publication date: Sep. 18, 2020

In Brief

Emily Tonorezos named head of NCI’s Office of Cancer Survivorship

Emily S. Tonorezos was named director of the NCI Office of Cancer Survivorship.

Tonorezos joins NCI from Memorial Sloan Kettering Cancer Center and the Weill Cornell Medical College, where she was director of the Adult Long-Term Follow-Up Program for survivors of childhood and young adult cancers.

Her research focuses on cardiometabolic consequences of cancer therapy, childhood and young adult cancer survivorship, diet and nutrition, and care coordination for this population. She was also co-leader of the International Guideline Harmonization Group for the metabolic syndrome guidelines, and she led a recent international effort to develop recommendations for adult survivors of heritable retinoblastoma.

Tonorezos replaces interim director Deborah Mayer, who led the office after retirement of Julia Rowland,

 

Electra Paskett named director of the Alliance Cancer Control Program and PI for the Alliance NCORP Research Base

Electra D. Paskett was named director of the Alliance Cancer Control Program and principal investigator for the Alliance NCORP Research Base. 

Paskett is the Marion N. Rowley Professor of Cancer Research and director of the Division of Cancer Prevention and Control in the College of Medicine at The Ohio State University. She is also professor of epidemiology in the OSU College of Public Health. 

Paskett has been a leader of Alliance cancer control programs since 2011 when the group was founded by the merger of the American College of Surgeons Oncology Group, Cancer and Leukemia Group B, and the North Central Cancer Treatment Group.  Most recently, she served as chair of the Alliance Health Disparities Committee and multiple-PI of the Alliance NCORP Research Base.

 

ACCC announces 2020 Innovator Award winners

The Association of Community Cancer Centers has named five recipients of the tenth annual ACCC Innovator Awards, highlighting the year’s leading-edge strategies to challenges faced by oncology programs and practices across the country.

The eight ACCC Innovator Award winners feature programs across the multidisciplinary team in cancer care. The awards were given out at the ACCC’s 37th virtual National Oncology Conference Sept. 14-18.

Winners were selected based on the potential of their program to have a real-world impact on the delivery of cost-effective, patient-centered care with replicable solutions in the areas of care coordination and quality improvement, technology, patient engagement, innovative training and staffing models, the provision of supportive care services, and collaborative practice agreements.

The ACCC 2020 Innovator Award winners are:

  • Integration of Prehab, Rehab, and Prospective Surveillance into Interdisciplinary Teams; Beaumont Health System, Beaumont Cancer Institute. This program improves the patient experience, reduces hospital length of stay, and facilitates early identification of physical impairments, functional limitations, and/or treatment restrictions. Other outcomes include reduction of cancer-related fatigue, lymphedema, and falls, and non-opioid pain management.

  • A Nurse Navigator-Led Community-Based Cardio-Oncology Clinic; Franciscan Health Cancer Center, Indianapolis. This program manages the cardio-toxic side effects of more than 1,000 cancer patients. Working in collaboration with medical oncologists and other members of the multidisciplinary team, the cardio-oncology team helps keep oncology patients in treatment and improves patient quality of life.

  • Leveraging a 3D Lung Nodule Educational Tool to Reduce Patient Distress; Maine Medical Center Cancer Institute. The use of a 3D lung nodule tool as part of shared decision-making facilitated high quality communication, improves patient knowledge about malignancy risk, reduces emotional distress, and improves quality of life. A geriatric nurse practitioner partnered with an art student to design and implement the 3D model.

  • Reducing ED Visits and Hospital Admissions after Chemotherapy with Predictive Modeling of Risk Factors; Mercy Cancer Care, St. Louis. After conducting a retrospective review to identify clinical variables associated with increased risk of hospital admissions and emergency department visits, Mercy Cancer Care developed and implemented a predictive algorithm that stratifies patients according to their 30-day risks. A daily dashboard report identifies all patients as high, intermediate, or low risk.

  • Onboarding Experienced Non-Oncology Nurses to Address Staffing Shortages: Development of a Transitional Oncology Training Academy; Miami Cancer Institute. This 12-week academy gives nurses the knowledge and skills to transition to radiology, blood and marrow transplant, outpatient infusion oncology, and Phase I/II research on a Precision Medicine Unit. The academy prepares participants for the ONS/ONCC Chemotherapy Immunotherapy Certificate.

  • Improve Oral Oncolytic Workflow and Reduce Treatment Delays with a Pharmacist Collaborative Practice Agreement; St. Luke’s Cancer Institute. This pharmacy resident pilot project supported the creation and implementation of an oral oncolytic collaborative practice agreement  that expanded pharmacist scope of practice, decreased turnaround time for processing prescriptions, improved provider satisfaction, and decreased patient prescription costs.

  • Utilizing Technology to Identify Patient Co-Morbidities and Reduce Hospital and ED Admissions; Tennessee Oncology. An analysis of Oncology Care Model data identified three comorbid illnesses that led to significantly higher rates of unplanned emergency department visits and hospitalizations—COPD, congestive heart failure, and diabetes mellitus. Tennessee Oncology used this data to develop targeted management algorithms that proactively address these conditions.

  • Shifting Chemo Administration from Inpatient to Outpatient Setting Improves Care and Reduces Costs; University of Arizona Cancer Center, Banner University Medical Center Tucson. A multidisciplinary team identified chemotherapy regimens administered in the inpatient setting that could be safely administered in the outpatient setting, and implemented a transition plan that reduced inpatient medical resources and chemotherapy costs, decreased inpatient bed stay, lower infection rates, improved quality of life, and decreased overall cost of care—conservatively estimated at almost $6 million.

 

NCI, NIBIB award contracts to develop innovative digital health technologies for COVID-19

NIH has awarded seven contracts to companies and academic institutions to develop digital health solutions that help address the COVID-19 pandemic.

The seven digital health solutions are:

  • Evidation Health Inc.: A health measurement platform for analyzing a wide range of patient-consented data, including self-reported data and wearable device data, to detect COVID-19 and differentiate it from the flu.

  • IBM: An integrated solution that supports sophisticated contact tracing and verifiable health status reporting, yielding an array of key research data that simultaneously empowers users and facilitates research.

  • iCrypto Inc.: A smartphone-based platform to provide irrefutable proof of testing, serologic, and vaccination status for individuals.

  • physIQ Inc.: An artificial intelligence-based data analytics and cloud computing platform plus U.S. Food and Drug Administration-cleared wearable devices to create a personalized baseline index that could indicate a change in health status for patients who have tested COVID-19 positive.

  • Shee Atiká Enterprises LLC: A smartphone-based platform to monitor and support individuals with COVID-19 symptoms (who may need testing) and those who have already tested positive. The app will integrate a Bluetooth-enabled thermometer and pulse oximeter into an approach uniquely designed for low-resource settings and underserved populations.

  • University of California, San Francisco: A GPS-based retroactive contact-tracing tool for alerting users about contact with SARS-CoV-2–infected individuals, identifying businesses that were visited by someone who later tested positive for COVID-19, and working with those businesses and public health departments on strategies to reduce the spread of the virus.

  • Vibrent Health: Mobile applications, data integrations, and validated machine learning algorithms to identify COVID-19 and differentiate it from the flu, and to perform contact tracing using Wi-Fi technologies.

  • In a separate but related effort, NIBIB has awarded a contract to CareEvolution, for SAFER-COVID, a digital health solution that integrates self-reported symptoms, data from consumer wearable devices, electronic health record and claims data, and COVID-19 test results to indicate whether users are ready to return to work and normal activities during the COVID-19 pandemic.

The work could lead to user-friendly tools like smartphone apps, wearable devices, and software that can identify and trace contacts of infected individuals, keep track of verified COVID-19 test results, and monitor the health status of infected and potentially infected individuals.

NCI and the National Institute of Biomedical Imaging and Bioengineering selected the seven projects from nearly 200 ideas.

“The tools these organizations plan to develop could allow us to use containment efforts, like COVID-19 testing, social distancing, and quarantine, precisely when and where they’re needed. That might let more people return to less restricted living and reduce the risk of devastating local outbreaks,” NCI Director Ned Sharpless said in a statement. “We are working as quickly as possible to help businesses and universities develop innovative tools to achieve this goal.”

This effort is a key component of NCI’s and NIBIB’s congressionally supported responses to COVID-19. This includes NCI’s $306 million effort to support serological science research, expand testing capacity, and develop other technologies for COVID-19, as well as NIBIB’s supplemental funding to address COVID-19.

The contracts are being awarded in two phases. Initial awards are for phase one and will be used to demonstrate feasibility of the project. After assessment of phase one results, a contractual option for phase two would provide additional funding for further development of the awardee’s program and demonstration of utility in response to the pandemic. If all seven projects were to move into the second phase, the total value of the contracts in this network would be $22.8 million. The awardees have one year to complete both phases.

The proposed digital health tools will leverage multiple data sources, including wearable devices and COVID-19 diagnostic and serology test results. Each organization will share data and other assets in an NIH-supported central data hub in ways that protect individuals’ privacy. To spur additional research, researchers will have access to data stored in the hub.

Because the collection of large digital health datasets has potential privacy implications, there is an emphasis on providing adequate privacy protections that allow personal health data to be collected without compromising civil liberties.

 

Lois Travis awarded $5.7 million from NCI to study chemo-induced hearing loss, toxicities

Lois B. Travis, the Lawrence H. Einhorn Professor of Cancer Research at IU School of Medicine, has been awarded a five-year, $5.7 million NCI grant to evaluate long-term health outcomes for cancer patients who receive platinum-based chemotherapies.

An expert on cancer survivorship, Travis leads the ongoing study that could lessen cancer treatment side effects for millions of patients.

Nearly 6 million patients globally are diagnosed with a cancer each year, in which first-line therapy potentially includes highly toxic, platinum-based chemotherapies. While the treatment may lead to hearing loss, ringing in the ears, numbness in hands and feet and other side effects, it is the only proven cure for the vast majority of testicular cancer patients.

When IU’s Lawrence Einhorn developed a revolutionary therapy for testicular cancer in the 1970s, he flipped the 95% mortality rate for the disease to a 95% survival rate. His regimen of platinum-based cisplatin and two other drugs continues to be the standard care for testicular cancer. Einhorn is the Livestrong Foundation Professor of Oncology at IU School of Medicine and a physician scientist at the IU Simon Comprehensive Cancer Center.

Travis, Einhorn and a team of researchers from other cancer centers are following more than 2,000 testicular cancer survivors who are part of the largest clinical cohort of germ cell cancer survivors worldwide. The alliance of researchers leads The Platinum Study, which was established through a previous NCI grant awarded to Travis in 2012.

“We have shown with audiometric examination that 80 percent of the patients had hearing loss with one in five classified as severe to profound, levels at which hearing aids are recommended,” Travis said. Additionally, researchers found that 56 percent of patients had nerve damage called neuropathy and 40 percent had tinnitus or permanent ringing in their ears.

With this grant, researchers will tap into the existing cohort of patients who are part of the Platinum Study. The median age at diagnosis for testicular patients is 30, and the cohort’s median age now is 37. As patients age, researchers will continue to follow health changes, including if they are more susceptible to age-related hearing loss.

“We will examine the role of genetic variants in the platinum toxicities to try to identify high-risk subgroups,” Travis said.

The team of investigators wants to understand better which patients are at higher risk for these adverse outcomes and the daily effects of the toxicities.

“The goal is to follow this cohort for many decades to characterize the longitudinal trajectory of toxicities related to platinum-based chemotherapy,” she said. “For the first time, we will evaluate the impact and severity of the hearing loss and tinnitus on the patients’ physical, emotional and social functioning.”

Patients will complete questionnaires to track the different facets of their lives that are affected by hearing loss, or pain and numbness associated with neuropathy, as well as other toxicities. Researchers will also investigate the social and emotional consequences of the constant ringing in the ears, such as difficulty sleeping or concentrating.

Additionally, researchers will continue to analyze previously collected patient blood samples to track platinum levels, which can remain in the body for decades after chemotherapy is completed.

“Platinum is not completely excreted and is believed to be held in several body reservoirs. As tissue is remodeled with age, platinum regains access to the circulation,” Travis explained. “We will continue to measure the residual serum platinum levels.”

While cisplatin is used for many cancers, Travis notes that the testicular cancer patient cohort offers researchers a unique opportunity to study the toxicities.

“If we want to improve our understanding of long-term cisplatin-related toxicities, this is an ideal population,” she said. “When doing genetic studies, we know that all patients received about the same cumulative dose of cisplatin. We can then consider: who developed hearing loss and who didn’t, and what genetic and other factors are associated with this outcome?”

Ultimately, Travis hopes this research can determine which patients are most likely to experience adverse effects from cisplatin and then provide guidelines that could decrease damaging side effects, such as duration of treatments or improved symptom management.

Collaborators include researchers from Memorial Sloan Kettering Cancer Center (Darren Feldman), Dana-Farber Cancer Institute (Neil Martin), University of Pennsylvania (David Vaughn), University of South Florida (Robert Frisina), Vanderbilt University (Nancy Cox), University of Chicago (Eileen Dolan), Princess Margaret Hospital (Robert Hamilton), the Royal Marsden Hospital (Robert Huddart), University of Rochester (Chunkit Fung), Loyola University (Heather Wheeler), Harvard School of Public Health (Howard Sesso), and the British Columbia Cancer Agency (Christian Kollmannsberger).

 

Katz, An, Kurian awarded $3.7 million in Moonshot funds to address genetic testing among families

A new $3.7 million grant, as part of the Beau Biden Cancer Moonshot Initiative, will support a clinical trial designed to test a personalized family genetic risk navigation support platform.

The trial will be extended to all first- and second-degree relatives of 900 patients in Georgia and California in whom genetic testing identified a variant indicating an elevated hereditary cancer risk.   

“This study has enormous potential to improve cancer prevention and early detection in families at high risk of hereditary cancer syndromes. Targeting genetic risk evaluation in families where a cancer susceptibility gene has been identified may be the most cost-effective approach to reduce the burden of cancer through prevention,” principal investigator Steven J. Katz, co-leader of the health behavior and outcomes program at the University of Michigan Rogel Cancer Center, said in a statement.

The study team will develop and evaluate the Family Genetic Health Program, a technology assisted, personally tailored education and communication tool to facilitate genetic risk evaluation and management between patients and their relatives.

The team will compare outcomes of the program with and without direct assistance from a personal genetic navigator. The trial will also assess various cost levels to understand the best price point.

In addition to Katz, the principal investigators are Allison W. Kurian, of Stanford University and Lawrence An, of the Rogel Cancer Center.

The study leverages a unique project led by Katz and Kurian, The Georgia California Genetic Testing Linkage Initiative, which has partnered with NCI Surveillance, Epidemiology and End Results regional registries, commercial genetic testing companies and academics to link genetic testing results to all patients diagnosed with cancer in the two states over six years.

 

YCC receives $1.2 million NIH grant to fund gene imaging research

Yale Cancer Center has received an Exploratory Developmental Grant from NIH to fund 3D gene imaging research.

The three-year, $1.2 million R33 award will help support research on multiplexed imaging of chromatin folding and RNA profiles in cancer and lead to new biomarkers for cancer diagnosis, prognosis, and treatment. The NIH R33 funding provides a second phase for the support for innovative exploratory and development research activities.

“This funding will make a significant impact as it will help open up new opportunities to study the 3D genome in cancer, including the clonal diversity of chromatin architectures in cancer and gene expression regulation mechanisms by 3D chromatin organization,” Mandar Muzumdar, assistant professor of genetics and medicine at YCC, researcher at the Yale Cancer Biology Institute and co-principal investigator, said in a statement. “We hope to apply these technologies in future clinical trials to validate their utility in human cancer biospecimens.”

“Our plan is to help better define cancer cell states, and in turn lead to the discovery of new prognostic and predictive biomarkers,” Siyuan (Steven) Wang, assistant professor of genetics and cell biology at YCC and co-PI said in a statement. “The research may also offer new avenues for chromatin-targeted approaches for cancer prevention and therapy.”

 

YCC receives $175k research grant from Breast Cancer Research Foundation

Yale Cancer Center has received a one-year, $175,000 research grant from the Breast Cancer Research Foundation to study reducing re-excisions for breast conserving therapy for women following surgery for breast cancer.

Principal investigator of the grant, Mehra Golshan, joins three other YCC BCRF funded researchers: Melinda Irwin, Lajos Pusztai, and David Rimm.

This grant reflects the need to find ways to reduce unnecessary re-excisions during their treatment that leads to delay in initiation of adjuvant therapy, increase in costs, negative psychological impact, more women choosing mastectomy and higher infection rates,” Golshan, deputy chief medical officer for Surgical Services at Smilow Cancer Hospital and YCC, and interim director of the Breast Center at Smilow Cancer Hospital, said in a statement.

During breast conserving surgery, the need for re-excision occurs between 15-25% of time. When removing a breast tumor, surgeons strive for clean margins. That means targeting not only the tumor, but also excising the surrounding border of tissue. Margins are clean if no cancer cells are found at the outer edge of that tissue.

 

Five researchers receive shared $9 million grant from Aligning Science Across Parkinson’s initiative

A multi-institutional team of scientists has received a grant from the Aligning Science Across Parkinson’s (ASAP) initiative to use stem cells to study how risk factors accumulate and interact to drive Parkinson’s disease (PD).

The team is led by Lorenz Studer, of Memorial Sloan Kettering Cancer Center, and includes including Gist Croft, of The NYSCF Research Institute; Vikram Khurana, of Brigham and Women’s Hospital, and a NYSCF – Robertson stem cell investigator; Jian Peng, of (University of Illinois at Urbana-Champaign; and Joseph Powell, of Garvan Institute of Medical Research.

The team will receive $9 million over three years to take a comprehensive look at the interplay between genetics, aging, and different brain cell types underlying individual risk for PD in a project entitled, “Defining the cellular and molecular determinants of variable genetic penetrance in Parkinson’s disease.”

Copyright (c) 2020 The Cancer Letter Inc.