New options needed, and likely, for ALK-positive lung cancer

March 30, 2014 | by   

People with what’s known as ALK-positive lung cancer usually develop resistance to crizotinib, the primary drug used to treat their disease. The drug’s limitations are all the more significant because its approval in 2011 was considered a crucial advance against this type of nonsmall cell lung cancer.

drugs for cancer

People with ALK-positive nonsmall cell lung cancer may have new drug options in the not-too-distant future. Those options are desperately needed.

“This makes new therapies for ALK-positive lung cancer essential to improving and prolonging life for these patients,” said Karen L. Reckamp, M.D. , M.S., co-director of City of Hope’s Lung Cancer and Thoracic Oncology Program., in an interview with MedPage Today.

Those new therapies are on the way. A new study suggests that one drug in particular shows promise in the fight against this type of cancer. The study, published online this week in the New England Journal of Medicine(NEJM), included 122 patients with nonsmall cell lung cancer linked to a genetic mutation in the ALK gene. Of those, 83 had relapsed on crizotinib (Xalkori).

In the NEJM study, the new drug ceritinib was found effective among 56 percent of patients who had relapsed on crizotinib. It was found effective among 62 percent of those who hadn’t taken crizotinib. » Continue Reading

Urologic cancers: Dispatches from research’s front lines

March 28, 2014 | by   

Urologic cancers, including prostate cancer, kidney cancer and bladder cancer, are diagnosed in more than 381,000 Americans each year, and almost 60,000 people die from the diseases. City of Hope’s physicians and scientists are determined to reduce those numbers.

Our groundbreaking research holds the promise of better treatments and cures for the millions of people worldwide battling these difficult cancers. The Division of Urology and Urologic Oncology, led by Timothy Wilson, M.D., Pauline & Martin Collins Family Chair in Urology and director of the Prostate Cancer Program, report the following developments in the treatment of urologic cancers.


Overcoming drug resistance in metastatic prostate cancer

African American men are 60 percent more likely than white men to get prostate cancer and 2.4 times more likely to die of the disease.

The drug pyrvinium shows promise in the treatment of prostate cancer. Even better, it doesn’t target testosterone.

When prostate cancer metastasizes, it is signaled to grow by a protein called the androgen receptor, which is activated by testosterone. Many men initially respond to hormone treatments that inhibit testosterone, but prostate cancer cells adapt and develop resistance to these therapies, and the cancer almost always returns.

Jeremy Jones, Ph.D., assistant professor of Molecular Pharmacology, found that pyrvinium, a drug used for decades to treat pinworm infections, could treat metastatic prostate cancer without targeting testosterone. Pyrvinium works by inhibiting the DNA binding domain – a different part of the androgen receptor that’s activated when testosterone is blocked –  and could be effective when all other therapies have failed. Jones is testing pyrvinium derivatives in cell cultures and mice, and his goal is to reach phase I clinical trial in the next two years.

Jones is also working with Cy Stein, M.D., Ph.D., Arthur & Rosalie Kaplan Chair of Medical Oncology, to combine the action of two drugs, enzalutamide and abiraterone, to treat prostate cancer that is resistant to hormone therapy. They have designed a compound called COH11023 that inhibits the production of testosterone, prevents testosterone from binding to the androgen receptor and breaks down the androgen receptor to rid the cancer cells of the protein. » Continue Reading

John Rossi awarded 5-year, $3.3 million grant to help patients beat HIV

March 27, 2014 | by   

John Rossi has been studying HIV — and how to help patients beat it — almost as long as scientists have known about the virus. His expertise is globally recognized, and it recently  helped net him a five-year, $3.3 million grant from the National Institutes of Health (NIH).

John Rossi, Ph.D

John Rossi

The grant extends the NIH’s funding of Rossi’s work to more than two decades; it will support his efforts to develop a practical way to deliver a gene therapy to HIV patients.

The gene therapy uses a form of RNA, a close genetic cousin to DNA, to stop the virus from hijacking and destroying the immune system’s infection-fighting T cells. In fact, Rossi, who holds the Lidow Family Research Chair and is chair of the Department of Molecular and Cellular Biology, and his City of Hope colleagues have already conducted the only clinical trial to test this therapeutic RNA in patients.

Up until now, this treatment approach, called RNAi-based therapy, has only been available to HIV-positive patients with lymphoma who were undergoing stem cell transplantation. The transplant regimen is a necessary part of the process.

“For the vast majority of HIV patients to benefit from RNAi-based therapies, we need to find another way to deliver it to them that doesn’t require transplantation,” Rossi said. » Continue Reading

Colon cancer: Physicians explain the facts (w/VIDEO)

March 25, 2014 | by   

The exact causes of colorectal cancer are not completely understood, but many facts about the disease are well-known – as are ways to reduce one’s risk. In our “Ask the Experts: Colon Health” presentation (above), City of Hope physicians provide those facts.

The video, recorded live, features colorectal cancer experts Donald David, M.D., chief of gastroenterology; Stephen M. Sentovich, M.D., M.B.A., clinical professor of surgery; and Marwan Fakih, M.D., co-director of the Gastrointestinal Cancer Program. They share their knowledge about colon cancer, including the importance of screenings, the risk factors for colon cancer, and details on colon cancer treatments.

Some highlights from the presentation:

  • —Colorectal cancer is the second-leading cause of cancer death in the U.S.
  • Colorectal cancer usually starts as a polyp and progresses over a period of years to cancer.
  • Having a colonoscopy is the single most important factor in reducing the risk of developing colon cancer.
  • Colonoscopy and removal of the polyp can be done in the same day; removal of a tumor with a “hemorrhoid type” operation can be done the same day or it might require an overnight stay. » Continue Reading

E-cigarettes as smoking-cessation devices? Study adds to skepticism

March 24, 2014 | by   

E-cigarettes have ignited plenty of debate recently, especially as cities have begun to ban public use of the devices, just as they’ve done with traditional cigarettes. Although users say e-cigarettes, or e-cigs, can help smokers quit, evidence that the devices are effective has been unconvincing – and a new study has failed to come to their defense.

Though often marketed as a potential aid for smokers who want to quit, no studies support e-cigarettes as smoking cessation tools. A new JAMA study adds to the growing pile of evidence that the devices don't help smokers quit.

E-cigarettes are often marketed as a potential aid for smokers who want to quit, but no studies support use of the devices as smoking-cessation tools. Instead, a new JAMA study adds to the evidence that the devices don’t help smokers quit.

The study, published today in the Journal of the American Medical Association, confirms the suspicions of many experts that e-cigarettes are not associated with greater rates of quitting cigarettes or even cutting back on smoking. The study found that women, younger adults and people with less education are more likely to use e-cigarettes and that, based on self-reported data after a year of use, the devices are not associated with quitting or even with a change in cigarette consumption.

“They try to market e-cigarettes as alternatives, but they are nicotine-delivery devices,” said Brian Tiep, M.D., director of pulmonary rehabilitation and smoking cessation at City of Hope. “We don’t know what else they’re bringing into our bodies. When cigarettes were first presented as a product that should be legal, everyone believed they were harmless. Given our present knowledge, if they were introduced for the first time now, we would say, ‘Of course these should not be legal products.’ Now we have an ‘alternative’ that has at least one of the same ingredients – and that’s the ingredient they get addicted to, nicotine.” » Continue Reading

Colonoscopy screenings: Hear the myths, get the facts (w/VIDEO)

March 24, 2014 | by   

Colonoscopy may not be the most pleasant of procedures, but it is one that can save your life.

According to the National Cancer Institute, getting colonoscopies at recommended intervals (for most people, this means starting at age 50 and every 10 years thereafter if the results are normal) can reduce colorectal cancer deaths by up to 70 percent. This is possible because the procedure can catch the cancer in its earlier stages, when it’s more treatable. Additionally, colonoscopies can detect and remove precancerous growths called polyps before they become malignant.

Despite the proven benefits, many people still put off getting a colonoscopy. Data from the U.S. Department of Health and Human Services estimates that 40 percent of Americans are not getting screened for colorectal cancer in accordance to recommended guidelines.

And according to Donald David, M.D., clinical professor and chief at City of Hope’s Division of Gastroenterology, many reasons people have for delaying or avoiding this lifesaving test are pure myths.

In the video above, David debunks some of the common misperceptions about colonoscopies, including: » Continue Reading

Meet our doctors: Dawn Gross on supportive care and palliative care

March 22, 2014 | by   

A cancer diagnosis and its treatment can be overwhelming. It’s normal for patients to experience burdensome physical symptoms and psychological distress, both from their disease and from the cancer treatment. Sometimes these symptoms require specialized care in addition to primary cancer treatment.

Dawn Gross of City of Hope

Dawn Gross says supportive care can provide patients with a better quality of, and happier, life.

Dawn Gross, M.D., Ph.D., the Arthur M. Coppola Family Chair in Supportive Care Medicine and chair of City’s of Hope’s Department of Supportive Care Medicine, explains that medical treatment isn’t just about a cancer directed therapy. It’s also about the total care of body, mind and spirit. The inclusion of supportive and palliative care in cancer treatment can provide patients not only with a better quality of life, but also a happier one, she says.

What is supportive and palliative care medicine?

Supportive medicine is another name often used to encompass palliative care medicine. Supportive medicine is aggressive care focused on comfort, and is designed to support patients and their families experiencing a life-altering illness. It is intended to be delivered simultaneously with all other forms of medical care. By discovering what people wish, we can deliver the care they want. In order to achieve this, we must first focus on alleviating all forms of suffering, including physical, mental and spiritual distress. This then allows for patient and family goals of care to be explored and supported. » Continue Reading

Chemo brain due to cancer treatment: Who’s at risk? What can be done?

March 21, 2014 | by   

Cancer treatments obviously save lives, but sometimes at a high price, with side effects that can have a lasting impact. One of those side effects is a mental cloudiness often referred to as “chemo brain.”

cancer treatment side effect

The confusion and memory problems linked to cancer treatment has a name: chemo brain. Some people are more likely than others to notice the problems.

Chemo brain is clinically known as cancer-related cognitive dysfunction – mental changes that occur in cancer patients during or after treatment. Patients can have trouble concentrating, remembering details like names and dates, and multitasking; they might also need longer to complete tasks and they can experience memory lapses, according to the American Cancer Society.

Although patients and caregivers have noticed chemo brain effects for sometime, serious research on the subject has only recently begun. City of Hope oncology nurse Denice Economou, R.N., M.N., C.N.S., A.O.C.N., discusses some of the causes of chemo brain and what patients can do about the condition.

What causes chemo brain?

Multiple factors contribute to the development of cognitive dysfunction. Chemo brain may be related to chemotherapy, and it is known that certain drugs are at higher risk. Cyclophosphamide, methotrexate and fluorouracil have a high association with increased risk, but depending on the dosing, the level of dysfunction may be minimal or moderate to severe. Higher doses and longer treatment regimens increase the exposure to the drugs and increase the probability of developing chemo brain.

Premenopausal women experiencing estrogen and progesterone reductions also experience changes that include memory loss and reduced ability to maintain focus or attention. Medications such as pain medications, sedatives and anti-nausea medications may also contribute.

» Continue Reading

Appendix rupture led to surprise diagnosis of kidney cancer (VIDEO)

March 20, 2014 | by   

“One day I had a pain in my side and ended up having my appendix rupture. During that time of the appendix rupturing, they discovered I had a large tumor covering most of my kidney,” said Joelle Hood, a learning center principal and a certified life coach.

Hood’s doctor referred her to City of Hope, where she met urologic oncology specialist Clayton Lau, M.D., an assistant clinical professor. They discussed the best treatment option for her cancer and took it day by day from there.

» Continue Reading

Scientists uncover important step in tumors’ blocking of immune system

March 19, 2014 | by   

Cancers thrive and spread in part because of their ability to create fortresses around themselves that ward off the body’s natural immune defenses, a so-called immunosuppressive microenvironment. 

A new study sheds light on how a tumor is able to work against the body's immune system, a discovery with the potential to unlock new immunotherapies.

A new study sheds light on how a tumor is able to work against the body’s immune system, a discovery with the potential to unlock new immunotherapies.

Although a healthy body’s defenses against cancer and infection are driven by T cells that recognize and destroy foreign intruders, the environment created by cancer tumors often prevents this system from working. A new City of Hope study may ultimately provide a way to overcome this challenge to T cells.

City of Hope scientists had long established that the protein STAT3 regulates a large array of genes in tumor cells, including those related to immunosuppression. Their new study, published this month in the journal Cell Reports, sheds light on how STAT3 interacts with another key protein, known as S1PR1, to regulate T cells that suppress the immune system. Those T cells are known as regulatory T cells, or Tregs.

“This has many therapeutic implications,” said Saul Priceman, Ph.D., an assistant research professor at City of Hope and the study’s first author. “This could be helpful across the board for solid cancers in combination with other immunotherapies. In most solid cancers, these proteins are blocking the immune system from killing the tumor. Our new findings suggest that by selectively targeting S1PR1, we can put the brakes on T cells that prevent the immune system from effectively attacking the tumor.” » Continue Reading