Pathways TO DISCOVERY
AT T H E FO R E F R O NT O F C A N CE R CARE AND DIS COVE RY
COVER STORY
The Immunotherapy Revolution ALSO IN THIS ISSUE 6
M EET THE EXPERT: AKASH PATNAIK, MD, PHD
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S POTLIGHT: GENITOURINARY (GU) CANCERS CLINICAL TRIALS
10 L IVER TUMOR CLINIC OFFERS MULTIDISCIPLINARY CARE, ACCESS TO CLINICAL TRIALS 13 AWARD-WINNING ARCHITECTURE FIRM TO DESIGN NEW CANCER HOSPITAL
SPRING 2017
Pathways
From the Director Each year, we strive to make our impact greater by embracing change and pursuing innovation. This year is no exception. From planning for a new dedicated cancer hospital for adults to adding accomplished researchers to our team, we are preparing for a future that is evolving more rapidly than ever.
TO DISCOVERY
AT THE FOREFRONT OF CANCER CARE AND D ISCOVERY
Spring 2017 E X E C U T I V E E D I TO R
Crystal Senesac M A N AG I N G E D I TO R A N D W R I T E R
Bethany Hubbard SENIOR SCIENCE WRITER
Kathleen Goss, PhD CO N T R I B U T I N G W R I T E R S
John Easton Michael McHugh E D I TO R I A L A DV I S O R S
Michelle Le Beau, PhD Marcy List, PhD P H O TO G R A P H Y
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G Thomas Partners LLC Pathways to Discovery is a triannual publication of the University of Chicago Medicine Comprehensive Cancer Center. T H E U N I V E R S I T Y O F C H I C AG O M E D I C I N E CO M P R E H E N S I V E C A N C E R C E N T E R 5 8 41 S . M A RY L A N D AV E . MC1140, H212 C H I C AG O , I L 6 0 6 3 7
Immunotherapy—the focus of this issue—embodies the changing world of cancer treatment. In the past decade, the notion that we could harness the body’s immune system to fight cancer evolved from an idea into a reality. Today, immunotherapies are helping patients live longer and providing hope for those who had little. Our researchers continue to lead the immunotherapy revolution through basic research, which aims to improve the efficacy of current treatments, and clinical trials testing new and promising therapies. This issue provides a look at our past and future contributions to the field. In this issue, you will also find examples of our most recent research breakthroughs, new faculty, member honors, and clinical trials. If you have visited cancer.uchicago.edu recently, you will notice that we recently redesigned our website. We hope you enjoy the new look and feel, and find it easy to navigate. We encourage you to visit it often as a way to keep up with all our advancements in research, clinical care, education, and community engagement. Thank you for your support, and we hope you have a wonderful summer! Regards,
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© 2017 The University of Chicago Medicine Comprehensive Cancer Center. All rights reserved.
Michelle M. Le Beau, PhD Director, The University of Chicago Medicine Comprehensive Cancer Center; Arthur and Marian Edelstein Professor of Medicine
THE IMMUNOTHERAPY
REVOLUTION In the past decade, immunotherapies have revolutionized the way we treat cancer. By activating the immune system, these powerful treatments are able to use the body’s own defense mechanisms to attack cancer cells and halt tumor growth. Scientists at the University of Chicago Medicine Comprehensive Cancer Center are leading the field of immunology, from basic research that aims to understand how the immune system works at the molecular level to clinical trials that are testing the newest and most promising therapies. However, immunotherapy is not always effective. No two cancers are alike, and genetic, biological and environmental factors can make some people less likely to respond to immunotherapy. So, how do you overcome this barrier and develop better therapies that can help more patients? UNDERSTANDING PATIENT RESPONSE TO IMMUNOTHERAPY Our researchers have uncovered several factors that play a role in a patient’s response to immunotherapy. For example, Thomas Gajewski, MD, PhD, professor of pathology and medicine, recently found that a person’s gut bacteria, or microbiota, may impact the effectiveness of certain immunotherapies (see sidebar on page 2). Another key player is the tumor microenvironment—the cellular environment in which a tumor lives. The microenvironment consists of tissue, blood vessels, immune cells, fibroblasts, and other components that interact with the tumor cells. As it turns out, the tumor’s “home” plays an important role in how tumors behave and their susceptibility to certain drugs.
Gajewski coined the term “T-cell-inflamed tumor microenvironment” to describe a major subset of tumors from patients whose cellular environments harbor qualities that make them more likely to respond to immunotherapies.1 More than two decades ago, researchers began testing cancer vaccines that aimed to elevate a person’s level of antigen-specific T cells—white blood cells that can recognize antigens, or short protein fragments, displayed on the surface of cancer cells. The scientists observed that some people already had elevated levels of T cells in their blood prior to vaccination, and the vaccine was ineffective at sparking a response in others. Gajewski’s team set out to decode this dilemma more than a decade ago. 2 Gajewski and his team analyzed tumor tissue samples from patients with metastatic melanoma, and found that certain tumor microenvironments contain cytotoxic (CD8+) T cells, a type of white blood cell that can recognize and kill cancer cells. They also identified the presence of inoleamine-2, 3-dioxygenase (IDO), programmed death-ligand 1 (PD-L1), and Foxp3+ regulatory T (Treg) cells, which are all inhibitory mechanisms that can restrict the function of tumor-specific CD8+ T cells. 3 The IDO enzyme, PD-L1 molecule, and Foxp3+ Treg cells all play a role in regulating the immune system by keeping T cells in check (see sidebar on CANCER.UCHICAGO.EDU
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page 4). Thus, Gajewski and his teamed originally hypothesized that the presence of these immune-suppressing mechanisms would make patients less responsive to vaccine therapies. However, the exact opposite turned out to be true. The patients with tumors containing these T-cell- inflamed tumor microenvironments had a better clinical response. Because IDO, PD-L1 and Foxp3+ are associated with the presence of CD8+ T cells in the tumor microenvironment, their presence actually predicts response to vaccines. “More importantly, this suggested that IDO, PD-L1, and Tregs might be targets for new therapy development—eliminating these inhibitory pathways could be therapeutic,” Gajewski said. PIONEERING NEW TREATMENTS Checkpoint inhibitor immunotherapies help the immune system mount an attack by
deactivating specific proteins or molecules that control immune checkpoints, which cancer cells use to avoid detection. PD-L1 is one such checkpoint target, along with programmed cell death protein 1 (PD-1), which is the protein PD-L1 binds to. PD-L1 and PD-1 are found on the surface of both normal and cancer cells, and help prevent the immune system from running rampant by limiting T-cell overactivation. However, this can hinder the body’s ability to fight cancer. Inhibitor drugs “turn off” these otherwise well-meaning proteins and molecules so the body can mount a robust immune response. Multiple clinical trials at the University of Chicago Medicine are testing combination therapies of PD-1 or PD-L1 inhibitors with other checkpoint inhibitors in various tumor types, including melanoma, bladder cancer, ovarian cancer, and triple-negative breast cancer, to name a few.
Immunotherapy and the Microbiome A team of researchers led by Thomas Gajewski, MD, PhD, professor of medicine and pathology, and including Comprehensive Cancer Center faculty Eugene Chang, MD, Martin Boyer Professor of Medicine, Bana Jabri, MD, PhD, professor of medicine, and Marisa Alegre, MD, PhD, professor of medicine, have shown that a person’s gut bacteria (microbiome) may play a role in patient response to immunotherapies. By introducing a particular strain of bacteria called Bifidobacterium into the digestive tracts of mice with melanoma, Gajewski and colleagues were able to boost the ability of the animals’ immune systems to attack tumor cells. The combination of oral doses of the bacteria and injections with a checkpoint inhibitor immunotherapy, called anti-PD-L1 antibody, nearly abolished tumor outgrowth. “The field has recently recognized close connections between the gut microbiome and the immune 2
PATHWAYS TO DISCOVERY SPRING 2017
Thomas Gajewski, MD, PhD, with a patient
system,” Gajewski said. “This finding provides a novel way to exploit that connection, to improve immunotherapy by selectively modulating intestinal bacteria.” The study1 garnered attention in the research community, and Gajewski has teamed up with Evelo Biosciences to develop a microbiome-based cancer therapy and clinical trial. 1 Sivan, et al., Science 350:1084-1089, 2015.
Researchers have found that combining immunotherapies with other treatments may provoke an even better clinical response in patients than either treatment alone. In addition, researchers have found that combining immunotherapies with other treatments may provoke an even better clinical response in patients than either treatment alone. Ralph Weichselbaum, MD, Daniel K. Ludwig Distinguished Service Professor of Radiation and Cellular Oncology, discovered that radiation therapy can improve the efficacy of immunotherapies. Radiation helps activate CD8+ T cells in tumors, while a checkpoint inhibitor helps protect those T cells from immune suppression. In one study, Weichselbaum added a vaccine to the mix and found that the combination of the three therapies helped overcome the non-T-cell-inflamed tumor microenvironment in pancreatic cancer.4 “Our results provide a step-by-step strategy to break the immune barriers that protect aggressive tumors by converting so-called ‘cold,’ or non-T-cell-inflamed, tumors to a ‘hot,’ or T-cellinflamed, phenotype,” said Weichselbaum. A phase I clinical trial led by Jason Luke, MD, assistant professor of medicine, and including Steven Chmura, MD, PhD, associate professor of radiation and cellular oncology, combines the PD-1 inhibitor pembrolizumab with stereotactic body radiotherapy (SBRT) in patients with advanced solid tumors. SBRT is a type of radiation therapy that delivers
precise doses of radiation to tumors in the body while limiting damage to normal tissue. 5 SBRT will also be combined with immunotherapy in upcoming clinical trials for liver cancer, led by Manish Sharma, MD, assistant professor of medicine. Other researchers leading immunotherapy clinical trials include: • Hongtao Liu, MD, PhD, assistant professor of medicine, in hematologic malignancies • Tanguy Seiwert, MD, assistant professor of medicine, in head and neck cancer • Hedy Kindler, MD, professor of medicine, in mesothelioma • Daniel Catenacci, MD, assistant professor of medicine, in gastroesophageal cancer • Jyoti Patel, MD, professor of medicine, in non-small cell lung cancer • Peter O’Donnell, MD, assistant professor of medicine, in bladder cancer • Everett Vokes, MD, John E. Ultmann Professor of Medicine and Radiation Oncology, in non-small cell lung cancer MAKING “COLD” TUMORS “HOT” Another protein that plays an important role in innate immunity—the body’s natural ability to
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Understanding the Life Cycle and Lifestyle of Tregs Peter Savage, PhD, associate professor of pathology, and his colleagues are studying Foxp3+ regulatory T (Treg) cells, a unique type of T cell that does not participate in host defense against pathogens and tumors. Instead, Treg cells actually suppress immunity by regulating other T cells. “Treg cells are the peacekeeper cells that suppress unruly immune responses,” said Savage, who co-leads the Immunology and Cancer scientific program at the Comprehensive Cancer Center with Gajewski. “They are essential for the prevention of autoimmune diseases like diabetes, arthritis and multiple sclerosis. But, they’re thought to be a major barrier to immunotherapy and the ability of our immune system to fight cancer.” A major step, he said, is understanding what other cells they interact with—what Savage calls the “dance partners” of Treg cells. “The goal is to manipulate Treg cells only in tumors—either take away the partners or block the interaction with the partners— because we need Treg cells to function properly elsewhere in the body,” Savage said. “Using the peacekeeper analogy— ask the peacekeepers to temporarily stand down in the tumor while we release this immune attack.” Many emerging immunotherapy studies, Savage said, are addressing this very puzzle. How can scientists target Treg cells in one part of the body, like a tumor, without creating disorder in the rest of the body? Disrupting the cells they interact with may be one solution. By solving this puzzle, scientists may be one step closer to developing targeted and more effective immunotherapies.
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Peter Savage, PhD, in his lab
mount a defense—is the Stimulator of Interferon Genes (STING) protein. In 2014, Gajewski and colleagues found that the STING pathway triggers a natural immune response against tumor cells and helps jump start the production of CD8+ T cells. This observation generated the idea that pharmacologic stimulation of STING could prove useful for patients with non-T-cell-inflamed tumor microenvironments, or “cold” tumors, who normally don’t have a robust response to immunotherapy. This proved to be the case, and STING agonists (chemicals that stimulate a biological response) were found to have profound therapeutic activity in mouse models of cancer. Justin Kline, MD, assistant professor of medicine, and Emily Curran, MD, clinical instructor of medicine, are studying the STING pathway in acute myeloid leukemia (AML). Using mouse models, they were able to stimulate STING by injecting substances that mimic tumor-cell DNA into the bloodstream. “Delivery of these substances into the blood led to massive immune responses,” said Kline. “I’ve worked extensively with animal models of this disease, and have never seen responses like this.” Based on this work and a licensing arrangement with Aduro Biotech, University of Chicago researchers are conducting clinical trials testing the first STING agonist in melanoma, head and neck cancer, and triple-negative breast cancer. THE FUTURE OF IMMUNOTHERAPY New and promising types of immunotherapy have emerged in the past five years. For example, CAR T-cell therapy for acute lymphoblastic leukemia (ALL) and other blood cancers involves engineering a person’s own immune cells to recognize and destroy cancer cells.
For patients suffering from relapsed/refractory ALL or other B-cell malignancies, CAR T-cell therapies may give doctors who have exhausted traditional chemotherapies another tool to use.
can impact the efficacy of pembrolizumab in melanoma. Still in early stages, the trial will be supported by Evelo Biosciences, a leading immune-microbiome company.
Michael Bishop, MD, professor of medicine, is leading CAR T-cell trials at the University of Chicago and has seen promising patient outcomes (see sidebar below).
In addition, basic science researchers are working to understand the basic wiring of the immune system, laying the groundwork for the development of future cancer therapies. Investigators like Hans Schreiber, MD, PhD, professor of pathology, and Peter Savage, PhD, associate professor of pathology, are leading their fields in cancer immunology.
Collaborative and transdisciplinary research efforts are helping elevate immunotherapies to a new level. Wenbin Lin, PhD, James Franck Professor of Chemistry, and colleagues including Weichselbaum are making checkpoint inhibitor immunotherapies more effective through the use of photodynamic therapy (PDT), a treatment that uses a drug called a photosensitizer. When photosensitizers are exposed to a specific wavelength of light, they produce a lethal type of oxygen that can kill cancer cells. Gajewski and Luke will lead a phase II study that examines how changing a person’s gut bacteria
These are just a few examples of how our researchers’ innovative and targeted approaches are shaping the future of immunotherapy, ensuring more effective treatments and better patient outcomes. 1 Gajewski, Mol Oncol 6:242-250, 2012. 2 Gajewski et al., Immunol Rev 213:131-145, 2006. 3 Gajewski et al., Semin Oncol 42:663-671, 2015. 4 Zheng et al., Oncotarget 7:43039-43051, 2016. 5 https://clinicaltrials.gov/ct2/show/record/ NCT02608385
CAR T-Cell Therapy Offers Patient Hope While driving the 500 miles from a client in Ten nessee to his home in Michigan, Andy Parker, 59, a tool and die engineer, noticed that his lower leg was sore and swollen. He thought it might just be how he was sitting. But, an ultrasound scan revealed three blood clots in that leg and a lethal disease—acute lymphoblastic leukemia (ALL). Parker immediately began chemotherapy. After one round of treatment: no change. Second round: no change. After unsuccessful treatment at a second institution, Parker was referred to Michael Bishop, MD, professor of medicine and an expert in CAR T-cell therapy, at the University of Chicago Medicine. “Dr. Bishop had something new,” Parker recalled. “I decided to do it. I had no choice.”
In Chicago, Bishop collected some of Parker’s T cells. He sent them to KITE Pharma, a California lab where they inserted proteins that enable T cells to detect and destroy the errant cells. Then they sent vast numbers of those T cells back. But before the T cells arrived, the FDA shut down the trial. Bishop immediately went to bat for Parker. Two weeks later, the FDA allowed treatment on a compassionate-use basis. The treatment began with an IV drip, but instead of drugs, in flowed a few million search-and-destroy T cells, trained to wipe out the misguided leukemic cells. This time, tests showed no leukemia, no sign of cancer. One month later, a second test confirmed: no cancer. Parker is now back at work, nearly back to normal, and plans to get married in the spring. CANCER.UCHICAGO.EDU
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Research
Meet the Expert Akash Patnaik, MD, PhD ASSISTANT PROFESSOR OF MEDICINE
Akash Patnaik, MD, PhD, joined the University of Chicago Medicine a year ago as a medical oncologist specializing in genitourinary cancers, including prostate, bladder, kidney, and testicular cancers. Also an accomplished researcher, Patnaik translates novel therapies developed in the lab into early-phase clinical trials. What is the focus of your research? The goal of my interdisciplinary research program, that spans both laboratory-based and early-phase clinical trial investigations, is to develop targeted therapeutic strategies to improve the responsiveness of prostate cancer to immunotherapy. My current efforts as an independent investigator blend a unique combination of expertise in medical oncology, cancer biology, and early-phase clinical trial investigation. Several drugs targeting dysregulated signaling pathways in tumor cells have been deployed in cancer therapy. However, their impact on immune responses within the tumor microenvironment is poorly understood. My laboratory is now actively investigating how interference with cell survival signaling and DNA repair pathways can enhance the effectiveness of immunotherapy in prostate cancer.
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What is the impact of your research? We anticipate that our parallel efforts in the laboratory and clinical trials will result in the development of new immune-based combination therapies to alleviate suffering from advanced prostate cancer within the next 5 years. What do you hope to accomplish during your career? I aspire to leverage the breadth of my parallel endeavors as a translational scientist, physician, and educator, to end suffering for patients with advanced prostate cancer. How did you get interested in studying cancer and/or treating cancer patients? At age 7, I had the misfortune of witnessing the progressive downhill course of my maternal grandfather, who was diagnosed with an aggressive form of brain cancer and died within a few months
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after diagnosis. It was the beginning of an endless journey of asking more questions than there were answers available. As a medical intern and resident in Internal Medicine, it was deeply inspirational and uplifting to care for cancer patients in the hospital, who transmitted an aura of hope and optimism in the face of terminal illness. I had an inner realization that the care of cancer patients provides a unique opportunity for humanism in medicine.
Research Highlights
During my clinical fellowship in Medical Oncology at Harvard, I lost a close maternal uncle to metastatic prostate cancer. At that time, I was emotionally humbled and intellectually challenged by the limited treatment options for patients with this disease, and so I dedicated my career to translating the most effective therapeutic approaches from the bench to the bedside to combat this disease. What is the most rewarding part of your job? The cancer problem is global, with an increasing need for international teams to come together to find creative solutions with a broader public health impact. It is an honor to be part of this international effort to end suffering from cancer. Who inspires you? I am continually inspired by our patients, who fight cancer with courage, optimism, and grace. I am grateful to my colleagues and team members, whose tireless efforts motivate me on a daily basis. I am deeply indebted to my family for their loving support, which serves as an inspiration for my efforts as a physician-scientist, even during the most challenging phases of this journey. What do you love about working at the University of Chicago? I particularly resonate with the culture of collegiality and team spirit at the institution. I am thankful for the invaluable commitment and support for translational research provided by the Section of Hematology/Oncology, Department of Medicine and Comprehensive Cancer Center. What is one thing on your bucket list? As a young boy growing up in India, I developed a love for science and a career in medicine/biomedical research, which remains with me today. I hope to come back full circle and collaborate with institutions in India, to advance infrastructure for translational cancer research and clinical trials in areas with the greatest unmet need.
Hormonal Therapy for Recurrent Prostate Cancer More than 30 percent of men who undergo surgery for prostate cancer will develop a recurrence, typically detected by a rise in the levels of the biomarker prostate specific antigen (PSA) in their blood. Radiation therapy is commonly used to treat these patients, as other anti-tumor strategies have not proven to be consistently beneficial. In a multicenter clinical trial involving biostatistician James Dignam, PhD, professor of public health sciences, researchers addressed whether drugs blocking androgen hormones (for example, testosterone) would improve cancer control and prolong survival. More than 750 prostate cancer patients were randomized to receive radiation and either daily doses of the antiandrogen bicalutamide or placebo for two years, and then followed for an average of 13 years. The research team found that overall survival was higher in those patients receiving bicalutamide and radiation. Furthermore, the incidence of both metastatic prostate cancer and death from prostate cancer were significantly lower in this group compared to those patients treated with radiation and placebo. These findings are likely to change how physicians treat recurrent prostate cancer by combining antiandrogen and radiation therapy to improve outcomes. (Shipley et al., N Engl J Med 376:417-428, 2017) CANCER.UCHICAGO.EDU
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Research Highlights (continued) Immunotherapy Trial in Metastatic Urothelial Cancer Urothelial cancer, the fifth most common cancer in the United States, occurs in the urinary system (kidney, urinary bladder and accessory organs) and is the most common type of bladder cancer. For patients in which the disease has spread, or metastasized, to other sites, treatment has been mostly limited to chemotherapy. However, recent advances in immunotherapy have suggested that strategies to mobilize the immune system and attack tumor cells might be beneficial for advanced urothelial cancer. Oncologist Peter O’Donnell, MD, assistant pro fessor of medicine, led a multicenter phase Ib clinical trial, part of the larger KEYNOTE-012 basket trial, testing the immunotherapy pembrolizumab in patients with locally advanced or metastatic urothelial cancer. Pembrolizumab, an antibody against the PD-1 immune checkpoint protein, was given to patients whose tumors expressed PD-L1 (a partner protein for PD-1 and thought to be required for PD-1 blockade to be effective). Thirty-three patients were enrolled in the study, and the drug was generally well-tolerated. More than one-quarter of the patients showed an overall response, including three with a complete response and four with a partial response. Results from this trial indicate that pembrolizumab demonstrated promising anti-cancer activity and acceptable safety in advanced urothelial cancer patients and supports ongoing phase II and III studies of pembrolizumab in these patients. (Plimack et al., Lancet Oncol 18:212-220, 2017)
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OF THE PATIENTS SHOWED AN OVER ALL RESPONSE
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The Origin of Ovarian Cancer Ovarian cancer only accounts for about 1.3 percent of new cancer cases each year, but less than half of patients survive for five years after diagnosis because it is frequently diagnosed in late stages after it has already metastasized, or spread to other organs. Whether these tumors actually originate in the ovaries or fallopian tubes has been poorly understood, but is important in terms of understanding their behavior and blocking tumor spread. A team led by Ernst Lengyel, MD, PhD, Arthur L. and Lee G. Herbst Professor of Obstetrics and Gynecology, and involving Samuel Volchenboum, MD, PhD, associate professor of pediatrics, and S. Diane Yamada, MD, Joseph Bolivar DeLee Professor of Obstetrics and Gynecology, addressed this issue by DNA sequencing to detect genetic mutations in samples of serous tubal intraepithelial carcinomas (STIC), ovarian, fallopian tube, and abdominal tumors from patients, representing the progression from early to later cancers. The team found that STIC lesions in the fallopian tubes do not necessarily mean the cancer is isolated to that location. While the study found that STIC were precursor lesions in half of the patients, those lesions in 25 percent of patients were actually metastases that had spread from another location in the abdomen. Further analyses using an innovative tissue culture model revealed that high-grade serous ovarian cancer (HGSOC) tumor cells can implant in the fallopian tubes and mimic STIC lesions. This finding could impact treatment protocols and suggests that the origin of gynecologic cancers isn’t always straight forward, and may differ from patient to patient. (Eckert et al., Cancer Discov 6:1342-1351, 2016)
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Clinical Trials As a NCI-designated Comprehensive Cancer Center and a lead site for the National Clinical Trials Network, we provide national leadership in developing clinical trials, which offer more options for patients. With more than 300 open therapeutic trials available, we enroll nearly 1,000 patients each year. For a full listing, visit clinicaltrials.uccrc.org.
Spotlight: Genitourinary (GU) Cancers • A Phase I/II Trial of Enzalutamide Plus the Glucocorticoid Receptor Antagonist Mifepristone for Patients With Metastatic Castration-Resistant Prostate Cancer (CRPC), IRB 13-0979 • A Randomized Phase II Study Comparing Bipolar Androgen Therapy vs. Enzalutamide in Asymptomatic Men with Castration Resistant Metastatic Prostate Cancer: The TRANSFORMER Trial (Testosterone Revival Abolishes Negative Symptoms, Fosters Objective Response and Modulates Enzalutamide Resistance), IRB 15-0956 • A Phase III, Open-Label, Multicenter, Randomized Study of MPDL3280A (Anti-PD-L1 Antibody) vs. Observation as Adjuvant Therapy in Patients With PD-L1 Selected, High-Risk Muscle Invasive Bladder Cancer After Cystectomy, IRB 15-0630
• A Phase III, Multicenter, Randomized, PlaceboControlled, Double-Blind Study of Atezolizumab (Anti-PD-L1 Antibody) as Adjuvant Therapy in Patients With Renal Cell Carcinoma at High Risk of Developing Metastasis Following Nephrectomy, IRB 16-1354
Upcoming Events JUNE
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American Society of Clinical Oncology (ASCO) Annual Meeting
JUNE 2–6, 2017 McCormick Place, 2301 S. King Dr., Chicago, IL Come visit us at Booth 4028 in the exhibition hall. See a full list of our faculty presentations at cancer.uchicago.edu/conferences/ ASCO2017.pdf
JUNE
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Opening Night Cocktail Reception at the 2017 ASCO Annual Meeting
FRIDAY, JUNE 2, 2017 The Signature Room at the 95th® Located atop the John Hancock Center 875 N. Michigan Ave, Chicago, IL RSVP at uchospitals.edu/ ASCOReception2017
Follow the action on Twitter at @UCCancerCenter and #ASCO2017
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Liver Tumor Clinic Offers Multidisciplinary Care, Access to Clinical Trials More than 750,000 people are diagnosed with liver cancer across the globe each year, according to the Centers for Disease Control and Prevention. Recognizing that the optimal treatment for liver cancer involves input from many different specialists, the University of Chicago Medicine recently launched a new comprehensive Liver Tumor Clinic. The Clinic brings together a multidisciplinary team of surgeons, hepatologists, radiologists, medical oncologists, surgical oncologists, and radiation oncologists that meets weekly to review each case to determine the best treatments for every patient. Together, they have expertise in both end-stage liver disease and liver cancer, including primary and metastatic disease, and the ability to handle complex cases and patients without curative options. UChicago Medicine’s Liver Tumor Clinic also offers innovative clinical trials for previously treated and untreated patients, including trials of new immunotherapies and combination therapies.
be targeted. Clinical trials are important for the advancement of treatment options for liver cancer because the standard of care has been centered on one drug, a kinase inhibitor called sorafenib, for the past decade. Sharma is currently recruiting for phase I, phase II and phase III trials for patients with HCC, the most common type of liver cancer. Clinical trials testing immunotherapies and combination therapies aim to uncover new and better treatment options. “We currently have a frontline study of the immunotherapy nivolumab versus sorafenib for HCC, which we’ve put six or seven patients on over the last year,” Sharma said. “The study has accrued 700 patients globally, and if it’s successful, it’s going to lead to drug approval for nivolumab for HCC.” Sharma and colleague Stanley Liauw, MD, associate professor of radiation and cellular oncology, are also collaborating on an upcoming clinical trial that would combine stereotactic body radiation therapy with immunotherapy for patients with HCC. For Sharma, the multidisciplinary approach of the Clinic not only provides more access to clinical trials, but also ensures that patients receive accurate diagnoses and the best treatment options. “For most patients, it benefits them to get a second opinion early on so that they can consider all available treatment options, including clinical trials that may not be available in their local community,” Sharma said.
“One of the things that distinguishes us as an institution is the availability of and the number of clinical trials that we have open in hepatocellular carcinoma (HCC),” said Manish Sharma, MD, assistant professor of medicine. Sharma often treats patients who aren’t transplant or resection candidates, or have had those procedures in the past and the disease has recurred. Clinical trials offer these patients hope. Liver cancer, unlike other cancers, does not have many known molecular features that can
Liver Tumor Clinic multidisciplinary team
The Clinic brings together a multidisciplinary team that meets weekly to review each case to determine the best treatments for every patient. 10
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Faculty Awards and Honors
Janet D. Rowley, MD, the Blum-Riese Distinguished Service Professor of Medicine, Molecular Genetics & Cell Biology and Human Genetics, will be posthumously inducted into the National Women’s Hall of Fame this fall. A pioneer in her field, Dr. Rowley established that cancer is a genetic disease.
Thomas Gajewski, MD, PhD, professor of pathology and medicine, has been awarded an Outstanding Investigator Award by the National Cancer Institute (NCI), a branch of the National Institutes of Health. The award guarantees $600,000 in direct costs per year for seven years.
Akash Patnaik, MD, PhD, assistant professor of medicine, Walter Stadler, MD, Fred C. Buffett Professor of Medicine and Surgery, and Dr. Gajewski, were awarded a $1 million Prostate Cancer Foundation Challenge Award grant. The team will use the funds to investigate whether loss of the PTEN gene, which commonly occurs in prostate cancer, leads to immune suppression and immunotherapy failure. If successful, this project will establish a new precision immunotherapy regimen for patients with advanced prostate cancer.
Nishant Agrawal, MD, professor of surgery, was recently appointed Chief of the Section of Otolaryngology-Head and Neck Surgery. Dr. Agrawal is a member of the 2017 International Liquid Biopsy Initiative Team, which was awarded the Team Science Award at this year’s American Association for Cancer Research (AACR) Annual Meeting.
Robert Grossman, PhD, professor of medicine, director of the Center for Data Intensive Science, and Co-PI of the NCI Genomic Data Commons, has been named the Frederick H. Rawson Professor. Dr. Grossman’s research focuses on bioinformatics, data science, and dataintensive computing.
Open in Orland Park Cancer services from the University of Chicago Medicine are now available at our new Center for Advanced Care at Orland Park. To learn more, please visit www.uchospitals. edu/orland-park
Bernard Roizman, ScD, the Joseph Regenstein Distinguished Service Professor of Virology, was awarded the 2017 Selman A. Waksman Award in Microbiology from the National Academy of Sciences for his pivotal research on how herpes viruses replicate and cause disease.
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New Faculty For more information about our new faculty, visit uchospitals.edu/physicians.
Talia Baker, MD, associate professor of surgery and director of the Living Donor Liver Transplant Program, is a hepatobiliary and liver transplant surgeon. Her research topics include downstaging complex hepatobiliary tumors to resectability and the ethical implications of using social media for organ donation opportunities.
Ami Desai, MD, assistant professor of pediatrics, is a pediatric hematologist/ oncologist who specializes in solid tumors, such as neuroblastoma, and bone and soft tissue sarcomas. Her research investigates new drugs to treat childhood, adolescent, and young adult cancers, as well as treatmentrelated toxicities.
John Moroney, MD, associate professor of obstetrics/gynecology, specializes in the diagnosis and treatment of gynecologic cancers, with a focus on providing skilled and personalized longitudinal care. He is PI at the University of Chicago for NRG Oncology, a NCI-supported clinical trials cooperative group.
Anjana Pillai, MD, associate professor of medicine and medical director of the Liver Tumor Clinic, is a gastroenterologist and transplant hepatologist who specializes in the management of chronic liver diseases. Her research focuses on viral hepatitis and hepatocellular carcinoma.
2015-2016 Community Benefit Report The University of Chicago Medicine contributed $373 million in fiscal 2015—18 percent more than the prior year—to address the urgent health needs of the South Side and provide other assistance to the community, according to its fifth annual Community Benefit Report. Murtuza Rampurwala, MD, assistant professor of medicine, is a medical oncologist and hematologist dedicated to caring for patients with blood disorders. He has special expertise in breast, lung, gastrointestinal and genitourinary cancers, and has extensive translational research experience developing novel clinical trial protocols.
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Ardaman Shergill, MD, assistant professor of medicine, is a medical oncologist and clinical hematologist dedicated to caring for patients with lung, colon, pancreas, breast, kidney and bladder cancers, and lymphoma and chronic leukemia. She has research experience developing protocols for novel drugs and studying proteins as biomarkers.
PATHWAYS TO DISCOVERY SPRING 2017
The report details benefits and services that UChicago Medicine provides to the community, and explains the assessment that the organization uses to address the biggest health challenges facing its service area, including cancer. Read the report: uchospitals.edu/ community-benefit
News
Award-Winning Architecture Firm to Design New Cancer Hospital Architecture firm Perkins+Will, a leading partner in the development of global cancer treatment centers, is the University of Chicago Medicine’s choice to design the renovation of the Bernard A. Mitchell hospital into a dedicated cancer hospital for adults. “We’re excited to work with the University of Chicago Medicine to deliver to Chicago, and the world, a best-in-class cancer hospital,” said Ralph Johnson, lead designer for the project and the global design director of Perkins+Will. “At this critical juncture in UCM’s future, we are honored to partner with the institution to advance their emergency department, trauma center, and cancer center initiatives, while ultimately improving human health with what will be a transformative facility.” The firm’s Chicago office was involved in the creation of preliminary concepts for the new Mitchell
facility, as part of the team that prepared the Certificate of Need application for the new cancer hospital, Emergency Department and adult Level I Trauma Center. Such involvement gives the firm a fundamental and unique understanding of how the new cancer hospital fits into UChicago Medicine’s overall growth strategy. Perkins+Will has been a key development partner with such global leaders in cancer treatment and research as Dana-Farber Cancer Institute, MD Anderson Cancer Center, Memorial Sloan-Kettering Cancer Center, Baylor University and Duke University. Locally, the firm worked on a number of high profile projects in Chicago, including Rush University Medical Center’s New Hospital Tower, for which it won the 2014 American Institute of Architects (AIA) National Healthcare Design Award.
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Pathways Summer '16 FIN.indd 4
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