Ovarian cancer is the 5th cause of cancer death in women. Older women with ovarian cancer have a markedly worse survival rate than for younger ones. This is likely due to a combination of biology and a treatment-related factors. In this project, we will study these older women using a two-pronged approach. First, we will look at gene array data and assess which gene expression patterns correlate with a more aggressive behavior in older women, how they are modified by chemotherapy, and whether a targeted therapy can help control these deleterious patterns. Secondly, we will investigate ways to improve the delivery of chemotherapy by factoring in body composition and the functional impact of side effects. We will proceed in three steps. In step 1, we will use the Total Cancer Care (TCC) database, which combines gene arrays and clinical data to identify promising patterns to be focused on. In step 2, we will conduct a prospective study and collect samples after preoperative chemotherapy, to see which genes fail to be inactivated by chemotherapy, and how body composition is related to the blood levels of chemotherapy. In Step 3, we will add a targeted drug therapy to the standard chemotherapy for ovarian cancer to try to thwart the resistance mechanisms we identified and improve response. In one of the arms, the chemotherapy will be adapted to body composition and functional impact of side effects. To have enough patients, Steps 2 and 3 will be multicentric studies conducted within the Moffitt Oncology Network and Total Cancer Care Partnership.
Dr. Hatem Soliman, a researcher and breast cancer medical oncologist at Moffitt Cancer Center, will be conducting a project to help increase accrual to clinical trials for breast cancer patients. The aim of the project is to first assess patient awareness of cancer clinical trials, perceived barriers that may prevent participation and what information would help patients to more readily participate in trials. Information will be collected from a target of 100 Moffitt breast cancer patients. Once this initial assessment is completed, the second aim of the project is to use this information to create a web hosted video to address questions and issues identified through the survey as perceived barriers to breast cancer clinical trial participation and provide vital information that may help increase participation. A short post video survey will be administered to ascertain the impact of the information presented on increasing clinical trial participation. If successful, our ultimate goal would be to expand this methodology to other cancer types to help increase clinical trial participation.
Pancreatic cancer is a devastating disease. Current therapies for pancreatic cancer have modest effects as the 5-year overall survival is a discouraging 5-6%. One contributing factor to increased morbidity and mortality is cancer cachexia. Cachexia is defined as weight loss, muscle atrophy, fatigue, and weakness, in someone who is not actively trying to lose weight. Cachexia is a devastating condition affecting most cancer patients, but significantly more pronounced in patients with pancreatic cancer and is a significant therapeutic and personal dilemma. I have a significant background in clinical oncology with specialization in pancreatic cancer. The aims of my therapies are to improve and extend my patient’s quality of life. Unfortunately, our therapies can be premature or delayed primarily by the overall health of my patients. Premature in that we treat weak and malnourished patients that should not be given aggressive therapies for the risk of causing more harm than good. Delayed in that the patient is too weak and malnourished to receive any therapy and therefore will succumb earlier to their disease. With the expertise and passion of our collaborative group, we will investigate the possible biologic factors that contribute to pancreatic cancer cachexia. Our plan will be the future development of strategies to interfere with its deleterious effects on our patient population. In summary, we hope to improve the quantity of quality life in patients with pancreatic cancer.
Adenocarcinoma is the most common type of lung cancer, and the majority of people diagnosed with this disease will die from metastases. Chemotherapy is the standard way to treat this cancer, and this provides clear benefits including increasing the lifespan of patients. However this benefit is limited and all patients eventually become resistant to standard therapy. Therefore new types of treatment need to be developed. Immunotherapy is a type of treatment designed to get a patient’s own immune system to kill their cancer. Very recently it was demonstrated that an immunotherapy called anti-PD1 has surprisingly good activity in lung cancer. Rapid and prolonged regressions of tumors occur in about one quarter of patients. Now it is important to develop combination therapies with this agent that may help the three quarters of patients who do not respond to anti-PD1. One such approach would be to combine anti-PD1 with a therapeutic cancer vaccine. Vaccines are designed to increase the number of lymphocytes in patients that can recognize and kill cancer cells. Many of these sorts of vaccines have been developed that are very effective in accomplishing this lymphocyte expansion, but none have been very good at killing tumors. One reason for this is that tumor cells can produce a protein called PD-L1 that binds to PD1, another protein on the surface of the lymphocytes activated by the vaccines, which shuts down their ability to kill cancer cells. Anti-PD1 prevents this from happening. We propose to combine anti-PD1 with a cancer vaccine for the first time to treat patients with advanced stage lung adenocarcinoma. We will use a vaccine that activates lymphocytes that recognize a protein called mesothelin which is produced by many lung adenocarcinomas and has been shown previously to expand the number of mesothelin-specific lymphocytes in cancer patients. We expect that combining this vaccine with anti-PD1 will be synergistic, producing improved clinical outcomes. We will also comprehensively analyze the immune systems of the patients and characteristics of their tumors which may be responsible for producing resistance to anti-PD1 and/ or the vaccine. This information can then be used to suggest additional agents that can be added to the anti-PD1/ vaccine combination in the future to further improve the effectiveness of this therapy.
Baptist Health South Florida is developing Miami Cancer Institute into a destination cancer center known for its leading clinical care, exceptional patient experience, advanced clinical research and state-of-the-art technology – including the first proton therapy center in South Florida, Latin America and the Caribbean. To accelerate its mission of hope, caring and innovation, Miami Cancer Institute has announced plans to join the Memorial Sloan Kettering Cancer Alliance, a dynamic partnership that will ultimately enable cancer patients to access potential breakthrough therapies right here in South Florida.
