Researchers have discovered that infiltrating gliomas, a common brain and spinal cord tumor, are shaped by their genetic evolution and microenvironment, a finding that could lead to more targeted treatments.
University of Colorado (CU) Cancer Center researchers have been on the leading edge of developing new therapies for leukemia. One of the most recent breakthrough therapies has been the development of venetoclax, a B-cell lymphoma-2 inhibitor, that that has shown profound results for adults with acute myeloid leukemia (AML) and has become a standard of care for patients with this disease all over the world.
The University of Colorado Cancer Center is excited to announce that the “interim” title before Christopher Lieu, MD, has been removed making him the Associate Director of Clinical Research. Dr. Lieu was in the interim role for 8 months before being named the associate director. Dr. Lieu, who is also the director of the gastrointestinal medical oncology program, joined the CU School of Medicine faculty in 2011. For the past nine years Dr. Lieu has been an investigator on numerous CU Cancer Center studies, including taking the lead on early-onset colorectal cancer research. Dr. Lieu received the National Cancer Institute Cancer Clinical Investigator Team Leadership Award in 2017. Additionally, Dr. Lieu is the Vice-Chair of the National Cancer Institute Colon Cancer Task Force and on the National Comprehensive Cancer Network Panel for Neuroendocrine Cancers.
An important goal of early-phase clinical trials is to discover a drug’s possible side effects. But despite FDA guidelines seeking to standardize this reporting, a University of Colorado Cancer Center study finds significant variation in how drug side effects are reported, potentially making some drugs seem safer or less safe than they really are.
Tejas Patil, MD, is a medical oncologist. Lisa Ferrigno, MD, MPH, FACS, is a trauma surgeon. Working with lung cancer patients at University of Colorado Cancer Center, they both, independently, noticed something strange: A small percentage of patients taking high doses of the drug osimertinib (Tagrisso) were developing a rare twist in the right side of their colon, a condition called cecal volvulus. Their case series, published in the journal Frontiers in Oncology, describes three of these patients, suggesting that doctors who use osimertinib with EGFR+ non-small cell lung cancer patients may consider watching for rare cases of cecal volvulus along with more expected side effects.
After five years as an assistant professor at the University of Miami treating sarcoma patients and running sarcoma clinical trials, Breelyn Wilky, MD, recently joined University of Colorado Cancer Center as Deputy Associate Director for Clinical Research. Here we speak with Wilky about what drew her to Colorado and what’s next for the treatment of sarcoma.
Pooled analysis of three phase 1 and 2 clinical trials published online ahead of print in the journal Lancet Oncology show that the drug entrectinib is effective and well-tolerated against advanced ROS1 and NTRK fusion-positive non-small cell lung cancers (NSCLC). Results of the trials STARTRK-1 (NCT02097810), STARTRK-2 (NCT02568267), and ALKA, show 77 percent response rate to entrectinib in 53 patients with ROS1+ NSCLC, with a median progression-free survival of 19 months and a median duration of response of 24.6 months. In 54 patients with NTRK+ NSCLC, 57 percent responded to entrectinib, with a median progression-free survival of 11.2 months and a median duration of response of 10.4 months. Based on the early promise of these trials, in August 2019 the U.S. Food and Drug Administration granted entrectinib accelerated approval for the treatment of metastatic ROS1+ NSCLC and for advanced tumors across cancer types defined by NTRK fusion. The current journal articles update these findings that led to approval.
In melanoma, myeloid-derived suppressor cells (MDSCs) are bad – the more MDSCs, the poorer a patient’s prognosis. That’s because when these MDSCs expand to accumulate near melanoma tissue and in blood circulation, they suppress the immune system so that it doesn’t attack the cancer. But how do MDSCs expand and how do they accumulate near melanoma tissue?
Clinical trials bring new treatments to Colorado patients, often offering innovative options years before they are available to patients outside academic medicine. The problem is that even after laboratory work and animal studies show the promise of a new cancer treatment, opening and enrolling a human clinical trial requires a painstaking process of planning and approvals. The faster doctors and administrators can accomplish this work, the sooner a clinical trial becomes available. Now a new grant from the National Cancer Institute will help University of Colorado Cancer Center speed this process of clinical trial approval, making more trials available sooner to patients who need them.
“Trials are the lifeblood of the Cancer Center – it’s how we move cancer treatments forward. This grant will help to ensure we’re on the cutting edge of new therapies. The earlier we can get a trial open, the earlier we can start offering it to patients,” says Victor Villalobos, MD, PhD, medical director of the CU Cancer Center Cancer Clinical Trials Office.
The competitive, two-year grant, called a Cancer Clinical Investigator Team Leadership Award (CCITLA), will allow Villalobos to, in his words, “buy some time back from the clinic to focus on being medical director.” His goals include reorganizing the Cancer Clinical Trials Office to improve trials’ time-to-open, a metric that can also entice drug companies to offer new treatments in Colorado.
Between the discovery of a new treatment and its delivery to patients is the often overlooked and incredibly complex process of clinical trial design and approval. And while clinical trial administration may not grab headlines like the discovery of a new way to fight cancer or the first patient who benefits from treatment, the process of deciding exactly how, when and to whom a trial is offered is an essential step toward the ability to more successfully fight the disease. Simply, this CCITLA will allow Villalobos and his team to help Coloradoans fight cancer better.
The saying “God doesn’t play dice” is meant to suggest that nothing happens by chance. On the other hand, cancer seems like the ultimate happenstance: Don’t we all have a 43-year-old, vegan, triathlete friend fighting cancer? Does this mean that cancer plays dice? According to the traditional model of how cancer develops, yes: Every time a cell divides, you roll a die, and the more years you roll, the greater your chance of rolling an unfortunate mutation that causes cancer. Some young people get very unlucky and some older people get very lucky, but overall, the longer you live, the more times you roll the die, the greater your risk of developing cancer. It makes perfect sense.
CU Cancer Center member Christopher Lieu, MD, and Namrata Vijayvergia, MD, of the Fox Chase Cancer Center conclude their discussion with considerations for managing immunotherapy-related toxicities in patients with metastatic hepatocellular carcinoma (HCC), along with a review of the available evidence regarding the duration of immunotherapy treatment.