Myelofibrosis clinical trial aims to halt cascade of symptoms

April 24, 2015 | by

To say that myelofibrosis patients need more treatment options would be an understatement. The severely low platelet counts, known as thrombocytopenia, that are one of the hallmark symptoms of the disease can lead to chronic fatigue and weakness that not only damage quality of life but, ultimately, shorten life span.

myelofibrosis and blood platelets

Myelofibrosis patients often suffer from severely low blood platelets, or thrombocytopenia. A myelofibrosis clinical trial at City of Hope could lead to a new treatment option.

City of Hope is now testing a new drug, pacritinib, that could help boost those platelet counts in myelofibrosis patients with thrombocytopenia.

Myelofibrosis begins in the bone marrow, spurring an accumulation of malignant bone marrow cells and causing scarring that prevents the marrow from making enough healthy blood cells. As a result, the spleen and liver have to take over the cell creation function, leading to their enlargement and damage. For the patient, the result is anemia, extreme fatigue, bleeding and an increased risk of infection. Other symptoms include itching and pain.

Controlling the severely low platelet counts could counteract this cascade of symptoms and affect progression of the disease.

“City of Hope is committed to advancing the medical community’s understanding of myelofibrosis and thrombocytopenia through research studies,” said David S. Snyder, M.D., associate chair of  the Department of Hematology and Hematopoietic Cell Transplantation at City of Hope. “Finding new ways to support patients with chronic diseases is important and helps fulfill our commitment to this community.” » Continue Reading

Clinical trials could lead to new options for colorectal cancer patients

April 23, 2015 | by
Clinical trials for metastatic colorectal cancer

Patients with metastatic colorectal cancer need more options. Two clinical trials currently underway at City of Hope could help provide those options.

Patients with metastatic colorectal cancer often stop responding to the primary drugs used against the disease, leaving them with few options and little hope. Determined to increase those options, doctors and researchers at City of Hope are conducting two clinical trials that could lead to new treatments for people with colorectal cancer, currently the third most common cancer in the U.S.

Marwan Fakih, co-director of the Gastrointestinal Cancer Program at City of Hope, highlighted those studies in a recent conversation, explaining how they show particular promise for patients with metastatic colorectal cancer. The first study will assess the potential impact of a new drug – one that targets a specific activated gene product, Fakih says – when used with a standard two-drug chemotherapy regimen. The second study will assess the maximum dosage of an investigational drug when used with a well-known three-drug chemotherapy regimen in patients who haven’t been helped by other therapies.

Here, Fakih answers questions about the two trials. » Continue Reading

To fight cancer, these researchers go where the action is – the nucleus

April 22, 2015 | by
molecular oncology

Molecular oncology researchers explore a cancer cell’s nucleus for new ways to fight tumors.

Investigators working at City of Hope are making many significant inroads against many forms of cancer. To do that, they have to take a variety of approaches.

Molecular oncology researchers focus on abnormal cancer-associated activity in a cell’s nucleus. One especially prominent factor in many breast and ovarian cancers is the BRCA1 tumor suppressor. When BRCA1 activity is compromised, cells cannot properly repair breaks in chromosomal DNA, which encourages the accumulation of even more cancer-causing mutations. In short, this increases a woman’s risk of developing breast and ovarian cancer.

In one study published in the Journal of Biological Chemistry, Jeremy Stark, Ph.D., associate professor of the Department of Radiation Biology, reported that biologically speaking, two wrongs can make a right. Stark inactivated factors in a signaling pathway called 53BP1/RNF168 and found that intervention blocked lethal failure in DNA repair caused by mutations in the BRCA1 gene. » Continue Reading

BMT reunion celebrates lives saved – on the frontiers of science

April 20, 2015 | by

Each year, City of Hope patients given another chance at life gather to pose for a picture like this one. Going on its 39th year, the celebration of patients free of blood cancers thanks to bone marrow or stem cell transplants has grown such that a photographer has to scale a cherry picker just to get them all in.

bone marrow transplant

City of Hope has performed over 12,000 hematopoietic cell transplants, and has the best outcomes in the nation. Here are some of our survivors at the 2014 BMT Reunion.

“Imagine this space if we didn’t have this program,” said Stephen J. Forman, M.D., Francis & Kathleen McNamara Distinguished Chair in Hematology and Hematopoietic Cell Transplantation at City of Hope. “There wouldn’t be any people. Just trees.”

Forman can remember when there was no such picture to take, when the first Bone Marrow Transplant Reunion consisted of a single patient and his donor – his brother. Since then, the event has expanded dramatically. Now, beloved Dodger baseball players offer their well-wishes to current patients and survivors, renowned musicians and comedians – cancer survivors themselves – perform for an empathetic audience, and patients meet their stem cell donors from across the globe.

The heart of the celebration is more than 6,500 patients and family members who celebrate their personal anniversaries, each wearing a button proudly proclaiming how long it’s been since their transplant, which ranges from months to decades. This year, the reunion is Friday, May 1. There – amid the cupcakes, barbecue, music and festive atmosphere for patients – physicians, nurses and other caregivers find the motivation that carries them to the next reunion. » Continue Reading

$6.8 million NCI grant will improve palliative care in clinical trials

April 18, 2015 | by
City of Hope's Betty Ferrell

City of Hope’s Betty Ferrell is testing a new palliative care model on patients in a phase I clinical trial.

Cancer patients who are participating in early-stage clinical trials need extra emotional and physical support due to their additional stress and often unique symptoms. Now an effort by researchers at City of Hope to create a model for such support has received a $6.8 million grant from the National Cancer Institute (NCI).
The grant will support work by City of Hope’s Betty Ferrell, Ph.D., R.N., and another institution to test a palliative care intervention program for cancer patients with a solid tumor who are also participating in a phase I clinical trial. The intervention aims to improve patients’ quality of life and symptoms and to promote the use of a hospital’s palliative care resources.
“The patients who are going on phase I clinical trials tend to be very sick,” said Ferrell, director of the Division of Nursing Research and Education at City of Hope and leader in the field of palliative care nursing and research. “Yet, they are volunteering to help us advance science by participating in our clinical trials and helping us advance treatments for the future. We want to make sure they are well-taken care of during the process and getting the best support possible.”

» Continue Reading

Brain tumor treatment needs new approaches. Here are 4 at City of Hope:

April 17, 2015 | by

The need for improvements in treating malignant brain tumors has never been greater. Survival for many patients with these tumors are sometimes measured in just months.

One reason that therapeutic options are limited is that traditional surgery is deemed too risky for many brain tumors, especially for those in hard-to-reach areas or in parts of the brain that control vital functions. Further, traditional treatment approaches have yielded only minor advances in the past few decades.

That’s why Behnam Badie, M.D., chief of the Division of Neurosurgery, along with other researchers and physicians at City of Hope, are developing novel therapies for cancer of the brain. “Being a neurosurgeon is not enough,” Badie said recently in an interview with BBC. “It has to be through science and technology. And that’s one of the reasons I came to City of Hope.”

Here are four ways in which City of Hope is advancing brain tumor treatment.

1. Using stem cells to deliver drugs into tumors

Neural stem cells have the ability to deliver anti-cancer therapies directly to the site of a brain tumor, without damaging healthy tissue. The latest study of this approach – from Karen Aboody, M.D., professor in the Department of Neurosciences and Division of Neurosurgery, and Jana Portnow, M.D., associate director of the Brain Tumor Program – will help determine the maximum tolerated dose of neural stem cells that can be safely administered directly into the brain. The researchers are also studying the possibility of administering repeat doses of the neural stem cells. A phase I clinical trial of this approach is currently underway.

» Continue Reading

Testicular cancer program’s goal: Return patients to normal life

April 14, 2015 | by

There’s never a “good” time for cancer to strike. With testicular cancer, the timing can seem particularly unfair. This disease targets young adults in the prime of life; otherwise healthy people unaccustomed to any serious illness, let alone cancer. And suddenly …

testicular cancer and fertility impact

The testicular cancer program at City of Hope is about more than tumor removal. It’s about getting young men back to their normal lives, with their fertility and health intact.

“I can only imagine what they must be thinking,” says Jonathan Yamzon, M.D., assistant clinical professor and surgeon in City of Hope’s Division of Urology and Urologic Oncology. Yamzon displays the genuine empathy that’s typical in every corner of City of Hope. He’s met and treated many testicular cancer patients, and he knows “how worried they must be, not only for themselves, but also for their young families, their small children.”

More than 8,400 men are diagnosed with testicular cancer each year. While rare, it is the most common cancer found in young men between the ages of 15 and 34. The good news is, if detected early, testicular cancer has an overall five-year survival rate of 96 percent. Treatment includes surgery to remove the testicle, and, if tests indicate remaining or spreading cancer cells, chemotherapy and radiation as needed. Even when the cancer has spread, the odds remain favorable.

When treating this younger population, the goal must be more than simply removing tumors. At City of Hope, the aim is to get the patient back to his normal life, preserving his fertility and longevity. » Continue Reading

Minorities and cancer: One factor can make a difference – exercise

April 11, 2015 | by
Minorities and cancer rates

The minorities and cancer statistics are grim, with African-American men and women having considerably higher death rates from the disease. City of Hope is working to erase those disparities. One way is by promoting exercise.

The statistics, direct from the American Cancer Society, are sobering:

Researchers have known for a long time that minority communities take a disproportionate hit when it comes to cancer. There are many explanations. Economics almost always plays a big role in early detection of cancer and in access to the most appropriate care. So do education levels and cultural differences. It may seem daunting, even impossible to address and correct such deeply-entrenched gaps. But experts do believe one critical factor can make a profound difference: preaching the gospel of prevention and supplying the tools to enable it.

We know that the best way to beat cancer is to stop it from occurring in the first place. But if prevention is indeed the first line of defense, it’s a tragically underused weapon in disadvantaged communities.

“When you’re unduly burdened with the necessities of daily life, when it’s a struggle just to get food on the table, you don’t have the time or energy to spend on prevention,” says Kimlin Tam Ashing, Ph.D., director of City of Hope’s Center for Community Alliance for Research & Education (CCARE).”

That’s why CCARE and Minority Cancer Awareness Week are so important. » Continue Reading

Jumonji may help explain how stem cells find cancer

April 8, 2015 | by
stem cells

Neural stem cells home in on invasive brain tumor cells. Now researchers are beginning to understand how they do this.

Neural stem cells have a natural ability to seek out cancer cells in the brain. Recent research from the laboratories of Michael Barish, Ph.D., and Karen Aboody, M.D., may offer a new explanation for this attraction between stem cells and tumors.

Prior to joining City of Hope, Aboody, now a professor in the Department of Neurosciences and the Division of Neurosurgery, found that neural stem cells are able to home in on invasive brain tumors. Since then, she and her colleagues have harnessed this ability to target cancer cells in a clinical trial at City of Hope, delivering localized chemotherapy directly to the most lethal form of brain cancer, high-grade gliomas. However, the specific drivers behind the stem cells’ ability to find tumors remain elusive.

The latest study, led by Patrick Perrigue, a former graduate student mentored by Aboody and Barish, points to a protein called Jumonji, expressed in both normal and cancer cells, as a key factor.

» Continue Reading

Cancer Insights: Make testicular cancer entirely, not highly, curable

April 7, 2015 | by

The American Society of Clinical Oncology, a group that includes more than 40,000 cancer specialists around the country, recently issued a list of the five most profound cancer advances over the past five decades. Near the top of the list was the introduction of chemotherapy for testicular cancer. To many in the field, this comes as no surprise.

Young men at risk

Testicular cancer is most likely to affect young men and, oncologists agree, is highly curable. It is not, however, entirely curable. Research must continue.

Prior to the advent of effective chemotherapy regimens, 90 percent of patients with advanced disease died. Now, the tables have turned entirely — more than 80 percent are survivors.

With April being Testicular Cancer Awareness Month, I think it’s entirely appropriate to celebrate these amazing statistics. After all, only a handful of cancers can be declared highly curable in 2015. As an oncologist, I can attest that treating testicular cancer can be highly rewarding. The disease tends to affect younger males, and a cure means they can return to the process of starting their careers and families.

However, it is important to draw a distinction between a disease that is highly curable and a disease that’s entirely curable — and testicular cancer is the former, not the latter. » Continue Reading