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Being pregnant — and diagnosed with cancer

Inaugural retreat explores unanswered questions surrounding cancer, fertility and pregnancy

Emily Cousins

Emily Cousins was diagnosed with breast cancer when she was nine months pregnant with her first child, Colm. She started treatment weeks after his birth.

Photo courtesy of Emily Cousins

EMILY COUSINS WAS DIAGNOSED with breast cancer at 32. She was nine months pregnant. She wasn't prepared for the dual unknown roles that came days apart: New mother and cancer patient.

"I had imagined the first months of being a mother, and suddenly it looked so different from what I had anticipated. And it was painful," Cousins said. "From being bald and wearing my goofy little hats to the mommy and me classes, to wondering, would I live to see this child enter kindergarten?"

In April, Cousins was among a group of cancer researchers, fertility specialists, survivors and patient advocates who gathered at the Fred Hutch-hosted Cancer & Pregnancy Retreat to discuss the unique issues at the intersection of cancer and reproduction.

Key themes emerged from the retreat: Many doctors — primary care providers and oncologists included — don't have the right information to communicate to their patients about fertility and pregnancy, and there's a lot that researchers still need to know to better inform patient and provider decisions.

"What inspires me to be a part of this event and why I think this work is so important is that I needed research to help me make crucial decisions," Cousins said.

Steve Stadum named new chief operating officer

Portland native comes to Seattle with impressive track record

Photo courtesy Carl Kiilsgaard

FRED HUTCH HAS NAMED STEVE STADUM as its new executive vice president and chief operating officer. Stadum is a lawyer by training and a native of Portland, Oregon, with a track record of accomplishment at Oregon Health & Science University.

"He's fantastic at building organizations," said Fred Hutch President and Director Dr. Gary Gilliland. "He understands academics, he understands administration, and he knows how to put buildings up. I have the greatest respect for what he did at OHSU."

As COO at OHSU's Knight Cancer Institute, Stadum played a central role in helping to secure $1 billion in funding to launch a vast expansion of the institute.

Speaking about his new role at Fred Hutch, which begins July 5, Stadum said: "It's a privilege to work in a place where, although I'm not going to find the cure, I can help bring together those who can. It makes my life much more meaningful."

Breast cancer research on 'mets' offers hope

Fred Hutch's Dr. Kevin Cheung speaks with metastatic breast cancer patients during a tour of his lab

Fred Hutch's Dr. Kevin Cheung speaks with metastatic breast cancer patients during a tour of his lab at the Fred Hutch campus in Seattle on Feb. 22, 2016.

Photo by Robert Hood / Fred Hutch

AN ESTIMATED 20 TO 30 PERCENT of women diagnosed with early stage breast cancers later go on to develop metastatic disease, which claims the lives of 40,000 women (and men) each year. Despite these numbers, there is still much that isn't known about metastatic breast cancer, or MBC. There aren't good systems in place to track the disease's progression. And without data, it's harder to get research funding. Increasingly, patient advocates like Beth Caldwell are partnering with scientists to help change that. Caldwell and other MBC patients recently toured the lab of Fred Hutch's Dr. Kevin Cheung to discuss his work, their advocacy and the current research climate. All say they're encouraged by recent advances in immunotherapy, targeted treatments, and new initiatives calling for data sharing.

Cheung is on the hunt to better understand and treat MBC. He and his team focus on clumps of cancer cells that travel through the bloodstream to set up residence in patients' lungs, liver, bones or other organs. Cheung believes it's these clusters that are the drivers of breast cancer metastasis. His latest paper showed clusters are "led" by a highly expressed protein called keratin 14 that he believes are the "bad guys" responsible for leading metastasis.

Dr. Peggy Porter, head of the Breast Cancer Research Program, is also working to tackle MBC. She's working to create a Metastatic Breast Cancer Initiative involving multiple Fred Hutch investigators and other Fred Hutch/UW Cancer Consortium partners, each of whom is attacking MBC from a different angle. Bringing together the power of the consortium could help fast-track research.

"I feel like this is the year," Caldwell said. "The 'metsters' are no longer being ignored."

93 percent of leukemia patients in remission after immunotherapy

Dr. David Maloney

Dr. David Maloney

Fred Hutch file

SOME OF THE PATIENTS were near death. All had advanced disease that had relapsed or was not yielding to treatment. Many had exhausted all options before enrolling in the clinical trial at Fred Hutch that re-engineered their T cells into cancer killers.

In April, the investigators leading the immunotherapy trial published their first set of results: 93 percent of participants with B-cell acute lymphocytic leukemia, or ALL, went into complete remission after receiving the experimental T-cell therapy — even though multiple other treatments had already failed them.

"Patients who come onto the trial have really limited options for treatment. They have refractory acute leukemia. So the fact that we're getting so many into remission is giving these people a way forward," said study leader Dr. Cameron Turtle.

The paper in the Journal of Clinical Investigation reported on data from 30 adult ALL study participants who received the engineered cells, known as CAR T cells. The study was funded by the National Cancer Institute, Hutch spinoff Juno Therapeutics, private philanthropists and a Washington state research fund. It was designed to evaluate the cell therapy's safety and lay the groundwork for future improvements.

While Turtle and senior author Dr. David Maloney caution it's still early days for the research, the results are encouraging, they said.

"In early-phase trials, you're continually learning," said Maloney. "You don't expect results like these from early-phase trials. That's why these response rates are so extraordinary."

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