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HIV/AIDS 2015: Changing treatment while pushing for a cure

January 2, 2015 | by   

HIV/AIDS researchers are determined not only to cure the disease, but to develop ever-more-effective treatments until that ultimate goal is reached. In 2015, they will gain ground in both endeavors.

HIV/AIDS

City of Hope researchers are developing potential cures for HIV/AIDS while improving treatments for those currently living with the disease.

In search of a cure: Stem cell and gene therapy

One of the most promising prospects for curing HIV is to recreate the success of the so-called Berlin patient, a patient with HIV who received a stem cell transplant to treat his acute myeloid leukemia. The transplant cured the man’s HIV because the donor had a previously unknown mutation that prevents the body from creating a key white blood cell receptor needed to establish an HIV infection.

The challenge for scientists has been to overcome the need to find a donor with the mutation who would also be a stem cell match for the patient with HIV/AIDS  – a rare combination. Now City of Hope scientists have two promising approaches – both using stem cells. The approaches will be studied in City of Hope’s new Alpha Clinic for Cell Therapy and Innovation, funded by an $8 million grant from the California Institute for Regenerative Medicine. » Continue Reading

Cancer research 2015: T cell immunotherapy, targeted drugs and more

January 1, 2015 | by   

Every year, researchers make gains in the understanding of cancer, and physicians make gains in the treatment of cancer. As a result, every year, more cancer patients survive their disease.

2015 in cancer research

In 2015, cancer research will move forward in ways both high-profile and little-heralded.

In those ways, 2015 will be no different. What will be different are the specific research discoveries and the specific advances in screening and treatment. We asked City of Hope experts to weigh in on the research and treatment advances they predict for the year to come.

Some of those advances will make headlines around the world – expect to hear much more about T cell therapy and targeted drug therapy – while some will garner attention largely among those affected by, or treating, the disease.

But all will have an impact. » Continue Reading

Cancer statistics show decline in deaths, but new threats loom

December 31, 2014 | by   

The American Cancer Society’s annual statistics show the death rate from cancer in the U.S. is down significantly from its peak more than a decade ago – certainly a reason to celebrate. But before the kudos give way to complacency, be forewarned: A number of increasingly serious public health issues could send cancer deaths and cancer incidence climbing again.

Cancer statistics don't tell whole picture

Breakthroughs in cancer treatment, early detection and reduction in smoking have resulted in a 22 percent decline in cancer deaths since 1991. But obesity could help send those numbers climbing again.

That’s the sobering perspective provided by City of Hope’s provost and chief scientific officer, Steven T. Rosen, M.D.

He added some context to the annual statistical analysis from the American Cancer Society. That analysis found that the death rate from cancer has dropped 22 percent from its peak in 1991; amounting to about 1.5 million deaths from cancer avoided. Between 2007 and 2011 – the most recent five years with data available – new cancer cases dropped by 1.8 percent per year in men and stayed the same in women. Cancer deaths decreased 1.8 percent per year in men and 1.4 percent in women for that same period of time.

Rosen attributed the overall decline in deaths to a number of factors, namely prevention, early detection and better therapies. » Continue Reading

Esophageal cancer 2015: Targeted therapy becomes an option

December 31, 2014 | by   
Jae Kim, M.D.

City of Hope’s Jae Kim offers his perspective on expected esophageal cancer advances for 2015.

Think “precision.” Doctors can now prescribe specific drugs that focus specifically on cancer cells, avoiding the healthy cells that need to be preserved. This kind of therapy, known as targeted therapy, has been increasingly available for lung cancer and some other diseases; now it can be used for esophageal cancer as well.

“Esophageal cancer has lagged behind other cancers in terms of having targeted drugs, rather than conventional chemotherapy, to fight the cancer,” said Jae Kim, M.D., chief of the Division of Thoracic Surgery at City of Hope. That’s now changing, with Herceptin, better known as a breast cancer drug, now a promising option.

“Trastuzumab (Herceptin) was approved in 2010 for treatment of patients with metastatic esophageal cancer whose tumors overexpress HER2,” Kim said. “City of Hope is currently participating in a multicenter trial using a combination of trastuzumab, chemotherapy, radiation and surgery for earlier stage patients with esophageal adenocarcinoma.” » Continue Reading

Lung cancer 2015: It’s all about customization

December 30, 2014 | by   
New targeted immune therapies can activate one's own immune system to attack lung cancer.

New targeted immune therapies can activate one’s own immune system to attack lung cancer.

Lung cancer experts understand the impact of molecular biology and the genetic makeup of  tumors more than ever before. Now they’re using that knowledge to great effect.

“Each person’s tumor is somewhat different,” said Karen Reckamp,  M.D., M.S., co-director of the Lung Cancer and Thoracic Oncology Program at City of Hope. “Now, with diagnoses and treatments, we’re focused on customizing in a precision way to attack a specific person’s cancer.”

Factor in a patient’s own immune system, which can attack lung cancer, and the ability to customize will grow even further. “There are new therapies that we’re looking at that activate a person’s own immune system against the lung cancer and seem to have some very durable long-term responses,” Reckamp said. And, she noted, they don’t rely on chemotherapy. » Continue Reading

Blood cancers 2015: Bringing T cell therapy to the clinic

December 29, 2014 | by   

Immunotherapy – unlocking the body’s immune system to fight diseases –  is one of the most exciting and promising areas of cancer research and treatment. In the coming year, City of Hope will be opening more clinical trials using an especially powerful type of immunotherapy focusing on T cells. Many of these trials will focus on blood cancers, but not all.

immunotherapy

City of Hope scientists are developing T cell therapies to prime the immune system to fight blood and brain cancers.

Chimeric antigen receptor – or CAR – T cell therapy is a promising approach to immunotherapy being studied at a handful of centers nationwide, including City of Hope, the only center currently offering clinical trials in California. The trials use a similar approach tailored to each cancer: Patients have their T cells collected from the blood then they are replicated in the lab. The cells are then modified using a lentivirus, a virus that encodes the T cells with specific antigen receptors, allowing them to recognize proteins found on cancer cells. This, researchers say, should trigger the immune system to fight cancer. » Continue Reading

Bladder cancer 2015: Personalized medicine meets ‘molecular selection’

December 28, 2014 | by   

Surgery for bladder cancer isn’t what it used to be; it’s better – much better. Advances in robotic surgeries have greatly improved both the options and the quality of life for people diagnosed with bladder cancer.

bladder cancer

City of Hope is leading several innovative studies in bladder cancer, with two of them focusing on what’s known as a molecular selection process.

These advances, which are constantly giving way to even newer ones, mean that the entire bladder doesn’t always have to be removed. When it does, not only can highly skilled surgeons sometimes create an artificial bladder, they can even create an internal reservoir (different from a bladder and known as an Indiana pouch) using the large intestine and part of the small intestine. Such alternatives are usually preferred  over the need for an external bag to collect the urine.

Much work remains, however, in the understanding of bladder cancer. Sumanta Pal, M.D., co-director of the Kidney Cancer Program at City of Hope, is leading several innovative studies in bladder cancer, with two of them focusing on what’s known as a molecular selection process. » Continue Reading

Stomach cancer 2015: A new spin on CT scans

December 26, 2014 | by   
CT Gastrography

City of Hope researchers are exploring the potential of two novel imaging methods to help guide the treatment of stomach cancer, more formally known as gastric cancer. Here is an example of CT gastrography showing a tumor in the stomach.

The ability to see inside the body will play an increasingly, perhaps surprisingly, important role in the treatment of stomach cancer, or gastric cancer, in the months ahead, with City of Hope researchers exploring the potential of two imaging methods – each with its own unique benefits.

One imaging study will assess the ability of PET scans and Herceptin, a drug best known for treating breast cancer, to guide the treatment of stomach cancer. The other study will use CT scans to determine the stage of cancer ahead of surgery.

Herceptin and PET scans: A potentially powerful duo

Recent clinical trials of chemotherapy plus Herceptin (trastuzumab), which interferes with the spread of cancer cells, suggest that the combination improves survival for some patients with advanced stomach cancer.

Currently, the drug is approved only for those patients whose tumors show an abundance of the HER2 protein. The HER2 protein is associated primarily with breast cancer and ovarian cancer, but it can be found in other cancers as well, including some gastric cancers. HER2-positive cancers are more likely to spread, and spread quickly, than other types of cancers. » Continue Reading

Cancer 2015: Liver cancer expert offers view from the front lines

December 25, 2014 | by   

Yuman Fong, M.D., is an internationally recognized expert in hepatobiliary cancer – that is liver cancer, pancreatic cancer, gallbladder cancer and cancer of the bile ducts. He’s also renowned for his use of genetically modified viruses to combat malignant disease, is a pioneer in the operating room and the laboratory, is the author of more than 600 peer-reviewed articles and 11 textbooks, and is the chair of the Department of Surgery at City of Hope. All told, he’s uniquely qualified to offer an overview of cancer advances expected in 2015.

Yuman Fong, M.D., an expert in hepatobiliary cancer.

Yuman Fong is an expert in hepatobiliary cancer, which includes liver cancer, pancreatic cancer, gallbladder cancer and cancer of the bile ducts. Here, he offers an overview of cancer advances expected in 2015, focusing on liver cancer, pancreatic cancer and viral gene therapy.

Here, Fong does just that, focusing on improved treatments expected for liver cancer, pancreatic cancer and viral gene therapy.

Liver cancer:

When it comes to liver cancer, Fong says, ablation (burning tumors with needles) and resection (surgical removal of tumors) will continue to improve, offering better prognoses for people diagnosed with the disease.

“Ablations can produce long-term remissions and potential cures for liver cancer,” Fong said, pointing to a recent article published in Advances in Surgery. That article’s key points:

  • Tumor ablation is a safe and easily performed treatment for hepatocellular carcinoma.
  • Randomized trials have shown tumor ablation to be durable and potentially curative therapy for small hepatocellular carcinoma.
  • Tumor ablation and minimally invasive therapies are changing the treatment paradigms for hepatocellular carcinoma.
  • These minimally invasive therapies are good bridge therapies to transplant for patient with advanced cirrhosis.

Further, Fong says, referring to a recent study published in PLoS One: “Combining ablation and resection can extend the number of patients who can be provided successful treatment for liver cancer.”

» Continue Reading

Myeloma 2015: Targeted drugs bring new promise

December 24, 2014 | by   

Many cancer patients have benefited from targeted therapy – medications that can identify cancers by their genetic properties and help eradicate them – but such therapy has been largely a pipe dream for multiple myeloma patients. Until now.

Myeloma

New drugs could provide targeted therapies to patients with multiple myeloma.

Currently, two medications are emerging as especially promising in the treatment of multiple myeloma: daratumumab and SAR650984. Each of the drugs targets different sites on the same receptor for multiple myeloma. Each was the subject of research presented at the annual meeting of the American Society of Hematology.

The drugs are offering new hope to patients who have already tried many other therapies with less-than-ideal results. “The most important thing is that these are targeting the patients who have high-risk disease who have been refractory to the other agents we’ve had standardly available,” said  Amrita Y. Krishnan, M.D., director of the Multiple Myeloma Program at City of Hope. “To see responses in these very advanced patients is extremely compelling.” » Continue Reading