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Dr. Cyrus Ghajar receives $4.1M grant to study metastatic breast cancer; Dr. Chris Peterson wins HIV cure prize; Dr. Stephen Schwartz appointed to NCI board

June 26, 2015 | By Fred Hutch staff

Dr. Cyrus Ghajar

Dr. Cyrus Ghajar is investigating two different paths for dealing with dormant metastatic tumor cells: keeping them asleep and inactive, or destroying them altogether.

Photo by Bo Jungmayer / Fred Hutch file

Dr. Cyrus Ghajar receives $4.1M grant to study ways to prevent metastatic breast cancer

Metastatic breast cancer researcher Dr. Cyrus Ghajar has received a $4.1 million Department of Defense Breast Cancer Research Program (BCRP) “Era of Hope” Scholar Award.

The Department of Defense’s BCRP is the second biggest funder of breast cancer research in the U.S. Its Era of Hope award encourages high-impact, collaborative research, particularly among innovative young researchers. For this work, Ghajar has teamed with Fred Hutch researchers Drs. Julie Gralow, Jason Bielas, Eric Holland and Cecilia Moens, as well as investigators at Harvard Medical School and at the University of Colorado, Denver. Ghajar also has involved two local breast cancer patient advocates on this project.

Ghajar is the director of the Laboratory for the Study of Metastatic Microenvironments (LSM2), which is housed within the Translational Research Program in Fred Hutch’s Public Health Sciences Division. The LSM2 studies how microenvironments within distant tissues influence dormancy, drug resistance and the re-emergence of disseminated tumor cells. He will use the funds to research ways to prevent breast cancer metastasis by treating dormant disseminated tumor cells.

Metastatic breast cancer claims 40,000 lives a year; it’s estimated that 30 percent of all breast cancer cases will become metastatic. Interestingly, 20 percent of these cases will not emerge until a decade following therapy.

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Cancer treatment quackery fuels concern among doctors, FDA

Be wary of possible side effects, drug interactions when using alternative health supplements, physicians caution

June 25, 2015 | By Bill Briggs / Fred Hutch News Service

Dictionary definition of Quackery

Photo by Bo Jungmayer / Fred Hutch News Service

One potentially fake cancer drug sold online can actually cause malignancies. One enema machine, purported to treat ovarian cancer under the FDA banner, was never cleared for sale in the U.S., federal health officials assert.

Those products and more were targeted last week in a global crackdown on more than 1,000 websites that sell possibly dangerous and bogus medicines and medical devices. The bust, conducted by the U.S. Food and Drug Administration and Interpol, coincides with the surge of unproven cancer “cures” hawked by Internet sellers, the FDA warns.

Cancer-treatment fraud is “particularly heartless,” FDA officials say, because it preys on the desperation of patients who are tempted “to jump at anything that appears to offer a chance for a cure.” At Fred Hutchinson Cancer Research Center, some doctors are equally leery when patients ask to add claimed “natural” remedies to their treatment regimens.

“We’re quite clear: No over-the-counter herbal treatments – the things people get that are supposed to help their immune system, [or] whatever scams that people come across,” said Dr. George Georges, a hematopoietic cell transplant doctor at Fred Hutch.

“We have a very nice way of doing it. And it can sometimes take a long time to have a nice long conversation, to hear them out and talk about things,” Georges said. “But we’re very clear.”

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New guide helps patients, doctors make decisions on cancer drugs

ASCO ‘Value Framework’ offers a way to weigh health outcomes, side effects and costs of various treatments

June 24, 2015 | By Susan Keown / Fred Hutch News Service

Boxes containing the breast cancer drug Herceptin

ASCO's new "Value Framework" decision guide aims to help cancer patients and their doctors determine the cost-benefit ratio of cancer drugs, such as the breast cancer drug Herceptin, so together they can make more-informed treatment decisions.

Photo by Jeff J. Mitchell / Getty Images

Would you choose to live a few weeks longer if it cost your family upwards of $10,000? What about a longer lifespan with a price tag that came in the form of difficult side effects?

A new decision guide, published Monday by the American Society of Clinical Oncology, seeks to help patients facing these types of devastating decisions by providing more clarity on the impact of new cancer drugs on health outcomes, side effects and finances.

The proposed methodology aims to make it easier for patients and providers to make more-informed decisions about care.

“This project is responding to patient concerns, as well as society’s concerns, about the rising costs of medical care, specifically cancer care, that make optimal care challenging at best and prohibitive in other cases,” said Dr. Gary Lyman, co-director of the Hutchinson Institute for Cancer Outcomes Research at Fred Hutch and member of the ASCO Value in Cancer Care Task Force that created the framework.

The ASCO Value Framework assigns a score, called a “Net Health Benefit,” to new drugs based on how they’ve stacked up against the current standard of care in randomized controlled trials. A new drug gets points for helping patients survive longer than the old therapy and for having less-severe side effects.

The framework provides the drug costs along with the Net Health Benefit so patients and their doctors can consider medical benefits side by side with the financial impact when choosing a course of therapy.

The framework’s authors demonstrated its use in metastatic lung cancer, advanced multiple myeloma, metastatic prostate cancer and HER2-positive breast cancer. As currently published, it is geared more toward physicians than for use by patients (with published results from a clinical trial in hand, users fill out a worksheet to derive a drug’s Net Health Benefit). But eventually, ASCO said in a statement, the goal is for the framework to serve as the basis for user-friendly tools that physicians and patients could use together to choose treatments based on the patient’s individual values and preferences for care. In fact, Lyman said, the task force envisions an electronic tool that integrates up-to-date information on benefits, harms and costs seamlessly into electronic health records.

“When all three elements are considered” — clinical outcomes, toxicity and cost — “distinct differences in the available options often emerge,” Lyman said. “It’s not telling people to take one agent or another, but rather to enhance the discussion between patient and provider.”

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'Can't sit and wait': Gene therapy trial aims to cure rare Fanconi anemia

Blood disorder in patients like 10-year-old Behzad can lead to leukemia, other cancers in adulthood

June 22, 2015 | By Bill Briggs and Diane Mapes / Fred Hutch News Service

Mahazareen Hathiram discusses the decision to enroll her son Behzad, 10, in a clinical trial to correct Fanconi anemia. Behzad focuses on his handheld game near his father, Marzban Hathiram.

Photo by Robert Hood / Fred Hutch News Service

The mother and father have heard so many tough questions about their choice, like: “Why this? Why now?” They’ve asked themselves the same things.

They know some friends doubt their decision to enroll their child in a study at Fred Hutchinson Cancer Research Center, one continent and one ocean away from their home in Mumbai, India. And they accept that it may be December before they see if the gamble paid off.

But the couple firmly believes they’ve given 10-year-old Behzad, their small and quiet son, a chance to beat his rare blood disorder. He has Fanconi anemia (FA), an inherited disease that often leads to bone marrow failure, leukemia and other cancers in adulthood. Among the roughly 5,000 patients worldwide with the malady, the average lifespan is 33, according to FA experts.

"The known universe of people who have it is so small, it was a very long road to discovery as to what options you have,” said Behzad’s father, Marzban Hathiram. “We can’t just sit and wait.”

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Catching a killer early

Cervical cancer is a top cause of cancer deaths in Uganda; a Fred Hutch partnership helps HIV clinics change that

June 18, 2015 | By Mary Engel / Fred Hutch News Service

Dr. Noleb Mugisha

Dr. Noleb Mugisha visits an HIV clinic in Kampala, Uganda on May 19, 2015. Mugisha is a UCI-Fred Hutch cancer researcher who specializes in family medicine.

Photo by Robert Hood / Fred Hutch News Service

Step out of a car into St. Balikuddembe Market in Kampala, Uganda, and the first thing you notice is the noise. A deafening clatter rises over the warren of stalls, drowning out even the hawking of vendors and the haggling of shoppers. In the largest street market in Uganda, where locals bargain for second-hand goods, dozens of men hammer discarded garbage cans into cooking pots for sale. The nonstop din of their open-air workshop follows visitors into the waiting room of the St. Balikuddembe Health Care Centre next door.

“We’re in their factory,” said Dr. Noleb Mugisha, a physician and a research fellow with the Uganda Cancer Institute-Fred Hutch Cancer Alliance, “so we have to bear it.”

Mugisha is there for the same reason that health center itself is there: This is where to find the people who need his services.

The St. Balikuddembe Health Care Centre is an HIV/AIDS clinic founded by and funded since 2005 by Uganda Cares, a partnership between the Los Angeles-based AIDS Healthcare Foundation, local governments and a market vendors association. Hundreds of thousands of vendors and shoppers spend large parts of their days in the market, and vendors themselves came together first to organize HIV prevention efforts and later to request a clinic as the best way to ensure access to HIV testing, counseling and antiretroviral treatment.

Now Mugisha is working with the clinic to combat another disease that works hand in hand with HIV: cervical cancer.

Cervical cancer is caused by the human papillomavirus, or HPV, a common sexually transmitted infection that most people shake off.  But because HIV weakens the immune system and also may work synergistically with HPV, HIV-infected women are more than five times more likely to develop cervical cancer than women without HIV. And in sub-Saharan Africa, the area hardest hit by the worldwide HIV/AIDS pandemic, transmission of HIV is mostly through heterosexual sex, with young women disproportionately affected.

In Uganda and throughout sub-Saharan Africa, cervical cancer is the most common cancer and the No. 1 cancer killer in women. But although significant progress has been made in setting up HIV clinics in sub-Saharan Africa – more than 9 million of the estimated 25 million people infected with HIV are now receiving lifesaving antiretroviral treatment – until very recently, little attention was paid to HIV-associated cancers.

“What good does it do to treat people with antiretrovirals for HIV,” asked Mugisha, “only to have them succumb to cancer?” 

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Good News at Fred Hutch

Dr. Aude Chapuis named Damon Runyon Clinical Investigator; Dr. Jonathan Bricker receives $3.1M NCI grant to test quit-smoking smartphone app; Dr. Hans-Peter Kiem appointed chair of NIH Recombinant DNA Advisory Committee; Dr. Julie Overbaugh receives award from Association for Women in Science

June 18, 2015 | By Fred Hutch staff

Dr. Aude Chapuis

Dr. Aude Chapuis is an immunotherapy researcher in Fred Hutch's Clinical Research Division.

Photo by Bo Jungmayer / Fred Hutch News Service

Dr. Aude Chapuis Named Damon Runyon Clinical Investigator

Fred Hutchinson Cancer Research Center immunotherapy researcher Dr. Aude Chapuis received a Clinical Investigator Award this month from the Damon Runyon Cancer Research Foundation. The award will provide Chapuis with three years of support, plus assistance with research costs, to conduct a trial of adoptive T-cell therapy for unresectable non-small-cell lung cancer, or NSCLC,  and an asbestos-related cancer called mesothelioma that affects the lining of the lungs.

“It’s a great honor,” Chapuis said. “The information that we’ll be able to extract from this trial is going to help us significantly ameliorate future adoptive immunotherapy.”

Chapuis’ Damon Runyon–supported trial will extend the use of an immunotherapy target called WT1 to NSCLC and mesothelioma. T cells engineered to attack WT1-bearing leukemic cells were developed in the laboratory of Fred Hutch’s Dr. Phil Greenberg. A similar clinical trial in patients with acute myeloid leukemia, using the same T-cell receptor, is currently underway.

Like many leukemia cells, many NSCLC and mesothelioma cells overproduce WT1, making them equally vulnerable to recognition and attack by T cells that identify the target. “This target is overproduced in NSCLC and is one of the signatures of this cancer,” said Chapuis, who is an assistant member of Fred Hutch’s Clinical Research Division and an assistant professor at the University of Washington School of Medicine.

The trial is a collaborative effort; As co-principal investigator, Chapuis oversees the laboratory work and is responsible for generating T-cell products and analyzing the outcomes. Dr. Sylvia Lee is the trial's co-principal investigator, responsible for the clinical work. The trial is designed to perform a head-to-head comparison of two types of T cells engineered to express a WT1-specific TCR: naïve T cells and central-memory T cells.

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