Issue 27Winter 2013
- UW-Oncoplex, Second to None in Genetic Profiling of Cancer Cells
- SCCA Proton Therapy, A ProCure Center Accepting Appointments
- Radiation Oncologist Embraces the Future
- New Multidisciplinary Colorectal Cancer Clinic Open
- Prostate Cancer Challenged by the Dream Team
- The Survivorship Clinic
Developed by Colin Pritchard, MD, PhD and his team in the Clinical Molecular Genetics Laboratory at UW Medicine, UW-OncoPlex analyzes 194 different genes for “driver mutations” that are associated with specific types of cancer.
The diagnostic power of UW-OncoPlex stems from the fact that it is evaluating the genetics of the patient’s tumor cells—not healthy tissue. A mutation that appears on the UW-OncoPlex panel points to a known sub-type of the disease, whether it’s melanoma, lung cancer, sarcoma, gastrointestinal/colon cancer, or leukemia. Armed with this information, doctors can choose the therapy that’s known to work best to destroy or control the patient’s tumor type.
For example, in lung cancer, UW-OncoPlex can identify mutations in three different tumor genes. Each of these lung cancer variants has a U.S. Food and Drug Administration-approved therapy that promotes tumor shrinkage two to three times better than chemotherapy. The patient benefit is significant, says Renato Martins, MD, MPH, medical director of Thoracic/Head and Neck Oncology at SCCA: “Patient responses can last between nine and 14 months, which used to be the time lung cancer patients survived—period. In some cases, the disease has remained under control for much longer than 14 months — a huge improvement in a patient’s expected outcome.”
Robin Jones, MD, MRCP is excited about the potential of UW-OncoPlex to drive innovation in his area of specialization: sarcoma. “Sarcoma actually consists of 60 to 70 different histological subtypes,” he explains. “Historically, these have been treated systemically with exactly the same therapy. Yet it’s clear they are completely different diseases.” He points to the success in identifying the driver mutation for gastrointestinal stromal tumor (GIST) as “the paradigm for targeted treatment in solid tumors.”
Says Pritchard, “I believe that, within 15 years, we’ll develop highly effective combination treatments that can turn some of the most lethal cancers into chronic diseases. I’m quite optimistic about that.” More about UW-Oncoplex at www.seattlecca.org/diseases/oncoplexoverview.cfm.
Widely recognized for its benefits, proton therapy is used to treat a broad range of cancers, including many pediatric cancers, adult sarcomas and tumors of the brain, central nervous system, gastrointestinal tract, head and neck, lung, and prostate. Proton therapy is most commonly recommended for treating anatomically complex tumors where avoiding damage to healthy adjoining tissue—particularly critical organs and structures—is imperative.
It is an emerging technology, and there is much that remains unclear about the cost-benefit profile of proton therapy relative to other radiation therapies. Our doctors view the center as a tremendous opportunity to take the lead in active clinical investigations that will help define the role of proton therapy in future cancer treatment.
Our goal is to provide patients with access to this technology in cases where its efficacy over standard X-ray treatment is clinically compelling. Ongoing studies conducted by our doctors will help chart a clear course for the use of proton radiation in achieving the best possible outcomes in treating cancer.
When proton therapy is recommended, you can be confident knowing your patient will receive excellent care at SCCA Proton Therapy, A ProCure Center. Our physicians are happy to talk with you at any time, and will provide you with updates throughout the treatment process, and a concise summary at the completion of treatment.
The new proton center is located on the campus of UW Medicine’s Northwest Hospital & Medical Center. For more information on proton therapy treatment, go to www.sccaprotontherapy.com. To determine whether your patient is a good candidate for proton therapy, or to refer a patient, call the center at (877) 897-7628 or email firstname.lastname@example.org.
Like all physicians, radiation oncologist Michael W. Brown, MD hopes to see continued progress with cancer treatments—not only improved outcomes but also decreased toxicity.
“We’ve made a lot of progress in cancer treatment, but there’s a long way to go,” Brown says. “I think specifically, we’ll see substantial improvements in the management of a number of cancers through biological manipulation and targeted therapies, and decreased side effects from treatment through more precise delivery of our current treatments.”
Brown’s work involves clinical research for treatment of breast and gynecologic malignancies, and he hopes to increase availability of clinical trials for a variety of cancers at SCCA Radiation Oncology at Northwest Hospital, which is also the site of the SCCA Proton Therapy, A ProCure Center.
“All UW providers get trained in proton therapy,” he says. “My goal is to provide the best care for my patients.” When proton therapy is appropriate, either alone or in combination with other therapies, Brown has privileges at the new proton therapy center to treat or to guide treatment with that therapy.
“There are a lot of misconceptions about protons,” he says, emphasizing that this may or may not be the best treatment option for all patients. “We only have patients’ best interests in mind. With thorough vetting to make sure it’s appropriate, we want to provide the maximum benefit for the patient.”
Brown welcomes phone calls or emails to collaborate with physicians regarding patient care options. “I want to work with any and all comers to improve patient care. We’re all here for one purpose—to care for patients.” Contact Dr. Brown at (206) 288-7318 or email@example.com. To view his profile, visit www.seattlecca.org/doctor/michael-brown-md.cfm.
The Colorectal Cancer Specialty Clinic (CCSC) opens February 28 at SCCA to provide comprehensive, collaborative care. In this new clinic, patients will meet with all their specialists in just one day. This one appointment-meets-all is convenient for patients and enables physicians from different disciplines to focus specifically on the patient. The result is well-coordinated, high-quality health care.
Colon cancer patients with non-metastatic disease typically receive surgery followed by chemotherapy. At the CCSC, patients will meet with their surgical oncologist and then their medical oncologist on the same day so that they understand their full treatment plan up front. Rectal and anal cancer patients will also meet with a radiation oncologist; concurrent chemotherapy and radiation is a critical component of their care. During the appointment day, the team of physicians will communicate in conference with one another to discuss the patient’s treatment plan. Specially designed clinical pathways enhance physician-to-physician and physicians-to-patient communication, streamlining the care experience, especially as patients transition from one treatment modality to the next.
“The idea behind this comprehensive clinic is to get patients into a treatment plan as quickly as possible,” says Alessandro Fichera, MD, director of the colorectal cancer surgery program at SCCA. “Our physicians are all present on the day the patient comes in for their appointment. The patient will leave with a plan in hand to treat their disease.”
Effective patient schedulingA team coordinator and colon cancer nurse keep track of patients as they progress through treatment and keep patients informed as to when their next treatment appointment will be and what they can expect. As the patient progresses through their treatment, they will continue to return to the CCSC so their physician team can determine next steps as a group to provide them with the best care. In addition, the clinic is staffed by a certified wound ostomy nurse who understands both the physician and emotional impact of ostomies, and works closely with patients, families, and providers.
To refer a patient to SCCA, call (206) 288-SCCA (7222) or complete the online referral form available at www.seattlecca.org/physician-referral.cfm.
“We are sequencing all of the genes in metastases from men dealing with resistant prostate cancers,” says Bruce Montgomery, MD, an SCCA oncologist who is participating in this multi-institutional project. “This process used to take a year and $500,000,” he says, “and now it takes four weeks and $10,000.”
The sequencing will identify any mutations that are specific to these cancers. It might also reveal new ways to treat cancers that are resistant to standard therapies.
“If mutations are found and we can target them with drugs that already exist but haven’t been used to treat prostate cancer before, then we will prescribe those medications with the potential that these could provide real benefit,” Montgomery says. “Defining mutations which occur in advanced, metastatic cancer has never been done in any systematic way, and this effort could also define new targets for therapy that we’ve never recognized before in prostate cancer.”
The Survivorship Clinic at SCCA addresses the problems cancer survivors may face after therapy and supports them as they move from the acute treatment phase into the day-to-day living as a cancer survivor, helping them focus on symptom management and a healthy lifestyle.
Patients can be seen in the Survivorship Clinic any time after they complete their acute cancer treatment, regardless of where they were treated. They may be on maintenance or hormone therapies, may be fresh off of treatment, or many years past treatment. Many of our patients need only one visit while others find further visits helpful over time.
Contact the Survivorship Clinic at SCCA at (206) 288-1021 for more information or visit online: www.seattlecca.org/survivorship.
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.
Read about important outcomes research at the Fred Hutch that may benefit your patients.
Each issue of Clinical Trials Monthly highlights several of the more than 200 clinical trials that are currently recruiting patients at SCCA.
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.