If you haven’t heard the term “precision medicine,” you will. If you don’t have an opinion about access to it, you will.
On Friday, President Obama unveiled details of the Precision Medicine Initiative, an effort intended to accelerate cancer research in a powerful way, giving doctors new knowledge and new therapies to help them better treat individual patients much more effectively than is generally currently possible.
The specific goal of the $215 million plan is the creation of more targeted treatments for individual patients, not general-approach therapies that doctors then try to modify to the best of their abilities. As the White House said in a briefing:
“Most medical treatments have been designed for the ‘average patient.’ As a result of this ‘one-size-fits-all-approach,’ treatments can be very successful for some patients but not for others. This is changing with the emergence of precision medicine, an innovative approach to disease prevention and treatment that takes into account individual differences in people’s genes, environments, and lifestyles. Precision medicine gives clinicians tools to better understand the complex mechanisms underlying a patient’s health, disease, or condition, and to better predict which treatments will be most effective.”
The lack of a practical way to produce and store enough stem cells for larger-scale therapies and clinical trials is creating a bottleneck in stem cell research. A new grant to City of Hope from the California Institute for Regenerative Medicine will help solve that problem.
The $899,728 grant, awarded Thursday to City of Hope researchers, will enable researchers to adapt current cell culture techniques to a more scalable and controllable system that reflects Good Manufacturing Practices.
Existing cell production methods allow for pluripotent stem cells and progenitor cells, but these methods simply can’t be scaled up, from a practical perspective, to the level necessary for clinical trials and for some of the stem cell products expected to be in high demand. For example, cardiomyocytes – heart muscle cells – derived from stem cells show promise as a treatment for heart failure, which is occurring at epidemic rates. However, large doses of these cells would be required for sufficient therapeutic use, and current production practices don’t support that type of increase. » Continue Reading
City of Hope has long known what researchers increasingly are confirming: Gardens and natural surroundings help seriously ill people recover from their treatment ordeals.
Already a trailblazer in the creation of beautiful natural spaces for cancer patients and their families, on Jan. 15, City of Hope dedicated the newest in a series of healing landscapes: the Argyros Family Garden of Hope.
Supported by the Argyros Family Foundation – led by former U.S. Ambassador to Spain George Argyros and his wife, Julia – the garden provides a natural space of light, water, trees and native plants designed to encourage emotional, mental and physical healing.
Strategically positioned between City of Hope Helford Clinical Research Hospital, where patients undergo treatment, and Beckman Research Institute of City of Hope, where researchers work to find cures, the Argyros Family Garden of Hope provides patients with easily accessible places to walk and to rest – complete with new and mature trees, gurgling fountains and the soothing use of sand and rock – all artfully integrated into an intimate Southern California vignette. » Continue Reading
Despite advances in surgery, radiation and drug therapy, brain tumors remain particularly challenging to treat. This is due to the tumor’s location, which can limit localized therapies’ effectiveness, and the blood-brain barrier, which blocks many cancer-fighting drugs’ passage from the bloodstream to the tumor site.
City of Hope scientists are currently researching a new method that can overcome these barriers, using nanoparticles that can activate the immune system to attack tumor cells in the brain.
Within these nanoparticles are CpG, small snippets of DNA molecules that can stimulate a localized immune response. The problem with CpG is that, when the snippets are administered on their own, they can disperse throughout the body, prompting immune cells to attack healthy tissues as well.
To address this issue, researchers Behnam Badie, M.D., director of the Brain Tumor Program and Jacob Berlin, Ph.D., assistant professor in the Department of Molecular Medicine, came up with the idea of packaging CpGs within carbon nanotubes (CNT), small structures that resembles a bacteria or virus in size. Because their structure mimics those of invasive microorganisms, they should be rapidly taken up by immune cells in the injection site, localizing their attack response.
In animal studies, Badie and Berlin have shown this is the case, and those injected with CNT-CpG had significantly better outcomes than the CpG-only and control groups. In their three-month measurement period, 100 percent of the CNT-CpG group survived versus 0 percent of the other two groups.
Further, the CNT-CpG group also remained tumor-free when injected with new brain tumor cells after the initiation treatment, showing that this treatment can provide long-term anti-tumor immunity.
Given the promising results of this novel therapy, Badie and Berlin are working with the Food and Drug Administration to develop the criteria for a Phase I trial using CNT-CpG and hope to begin an in-human study within the next two years.
Equipping the immune system to fight cancer – a disease that thrives on mutations and circumventing the body’s natural defenses – is within reach. In fact, City of Hope researchers are testing one approach in clinical trials now.
Scientists take a number of steps to turn cancer patients’ T cells – white blood cells that are part of the immune system’s defenses – into smart cells that can locate elusive cancer cells. They also get help from nature, using the natural properties of what most people consider agents of infection.
First, they use bacteria to help the patient’s own T cells grow in the lab – because cell reproduction is something bacteria do very well. Then they use a harmless virus to manipulate the DNA of the T cell so it can recognize certain markers on a cancer cell that flag them as targets for attack.
KPCC recently reported on this research, explaining how the immune system might be mobilized to attack cancers that are good at hiding from the body.
Bacteria, viruses, a patient’s own immune system and a team of top scientists all working in concert against cancer … Sound complicated? In about two and a half minutes, the above video artfully sums up the process step by step.
So far, City of Hope is studying this approach in a number of blood cancers through the Hematologic Malignancies and Stem Cell Transplantation Institute.
Learn more about T cell immunotherapy at City of Hope.
Learn more about becoming a patient or getting a second opinion at City of Hope by visiting our website or by calling 800-826-HOPE (4673). City of Hope staff will explain what’s required for a consult at City of Hope and help you determine, before you come in, whether or not your insurance will pay for the appointment.
As treatments for lung cancer become more targeted and effective, the need for better technology to detect lung cancer mutations becomes increasingly important. A new clinical study at City of Hope is examining the feasibility of using blood and urine tests to detect lung cancer mutations, potentially allowing for targeted cancer treatments without an invasive biopsy.
The trial, a collaboration with Trovagene Inc., focuses specifically on mutations that make EGFR proteins (for epidermal growth factor receptor) grow and divide faster than they should. The protein is normally found on the surface of cells, but nonsmall cell lung cancer cells can have too much of this protein.
Sometimes, a patient can require two procedures to obtain an adequate biopsy that determines the presence of EGFR mutation. In this first clinical study, patients who have been biopsied will also get specific blood and urine tests to determine if those tests are as effective as a traditional biopsy to determine an EGFR mutation.
“Tracking various alterations in the EGFR oncogene has potential to improve therapeutic strategies for treating patients with nonsmall cell lung cancer,” said Mihaela Cristea, M.D., lead investigator and associate professor in City of Hope’s Lung Cancer and Thoracic Oncology Program. “We look forward to evaluating Trovagene’s molecular diagnostics for the monitoring of circulating tumor DNA found in both urine and blood, with the goal of delivering highly personalized cancer treatment to improve patient outcomes.” » Continue Reading
When it comes to breast cancer risk, insulin levels may matter more than weight, new research has found.
The study from Imperial College London School of Public Health, published in the journal Cancer Research, indicates that metabolic health – not a person’s weight or body mass index – increases breast cancer risk in postmenopausal women. Although high insulin levels frequently occur in women who are overweight or obese, women at normal weights may have unhealthly insulin levels, as well, putting them at a perhaps unexpected increase in breast cancer risk. Likewise, some obese women may have normal levels of the hormone.
The study of insulin and breast cancer risk included 3,300 women without diabetes, 497 of whom developed breast cancer during the study’s eight years. The study analyzed weight, fasting insulin levels and insulin resistance. Insulin is a hormone that aids in using digested food for energy. An inability to produce insulin or use it properly leads to diabetes. Insulin resistance occurs when the body is unable to use insulin efficiently, resulting in hyperglycemia. The condition is often a precursor to type 2 diabetes. » Continue Reading
No one ever plans to have cancer – and there’s never a good time. For Homa Sadat, her cancer came at a particularly bad time: just one year after losing her father to the pancreatic cancer he had battled for two years.
She was working a grueling schedule managing three commercial office buildings. She’d just started dating someone very promising – and her family was still mourning her father.
Sadat, now 30, was 27 when she first found a lump in her breast. She called it to her doctor’s attention, but her concerns were dismissed. She couldn’t have cancer, her doctor said. She was too young. Six months later, a shooting pain prompted her to insist on a biopsy that found breast cancer. Specifically, she had triple-negative breast cancer – the hardest type to treat, because it doesn’t respond to any current targeted therapies.
Sadat considered other caregivers, but ultimately chose the Breast Cancer Program at City of Hope because of her confidence in her oncologist, George Somlo, M.D., professor in the departments of Medical Oncology and Therapeutics Research and Hematology and Hematopoietic Cell Transplantation. One of Somlo’s areas of research interest is triple-negative breast cancer. Sadat volunteered for a Phase II clinical trial that combined carboplatin and a novel nano-particle drug called nab-paclitaxel. The trial called for her to undergo 16 weeks of chemotherapy before having surgery to address her cancer.
Halfway through chemotherapy regimen, she had a extremely welcome surprise.
“I went in for an ultrasound-guided biopsy, and they said there’s nothing to biopsy,” Sadat said. “They couldn’t find the tumor.” » Continue Reading
Patients at City of Hope – most of whom are fighting cancer – rely on more than 37,000 units of blood and platelets each year for their treatment and survival.
Every one of those units comes from family, friends or someone who traded an hour or so of their time and a pint of their blood to save lives. Science has yet to develop a replacement for human blood. January is National Blood Donor Month, and a good time to schedule a blood or platelet donation.
Cancer patients need transfusions for many reasons. Those with leukemia or other blood cancers may have low red or white blood cell counts, as cancer crowds out the normal blood-making cells in their bodies. Patients who have had cancer for a long time may develop anemia. The kidneys or spleen, if affected by the cancer, may not be able to keep enough healthy cells in the bloodstream.
Cancer treatments can lead to blood loss and create need for red blood cell or platelet transfusions. Many therapies also affect the bone marrow, leading to low blood counts. Patients who receive bone marrow or stem cell transplants have endured large doses of chemotherapy and radiation therapy. Their blood-making cells are destroyed as part of their treatment, and often need transfusions following their transplant. » Continue Reading