumab (Avastin) followed by maintenance targeted therapy with bevacizumab and erlotinib (Tarceva). The hope is to prolong progression-free survival. This study will focus on pathways for disease progression related to vascular endothelial growth factor (VEGF) and epidermal growth factor (EGFR) which are thought to be critical for triple negative breast cancer.

For reasons yet unknown, triple negative breast cancers also often over-express the protein EGFR. Inhibitors of EGFR activity have been in development for years. Although earlier compounds lacked specificity and potency, newer compounds have proven active in clinical studies. In lung cancers, the use of erlotinib has proven to be a successful targeted therapy that stops the production of this protein. Specht hopes to show that this drug will be successful with triple negative breast cancer patients as well.

“We hope this treatment will allow women to have a break from chemotherapy and prevent tumor growth by targeting these two important biologic pathways,” Specht says.

Eligibility Criteria

This is a phase II study. All patients will receive active treatment. There will be no placebo. All patients must have a new recurrence of triple negative breast cancer with either measurable disease or non-measurable disease and an elevated tumor marker. Patients should be at least 12 months from previous weekly neoadjuvant or adjuvant paclitaxel.

Sixty-three patients are needed to complete the study which is open at Skagit Valley Regional Cancer Care Center, Cascade Cancer Center, Multicare Health System, and Wenatchee Valley Medical Center. If you would like this study to be available for your patients at your institution, please contact Tove Thompson at tovethom@seattlecca.org or by calling (206) 288-1233.

Referral Contact

Contact Tracy Headley, SCCA breast cancer patient care coordinator, to refer a patient for treatment at SCCA at theadley@seattlecca.org or by calling (206) 288-2166.

Clinic Cancer Care, Great Falls

Clinic Cancer Care is a division of Great Falls Clinic, the largest physician-owned and operated multi-specialty group in Montana.

Physicians at Clinic Cancer Care provide a comprehensive and coordinated approach to treat people with blood diseases and cancer. Using leading-edge technology, including advanced radiographic imaging and intensity modulated radiation therapy, Clinic Cancer Care was the first Montana provider to offer high-dose rate brachytherapy, respiratory gating of radiation treatments, and image-guided radiation therapy. They offer access to over 200 clinical trials, offering new and advanced treatment therapies.

The health-care team at Clinic Cancer Care includes committed physician specialists, clinical research staff, a nuclear physicist, radiation therapists, oncology certified registered nurses, social workers, dietician and wellness programs, hospice care, and an entire support staff contributing their collective energies to the needs of patients.

Located in the Great Falls Clinic Specialty Center, Clinic Cancer Care has direct access to an array of specialists, surgeons, and surgical sub-specialists, and the entire diagnostic radiology department of the Great Falls Clinic. In short, they are a community of care equipped for virtually any medical need under one roof.

Physician Profile: Bryan Martin, MD

Medical Oncologist, Clinic Cancer Care, Great Falls

Clinic Cancer Care is pleased to welcome Dr. Bryan Martin to the Great Falls medical community and their team.

Dr. Martin worked in a private Internal Medicine practice in Great Falls, and left to complete a Medical Oncology Fellowship at Texas A & M University in 2007.

Dr. Martin is Board Certified in Internal Medicine. Prior to completing his Medical Oncology Fellowship in 2007 - 2009, received his medical degree from the University of Washington in Seattle and completed his Internal Medicine residency at Providence Portland Medical Center in Portland, Oregon.

As part of the Clinic Cancer Care medical team, Dr. Martin specializes in the diagnosis and treatment of cancer. He has a special interest in the treatment of diabetic cancer patients which was his research focus during fellowship training.

Wenatchee Valley Medical Center

Wenatchee Valley Medical Center, established in 1940, is a physician-owned health-care delivery system in rural Washington State. With a service area encompassing roughly 12,000 square miles, Wenatchee Valley Medical Center has a regional focus and includes clinics in eight locations, a 20-bed hospital/acute rehabilitation center, 182 physicians, and 64 mid-level providers of comprehensive medical and ancillary services. Their 735,000 annual patient visits include primary care and specialty care for patients from the region. Their mission is a commitment to serve patient needs by providing the highest quality healthcare and service in an atmosphere of concern and caring.

The Wenatchee Valley Cancer Treatment Center offers patients programs in community outreach, prevention, screening, cancer diagnosis, treatment, and clinical research. Medical oncologists/hematologists provide cancer treatment, continuous follow-up, consultations, and second opinions for cancer management and serve as leaders on treatment teams, working closely with other cancer specialists. Radiation oncologists work closely with medical oncologists, surgeons, and other physicians to coordinate optimal care for each cancer patient. Wenatchee Valley Medical Center has been an SCCA Network Member since 2006.

Physician Profile: Julie Smith, MD

Medical Oncology Medical Director Wenatchee Valley Medical Center

Dr. Julie Smith is a hematology oncologist at Wenatchee Valley Medical Center. She earned her medical degree and completed her internship and residency at the University of Utah School of Medicine, where she also completed a fellowship in oncology and hematology.

“The affiliation which has been formed between Wenatchee Valley Medical Center and SCCA will be of great benefit to our patients,” says Dr. Smith, “enabling them to receive state-of-the-art care locally and regionally. I am looking forward to strengthening the medical bonds between our two institutions.”

Outside of work, Dr. Smith enjoys outdoor activities that both Eastern and Western Washington have to offer. “Music and dance are also important lifelong parts of me that I enjoy sharing with others,” she says. “I mostly enjoy spending my spare time with my children.”

SCCA Physician Profile: Corey Casper, MD, MPH

SCCA Medical Director, Infection Control

Corey Casper, MD is the medical director for SCCA’s Infection Control Program, assistant member at Fred Hutchinson Cancer Research Center, and Associate Professor of Medicine in Infectious Disease at the University of Washington School of Medicine.

Infections are among the leading complications of cancer care. Infection Control at SCCA works to protect patients and staff from communicable diseases, which helps save lives, manage health-care costs, and allow adherence to regulatory guidelines.

For Casper, “the SCCA Network model brings patients to centers of excellence and allows for closer ties with the community.” As the Keynote speaker at the June Network Summit, Casper acknowledges that building relationships between providers is a positive result of the Network program. He looks forward to working with network members to strengthen infection control programs.