lung Cancer Out loud - Moores Cancer Center - UC San Diego

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Message from the Director s the Moores UCSD Cancer Center continues to expand our services and develop a far greater reach in the community, the Cancer Center is also undergoing some growing pains, not unlike the city of San Diego. While we continue to see more patients than ever before, and have recently recruited several new physicians, we still need more resources to meet the increasing demands placed on us by the community for patient services. We see this as a mark of our success, but also a continuing challenge for the future. Our newest faculty brings impressive credentials. Ithaar Derweesh, M.D., for example, who recently joined us from Tennessee, is a urologic oncologist who specializes in minimally invasive surgery techniques to treat, among other diseases, kidney cancer. As a scientist, Derweesh will be involved in testing the latest drugs to find innovative ways to combat kidney cancer, which is on the rise in this country. Moores Cancer Center physician-scientists continue to make substantial advancements in clinical research and have a number of outstanding clinical studies that are exploring the latest in potential therapeutic advances. Our oncologists are hoping to slow the progression of advanced lung cancer by treating patients with a novel kind of cancer vaccine designed to both pump up immunity while tricking the cancer into turning off its immune systemsuppressing activities. Leukemia researchers are examining the use of gene therapy for patients with chronic lymphocytic leukemia. In only one year, a unique partnership between industry and academia has led to human clinical trials of a new drug for a rare class of blood diseases called myeloproliferative disorders (MPD). The latter partnership and our ongoing efforts to establish relationships with local and regional biotechnology and pharmaceutical companies are additional indications of how connected we are to the San Diego community. We’re breaking down barriers and increasing collaborations. We’re finding new ways for industry and academia, historically sometimes worlds apart, to work together. The traditional barriers such as scientific secrecy, liability, and intellectual property rights are slowly being overcome. A recent symposium at the Cancer Center was aimed at fostering and strengthening the ties between scientists in the laboratory and experts at pharmaceutical and biotechnology companies to develop new, potentially valuable drugs against cancer. The Cancer Center’s role as an incubator of new ideas and research directions, as well as in evaluating promising new treatments and technologies, is vital for the benefit of our patients. As always, this is our focus—to get the newest, most effective therapies out of the laboratory and to our patients’ bedsides. Sincerely, A Nano-Tumor Research c o n t i n u e d f r o m f r o n t c o v e r His focus on starving tumors by shutting off their blood supply has led to new insights into understanding how tumors form and behave. Without a blood supply, tumors have no way to grow. Cheresh and his group recently developed a new treatment strategy using tiny “smart bombs” made of nanoparticles to target the spread of cancer with anti-cancer drugs. This summer they reported in the Proceedings of the National Academy of Sciences that a nanoparticle carrying a payload of chemotherapy drugs can specifically target proteins found on certain tumor blood vessels. The nanoparticle/drug combination didn’t have much impact on primary tumors, but it stopped pancreatic and kidney cancers from spreading in mice. As a result, the researchers needed lower amounts of dangerous drugs to stop the cancer from growing, and there was less damage to nearby normal tissue. It’s only the beginning, says Cheresh. “We’re building new particles that we think will be scalable for potential human use.” Cancer Center Project Scientist and immunologist Davorka Messmer, Ph.D., hopes to use nanotechnology to help the immune system recognize and kill tumor cells, rather than rely on drugs. She and her team are developing a vaccine using nanoparticles that attracts the immune system to the cancer and revs it up. But it hasn’t been easy. “Even if you successfully immunize, the tumor suppresses the immune response,” she explains. “We have to do a two-pronged approach. You’re pumping the gas pedal on the immune response, but it won’t be enough unless you take off the brakes—the immune suppression from the cancer.” While the research is in its early stages, Messmer is hopeful. “Eventually, we would like to have particles that don’t have to be tailored to the patient, but can be a general vaccine and with which the immune system can take care of the tumor,” she says. “Such a vaccine might be used to prevent a cancer from returning.” Dennis A. Carson, M.D. Director, Moores UCSD Cancer Center Chugai Pharmaceutical Chair in Cancer Associate Dean, UCSD Health Sciences 2 c o n t i n u e d o n p a g e 3
Lung Cancer c o n t i n u e d f r o m f r o n t c o v e r Other NANO-TUMOR center projects include: • Developing “mother ships” that can home in on tumors and deliver smaller particles that could carry out a variety of jobs, including imaging tumors and releasing drugs • Creating nanoparticles that will clump in tumors and enable imaging and treatments • Studying nanoparticles that monitor genetic changes in cancer cells over time • Using nanotechnology to develop detection and monitoring systems for signs of cancer, and to follow the paths of drugs in the bloodstream. With two years left on the grant, Cheresh still has big plans. He and his team would like to use nanotechnology to package and target drugs more specifically to tumors, since some hit a range of targets in the body, not all of which are cancer. The same strategy, he says, could work for combinations of agents. He notes that his team is using imaging to see within hours whether a particle hits its target. “We’ve combined bioengineering, biochemistry, and biology with an engineering approach that involves designing a device that allows us to image blood vessels in real time,” he says. Cheresh is confident of nanotechnology’s potential. “I think in the next five to 10 years, we will begin to see the real impact of nanotechnology in cancer and medicine.” five-year relative survival rates for women in 1975 and in 2000: for breast cancer, the rate went from 75 percent survival to 90 percent; for colorectal cancer, it went from 50 percent to 65 percent; but for lung cancer, the rate went from 15 percent to 18 percent. “This disease needs more advocates,” says Bazhenova, whose clinical practice concentrates on lung cancer patients, with a focus on women and non-smokers. Bazhenova oversees cooperative group trials and designs and implements clinical investigations at the Moores Cancer Center. “We should learn from breast cancer patients, physicians, and researchers how to successfully raise awareness,” says Bazhenova. “There is a big stigma with lung cancer connected with smoking, yet 60 percent of our patients have never smoked or quit.” “That’s the very first thing out of someone’s mouth when you tell them you have lung cancer: ‘Did you smoke’” says Sheila Inman, one of Bazhenova’s patients. “It’s a way of asking, ‘Did you do this to yourself’” Another patient, Mary Lebkuecher, was one of the 1,308 new lung cancer cases diagnosed in San Diego County in 2006, and she is among the 20 percent of lung cancer patients who has never smoked. After a poor prognosis, Mary sought Bazhenova for a second opinion. “My first doctor gave me six months to live, so when I met with Dr. B for a second opinion I was desperate,” she says. “But she gave me hope. And today it’s been a year since my diagnosis,” says Mary. Although she didn’t qualify for participation in a clinical trial, Mary is still experiencing the value of academic medicine via Bazhenova’s experience as a clinician, researcher, and teacher. Bazhenova placed Mary on the drug Tarceva and treated her with chemotherapy and radiation. Both Mary and Sheila were astonished when they received a lung cancer diagnosis, particularly since they lead healthy and active lives. “I’m only the second person in my family who has been diagnosed with cancer, and I have a large family,” says Sheila Inman. Sheila’s cancer was discovered because of a blood clot in her leg. “I went back and looked at a pamphlet I’d received a couple years ago when I had my first clot, and there it was: blood clots can be a symptom of lung cancer.” As a non-smoker, it never occurred to her to connect the two. The next shock for these women was the comparative lack of research and treatments. “Initially you just assume it’s like a lot of cancers,” says Sheila. “We were hoping there would be options, and it could be cured or managed. It’s just shocking.” Shocking, yes. According to the American Cancer Society, lung cancer is the leading cause of cancer death, and more people die from lung cancer than of colon, breast, and prostate cancers combined. Lung cancer is also the leading cancer killer of women in the United States, claiming nearly twice as many lives as breast cancer. Nearly 20 percent of these deaths are in women who have never smoked. In fact, women who have never smoked are at greater risk for lung cancer than men who have never smoked. This is why more research is desperately needed. Meanwhile, Mary Lebkuecher and Sheila Inman aren’t waiting. They’re fighting lung cancer with the most targeted treatments available at the Moores Cancer Center. And with Bazhenova’s encouragement, they’re talking about lung cancer. 3
Page 1: Pathways Fall 2008 University of Ca
Page 5 and 6: Hope for a Cure Foundation “Doing

lung Cancer Out loud - Moores Cancer Center - UC San Diego

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