Statewide Studies Supported by Pelotonia Will Have Wide Impact
The OSUCCC – James has invested $4 million in funds to launch a second and a third statewide initiative—one taking aim at lung cancer, the No. 1 cancer killer among men and women in the United States, and the other targeting endometrial (uterine) cancer, one of the few cancers rising with incidence and death rates in this county.
The first statewide effort was the Ohio Colorectal Cancer Prevention Initiative (OCCPI), which was designed to reduce deaths from colorectal cancer across the state.
“The goal of our statewide initiative program is to take stateof-the art science and translate it into communities across Ohio to elevate cancer patient care, prevention and education, and to reduce health care costs,” says OSUCCC Director and James CEO Michael A. Caligiuri, MD.
Beating Lung Cancer – in Ohio (BLC-IO)
Supported by $3 million in Pelotonia funds, this initiative— led by Peter Shields, MD, David Carbone, MD, PhD, and Mary Ellen Wewers, RN, PhD, MPH—will draw upon an existing network of more than 50 partner hospitals from communities across Ohio. The network was established as part of the OCCPI.
Patient recruitment began last March and will continue for three years. BLC-IO has two aims: to evaluate the effect of advanced gene testing combined with expert advice on treatment and patient survival, and to improve smoking-cessation rates among smokers with and their family members. Quality of life also will be assessed for all patients.
Project leaders expect more than 2,000 newly diagnosed, stage 4, non-small-cell lung cancer patients to enroll in the BLC-IO trial. Enrollees will receive free testing for more than 300 genes in their cancer specimens. Local treating physicians will receive expert support for interpreting test results and determining possible treatments.
Published data suggests that up to 64 percent of lung cancer patients have genetic mutations in their tumor cells that can be treated with U.S. Food and Drug Administration-approved targeted therapies or drugs in clinical trial testing.
BLC – IO also will provide smoking-cessation support for up to three years to all participating lung cancer patients and their family members.
“Smoking addiction is a chronic, relapsing disease, and many factors contribute to a person’s success or failure to kick the habit long-term,” says Shields, deputy director of the OSUCCC – James. “Science has shown that smokers with cancer have more toxicity and shorter survival, and that some drugs work less effectively in these patients.”
Researchers will test different models for smoking-cessation support among lung cancer patients and their families, working in collaboration with the patients’ primary care physicians. “We believe there is a strong potential to save many years of life—and millions of dollars associated with cancer treatment later—by helping people reduce their risk for lung and other cancers through smoking cessation,” Shields says.
Ohio Prevention & Treatment of Endometrial Cancer (OPTEC)
Through an allocation of $1 million in Pelotonia funding, the OSUCCC – James has launched the OPTEC initiative, which will recruit up to 700 women from at least 25 partner hospitals in communities around Ohio. The women will be screened for Lynch syndrome (LS) and other inherited genetic mutations that increase the risk for endometrial, colon, stomach and ovarian cancer.
Tumor samples from study participants also undergo molecular profiling to guide and personalize treatment according to each patient’s tumor characteristics. Patients identified with LS and their at-risk family members will be educated on the importance of genetic testing and of cancer-prevention strategies based on their increased risk for LS-associated cancers. Patients whose tumors have defective DNA mismatch repair will be considered for novel immunotherapy clinical trials for their endometrial cancer.
OPTEC is led by David Cohn, MD, and Paul Goodfellow, PhD, with multiple collaborators from the OSUCCC – James and Nationwide Children’s Research Institute.
“Because endometrial cancer incidence and death rates are rising in the United States, we must escalate our efforts to understand this disease and to develop new therapies,” says Cohn, director of the Division of Gynecologic Oncology at Ohio State.
Over 61,000 women are diagnosed with endometrial cancer annually in the United States, and up to 5 percent of them have inherited LS. The lifetime risk for endometrial cancer in a woman with LS is 50 percent, 10 times higher than for a woman without LS. Women with LS have a similar risk for colorectal cancer.
OPTEC will test endometrial cancer patients in Ohio for LS using a novel genetic sequencing technique developed by Goodfellow, a geneticist at the OSUCCC – James, and Elaine Mardis, PhD, a geneticist at Nationwide Children’s Research Institute. OPTEC also will help LS patients and their at-risk family members understand the importance of genetic testing and cancer-prevention strategies based on their increased risk for LS-associated cancers.
“In the past, genetic testing for LS was a multi-step process associated with higher costs and delayed results. We have developed a one-step tumor sequencing method that allows us to test for inherited genetic mutations rather than relying on sequential screening and testing,” Goodfellow explains. “We will confirm all inherited LS mutations that are identified in patient tumors with a follow-up test that identifies the mutation in white blood cells and is conducted in a clinical genetics laboratory.”
To help increase compliance with follow-up care for cancer prevention, researchers also are creating a registry to track endometrial cancer patients from the OPTEC study, and colon cancer patients identified through the earlier OCCPI, along with affected family members.