Myeloproliferative neoplasms, or MPNs, are a trio of blood disorders that if unchecked can develop into full-blown leukemia. All three MPNs, including myelofibrosis, polycythemia vera and essential thrombocythemia (ET), are caused by overproduction of a particular blood cell. ET patients, for example, make too many platelets, cells required for clotting, and are thus at risk for clotting disorders.
About half of the patients that hematologist David Snyder, M.D., sees in his City of Hope practice have a myeloproliferative neoplasm. Snyder says that currently available drugs can manage symptoms and, in the case of ET, protect many patients from thrombotic events such as heart attack, stroke or other vascular problems.
“But some ET patients are intolerant or resistant to these drugs,” says Snyder, who is also associate chair and professor in City of Hope’s Department of Hematology & Hematopoietic Cell Transplantation. “Plus, existing drugs don’t impact molecular defects so their effects are not durable. We still need treatments that have more long-term benefits.”
In that effort, Snyder recently joined a multinational team of researchers from the San Francisco Bay area and Europe in announcing success of a phase II clinical trial of a novel anti-ET drug. That study, published in the Sept. 3 edition of the New England Journal of Medicine, reported that 18 ET patients treated with the drug imetelstat exhibited reduced platelet levels and 16 showed complete normalization of blood cell counts. Eight patients were treated at City of Hope; the rest were treated in Germany and Switzerland. Most participants suffered only mild or moderate adverse reactions. » Continue Reading
More than 2.9 million men living in the U.S. today have been diagnosed with prostate cancer. Many of these men have had treatment with surgery or radiation and will never see their cancer return, giving hope to the roughly 220,800 people who will be diagnosed with prostate cancer this year. Unfortunately, for a significant percentage of patients with prostate cancer, the disease remains highly lethal. Prostate Cancer Awareness Month is an ideal time to shift focus to these men.
One of the key unknowns facing doctors, researchers and, of course, patients comes when trying to determine whether a highly curable cancer might turn lethal. Novel gene-profiling techniques offer clues about which prostate cancers appear to be more aggressive, but these tests are far from definitive. Furthermore, many of these tests rely on a biopsy of the prostate, a painful procedure laden with risks such as infection and bleeding. That could change. Jeremy Jones, Ph.D., a City of Hope scientist, is developing an alternative testing approach known as a “liquid biopsy.”
“The liquid biopsy simply involves taking a small sample of blood,” Jones said. “We now have the technology to pull from blood some of the same information we would get from cancer tissue.”
In April, Jones presented his work at the 2015 American Association of Cancer Research Meeting in Philadelphia. His project involved analyzing blood samples he had collected from patients receiving treatment at City of Hope for prostate cancer that had spread to the bone and other organs.
Sebastian Sanchez-Luege knows too well how crucial cancer research is in saving people’s lives.
The 19-year-old was diagnosed with non-Hodgkin anaplastic large-cell lymphoma, a rare condition that accounts for just 2 percent of blood cancers, when he was just 6 years old.
When standard treatments didn’t work, he came to City of Hope for a stem cell transplant. The procedure was successful and now, 13 years later, the native of Tustin, California, is cancer-free.
“That experience just changed my life so much that I know I want to give back to society as a whole,” Sanchez-Luege said in an interview with the Orange County Register.
And this summer, he got to do just that at City of Hope’s Eugene and Ruth Roberts Summer Student Academy.
People with a family history of cancer often want, or need, to know whether they have a gene mutation linked to that cancer. For that, they seek genetic testing, involving a blood sample that is analyzed for specific gene abnormalities.
Thomas Slavin, M.D., a geneticist and assistant clinical professor at City of Hope, typically works with patients – primarily breast, ovarian or colorectal cancer patients – who have a hereditary predisposition to cancer. Most are part of City of Hope’s large Hereditary Cancer Registry and are working with a genetic counselor. Slavin, the counselor and the patient use the patient’s history and genetic information to inform testing and make treatment plans.
Here, Slavin explains why he chose such a complex and rapidly involving field.
Why did you choose the field of genetic testing?
It has been an interest of mine since I was very young. When I was in middle school, I wrote to the American Society of Human Genetics requesting information about careers in genetics because I’ve always found it intriguing that one little mutation in a single gene can be life-changing for a family. After pursuing residencies in both pediatrics and medical genetics and completing a board certification in molecular diagnosis, I became particularly interested in the rapid advances in genetics sequencing and the newfound ability to make detailed molecular diagnoses on individuals. » Continue Reading
It was 2009 when a City of Hope patient in her 40s learned that the cancer she had been fighting for several years had metastasized to her lungs. Her medical team ran genetic tests on the tumor, but none of the drug therapies available at the time targeted the known mutations in the tumor cells.
Although at first the woman responded to chemotherapy, by 2013 toxicity had caused side effects so grave that the patient was faced with stopping her treatment. And then her doctors ran another test.
“We retested the biology of the tumor and this time, it turned out that we knew so much more about it,” said Karen Reckamp, M.D., M.S., medical director for Clinical Research Operations at City of Hope. Just four years after that initial diagnosis, doctors were able to identify a genetic mutation that previously had gone unrecognized. The best news of all – a drug that acted against that specific mutation was now available.
“She has been on the new treatment for two years now, with very good success,” said Reckamp, also co-director of the Lung Cancer and Thoracic Oncology Program at City of Hope. “That’s one of my favorite stories.” » Continue Reading
Diagnosed with type 1 diabetes when she was 9 years old, Gina Marchini accepted the fact that she would need insulin the rest of her life. Every day, she injected herself with the lifesaving hormone. She also carefully controlled her diet and monitored the rise and fall of her blood glucose with military precision.
That was before her islet cell transplant.
“I thought diabetes was a life sentence. Now, I’m insulin-free,” said the 33-year-old kindergarten teacher from Palmer, Alaska.
Even now she finds it hard to believe. Only hours after the surgery that provided her with insulin-producing islet cells of her own, Marchini’s doctors told her that her glucose levels were at normal levels. Within a few days, she was able to forgo insulin altogether.
“I thought there was no way around it without my insulin shots, but now, after checking my blood sugar levels every two hours for days on end with results in the nondiabetic range, I’m starting to believe I’m free,” Marchini said.
The results of the recently opened trial have yet to be written or even completed. But, as one of the approximately 1.25 million Americans diagnosed with type 1 diabetes, Marchini highlights the improvements and goals in diabetes research – as well as the still almost inconceivable promise of a life free of needles and restrictions. » Continue Reading
The defeat of cancer will require a team effort. Nowhere is this more necessary (or apparent) than in efforts to combat two of the most deadly forms of the disease – pancreatic cancer and triple-negative breast cancer.
It’s the approach City of Hope is taking with its newly launched multidisciplinary teams, bringing the power of collaboration to advance research into earlier diagnoses, better treatments and potential cures for patients with these and other cancers.
Both pancreatic cancer and triple-negative breast cancer are aggressive, difficult to diagnose and have limited treatment options. Pancreatic cancer represents just 3 percent of all cancer cases yet 7 percent of cancer deaths. Triple-negative breast cancer represents 10 to 20 percent of breast cancers and occurs typically in younger women and disproportionately in African-American and Hispanic women. In both diseases, survival rates at Stage 4 are dismal – only 12 months with pancreatic cancer; 18 to 24 months for triple-negative breast cancer.
The new specialized teams that City of Hope has created are offshoots of larger disease teams rolled out across the institution over the past year. Together and individually, they bring a holistic approach toward advancing knowledge and treatment of all the major tumors and blood cancers.
It’s a reasonable question: Why is the National Cancer Institute funding a study on preventing heart failure?
The answer is reasonable as well: Rates of heart failure are drastically high among childhood cancer survivors — 15 times higher than among people the same age who were never treated for cancer. The biggest culprit appears to be a group of chemotherapy drugs called anthracyclines, which are used to treat up to 60 percent of childhood cancer patients.
Anthracyclines have been linked to cardiomyopathy, a deterioration in the heart muscle. And research by City of Hope assistant professor Saro Armenian, D.O., M.P.H., and others has found that as the cumulative dose goes up, so does the prevalence of heart failure.
Now, Armenian — with a $3.2 million grant from the NCI — is going to assess whether medical intervention might curb that risk.
“Anthracyclines cause heart problems no matter what the age of the patient, and there are already caps on how much you can give someone. But children, from what we can tell, are more susceptible. These drugs destroy the heart cells, and if you do that to a developing heart, the injury is going to be more significant,” Armenian said.
In addition to holding joint appointments in the departments of Pediatrics and Population Sciences, Armenian is also director of City of Hope’s Childhood Cancer Survivorship Program. » Continue Reading
Many teenagers take a break from academics during the summer, but not the eight high school students enrolled in the California Institute for Regenerative Medicine (CIRM) Creativity Awards program at City of Hope. They took the opportunity to obtain as much hands-on research experience as possible, learning from City of Hope researchers and scientists along the way. And, while they were at it, they made a music video.
Through the CIRM Creativity Awards program, the students worked full-time as members of City of Hope biomedical research teams, studying stem cell science and developmental biology research. As part of their work, students shared their experience in the lab by creating videos and blogs, which were shared on The Stem Cellar, the official CIRM blog.
This year, the CIRM students created a music parody video to Carly Rae Jepson’s “I Really Like You,” now called “We’re Really Close to a Breakthrough.” The video, solely produced by the students, earned an honorable mention for best video in the program. » Continue Reading
As genetic testing becomes more sophisticated, doctors and their patients are finding that such tests can lead to the discovery of previously unknown cancer risks. In his practice at City of Hope, Thomas Slavin, M.D., an assistant clinical professor in the Division of Clinical Cancer Genetics, sees the full spectrum of hereditary cancer disorders in adults and children. Here, he discusses the expanded genetic testing options for people at risk for hereditary breast, ovarian and other cancers.
What are some of the latest advancements in genetic testing?
Breast and ovarian cancer patients and family members at risk for hereditary breast and ovarian cancer syndrome are now being offered testing for many more genes outside of the well-known genes BRCA1 and BRCA2. And while there doesn’t appear to be a “BRCA3,” many other genes have been linked to breast and ovarian cancer predisposition. The recent advances in high throughput, cost-effective, next-generation sequencing techniques and the decision by the Supreme Court that genes cannot be patented have combined to form an explosion in hereditary cancer genetics testing. » Continue Reading