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.
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
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.
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
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 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
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.
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
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.
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
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
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.
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