Ohio State Researchers Improve Lives With Support From Spielman Fund

Maryam Lustberg, MD, MPH, and Robert Wesolowski, MD, have worked for years with cancer patients at The Ohio State University Comprehensive Cancer Center – James Cancer Hospital and Solove Research Institute (OSUCCC – James), and they know how difficult treatment can be.

With the help of the Stefanie Spielman Fund for Breast Cancer Research, they are finding ways to make cancer treatment more effective, less harrowing and more enduring. Here’s a peek at what they are working on.

Striving to Un-Fog 'Chemo Brain'

Maryam LustbergPeople who have undergone chemotherapy know the feeling of “chemo brain,” a form of cognitive impairment associated with chemotherapy treatment. Patients may struggle to remember appointments or directions, have difficulty multitasking effectively, change moods quickly, and even struggle to walk with their usual agility and coordination. It’s a frustrating and demoralizing part of cancer treatment.

Lustberg knows this all too well, both from talking to patients and from functional MRI imaging. When people do a mental task in an MRI machine, specific areas of their brains are activated, and this is shown as lighted areas on the MRI display.

However, when patients who have cancer treatment-related cognitive impairments undergo the same tests, “You can see all these circuits light up,” she says. The cancer patients have to use more of their brains and work harder to accomplish the same thing. The MRI display is a visual testament to the difficulty experienced by many people with cancer.

Lustberg is an associate professor in the Division of Medical Oncology and the medical director of survivorship for the OSUCCC – James. Her unit focuses on cancer survivors’ quality of life, often referring patients for services ranging from support groups to acupuncture. “It’s not just coming in and getting your treatment,” she says. “We focus on a comprehensive intake assessment for each patient.”

Lustberg and her team are focusing on the effects of minocycline on chemo brain. Minocycline, sold under the brand name Minocin®, is a common antibiotic. The study is ongoing, says Lustberg, but the results in the animal models were promising. If minocycline can do the job, it would also be a relatively inexpensive solution. Developing a new use for an existing and widely available drug to relieve one of the more notorious symptoms of chemotherapy would be hugely beneficial to cancer patients.

“In breast cancer research, there are a lot of exciting things going on,” says Lustberg. “The after-effects of breast cancer treatment are very important. Breast cancer survivors are the largest group of cancer survivors.” Innovations supported by the Spielman Fund that positively affect breast cancer survivors will have a big impact.

Training the Body's Immune System to Help Fend Off Cancer

Robert WesolowskiWesolowski is helping cancer patients help themselves. More precisely, his goal is to help their bodies help themselves. Wesolowski, an assistant professor in the Division of Medical Oncology, is focusing on myeloid-derived suppressor cells (MDSCs). Everyone has these cells, but they are present at low levels in the immune systems of healthy people. MDSCs regulate the immune system.

“As with everything in our bodies, there’s a gas pedal and a brake pedal,” says Wesolowski, explaining that MDSCs are the brakes. “If we did not have those cells, if you got a cold and your immune system cleared the offending virus or bacteria, you would continue to have a fever, fatigue and body aches.”

MDSCs tell your immune system not to overreact. Most of the time, that’s a good thing. However, overproduction of these cells is a problem. Cancer promotes MDSCs, and excessive MDSCs result in a depressed immune system that is unable to mount an effective anticancer immune response. These cells make a person with cancer less likely to respond to anticancer immunotherapy treatments such as immune checkpoint inhibitors.

Wesolowski and his colleagues are looking at how agents that can inhibit MDSC function such as ibrutinib can tamp down the MDSCs’ effect—making the cancer more vulnerable to treatment with immune checkpoint inhibitors and the body more able to defend against cancer metastasis (spread).

“It may take a while for the body to produce a response,” says Wesolowski. But if that response happens, it can be life-changing. “Immunotherapy can produce a response that lasts for years. The patient’s prognosis becomes excellent. That lucky fraction typically has a long, durable response.”

Not all patients have this response, so Wesolowski and his team want to increase the number of people whose bodies can fend off cancer and experience the full benefits of treatment.

Wesolowski likes that his work may help patients’ bodies defend against cancer and become stronger in the process. “I think it’s quite elegant that we can manipulate the immune system to defend against cancer cells.” Spielman Fund support is often the push that such research needs. “We’re grateful to the Spielman Fund. It’s difficult to get funding from the National Institues for Health without preliminary data. Funding for pilot projects helps us get that preliminary data,” says Wesolowski—and that can lead to life-saving advances for cancer patients and their families.

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