New clinical research findings on oncology to be highlighted at ASCO 2010

Researchers from University Hospitals Case Medical Center's Ireland Cancer Center will present new clinical research findings at the 46th Annual Meeting of The American Society of Clinical Oncology (ASCO) June 4-8 in Chicago.

In addition to the data presentations detailed below, Neal Meropol, MD, chief of hematology and oncology at University Hospitals Case Medical Center and Case Western Reserve University School of Medicine, chair of a new ASCO task force on comparative effectiveness research (CER) and the chair-elect of the ASCO Cancer Research Committee, will lead an education session titled "Comparative Effectiveness Research in Oncology: Opportunities and Challenges" on Tuesday, June 8 from 8:00 - 9:15 a.m. In this session, Dr. Meropol and other experts will discuss CER as a way of addressing important questions that can't be addressed in clinical trials.

Dr. Meropol will also be leading an education session titled "Biomarker-driven Treatment in Stage II Colon Cancer: When to Hold and When to Fold" on Monday, June 7 from 8:00 - 9:15 a.m.

Other presentations of note include:

Saturday, June 5

Poster Discussion Session: Central Nervous System Tumors

Iatrogenic Immunosuppression in Patients with High-Grade Gliomas Treated with Radiation and Temozolomide: A NABTT CNS Consortium Study
Abstract #2013: 8:00 a.m. - 1:00 p.m.
Presenter: Andrew Sloan, MD, director of the Brain Tumor & Neuro-Oncology Center, University Hospitals Case Medical Center, Case Western Reserve University School of Medicine
Lead Author: Stuart A. Grossman, MD, Johns Hopkins Sidney Kimmel Comprehensive Cancer Center

Researchers found that standard therapy of high grade gliomas (HGG) - brain tumors -- results in substantial suppression of the immune system. Standard therapy often involves dexamethasone (a corticosteroid), radiation, and temozolomide (a chemotherapy drug). These results support the monitoring of CD4 counts and have important implications for studies looking at increasing doses of chemotherapy used to treat HGG, and for studies of cancer vaccines. Future studies will determine the role of CD4 counts in modifying the duration of prophylactic antibiotics and the intensity and duration of temozolomide therapy.

General Poster Session: Breast Cancer

Utility of the Vulnerable Elders Survey for Predicting Sixth-Month Functional Decline Among Older Patients with Newly Diagnosed Breast Cancer
Abstract #598: 2:00 p.m. - 6:00 p.m.
Presenter/Lead Author: Cynthia Owusu, MD, hematologist/oncologist at the University Hospitals Case Medical Center, Case Western Reserve University School of Medicine
Additional Presenters: Mark Schluchter, PhD; Siran Koroukian, PhD; Nathan Berger, MD, University Hospitals Ireland Cancer Center, Case Western Reserve University School of Medicine

Instruments specifically validated for predicting functional decline in geriatric-oncology are nonexistent. The Vulnerable Elders Survey (VES), an instrument predicting functional decline among community dwelling older adults, has never been validated in oncology patients. In this study, researchers found that the VES is a useful tool for predicting risk of functional decline among older women with incident breast cancer who may then be targeted for early intervention to improve treatment tolerance and cancer outcomes.

Sunday, June 6

Clinical Science Symposium: Optimizing Care of the Elderly and Underserved

Predicting Chemotherapy Toxicity in Older Adults with Cancer: A Prospective 500-Patient Multicenter Study
Abstract #9001: 11:30 a.m. - 1:00 p.m.
Presenter: Cynthia Owusu, MD, hematologist/oncologist at University Hospitals Case Medical Center, Case Western Reserve University School of Medicine

This study of 500 patients identified risk factors for grade 3-5 chemotherapy toxicity in older adults, and developed a risk stratification schema for grade 3-5 chemotherapy toxicity based on the number of risk factors.

General Poster Session: Sarcoma

Effect of Radiation Therapy on Survival of Patients with Surgically Resected Retroperitoneal Sarcoma: A Population-Based Matched Pair Study
Abstract #10082: 2:00 p.m. - 6:00 p.m.
Presenters: Julian Kim, MD, chief of oncologic surgery at University Hospitals Case Medical Center and Jill Barnholtz-Sloan, PhD, assistant professor at Case Western Reserve University School of Medicine

Although the only curative treatment for retroperitoneal sarcoma (RPS) is surgical resection, radiation therapy is frequently added. Currently no prospective randomized trial has measured the efficacy of neoadjuvant or adjuvant radiation therapy in patients with resected RPS. In this study, researchers sought to determine the effect of radiation therapy on overall survival between propensity score-matched, surgically-resected retroperitoneal sarcoma (RPS) patients using the Surveillance, Epidemiology, and End Results (SEER) database. The study's results indicate that patients with surgically-resected RPS entered into the SEER database who have received radiation therapy have not demonstrated a survival benefit as compared to surgery alone.

Poster Session: Gastrointestinal (Noncolorectal) Cancer

Effect of Hyperacute Immunotherapy in Addition to Standard Adjuvant Therapy for Resected Pancreatic Cancer on Disease-Free and Overall Survival: Preliminary Analysis of Phase II Data
Abstract #4059: 2:00 p.m. - 6:00 p.m.
Presenter: Jeffrey Hardacre, MD, surgical oncologist, University Hospitals Case Medical Center, assistant professor at Case Western Reserve University School of Medicine

Pancreatic cancer portends a poor prognosis, with long-term survival less than 5%, and better chemotherapies and/or other treatment modalities are needed to improve survival for pancreatic cancer patients. These two open-label nonrandomized phase II studies evaluated live, allogeneic, cellular immunotherapy (HyperAcute-Pancreas, HAPa) plus standard adjuvant gemcitabine-based chemotherapy/5-FU-based chemoradiotherapy for patients with resected pancreatic adenocarcinoma. The data suggest that the addition of HAPa to standard adjuvant therapy for resected pancreatic cancer may improve survival. A phase III study is under way.

Monday, June 7

General Poster Session: Developmental Therapeutics - Clinical Pharmacology and Immunotherapy

Final Results From a Phase 1 Study of Oral TRC102 (Methoxyamine HCl), an Inhibitor of Base-Excision Repair, to Potentiate the Activity of Pemetrexed in Patients with Refractory Cancer
Abstract #2576: 8:00 a.m. - 12:00 p.m.
Presenters: Panos Savvides, MD; Lili Liu, MD, PhD; Yan Xu, PhD; Stanton Gerson, MD, University Hospitals Case Medical Center, Case Western Reserve University School of Medicine
Lead Author: G. J. Weiss, MD, Virginia G. Piper Cancer Center at Scottsdale Healthcare

A new first-in-class drug discovered and tested at University Hospitals Case Medical Center has been found to be promising in the treatment of advanced cancer through increasing the efficacy of chemotherapy. The multi-center phase one study of TRC102, a novel oral anti-cancer drug intended to overcome resistance to chemotherapy by targeting a DNA repair pathway, has the potential to improve the lives of many patients.

TRC102 (introduced as Methoxyamine) is a small molecule that has been shown to reverse resistance to the chemotherapy agent Pemetrexed (Alimta), by targeting a newly identified pathway used to repair chemotherapy-induced DNA damage. TRC102 was identified and developed by researchers at UH Case Medical Center and Case Western Reserve University School of Medicine and further developed by TRACON Pharmaceuticals, Inc. of San Diego, CA.

TRC102 is also being developed to reverse resistance to the chemotherapeutic Temodar and a second Phase 1 trial of TRC102 combined with Temodar is ongoing.

General Poster Session: Patient and Survivor Care

Polypharmacy and Functional Status in Older Patients with Breast, Colon, and Lung Cancers
Abstract #9087: 1:00 p.m. - 5:00 p.m.
Presenters: Siran Koroukian, PhD; Nathan Berger, MD; Cynthia Owusu, MD, University Hospitals Case Medical Center, Case Western Reserve University School of Medicine
Lead Author: G. K. Prithviraj, MD, University Hospitals Case Medical Center, Case Western Reserve University School of Medicine

Researchers sought to evaluate the prevalence of polypharmacy and the inappropriate prescribing of medications (IPM), and to determine the relation between polypharmacy, IPM, and functional status in older cancer patients. Polypharmacy and IPM were highly prevalent in the group of older patients with breast, colon, or lung cancer that were studied; and polypharmacy was associated with poorer functional status at diagnosis. The study's results suggest that interventions for polypharmacy may improve functional status, treatment tolerance and cancer outcomes among older patients and are therefore warranted.

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