Diabetes affects nearly every organ in the body. In type 1 diabetes (previously called juvenile onset, or insulin-dependent, diabetes), its cause, and potentially its cure, can be found in the pancreas — home to islet cells which produce insulin, the hormone that enables the body to process sugar.
In people with type 1 diabetes — a lifelong condition — the body’s immune system attacks and kills the islet cells. Patients must inject themselves with insulin to control their blood sugar (known as glucose). Transplantation of healthy insulin-producing islet cells is the first step on the path to freedom from this constant struggle.
A leader in the field
Fouad Kandeel, M.D., Ph.D, chair of the Department of Clinical Diabetes, Endocrinology & Metabolism, was instrumental in launching City of Hope’s Islet Cell Transplantation Program. Since leading the first transplantation in 2004, he has pursued the safest and most effective methods of transplantation — using islet cells from donors — a far simpler procedure than transplantation of an entire pancreas.
As Kandeel works to perfect the protocols, or rules, for islet cell transplantation, he’s also working with other researchers and clinicians at City of Hope to create a comprehensive — potentially conclusive — approach to curing diabetes. » Continue Reading
When it comes to cancer, your family history may provide more questions than answers: How do my genes increase my risk for cancer? No one in my family has had cancer; does that mean I won’t get cancer? What cancers are common in certain populations and ethnicities?
City of Hope experts have some guidance. “Your genes are not your destiny, but they can play a role in the decisions you make related to cancer screenings, diet and interventions that you do along the way,” said Joseph Alvarnas, M.D., director of medical quality and an associate clinical professor in the Department of Hematology & Hematopoietic Cell Transplantation at City of Hope. “You can take an active role in how you move along in life, rather than be the passive recipient of the hand that genetics happens to deal to you.” » Continue Reading
The body’s immune system is usually adept at attacking outside invaders such as bacteria and viruses. But because cancer originates from the body’s own cells, the immune system can fail to see it as foreign. As a result, the body’s most powerful ally can remain largely idle against cancer as the disease progresses. Immunotherapy in general seeks to spur the immune system to action, helping the body fight cancer. One type of immunotherapy —T cell therapy — reprograms immune cells known as T cells to recognize and destroy cancer cells.
A wave of clinical trials
Normally, T cells attack bacteria and other infectious agents. In T cell therapy, T cells are isolated from a sample of the patient’s blood, then genetically engineered to seek out and attack a specific cancer. Researchers grow millions of these engineered T cells in the laboratory. The engineered cells are reinfused into the patient, where they go to work eliminating cancer.
Stephen J. Forman, M.D., the Francis & Kathleen McNamara Distinguished Chair in Hematology and Hematopoietic Cell Transplantation, has long pursued breakthrough treatments for hematologic cancers and blood-related disorders, and heads up City of Hope’s bone marrow transplant program. Under his direction, a wave of T cell clinical trials is underway, all of which are moving the treatment out of the lab and directly to patients. » Continue Reading
Hematologist Robert Chen, M.D., is boosting scientific discovery at City of Hope and, by extension, across the nation. Just ask the National Cancer Institute.
The institution recently awarded Chen the much-sought-after Clinical Investigator Team Leadership Award for boosting scientific discovery at City of Hope. He is one of just 11 researchers in the nation this year to receive the prestigious $100,000 grant from the NCI.
Fewer than 60 scientists have been granted the award since its inception five years ago.
The two-year NCI grant recognizes Chen’s exceptional merit as a clinical researcher whose innovative efforts are advancing therapies for lymphoma patients.
Chen, an assistant professor in the Department of Hematology & Hematopoietic Cell Transplantation, specializes in Hodgkin lymphoma research and treatment. His recent leadership of clinical trials testing the drug brentuximab vedotin helped clear its use for treating certain Hodgkin lymphoma patients who don’t respond well to stem cell transplantation. » Continue Reading
Identifying cures for currently incurable diseases and providing patients with safe, fast and potentially lifesaving treatments is the focus of City of Hope’s new Alpha Clinic for Cell Therapy and Innovation (ACT-I).
The clinic is funded by an $8 million, five-year grant from the California Institute for Regenerative Medicine. The award is part of CIRM’s Alpha Stem Cell Clinics program, which aims to create one-stop centers for clinical trials focused on stem cell treatments for diseases.
Two trials were identified to launch the center, but additional trials are currently enrolling patients and will be part of this clinic. The first trials center on transplants of blood stem cells that have been modified to treat patients with AIDS and lymphoma, and on the use of neural stem cells – which naturally home to cancer cells – to deliver drugs directly to cancers hiding in the brain. Coming soon will be trials that use T cell immunotherapy, developed by researchers in City of Hope’s new Hematologic Malignancies and Stem Cell Transplantation Institute.
“We are committed to finding cures and treatments to diseases that are, for now, incurable,” said John Zaia, M.D., the Aaron D. Miller and Edith Miller Chair in Gene Therapy, chair of the Department of Virology and principal investigator for the stem cell clinic. “This grant recognizes City of Hope’s commitment to and leadership in this endeavor, as well as enables us to pursue the crucially important work of bringing the promising potential of stem cell treatments to fruition.” » Continue Reading
Chemotherapy drugs work by either killing cancer cells or by stopping them from multiplying, that is, dividing. Some of the more powerful drugs used to treat cancer do their job by interfering with the cancer cells’ DNA and RNA growth, preventing them from copying themselves and dividing.
Such drugs, however, like Hydroxyurea, do have drawbacks. One is that the body metabolizes them quickly. Patients need frequent doses to achieve the desired effects. Because the side effects of the drugs are already considerable, increased use of them raises the risk of negative reactions. Another drawback is that cancer cells develop rapid resistance to the drugs, reducing their effectiveness.
A team effort
As a physician, molecular pharmacologist Yun Yen, M.D., Ph.D., knows well the limitations of chemotherapy drugs. He partnered with medicinal chemist David Horne, Ph.D., to find — and improve — a molecule, or compound, to overcome these problems.
First, Yen selected a promising anti-cancer compound from the National Cancer Institute’s library of anti-cancer agents. Then, using data obtained with the help of the skilled laboratory scientists in City of Hope’s Core (or “Shared”) Services, Horne began to make structural adjustments to improve the molecule’s effectiveness. Core Services provides researchers, specialized expertise, testing and instrumentation in fields such as molecular modeling, screening, medicinal chemistry and cancer biology. Access to these services enabled Yen and Horne to determine, even before preclinical testing, how the compound worked. » Continue Reading
Cancer that spreads to the liver poses a significant threat to patients, and a great challenge to surgeons. The organ’s anatomical complexity and its maze of blood vessels make removal of tumors difficult, even for specialized liver cancer surgeons. Following chemotherapy, the livers of cancer patients are not optimally healthy. This compromises the power of the residual liver to compensate functionally, postsurgery, and to regenerate over time. Hence, saving as much of the liver as possible is key.
Gagandeep Singh, M.D., has long pursued surgical techniques that would allow for successful removal of tumors. Over time, he devised a technique that incorporated tools normally used in laparoscopy and neurosurgery.
Using this technique in 2012, he operated on Susan Stringfellow, a patient in her 60s, whose colon cancer had metastasized to her liver. Removal of the tumors required resecting almost 75 percent of her liver. In the year following the surgery, the patient’s liver regenerated itself. Encouraged, Singh continued to use the technique, teaching it to his surgical oncology fellows at City of Hope. Close to 200 surgeries later, he had amassed data confirming that the technique reduced the need for blood transfusions and resulted in no biliary leaks.
A new study suggests that the colorectal cancer outlook is more grim than many thought, with the number of cases among young adults actually rising. But the study, which made headlines around the country, might not have the obvious message many consumers think.
Donald David, M.D., chief of gastroenterology at City of Hope, says some of the statistics might be linked to detection bias.
First, some context: Colorectal cancer cases and related deaths have been steadily declining in the United States for the past couple of decades. Chalk that up to improvements in prevention, screening and treatment. But the new research found that not only is colorectal cancer rising in young adults, it will probably continue to rise over the next 15 years. » Continue Reading
Among bone marrow and stem cell transplant programs, one measure of quality stands out: accreditation by the Foundation for the Accreditation of Cellular Therapy, or FACT. Now, City of Hope’s program has received a full three-year accreditation from FACT — its fourth since first applying in 2004.
The accreditation — which is now required by many insurance payors — applies to all City of Hope services and facilities inspected by FACT. These include adult and pediatric autologous (self-donated) and allogeneic (donor-derived) blood stem cell transplantation, bone marrow and peripheral blood cellular therapy product collection, and cellular therapy product processing.
Eileen Smith, M.D., associate director of clinical research in the Department of Hematology & Hematopoietic Cell Transplantation (HCT), says that FACT “is the most important accreditation for transplant programs in the U.S.” She helped oversee the accreditation process in collaboration with David Snyder, M.D., director of quality management for the HCT Program.
“FACT accreditation is similar to Joint Commission accreditation — it gives patients, payors and referring physicians confidence that we’re among the top centers in the country,” Smith said. » Continue Reading
The single largest risk factor for lung cancer is smoking, and it contributes to the overwhelming majority of lung cancer cases.
That’s old news, of course. What might be news to many people is that, although smoking is a major cause of lung cancer, it’s not the only cause. In fact, a growing number of cases are occurring in patients who never smoked and who did not have significant exposure to secondhand smoke.
About 15 percent of lung cancers are diagnosed in people who do not smoke. Further, about 60 percent or more occur in nonsmokers, including people who never smoked and those who quit many years before their diagnosis.
Success in smoking education and cessation efforts means fewer smokers, but as the numbers of smokers developing lung cancer declines, scientists are recognizing how much we have to learn about the causes of this disease.
Other lung cancer risk factors: » Continue Reading