News from Around the Cancer Center

Kachnic is new chair of Radiation Oncology

Lisa Kachnic, M.D., is now professor and chair of the Vanderbilt Department of Radiation Oncology.

She came to Vanderbilt from the Boston University School of Medicine, where she served as professor and chair of Radiation Oncology and associate director of Multidisciplinary Cancer Research. She was also the chief of Radiation Oncology at Boston Medical Center.

Kachnic, who is a fellow of the American Society for Therapeutic Radiology and Oncology (ASTRO), succeeds Arnold Malcolm, M.D., MBA, who retired from the position in December 2014.

As the new chair, Kachnic is responsible for overseeing a department known for delivering world-class oncology services at Vanderbilt-Ingram Cancer Center (VICC), scientific discovery and educating leaders, along with its thriving residency program that trains academic clinicians and physician–scientists as well as the nation’s first accredited medical physics professional doctorate program.

Kachnic’s primary areas of clinical interest include gastrointestinal (GI) malignancies, image-guided radiation delivery and outcomes and symptoms management research.

She is a 1987 graduate of Boston College and a 1991 graduate of the Tufts University School of Medicine. She completed a residency in Radiation Oncology at Harvard.

At Boston Medical Center, Kachnic has served as chair of the hospital’s cancer committee for the last decade, was the principal investigator of multiple Department of Defense awards and their NCI Minority-Based Cancer Community Oncology Program, and has been a member of the Harvard Radiation Oncology Residency Program Executive Committee since 2011.

– by John Howser

 

Bethany Rhoten examines quality of life among cancer survivors

Bethany Rhoten’s research focuses on issues that few people openly discuss—those surrounding body image and sexuality among cancer survivors.

“While conducting research for my dissertation, I saw how difficult it is when a patient with head and neck cancer looks in the mirror and the person they see is not the person they saw six months ago, or the idea of who they think they should be,” said Rhoten, assistant professor of Nursing. “These patients are grateful to be alive, but maybe they don’t want to go out in public or socialize with their friends. Maybe now they avoid being affectionate with their spouse or partner.”

Rhoten’s work focuses on patients with recurrent head and neck cancers who make the decision to pursue more treatment and how that decision affects their quality of life, body image and sexual satisfaction. These patients must determine if the risk and morbidity associated with the treatment outweigh the benefit. “A patient with recurrent head and neck cancer will want to know if the treatment will prolong their life but also if they will be able to talk and eat and drink normally. Will they be able to enjoy time with family and friends?”

There is little research about the decision-making processes of this population, according to Rhoten, who received her M.S.N. and Ph.D. degrees at Vanderbilt. Her study will include surveys of patients at the time of their decision to pursue further treatment as well as at three- and six-month intervals post decision.

“We want to learn if the patients are happy with their decision, what they are happy or unhappy about, and would they make that decision again,” Rhoten said. “It’s very patient-centered and individualized for each person, with a number of elements coming into play. Of those elements, we want to know which are most important to patients.” Rhoten’s ultimate goal is to help future patients with recurrent head and neck cancers make more informed decisions, and for clinicians to be equipped with more scientific evidence on which to base potential outcomes.

Rhoten’s study is made possible by a Vanderbilt Patient-Centered Outcome Research Career Knowledge, Education and Training Program (V-POCKET) grant, specifically the portion designed to develop and recruit scholars.

– by Kathy Rivers

 

VICC investigators land cancer grants

Two Vanderbilt-Ingram Cancer Center (VICC) investigators—Jennifer Pietenpol, Ph.D., Benjamin F. Byrd Jr. Professor of Oncology and director of VICC, and Valerie Jansen, M.D., Ph.D., medical oncology fellow—have received new cancer research grants awarded by Susan Komen, the world’s largest nonprofit funder of breast cancer research.

The 2015 grants will provide nearly $600,000 over three years for the two VICC investigators for their individual breast cancer research projects.

They are among 124 researchers in 25 states and eight countries to receive the 2015 Komen grants, with about half of the grants targeted to early-career researchers. This group has been hit especially hard by declines of as much as 25 percent in federal research funding over the past decade.

Each year, nearly 230,000 women and 2,300 men are diagnosed with breast cancer, which is the second leading cause of cancer-related deaths among women.

“The Susan G. Komen organization has provided tremendous support for our breast cancer research at VICC, from basic, to clinical, to population studies that impact our patients in the clinic and individuals in the community,” said Pietenpol, a Komen Scholar.

“This continued source of financial support has been crucial for our discoveries about the biological mechanisms that spur cancer growth, as well as new rationales for therapeutic options for the disease.”

Pietenpol is investigating the causes and potential treatments for triple-negative breast cancer (TNBC), which is more common among African-American women and those with BRCA1 mutations. Triple-negative tumors lack receptors for the hormones estrogen and progesterone, as well as amplifications in the HER2 gene, and they do not respond to current targeted therapies.

The new funding will allow Pietenpol’s group to focus on analyzing tumor tissue from patients enrolled in a novel clinical trial to determine if a set of genomic markers can predict sensitivity or resistance to the drugs tested in the trial. The trial will help investigators understand why specific patients respond to treatment while others don’t and to find better methods to target those resistant tumors.

Jansen, who works in the laboratory of Carlos Arteaga, M.D., director of the Center for Cancer Targeted Therapies and the Breast Cancer Program at VICC, is investigating breast cancers that depend on estrogen for growth. These estrogen receptor (ER)-positive tumors usually respond to therapies that block the ER function. However, after an initial response to treatment, many ER-positive tumors develop resistance and start growing again.

Jansen is investigating promising new therapies that focus on CDK4 and CDK6 proteins that are involved in the regulation of the cell cycle pathway. Inhibiting CDK4 and CDK6 prevents the proliferation of cancer cells, but resistance is also a problem with these therapies. Jansen is investigating the role of another protein (PDK1) in combination with CDK4/6 inhibitors as a novel treatment strategy for ER-positive cancers.

The 2015 grant awards bring Komen’s total research investment to more than $889 million since 1982, second only to the U.S. government. Grants from Komen’s nearly $36 million research portfolio — including more than $17.6 million in grants awarded to early-career investigators — span the entire cancer continuum from prevention to treatments for aggressive and metastatic disease.

– by Dagny Stuart

 

Kimryn Rathmell named director of Division of Hematology and Oncology

Kimryn Rathmell, M.D., Ph.D., has been named director of Vanderbilt’s Division of Hematology and Oncology.

She came to Vanderbilt-Ingram Cancer Center (VICC) from University of North Carolina, Chapel Hill, where she was Alexander Professor for Translational Science and associate director for Training and Education at Lineberger Comprehensive Cancer Center.

Rathmell is a physician–scientist whose research focuses on the genetic and molecular signals that drive renal cell carcinomas (kidney cancers), and who specializes in the treatment of patients with rare and complex kidney cancers as well as prostate, bladder and testicular cancers.

Her research program includes development of animal models, innovative imaging strategies and novel therapeutics. At UNC, she also served as a director for the Medical Scientist Training Program and led the mentoring activities of the Hematology and Oncology Division and the Lineberger Cancer Center.

In her current research, Rathmell and colleagues have identified factors that are critical to transitions in the progression of kidney cancer. She has also led or participated in a number of the Cancer Genome Atlas projects.

At Vanderbilt, Rathmell will continue to care for patients with genitourinary malignancies in addition to continuing research in her laboratory at VICC. She said she has always been impressed with Vanderbilt’s commitment to high impact scientific research.

Rathmell earned undergraduate degrees in biology and chemistry at the University of Northern Iowa, Cedar Falls, then went to Stanford University, where she earned her M.D. and Ph.D. in biophysics.

Following an internship at the University of Chicago, she completed a residency and fellowship at the University of Pennsylvania.

– by Dagny Stuart

 

Hospital employees help make wedding happen for dying patient.

Their wedding date was just weeks away when Caleb Hanby and his fiancée Bethany Davidson rushed to Vanderbilt University Medical Center in the early morning hours in September.

Hanby, 28, was gravely ill and having trouble breathing. About a year earlier, he had been diagnosed with a rare cancer of the skeletal muscle in his jaw.

The illness was progressing faster than they had expected. That morning, as emergency physicians placed Hanby on oxygen to help stabilize him, Davidson realized that she might lose her fiancé before their wedding day.

“I knew it needed to happen that day,” Davidson said. “I couldn’t live without the opportunity to be married to my soul mate.”

Shortly after he was placed in the Medical Intensive Care Unit on the 8th floor, plans went into motion to throw an impromptu ceremony. With their parents already in town or on their way, Hanby and Davidson called their pastor from Judson Baptist Church in Nashville to come to the hospital.

Hanby, a personal trainer originally from Michigan, had been undergoing treatment for rhabdomyosarcoma since October — rounds of both chemotherapy and radiation therapy. But the cancer had resisted treatment.

Mary Ann George, a medical receptionist for the unit, called the gift shop to arrange for a bouquet and asked Executive Chef George Moran for a wedding cake within two hours.

She even called on her mother to serve as the dedicated photographer for the event.

The dining services staff worked quickly, setting aside time from their normal duties to prepare a cake with two stacked tiers and smooth white frosting decorated with purple icing flowers.

Meanwhile on a walk through the hospital, George found several bouquets of flowers that were to be thrown away. She gathered and brought them to Hanby’s room for the ceremony and a boutonniere was pinned onto Hanby’s hospital gown.

As the ceremony began, Todd Rice, M.D., MSCI, associate professor of Medicine, the attending physician for the unit that day, walked into the room carrying the two simple rings from the hospital gift shop. Lauren Hill, R.N., a nurse on the unit, walked with him, casting paper flower petals onto the floor.

Finally, Davidson, escorted by her mother, walked tearfully into the flower-filled room and took her place alongside Hanby’s bed. He reached out and held her hand as they listened to the words of their minister and repeated their vows.

For the family, the efforts shown by VUMC faculty and staff far exceeded their expectations for patient care.

“They’ve gone above and beyond,” said Michelle Hanby, Caleb’s mother. “It’s not just a job for them.”

Davidson said she was overwhelmed with the emotion that filled the room during the ceremony and touched by the gestures of hospital staff and faculty.

“They’ve made us feel like we’re the most important people at this hospital, with all that they’ve done,” Davidson said.

Hanby called the ceremony beautiful and perfect.

“It made me feel complete,” he said.

Caleb Hanby died seven days after his wedding.

– by Josh Brown

 

Horn lands NCI Team Leadership Award

Leora Horn, M.D., M.Sc., associate professor of Medicine and clinical director of the Thoracic Oncology Program at Vanderbilt-Ingram Cancer Center (VICC), has received a 2015 Cancer Clinical Investigator Team Leadership Award from the National Cancer Institute (NCI).

Horn is one of 11 clinical investigators selected to receive one of the awards. Established in 2009, the awards are designed to recognize and support outstanding mid-career clinical investigators at NCI-designated Cancer Centers who are actively engaged in collaborative clinical research trials. These clinical investigators are recognized for their leadership activities and for their role as mentors for junior faculty and trainees interested in research that benefits cancer patients.

Horn specializes in treating lung cancer patients and has served as VICC principal investigator for several clinical research trials testing potential new drug therapies for patients.

– by Dagny Stuart

 

Visionary philanthropy holds promise for patients

In 2005, Tennessee philanthropists Jim and Janet Ayers gave $10 million to help Vanderbilt University scientists find early markers for colorectal cancer that could improve diagnosis and potentially save many lives.

Within nine years, the gift, which established the Jim Ayers Institute for Precancer Detection and Diagnosis at Vanderbilt-Ingram Cancer Center, had yielded an impressive return: identification of protein “signatures” of the genetic mutations that drive the nation’s second leading cancer killer after lung cancer.

“You can argue that it’s now within our grasp to change the outcome for patients with several types of cancers because of the knowledge gained,” said Cancer Center director Jennifer Pietenpol, Ph.D. “It was money well invested.”

“The Ayers Institute really launched proteomics (the study of proteins) in cancer diagnostics as a national enterprise,” added institute director Dan Liebler, Ph.D., Ingram Professor of Cancer Research and a nationally known expert in the field.

Pharmaceutical companies are rushing to develop new, more effective cancer drugs that target specific features of individual tumors, what Pietenpol calls precision oncology. But “you need a molecular test to determine which features a patient’s tumor has and which drug is the best match,” Liebler explained.

The research enabled by the Ayers Institute provided the “proof of concept,” he said. It “convinced us that it’s time to develop protein-based diagnostics that would guide new cancer therapeutics.”

Meanwhile, the work at Vanderbilt continues, in genomics as well as proteomics, in imaging, and in bioinformatics, the development of techniques for handling huge amounts of data. “Now we can begin to piece together part of the puzzle we never had before,” said Pietenpol, who is also the Benjamin F. Byrd Jr. Professor of Oncology.

Success in science requires people who ask good questions and are passionate about making change. “That’s Dan Liebler,” she said. “That’s the Ayerses. Together, they did things far beyond our ideas when the institute was formed. That’s the real gift of the Ayers Institute.”

A year after the 2005 gift from The Ayers Foundation, the National Cancer Institute joined the effort, and launched the Clinical Proteomic Tumor Analysis Consortium (CPTAC), an ambitious, multi-center effort to identify abnormal patterns of protein regulation that could distinguish cancers from normal tissues.

Vanderbilt was one of five centers to receive an initial CPTAC grant, $8 million over five years, and has continued to be funded through the current fiscal year. The NCI recently renewed CPTAC for another five years, “due in significant part to our success,” Liebler said.

Liebler and his team analyzed hundreds of samples of colon tissue removed during colonoscopies and, by comparing normal to cancerous tissue, looked for protein markers that were unique to tumors. Bing Zhang, Ph.D., associate professor of Biomedical Informatics, developed algorithms for analyzing the data.

The high point for institute scientists was the 2014 publication of their findings in the journal Nature. The technological tour de force was described at the time as the first integrated “proteogenomic” characterization of human cancer.

The proteins elevated in colon tumors did not get into the bloodstream in high enough levels to be detectable “biomarkers” for cancer but, said Jim Ayers, “we knew this thing wasn’t a slam dunk. Nothing is a slam dunk.”

Nevertheless, Pietenpol said several key scientific advances came out of the institute, including:

• Development of a proteomic “platform” that can analyze many types of cancer;
• Development of cutting-edge bioinformatics for dealing with reams of data and
• Stimulating new avenues of research in gastrointestinal, breast, lung and head-and-neck cancers.

In addition, the Ayers Institute attracted an estimated $125 million in funds from the federal government, pharmaceutical companies and private foundations to support the research of more than a dozen Vanderbilt investigators.

– by Bill Snyder