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SCCA Network News, Issue 13 Winter 2012

In this issue:

Tri-Cities oncology practice joins Seattle Cancer Care Alliance Network

Columbia Basin Hematology & Oncology (CBHO), based in the Tri-Cities, has joined the Seattle Cancer Care Alliance Network.

Access to clinical trials of the latest cancer therapies is a key reason CBHO chose to join the Network, according to Thomas Rado, MD, PhD, leader of the private practice group.

“Our vision is to provide evidence-based care when evidence exists, and to make clinical trials available to patients who might benefit from them, Rado says. “We see our affiliation with SCCA as one of the best ways for our patients to have access to the latest clinical trials of promising new therapies.”

CBHO sees patients from southeast Washington and northeast Oregon. Established in 1998, it provides about 15,000 patient visits a year. The practice group includes five physicians, four oncology-certified nurse practitioners, and four staff dedicated to research protocols, among other staff members.

Removing the age limit for transplantation

(Summarized from Center News Weekly; November 7, 2011)
Age alone should no longer be considered a defining factor when determining whether an older patient with blood cancer is a candidate for stem cell transplantation.

Findings from the first study summarizing long-term outcomes from a series of prospective clinical trials of patients age 60 and over who were treated with the mini-transplant, a “kinder, gentler” form of transplantation developed at Fred Hutchinson Cancer Research Center, were published on Nov. 2, 2011 in the Journal of the American Medical Association (JAMA).

Mini-transplants, also known as non-myeloablative transplants, were developed for older and sicker patients who otherwise could not tolerate the standard, more toxic, high-dose regimens used to prepare patients for transplantation. Mini-transplants rely on the ability of donor immune cells to target and destroy the cancer without the need for high-dose chemotherapy and radiation. Instead, low-dose radiation and chemotherapy is used to suppress the immune system rather than destroy it. This helps the body accept the donor stem cells, which then go to work to attack cancer cells—called the graft-vs.-leukemia effect—and rebuild the immune system.

The five-year rates of overall and disease-progression-free survival among mini-transplant patients were 35 percent and 32 percent, respectively. Patients were in three age groups: 60 to 64, 65 to 69, and 70 to 75 and had comparable survival rates, which suggested that age played a limited role in how patients tolerate the mini-transplant.

Increased medical problems unrelated to cancer (comorbidities) and a higher degree of cancer aggressiveness were the two factors that affected survival among these older patients.

Although a long-term survival rate of one-third of patients may seem low, these patients all would have died of their diseases within a matter of months without a transplant. “The majority of patients were referred for a transplant after they had exhausted all forms of conventional therapy,” says corresponding author Mohamed Sorror, MD, PhD of the Clinical Research Division at the Hutchinson Center. Dr. Sorror works in the research group led by Rainer Storb, MD, PhD who developed the mini-transplant.

“While there is much room for improvement, particularly with regard to relapse, these results are encouraging given the poor outcomes with non-transplantation treatments, especially for patients with high-risk acute myeloid leukemia, fludarabine-refractory chronic lymphocytic leukemia, or progressive lymphoma,” the authors write.

Conventional transplants, which are generally not performed for people over age 60 or others who are medically unfit, use high doses of total-body irradiation and potent chemotherapy to eliminate leukemic cells. The intense treatment destroys the blood and immune system and is fatal unless the patient is rescued by infusion of donor bone marrow or stem cells isolated from peripheral blood.

The study involved 372 patients ages 60 to 75 who were enrolled in pro-spective clinical trials between 1998 and 2008 at 18 collaborating U.S. and European cancer centers known as the “Seattle Consortium.” All patients at these centers were treated with the same regimen. The patients in the study were treated for acute and chronic leukemia, lymphoma, multiple myeloma, myelodysplastic syndromes (which can progress to acute myeloid leukemia if not treated), and myeloproliferative diseases such as chronic myelogenous leukemia.

More information about stem cell transplants at SCCA can be found at www.seattlecca.org/transplant.

Radiation Therapy Oncology Group protocols now available

When Wenatchee Valley Medical Center became a satellite member of the Radiation Therapy Oncology Group (RTOG) through the University of Washington in June 2011, the SCCA Network Research Office officially added a new component to the types of clinical trials offered to Network member institutions. Following this membership, in October Skagit Valley Hospital Cancer Center also joined the RTOG. Overlake Hospital Medical Center and Olympic Medical Cancer Center are applying for RTOG membership as well.

George E. Laramore, MD, PhD, and chair of the UW Department of Radiation Oncology, is the principle investigator for the UW’s RTOG membership program and must approve all new members. Dr. Laramore has been very supportive of our Network sites applying for membership.

Keys to offering membership to a new site are a willingness to commit the resources needed to navigate the new member application process and a strong commitment to accrue patients to the RTOG trials. Our thanks to Dr. Tom Carlson and Dr. David Kantorowitz, lead radiation oncologists at Wenatchee Valley Medical Center and Skagit Valley Hospital Cancer Care, for their support of this endeavor.

The SCCA Network Research Office assists SCCA Network members by overseeing the new member application process. Once approved, the research office works with Network members to identify and activate protocols of interest, assist with credentialing processes, screen patients for eligibility, and complete case report forms for Network member investigators.

If your cancer center does not have access to RTOG trials and is interested in working with Dr. Laramore, call the SCCA Network Research Office for assistance at (206) 288-1066.

Skagit Valley Hospital Regional Cancer Center

Skagit Valley Hospital is located north of Seattle in Mount Vernon, Wash. Striving to be one of the best regional hospitals in the Northwest, they work with their community to promote health and wellness providing outpatient diagnostic and rehabilitation services, surgery, and acute care. They were one of the first hospitals in the region to join the SCCA Network.
Their Regional Cancer Care Center has provided state-of-the-ar

cancer care to the region for over 20 years. Radiation oncology, medical oncology, access to clinical trials, complementary medicine, and support services are all included in their comprehensive cancer care program.

Michal Anne Whiton, MD recently returned to her native Skagit County and joins David Kantorowitz, MD, PhD and a skilled team of physicists, dosimetrists, therapists and nurses in providing radiation therapy and stereotactic radiosurgery.

“I am looking forward to working with the entire oncology team at the Skagit Valley Regional Cancer Care Center. I have been continually impressed with the level of technology and expertise offered by Dr. Kantorowitz and the talented medical oncology team within this local cancer center.”

Michal Ann Whiton, MD

Radiation Oncologist, Skagit Valley Hospital Regional Cancer Care Center

Michal Anne Whiton, MD is a radiation oncologist at Skagit Valley Hospital Regional Cancer Care Center. She works with David Kantorowitz, MD, PhD and a skilled team of physicists, dosimetrists, therapists, and nurses to provide radiation therapy and stereotactic radiosurgery.

“I am thrilled to have returned to my hometown to join the dynamic team of oncologists at the Skagit Valley Hospital Regional Cancer Care Center,” Dr. Whiton says. “It’s a privilege to provide radiation services to the community in which I grew up. I look forward to continuing the tradition of providing compassionate oncology services at this progressive local cancer care center.”

Dr. Whiton has a special interest in community education and plans to provide various workshops and lectures for patients who are interested in learning about the biology of cancer, the various treatment methods available, and the components of a cancer prevention lifestyle. She received a bachelor’s degree from Washington State University and her Doctor of Medicine from the University of Washington. She completed her residency in radiation oncology at Thomas Jefferson University in Philadelphia. Her training included clinical rotations at Washington University in St. Louis with a focus on gynecological malignancies and brachytherapy and at St. Jude Children’s Research Hospital in Memphis, with a focus on pediatric malignancies.

Sea Mar Community Health Centers

Sea Mar Community Health Centers is a community-based organization committed to providing quality, comprehensive health and human services to diverse communities, specializing in service to Latinos.

Seattle Cancer Care Alliance and Sea Mar have agreed to collaborate on education about screening and early detection, and on community outreach (with regard to cancer education). SCCA will participate in Sea Mar’s health events, and SCCA oncologists will work with Sea Mar primary care physicians as they care for their cancer patients, opening up new opportunities for clinical research for Latino and minority communities.

With locations along the I-5 corridor from Vancouver, Wash. to the Canadian border, Sea Mar Community Health Centers was organized in 1978 by a group of Latino community leaders and health activists who dreamed of developing a comprehensive health center for the Latino community in Seattle. Today, Sea Mar is one of the largest providers of health and human services, including community and migrant primary medical and dental care, social services, case management, maternal support services, migrant and homeless support services, health education and nutrition programs, pharmacy services, community- and facility-based long-term care services, affordable housing, and child care.

Physician Profile: Philip Reilly, MD

Clinical Director, Sea Mar Community Health Centers

Dr. Philip Reilly worked at Sea Mar’s Tacoma Medical Clinic for three years, where he served as clinical director. In 2003 he accepted the same position at Sea Mar’s Seattle Medical Clinic, located in Seattle’s South Park neighborhood, where he is regarded as a strong leader and for his long-time involvement in community activities.

He served as a member of the board of directors for Centro Amauta de Estudios y Promoción de la Mujer in Perú, where he lived and worked for several years before going to medical school. Today, he is a lead clinician in support of the Sea Mar’s Boxing Club, based in South Park.

Dr. Reilly earned his Doctor of Medicine degree from the University of California, San Francisco in 1996, followed by a three-year residency in family practice at Providence Hospital, Seattle. Today he works to improve access to high-quality healthcare for the traditionally underserved by focusing on individual and systems issues.
 

SCCA Announcements

Ben Greer, MD is now on the Board of Trustees for the Washington State Medical Oncology Society (WSMOS). Dr. Greer joins other SCCA Network member colleagues -- Mathew Lonergan, MD of Cascade Cancer Center, Jack Keech, MD of MultiCare in Gig Harbor, and Thomas Tucker, MD of Wenatchee Valley Medical Center.

The mission of WSMOS is to provide advocacy for cancer patients and to promote standards of excellent for high quality cancer care. For more information on WSMOS, visit www.wsmos.org.

Cec Zapata, director of the SCCA Network and Physician Outreach, recently joined the board of directors for the Leukemia & Lymphoma Society’s Washington/Alaska chapter. The LLS is dedicated to funding blood cancer research, education, and patient services. The mission of the LLS is to cure leukemia, lymphoma, Hodgkins disease, and myeloma, and to improve the quality of life of patients and families. To get involved or for more information, visit www.lls.org/wa.