innovation-2014

Yu Kuang:Dangerous Tumors,ExpeditedAssessmentsYU KUANG, AN ASSISTANT PROFESSORin the School of Allied Health Sciences, is focusedon the early detection of cancer and image-guidedcancer treatment. His recent workexplores whether testing for genetic markersassociated with tumors, coupled with new approachesto quantitative magnetic resourceimaging (MRI) analysis, might lead to moreeffective treatments for sarcomas, malignanttumors that form in bone, cartilage, fat, muscle,or vascular tissue.Patients diagnosed with sarcoma usuallyundergo what health care providers call “neoadjuvant”therapy — typically chemotherapy— to shrink their tumors before surgery.Reducing tumor size prior to operating, oncologistshave found, not only makes surgerymore effective but also enhances patients’long-term survival rates.A drawback of this approach is that determiningwhether neoadjuvant therapy hasdone its job can only happen via tumor-tissueanalysis following surgery. This means thatpatients don’t learn if they’ve benefitted untilafter leaving the operating room, an unfortunatereality that ensures some patientswill endure the toxic effects of chemotherapywithout any therapeutic advantage. For thesepatients, the harm in superfluous chemo isnot just in the unnecessary discomfort it inflicts.Precious time has been wasted — timethat could have been spent on potentially lifesavingtreatment alternatives.Kuang has teamed up with the Children’sSpecialty Center of Nevada and Nevada ImagingCenters to develop an earlier, non-invasivemethod for predicting success or failureof neoadjuvant chemotherapy. His method involvescombining an analysis of tumor markersin mitochondrial DNA from blood drawsand diffusion MRI data. The goal, Kuang says,is to identify the early changes of genetic biomarkerlevels in the blood and the imagingfeatures in the MRI scan that can help cliniciansmore effectively ascertain how well sarcomashave responded to pre-operative chemotherapy.By determining patients’ response to thetreatment early in the course of chemotherapy,Kuang’s team expects this research willultimately enable oncologists to optimizetreatment protocols for individual patients,improving quality of life and enhancing disease-freesurvival for patients with sarcoma.If successful, Kuang’s next step will likelyinvolve multi-institutional clinical trials.These will seek to determine how this combinedbiological- and imaging-biomarkermethod might be used to guide future chemotherapytreatments.Kuang is also actively involved in multiinstitutionalcollaborative work related toprostate cancer. Earlier this year, he teamedup with Sandi A. Kwee, a physician and associateprofessor at the John A. Burns Schoolof Medicine at the University of Hawaii, to developa positron emission tomography (PET)image guided prostate cancer radiation therapymethod. PET scan is an imaging test thathelps reveal how patients’ tissues and organsare functioning via a radioactive drug (radiotracer).In this collaboration, the radiotracerKuang and Kwee are using is a new U.S. Foodand Drug Administration-approved investigationaldrug that could allow for better targetingof radiation treatments used against intermediate-and high-risk prostate cancer.The collaborative relationship is expectedto lead to a multicenter clinical trial initiativebetween UNLV and University of Hawaii, atrial that could bring this potentially gamechangingapproach to prostate cancer patientsin Southern Nevada.ACCELERATED ANSWERS A diagnostic tool developed in part by UNLV’s Yu Kuang promises to speed physicians’ability to assess the effectiveness of neoadjuvant therapy in sarcoma patients. If successful, the approach couldlead to new, more effective ways to combat these potentially deadly malignancies.research.unlv.eduINNOVATION / 27