University of Colorado (CU) Cancer Center leader Wells Messersmith, MD, has been named chief medical officer of oncology services at UCHealth. In this new role, Messersmith will oversee cancer care at all UCHealth locations with a focus on expanding advanced treatments and the clinical trials UCHealth offers in partnership with the CU Cancer Center.
Comedian Louie Anderson — known for his stand-up routines, as well as a hosting stint on “Family Feud,” his animated series “Life With Louie,” and a more recent role on the FX comedy series “Baskets” — died January 21of diffuse large B-cell lymphoma. He was 68.
This was another exciting year for the University of Colorado Cancer Center, and we were able to share more than 80 stories spotlighting our members and their research. We also shared the cancer journeys of some of our patients.
A three-drug regimen was shown to lengthen the amount of time before cancer progressed to the central nervous system — known as central nervous system progression-free survival — in certain patients with breast cancer.
Of the 18,000 people diagnosed with large B-cell lymphoma each year, only half will be successfully treated with chemotherapy. The 9,000 remaining patients typically have poor outcomes, with only 25% responding to additional, higher-intensity chemotherapy, followed by a stem cell transplant.
The University of Colorado Cancer Center is pleased to announce several leadership transitions that will support the center in its mission to overcome cancer through innovation, discovery, prevention, early detection, multidisciplinary care, and education.
It’s worth noting, in light of recently published research, that a majority of people won’t be diagnosed with cancer in their lifetimes. According to the National Cancer Institute, about 40% of people will, which means 60% won’t.
Sandra Luna-Fineman, MD, treats children and adolescents with cancer from around the U.S. in her role as a pediatric oncologist at Children’s Hospital Colorado, but she knows that children in low- and middle-income countries around the world need her help the most.
One of the primary tools that oncologists use to stage cancers is the PET (positron emission tomography) scan, an imaging test that uses a small amount of radioactive sugar to detect metabolically active areas within the body.
Lung cancer screening is recommended only for those who are at high risk for the disease — adults ages 50–80 who smoke at least 20 packs a year — but even among members of that high-risk group, screening rates remain low, ranging from 5% to 20% of those eligible for the screening CT scan.
“When you lose hope, you lose everything,” says Ron Randolph. “It’s like you’re in the bottom of a hole and you see this light at the top of the hole. It’s a very small light, but there’s no way to escape.”
There are two things most people believe about lung cancer, says Jamie Studts, PhD, co-leader of the Cancer Prevention & Control Program at the CU Cancer Center: Those who suffer from it most likely caused it by using tobacco, and the prognosis for surviving the disease is poor.
The cancer survivorship journey can have many components, but one of the most important is regular exercise. Physical activity for individuals who have completed cancer treatment can build stamina, reduce anxiety, improve quality of life and physical fitness, and even improve survival outcomes.
One of the reasons why cancer continues developing and growing is not just because cancer cells exist, but because they can recruit help from the body’s own blood vessels, stromal cells, and immune cells.
Recent advances in immunotherapy have allowed doctors at the University of Colorado Cancer Center to more effectively treat melanomas that spread to other parts of the body. Immunotherapy drugs such as checkpoint inhibitors, which are commonly used to treat melanomas, work to strengthen a patient’s immune system so that it can prevent a tumor from “turning off” the ability of the immune system to fight it.
One of the most impactful advancements during the past decade in treating ovarian cancer is the use of PARP inhibitors (short for poly adenosine diphosphate-ribose polymerase). PARP inhibitors are a type of cancer drug that blocks the PARP enzyme from helping to repair DNA damage in cancer cells.
Though the two main histological types of breast cancer — lobular and ductal — are treated with the same hormonal therapies, women with lobular breast cancer often have recurrence or metastasis of the disease several years after their initial treatment.
When you ask a classroom full of middle schoolers what they want to be when they grow up, you’re likely to get a range of answers, from “pro athletes” and “astronauts” to “musicians” and “movie stars.”
The early days of the COVID-19 pandemic were an adjustment period for medical professionals across the board, but they brought up particular challenges for the Cancer Clinical Trial Office (CCTO) at the University of Colorado Cancer Center. A number of procedures that used to take place in person or in the office — collecting signatures from patients and doctors, delivering medications, submitting data to trial sponsors — suddenly had to be done in a whole new way.
It’s difficult enough when a loved one is diagnosed with cancer, but employed spouses of those who receive the diagnosis also are confronted with an array of practical problems. It’s now up to them to untangle issues around medical leave, health insurance, caregiving benefits, and more.
Dmitri Simberg, PhD, an associate professor in the Department of Pharmaceutical Sciences in the Skaggs School of Pharmacy and a CU Cancer Center member, has released the results of a new study of the effectiveness of different types of fluorescent labels used to monitor the accumulation of liposomes in tumors.
Nearly 30 researchers and physicians from the University of Colorado Cancer Center shared the results of their work at a June 15 online event titled “Collaborating to Conquer Cancer: A virtual conversation benefiting the CU Cancer Center.”
All cells use the process of metabolism to turn nutrients into energy — including cancer cells. Metabolism is a fundamental function whose role in cancer is being explored by researchers across the CU Cancer Center.
A pilot study of childhood leukemia patients living near Colorado’s oil and gas drilling sites recently led to an American Cancer Society (ACS) grant award for CU Cancer Center member Lisa McKenzie PhD, MPH.
Research and treatment of head and neck cancers at the University of Colorado Cancer Center reached a new level this month with a highly competitive Specialized Programs of Research Excellence (SPORE) grant from the National Cancer Institute (NCI). The SPORE was approved by NCI Scientific Program leadership for FY2021 funding; the projected starting date is July 1
Looking for better ways to treat patients with esophageal cancer, University of Colorado Cancer Center member Martin McCarter, MD, is investigating whether a new treatment sequence will result in better outcomes.
Long before RNA and mRNA became important parts of the COVID-19 vaccine conversation, researchers at the University of Colorado School of Medicine were studying how RNA biology can improve diagnostics and therapeutics for a range of diseases.
May is National Cancer Research Month, during this time we aim to raise awareness of the high-quality, innovative cancer research happening at the University of Colorado Cancer Center. This research continues to help the more than 16.9 million people in the United States who are living with, through, and beyond their cancer diagnoses.
When Manali Kamdar, MD, joined the University of Colorado School of Medicine’s Division of Hematology as clinical director of lymphoma services in January 2015, she was fresh off her third fellowship (a bone marrow transplant and lymphoma fellowship at Stanford) and ready for a new challenge.
Not all cancerous tumors are created equal. Some tumors, known as “hot” tumors, show signs of inflammation, which means they are infiltrated with T cells working to fight the cancer. Those tumors are easier to treat, as immunotherapy drugs can then amp up the immune response.
Over the past few years, Camille Stewart, MD, assistant professor of surgery in the Division of Surgical Oncology, has conducted research for the Society of Surgical Oncology (SSO) to examine unconscious bias within the organization. In her studies, Stewart examines unconscious bias and microaggressions by focusing on the subtle differences in introductions of speakers at professional meetings and conferences.
Although rare, kidney cancer is the third most common type of solid tumor affecting children. Thankfully, pediatric kidney tumors are generally treatable and most have high cure rates. Treatment outcomes depend on several factors including age, tumor type, staging, genetics, the overall health of the patient, and the risk of treatment side effects.
A new phase 3 randomized clinical trial overseen by CU Cancer Center member Chad Rusthoven, MD, and Vinai Gondi, MD, from Northwestern University, is testing whether a new treatment approach could result in improved outcomes for patients with small cell lung cancer (SCLC) that has spread to the brain.
A team of University of Colorado School of Medicine researchers recently published a paper offering new insight into the role that oxygen deprivation, or hypoxia, plays in cancer development. CU Cancer Center member Joaquin Espinosa, PhD, is the senior researcher on the paper, which he hopes will help lead to more targeted treatments for cancer.
Though breast cancer patients are now living longer than ever before, treatments for the disease can have wide-ranging effects on their long-term quality of life. Physical, social, and sexual wellbeing all can be impacted by radiation, chemotherapy, surgery, antiendocrine therapy and other challenges that go along with a breast cancer battle.
Three University of Colorado Cancer Center researchers are part of a team that recently published a paper offering new insight into how the immune system relates to cancer. Quentin Vicens, PhD, Jeffrey Kieft, PhD, and Beat Vögeli, PhD, are authors on the paper, which looks at how an enzyme called ADAR1 operates in pathways associated with cancer.
Three projects from University of Colorado Cancer Center researchers have received grants from the Denver-based Michele Plachy-Rubin Fund for Pilot Grants in Brain Cancer Research. Receiving $40,000 each to fund their work around brain cancer are Sujatha Venkataraman, PhD; and the teams of Philip Reigan, PhD, and Michael Graner, PhD; and Natalie Serkova, PhD, and Nicholas Foreman, MD, MBChB.
For more than a year, a working group at the University of Colorado Cancer Center has been studying the many ways the aging process impacts cancer — including incidence, progression, and prognosis of the disease, therapeutic options and outcomes, and the psychosocial aspects of living with cancer.
Breast cancer is harmful enough on its own, but when cancer cells start to metastasize — or spread into the body from their original location — the disease becomes even more fatal and difficult to treat.
New research from CU Cancer Center member Jing Hong Wang, MD, PhD, and recent University of Colorado Immunology program graduate Rachel Woolaver, PhD, may help researchers develop more effective personalized immunotherapy for cancer patients.
The global pandemic of 2020 has been a pivotal year for the health care industry. This year lead some CU Cancer Center members to shift their focus to learning more about COVID-19 while others continued their research on cancer. Whether the focus was on COVID-19 or Cancer this year showed how coming together as a community can make a difference.
Craig Jordan, PhD, has spent more than 20 years developing better treatments for acute myeloid leukemia (AML), a rapidly progressing cancer of the blood and bone marrow that can spread to other parts of the body, including the lymph nodes, liver, spleen and central nervous system.
Thanks in large part to early work by investigators at the CU Cancer Center, patients with acute myeloid leukemia (AML) have a new treatment option that has fewer side effects and has been shown to increase longevity.
In the 1860s, French physician Armand Trousseau noticed that patients with a certain form of abnormal blood clotting often went on to be diagnosed with pancreas or gastric cancers. Unfortunately, at age 66 he noticed these same symptoms in himself and died of gastric cancer only a few months later.
Studies have long reported that Black cancer patients have poorer outcomes than their white counterparts. But two University of Colorado Cancer Center researchers decided to investigate the data further and figure out why. What they found was that the outcome disparity was caused not by biology, but simply by differences in access to health care.
After nearly four years of work, a group of researchers and clinicians from the University of Colorado (CU) published a paper this week in the Clinical Cancer Research that shares findings from research looking at how the composition of ovarian cancer tumors changes during chemotherapy and contributes to therapeutic response.
Last month the American Cancer Society (ACS) released updated guidelines for cervical cancer screening. The most notable change in guidelines is the changes in the age to begin screening. Per the new guidelines, it is recommended that cervical cancer screening begin at age 25. Previously, the starting age for screening was 21.
A key component in treating newly diagnosed leukemia is genetic and molecular testing. With this knowledge, physicians can better determine which treatment options are best suited for patients based on genetic mutations, fusions and other biologic features.
Black and Hispanic children diagnosed with brain and central nervous system (CNS) cancers have worse outcomes than their white counterparts in the United States. The reasons behind this are unclear but may include socioeconomic factors and/or limited access to quality care. Now, researchers at the University of Colorado (CU) Cancer Center and Children’s Hospital Colorado on the Anschutz Medical Campus are collaborating to better understand these disparities, as well as develop ways to reduce the burden of disease in these populations.
University of Colorado Cancer Center member and associate professor of Pathology Paul Jedlicka, MD, PhD, has received the St. Baldrick’s Research Grant with generous support from Marlee’s Smile. His research will focus on better understanding the mechanisms behind rhabdomyosarcoma, a common and aggressive cancer type in children. The goal of the research is to identify new approaches to interfering with disease progression.
Cecilia Caino, PhD, has been researching cancer cell biology at University of Colorado Cancer Center since 2017. Cecilia earned her PhD in Cellular Biology from the University of Buenos Aires with her research component performed at the University of Pennsylvania, and completed a postdoctoral fellowship at The Wistar Institute. We spoke with Dr. Caino about her research on how cancer cells use energy and how their unique energy strategies could help cancer cells spread.
January 2020 was unseasonably warm and dry, so pleasant that students on the Anschutz Medical Campus ate lunch at picnic tables and scientists emerged confused and squinting from hibernation in the campus research buildings. One person who was not there was Deguang Kong, visiting graduate student in the lab of Heide Ford, PhD, University of Colorado (CU) Cancer Center Associate Director for Basic Research. With his PhD work wrapping up, Deguang had taken a quick leave to interview for jobs near his home…in Wuhan, China.
Many patients diagnosed with COVID-19 have symptoms such as a persistent dry cough, shortness of breath, and in some cases, incredibly low oxygen levels in their blood. Additionally, many patients report having long-lasting side effects, for example decreased lung capacity, even after they recover from the virus.
Nearly two thousand people living in Colorado will be diagnosed with head and neck cancer (HNC) in 2020. Generally, a very aggressive disease, head and neck cancer require expert care that is not widely available in community cancer clinics. However, patients that are not well-represented in clinical studies, especially Hispanic patients, are less likely to get care from centers that specialize in the disease, such as the University of Colorado Cancer Center.
Lung cancer is the deadliest cancer in the United States. In Colorado more than 2,500 people will be diagnosed with the disease and more than 1,400 will die of it in 2020. While advances in lung cancer treatment have gifted many patients with more time, the benefit of these treatments is limited by the racial and socioeconomic status of some patients in Colorado. A new study at the University of Colorado Cancer Center focuses on reducing disparities in lung cancer patients with diverse backgrounds.
While many cancer types have added new treatments including genetically targeted drugs and immunotherapies, treatment for the rare types of cancer known as sarcomas have remained largely the same for about two decades. Now, two grants to University of Colorado Cancer Center researchers from the Sarcoma Foundation of America hope to change this.
University of Colorado radiation oncologist Chad Rusthoven, MD, was recently awarded the prestigious Dr. Charles A. Coltman Jr. research fellowship award from the Hope Foundation for Cancer Research. The award provides two years of salary support to engage early career investigators from Southwest Oncology Group (SWOG) affiliated institutions in clinical trial research.
When a blood cancer patient needs a bone marrow transplant, there are four common donor sources: A matched related donor (sibling), a matched unrelated donor (from a donor database), a half-matched donor, or umbilical cord blood. Of course, there are plusses and minuses to each approach, but consensus has generally ranked a matched sibling first, followed by a matched unrelated donor, with cord blood and half-matched donors reserved for patients without either of the first two options. Now a University of Colorado Cancer Center study based on a decade of research and treatment may reshuffle this list. In fact, the comparison of 190 patients receiving cord-blood transplants with 123 patients receiving transplants from the “gold standard” of matched sibling donors showed no difference in survival outcomes between these two approaches, with significantly fewer complications due to chronic graft-versus-host disease in patients receiving transplants from cord blood.
Results of the phase III Inter-B-NHL-ritux 2010 clinical trial reported today in the New England Journal of Medicine show 95 percent three-year survival for pediatric patients with advanced B-cell non-Hodgkin lymphoma treated with the addition of anti-cancer immunotherapy rituximab to standard chemotherapy. The trial represents a major international collaboration between the European Intergroup for Childhood Non-Hodgkin Lymphoma (EICNHL) and the Children’s Oncology Group (COG), and was led in the United States by Thomas Gross, MD, PhD, University of Colorado Cancer Center investigator and pediatric oncologist at Children’s Hospital Colorado, and in Europe by Véronique Minard-Colin, MD and Catherine Patte, MD, both pediatric oncologists at the Gustave Roussy Department of Child and Adolescent Oncology in Paris, France. The addition of rituximab decreased treatment failures by 70 percent resulting in a 10 percent increase in the three-year survival rate seen with chemotherapy alone (LMB protocol).
In mid-March, the University of Colorado Cancer Center Cell Technologies Shared Resource shut down along with almost all the other labs and technologies on the Anschutz Medical Campus. Then shared resource director, Steve Anderson, PhD, got an email from a colleague asking if the facility could make COVID-19 proteins. They could: The shared resource has been making proteins for over 15 years.
In 1844, multiple myeloma was first treated with a rhubarb pill and an infusion of orange peel. Since then, more than 15 drugs have earned FDA approval to treat multiple myeloma and with so many options, a major question has become what cocktail and sequence is best?
You’ve heard of the Human Genome Project. Now the University of Colorado Cancer Center Human Immune Monitoring Shared Resource (HIMSR) is partnering with the Cancer Center Tissue Biobanking and Histology Shared Resource to store COVID-19 samples for individual research efforts and for a major project known as the COVID-ome.
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.
Cells have a big decision: Should they replicate or sleep? Healthy cells can go either way. Cancer cells’ replication switches are stuck in the ‘on’ position. Now a study by University of Colorado Cancer Center researchers working at CU Boulder’s BioFrontiers Institute and published today in the journal Science overturns the conventional wisdom of how these switches work – a model accepted since 1974 and included in current textbooks.
Most ovarian cancer starts in fallopian tubes. Then it sloughs from its site of origin and floats around in fluid until finding new sites of attachment. It’s not easy for cancer cells to survive away from their moorings. Observations by ovarian cancer doctors at University of Colorado Cancer Center and elsewhere hint at how they might do it: These doctors have seen that ovarian cancer cells often collect in tissues with high fat content. Could these cells be somehow using fat to survive the journey from their point of origin to their sites of growth?
Immunotherapies have revolutionized the treatment of many cancers. The most common anti-cancer immunotherapies are called checkpoint inhibitors, which block a handshake between the protein PD-L1 on tumor cells and the protein PD-1 on immune system T cells. Checkpoint inhibitors including pembrolizumab (Keytruda) and nivolumab (Opdivo) block the action of PD-1 and atezolizumab (Tecentriq) blocks the action of PD-L1, but the result is largely the same: When this tumor-to-T-cell handshake can’t take place, the immune system attacks the cancer.
When you think about what defines Colorado’s Front Range, adventure sports including rock climbing are near the top of the list. More and more, biosciences and medical innovation including cancer research are high on the list, too. Now a fun event at the Denver Bouldering Club combines the two. On February 29, the 7th annual Heart & Soul Climbing Competition will raise money and awareness for research at University of Colorado Cancer Center.
“Cancer is something that has affected every member of our staff personally – you could go through the crowd at Heart and Soul and every person would have their own cancer story.
Climbing is a selfish pursuit to some extent, and this is our way to step outside our own bubble and say there’s something else going on in the world,” says John Gass, the gym’s climbing services manager.
The fun event is appropriate for all ages and ability levels, from beginners who can rent climbing shoes at the gym, to pros who will compete for $4,000 in cash prizes in the Open division. Since the inaugural event in 2014, the Heart and Soul Climbing Competition has raised just over $70,000 for cancer research through ticket sales, day-of donations, and online fundraising (if you can’t make it to the event, click to donate!).
“We’ve gotten bigger and better every year,” Gass says. “This year, we’re hoping to push the bar even higher and make it to that $100,000 mark for cancer research. If we can knock it out of the park, we can make it happen!”
CU Cancer Center researcher James Costello, PhD, promises to keep his welcome speech to 5 minutes, tops, before the 7pm finals. And you may even catch a few of his postdocs climbing earlier in the day – if you see folks in blue CU Cancer Center tee shirts, encourage your kids to ask them about their research! Pointing the flow of the climbing/research collaboration in the other direction, Denver Bouldering Club staff recently had the opportunity to tour labs at CU Cancer Center to see their money at work.
“A couple years ago, one of our employees was going through chemo at the same time he was helping with the event. It was really empowering for him and showed us all why we do what we’re doing,” Gass says.
Tickets are $55 until Feb 28 and $65 at the door. Registration includes free food and door prizes donated by event sponsors including Friction Labs, Milestone Homes, Organic Climbing, Groove Toyota Scion, Stone Brewing, Metolius, X-Cult, Escape, Rhino Skin Solutions, Honey Stinger, Brazos Wine Imports, and more.
Really, don’t be shy: “Heart and Soul takes that stress you feel at most climbing comps and replaces it with a community feel where we’re all supporting each other and supporting cancer research,” Gass says.
See you there for this truly only-in-Colorado event!
The lab of CU Cancer Center investigator, Jennifer Richer, PhD, has been hot on the trail of new treatments against triple-negative breast cancer (TNBC), an especially dangerous form of the disease. Recently, the lab has been exploring changes that allow these breast cancer cells to hide from the immune system while traveling through the body to seed new sites of metastasis. This line of research is paying off, showing chains of events that make TNBC especially aggressive. The question has been where these chains can be broken – where are the weak links?
Chemotherapy used to shrink a tumor before surgery, called neoadjuvant chemotherapy, is becoming more common in many cancers, including stage II and III rectal cancer. However, the chemotherapy regimens FOLFOX and CapeOx used in this setting come with significant side effects, to the degree that many patients are unable to complete the recommended schedule. Now a University of Colorado Cancer Center study presented at the 2020 Gastrointestinal Cancers Symposium shows they may not have to: A small study of 48 patients with locally advanced rectal cancer receiving neoadjuvant chemotherapy, found that patients receiving lower-than-recommended doses in fact saw their tumors shrink more than patients receiving the full dose.
As you age, your cancer risk increases. It seems so obvious! And maybe because it seems so obvious, the connection between aging and cancer has received surprisingly little research attention. Basically, the story has been the longer you live, the more time you have to accumulate a cancer-causing genetic mutation, and we’ve largely left it at that: The more time, the more risk. But recent research shows that in addition to the “accumulation of mutations over time” theory, cancer requires (or at least benefits from) a host of other aging-associated changes that let these cells with dangerous genetic changes take root and grow. Some of these changes, for example those to the tissue ecosystem and the immune system, may be preventable or even reversible.
These features of age and cancer that go beyond just the idea of risk over time are the topic of a new academic journal, appropriately titled Aging and Cancer, by the publisher Wiley. The founding Editor-in-Chief will be CU Cancer Center Deputy Director, James DeGregori, PhD, the Courtenay C. and Lucy Patten Davis Endowed Chair in Lung Cancer Research at the CU School of Medicine.
For example, DeGregori points out that the immune system changes dramatically with age, but the vast majority of anti-cancer immunotherapies are tested in young mice. Is it any surprise that many immunotherapies that show promise in (young) mouse models fail to show clinical benefit in (primarily older) patients? Or, for another example among many, additional attention at the intersection of aging and cancer could help to better define how frailty indexes influence cancer treatments offered to older patients, a topic being studied at CU by researchers including Drs. Dan Sherbenou, Tomer Marks, and Elizabeth Kessler.
“It’s the elephant in the room if the elephant was wearing camouflage,” DeGregori says, “as if it’s been hiding in plain sight all this time: These aging-associated physiological changes matter.”
Academic journals help to define fields of study, providing a forum for researchers from many disciplines to display and discuss findings that come at a topic from many angles.
“When you create a new forum that highlights an area of study, it stimulates the research – it creates a community, and it helps catalyze interactions with a community. Despite the fact that it should be slapping us in the face, until now it’s mostly been individual researchers here and there,” DeGregori says. “I would say this new journal will help coalesce a field.”
The journal, which is accepting submission for the inaugural issue publishing this spring, will include research papers, brief reports, opinions, commentaries, and reviews.
“This is a multidisciplinary journal,” DeGregori says. “We want to be a forum for research that looks at these connections, from basic research through clinical studies. If it’s really good solid science and it’s relevant to our focus and making an advance, we would be the forum for it.”
Interestingly, cancer research as a whole originally defined cancer by where it lives in the body – think lung cancer or breast cancer. Then the focus turned inside-out to examine the genetics driving cancers. Now cancer research is again broadening its focus to include study of the tissues where cancer grows – the “microenvironment” that acts for or against the disease. And what this research shows is that while mutation may create the potential for cancer, it’s largely the microenvironment that decides whether or not it grows.
“If a doctor has a patient and they want to know if a patient has a high risk of getting cancer, the first thing you should ask is their age. Instead, we tend to focus on things we can do something about – you can not smoke, you can maintain your weight and exercise, and by doing these things, you can reduce your risk of cancer. But you can’t stop yourself from getting old,” DeGregori says. “However, if we understand what factors associated with getting older increase the chance of getting cancer, maybe we could develop interventions to counteract this aging-associated risk.”
Cancers used to be defined by where they grow in the body – lung cancer, skin cancer, brain cancer, etc. But work in recent decades has shown that cancers sharing specific genetic changes may have more in common than cancers that happen to grow in an area of the body. For example, lung cancers, skin cancers, and brain cancers may all be caused by mutation in a gene called BRAF. And drugs targeting BRAF have changed the treatment landscape for melanoma, an aggressive form of skin cancer, and are also in use against lung cancers and brain cancers with BRAF mutations.
A massive research effort over more than a quarter century has tried to make personalized blood stem cells for use in treating leukemias, among many other uses. One way researchers have gone about this is to sample a patient’s adult cells and then “deprogram” them to create induced pluripotent stem cells (iPSCs), which are capable of forming any of the body’s cell types, including blood cells. Unfortunately, these iPSCs also have the potential to become cancer. So researchers have largely refocused their efforts on making hematopoietic stem cells (HSCs), which can’t make any cell type, but can produce many types of blood cells. The good news is that HSCs don’t seem to cause cancer like iPCs. The bad news is that researchers have been unable to create HSCs that can take hold and grow in the body.
BACKGROUND AND OBJECTIVES: To examine, among pediatricians and family physicians (FPs) (1) human papillomavirus (HPV) vaccine delivery practices, (2) delivery experiences, and (3) attitudes regarding new 2-dose HPV vaccination schedules.
Phase III clinical trial results reported today in the New England Journal of Medicine and presented concurrently at the San Antonio Breast Cancer Symposium (SABCS) 2019 show the combination of the investigational drug tucatinib with standard of care treatment including the drugs trastuzumab and capecitabine nearly tripled one-year progression-free survival (33 percent vs. 12 percent), and nearly doubled the two-year overall survivor (45 percent vs. 27 percent) in women with HER2+ metastatic breast cancer. The international, multi-center trial, named HER2CLIMB (NCT02614794), builds on early development and clinical trials involving the University of Colorado Cancer Center.
Biomedical research can generate big data and it takes big brains running big computers to make any sense of it. For University of Colorado Cancer Center investigators, the solution has been to enlist the bioinformatics expertise provided through the Biostatistics and Bioinformatics Shared Resource (BBSR). Led by Director James Costello, PhD, and Manager/Data Analyst Andrew Goodspeed, PhD, the team of five experts at the BBSR shakes and sifts numbers until meaning emerges. But despite BBSR expertise in data analysis, the researchers generating the data in the first place are often in the best position to define “meaning,” and sending data away for analysis can leave these experts one step removed from their own work. Also, there is only so much shaking and sifting the BBSR can do, leading to a bottleneck in the workflow of research: Data is being generated across the Anschutz Medical Campus faster than investigators can make sense of it.
When prostate cancer spreads, it most often spreads to bone. And while the 5-year survival rate for prostate cancer that has not spread is nearly 100 percent, once the disease reaches bone, the 5-year survival rate is only 29 percent. Now a University of Colorado Cancer Center study published in the Journal for Immunotherapy of Cancer suggests a new approach, or, possibly two new approaches against these bone metastases: While targeted therapies and anti-cancer immunotherapies have not been especially successful against primary prostate cancers, the study suggests that both these approaches may be effective against the bone metastases that grow from primary prostate cancers, and, in fact, the type of bone metastasis may dictate which targeted therapies and immunotherapies work best.
When you think of melanoma, you picture the sun. But there is another class of these dangerous cancers that has nothing to do with sun exposure. Mucosal melanomas arise seemingly spontaneously from mucosal tissues, accounting for about 1.3 percent of all melanomas. In part because most of these tissues are hidden, mucosal melanomas tend to be diagnosed late. Late diagnosis combined with lack of response to many newer treatments (especially immunotherapies), leads to a 5-year survival rate for rare melanomas less than half that of the more common form of the disease.
Genetically targeted drugs and immunotherapies are transforming the way we treat many forms of lung cancer. However, a University of Colorado Cancer Center study published in the Journal of the National Cancer Institute shows that while the use of these drugs rose 27 percent from 2007 to 2015, new, high-cost lung cancer drugs are not used equally in all places, with all patients. Patients who lived in high-poverty areas were 4 percent less likely to be treated with high-cost lung cancer drugs. On the other hand, patients treated at National Cancer Institute-designated cancer centers were 10 percent more likely to be given these drugs than were patients treated in other settings.
On Tuesday, November 5, University of Colorado Cancer Center members met to present cutting-edge research taking place in labs and clinics across CU Cancer Center consortium partners, including CU Anschutz, CU Boulder, CSU Flint Animal Cancer Center, the UCHealth system, Children’s Hospital Colorado, Denver Health, and the Denver V.A. Medical System. “As Director of CU Cancer Center, I have come to realize and experience the energy and collegiality of our cancer center, the vast amount of hard work and progress we’ve made over the past years,” said Richard Schulick, MD, MBA, CU Cancer Center Director, opening the event.
First to speak was Colorado Lieutenant Governor, Dianne Primavera.
“If you had told me 31 years ago in September that I would be standing here as Lieutenant Governor, I would have said that was cruel,” Primavera said. That’s because 31 years ago, Primavera was diagnosed with breast cancer and given five years to live. “I lost my job, my health insurance, my marriage crumbled under the pressure. How was I going to put food on the table and keep a roof over my daughters’ heads? And they had to cope with the fact their mother was dying.” Her search for a medical oncologist would treat her with hope instead of resignation brought her to Dr. William Robinson at CU Cancer Center.
“He said, ‘Oh hell, Diane, you’re healthier than 95 percent of the doctors in this hospital. Come with me and we’ll make you well — and he did,” Primavera says, mentioning that because on the day of the retreat she was technically acting governor, she would like to make a state mandate that Dr. Robinson can’t retire.
First on the scientific program was Craig Jordan, PhD, Nancy Carroll Allen Chair and Chief of the CU School of Medicine Division of Hematology. Basically, Dr. Jordan described an Achille’s heel of cancer stem cells, the cells that commonly survive chemotherapy and other treatments to restart many forms of the disease. This Achille’s heel is the dependence of cancer stem cells on a special form of energy. Most cells burn glucose; cancer stem cells burn amino acids. Now, based on these findings, doctors are using the drug venetoclax to block the uptake of amino acids by cancer stem cells, leading to a 91 percent response rate in patients with acute myeloid leukemia, a form of cancer that previously had a dismal prognosis. Additional clinical trials are testing combinations of venetoclax with other chemotherapies and targeted therapies in other cancer populations.
“It’s providing significant clinical benefit for patients with a horrible disease,” Jordan said.
Next, Diana Cittely, PhD, CU Cancer Center investigator and assistant professor in CU School of Medicine Department of Pathology described the role of estrogen in promoting brain metastasis in estrogen-negative breast cancers.
The problem is that breast cancers that don’t depend on estrogen, and especially those known as triple-negative breast cancers (that also don’t depend on HER2 or progesterone), are difficult to treat and especially likely to metastasize to the brain. What drives this dangerous behavior? Cittelly’s work shows that while estrogen doesn’t directly affect triple-negative breast cancer cells, it can affect surrounding brain cells in ways that promote cancer cell migration and invasiveness. Importantly, she suggests ways to stop the activity of estrogen in the brain that fertilizes triple-negative breast cancer metastasis.
“The cancer cells aren’t responsive to estrogen, but estrogen influences the microenvironment. We found that astrocytes – one of the main components of the microenvironment in the brain – are estrogen-responsive. When they are stimulated with estrogen, they produce chemokines, growth factors, and other things that promote brain metastasis,” Cittelly said. Specifically, she suggests that estrogen may magnify the effect on other known cancer-promoting pathways, including EGFR and TrkB.
After a coffee break, York Miller, MD, described the best time to treat lung cancer: Before it fully forms. The period of pulmonary “premalignancy” is a bit like the more well-known period in which a colon polyp has not yet become cancer. Left to their own devices, these precancerous conditions often progress into cancer; Miller described the development of interventions to prevent this progression.
“As a pulmonary doctor, I’m interested in prevention and early detection of lung cancer,” Miller said. Specifically, he described deficiencies in normal processes of lung tissue repair that lead to an environment in which premalignant cells can grow (as in tissues affected by smoking or COPD).
“By keeping track of people over time, we have been able to see the progression from premalignant conditions to lung cancer,” Miller said, showing slides of patient lung tissue taken over decades, showing this progression. The progression often starts with a condition known as squamous dysplasia, frequently resulting from smoking. Treatments like iloprost cna improve dysplasia and reduce lung cancer risk. Miller’s current work is focused on immunotherapies to reverse squamous dysplasia and achieve similar cancer-prevention effects.
Then Sunnie Kim, MD, assistant professor at CU School of Medicine and gastroenterologist at UCHealth University of Colorado Hospital (who arrived from the NIH only three months ago and so instead of a faculty photo is illustrated here with her Twitter profile image), spoke about her work with DNA damage and repair in cancers of the esophagus. Basically, the body seeks to repair DNA damage or kill cells with this damage, while cancer cells depend on DNA damage to create the differences that make them cancerous. This means that many cancers break these DNA repair pathways, often through the action of a gene called PARP.
“We’ve been thinking about adding DNA damaging agent with a checkpoint inhibitor — or the thought is doing a little lead-in with a DNA damaging agent to cause immune presentation, followed by a checkpoint inhibitor,” Kim says. Based on these ideas, Kim is running a clinical trial combining the PARP inhibitor, naraparib, with anti-PD-1 immunotherapy against esophageal cancer.
Sabrina Spencer, PhD, assistant professor in the CU Boulder Department of Chemistry and Biochemistry, followed with a presentation describing how melanoma cells escape therapy long enough to develop the genetic changes that let them further resist therapy.
“If all the cells are initially drug sensitive, how do these cells survive the drug long enough to develop resistance mutations?” she asked.
To answer this questions, Spencer watched individual melanoma cells that depend on the gene BRAF evade anti-BRAF therapy. What she found is that even within three days of treatment, melanoma cells find a way to activate a survival pathway known as MEK – not with mutations, but with a more flexible and temporary way to allow these cancer cells to continue survival signaling. In fact, the FDA recently approved combination treatment in BRAF+ melanoma, using the drug dabrafenib against BRAF and another drug, trametinib, against MEK to delay this escape. Still, Spencer shows that 3 percent of BRAF+ melanoma cells continue to survive this combination treatment, and the question remained how? Spencer’s recent work with single cell RNA sequencing identified suspicious activation of 34 genes in these “escapee” cells that may drive their escape, half of which are targeted by the single gene ATF4 and 7 of which predict poor patient prognosis (making ATF4 or other genes in the ATF4 pathway possible targets to further reduce the escape of BRAF+ melanoma cells).
During lunch, attendees voted for grad student, postdoc and early-career scientist posters, including those describing new treatments for canine bladder cancer, emotional distress in head & neck cancer patients, chronic pain in young cancer survivors, autophagy inhibition in brain tumors, the role of macrophages in creating resistance to targeted treatments, and the role of ancient viruses in shaping the body’s response to cancer.
After lunch, Traci Lyons, PhD, spoke about factors that increase breast cancer risk in women undergoing postpartum mammary gland involution, the process by which the lactating mammary gland returns to its pre-pregnant state. Her previous work has implicated the molecule SEMA7A in the recurrence and metastasis of breast cancers across age and subtype. Now Lyons’ work shows that SEMA7A may drive cancer through suppressing immune system action against tumors. Findings may influence the design of drugs targeting SEMA7A directly, or clinical trials attempting to resensitize the immune system against breast cancers expressing SEMA7A.
Breelyn Wilky, MD, described a push to personalize the use of anti-cancer immunotherapies in the treatment of sarcoma. Basically, despite the fact that the genetics of sarcomas vary considerably, a one-size-fits-all approach to immunotherapy has been used to treat them. Wilky’s work suggests that subtypes of sarcoma may respond better when immunotherapy is combined with other targeted therapies, for example perhaps those against DGFRα/KIT, β-Catenin/APC/NOTCH, IDH-1/2 mutations, MDM2 amplifications, EZH2/INI1 expression loss, ALK fusion, or ASPSCR1-TFE3 fusion.
The retreat’s final scientific speaker was Evelinn Borrayo, PhD, CU Cancer Center Associate Director for Community Outreach and Engagement, who spoke about interventions to improve mental health outcomes among lung cancer and head & neck cancer survivors and caregivers. Interestingly, it is specifically because patients with these cancers are surviving longer that researchers are starting to turn their attention to issues of survivorship and quality of life. During November’s Family Caregiver Awareness Month, it seemed especially fitting that the CU Cancer Center retreat’s final scientific speaker included the experience of caregivers in her presentation.
Radiation is one of our best weapons against cancer. However, after radiation treatments, cancer often returns. Now an 2-year, $2 million National Cancer Institute (NCI) award to Boulder-based startup SuviCa, Inc. co-founded by CU Boulder and CU Cancer Center investigator, Tin Tin Su, PhD, hopes to find drugs that augment the effect of radiation to keep cancer at bay.
University of Colorado Cancer Center member, Tejas Patil, MD, received the John Fisher Legacy Fellowship Award at the International Association for the Study of Lung Cancer (IASLC) World Conference held in Barcelona last month. Patil is the first physician worldwide to receive the prestigious $50,000 grant, which Patil will use to further his research in detecting lung cancer recurrence in early stages.
With improved treatments, especially the use of anti-cancer immunotherapies, more than two-thirds of all patients diagnosed with diffuse large B-cell lymphoma (DLBCL) will survive. However, after treatment, patients are at a small but real risk of developing a new cancer, called a second primary cancer. Now a Colorado study of long term DLBCL survivors shows, for the first time, that the stage at which DLBCL is originally diagnosed impacts the types of second cancers that may form after treatment.
Since its start in 1969, the Cancer League of Colorado (CLC) has raised over $16 Million dollars for cancer research and patient care in the state of Colorado. Not bad for an entirely volunteer-run organization! Maybe you’ve seen the organization’s Hope Ball, or the Race for Research, or, this year, the first annual Youth Creates Gala, which was held in the Englewood High School auditorium on August 10? Or maybe in early September, you were walking by the Convention Center, looked up at the roof of the Hyatt Regency Denver, and thought to yourself, “Hey, there’s Dinger the Dinosaur falling from the sky!” In fact, Dinger wasn’t falling from the sky – the Rockies mascot along with 192 other intrepid and compassionate souls were rappelling 39 stories from the Hyatt roof in what is certainly Cancer League of Colorado’s most death-defying event, Over the Edge 2019.
Among them was University of Colorado Cancer Center Deputy Director, the Courtenay C. and Lucy Patten Davis Endowed Chair in Lung Cancer Research, James DeGregori, PhD.
“The CLC has supported MILLIONS of dollars for cancer research in Colorado, including numerous grants to my lab. These grants have allowed us to pursue new directions in cancer research, leading to new discoveries that we believe will make a big impact on our ability to prevent, control, and treat this dreaded disease,” DeGregori says.
In fact, this was Dr. DeGregori’s second consecutive year rappelling to raise funds for cancer research. This year, he was willing to not only put his neck on the line, but also his pocketbook, agreeing to rappel even before he had secured the minimum $1,500 in donations (he would be responsible for any shortfall). Fortunately, the CU Cancer Center community came to his rescue, and Dr. DeGregori has now officially raised $1,830 for the event. And the good news is that there’s still time to get involved! Cancer League of Colorado is accepting donations to any rappeler, including DeGregori, until October 31. Longtime CU Cancer Center supporter, Gary Reece, is currently in the lead, though Mike Zitelli of team Wyoming Whisky, and Tina Lovelace of team Woodhouse Day Spa could conceivably finish strong to overtake Reece in the event’s waning minutes of fundraising).
“I’m absolutely terrified, but I did it anyway. Maybe it helped that I promised to pledge an extra $500 donation if I chickened out,” says DeGregori.
So far, the even has raised $332,642 and hopes to top $360,000 when all is said and done at the end of the month. These funds go directly toward research grants, service grants, and investigator initiated clinical trials. In the past, Cancer League of Colorado has directly funded trials including immunotherapy for relapsed women’s cancers, precisely targeted radiation therapy for pancreatic cancer, and even an innovative study exploring whether grape seed extract could slow the growth of watch-and-wait prostate cancer. Research grants have included (among many others), explorations of the intersection between obesity and cancer, a study defining the molecular damage of tanning beds, and a project looking at single cells within tumors to see how many different kinds of “cancer” are within any given cancer.
In other words, CLC funds go directly to projects that improve treatments for patients in Colorado and beyond. Many of these projects would never happen without CLC support.
So join us in donating in these last few weeks of fundraising to Dr. DeGregori or any of the other brave folks who participated in this year’s event. We may not realistically be able to help Dr. DeGregori top the leaderboard, but we can help to ensure that his studies and others at CU Cancer Center continue to make important advances against the disease.
On October 1, the American Cancer Society (ACS) Cancer Action Network (CAN) along with presenting sponsors University of Colorado Cancer Center and UCHealth hosted more than a hundred leaders from business, education, government, and research communities to answer an interesting question: What do a highly successful new treatment against leukemia stem cells, a new way to point the immune system at pediatric cancer cells, and new understanding of how Medicare expansion affects cancer outcomes have in common? The answer: All three are born in Colorado. Due in part to new investments in infrastructure and the recruitment of top talent, combined with a climate of collaboration and innovation, CU Cancer Center researchers are at the forefront of discoveries and initiatives that are driving a golden age of cancer prevention, research, and care.
One of the International Atomic Energy Agency’s (IAEA) missions, in addition to being the world’s central organization for the peaceful use of nuclear technology, is to promote the safe, high quality use of radiation in medicine. Recently, the IAEA hosted a competition that encouraged medical professionals to contribute their good ideas for radiation safety, particularly how to cultivate a strong culture of safety. Guess what? Researchers from University of Colorado Cancer Center Department of Radiation Oncology working at UCHealth University of Colorado Hospital won! Their innovation? Recognizing that safety can be fun.
Miguel and Bonita (Bonnie) Birge first met in high school, when Bonnie’s brother introduced them. The casual start became a lifetime commitment: they celebrated their 20thwedding anniversary in late June. Many others share their Aurora home, including four dogs, four cats and two snakes, which Miguel says are just as companionable and worthy of affection as the furry four-legged friends.
Since the 1940’s, blocking the body’s production of androgen has been the only systemic therapy against prostate cancer. Today, while we’ve gotten better at targeting androgen signaling, treatments targeting the genetic causes of prostate cancer have lagged behind those for other forms of the disease.
The National Cancer Institute (NCI) is set up to fund individual projects in fields like genomics, computational biology, and pathology. Now researchers at University of Colorado Cancer Center are taking advantage of an innovative new program in cancer systems biology to combine the three research areas, earning a prestigious “U01” grant to study the complex genetic drivers of aggressive prostate cancer. By combining the tools of pathology, computational modeling and genomics, the project hopes to discover and test therapeutic interventions for three molecularly distinct types of prostate cancer.
“Prostate cancer is defined by its pathology – you take a biopsy, give it to a pathologist, and they score it, for example they will characterize it as ‘pathological stage 3 disease.’ What we want to do is to understand how genetics contributes to driving aggressive pathology. By understanding what pathways and processes are dysregulated by distinct genetic alterations, we can start to explore therapeutic options to match the genetic alterations,” says James Costello, PhD, CU Cancer Center investigator and assistant professor in the Department of Pharmacology at the CU School of Medicine.
In cancers like melanoma, there tends to be a single genetic driver.
“You have mutations in oncogenes such as BRAF or RAS that drives disease,” says Scott Cramer, PhD, investigator at the CU Cancer Center and professor in the CU School of Medicine Department of Pharmacology. “But in prostate, it’s tricky. Prostate cancer tends to be driven by the loss of tumor-suppressor genes – for example, you lose TP53 and the tumor can grow. In prostate, we find that aggressive disease is often associated with loss of multiple tumor suppressors.”
The field of cancer research is getting better and better at turningoffoncogenes that cause cancer. However, the field is far less adept at therapeutically targeting cancers where good genes are lost.This means that in prostate cancer and other cancers created bylossof tumor suppressors, treatment isn’t as simple as switching these lost genes back on. Instead, this project hopes to discover what else happens in prostate cancers with loss of these tumor suppressor genes – possibly, in this tangled network of cause-and-effect, turningoffa tumor suppressor like TP53 may turnonanother gene that aids cancer growth. And if that’s the case, Costello, Cramer, and colleagues would have a target they could do something about – a target gene they could turn off.
Likewise, “In prostate, you get big deletions in chromosomes – there are multiple genes in there and we need to know which ones are the causal drivers of aggressive disease,” Cramer says.
In other words, deleted along with these known tumor-suppressor genes like TP53, may be the loss of many other genes. Some of these losses are unimportant – only about 1.2 percent of our genome is actually manufactured into proteins. But some losses may be additional drivers of cancer.
To discover these genetic drivers of prostate cancer, Costello and Cramer will turn off various combinations of genes in mouse models of the disease to see which combinations grow into aggressive cancers. Then the team will look inside these models of aggressive cancer to see which genetic pathways are affected.
“We end up with the genetically altered cells that drive the disease, which allows us to ask what is the most likely therapeutic target? Then we can treat mouse models with drugs and see if it’s successful,” Costello says. If these studies are promising the next step may be clinical trials in men with this aggressive form of prostate cancer.
Until recently, the project would have struggled to find funding.
“When you submit a grant, it gets evaluated by a ‘study section,’” says Cramer. “Most study sections are very focused – you submit this project to a pathology study section and they might not get the computational modeling that is used to help make sense of genome-wide measurements to identify therapeutic targets. But if you submit the grant to a computational modeling study section, they don’t get the pathology side and tend to score it poorly. The balance is tricky.”
With only 8 percent of cancer research project grant applications earning funding, even perceived weakness or misinterpretations by a reviewer in the study section can be fatal.
“The National Institutes of Health recognized there were research areas they wanted to fund that weren’t getting funded in standard study sections, so they developed the Cancer Systems Biology Consortium, for which the U01 is one mechanism to foster collaborations like this,” Costello says.
Despite decades of effort, no one set of tools has been able to point to the genes driving prostate cancer. Now with three sets of tools – genomics, computational modeling, and pathology – Cramer, Costello and CU Cancer Center colleagues hope to finally pinpoint the causes of aggressive prostate cancers. Knowing the cause is an important step toward finding a cure.
Healthy cells have a built-in self-destruct mechanism: Strands of DNA called “telomeres” act as protective caps on the ends of your chromosomes. Each time a cell replicates, telomeres get a little shorter. Think of it like filing your nails with an Emory board – after enough filing, you hit your fingertip – ouch! In the case of healthy cells, after enough replications, telomeres are “filed” away, leaving bare ends of the chromosomes exposed. At that point, healthy cells are inactivated or die. The eventual loss of telomeres is a major reason you are not immortal. This cellular mortality is also a major way your body fights cancer.
Cancer League of Colorado has generously pledged $150,000 to inspire others to support innovation in cancer research at the CU Cancer Center. CLC will match $2-to-$1 every gift made to the Investigator-Initiated Trial Program from now through September 30th, tripling donors’ impact and accelerating cancer research and developing new treatments.
Your immune system’s natural killer cells recognize and attack two major kinds of danger – cells infected by viruses and cells affected by cancer. When natural killer (NK) cells see a cancer cell, they kill it (naturally…). And a major research focus has been to define how NK cells do this “seeing.” One way NK cells see cancer is by recognizing bits of mutated DNA displayed on “silver platters” made by human leukocyte antigen (HLA) genes.
Patients aren’t the only ones affected by cancer. Often alongside patients are family caregivers who struggle to keep their own lives on track while supporting their loved one’s treatment and recovery. It’s not easy. For example, a study showed that stress increases a family caregiver’s chance of death by 63 percent over four years. Now a nearly $4M grant from the National Cancer Institute to researchers at University of Colorado Cancer Center seeks to lessen the impacts of stress specifically on cancer caregivers who are also employed. The project hopes to help caregivers manage the demands of their jobs and their lives, while also meeting the day-to-day needs of their loved one with cancer.
The grant leverages the expertise of co-principal investigators Cathy Bradley, PhD, a health economist, and Mark Laudenslager, PhD, a stress researcher.
Dr. Bradley, Deputy Director and the David F. and Margaret Turley Grohne Endowed Chair for Cancer Prevention and Control Research at CU Cancer Center, focuses her research on defining the associations between health insurance and employment on cancer outcomes, while identifying socioeconomic disparities in the delivery of and response to care. Dr. Laudenslager, is a professor in the CU School of Medicine Department of Psychiatry, and director of the Behavioral Immunology and Endocrinology Laboratory. His works focuses on the physiological impacts of stress such as increased inflammation and shortening of telomeres, the protective caps on chromosomes that shorten with stress and aging.
The current study will test the ability of an intervention that was proven effective in reducing stress in cancer caregivers when delivered face-to-face, now transformed by Laudenslager and former fellow, Dr. Nicole Amoyal-Pensak, for delivery via a website (Pep-Pal) at the caregiver’s discretion.
“Mark has developed effective interventions to reduce stress in caregivers. My research is on employment outcomes of people with cancer. We intersect at the point of employed caregivers,” Bradley says.
Pep-Pal will be delivered via a mobile application and/or website including eight 20-minute sessions: (1) Introduction to Stress Management, (2) Stress and the Mind-Body Connection, (3) How Our Thoughts Can Lead to Stress, (4) Coping With Stress, (5) Strategies for Maintaining Energy and Stamina, (6) Coping With Uncertainty, (7) Managing Relationships, and (8) Getting the Support You Need. In addition, the website includes short (3-minute) videos demonstrating an activity or exercise to decrease stress, focusing on relaxation and mood.
“The caregiver actually gets to select between face-to-face meetings with a social worker, video chat with the social worker, or using Pep-Pal at their discretion. The idea is to maximize caregiver convenience and hopefully keep them more engaged during the three-month program,” Laudenslager says.
The study follows caregivers for one year, starting when the caregiver’s patient begins “adjuvant” therapy (used after primary treatment to keep cancer from returning).
“The grant will allow us to look at whether less stress correlates with improved health and employment outcomes for the caregivers – and perhaps result in improved outcomes for patients,” Bradley says.
If the intervention proves effective in employed caregivers, the team hopes the program could provide a model for reducing caregiver stress, and perhaps be useful with health conditions beyond cancer.
Patients aren’t the only ones affected by cancer. Often alongside patients are family caregivers who struggle to keep their own lives on track while supporting their loved one’s treatment and recovery. It’s not easy. For example, a studyshowed that stress increases a family caregiver’s chance of death by 63 percent over four years. Now a nearly $4M grant from the National Cancer Institute to researchers at University of Colorado Cancer Center seeks to lessen the impacts of stress specifically on cancer caregivers who are also employed. The project hopes to help caregivers manage the demands of their jobs and their lives, while also meeting the day-to-day needs of their loved one with cancer.
The University of Colorado Cancer Center Cancer Research Summer Fellowship (CRSF) program provides the opportunity for about 40 undergraduate students to learn the basics of cancer research over the course of 10 weeks working in the laboratories of scientific mentors. In addition, the program helps participants explore the range of careers related to cancer science. One of these activities aimed at opening students’ eyes to career possibilities is the Explore Biotech Fieldtrip. This July, students visited the Biosciences 2 building, just north of the Anschutz Medical Campus, to see biotech in action.
“The biosciences buildings are incubators for startups, many of which are built around technologies that investigators discovered or developed here at CU. Because of my experience working in Tech Transfer with CU Innovations, I had an appreciation for how ideas become companies, and how innovations within companies get brought into public use,” says Education Manager, Jill Penafiel, who pioneered the Explore Biotech Fieldtrip in 2011.
The first stop was theCU Center for Surgical Innovation, where students observed third-year neurosurgery residents exploring new surgical techniques while operating on cadaver heads. In fact, one of the residents operating that day was a past participant of the CRSF program in 2012.
“It was really neat to see Dr. Timothy Ung in the surgical center!” Penafiel says. “Here was someone who was in the program many years ago as an undergraduate, now showing our current students one of the career paths open to them.”
Next, the group visited theGates Biomanufacturing Facilitywhere students learned about the manufacturing of cell lines, cell-based therapeutics, and biologic proteins used in basic science and clinical trials.
“Each area that we went today was amazing. It is great to see other facets of science/health care and to be reminded why I am excited for the future of medicine,” wrote one student about the experience. Another commented, “I earned a great deal, and it was definitely motivating to see so many cool applications of science.”
Then it was on to Touch of Life Technologies (ToLTech), the startup built around the innovative project by Vic Spitzer, PhD, to “thin slice” a human body to build a high-resolution digital representation of human anatomy.
“Students had the chance to experiment with two virtual reality setups of the visible human – they could remove and look at body parts within this virtual human standing directly in front of them,” Penafiel says. “I put on the VR mask, I walked into the back of the head of the person, and I could see the muscles holding the eyeballs in place. I also looked down through the body and saw the pelvic bones and interior structure. It was incredible!”
On a survey following the fieldtrip, 70 percent of students said they would consider a career in biotech. 100 percent of students asked that the field trip continue to be offered as part of the Summer Fellowship Program in future years. In fact, due to the success of this outreach, Penafiel plans to expand students’ opportunities to interact with area biotech, offering half-day, hands-on experiences as part of the summer 2020 program.
“My hope for an experience like this is to offer the possibility of additional careers for our students that are not only going into medical school. There is so much that can be done!” Penafiel says. “It definitely opened their eyes to the opportunities within biotech.”
Fight Colorectal Cancer (Fight CRC) is excited to announce that the manuscript titled “A summary of the Fight Colorectal Cancer working meeting: exploring risk factors and etiology of sporadic early-age onset colorectal cancer” has been published in the August edition of Gastroenterology. Over 45 experts studying colon and rectal (colorectal) cancer in young adults participated in this effort.
Breast cancer patients and women undergoing cancer-preventive breast surgeries may consider combining these procedures with hysterectomy and/or ovarian removal. However, a University of Colorado Cancer Center study published in Breast Journal argues against this combined approach: Patients undergoing coordinated breast and gynecologic procedures had a significantly longer length of hospital stay, and higher complication, readmission, and reoperation rates compared with patients who underwent single site surgery.
Ashkenazi Jewish women have a 1-in-40 chance of carrying the BRCA mutation and these BRCA-positive women have an 80 percent lifetime risk of developing breast or ovarian cancer. A study by University of Colorado Cancer Center and Shaarei Zedek Medical Center, Israel presented at the European Society of Human Genetics Annual Meeting 2019 shows the importance of healthy women knowing their BRCA status, even when these women choose not to undergo prophylactic mastectomy: Of 63 Ashkenazi Jewish women unaware of their BRCA+ status at the time of breast cancer diagnosis, and 42 women who were aware they were BRCA+ prior to their breast cancer diagnosis (but had decided against surgical prevention), the women who knew their BRCA+ status were diagnosed with earlier stage breast cancer, needed less chemotherapy, less extensive surgery, and had greater overall 5-year survival (98 percent vs. 74 percent).
Jean Mulcahy-Levy, MD, has spent a decade researching how, why and when cells eat themselves. Healthy cells use this process, called autophagy, to recycle unneeded bits of themselves, often to survive periods of stress. Unfortunately, cancer cells use autophagy as well and for similar reasons – autophagy can help cancer cells survive the stress of drugs designed to kill them.
Some of what we learn through the compassionate treatment of dogs with cancer goes on to help human patients. Now a study by researchers at University of Colorado Cancer Center and Colorado State University Flint Animal Cancer Center returns the favor: We know so many of the genetic changes that cause human cancer – the current study, recently published in the journalMolecular Cancer Therapeutics,sequences 33 canine cancer cell lines to identify “human” genetic changes could be driving these canine cancers, possibly helping veterinary oncologists use more human medicines to cure cancer in dogs.
The growth of some breast cancers is driven by hormones like estrogen and progesterone. Other breast cancers are driven by changes in the gene HER2. Still some cancers are driven by both – and breast cancers whose growth can be controlled by hormonal receptors and HER2 can be especially tricky to treat. A University of Colorado Cancer Center phase 1b study presented at the American Society for Clinical Oncology (ASCO) Annual Meeting 2019 offers an attractive alternative to the chemotherapy that is often used with these patients: the three-drug cocktail of targeted treatments – tucatinib, palbociclib and letrozole – was overall well-tolerated and showed preliminary evidence of promising anti-cancer activity. Results support the continued development of the combination in an ongoing phase 2 clinical trial.
“I see this as a promising chemotherapy-free combination for patients who have been without good options, especially for those whose disease has spread to the brain,” says Elena Shagisultanova, MD, PhD, investigator at CU Cancer Center and the trial’s principal investigator.
Tucatinib is a targeted HER2 inhibitor; palbociclib stops cancer cells from rushing through the cell cycle required for fast proliferation; and the anti-hormonal drug letrozole restricts the ability of cancers to drive growth using estrogens. Previous work has shown that palbociclib and letrozole combine to kill more cancer cells than letrozole alone. And lab work by Shagisultanova and her mentor Virginia Borges, MD, at CU Cancer Center led them to believe that tucatinib should be a potent addition to this combination.
Results of the current trial show that the theory holds up in humans: of 20 patients enrolled on the study since November 2018, 14 remained on study as of 1/4/2019, five of which had been on the study more than 6 months. The goal of the phase 1b study was to explore the safety of this combination, with no patients experiencing side effects that required study withdrawal.
“All these patients have metastatic breast cancer and up to five different treatments before trying this trial. Also, 45 percent have brain metastases. In this population, our results look promising,” Shagisultanova says.
A phase 2 trial further exploring the combination is offered at CU Cancer Center, University of Arizona, Northwestern University, New Mexico Cancer Care Alliance, Stony Brook University, and University of Texas Health Science Center San Antonio.
In the years since Richard Nixon signed the National Cancer Act in 1971, the overall five-year survival rate for patients diagnosed with the disease has risen from about 50 percent to almost 70 percent. Adding the influence of improved cancer prevention (especially the more than 50 percent reduction in smoking since 1964), combined with better screening and better therapies, makes an overall decrease in the cancer death rate of 27 percent just since 1995. Here, for May’s Cancer Research Month, we speak with University of Colorado Cancer Center Founding Director, Paul Bunn, MD, and current CU Cancer Center Director, Richard Schulick, MD, MBA about the innovations that have driven these improvements and the challenges that remain for the future of cancer research and treatment.
When it comes to cancer research the more data, the better. That is the premise behind the Oncology Research Information Exchange Network (ORIEN). The research initiative brings together 19 accomplished cancer centers to accelerate the progress of cancer research and improve clinical care.
The American Association for Cancer Research (AACR)announcedtoday that in partnership with the Lung Cancer Initiative at Johnson & Johnson, it will fund a major grant led by University of Colorado Cancer Center investigators to pinpoint the lung tissue characteristics that allow cancer cells to grow, potentially leading to new strategies to prevent and treat the disease.
Triple-negative breast cancers are more likely than other breast cancer types to metastasize and are especially likely to go the brain in younger women. Researchers have tested various hypotheses to explain this danger. One idea that has gotten little attention is the thought that estrogen might be to blame. After all, triple negative breast cancers lack estrogen receptors (along with progesterone receptors and HER2, thus the name triple negative), and so these cancers can’t possibly be influenced by estrogen. Right?
Inspiring the next generation of cancer scientists is the idea behind the University of Colorado Cancer Center’s annual “Learn About Cancer Day.” One hundred twenty students from five high schools in the Denver metro area participated.
Study after study has shown that for cancer survivors, exercise is good. But what kind of exercise is best? A pilot study by Colorado researchers hints that group exercise and personal training may lead to similar physical gains, but that a specially designed class for cancer survivors incorporating group dynamics-strategies may increase quality of life beyond that of survivors using personal training. The study now results in a $718,000 grant from the American Cancer Society that will dramatically expand the program, including new offerings through University of Colorado Cancer Center at the Anschutz Health and Wellness Center.
Student loans aren’t the only reason young adults end up in debt. One of the largest-ever studies of work-related risks in young adult cancer survivors finds that of 872 survivors, 14.4 percent borrowed more than $10,000 and 1.5 percent said they or their family had filed for bankruptcy as a direct result of illness or treatment. Fifty-eight percent of respondents said that cancer or treatment interfered with physical demands of their job, and 54 percent said that cancer or treatment interfered with their ability to perform mental tasks related to their job.
It is well known that exposure to high-molecular weight polycyclic aromatic hydrocarbons (PAHs) increases cancer risk, leading to regulation of compounds like benzo(a)pyrene (BAP). However, less is known about the health effects of low molecular weight PAHs. Now, a University of Colorado Cancer Center study shows cancer-promoting changes in lung cells as soon as 30 minutes after exposure to low-molecular weight PAHs, adding further evidence that regulators may be underestimating the risk of these compounds commonly found in secondhand cigarette and marijuana smoke, as well as other environmental and occupational exposures.
According to the U.S. Centers for Disease Control, Colorado has thefifth lowestoverall rate of cancer in the United States, behind only District of Columbia, Arizona, New Mexico, and Nevada. And the American Cancer Societyrecently reportedthat the U.S. cancer death rate has dropped 27 percent over 25 years. In Colorado, the decline in the cancer death rate is even steeper: 31 percent reduction over the same period. Does this mean that cancer in Colorado is a concern of the past? Not so fast, says Myles Cockburn, PhD, co-leader of the University of Colorado Cancer Center’s Cancer Prevention and Control Program.
While the overall incidence of colorectal cancer has fallen about 2 percent annually over the previous two decades, the incidence of early-onset colorectal cancer has risen. In adults ages 20-49, the incidence of colorectal cancer rose 1.5 percent annually over this period. For the youngest end of this age range, those aged 20-29, the annual percentage increase in colorectal cancer incidence was 5.2 percent in men and 5.6 percent in women.
A study by researchers at the University of Colorado Cancer Center and Oregon Health & Science University published today in the Journal of the American Medical Association Network shows that breast cancers diagnosed in young women within 10 years of giving birth are more likely to metastasize, and thus more likely to cause death, than breast cancers in young women who gave birth less recently or not at all.
Doctors would like to use all sorts of nanoparticles in the body, for example to construct detailed images of anatomy and disease, and to deliver cancer-fighting drugs deep within tumor tissue. However, millions of years of evolution have equipped the body to identify and reject foreign particles, even nanoparticles. And so one major challenge in the use of nanomedicine has been the immune system’s unfortunate efficiency in responding to what it sees as infection, at best clearing nanoparticles before they can accomplish their goals, and at worst, leading to dangerous immune overreaction that creates side effects and serious risks.
Nearly a decade ago, a lightbulb went on in Christopher Lieu’s head. At the time, Dr. Lieu was in the beginning of his fellowship and the lightbulb was his recognition of a disturbing trend: More and more young people were being diagnosed with colon cancer.
The National Cancer Institute’s steering committees review and prioritize concepts for large phase 2 or phase 3 clinical trials conducted in the National Clinical Trials Network, thus in large part driving the direction of new treatments. University of Colorado Cancer Center’s Associate Director for Clinical Research, Karyn Goodman, MD, MS, the David and Margaret Turley Grohne Chair in Clinical Cancer, was recently appointed co-chair of the NCI Gastrointestinal Cancer Steering Committee (GISC).
Cancer needs energy to drive its out-of-control growth. It gets energy in the form of glucose, in fact consuming so much glucose that one method for imaging cancer simply looks for areas of extreme glucose consumption – where there is consumption, there is cancer. But how does cancer get this glucose? A University of Colorado Cancer Center study published today in the journal Cancer Cell shows that leukemia undercuts the ability of normal cells to consume glucose, thus leaving more glucose available to feed its own growth.
The University of Colorado Cancer Center is always looking for unique approaches to advance cancer science and advanced ways to strengthen our programs. A powerhouse in the field of immunology is now part of the CU Cancer Center leadership team. Eduardo Davila, PhD, co-leader of the Tissue-Host Interaction program, will lead our efforts to understand the role of the immune system in the development and progression of cancer.
If a new anti-cancer drug shows promise in a Petri dish, often the next step is to test the drug’s effect in mice. This system tends to work well with drugs that directly target cancer, but breaks down with immunotherapies. That’s because tumors from human cancer samples can only grow in mice with suppressed immune systems. Immunotherapies activate the immune system against cancer. And in a mouse model in which the immune system has been suppressed, there is no immune system to activate against cancer.
Richard D. Schulick, MD, MBA, a renowned cancer surgeon and accomplished administrative leader, has been named director of the University of Colorado Cancer Center to lead a $100 million investment in the program over the next five years.
For many years, oncologists have known that cancers can secrete complex molecules into the blood and that levels of these molecules can be easily measured. These so-called ‘tumor markers’ are traditionally associated with a single dominant cancer type, for example Prostate Specific Antigen (PSA) linked to prostate cancer, Carcinoembryonic antigen (CEA) to colorectal cancer, CA125 to ovarian cancer, CA19.9 to pancreatic cancer and CA27.29 to breast cancer. However, the real challenge has been to determine a practical use for these markers. They don’t appear to be useful as a means of screening otherwise healthy people for evidence of underlying cancers.
After her brain cancer became resistant to chemotherapy and then to targeted treatments, 26-year-old Lisa Rosendahl’s doctors gave her only a few months to live. Now a paper published January 17 in the journal eLife describes a new drug combination that has stabilized Rosendahl’s disease and increased both the quantity and quality of her life: Adding the anti-malaria drug chloroquine to her treatment stopped an essential process that Rosendahl’s cancer cells had been using to resist therapy, re-sensitizing her cancer to the targeted treatment that had previously stopped working. Along with Rosendahl, two other brain cancer patients were treated with the combination and both showed similar, dramatic improvement.
A University of Colorado Cancer Centerstudypublished ahead of print in the journalBrachytherapyshows that intermediate risk prostate cancer patients experience modest benefit from the addition of external beam radiation therapy (EBRT) to brachytherapy. The study is based on the results of 10,571 patients, of which 3,148 received brachytherapy plus EBRT and 7,423 received brachytherapy alone. Overall survival rates were 91.4 percent versus 90.2 percent at five-year follow up, and 85.7 percent versus 82.9 percent at seven-year follow up.
Within two miles of the University of Colorado Cancer Center are at least seven recreational marijuana dispensaries with names like Pink House, Terrapin Care Station, Sweet Leaf, Lightshade and Starbuds. And the influence of what happens off campus doesn’t stay off campus. Our patients are using marijuana – some recreationally, some to alleviate the symptoms of cancer and cancer treatments, and some with the belief that cannabis and cannabis-based products could improve or cure their disease.
It seems like everybody’s got a story about that “one bad burn” – the time you fell asleep next to the pool and tattooed a white handprint on your lobster-red chest, or forgot to pack the sunscreen while hiking a Colorado 14er. As you know, sunburn increases your chance of developing melanoma and other skin cancers. But what about just one bad burn? And what can you do about it now?
While dietary supplements may be advertised to promote health, a forum at the American Association for Cancer Research (AACR) Annual Meeting 2015 by University of Colorado Cancer Center investigator Tim Byers, MD, MPH, describes research showing that over-the-counter supplements may actually increase cancer risk if taken in excess of the recommended daily amount.
A University of Colorado Cancer study published this week in the journal Carcinogenesis shows that bitter melon juice restricts the ability of pancreatic cancer cells to metabolize glucose, thus cutting the cells’ energy source and eventually killing them.
When the going gets tough, grape seed extract gets going: A University of Colorado Cancer Center study recently published in the journal Cancer Letters shows that the more advanced are colorectal cancer cells, the more GSE inhibits their growth and survival. On the other end of the disease spectrum, GSE leaves healthy cells alone entirely.
A three-drug regimen was shown to lengthen the amount of time before cancer progressed to the central nervous system — known as central nervous system progression-free survival — in certain patients with breast cancer.
Second-line lisocabtagene maraleucel more than quadrupled EFS compared with standard therapy for patients with relapsed or refractory large B-cell lymphoma, according to study results presented at ASH Annual Meeting and Exposition.