This project attempts to use advanced analytical software (IBM’s Watson) to provide a comprehensive picture of our metastatic breast cancer patient population over a 5 year period at the Moffitt Cancer Center. The projects aims are to capture this dataset over the course of a year and enter in many different data points about the patients. These data points describe what this population of patients looks like from the perspective of an oncologist determining how many of them are eligible for any given trial that they have open. With this information we can use Watson to generate a detailed report to help us understand what types of patients we see, how those groups have changed over time, and most importantly what trials can we seek out to best match up with the patients we see at our center. The goal is to use data analysis to help us plan what mix of different trials we need to open in the future to best serve our patients’ needs.
The Robert Shields Memorial Grant for Esophageal Cancer was funded by two fundraisers organized by Frank Cannata: Rolling Thunder’s 2015 “Ride for Freedom,” and The Cannata Report Awards and Charities Dinner
Unlike treatment of other common diseases, cancer therapy is constantly limited by rapid evolution of resistance in the treated (cancer) cells. Unfortunately, the amazing capacity of tumor cells to evolve resistance strategies limits virtually every treatment so that metastatic cancers generally remain fatal.
We propose that, while the ability to evolve confers a great advantage on cancer cells, it also imposes a subtle opportunity for treatment. This is because evolving populations can only adapt to current conditions – they can never anticipate future environments. Importantly we can. In this project we employ a sequence of treatments. The first therapy both actively kills cancer cells and guides the evolution of cancer cells so that development of resistance, although inevitable, uses a cellular strategy that we can attack with the second line therapy. We term this “double bind” cancer treatment strategy. An excellent illustration of this approach is pest management through “predator facilitation.” For example, in the event of a rodent infestation, a farmer may introduce an owl. However, rodents typically adapt to the owl predation by shifting their activity to the safety of shrubs. While this would seem to be discouraging result (similar to evolution of resistance to therapy in cancer), the “resistance” strategy can, in fact, be exploited by the farmer by introducing snakes. This is a double bind because the owls facilitate the hunting success of snakes and vice-versa. In this project we construct a similar evolutionary dynamics for treating esophageal cancer using a combination of target therapy and immunotherapy.
