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Dec. 8, 2016

Cures Act

House Speaker Paul Ryan gives a thumbs-up to Max Schill, 7, who has Noonan Syndrome. Lawmakers who also were present for signing of the 21st Century Cures Act included House Minority Leader Nancy Pelosi, Sen. Lamar Alexander, R-Tenn., Rep. Fred Upton, R-Mich., Rep. Diana DeGette, D-Colo. and House Majority Whip Steve Scalise.

AP Photo/Cliff Owen

Congress passes 21st Century Cures Act, propelling work to end cancer

The U.S. Senate's approval Wednesday of the 21st Century Cures Act will help drive the top goal of the Cancer Moonshot ― speeding development of new cancer cures, said Dr. Nancy Davidson, president of the American Association for Cancer Research, or AACR, and senior vice president and director of the Clinical Research Division at Fred Hutchinson Cancer Research Center.

The Senate passed the bill in a 94-five vote. The House passed a nearly identical version on Dec. 1, voting 392-26. President Barack Obama, who said the Cures Act brings the world "one step closer to ending cancer as we know it," is expected to sign the bill into law. 

The bill provides $4.8 billion in funding to the National Institutes of Health to pay for an array of medical research programs, including $1.8 billion over seven years to bolster cancer science through the Moonshot, an initiative launched and led by Vice President Joe Biden. Senators also approved an amendment to rename the Moonshot portion of the bill after Biden’s son, Beau, who died from brain cancer in May 2015. It is now called the Beau Biden Cancer Moonshot.

"This targeted, multi-year funding will help support the 10 cutting-edge scientific recommendations identified by the National Cancer Moonshot Initiative Blue Ribbon Panel for realizing the Vice President’s goal of achieving 10 years of progress within the next five years," Davidson said in an AACR statement co-authored by Dr. Margaret Foti, chief executive officer of the AACR.

They specifically called out Sen. Patty Murray, D-Wash., and Sen. Lamar Alexander, R-Tenn., for their "leadership and unwavering commitment to ensuring the passage of the bill."

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The quest to better understand the deadliest childhood leukemia

Oncologists are beginning to leverage unique genomic characteristics of pediatric AML to improve treatment and prognosis

Dec. 7, 2016 | By Sabrina Richards / Fred Hutch News Service

Dr. Soheil Meshinchi

Findings by researchers, including Fred Hutch's Dr. Soheil Meshinchi, may help inform better treatment decisions for pediatric AML patients.

Photo by Bo Jungmayer / Fred Hutch News Service

Acute myeloid leukemia is the deadliest leukemia among children. Only half of patients will achieve long-term remission. But scientists see change on the horizon. Taking advantage of today’s genomic sequencing technologies, researchers are discovering that on the molecular level, AML in children is dramatically different from the disease in adults. At the same time, researchers are clarifying how unique each child’s disease may be, with implications for more tailored treatment, individualized prognosis and monitoring, and the opportunity to develop therapies that target childhood AML’s particular characteristics.

Studies presented at this year’s conference of the American Society of Hematology exemplify the widening scope, and burgeoning hope, of childhood AML research.

“In general, the field [of pediatric AML] has been rather stagnant until recently,” said Dr. Soheil Meshinchi, a pediatric oncologist and investigator of childhood AML at Fred Hutchinson Cancer Research Center. Patients receive the same combination of chemotherapy because their AML “looks the same under the microscope,” said Meshinchi, “but we’re learning more and more that all AML is not the same entity.”

Most AML occurs in adults, especially older adults, and the treatments devised for these patients “trickles down to pediatrics,” said Dr. Katherine Tarlock, a pediatric AML investigator at Fred Hutch who also treats children with AML at Seattle Children’s Hospital. “But the more we’re now learning about pediatric AML [the more we realize that] it’s really drastically different from adult AML … Which has big implications for treatment strategies, especially as we move forward into targeted treatment strategies.”

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Big support for the littlest patients

Fred Hutch Holiday Gala brings in more than $13 million to grow pediatric cancer research and develop needed therapies for children

Dec. 5, 2016 | By Diane Mapes / Fred Hutch News Service

Families of pediatric cancer patients

Families of pediatric cancer patients stand on stage holding pictures of their loved ones while "Calling All Angels" is performed during an emotional moment at the Fred Hutch Holiday Gala.

Photo by Robert Hood / Fred Hutch News Service

This one was for the kids.

The Hutch Holiday Gala, the single largest fundraiser for Fred Hutchinson Cancer Research Center, attracted 800 guests to the Seattle Sheraton Saturday for an evening of music, laughter, cocktails and dazzling attire. But underneath the glitz and glamour was a deadly serious goal: fast-forwarding cures for the littlest patients — children diagnosed with cancer.

As in previous years, Fred Hutch donors gave from the heart, with funds coming in from ticket sales, sponsorships, raffles, two auctions and Help the Hutch, a lively paddle-raiser which brought in donations from the floor. Thanks to a generous $4 million challenge gift by the Hughes family, donations totaled more than $13 million. A final tally will be announced in days to come.

“The words ‘you have cancer’ are terrifying,” said Dr. Gary Gilliland, Fred Hutch director and president, in his opening remarks. “That fear is compounded when cancer strikes a child.”

Sadly, each year, nearly 16,000 children and adolescents in the U.S. are diagnosed with cancer and nearly 2,000 die from it. Yet funding for pediatric cancers represents only 2 to 4 percent of the National Cancer Institute’s spending on cancer research. This lack of funding has created a dearth of knowledge when it comes to the diseases that affect children, some of which are so rare there are no known treatments. As a result, children are often treated with therapies designed for adults, subjecting them to a host of harrowing side effects that can sometimes last a lifetime.

Money from the gala, which featured music by the funk/soul legends Kool & the Gang, will be used to recruit world-class leaders in the field of pediatric oncology. It will also expand the research infrastructure at Fred Hutch to provide much-needed safe and effective therapies specifically for kids.

“We have reached a point where we can tailor therapies to the nuances of children’s diseases,” Gilliland said. “The impact of your support will be extraordinary.”

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Immunotherapy shows promise in preventing leukemia relapse

Group of 12 high-risk patients who received engineered T cells after bone marrow transplant still in remission after more than two years

Dec. 5, 2016 | By Susan Keown / Fred Hutch News Service

Dr. Aude Chapuis and her Fred Hutch colleagues are working to use the human immune system to target and cure cancer.
Photo by Robert Hood / Fred Hutch News Service

For patients with high-risk acute myeloid leukemia, relapse after bone marrow transplant signals a low chance of survival. But results from a small trial of genetically engineered immune cells show promise for keeping these patients out of danger: Of the 12 AML patients who received this experimental T-cell therapy after a transplant put their disease in remission, all are still in remission after a median follow-up of more than two years.

Giving these cells after transplant when disease is in remission “might actually be helping patients who have a high risk of relapsing to not relapse down the line,” said Dr. Aude Chapuis of Fred Hutchinson Cancer Research Center, one of the study’s leaders. Chapuis presented these results Monday at the 2016 annual meeting of the American Society of Hematology in San Diego, California.

The findings in this group of trial participants contrast with the outcomes the researchers observed in a cohort of similar patients who received transplants around the same time but did not receive engineered T cells. In all of these transplant-only patients, the transplants produced remissions, but more than a quarter of them relapsed within just 10 months.

As an early trial with a small number of patients and no randomized control group, this trial is a beginning, not a final answer. Nevertheless, the difference in outcomes between the two groups suggests that the patients in the engineered T-cell group “are getting a protective effect from the cells that they are receiving,” Chapuis said.

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'Back to normal life'

Sorting stem cells before transplant helps lower the risk of graft-vs.-host disease, researcher reports

Dec. 5, 2016 | By Bill Briggs / Fred Hutch News Service

Dr. Curtis Mack

Dr. Curtis Mack, a radiation oncologist, was diagnosed in 2013 with leukemia and underwent a stem cell transplant. He participated in a clinical trial to investigate a way to lower the risk of graft-vs.-host disease.

Courtesy of Dr. Curtis Mack

[Editor's note: We've updated this story, originally published in June 2015, to reflect new findings about this clinical trial that were presented at the American Society of Hematology's annual meeting.]. 

For some leukemia patients, getting a blood stem cell transplant isn’t necessarily the biggest hurdle they face. In the first months after a transplant, up to 70 percent develop acute graft-vs.-host disease, an often-debilitating illness where the donor cells attack not just the disease but also the patient’s own healthy cells.

In about 50 percent of blood stem-cell recipients, it evolves into a long-term medical condition. When GVHD becomes chronic, patients typically need ongoing medical care, often develop disabilities and an impaired immune system, and can’t return to work or school. Some need frequent hospitalizations. Some die.

But now, researchers may have found a way to help lower the risk of GVHD.

On Monday, at the American Society of Hematology annual meeting in San Diego, Fred Hutch researcher Dr. Marie Bleakley reported that scientists have been able to drastically reduce the risk of GVHD in transplant patients by filtering fresh blood stem cells with magnets.

In a clinical trial at Fred Hutchinson Cancer Research Center, among 70 acute leukemia patients infused with specially filtered stem cells, less than 10 percent showed chronic GVHD, Bleakley reported. (Chronic GVHD symptoms can include joint pain, blurred vision, mouth sores, trouble breathing, rashes and other manifestations.) 

The paper updated findings Bleakley first reported in 2015 when the trial included 35 acute leukemia patients. 

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Three's a charm in a triple-drug combination for transplant patients

A drug with a storied past offers a new edge against an old foe

Dec. 4, 2016 | By Sabin Russell / Fred Hutch News Service

Dr. Brenda Sandmaier

Dr. Brenda Sandmaier

Photo by Robert Hood / Fred Hutch News Service

Discovered nearly 45 years ago in the volcanic soils of fabled Easter Island in the Pacific, a drug first thought of as an antifungal agent has found a new purpose by boosting the survival of leukemia patients after blood stem cell transplants.

In a clinical trial conducted by Fred Hutchinson Cancer Research Center, the addition of a third drug, sirolimus, to a standard two-drug regimen effectively cut in half the incidence of acute graft-vs.-host disease, or GVHD, a common and dangerous complication of these lifesaving procedures.

So convincing were the early results of the trial that the independent Data Safety and Monitoring Board, which advises such studies, halted it in July. The new combination using sirolimus saved lives, so it was considered unethical to withhold it any longer from the patients in the control arm of the trial who were taking only the standard two-drug therapy.

At the American Society of Hematology annual meeting in San Diego, Fred Hutch physician/researcher Dr. Brenda Sandmaier on Sunday presented the interim study results that led to the decision, which in turn has already changed how patients at Fred Hutch’s clinical care partner, Seattle Cancer Care Alliance, and other participating hospitals are being treated.

“I do a lot of studies. It is not often you get to see an exciting result like this one,” said Sandmaier in an interview prior to her trip to the San Diego conference.

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