UPMC Hillman Cancer Center

June 2012

Each year, The American Society of Clinical Oncology (ASCO) annual meeting reports advances in oncology research. The 2012 meeting was held earlier this month and many University of Pittsburgh Cancer Institute members attended and shared their findings.

The promise of targeted or personalized therapy—striving to match the right therapy with the right patient at the right time—characterized much of our collective work. Here are a few examples of our contributions to this important goal.

John KirkwoodIt was a banner year for our melanoma specialists. John Kirkwood, M.D., presented a talk on the activity of a targeted agent, dabrafenib, against brain metastasis from the subset of advanced melanomas that is characterized by a mutation in the b-raf gene. Ahmad Tarhni, M.D, Ph.D. reported a pilot study of another targeted therapy, ipilumimab, a monoclonal antibody directed against the CTLA-4 molecule, in the preoperative setting of advanced melanoma. The excitement around new systemic therapies for melanoma is infectious indeed. Two medical residents, David Lobur and Diwakar Davar, also had the opportunity to discuss plans for a study to use the natural product, sulforaphane, as a chemopreventive for melanoma survivors.

Similarly, members of our new drug development team, including physician-researchers Shannon Puhalla, Leonard Appleman, Edward Chu, and Jan Beumer provided up to date accounts about early phase trials of the PARP inhibitor, ABT888. Collectively the team has demonstrated the activity and safety of ABT888 as monotherapy in a subset of breast and ovarian cancers. Ahmad Tarhni, Jan Beumer, Shannon Puhalla, and Leonard ApplemanFurthermore they are working out the details about how best to combine ABT888 with the common chemotherapy combination of carboplatin and paclitaxel. These studies add to our thinking about how to move the family of PARP inhibitors forward toward clinical utility. A report from medical oncology fellow, Peng Wang, M.D. and many members of the experimental therapeutic team also described the toxicities of vandetinib, a multi-targeted receptor tyrosine kinase inhibitor, with a combination of gemcitabine and oxaliplatin in patients with advanced malignancies.

New ways to use old drugs was also a theme, as exemplified by the work from our hematological malignancies team led by medical oncology fellow, Annie Im, M.D. that demonstrated the activity of mitoxantrone and etopside for treatment of relapsed acute myelogenous leukemia.

Personalized therapy is not the domain of medical oncologists alone. Led by Matthew Schuchert, M.D. Rodney Landreneau, M.D. and James Luketich, M.D., our UPCI thoracic surgical oncology team described an extensive clinical experience on selection of optimal surgery for individuals with stage I lung cancer, comparing lobar and anatomic segmental resections in over 1000 patients.

Our translational scientists were also well-represented. Graduate student Reety Arora reported on work from the cancer virology team of Patrick Moore, M.D., M.P.H. and Yuan Chang, M.D. about the use of high throughput techniques to identify putative therapeutics for Merkel Cell Cancer, agents that will shortly enter early phase clinical testing. Led by medical oncology fellow Jorge Rios, M.D., the breast cancer team examined metallothenein expression as a poor prognostic factor for women with breast cancer. In addition breast cancer investigator, Margaret Rosenzweig, Ph.D. used the extensive clinical data base for women with metastatic breast cancer to identify prognostic factors for outcome in these women. Finally the poor response of metaplastic breast cancers to neoadjuvant chemotherapy was documented by medical resident Anna Kaminsky with her medical oncology mentors.

The ASCO meeting is also a venue for the recognition of physicians and scientists in training in oncology. We at UPCI are especially pleased to recognize Pitt medical student Mark Bernard, who received an ASCO fellowship to support an intensive introduction of underserved minority medical students to the field of oncology. Thanks to this support Dr. Bernard will undertake internal medicine training at Shadyside Hospital with a goal of subspecialty training in medical oncology. In addition, graduating medical oncology fellow, Michal Krause, M.D. received a merit award in recognition of his work on determinants of outcome for individuals with melanoma and brain metastasis.

The accomplishments of our newest investigators give us great hope for the future of cancer research and practice. Truly we at UPCI and UPMC CancerCenter can feel we are contributing to the goal of reducing the burden of cancer through our clinical care and trials, discovery science, and education of the next generation of cancer specialists!