Pelotonia-Funded Initiatives Take Aim at Colorectal, Endometrial and Lung Cancers in Ohio
The OSUCCC – James has invested millions of dollars in Pelotonia funds to support three statewide initiatives that promote early detection and better outcomes in colorectal, endometrial (uterine) and lung cancers in Ohio.
The initiatives take the OSUCCC – James’ individualized genetic screenings, education and care on the road through partnerships with a network of some 50 Ohio community hospitals.
“The goal of our statewide initiative program is to take state-of-the-art science and translate it to the communities across Ohio to help elevate cancer patient care, prevention and education, and to reduce healthcare costs while saving lives,” says OSUCCC Director and James CEO Michael A. Caligiuri, MD.
The first initiative, called the Ohio Colorectal Cancer Prevention Initiative (OCCPI), began in 2013 and involved $4 million in Pelotonia funds. The project set out to screen newly diagnosed colorectal cancer (CRC) patients and their biological relatives for Lynch syndrome (LS), a cancer-causing condition that occurs when a person inherits a mutation in one of four genes. Individuals with LS are very likely to develop CRC, uterine, ovarian, stomach or other cancers. The screenings identified family members who may be at risk of developing these cancers so they can take precautionary measures.
“People with Lynch syndrome need intensive surveillance, with annual colonoscopies beginning at age 20-25,” says OCCPI principal investigator Heather Hampel, MS, LGC, associate director for the Division of Human Genetics at Ohio State. “This increased monitoring can save lives by catching precancerous polyps early, before cancer develops.”
Beating Lung Cancer – in Ohio (BLC-IO)
Supported by $3 million in Pelotonia funds and other philanthropy, this initiative—led by Peter Shields, MD, David Carbone, MD, PhD, and Mary Ellen Wewers, RN, PhD, MPH—also will draw upon a network of 50 partner hospitals in communities across Ohio (the same network created by the OCCPI).
A three-year period of patient recruitment began last March. BLC-IO has two aims: to evaluate the effect of advanced gene testing combined with expert advice on lung cancer treatment and patient survival, and to improve smoking-cessation rates among smokers with lung cancer and their family members. Quality of life also will be assessed for all patients.
Project leaders expect more than 2,000 newly diagnosed, stage IV, 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 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 (FDA)-approved targeted therapies or drugs in clinical trial testing. “Lung cancer is most often diagnosed in a metastatic (stage IV) state, so getting patients on the right treatment—the first time—is critical,” says Carbone, who directs the Thoracic Oncology Center at the OSUCCC – James.
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 in kicking the habit,” 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 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 adds.
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 with endometrial (uterine) cancer 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 of endometrial, colon, stomach and ovarian cancer. Tumor samples from study participants will also undergo molecular profiling to guide and personalize treatment according to each patient’s tumor characteristics.
Patients who are identified with LS and their at-risk family members will be educated about the importance of genetic testing and cancer-prevention strategies based on their higher risk of 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 develop new therapies,” says Cohn, who directs the Division of Gynecologic Oncology at Ohio State. 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.
“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 tumorsequencing 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.”
Genomic profiling through OPTEC will also help identify patients most likely to benefit from new medical therapies, including immunotherapy drugs that target the PD-1 (programmed cell death-1) protein. Drugs targeting PD-1 have emerged as promising approaches to treating tumors in patients with LS.