Frontiers Winter 2013

Understanding the Molecular Mechanisms of Malignancy is Key to Cancer Care

A tenet of Ohio State’s cancer program is that there is no such thing as a routine cancer. Likewise, there is nothing routine about the science-based care we offer.

Research is teaching us that we cannot characterize cancer solely by its location in the body; we must also consider its biology. We now realize that cancer is hundreds of diseases, with disparate causes, that act, react and adapt differently to each person’s biological makeup and that require individualized treatment.

To cure cancer, we must examine the molecular attributes of each patient’s malignancy to see what mechanisms are at work and develop targeted therapies tailored to a tumor’s genetics. That’s how we are working to create a cancer-free world, and we chronicle several examples in this issue of Frontiers.

For instance, our cover story, “About-Face for Leukemia,” focuses on an amazing new molecularly targeted drug, ibrutinib, that in clinical trials is proving to be highly effective and well tolerated among patients with chronic lymphocytic leukemia, producing durable remissions even among elderly patients and those who have relapsed and are resistant to other therapies.

In “Mechanisms of Resilience,” we examine how our scientists are identifying biological mechanisms that enable certain cancer cells to survive radiation therapy so they can devise counteractive measures to improve treatment.

“A Singular Focus on Lung Cancer” features Dr. David Carbone, an expert in this disease who has joined our strong lung cancer team to organize and lead a thoracic oncology center that will integrate research with patient care to improve outcomes for patients with this malignancy, the top cancer killer in the United States. David specializes in the molecular biology of lung cancer and developing drugs to treat it.

I hope you will enjoy reading about some of our efforts to rise above the routine in fighting a foe that is anything but.

Recurrent Ovarian Cancer: We Must Do Better

Lacking a reliable screening test, 60 percent of ovarian cancer cases have distant metastases and a five-year survival of 27 percent at diagnosis.

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Hedgehog Hunting

Researchers at The Ohio State University Comprehensive Cancer Center – James Cancer Hospital and Solove Research Institute (OSUCCC – James) have discovered how tamoxifen-resistant breast cancer cells grow and proliferate. The study suggests an experimental agent might offer a targeted therapy for tamoxifen-resistant breast cancer.

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Transoral Technique

Robotic surgery through the mouth is a safe and effective way to remove tumors of the throat and voice box, according to a study by head and neck cancer surgeons at the OSUCCC – James.

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Inimical Inflammation

When present at high levels, a hormone-like substance produced by the body to promote inflammation can cause an aggressive form of leukemia, OSUCCC – James researchers have found.

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Auspicious Agent

Updated results from a phase Ib/II clinical trial indicate that a novel therapeutic agent for chronic lymphocytic leukemia (CLL) is highly active and well tolerated in patients who have relapsed and are resistant to other therapy.

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Less is More

A study led by researchers at the OSUCCC – James shows that preparing older acute myeloid leukemia (AML) patients for bone marrow transplants (BMT) with a reduced-intensity conditioning regimen is associated with higher rates of disease-free survival relative to the more typical treatments these patients usually receive.

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Age Analysis

Doctors should use different therapies when treating older and younger patients with chronic lymphocytic leukemia (CLL), a new study at the OSUCCC – James suggests.

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Of Note

A listing of the recent recognitions of OSUCCC – James physicians and researchers.

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About-Face for Chronic Leukemia

A few days before Christmas 2011, physician assistant Margaret Lucas walked into her chronic lymphocytic leukemia clinic to see a dozen patients and for a moment wondered if she’d entered a flu vaccination clinic by mistake.

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A Singular Focus on Lung Cancer

David Carbone, MD, PhD, a renowned lung cancer specialist recently recruited to The Ohio State University, believes that integrating basic and clinical research with patient care is essential for improving patient outcomes and the dismal statistics associated with this malignancy.

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Mechanisms of Resilience

More than 1.6 million Americans were expected to develop cancer in 2012, and more than half of them were likely treated with radiation therapy.

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Bench to Bedside: From the Laboratory to the Pharmacy

Patients are randomized to one of two treatment arms. Oral low-dose lenalidomide is administered daily on a continuous basis for at least 24 28-day courses in the absence of disease progression or unacceptable toxicity.

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Nucleic Acid Shared Resource Adds New Technologies and Applications

The OSUCCC – James Nucleic Acid Shared Resource (NASR) provides genomic support for biomedical research, including Sanger sequencing, next-generation sequencing, genotyping, methylation and gene-expression analysis.

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Second Floor Radiation Oncology

A second-floor perch is unusual for a radiation therapy department – most such facilities are located below ground – but when it opens in 2014, its windows will allow natural daylight to enter from the north and south, providing a more cheerful treatment environment.

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Need to Know

A wrap-up of the other news that happened in the last six months.

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