Nov. 2, 2015:

November is the national month of awareness for pancreas, stomach, and lung cancers. Within the Big Ten Cancer Research Consortium, member institutions are tackling these cancers through innovative multidisciplinary efforts that leverage the scientific expertise of Big Ten universities.

Innovation in Early Detection

Vadim Backman, PhD, Walter Dill Scott Professor of Biomedical Engineering in the McCormick School of Engineering at Northwestern University believes if there were regular, reliable screening for lung cancer and other cancers, there could be a significant reduction in cancer-related deaths.

The McCormick School of Engineering reports that Backman has developed a new suite of tools for early cancer detection and diagnostics. The new technologies that Backman has developed have one common denominator: they provide information about the structure and function of tissues at the nanoscale level. Catching pre-cancer at this early stage — when small dysfunctions just begin to percolate within the cells — could possibly lead to treatment before the formation of tumors and the aggressive spread of disease.

The Lurie Cancer Center received an $11.7 million grant to improve treatment using nanotechnology through the new Northwestern University Center for Cancer Nanotechnology Excellence.

In a news release, the cancer center reports that “recently, the field of nanotechnology has offered up a multitude of interesting structures, materials and tools that are showing promise in the development of new detection and treatment methodologies. These methods could permit highly efficacious, targeted and personalized solutions for the prediction of prognoses as well as for early diagnosis and treatment of patients struggling with advanced cancers.”

[Pictured are some of the Big Ten cancer investigators highlighted in this story. Top row (l-r): Vadim Backman, Sunitha Nagrath, Tony Hollingsworth; 2nd row: Sheetal M. Kircher, Leonidas C. Platanias, Mary F. Mulcahy; 3rd row: Kalpaj Parekh, Judith Paice, Dustin Deming; bottom row: Chad A. Mirkin, Al B. Benson III, Diane Simeone.]

Collaboration Moves Research Forward

The Pancreatic Cancer Center at the University of Michigan utilizes a multidisciplinary team of scientists and clinicians to revolutionize pancreatic cancer care, particularly with regard to early detection. Sunitha Nagrath, PhD, assistant professor of chemical engineering, recognized the need for early detection of pancreatic cancer. “Once you detect circulating tumor cells, you can tell a lot about the disease, for example, the kind of cancer, its genetic makeup, how it responds to the environment and therapies, how aggressive the cancer is and so on,” Nagrath wrote in an mCancer Talk blog post. “For someone with pancreatic cancer, the only way currently to know these things is through studying a biopsy.”

The team’s “liquid biopsy” device uses microfluidics and nanotechnology to capture circulating tumor cells from blood samples of pancreatic and lung cancer patients. Researchers at University of Michigan are collaborating to make this technology available to a world of cancer patients to whom early detection tools are not currently available.

Diane Simeone, MD, the Lazar J. Greenfield Professor of Surgery and director of the Pancreatic Cancer Research Center, envisions the device as part of a new treatment paradigm. “The Holy Grail is two-fold: a blood test to reliably pick up cells in people at high risk, and molecular imaging to find the source so that the microscopic cancer-in-situ can be treated,” said Simeone. “I believe collaborations like ours that cross schools, colleges, and disciplines hold the key to finding pancreatic cancer’s Holy Grail.”

Read the two-part blog post, Cell hunters: the quest to diagnose pancreatic cancer early:

• Part 1: Diane Simeone, MD
• Part 2: Sunitha Nagrath, PhD

A new study by University of Wisconsin Carbone Cancer Center researchers has found a small subset of pancreatic cancers may be caused by a gene mutation that can be therapeutically targeted, leading to new treatment options for those patients with the mutation.

“My lab is interested in what the mutation profiles are in cancers,” said Dustin Deming, MD, assistant professor of medicine at UWCCC. “Nearly 90 percent of pancreas cancers have a mutation in the KRAS gene, but there is currently no successful drug therapy to target those mutations, making pancreas cancer one of the more difficult cancers to treat. … We are excited that this work might have identified a more treatable subtype of pancreatic cancer that could respond to drugs that are already in clinical development.”

The University of Nebraska Medical Center’s (UNMC) pancreatic cancer SPORE — a model built upon translational collaboration among teams led by basic science and clinical co-leaders — was recently renewed by the National Cancer Institute (NCI) for $11.5 million over the next five years. The UNMC SPORE will feature four new research projects and researchers hope to accumulate the pre-clinical evidence to move these projects closer to clinical trials. A key feature of the UNMC SPORE is the inclusion of three specialized cores — administration, tissue, and biostatistics — that interact with and support the research projects.

A UNMC article notes that while pancreatic cancer is poised to become one of the leading causes of cancer death, Tony Hollingsworth, PhD, Leon Professor of Cancer and professor and director of pancreatic cancer and director of the pancreatic SPORE, predicts a coming momentum shift.

“Thanks to research, we have come up with treatments for other cancers,” he said, “there have been only a few therapies that work for pancreatic cancer; however, we have made huge progress in our understanding of the disease. Now, we need to turn some of these discoveries into ways of improving patient care and survival.”

Along with the pancreatic SPORE, UNMC is home to a rare program — Rapid Autopsy Program (RAP) — for advancing research in pancreatic cancer. The rapid autopsy program provides a unique collection of specimens to be used to further the research of pancreatic cancer. Hundreds of samples have been sent to other SPORES and Centers for DNA, RNA, and protein expression studies; UNMC currently has several ongoing studies utilizing specimens from these autopsies.

Generosity Moves Cancer Research Forward

In cancer research, it is often the kindness of generous donors who keep the momentum going. A year ago, the University of Wisconsin Carbone Cancer Center began a crowdfunding initiative which raised $22,000 for Dr. Emily Winslow’s pancreatic cancer research.

To date, the funds have been used to identify ways to improve treatment plans and outcomes for pancreatic cancer, and Winslow and her colleagues are not done yet!

“So far, we have looked at a diagnostic test for pancreas cancer called endoscopic ultrasound (EUS) and asked what factors influence which people undergo this procedure and then how that affects subsequent testing and the timing of surgery,” Winslow said.

With that question in mind, Winslow and her team, including master’s student and surgical resident Dr. Ryan Schmocker and other UW researchers at the Wisconsin Surgical Outcomes Research program and the Health Innovation Program, analyzed a national patient data set using custom computer programming.

“We found the use of EUS, like many other complex and new technologies, is not dependent on specific patient or tumor factors, but rather is dependent on geography, the type of medical center and the type of doctor a patient sees for the initial visit,” Winslow said. “Further, we have found that use of EUS delays time to surgery and increases the expense of evaluation for the health care system, and other research groups have shown it does not improve survival.” She added the data suggest there may be overuse of EUS in the diagnosis and staging of pancreatic cancer which could allow room for improvements in efficiency of the evaluation of patients.

“The EUS analysis was an important study, but it also provided a proof of principal that our programmers and our research team can efficiently take this large data set and effectively answer questions relative to pancreas cancer,” Winslow said. “We’re now ready to use more recent data sets to identify risk factors for pancreas cancer.”

Tackling Complex Cases Through Multidisciplinary Approach

At the end of 2014, 20-year-old Jamie Miller of Cedar Rapids, Iowa had just gotten a new job, had recently moved into a new apartment, and was looking forward to the future.

A surprising lung cancer diagnosis eventually led her to University of Iowa Hospitals and Clinics. Their multidisciplinary cooperation was just what she needed.

“In my opinion, she has had the best possible outcome,” he says. “The team at Iowa pulled everyone she needed together to get rid of this cancer—intensive care, pulmonology, oncology, anesthesiology, and surgery. It really highlights how we are geared to tackle the more complex cases through a multidisciplinary approach.”

Read the full story in Health at Iowa, published by University of Iowa Health Care.

Education and Community Outreach

Four Lurie Cancer Center members (Sheetal Kircher, MD; Al B. Benson III, MD; Mary Mulcahy, MD; and Judith Paice, PhD, RN) will participate on a panel this month for a stomach cancer education symposium and webinar. The event will be hosted by Debbie’s Dream Foundation and is free for anyone to attend. The event will be an opportunity for patients, families, caregivers, the general public, and health care professionals to hear from leaders in the field of stomach cancer.

On Friday, November 20, the Robert H. Lurie Comprehensive Cancer Center of Northwestern University will host the 18th Annual Oncology Nursing Conference, attracting over 250 oncology nurses from across the region. This year’s conference is focused on Transforming Care through Advocacy, Change and Knowledge. There will be sessions devoted to clinical research and trials, genetic testing, oral oncolytics, and more.

National Occurrence

According to the National Cancer Institute, lung cancer is the second most common cancer and the primary cause of cancer-related death in both men and women in the United States. The overall mortality rate for lung and bronchus cancers rose steadily through the 1980s, peaked in the early 1990s, and has been slowly declining since 2001. Trends in lung cancer incidence and mortality rates have closely mirrored historical patterns of smoking prevalence.

Although smoking is the main cause of lung cancer, lung cancer risk is increased by exposure to secondhand smoke; environmental exposures, such as radon, workplace toxins (e.g., asbestos, arsenic), and air pollution.

Pancreatic cancer, the 12th most common cancer in the United States, is relatively rare; however, it is the fourth leading cause of cancer-related death in both men and women in the United States.

Stomach (gastric) cancer is relatively rare, as the 16th most common cancer in the United States. The overall incidence and mortality of stomach cancer in the United States have both declined in the past 35 years. Incidence rates for stomach cancer fell on average 1.5% each year over the last 10 years. Mortality rates have fallen on average 3.0% each year since 2002. In 2014, it was estimated that over 22,000 Americans would be diagnosed with stomach cancer and nearly 11,000 would die of the disease.

You Can Move Cancer Research Forward

Did you know you can directly support the team efforts of the Big Ten Cancer Research Consortium? Make a gift today!

This story was written by Alecia Burkhardt, communications associate for the Big Ten Cancer Research Consortium, with contributions from the Robert H. Lurie Comprehensive Cancer Center, the UW Carbone Cancer Center, University of Michigan Comprehensive Cancer Center, Holden Comprehensive Cancer Center, and the Fred & Pamela Buffett Cancer Center.

About the Big Ten Cancer Research Consortium: The Big Ten Cancer Research Consortium creates a unique team-research culture to drive science rapidly from ideas to treatment-changing paradigms. Within this innovative environment, today’s research leaders collaborate with and mentor the research leaders of tomorrow with the unified goal of improving the lives of all patients with cancer.

About the Big Ten Conference: The Big Ten Conference is an association of world-class universities whose member institutions share a common mission of research, graduate, professional and undergraduate teaching and public service. Founded in 1896, the Big Ten has sustained a comprehensive set of shared practices and policies that enforce the priority of academics in the lives of students competing in intercollegiate athletics and emphasize the values of integrity, fairness and competitiveness. The broad-based programs of the 14 Big Ten institutions will provide over $200 million in direct financial support to almost 9,500 students for more than 11,000 participation opportunities on 350 teams in 42 different sports. The Big Ten sponsors 28 official conference sports, 14 for men and 14 for women, including the addition of men’s ice hockey and men’s and women’s lacrosse since 2013. For more information, visit www.bigten.org.