A $3.2 million grant from the National Cancer Institute will allow Fred Hutchinson Cancer Research Center clinical researcher Dr. Damian Green to test a multiple myeloma treatment that uses a powerful but elusive radioactive particle to deliver immunotherapy to tumor sites throughout the body.
“If successful, the treatment would provide a unique approach that could benefit the 30,000 people each year diagnosed with multiple myeloma and could potentially be adapted for other cancers,” said Green. Multiple myeloma is a cancer of the plasma cells, which are found in the bone marrow and play a crucial role in the immune system.
The new grant comes at a promising time for multiple myeloma, a generally incurable disease. Treatments approved by the U.S. Food and Drug Administration since 2003 have extended survival to about seven years, which is an improvement from the historical two- to three-year survival. But long-term, complete remission evades most patients.
Despite high rates of initial response to treatments, almost all patients relapse even if the cancer is undetectable by traditional methods.
“Therapies knock back the disease but it still returns, often as a consequence of a very small number of remaining tumor cells also known as minimal-residual disease,” said Green, who’s also an assistant professor in the University of Washington School of Medicine.
Minimal-residual disease is identified through very sensitive testing that detects small pockets of cancer cells throughout the body that presumably did not respond to treatment and remain behind to ultimately flourish.
To target those leftover cancer cells, Green, along with Fred Hutch clinical researcher Dr. Oliver Press and their colleagues in Radiation Oncology at UW have been investigating how to deliver radiation directly to the diseased cells to essentially zap them on the spot.
“In rare cases, [when] the same cells that are found in myeloma show up in just one area of the body, that condition is potentially curable with traditional external-beam radiation,” Green said. “This demonstrates that these cancer cells can be eliminated by radiation if we could get it to all of them, but with multiple myeloma, the disease is throughout the bone marrow and often elsewhere, so you can’t safely give traditional radiation to all those sites in the body.”
For the past 30 years, the research team has been figuring out how to directly target radiation to cancer cells. They have turned their focus to a high energy, alpha-emitting particle, since it is very good at giving a “local killer punch,” Green said.
But the trick is getting the particle close enough to the cells. Alpha emitters are slippery: They can’t just be linked to any molecule, and there hasn’t been a way to attach the radiolabel onto an antibody to home in on cancer.
The UW collaborators created a cage consisting of 10 boron atoms to encapsulate the alpha particle, then, with Green, they attached the cage to the CD38 antibody, which hunts down the CD38 receptor prevalent on myeloma cells.
“The alpha particle can’t go through a piece of paper,” Green said, “but it can deliver its payload through the boron cage and travel one to two cells in diameter to enable a targeted, localized attack.”
With the NCI funding, the researchers will embark on a clinical trial, which they aim to open in 2018. The trial will involve giving the antibody tagged with the alpha particle to multiple myeloma patients in combination with a standard type of chemotherapy, melphalan, as preparation for a stem cell transplant.
First, though, the researchers will spend the next year making the reagents necessary for the trial, using the Biologics Production Facility at Fred Hutch, and then seek FDA approval.
For Green, this project gives more hope for the multiple myeloma patients he sees.
”We’ve kicked the can down the road with all the great new therapies, but my patients still need a breakthrough,” he said
“The reason I love this place is it provides the opportunity to engage in collaborative translational work,” Green said of Fred Hutch.
— Molly McElroy / Fred Hutch News Service
Fred Hutch smoking-cessation expert Dr. Jonathan Bricker has received a $100,000 grant from the CVS Health Foundation — supplemented by a $30,000 grant from Seattle Cancer Care Alliance — to create and implement a digitized screening process to help identify and support cancer patients who want to quit smoking.
The program, tentatively named Electronic Health Assessment and Resources Tool, or eHART, will provide what Bricker called a “21st-century solution” to help identify cancer patients who want to kick the habit: a tablet-based software application, or app, that patients can potentially use in waiting or exam rooms.
The vision of the eHART app is to determine the patient’s smoking status (and other pertinent data), evaluate their interest in kicking the habit and, if so, connect them with a number of evidence-based smoking-cessation options including in-person or telephone counseling; the SmartQuit app developed by Bricker; or anti-smoking medications (think Chantix, Zyban or a nicotine patch). Participating patients would have their progress tracked through electronic medical records so additional help could be offered if needed.
If successful, eHART potentially could be disseminated to cancer centers across the U.S., the public health researcher said. A 2014 study from the American Cancer Society found nearly 10 percent of cancer patients still smoke.
“We are thrilled at the generosity of the CVS Health Foundation and Seattle Cancer Care Alliance in helping us create this program,” said Bricker upon receiving the two grants. “Cancer patients are inconsistently being triaged for smoking cessation. There are a lot of reasons for that — attitudinal barriers, a belief that it doesn’t matter — but this is a way to cut through all of that and make sure everyone gets screened and everyone gets asked how motivated they are to quit. It will give the patients choices. Do they want medication? Counseling? Do they want to get help through an app?
“We want to make the technology be the touchpoint,” he said. “That way, clinicians who may not have time to do it, don’t have to do it. The technology does it for them.”
CVS Health has been a staunch proponent for tobacco-free lives for several years. In 2014, the company became the first and remains the only national pharmacy to quit selling tobacco products. Today, it offers its customers a variety of tools to help with smoking/tobacco cessation; and last spring launched a five-year $50 million initiative, Be The First, which is designed to help deliver the nation’s first tobacco-free generation. Through it, the organization partners with a number of nonprofit organizations on the front lines of tobacco control, including Campaign for Tobacco-Free Kids, American Academy of Pediatrics and the American Cancer Society.
The $100,000 grant, inspired by the national Cancer Moonshot effort, marks CVS’ first partnership with Fred Hutch.
“Addressing smoking among at-risk populations, including cancer patients, is a priority for us,” said Eileen Howard Boone, president of the CVS Health Foundation. “We’re proud to support Dr. Bricker and the Fred Hutchinson Cancer Research Center as they bring an innovative smoking-cessation offering to lead the improvement of cancer treatment outcomes for patients and bring us one step closer to the first tobacco-free generation.”
The additional $30,000 from Fred Hutch’s clinical care partner, Seattle Cancer Care Alliance, will complement its current Living Tobacco-Free Services.
Katie Brown, associate director of SCCA’s clinical operations, termed the eHART project an outstanding opportunity to take advantage of Fred Hutch’s cutting-edge smoking-cessation research.
“SCCA is privileged to be a place where Dr. Bricker and his world-class team can explore their questions and learn from SCCA’s dynamic patient population,” she said. “This pilot represents the beginning of a longer relationship with Dr. Bricker and his team to continue developing SCCA’s tobacco-cessation services. It’s an incredible opportunity for the future of the program and for our patients and their families because we can fully integrate research into our clinical program. We’re optimistic that, together, our reach will extend beyond this region to improve tobacco-cessation programs at cancer centers across the country.”
Bricker said the program’s goal is to work with all cancer patients, not just those with cancers commonly associated with smoking such as lung and head and neck cancers. He said the new tool will also help to educate cancer patients and others (think spouses, partners, caregivers and even physicians and researchers) about the survival benefits of kicking a smoking habit.
“Some people may think it’s too late, that it won’t make a difference,” he said. “But there’s a lot of literature that shows that if a person goes through cancer treatment and they continue to smoke, they’ll have much worse outcomes. They’ll have a greater likelihood of recurrence, more complications in surgery and in wound healing and their recovery from the treatment will be worse.”
Bricker anticipates it will take about 12 to 14 months to conduct a patient-clinic needs assessment; develop, test and refine a prototype design; then develop and deploy the technology.
He also believes the health-assessment tool eventually can be used to screen for a number of other behaviors that could lead to interventions beneficial to cancer patients.
“We’re going to ask about smoking cessation but we’re also going to ask about other things like exercise and diet and drinking habits and mental health,” he said. “We’re doing this for smoking but the app can be broadened. It can eventually become a one-stop platform for assessing common health behaviors then connecting patients to service.”
— Diane Mapes / Fred Hutch News Service
The American Association for Cancer Research, or AACR, on March 17 announced that Fred Hutch’s Dr. Nancy Davidson, an internationally acclaimed breast cancer oncologist, is among its newly elected class of Fellows of the AACR Academy.
Davidson, vice president and director of the Clinical Research Division at Fred Hutch, also serves as AACR’s president. She is among 12 members of the new class from the U.S. and around the world who, according to an AACR statement, “have made quintessential scientific discoveries that have and continue to revolutionize how we study, treat, and prevent cancer.”
“It is a special honor to be selected as a Fellow of the AACR Academy,” Davidson said. “I am both humbled and thrilled to join this illustrious group of researchers who are united in their passion to make a difference in the battle against cancer.”
Her research has teased out the role of hormones in breast cancer growth and she has had a major impact on the development of new standards of care that exploit the Achilles’ heels of breast cancer cells.
Davidson’s team was the first to describe how the activity of one of the estrogen receptor genes is regulated by epigenetic factors that affect how the DNA code is read and eventually translated into proteins. She also has contributed foundational research to our understanding of how estrogen deprivation and other therapies trigger breast cancer cells to kill themselves through apoptosis, or programmed cell death.
Her lab studies paved the way for new clinical trials of drugs that exploit these pathways to kill breast cancer. She has also led several critical clinical trials that have advanced the care of breast cancer patients, for example, establishing a combination chemotherapy and hormone therapy regimen for premenopausal women with the disease.
In addition to her leadership role at Fred Hutch, Davidson is president and executive director of its patient-care arm, Seattle Cancer Care Alliance; and she is professor and head of the Division of Medical Oncology of the University of Washington School of Medicine. In these roles in the Fred Hutch/UW Cancer Consortium, Davidson serves as a bridge builder across the cancer treatment, clinical, translational, basic sciences and public-health research programs of consortium members Fred Hutch, UW School of Medicine, UW School of Public Health, Seattle Children’s and SCCA.
Other AACR Academy Fellows from Fred Hutch are:
Dr. Leland “Lee” H. Hartwell, Nobel laureate and former president and director of Fred Hutch, has received Research!America’s Geoffrey Beene Builders of Science Award for “his leadership and determination in building an outstanding scientific research organization.” He received the award in honor of his leadership as president and director of the Hutch from 1997 to 2010.
Hartwell, now director of the Pathfinder Center at Arizona State University’s Biodesign Institute and Virginia G. Piper Chair of Personalized Medicine, accepted the award March 15 at the 21st annual Advocacy Awards at the Andrew W. Mellon Auditorium in Washington, D.C. The awards dinner, brings more than 400 leaders from government, industry, academia and health advocacy organizations to recognize top medical and health research advocates who have made an impact in advancing the nation’s commitment toward research.
“Research!America is honored to recognize Dr. Hartwell for his exemplary leadership as a researcher, educator and lifelong advocate for scientific discovery,” said Mary Woolley, president and CEO of Research!America, in a statement. “Dr. Hartwell is deeply committed to educating the next generation of critical thinkers in health, education, technology and sustainability. We salute his achievements.”
Hartwell won the 2001 Nobel Prize in physiology or medicine for his research on the cell cycle, a process that describes how cells grow and divide. His research provides a deeper understanding of how cancer cells grow uncontrollably in the body. Hartwell also discovered a series of checkpoints during division, where cells can pause to repair any damage they’ve incurred before continuing to divide. However, cancer cells are devious and evade checkpoints, allowing them to reproduce errors and form tumors. These seminal discoveries shaped our modern understanding of cancer.
His leadership further elevated Fred Hutch into a premier research center working to prevent, diagnose and treat cancer, HIV/AIDS and other diseases. In 2010, Hartwell joined ASU to lead a personalized medicine initiative and has appointments in the schools of Education, Sustainability and Biomedical Engineering.
Other 2017 Research!America Advocacy Award honorees included Joe Biden, 47th vice president of the United States, who received Research!America’s Gordon and Llura Gund Leadership Award; Anthony S. Fauci, director of the National Institute of Allergy and Infectious Diseases at the National Institutes of Health, who received the Legacy Award; and award-winning actress Kathy Bates, a spokesperson for the Lymphatic Education & Research Network.
— Adapted from an Arizona State University news release