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Cancer Featured Stories

UAMS Cancer Researchers Publish Findings on Rare Childhood Leukemia

LITTLE ROCK – New findings on juvenile myelomonocytic leukemia (JMML) by researchers at the University of Arkansas for Medical Sciences (UAMS) and collaborators at other institutions were published online this month by the medical journal Nature Genetics.

UAMS scientists collaborating on the research titled “The Genomic Landscape of Juvenile Myelomoncytic Leukemia” were led by Peter Emanuel, M.D., director of the UAMS Winthrop P. Rockefeller Cancer Institute and a professor in the Division of Hematology/Oncology, and included Y. Lucy Liu, M.D., Ph.D., assistant professor in the Division of Hematology/Oncology, and Kimo C. Stine, M.D., professor in the Department of Pediatrics, all in the UAMS College of Medicine.

JMML is a very rare and aggressive form of childhood leukemia most often found in children younger than 6. Only about 50 children in the United States are diagnosed with JMML each year. While the most successful therapy is bone marrow transplantation, this intensive treatment is only effective for about 50 percent of patients and can result in long-term side effects.

The UAMS study, published Oct. 12, confirms two important findings that can assist doctors in determining which patients will most likely respond to existing treatment options and which are candidates for experimental or other therapies.

The findings include confirmation that JMML arises due to abnormalities in the Ras signaling pathway within blood cells. Ras proteins control signaling pathways that affect cell growth and division and can lead to the mutations found in tumors. The study also revealed that the number of genetic mutations present at diagnosis is an important predictor for prognosis and survival.

“These findings are a major step forward in understanding the development of this rare disease and future advances in treatment, not only for JMML but also for other more common leukemias,” said Emanuel, who has studied JMML since 1986 and was one of the first — along with Kevin Shannon, M.D., professor of pediatrics at the University of California San Francisco — to hypothesize the study’s findings concerning the Ras signaling pathway.

Emanuel and Shannon’s research groups have collaborated on JMML research for 23 years. Additional investigators from the Broad Institute of Harvard and MIT and St. Jude Children’s Research Hospital participated in the study, which used cell and tissue samples collected during a five-year nationwide clinical trial conducted by the National Cancer Institute’s Children’s Oncology Group.

“Our study examined the entire genome of many JMML patients, thanks in large part to those who donated cells and tissue during the clinical trial,” Emanuel said. The cell and tissue bank, which is housed at UAMS, provided more than half of the specimens used in the study.

A second JMML study also published on Oct. 12 by Nature Genetics corroborated the UAMS group’s findings and referenced Emanuel’s research as supporting documentation.

Guess the Diagnosis with Frits van Rhee, MD, PhD

Guess the Diagnosis: Case 1

Lisa B. is a 47-year-old female store owner from St. Louis, with a 10-month history of fatigue, night sweats, and weight loss.

  • She presents to her PCP with generalized lymphadenopathy, most prominent in the cervical region; there is no polyneuropathy, and patient does not report joint pain. She is referred to a hematologist to rule out lymphoma
  • Medical history is unremarkable; family history relevant for a mother with systemic lupus erythematous and father who died with prostate cancer at 65 years old
  • Her physical exam is notable for bilateral cervical lymphadenopathy (1-2 cm), mild splenomegaly, and mild edema
  • Laboratory findings: anemia (Hgb 11 gm/dL), elevated CRP (35 mg/L) and ESR (80mm/hr), elevated platelets (400,000/mK), Igs (IgG: 4500 mg/dL, IgM: 1500 mg/dL, IgA: 300mg/dL)
  • PET scan showed generalized lymphadenopathy with a maximum SUV of 4.5; FNA of the lymph node is uninformative; she was referred to a general surgeon for excisional lymph node biopsy

Lisa’s pathology report shows the following findings:

  • Regressed germinal centers, scattered hyperplastic follicles, preserved architecture with patent peripheral sinuses and florid interfollicular plasmacytosis with no light chain restriction
  • Prominent vascularization and hyalinization is present

In view of these findings, the hematologist orders further tests, which yield the following results:

  • Lymph node: negative EBER, LANA-1, and IgG4 stains; negative PCR for B-cell clonality
  • Additional laboratory work: negative ANA, negative dsDNA, anti-Smith and anti-phosholipid antibodies; monospot negative

How I Treat Myeloma Using Genomic Analysis

Dr. Faith Davies is a professor of medicine and the director of the Phase I Clinical Trials program for both the Myeloma Center and the Winthrop P. Rockefeller Cancer Institute at the University of Arkansas for Medical Sciences. She is recognized internationally for her focus on innovative targeted molecular therapies and her expertise in the treatment of relapsed refractory myeloma. She is widely published in leading peer-reviewed journals and has contributed to a number of book chapters and reviews on myeloma biology and treatment.

http://www.hematology.org/Meetings/Malignancies/Speakers/3895.aspx

ASH Meeting on Hematologic Malignancies: Faith Davies, MD

Understanding Your Multiple Myeloma Genetics and Why You Need to Know

Originally from the UK but now at UAMS, Dr. Gareth Morgan, MD, PhD believes it to be a very valuable test and uses the information that the test provides to alter treatment approaches. He notes:

We did significant work comparing the GEP70 to i-FISH, the interface FISH which people out there use as a standard and there is no doubt that the GEP70 was more accurate, shall we say, at identifying patients with high-risk behavior. It doesn’t identify all of the high-risk behavior, but if you are GEP70 positive, your clinical outcome is going to be aggressive and you are sure that people are going to relapse early and if you know that data, you alter your clinical approach to treatment – that is very, very clear and that is becoming more obvious. So it is good. It doesn’t identify all high-risk patients and in low risk there are some people with high-risk behavior, but if you are positive, you are sure that people are going to behave badly and need their treatment altered.

Read more here:

http://www.myelomacrowd.org/myeloma-genetics/

Nine of 10 Arkansans Named by Newsweek/Castle Connolly As the “Top Cancer Doctors” in U.S. are at UAMS

LITTLE ROCK – Nine of the 10 cancer physicians from Arkansas named as “2015 Top Cancer Doctors” in the United States are from the University of Arkansas for Medical Sciences (UAMS) and its Winthrop P. Rockefeller Cancer Institute.

The Top Cancer Doctors list was printed in the July 31-Aug. 7, 2015, issue of Newsweek in conjunction with Castle Connolly Medical Ltd., the producers of “America’s Top Doctors.” The list was compiled through peer nominations and research conducted during the course of two decades.

“This is just a further confirmation that UAMS has more doctors recognized for their clinical excellence than any other facility in the state, and that, as the Cancer Institute continues to grow and expand that there are fewer and fewer instances where Arkansans need to leave the state to obtain state-of-the-art cancer care,” said UAMS Cancer Institute Director Peter Emanuel, M.D.

The following UAMS physicians were named Top Cancer Doctors in the United States:

  • V. Suzanne Klimberg, M.D., breast surgeon, director of the UAMS Division of Breast Surgical Oncology and professor in the UAMS College of Medicine
  • James Y. Suen, M.D., head and neck surgeon, chairman of the UAMS Department of Otolaryngology-Head and Neck Surgery, and distinguished professor in the UAMS College of Medicine
  • Alexander F. Burnett, M.D., gynecologic oncologist and professor in the UAMS College of Medicine
  • Laura Hutchins, M.D., hematologist/oncologist and professor in the UAMS College of Medicine
  • Peter Emanuel, M.D., hematologist/oncologist, director of the UAMS Winthrop P. Rockefeller Cancer Institute and professor in the UAMS College of Medicine
  • Issam Makhoul, M.D., hematologist/oncologist, director of the UAMS Division of Hematology/Oncology and associate professor in the UAMS College of Medicine
  • Bart Barlogie, M.D., Ph.D., founder of the UAMS Myeloma Center and distinguished professor in the UAMS College of Medicine
  • James Yuen, M.D., plastic surgeon and professor and chief of the Division of Plastic and Reconstructive Surgery in the UAMS College of Medicine
  • Richard J. Jackson, M.D., pediatric surgeon at Arkansas Children’s Hospital (an affiliate of UAMS) and professor in the UAMS College of Medicine

Important Lessons Learned from the Measles Virus in Multiple Myeloma

Full MCRI Show: Important Lessons Learned from the Measles Virus in Multiple Myeloma and the Next Step to Advance the Fascinating Viro Therapy with Dr. Frits van Rhee and Dr. Stephen Russell

The measles virus grabbed media attention with one patient’s amazing outcome. Dr. Russell and Dr. van Rhee hope to expand those results into more patients with lessons learned from the first clinical trials.

Be sure to listen to the show or read the transcript from the latest interview with the MyelomaCrowd funding initiative discussing the Measles Virus in Multiple Myeloma and Advancing Viro Therapy with our own Dr. Frits van Rhee and colleague Dr. Stephen Russell!

http://www.myelomacrowd.org/full-vanrhee-russell-measles/

 

Celgene Gift to UAMS Myeloma Institute for Bart Barlogie Center for Molecular Diagnostics

The Myeloma Center at the University of Arkansas for Medical Sciences (UAMS) has received a generous gift from Celgene Corporation to benefit patients with multiple myeloma through the creation of The Bart Barlogie Center for Molecular Diagnostics and the establishment of the Celgene Distinguished Endowed Chair in Molecular Therapeutics.

“This is an exciting, new collaboration between the Myeloma Center and Celgene, bringing together leading institutions for consummate innovation in myeloma research,” said Gareth Morgan, M.D., Ph.D., director of the institute. “There has been a 57 percent increase in the total number of myeloma survivors since 2001 as a result of medical innovation. This is encouraging news for myeloma patients and our health care system but we can and must do better. The Bart Barlogie Center creates an exciting opportunity for the next generation of revolutionary transformation in myeloma care.

“The use and refinement of genomics and other novel diagnostic tools will enable development of precision medicine strategies aimed at targeting the distinct genetic signals that affect each patient’s disease. Through a deeper understanding of the molecular changes that take place in myeloma, the Myeloma Center will be better equipped to identify the most appropriate drug therapies that will produce the best outcomes with minimal toxicity and that will make a cure truly achievable for the majority of patients,” Morgan said.

“Celgene’s contribution to the UAMS Myeloma Center reflects our continuing commitment to advance transformational science, deliver life-enhancing medicines and serve patients with multiple myeloma the world over,” said Bob Hugin, chairman and CEO of Celgene Corp. “The Myeloma Center has established itself as a leader in developing precision medicine strategies, and we’re happy to support it in continuing that standard of innovation and excellence.”

From its founding in 1989 until 2014, Barlogie led the UAMS myeloma program. Barlogie chose in 2014 to step down as director of the Myeloma Center to focus on clinical care and research, with an emphasis on curing high-risk myeloma. Morgan became director July 1. He came to UAMS from The Royal Marsden Institute NHS Foundation Trust and the Institute of Cancer Research in London where he was a professor of hematology and director of the Centre for Myeloma Research.

At a ceremony today at UAMS, Gov. Asa Hutchinson thanked Celgene for supporting UAMS and the state of Arkansas.

“A shared compassion for myeloma patients and their care along with a commitment to innovation in that care has been the foundation of a vital, long-lasting partnership between Celgene and the Myeloma Center,” Hutchinson said.

The myeloma program at UAMS has seen more than 11,000 patients from every state in the United States and more than 50 foreign countries and has performed more than 9,000 peripheral blood stem cell transplants.

“Barlogie and his colleagues fundamentally changed the course of the disease and its effects through new diagnostic procedures and therapeutic interventions,” Hugin said. “Celgene has been happy to work with him for many years, and we wanted to acknowledge his achievement in a lasting and meaningful way with this center.”

An endowed chair is one of the highest academic honors that can be bestowed on its most distinguished faculty by a university and donor. The endowment provides a dependable source of income for academic program support and creates permanent legacies for some of its most distinguished professors. Celgene contributed $10 million to the UAMS Myeloma Center for The Bart Barlogie Center for Molecular Diagnostics and the endowed chair.

“The Celgene Endowed Chair in Molecular Therapeutics will ensure continued recruitment and support retention of the highest caliber faculty members, who will bring new ideas and create new programs related to molecular therapeutics, an essential component of precision medicine,” said UAMS Chancellor Dan Rahn, M.D. “We’re grateful for this generous gift from a company that has such a strong history of collaboration with the Myeloma Center and UAMS.”

Headquartered in Summit, New Jersey, Celgene Corp. is an integrated global biopharmaceutical company engaged primarily in the discovery, development and delivery of innovative therapies for the treatment of cancer and inflammatory diseases through gene and protein regulation.

UAMS is the state’s only comprehensive academic health center, with colleges of Medicine, Nursing, Pharmacy, Health Professions and Public Health; a graduate school; a hospital; a northwest Arkansas regional campus; a statewide network of regional centers; and seven institutes: the Winthrop P. Rockefeller Cancer Institute, the Jackson T. Stephens Spine & Neurosciences Institute, the Myeloma Center, the Harvey & Bernice Jones Eye Institute, the Psychiatric Research Institute, the Donald W. Reynolds Institute on Aging and the Translational Research Institute. It is the only adult Level 1 trauma center in the state. UAMS has 2,890 students and 782 medical residents. It is the state’s largest public employer with more than 10,000 employees, including about 1,000 physicians and other professionals who provide care to patients at UAMS, Arkansas Children’s Hospital, the VA Medical Center and UAMS regional centers throughout the state.