Surgeons Rebuild Cancer Patient’s Pelvis

A multidisciplinary team of surgeons at the OSUCCC – James removed the left leg, hip and pelvis of a cancer patient and used the healthy bones from his amputated leg to rebuild the connection between his spine and remaining right pelvis to support a high-tech prosthetic leg. It was the first time the procedure had been performed in the United States, according to Joel Mayerson, MD, an orthopaedic oncologist who worked with a team that included spine neurosurgeon Ehud Mendel, MD, and plastic surgeon Michael Miller, MD. Their work was voted “Reconstructive Surgery Case of the Year” at the American Society of Reconstructive Microsurgeons annual meeting.

Removing Brain Tumors Through the Nose

Within a week’s time, a 33-year-old woman gave birth to a healthy baby and underwent successful endoscopic endonasal surgery for removal of a large malignant tumor from her sinus cavity, thanks to collaboration between a team at the Ohio State Cranial Base Center and the patient’s obstetrician. The endoscopic endonasal approach is a minimally invasive neurosurgical technique that gives surgeons access to the base of the skull, intracranial cavity and top of the spine by operating via the nose and paranasal sinuses with tiny surgical instruments. As part of her treatment, surgeons also implanted a prosthetic roof of her mouth. Ohio State’s cranial base team includes Ted Teknos, Daniel Prevedello, Bradley Otto and Matthew Old, all MDs.

Rare ‘Rotationplasty’ Surgery Helps Young Patient Stay Active

When Dugan Smith, an athletic fourth-grader, fell and broke his femur, doctors found a softball-sized tumor above his knee. After learning their son had osteosarcoma, a rare cancer that attacks the bones, his parents opted for an unusual surgery called rotationplasty to increase his chance not only of survival but of regaining an active lifestyle. A team led by Joel Mayerson, MD, who directs the Division of Musculoskeletal Oncology at Ohio State, amputated the boy’s lower leg, removed the tumor, rotated his leg and reattached it so his ankle functions as his knee. He is cancer-free and back to playing sports. His story appeared on ESPN and on the Anderson Cooper syndicated talk show.

Findings May Result in Blood Test for Lung Cancer

OSUCCC – James researchers identified patterns of abnormal microRNA molecules in the blood of people with lung cancer that might reveal the presence and aggressiveness of the disease, and perhaps who is at risk of developing it. These patterns may be detectable up to two years before the tumor is found by a sensitive method such as spiral computed tomography (CT) scans. Principal investigator Carlo Croce, MD, says researchers showed it might be possible to use the patterns to detect lung cancer in a blood sample. The findings appeared in the journal Proceedings of the National Academy of Sciences.

OSUCCC – James Leads National Pancreatic Cancer Trial

The OSUCCC – James is leading a phase II clinical trial on a formulation of the human reovirus that is designed to kill cancer cells. The study, expected to enroll 70 patients with recurrent or metastatic pancreatic cancer at Ohio State and other institutions, will assess results for those who receive the virus Reolysin® plus standard chemotherapeutic drugs, relative to those who receive the standard drugs followed by addition of the virus. Principal investigator Tanios Bekaii-Saab, MD, says Reolysin® is an engineered version of the reovirus that replicates in and destroys cells with mutations that activate the RAS gene signaling pathway. RAS mutations are found in nearly 90 percent of pancreatic cancers, making this pathway a prime therapeutic target.

Novel Agent Active Against Chronic Leukemia

An interim analysis of a phase II clinical trial indicated that an experimental agent for treating chronic lymphocytic leukemia (CLL) is active and well-tolerated both in patients undergoing initial treatment and in those who have relapsed and are resistant to other therapy. The agent, PCI-32765, was the first drug designed to target Bruton’s tyrosine kinase, a molecule that is essential for CLL cells to grow and proliferate. Study leader John C. Byrd, MD, says the early findings suggest that this agent is an active oral therapeutic that produces a high rate of durable remissions with acceptable toxicity in relapsed and refractory CLL. He presented the findings at the 2011 American Society of Clinical Oncology annual meeting.

Scientists Identify Subset of Cells That Leads to Rare Leukemia

OSUCCC – James researchers led by Michael A. Caligiuri, MD, identified a subset of normal white blood cells that gives rise to large granular lymphocyte leukemia, a rare and incurable disease. The subset involves NKT cells, which share features of immune cells known as T lymphocytes and natural killer cells. Researchers found that, in mice and humans, NKT cells responsible for this leukemia are marked by a surface protein called NKp46. They also found that over-expression of the interleukin-15 hormone can drive NKT cells, but not others, to become leukemic. In addition, they showed that using an antibody to block interleukin-15 kept this leukemia from developing in a mouse model. The study was published in the Journal of Clinical Investigation.

Experimental Cancer Vaccine Study Under Way

An early-phase clinical trial on the safety of a vaccine designed to prevent several types of solid tumors opened in July 2011 at the OSUCCC – James. The vaccine targets two regions of the human epidermal growth factor receptor 2 (HER-2), a molecule that occurs at abnormally high levels in up to 30 percent of breast cancers. Another component of the vaccine targets HER-1 (EGFR), a molecule that is overexpressed in many other solid tumors, including ovarian, renal, colon, lung and gastrointestinal cancers. Study leader Pravin Kaumaya, PhD, led development of the vaccine and the protocol for this National Cancer Institute (NCI)-funded trial. Tanios Bekaii-Saab, MD, is the clinical principal investigator, and William Carson III, MD, is co-principal investigator.

Loss of Gene Promotes Brain Tumor Development

Research at the OSUCCC – James showed that loss of a gene called NFKBIA promotes the growth of glioblastoma multiforme, the most common and deadly form of brain cancer. Published in the New England Journal of Medicine, the study suggested that therapies to stabilize this gene may improve survival for certain patients. Senior co-author Arnab Chakravarti, MD, says investigators showed that NFKBIA status may be an independent predictor of survival in some patient populations. They also showed that this gene plays a key role in glioblastoma behavior, and that it could be useful for predicting treatment outcomes. Chakravarti, along with Markus Bredel, MD, PhD, and colleagues analyzed data from 790 cases of glioblastoma for this study.

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