Dr. Linda Greenbaum was selected as the Chair of the American Association for the Study of Liver Diseases (AASLD)/ American Liver Foundation (ALF) joint grant review committee for the term 2011-14.
Dr. Linda Greenbaum was selected as the Chair of the American Association for the Study of Liver Diseases (AASLD)/ American Liver Foundation (ALF) joint grant review committee for the term 2011-14.
Receiving radiation therapy immediately after a radical prostatectomy is a cost-effective treatment for prostate cancer patients when compared with waiting and acting on elevated prostate-specific antigen (PSA) levels, according to a new study by researchers at Thomas Jefferson University and Hospital.
What’s more, a separate, but related study, found that urologists were less likely than radiation oncologists to recommend adjuvant radiation therapy or to believe it improves overall survival.
There has been question over whether administering adjuvant radiation therapy after removing the prostate is an appropriate course of action because of associated toxicities, risk of overtreatment and costs, even with data supporting its benefits to overall survival, but a new decision analysis published online in the Annals of Oncology on June 9 found that the procedure is a practical option for patients.
“This work demonstrates that adjuvant radiation therapy is a cost-effective strategy for selected patients after prostatectomy,” said Laura Pizzi, PharmD, associate professor at the Jefferson School of Pharmacy, and senior author of the study. “It is typical for cancer treatments to provide clinical be
nefit at a cost; however, the cost per success that we reported for adjuvant radiation therapy is on the low end when one broadly considers the cost per success reported for other cancer treatments.”
The objective of the study was to construct a decision analytic model to estimate the real world cost of adjuvant radiation therapy versus observation from the payers’ perspective, using peer-reviewed, published data from a Southwest Oncology Group prospective, randomized trial. Side effects, overtreatment and the price tag were taken into account.
Nearly one-third of newly diagnosed men with prostate cancer—almost 220,000 men were diagnosed in 2010—undergo radical prostatectomy. Previous studies have shown that adjuvant radiation therapy improves biochemical progression-free survival and overall survival for these patients; however, most do not receive the treatment.
“Despite being shown to be effective, less than 20 percent of qualifying patients receive it,” said Timothy Showalter, M.D., assistant professor of Radiation Oncology at Thomas Jefferson University, associate research member of the Kimmel Cancer Center at Jefferson, and lead author of the study. “Although not all patients will benefit from adjuvant radiation therapy, the level of utilization is low
er than expected based on the positive, published results of randomized clinical trials.”
“Studies like this one are an important step toward establishing the value of this treatment and suggest that adjuvant radiation therapy should have a role in the treatment of selected patients. Our group has embarked on a large-scale research program to evaluate and improve treatments after prostatectomy for patients with high-risk prostate cancer, and these studies are critical foundational accomplishments,” he added.
Side effects, risk of overtreatment (the subset of patients who may not have failed PSA tests after radiation therapy despite adverse pathologic factors) and the high price have cast some doubts for patients and physicians alike. In many cases, physicians choose to observe patients closely with serial PSA tests and offer radiation therapy only as a salvage treatment after a rise in the PSA levels.
But this new analysis, Dr. Showalter says, “substantiates the benefit of adjuvant radiation therapy,” taking these factors into consideration, including toxicity and overtreatment.
Another study by Dr. Showalter and colleagues, published online in the International Journal of Radiation Oncology, Biology and Physics on May 25, attempted to gauge physician beliefs and practices for adjuvant radiation therapy after a radical prostatectomy.
Significant discordance was identified. An online survey found that urologists were less likely to recommend radiation therapy immediately after a radical prostatectomy than radiation oncologists. Instead, those clinicians most likely opt to perform frequent PSA tests to monitor cancer, recommending salvage therapy if levels become elevated.
The investigators designed a Web-based survey of post-radiation prostatectomy radiation therapy beliefs and policies. A total of 218 radiation oncologists and 92 urologists completed the survey instrument. Adjuvant radiation therapy after a radical prostatectomy was recommended for qualifying patients by 78 percent of radiation oncologists and only 44 percent of urologists.
Urologists were also less likely to believe that adjuvant radiation therapy improves overall survival (71 percent of radiation oncologists vs. 63 percent of urologists), and perceived higher rates of radiation-related toxicities than radiation oncologists. Physicians’ estimates of radiation-induced urinary problems affected their likelihood of recommending radiation therapy.
The fact that adjuvant radiation therapy use has not increased since the publication of randomized trials supporting the therapy suggests that clinicians have not embraced it, according to the researchers.
“These two studies provide important insights into decision-making regarding radiation therapy after prostatectomy,” said Leonard Gomella, M.D., the Bernard W. Godwin, Jr. Professor of Prostate Cancer and Chairman of the Department of Urology at Thomas Jefferson University. “The disagreement between urologists and radiation oncologists highlights the need for additional research to determine the role of adjuvant therapy in selected patients, and is another example of the importance of multidisciplinary prostate cancer care for our patients to make informed medical decisions.”
The Kimmel Cancer Center held it’s quarterly “All Hands” meeting on June 29, 2011. Dr. Richard Pestell, Director of the Kimmel Cancer Center, delivered his quarterly “State of the Cancer Center” address. Awards were presented in two categories. The Nursing Award was presented to JoAnn Silcox, RN, MSN. The Basic Science Award was presented to Madhukar (Matthew) Thakur, PhD. A special “Appreciation” award was presented to Richard Haldeman, CPA, MBA. Also a special “Wings” award was presented to Isidore Rigoutsos, PhD.
On June 8th, 2011, The Kimmel Cancer Center at Jefferson honored our cancer survivors. The Celebration of Life was held in the Bluemle Life Sciences Building’s first floor area. We had great artwork, excellent entertainment, inspirational speakers, which included Jefferson’s PhD candidate and Susan Conley, a cancer survivor and author of “The Foremost Good Fortune” one of Oprah’s best reads for the month of February this year
Dr. Richard Pestell, director of the Kimmel Cancer Center at Jefferson and former national-class distance runner, was featured in the July issue of Runner’s World.
Dr. Pestell spoke with the magazine for the cover story titled “Outrunning Cancer”–which focused on the running community’s ability to raise million of dollars each year to fight cancer.
“When the story of cancer meets a runner’s story, the combination can be quite powerful,” said Dr. Pestell.
Read the full feature story here: “Outrunning Cancer: Team Effort” by John Brant.
Dr. John Wagner, of the medical oncology department and also a runner, was mentioned in the article, as well.
Bernadette E. Garofola, M.Ed., R.T.(R)(T)(CT), chief radiation therapist at Thomas Jefferson University Hospital, has been named a Fellow of the American Society of Radiologic Technologists.
Ms. Garofola was honored at a ceremony on June 18 at the ASRT Annual Governance and House of Delegates Meeting in Albuquerque, N.M.
The honorary Fellow category was established by ASRT in 1956 to recognize members who have made outstanding contributions to the profession and to ASRT. Fellows have volunteered in leadership positions at the national and local levels, written articles for publication, presented at professional meetings and helped advance the radiologic science profession.
Backed by a radiologic science career that spans nearly 30 years, Ms. Garofola has participated in ASRT volunteer activities since she joined the association in 1986. In addition to serving terms as a delegate for the Radiation Therapy and Management Chapters, she has been a member of a number of ASRT communities including the Committee on R.T. Advocacy, Committee on Bylaws and Committee on Nominations. She also is a member of the Philadelphia Society of Radiologic Technologists and served as its president in 2001.
For more information about ASRT and the radiologic science profession, visit www.asrt.org.
Edith Mitchell, M.D., clinical professor of Medicine and Medical Oncology at Jefferson Medical College of Thomas Jefferson University, was named 2011 “Practitioner of the Year” Award by the Philadelphia County Medical Society (PCMS).
For her excellence in clinical care and community service, Dr. Mitchell will be presented the award on Saturday, June 11, during the PCMS President’s Ball at the Ace Conference Center in Lafayette Hill, Pa., celebrating the installation of its 150th president.
“For over 165 years, this society has been advocating for the best in healthcare for all the citizens of Philadelphia,” said Dr. Mitchell, who is also Associate Director for Diversity Programs at the Kimmel Cancer Center at Jefferson. “It’s a great honor to be part of those efforts and recognized for it with this award.”
Dr. Mitchell has spent her medical career helping individuals in medically underserved areas to realize that simple changes in lifestyle can have a dramatic impact on cancer care. Through her work, Dr. Mitchell has demonstrated the importance of community service and outreach especially to those individuals who may not have the means to seek out more conventional medical advice.
She received a bachelor of science in Biochemistry “With Distinction” from Tennessee State University and her medical degree from the Medical College of Virginia in Richmond. Dr. Mitchell entered active duty after completion of her internship and residency in Internal Medicine at Meharry Medical College and a fellowship in Medical Oncology at Georgetown University. She is now a retired Brigadier General from the United States Air Force.
Dr. Mitchell’s research in pancreatic cancer and other gastrointestinal malignancies involves new drug evaluation and chemotherapy, development of new therapeutic regimens, chemoradiation strategies for combined modality therapy, patient selection criteria and supportive care for patients with gastrointestinal cancer.
She travels nationally and internationally teaching and lecturing on the treatment of gastrointestinal malignancies.
As a distinguished researcher, she has received numerous Cancer Research and Principal Investigator Awards, and serves on the National Cancer Institute Review Panel and the Cancer Investigations Review Committee. She has also authored and co-authored more than 100 articles, book chapters, and abstracts on cancer treatment, prevention, and cancer control.
May is Melanoma Awareness Month. Kelly Kroll of Ambler PA has set up the “Bonnie Kroll Melanoma Memorial Fund” in honor of her mother who died in 2001 from uveal melanoma. The fund has raised over $150,000 to support research at the the Thomas Jefferson University Hospital and the Kimmel Cancer Center of Thomas Jefferson University. Kelly marked the 10th anniversary of the fund by organizing a special Melanoma Awareness night with the Philadelphia Phillies. Jefferson Doctors participated in the attached video and also were present to throw out the first pitch.
Below are some photos of the event at Citizens Bank Park and the check presentation prior to the game. The photos from Citizens Bank Park were provided by photo: Sarah F Wimberley / www.flickfoto.com
See the Award Announcement for more information about the Award and its latest recipient. The following was abstracted from the announcement.
Dr. Karen Knudsen of the Kimmel Cancer Center received the Ron Ross Award at the 5th Pacific Rim Breast and Prostate Cancer Meeting, held in Kingscliff, Australia, May 3-7, 2011. Dr. Ron Ross was the Flora L. Thornton Chairman of Preventive Medicine and the Catherine and Joseph Aresty Professor of Preventive Medicine and Urology at the Keck School of Medicine of the University of Southern California. Under his leadership, the Department of Preventive Medicine became the leading department in this field in the United States. Ron was also Director of the Los Angeles Cancer Surveillance Program, the cancer registry of Los Angeles County, from 1987. A respected pioneer in research on the relationship between hormones and cancer, Ron died of brain cancer on April 21 2006 at the age of 57. The Ron Ross Award acknowledges Ron’s remarkable contribution in the field of hormonal carcinogenesis and also recognizes significant contributions by others in the field.
This year’s Award was presented to Professor Karen E Knudsen from the Kimmel Cancer Center, Thomas Jefferson University. Her postdoctoral studies focused on the cross talk between androgen receptor signaling and proliferative control mechanisms in prostate cancer, and she was first to discover that interplay between hormone receptor networks and the cell cycle machinery is frequently perturbed in prostate cancer, and promotes loss of proliferative control. She was recruited to the NCI-designated Kimmel Cancer Center at Thomas Jefferson University in 2007, where she is a Professor of Cancer Biology, Urology, and Radiation Oncology. Recent pivotal findings from her group relate to critical co-factors that drive castrate resistant prostate cancer, novel therapeutic targets for treatment, and intricate mechanisms which impinge on androgen receptor function that contribute to the lethality of disease. Most recently, her group has provided seminal evidence that the retinoblastoma tumor suppressor pathway plays a critical role in the progression of prostate cancer that could be exploited to more efficiently treat advanced disease.
Researchers at the Kimmel Cancer Center at Jefferson have shed new light on the longstanding conundrum about what makes a tumor grow—and how to make it stop. Interestingly, cancer cells accelerate the aging of nearby connective tissue cells to cause inflammation, which ultimately provides “fuel” for the tumor to grow and even metastasize.
This revealing symbiotic process, which is similar to how muscle and brain cells communicate with the body, could prove useful for developing new drugs to prevent and treat cancers. In this simple model, our bodies provide nourishment for the cancer cells, via chronic inflammation.
“People think that inflammation drives cancer, but they never understood the mechanism,” said Michael P. Lisanti, M.D., Ph.D., Professor and Chair of Stem Cell Biology & Regenerative Medicine at Jefferson Medical College of Thomas Jefferson University and a member of the Kimmel Cancer Center. “What we found is that cancer cells are accelerating aging and inflammation, which is making high-energy nutrients to feed cancer cells.”
In normal aging, DNA is damaged and the body begins to deteriorate because of oxidative stress. “We are all slowly rusting, like the Tin-man in the Wizard of Oz,” Dr. Lisanti said. “And there is a very similar process going on in the tumor’s local environment.” Interestingly, cancer cells induce “oxidative stress,” the rusting process, in normal connective tissue, in order to extract vital nutrients.
Dr. Lisanti and his team previously discovered that cancer cells induce this type of stress response (autophagy) in nearby cells, to feed themselves and grow. However, the mechanism by which the cancer cells induce this stress and, more importantly, the relationship between the connective tissue and how this “energy” is transferred was unclear.
“Nobody fully understands the link between aging and cancer,” said Dr. Lisanti, who used pre-clinical models, as well as tumors from breast cancer patients, to study these mechanisms. “What we see now is that as you age, your whole body becomes more sensitive to this parasitic cancer mechanism, and the cancer cells selectively accelerate the aging process via inflammation in the connective tissue.”
This helps explain why cancers exist in people of all ages, but susceptibility increases as you age. If aggressive enough, cancer cells can induce accelerated aging in the tumor, regardless of age, to speed up the process.
The researchers’ findings were published in the June 1 issue of Cell Cycle in three separate papers.
One paper analyzes the gene profiles of the laser-captured connective tissue, associated with lethal tumors, in human breast cancer patients. In this paper, lethal cancers show the same gene expression pattern associated with normal aging, as well as Alzheimer’s disease. In fact, these aging and Alzheimer’s disease signatures can identify which breast cancer patients will undergo metastasis. The researchers find that oxidative stress is a common “driver” for both dementia and cancer cell spreading.
In another study, the researchers explain that cancer cells initiate a “lactate shuttle” to move lactate—the “food”—from the connective tissue to the cancer cells. There’s a transporter that is “spilling” lactate from the connective tissue and a transporter that then “gobbles” it up in the cancer cells.”
The implication is that the fibroblasts in the connective tissue are feeding cancer cells directly via pumps, called MCT1 and MCT4, or mono-carboxylate transporters. The researchers see that lactate is like “candy” for cancer cells. And cancer cells are addicted to this supply of “candy.”
“We’ve essentially shown for the first time that there is lactate shuttle in human tumors,” said Dr. Lisanti. “It was first discovered nearly 100 years ago in muscles, 15 years ago in the brain, and now we’ve shown this shuttle also exists in human tumors.”
It’s all the same mechanism, where one cell type literally “feeds” the other. The cancer cells are the “Queen Bees,” and the connective tissue cells are the “Worker Bees.” In this analogy, the “Queen Bees” use aging and inflammation as the signal to tell the “Worker Bees” to make more food.
Researchers also identified MCT4 as a biomarker for oxidative stress in cancer-associated fibroblasts, and inhibiting it could be a powerful new anti-cancer therapy.
“If lethal cancer is a disease of “accelerated aging” in the tumor’s connective tissue, then cancer patients may benefit from therapy with strong antioxidants and anti-inflammatory drugs,” said Dr. Lisanti. “Antioxidant therapy will “cut off the fuel supply” for cancer cells.” Antioxidants also have a natural anti-inflammatory action.
The Kimmel Cancer Center at Jefferson hosted the 3rd Annual American Cancer Society Research Symposium: Celebrating the ACS Institutional Research Grant at KCC on May 6, 2011.
Dr. Nevalainen welcomed members of the KCC and TJU community and the American Cancer Society.
Richard Pestell, MD, PhD gave the Keynote Address, “Cancer Invasion and Metastasis and a New Role for Junk DNA”.
Following this, the IRG Pilot Project recipients for 2010 presented the results of their research: Amy Leader, DrPh, MPH, of the Department of Medical Oncology, discussed “Factors Influencing Decision Making About Human Papillomavirus (HPV) Vaccination Among African American Adolescent Males And Their Caregivers”; while Hushan Yang, PhD, also of the Department of Medical Oncology, presented “Genetic Variations in Inflammation-Related Genes And The Risk Of Hepatocellular Carcinoma in HBV Patients”.
Larry Slagle represented the American Cancer Society.
Dr. Leonard Gomella, M.D., F.A.C.S., the Bernard W. Godwin, Jr. Professor of Prostate Cancer, associate director for Clinical Affairs at the Kimmel Cancer Center (KCC) at Jefferson, and Chair of the Department of Urology at Jefferson Medical College of Thomas Jefferson University, has been appointed as a member of the Urology Times Editorial Council. He will represent the area of urologic cancer on the Editorial Council. “Dr. Gomella is an internationally recognized leader in the urologic cancer field,” said Richard R. Kerr, Urology Times editor-in-chief. “Dr. Gomella will be an excellent addition to our team of experts in urology.”
Dr. Gomella has also been elected the Mid Atlantic Section Representative to the Society for Urology Chairpersons and Program Directors. The mission of SCUCPD is to provide urology program chairpersons and program directors a forum for the discussion, review and implementation of issues critical to the conduct of urologic residency programs and academic practice for the purpose of advancing academic urology to the highest state of innovation resourcefulness and preparation in urologic practice and training of urologists of the future.
For this and more news from the Department of Urology at Thomas Jefferson University please see the 2010 edition of the newsletter
PHILADELPHIA—Cancer researchers at the Kimmel Cancer Center at Jefferson and an international team of collaborators have discovered a biomarker in breast cancer that may help identify which women will respond to anti-estrogen therapy.
The research appears in the May 16 online issue of the Journal of Clinical Oncology.
Anti-estrogen drugs, most notably tamoxifen, are widely used in patients diagnosed with estrogen receptor-positive breast cancer. However, as many as a third of the women given tamoxifen fail to respond.
In this new study, the investigators found that women whose tumors retain the active form of the protein biomarker Stat5 have an increased likelihood of responding to tamoxifen. In contrast, women treated with tamoxifen whose tumors lacked active Stat5 had up to a 20-fold increased risk of dying from breast cancer after adjustment for effects of standard hormone receptor markers and other pathology data.
“Identification of predictive biomarkers present in breast cancer will lead to improved individualized therapies tailored specifically towards each woman’s cancer,” said Hallgeir Rui, M.D., Ph.D., professor of oncology, Kimmel Cancer Center at Thomas Jefferson University, and principal investigator of the study. “Absence of the active form of Stat5 could help identify a group of patients unlikely to respond to tamoxifen so they may be offered alternative and more aggressive treatments.”
Benefactors Mark and Alison Weinzierl pose with Kimmel Cancer Center Director Dr. Richard G. Pestell (R) and Dr. Takami Sato (L), Professor of Medical Oncology and director of the Uveal Melanoma research program at the KCC. The Weinzierls (from the Dallas, Texas, area) are providing $1 million in support of Dr. Sato’s work.
Neal Flomenberg, M.D., chair of medical oncology at Jefferson, and Dolores Grosso, RN, CRNP, were featured in a news article on haploidentical bone marrow transplants in the Journal of the National Cancer Institute titled, “Half-Match Bone Marrow Transplants May Raise Odds for More Recipients.”
Dr. Flomenberg and Dolores Grosso devised a two-step, half-match procedure that begins with separating the T-cell component of the graft from the stem cell component by using a cell sorter.
Read the full story published here.
The Kimmel Cancer Center at Jefferson is joining the American Association for Cancer Research to celebrate the month of May as National Cancer Research Month.
KCC—a National Cancer Institute (NCI) designated cancer center—is home to internationally renowned cancer physicians and research scientists.
Our world-renowned research faculty is discovering cancer risk factors, designing effective prevention strategies, and learning how to detect cancers earlier. They are developing and testing the cancer treatments of tomorrow — targeted therapies that will improve both survival and quality of life. They are making progress toward the ultimate goal: to eradicate cancer.
KCC’s Director, Dr. Richard Pestell, is an internationally renowned expert in oncology and endocrinology, and a highly respected researcher and clinician whose current work is focused on developing new cancer therapies that specifically target tumors, and reduce the side effects that are associated with commonly used cancer treatments, such as chemotherapy and radiation.
Dr. Pestell’s research is focused on identifying molecular markers of pre-malignant disease to develop preventive approaches to cancer. He has made significant contributions to our understanding of cell cycle regulation and the disturbances that can lead to the malignant transformation of cells. Dr. Pestell has particular expertise in hormonally-responsive tumors, such as those of the breast and prostate, and his work is directed toward the eventual discovery of novel therapies for these cancers.
Some other examples of groundbreaking research taking place at the Kimmel Cancer Center:
The 3rd Annual Kimmel Cancer Center American Cancer Society Research Symposium will be held today at 2 p.m. in 101 BLSB.
KCC Director Richard Pestell, M.D, Ph.D, will present the keynote address and 2010 American Cancer Society-Institutional Research Grant Award recipients.
Amy Leader, DrPH, MPH, and Hushan Yang, Ph.D, will discuss their research. A reception will follow.
This event celebrates the ACS Institutional Research Grant at Thomas Jefferson University, which provides support for junior faculty members performing cancer research.
The Kimmel Cancer Center and the Department of Medical Oncology are happy to announce that Drs. Rita Axelrod, Matthew Carbasi and Neal Flomenberg were names in the “Philly Magazine” top 100 Medical Oncologists listing.
Dr. Pestell seen here at dinner with the Prime Minister of Australia, Julia Gillard, discussing Jefferson’s Kimmel Cancer Center at the Prime Ministerial visit to the USA on March 9, 2011 in New York City.
It is estimated that more than 70,000 new cases of bladder cancer were diagnosed in 2010, making it the 5th most commonly diagnosed cancer in the U.S.
Please join Dr. Jean Hoffman-Censits, of the Department of Medical Oncology, Solid Tumor Division, and the Kimmel Cancer Center at Jefferson Team in raising awareness of the disease by walking the Radnor Trail, in Wayne, Pa., on Saturday May 7 at 9:00 a.m.
The walk is taking place on the Radnor Trail off Route 30 in Wayne, Pa. Meet at 9 a.m. behind the parking lot of the VIST Financial Bank, 600 West Lancaster Avenue (at the intersection of Sugartown Road and Old Eagle Road) near the sign for the entrance to the trail.
For more information or to join our Jefferson Team, please contact Teresa Bryant at 215-503-5455 or visit http://www.firstgiving.com/fundraiser/thomasjefferson/walkforbladdercancer to sign up for the walk or make a donation.
For more information regarding the Bladder Cancer network visit, WWW.bcan.ORG
Learn more by watching BCAN’s Bladder Cancer Awareness Video.
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