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News Article | April 25, 2017
Site: www.eurekalert.org

HOUSTON - (April 25, 2017) - Higher costs for complex cancer surgery may be an indicator for worse -- rather than better -- quality of care, according to new research by experts at Rice University and the University of Texas MD Anderson Cancer Center. Their findings are published in the journal Surgery and provide multiple implications for care delivery. In the study, the authors analyzed Medicare hospital and physician claims from 2005 to 2009 for patients who were age 65 or older from all 50 states. The researchers looked at six different cancer operations: colectomy, rectal resection, pulmonary lobectomy, pneumonectomy, esophagectomy and pancreatic resection. In their initial review of the data, they found that surgeons who performed just two operations of a specific type in a given year versus one could achieve patient cost savings for four of the six cancer operations, ranging from 0.6 percent for colectomy to 2.8 percent for pancreatic resection. Savings for the highest-volume surgeons (at the 95th percentile of the volume distribution) were even greater. A surgeon performing 14 pancreatic resections had patient costs that were 8.5 percent lower ($3,286) than a surgeon who performed only one operation; and a surgeon performing 22 colectomies per year had costs that were 5.4 percent lower ($1,089). However, when the researchers accounted for the processes of care listed in each patient's treatment, the cost savings associated with high-volume surgeons decreased by 50 percent for pancreatic resection and completely disappeared for colectomy. Apparent cost savings for pulmonary lobectomy also disappeared, and cost savings for rectal resection also fell substantially, said co-author Vivian Ho, the chair in health economics at Rice's Baker Institute for Public Policy and director of the institute's Center for Health and Biosciences. Processes of care are actions that health care providers take to improve the quality of care and patient outcomes, such as placing of arterial lines or providing epidural anesthesia. Many of these are actions taken to avoid or treat complications that can occur during surgery. "Basically, our analyses indicate that the lower patient costs achieved by high-volume surgeons can be explained by their lower occurrence of processes of care that are associated with surgical complications, as well as their higher use of processes of care associated with better outcomes," said co-author Dr. Thomas Aloia, associate professor in the Department of Surgical Oncology, Division of Surgery, at MD Anderson. "People mistakenly think that higher spending in health care implies higher quality care," Ho said. "In this case, higher spending is a marker of worse patient care. The results imply that patients who need cancer surgery can expect lower costs and better outcomes with high-volume surgeons." "Can Postoperative Process-of-Care Utilization or Complication Rates Explain the Volume-Cost Relationship for Cancer Surgery?" was also co-authored by Marah Short, associate director of the Baker Institute's Center for Health and Biosciences. The study references a 2008 paper by the authors that found that patients treated by surgeons performing a higher number of particular cancer operations (such as pneumonectomy for lung cancer or esophagectomy for esophageal cancer) had lower costs for their hospital stays compared with patients operated on by low-volume surgeons. However, the authors didn't know why this inverse volume-cost relationship existed. Their new research set out to find the reasons underlying the volume-cost relationship. "Our volume-cost comparison suggests that patients treated by low-volume surgeons were less likely to receive two processes of care (epidural anesthesia and daily epidural management) that have been associated with better patient outcomes," said Ho, who is also a professor of economics at Rice and a professor of medicine at Baylor College of Medicine. "However, patients treated by low-volume surgeons almost always were significantly more likely to experience transfusions, consultations and complication-related processes of care (for example, TPN, critical care and inpatient consultations)." TPN stands for total parenteral nutrition, in which patients who are unable to eat are administered nutrients intravenously. The results provide multiple implications for care delivery, the authors said. First, it may be beneficial to refer patients to high-volume surgeons because of the surgeons' enhanced value (higher quality with lower costs). Second, government and private insurers should compare measures of processes of care and complications across surgeons and notify hospitals about surgeons with high complication rates and processes of care associated with poor patient outcomes. Hospitals could work with surgeons to improve surgical care, which should improve patient care and lessen costs. More broadly, the results suggest that action under the Affordable Care Act to shift hospital reimbursement toward bundled payment for hospitals and doctors for complex surgery should be encouraged, the authors said. "The current fee-for-service system often leads to higher payments for physicians and hospitals when patients suffer surgical complications and require higher levels of care," Ho said. "Specifying a fixed, bundled payment that doesn't vary with treatment intensity will discourage low-volume surgeons from performing operations that could generate costly complications for which they will not be compensated." For more information, to receive a copy of the study or to schedule an interview with Ho, Aloia or Short, contact Jeff Falk, associate director of national media relations at Rice, at jfalk@rice.edu or 713-348-6775. Follow the Center for Health and Biosciences via Twitter @BakerCHB. Founded in 1993, Rice University's Baker Institute ranks among the top five university-affiliated think tanks in the world. As a premier nonpartisan think tank, the institute conducts research on domestic and foreign policy issues with the goal of bridging the gap between the theory and practice of public policy. The institute's strong track record of achievement reflects the work of its endowed fellows, Rice University faculty scholars and staff, coupled with its outreach to the Rice student body through fellow-taught classes -- including a public policy course -- and student leadership and internship programs. Learn more about the institute at http://www. or on the institute's blog, http://blogs. .


The International Association of HealthCare Professionals is pleased to welcome Carolyn Nessim, MD, MSc, FRCSC, FACS to their prestigious organization with her upcoming publication in The Leading Physicians of the World. She is a highly trained and qualified Surgical Oncologist with an extensive expertise in all facets of her work, especially melanoma, soft tissue sarcoma/GIST and gastric cancer. Dr. Nessim has been in practice for 4 years and is currently serving patients within The Ottawa Hospital located in Ottawa, Ontario. In addition to her clinical work, Dr. Nessim serves as Assistant Professor of Surgery at the University of Ottawa and a Clinician Investigator in the Cancer Therapeutics Program at The Ottawa Hospital Research Institute and has publications in peer-reviewed journals. Her main research focus is identifying predictive markers in cancer care as well as quality and access to cancer care for patients. Dr. Nessim graduated with her Medical Degree at the University of Montreal in 2004, followed by her Master Degree in Biomedical Sciences in 2014 within the same educational venue. She went on to serve her General Surgery residency at the University of Montreal, before undertaking her fellowship in Surgical Oncology at the University of Toronto, and an additional fellowship in Surgical Oncology at Peter MacCallum Cancer Center in Melbourne, Australia. She is board certified in General Surgery by the American Board of Surgery and has earned the coveted title of Fellow of the American College of Surgeons. She also holds board certification in General Surgical Oncology and General Surgery with the Royal College of Physicians and Surgeons of Canada, of which she is also a Fellow. Dr. Nessim keeps up to date with the latest advances in her field by maintaining professional memberships with the the Society of Surgical Oncology, the American Society of Clinical Oncology, the Canadian Society of Surgical Oncology, the Canadian Association of General Surgeons, the American College of Surgeons and the Canadian Medical Association. She has a passion for her surgical field and for her patients and is kind, very empathetic, and personable. Dr. Nessim attributes her success to the excellent mentors and teachers she has had, and in her free time, she enjoys theatre, music, painting, reading, eco-traveling, canoeing, rafting, hiking, and camping. Learn more about Dr. Nessim here: http://carolynnessim.com/ and be sure to read her upcoming publication in The Leading Physicians of the World. FindaTopDoc.com is a hub for all things medicine, featuring detailed descriptions of medical professionals across all areas of expertise, and information on thousands of healthcare topics.  Each month, millions of patients use FindaTopDoc to find a doctor nearby and instantly book an appointment online or create a review.  FindaTopDoc.com features each doctor’s full professional biography highlighting their achievements, experience, patient reviews, and areas of expertise.  A leading provider of valuable health information that helps empower patient and doctor alike, FindaTopDoc enables readers to live a happier and healthier life.  For more information about FindaTopDoc, visit:http://www.findatopdoc.com


News Article | June 13, 2017
Site: www.prweb.com

Dr. James C. Wittig, Vice Chairman, Orthopedic Surgery; Chief, Orthopedic Oncology and Sarcoma Surgery at HackensackUMC and Director, Skin and Sarcoma Division at the John Theurer Cancer Center in New Jersey will be featured in New York Magazine for the 9th year in a row as one of New York Metros Best Orthopedic Surgeons. The recognition is a true testament to Dr. Wittig’s undeniable compassion, direct doctor-patient relationships and ongoing commitment to treating musculoskeletal cancers with the most innovative advances. The fine-tuned listing of Best Doctors in New York Magazine provides patients with an opportunity to utilize this guide as the resource for the specialty they require. For many current and past patients, finding Dr. Wittig proved to be a positive beginning of an uncertain journey but one guided by a true leader in his field. The difficulties of orthopedic oncology treatments are lessened by the advances that Dr. Wittig has achieved in his 16+ years handling an array of cases from the straightforward to the most complex ones in nature. "Although most would agree that oncology cases are the toughest, I am truly challenged by each and every diagnosis, confronting them with a customized plan as individual as each patient," notes Dr. Wittig, "…and, when you are backed by a team that shares the same commitment and personal devotion to providing an environment that fosters a continuum of extraordinary, multidisciplinary care only enhances the process and leads to the most desirable outcomes.” The sharing of knowledge and expertise goes beyond Dr. Wittig’s daily practice. In addition to co-authoring the invaluable ‘one and only in-depth guide’ to Orthopedic Oncology available today, “Operative Techniques in Orthopedic Surgical Oncology,” nine abstracts were presented during the 2016 ACS Clinical Congress in Washington, DC and six orthopedic oncology education videos were presented during the 2017 AAOS Annual Meeting in San Diego, CA. Dr. Wittig’s commitment to his field of study expands beyond the boundaries of the surgical suites as well and into the heart of raising awareness for these diseases that affect many, and; in many ways.    Recently, Dr. Wittig worked with the NJ based E’s Battle Buddies gang to help raise over $100k for sarcoma research at Hackensack UMC. “I am grateful for the opportunity to serve in many ways and being recognized by my colleagues provides the drive and motivation to delve deeper into research and seeking answers,” remarked Dr. Wittig. About Dr. Wittig James C. Wittig, MD specializes in limb-sparing surgery; pediatric and adult bone and soft tissue sarcomas; melanoma; benign musculoskeletal tumors; metastatic cancers; as well as complex hip and knee replacement surgery. He also has special expertise with regard to tumors that affect the shoulder girdle and scapula. In addition to his Hackensack University Medical Center office located at 20 Prospect Avenue, Suite 501, Hackensack, NJ, Dr. Wittig has a Morristown Office within Tri-County Orthopedics, 190 Ridgedale Avenue, Suite 300, Cedar Knolls, NJ 07927. He is a member of the American Academy of Orthopedic Surgeons; New York State Society of Orthopedic Surgeons, Inc.; and the Medical Society of New Jersey. He has published over 90 educational materials ranging from original reports, abstracts, videos and articles in the following publications: Clinical Orthopedics and Related Research, The Journal of the American College of Surgeons, American Family Physician, Journal of Arthroplasty, Radiology and Journal of Bone and Joint Surgery. He is also a prominent lecturer in the field of Orthopedic Surgery throughout the nation. Dr. James C. Wittig has been interviewed in national and local print, TV and radio outlets including The Dr. Oz Show, New York Daily News and other publications. He has also been recognized as one of “The Nation’s Top Doctors” by New York Magazine. For more information about this or other related topics, or to schedule an appointment, please call, in NJ,551-996-2533 or out of state, 1-855-DRWITTIG (1-855-379-4884), visit TumorSurgery.org or email Dr. Wittig at drjameswittig(at)gmail(dot)com.


News Article | June 5, 2017
Site: www.sciencedaily.com

The blend of bacteria in the digestive tract of metastatic melanoma patients is associated with disease progression or delay in patients treated with immunotherapy, researchers at The University of Texas MD Anderson Cancer Center report at the 2017 annual meeting of the American Society of Clinical Oncology. Their study of fecal samples from 105 patients treated with immune checkpoint blockade indicates that certain characteristics of patients' microbiomes correlate with slower disease progression while other qualities are associated with rapid worsening of the disease. "Greater diversity of bacteria in the gut microbiome is associated with both a higher response rate to treatment and longer progression-free survival," said study leader Jennifer Wargo, M.D., associate professor of Surgical Oncology at MD Anderson. Wargo and colleagues also found that an abundance of specific bacteria also is associated with higher response rate and longer progression-free survival. "The microbiome appears to shape a patient's response to cancer immunotherapy, which opens potential pathways to use it to assess a patient's fitness for immunotherapy and to manipulate it to improve treatment," said Wargo, who is also co-leader of the Melanoma Moon Shot™, part of MD Anderson's Moon Shots Program™ to reduce cancer deaths by accelerating development of therapies from scientific discoveries. In collaboration with the Parker Institute for Cancer Immunotherapy (PICI), Wargo's team is developing the first immunotherapy-microbiome clinical trial, with a goal of launching it later this year. Researchers have found in recent years that single-celled organisms and viruses harbored in the human body outnumber the body's own cells. This microbiome plays a role in many regular functions, including the initial priming of the immune system and then its normal operation. Patients in the study were treated with immune checkpoint inhibitors that block the activation of PD1, a protein on immune system T cells that halts immune response. The drugs' effect is to free the immune system to attack tumors. The team found that patients with more varied types of bacteria in their digestive tract had longer median progression-free survival, defined at the time point where half of studied patients have their disease progress. As a median time to follow-up of 242 days, the patient group with high microbiome diversity had not reached median PFS (more than half had not progressed), while those with intermediate diversity had median PFS of 232 days and those with lower diversity had median PFS of 188 days. Specific bacterial types also had an apparent effect. More than half of those with abundant F.prausnitzii had not reached median progression-free survival, while half of those with low abundance had their disease progress by 242 days. An abundance of Bacteroidales was associated with more rapid disease progression, with patients at high abundance having median PFS of 188 days, while those with lower levels of the bacterium had median PFS of 393 days. Research has shown that a persons' microbiome can be altered by diet, exercise, antibiotic use or, more recently, through transplantation of fecal material. Wargo cautions that there is much to understand about the relationship between the microbiome and cancer treatment and urges people not to attempt self-medication with probiotics and other methods. As they develop human clinical trials, Wargo and colleagues also are conducting lab and mouse model research to better understand the mechanisms that connect bacteria and the immune system. This will include a project funded by Stand Up to Cancer that involves fecal transplants from patients who responded to therapy and from non-responders into germ-free mice providing favorable and unfavorable microbiomes to study in detail. The team conducted 16S rRNA sequencing, an analysis of the presence of 16S ribosomal RNA used to identify bacteria, to determine microbiome composition from fecal samples. Whole genome sequencing and immune monitoring were conducted on the tumors after treatment and in some tumors before treatment. The immune profiling showed that responders to anti-PD1 treatment had significantly increased immune infiltrates in their tumors, including the presence of CD8+ killer T cells, correlated to the abundance of a specific bacterium. Co-investigators on the study are Vancheswaran Gopalakrishnan, doctoral student at The University of Texas Health Science Center at Houston School of Public Health; Christine Spencer, Tatiana Karpinets, Ph.D., Robert Jenq, M.D., and Andrew Futreal, Ph.D., of Genomic Medicine; Miles Cameron Andrews, Ph.D., Alexandre Reuben, Ph.D., Jeffrey Lee, M.D., and Jeffrey Gershenwald, M.D., of Surgical Oncology; Michael Tetzlaff, Ph.D., M.D., and Alexander Lazar, M.D., Ph.D., of Pathology; Wen-Jen Hwu, M.D., Ph.D., Claudia Glitza, M.D., Ph.D., Hussein Tawbi, M.D., Ph.D., Sapna Patel, M.D., Michael Davies, M.D., Ph.D., and Patrick Hwu, M.D., of Melanoma Medical Oncology; Padmanee Sharma, M.D., Ph.D., of Genitourinary Medical Oncology and Immunology; and Jim Allison, Ph.D., of Immunology.


News Article | June 15, 2017
Site: www.prweb.com

A newly-published report suggests that living longer between cytoreductive surgeries bodes well for survival in patients with peritoneal mesothelioma. Surviving Mesothelioma has just posted an article on the new research. Click here to read it now. Doctors with the City of Hope Cancer Center and the Wake Forest School of Medicine in North Carolina analyzed the cases of 103 patients with peritoneal surface cancers like malignant mesothelioma who had repeat CRS/HIPEC surgery between 1993 and 2015. “In multivariate analysis, the R status [a measure of the completeness of the tumor removal] and a time interval of more than two years were strongly associated with survival with each additional month between the surgeries conferring a 2.6 percent reduction in the risk of death,” writes study author Ioannis Konstantinidis, MD, a surgeon with City of Hope in Duarte, California. According to the study in the Journal of Surgical Oncology, among the patients who lived for more than two years before they needed a second surgery, the median overall survival was seven years. “There is no clear-cut way to decide how much a patient with peritoneal mesothelioma is likely to benefit from a second CRS/HIPEC procedure,” says Alex Strauss, Managing Editor for Surviving Mesothelioma. “The information in this study may help mesothelioma patients and their families make more informed decisions about surgery.” For all the details of the new study, see Length of Time Between Surgeries a Marker for Mesothelioma Survival, now available on the Surviving Mesothelioma website. Konstantinidis, IT, et al, “Interval between cytoreductions as a marker of tumor biology in selecting patients for repeat cytoreductive surgery with hyperthermic intraperitoneal chemotherapy,” June 12, 2017, Journal of Surgical Oncology, Epub ahead of print, http://onlinelibrary.wiley.com/doi/10.1002/jso.24703/full For more than a decade, Surviving Mesothelioma has brought readers the most important and ground-breaking news on the causes, diagnosis and treatment of mesothelioma. All Surviving Mesothelioma news is gathered and reported directly from the peer-reviewed medical literature. Written for patients and their loved ones, Surviving Mesothelioma news helps families make more informed decisions.


News Article | June 8, 2017
Site: www.eurekalert.org

Lesions of the appendix are being over diagnosed as invasive cancer, report University of California San Diego School of Medicine researchers in a paper published June 7 in the journal PLOS ONE. The scientists found that originating pathologists were more likely to diagnose lesions of the appendix as adenocarcinoma compared to pathologists at a single referral academic medical center. Pathologists with less experience examining tumors of the appendix also had a difficult time diagnosing a tumor of the appendix known as low-grade appendiceal mucinous neoplasm (LAMN). "Appendix cancer remains extremely challenging for proper pathological classification of tumor type," said Mark A. Valasek, MD, PhD, assistant professor of pathology at UC San Diego School of Medicine and first author. "This is in part because the appendix can harbor not only invasive cancer, but also an enigmatic and confusing low-grade malignancy called LAMN. In addition, the literature on classification of appendix cancer utilizes inconsistent terminology and is constantly evolving. Our findings highlight a critical need for universally accepted criteria to diagnose appendix tumors to help pathologists separate benign, low grade and invasive tumors." Mucinous appendix tumors can lead to pseudomyxoma peritonei, a rare cancer syndrome that most often starts as a lesion in the appendix that bursts, liberating mucus-secreting tumor cells which grow within the abdominal cavity. Properly identifying the type of tumor strongly influences both prognosis and treatment. Together with researchers from UC San Diego Moores Cancer Center, Valasek and team performed a retrospective pathological chart review to measure agreement between the diagnosis of originating pathologists and a single large academic medical center during patient referral. A search of pathology reports for appendiceal lesions that were first evaluated by an outside pathology group and then referred to UC San Diego Health identified 46 cases over a two-year period. Originating pathologists identified half of these cases as adenocarcinoma while UC San Diego Health pathologists identified just over one-quarter as such. Originating pathologists diagnosed the other half of the patients with LAMN while UC San Diego Health said 63 percent of patients had LAMN. In other words, in 57 percent of the cases UC San Diego Health reviewers were in agreement with an invasive cancer diagnosis; overall agreement was 72 percent. The originating pathologist practices were usually non-academic, mid-sized and did not have subspecialty training in gastrointestinal pathology. "A second evaluation of appendiceal lesions changed the diagnosis and therefore management of a significant number of patients," said Andrew M. Lowy, MD, professor of surgery, chief of the Division of Surgical Oncology and senior author. "It is important for someone with expertise in appendix cancer to evaluate pathology reports for the benefit of patients. In addition, recently published guidelines may help facilitate improvement of diagnostic interpretations and reduce over-interpretation and potential overtreatment." Co-authors include: Irene Thung, Esha Gollapalle, Alexey A. Hodkoff, Kaitlyn J. Kelly, Joel M. Baumgartner, Vera Vavinskaya, Grace Y. Lin, Ann P. Tipps, and Mojgan V. Hosseini, all at UC San Diego.


LOS ANGELES (June 8, 2017) -- Patients who receive the standard surgical treatment for melanoma that has spread to one or more key lymph nodes do not live longer, a major new study shows. The study, published today in The New England Journal of Medicine, found that immediately removing and performing biopsies on all lymph nodes located near the original tumor, a procedure called completion lymph node dissection, did not result in increased overall survival rates. "The new findings likely will result in many fewer of these procedures being performed around the world," said the study's lead author, Mark B. Faries, MD, co-director of the Melanoma Program and head of Surgical Oncology at The Angeles Clinic and Research Institute, an affiliate of Cedars-Sinai. "The results also will likely affect the design of many current and future clinical trials of medical therapies in melanoma." More than 1,900 patients with melanoma, the deadliest kind of skin cancer, participated in the study conducted at more than 60 medical institutions nationally and internationally. Faries led the research at the John Wayne Cancer Institute in Santa Monica, before joining The Angeles Clinic and Research Institute in April. The study, among the largest ever conducted on melanoma, examines what Faries describes as the most important question facing physicians and those newly diagnosed with the disease: whether patients who have melanoma cells in a limited number of lymph nodes should undergo extensive surgery to remove all the remaining nodes in that area of the body. The results of the new research suggest they do not. "This new approach spares patients significant negative side effects and clarifies the road forward in development of additional therapies," said Omid Hamid, MD, chief of Research/Immuno-Oncology, The Angeles Clinic and Research Institute, and co-director, Cutaneous Malignancy Program, Cedars Sinai. "Dr. Faries and colleagues' contribution to the field of surgical oncology cannot be overstated." Although the completion dissections did not help overall survival, they did have some value, Faries said. By examining the dissected lymph nodes, physicians were able to better gauge how extensively the cancer had spread and to lengthen the time that their patients were disease-free. But those advantages did not translate into longer lives, he explained. Additionally, nearly 25 percent of the patients who underwent the completion dissections suffered from lymphedema, compared with about 6 percent of the control group, the study found. Lymphedema is swelling that may result when lymph nodes are damaged or removed. Symptoms include hardening of the skin, infections and restricted range of motion. "This is a larger operation that has a higher risk of complications," Faries said, "including wound infection and nerve damage." Prior to the now-common sentinel node biopsy procedure, dissection of all regional lymph nodes at the early diagnosis of melanoma was the standard of care. Today, lymphatic mapping techniques are applied worldwide, and the removal of all regional nodes is undertaken only if the sentinel nodes are positive for cancer. "The larger procedure will remain an option for some patients, but it will no longer be the only 'standard' option," Faries said. Research reported in this publication was supported by the National Cancer Institute of the National Institutes of Health under award number NCT00297895. Disclosure: Dr. Faries reports receiving fees for serving on an advisory board from Myriad Genetic Laboratories, Amgen and Immune Design. Full URL to the article once the embargo lifts and it publishes online on NEJM.org will be: http://www.


Pat Whitworth, MD is a Surgical Oncologist at AdvancedHEALTH, the largest, independent, multi-specialty practice in Middle Tennessee. AdvancedHEALTH includes over 350 physicians, surgeons, and mid-level providers within 30 specialties. They are focused on providing the highest level of quality care, while reducing costs to their patients. Dr. Whitworth is also affiliated with TriStar Centennial Medical Center and Saint Thomas Midtown Hospital, and has been named a 2017 Top Doctor in Nashville, Tennessee. Top Doctor Awards is dedicated to selecting and honoring those healthcare practitioners who have demonstrated clinical excellence while delivering the highest standards of patient care. Dr. Pat Whitworth is a highly experienced Surgical Oncologist, having been in practice in Nashville since 1991. After graduating from the University of Tennessee College of Medicine he completed surgical residency at the University of Louisville and then completed fellowship in Surgical Oncology at the MD Anderson Cancer Center in Houston in 1991. Dr. Whitworth is certified by the American Board of Surgery, and throughout his career has served in leadership positions in national surgical and breast surgery professional organizations. He is renowned across Tennessee and beyond, however, as an expert surgical oncologist and breast surgeon, and he currently serves as Director of the Nashville Breast Center. Dr. Whitworth is known not only for his surgical excellence, but also for his patient-centered approach to medicine and his caring and compassionate attitude. This makes him popular with his patients and peers alike, and it also makes Dr. Pat Whitworth a very worthy winner of a 2017 Top Doctor Award. Top Doctor Awards specializes in recognizing and commemorating the achievements of today’s most influential and respected doctors in medicine. Our selection process considers education, research contributions, patient reviews, and other quality measures to identify top doctors.


EMERYVILLE, Calif. & DUARTE, Calif.--(BUSINESS WIRE)--Eureka Therapeutics Inc., a biotechnology company focused on developing novel T-cell immunotherapies for the treatment of solid tumors, and City of Hope, a world-renowned independent research and cancer and diabetes treatment center, announced today that they have reached agreement to conduct an open-label, dose-escalating Phase 1 clinical trial of ET1402L1-CAR, a potential CAR-T therapy for the treatment of hepatocellular carcinoma, the predominant type of liver cancer. ET1402L1 is a human antibody, identified from Eureka’s proprietary E-ALPHA™ phage library, which selectively targets liver cancer cells overexpressing alpha-fetoprotein (AFP). “The clinical trial agreement represents an important milestone for Eureka, as it provides a pathway for treating patients with liver cancer, and it supports our business objectives to develop ET1402L1-CAR in areas of significant unmet medical need,” said Cheng Liu, Ph.D., President and Chief Executive Officer of Eureka Therapeutics. “This is a significant step in demonstrating that CAR-T cell therapy can be successfully used to target a major histocompatibility complex (MHC) presented antigen in solid tumors.” Intracellular antigens, which account for the most tumor-specific antigens, are inaccessible by conventional CAR-T therapy. Such antigens which include AFP, however, are processed into peptides and presented by the class I MHC on the surface of tumor cells. A 2017 study (DOI: 10.1158/1078-0432.CCR-16-1203), published by Eureka and City of Hope in Clinical Cancer Research, showed that ET1402L1-CAR T cells can recognize the AFP-MHC complex and launch a potent anti-tumor response, offering a promising new avenue for T cell therapy against solid malignancies. "We are pleased to be working with Eureka Therapeutics on this unique approach to treating liver cancer with CAR-T therapy," said principal investigator Yuman Fong, M.D., The Sangiacomo Family Chair in Surgical Oncology and chair and professor of the Department of Surgery at City of Hope. "CAR-T therapy has shown remarkable success with liquid tumors. However, the lack of cancer specific cell surface antigens has limited the use of CAR-T therapy to other cancers. The results of this study could have a wide range of applications in other difficult-to-treat solid cancers such as lung and prostate cancer, which have few cell surface markers that are tumor-specific.” “City of Hope has accepted the challenge to bring leading-edge treatments to patients with liver cancer,” said investigator Stephen J. Forman, M.D., Francis & Kathleen McNamara Distinguished Chair in Hematology and Hematopoietic Cell Transplantation and director of City of Hope’s T Cell Immunotherapy Research Laboratory. “We are optimistic that CAR-T therapy can be an important component in treating patients with solid tumors, including liver cancer.” The Phase 1 clinical trial will be led by Fong and Forman. Other collaborating investigators include Christine Brown, Ph.D., Heritage Provider Network Professor in Immunotherapy, John Kessler, M.D., John Park, M.D., Ph.D., Saul Priceman Ph.D., Shirong Wang, M.D., M.P.H., and Susanne Warner, M.D., all of City of Hope in Duarte, California. Liver cancer is the fifth most prevalent and third most lethal cancer worldwide, with incidence rates on the rise and limited treatment options. Hepatocellular carcinoma is the predominant type of liver cancer, affecting over 700,000 people each year worldwide. Alpha-fetoprotein (AFP) is overexpressed, specifically in liver cancer, making it an ideal target for chimeric antigen receptor (CAR) T cell immunotherapy. However, AFP is intracellularly expressed and secreted, and therefore, not targetable by conventional antibody-based therapies. Eureka Therapeutics Inc. is a privately held biotechnology company, headquartered in the San Francisco Bay area, focused on developing first-in-class T cell immunotherapies for hematological malignancies and solid tumors. Its core technology platforms center around the discovery and engineering of fully human antibodies against intracellular targets via the MHCI complex. The company is developing a pipeline of novel cancer therapeutics targeting intracellular oncogenes. For more information, visit the company's website at www.eurekainc.com. City of Hope is an independent research and treatment center for cancer, diabetes and other life-threatening diseases. Designated as one of only 48 comprehensive cancer centers, the highest recognition bestowed by the National Cancer Institute, City of Hope is also a founding member of the National Comprehensive Cancer Network, with research and treatment protocols that advance care throughout the world. City of Hope is located in Duarte, California, just northeast of Los Angeles, with community clinics throughout Southern California. It is ranked as one of "America's Best Hospitals" in cancer by U.S. News & World Report. Founded in 1913, City of Hope is a pioneer in the fields of bone marrow transplantation, diabetes and numerous breakthrough cancer drugs based on technology developed at the institution. For more information about City of Hope, follow us on Facebook, Twitter, YouTube or Instagram.


News Article | June 9, 2017
Site: www.sciencedaily.com

Lesions of the appendix are being over diagnosed as invasive cancer, report University of California San Diego School of Medicine researchers in a paper published June 7 in the journal PLOS ONE. The scientists found that originating pathologists were more likely to diagnose lesions of the appendix as adenocarcinoma compared to pathologists at a single referral academic medical center. Pathologists with less experience examining tumors of the appendix also had a difficult time diagnosing a tumor of the appendix known as low-grade appendiceal mucinous neoplasm (LAMN). "Appendix cancer remains extremely challenging for proper pathological classification of tumor type," said Mark A. Valasek, MD, PhD, assistant professor of pathology at UC San Diego School of Medicine and first author. "This is in part because the appendix can harbor not only invasive cancer, but also an enigmatic and confusing low-grade malignancy called LAMN. In addition, the literature on classification of appendix cancer utilizes inconsistent terminology and is constantly evolving. Our findings highlight a critical need for universally accepted criteria to diagnose appendix tumors to help pathologists separate benign, low grade and invasive tumors." Mucinous appendix tumors can lead to pseudomyxoma peritonei, a rare cancer syndrome that most often starts as a lesion in the appendix that bursts, liberating mucus-secreting tumor cells which grow within the abdominal cavity. Properly identifying the type of tumor strongly influences both prognosis and treatment. Together with researchers from UC San Diego Moores Cancer Center, Valasek and team performed a retrospective pathological chart review to measure agreement between the diagnosis of originating pathologists and a single large academic medical center during patient referral. A search of pathology reports for appendiceal lesions that were first evaluated by an outside pathology group and then referred to UC San Diego Health identified 46 cases over a two-year period. Originating pathologists identified half of these cases as adenocarcinoma while UC San Diego Health pathologists identified just over one-quarter as such. Originating pathologists diagnosed the other half of the patients with LAMN while UC San Diego Health said 63 percent of patients had LAMN. In other words, in 57 percent of the cases UC San Diego Health reviewers were in agreement with an invasive cancer diagnosis; overall agreement was 72 percent. The originating pathologist practices were usually non-academic, mid-sized and did not have subspecialty training in gastrointestinal pathology. "A second evaluation of appendiceal lesions changed the diagnosis and therefore management of a significant number of patients," said Andrew M. Lowy, MD, professor of surgery, chief of the Division of Surgical Oncology and senior author. "It is important for someone with expertise in appendix cancer to evaluate pathology reports for the benefit of patients. In addition, recently published guidelines may help facilitate improvement of diagnostic interpretations and reduce over-interpretation and potential overtreatment."

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