2013 Year in Review
Leading Cancer Care & Research
A proud tradition of excellence, with a new name. The Methodist Hospital is now Houston Methodist Hospital. This new name reflects the pride in who we are and where we are from. Our commitment to advancing medicine with global impact begins in Houston, Texas, where we pioneer a better tomorrow through research, cutting-edge innovation and breakthroughs to rewrite the future of health.
That’s the difference between practicing medicine and leading it.
Contents
10
13
6
17
Leading Medicine: An Overview
3
Breaking new ground
5
Pursuing Medical Discoveries
9
Advancing Technology
13
Delivering Better Outcomes
17
Educating for Tomorrow
19
Leading Medicine: An Overview
Breaking New Ground
Pursuing Medical Discoveries Advancing Technology Delivering Better Outcomes Educating For Tomorrow
H OUSTON METH OD I ST CANCER CENTE R At the Houston Methodist Cancer Center we are committed to a comprehensive, multidisciplinary team approach in the detection and treatment of cancer in an environment that is rich in collaboration and compassion. Our highly trained and specialized clinicians provide individualized therapies, optimizing treatments for each patient. Our oncologists are committed to bringing the latest technologies and advanced treatment options to our patients as quickly as possible. We do this through our relationship with the Houston Methodist Research Institute where we have dedicated teams of world-renowned researchers conducting basic and applied cancer research. The Houston Methodist Research Institute is one of the largest research facilities in Texas with $55 million in total research funding and more than $5 million in cancer specific funding supporting 96 active clinical protocols. Our specialized oncologists partner with our researchers to rapidly translate discoveries made in the laboratory to the clinical setting. Houston Methodist has recently developed the infrastructure to support multi-phase clinical research. The New Drug Development Program provides researchers with the sophisticated framework
3
Houston Methodist Cancer Center
and support to conduct early-phase clinical research and “first in human” studies with drugs. Our ability to conduct Phase I clinical drug trials allows us to bring beneficial treatment options to our patients sooner. Not all patients respond in the same way to prescribed cancer treatments, thus the need for developing personalized therapies unique to each patient. In response, our physicians at Houston Methodist Cancer Center have established a variety of specialized treatments and services that target aggressive and rare cancers. These cancer-specific programs focus on the reduction of cancer development, the discovery of new treatments for highly resistant cancers and the provision of specialized and complex treatments. Our commitment to our patients is unconditional and unrestricted, heartfelt and genuine. And our determination to cure cancer is resolute, uncompromising and boundless.
Houston Methodist cancer center Leadership Barbara L. Bass, MD, FACS
Alan L. Kaplan, MD
Timothy B. Boone, MD, PhD
Reginald F. Munden, MD, DMD, MBA
Gavin W. Britz, MD, MBBCh, MPH, FAANS E. Brian Butler, MD Jenny C. Chang, MD
James M. Musser, MD, PhD Richard J. Robbins, MD, FACP
$5 million cancer research funding
96
active clinical protocols
Learn more at houstonmethodist.org/cancer
Letter from the Director: MOVING FORWARD, WITH VISION The Houston Methodist Cancer Center is on an amazing growth trajectory with outstanding new hires in both clinical and research areas; expansion of programs supporting high-risk prevention and genetically-motivated treatment protocols; new collaborations with nanotech experts; and the addition of new fellowships in medical oncology and thoracic surgery, to name only a few. The inspiration behind this growth is the desire to eradicate cancer and to support those who have it. I am honored to share with you highlights of the past year in the pages of this report. Our patients are our biggest motivation for growth – growth in programs that help them reduce their risk of developing cancer, programs that increase their chances for successful elimination of cancer, and programs that improve their lives after treatment. We have invested in a high-risk breast cancer program, genetic sequencing technology and expertise to better target personalized treatment of triple negative breast cancer. The Houston Methodist Neurological Institute and the Departments of Otolaryngology and Radiation Oncology worked together to design tools for functional avoidance of key pathways in the brain – helping to preserve quality of life after treatment for neurological or ENT cancers. To help the field advance in research and treatment, we created two new programs that we have highlighted in the report: One is a collaboration of cancer centers that work together to speed clinical research on promising protocols. Another is a program that standardizes advanced radiation practices for seven institutions across Eastern Europe. With growth must come a commitment to excellent and compassionate patient care. At the Houston Methodist Cancer Center, we provide each patient with highly personalized, multidisciplinary care, along with some of the most hopeful new clinical trials available today. We look forward to what is ahead and where this growth will lead us. Most importantly, we look ahead to the elimination of cancer in all its forms.
Jenny Chang, MD Director, Houston Methodist Cancer Center Houston Methodist Hospital Professor of Medicine, Weill Cornell Medical College Full Member, Houston Methodist Research Institute
4
Houston Methodist Cancer Center
3
Cancer
Leading Medicine: An Overview
Breaking New Ground
Pursuing Medical Discoveries Advancing Technology Delivering Better Outcomes Educating For Tomorrow
cha llen gin g the norm to create new treatments f or breast cancer Houston Methodist Cancer Center is committed to eliminating cancer in all its forms. We serve patients with breast cancer by providing comprehensive, patient-focused care, including aggressive prevention, innovative research, and forward-thinking clinical physicians that challenge us to consider new ways of curing cancer. Managing risk: start by recognizing it The goal of the Houston Methodist high-risk prevention program is to identify women who are at an increased risk of developing breast cancer. The program provides these women with a comprehensive breast cancer risk assessment, regular clinical exams, nutrition counseling, genetic counseling and, when appropriate, genetic testing. Specialized breast oncologists and genetic counselors work with patients to determine each individual’s risk, based on the patient’s personal and family history. Once risk is determined, the team is able to make recommendations to reduce risk, ranging from FDA-approved medications and more intensive surveillance to lifestyle modifications, exercise, nutrition and access to clinical trials targeting risk reduction.
Advancing breast cancer treatment: shorter trials for faster results To eliminate cancer, our researchers study both prevention and treatment of breast cancer, and we are able to offer access to clinical trials for patients in the prevention program and those undergoing active treatment. We look for effective drugs that have fewer side effects than existing medications. We also look for ways to get safe, effective treatments to patients faster. To expedite the process of moving drugs from research to clinical care, we are initiating studies in which we give an experimental drug for one year rather than the common 5-year trial span. We measure a surrogate endpoint, such as mammographic density, before and after treatment. If patients show improvement in the surrogate, the drug can be studied for efficacy in a larger population.
5
Houston Methodist Cancer Center
“Every woman on the planet should know her risk, especially women with a family history of breast or ovarian cancer, personal or family history of BRCA1 or 2 mutation and/or a personal history of abnormal biopsy. More can be done to prevent breast cancer. The tools we have are for everyone.” Tejal Patel, MD Leader, High Risk Program - Breast
E xc lusi ve T ria ls For Breast Cancer One such trial looks at hydroxytyrosol – a derivative of olive oil – for biomarker modulation in women at increased risk of breast cancer. Hydroxytyrosol is endorsed by the European Food Safety Authority (EFSA) for heart health, and it is shown to produce fewer side effects such as hot flashes. It has also shown activity against breast cancer cell lines in the laboratory. The trial will evaluate breast density in patients after one year of treatment with hydroxytyrosol. In addition to prevention, we also actively pursue clinical trials to fight existing breast cancer. Jenny Chang, MD, director of the cancer center, is the principal investigator for NECTAR, a study which tests if Everolimus will effectively stunt the growth of triple negative breast cancer (TNBC). Everolimus is used to treat kidney cancer, but it has been shown to be effective in blocking cell growth caused by the same genetic mutations that are common to TNBC. Houston Methodist is the only site in the U.S. to offer these pilot studies.
To learn more about our clinical trials, visit houstonmethodist.org/clinicaltrials
Houston Methodist Cancer Center
6
Leading Medicine: An Overview
Breaking New Ground
Pursuing Medical Discoveries Advancing Technology Delivering Better Outcomes Educating For Tomorrow
Gene sequencing uncovers the clues for personalized treatment of triple negative breast cancer Dr. Angel Rodriguez’s mission is to find a “druggable” target for every patient’s triple negative breast cancer (TNBC), and to ensure that these patients have access to promising drugs that might kill their cancer. To do this, he has teamed with Foundation Medicine, a genetic sequencing company, and The Patient Advocate Foundation, a group that helps patients fight for access to clinical trials and works with pharmaceutical companies as well as health insurance providers to get affordable access to potential medications. When a patient is diagnosed with TNBC, a biopsy is taken of the patient’s tumor. DNA is extracted and sent to the lab for genetic sequencing to identify the genetic mutation that is causing the cancer to grow. Once that mutation is identified, it is compared to a large database of existing drugs that are shown to have an effect on that broken gene. These drugs might be in clinical trials or only approved to treat other diseases. Sometimes it is difficult for patients to get into a trial, or it is cost prohibitive to buy the medications that are not covered by insurance. The Patient Advocate Foundation then steps in and provides the patient with expertise and resources to gain access to the drugs. This technique represents a different way of looking for a cure for cancer. With no universal genetic target for TNBC, Rodriguez looks for a mutation that is unique to each patient’s tumor and attacks that specific genetic defect. His team is collecting data and identifying sub-types of TNBC to eventually prove this technology – genetic sequencing of tumors – can make a difference for patients with TNBC.
7
Houston Methodist Cancer Center
“Having these three components working together – the hospital, genetic sequencing and patient advocates – is crucial to making a difference in TNBC, which currently does not have a target, or an identified genetic mutation that causes the cancer to grow, like other breast cancers do.” Angel Rodriguez, MD Leader, Triple Negative Breast Cancer Program
Mastectomies that preserve the nipple for a more natural result While we look for a cure, we also invest in the most advanced practices for treating breast cancer. Sherry Lim, MD, surgical oncologist, and Pierre Chevray, MD, reconstructive plastic surgeon, work as a team to offer nipple-sparing mastectomies and breast reconstruction. Sparing the nipple is a complex technique that is not commonly offered by all surgical oncologists in this field. It does, however, provide much more natural results for patients. The procedure involves strategically placed incisions either partially around the areola, effectively camouflaging most of the surgical scar while preserving the nipple, or along the crease of the breast, which preserves the nipple and leaves almost no visible scar. Dr. Lim has a high level of expertise and experience in this technique having performed more than 75 nipple-sparing mastectomies at Houston Methodist with excellent outcomes.
Criteria for patients to qualify for nipple-sparing surgery: • The tumor must be more than 2 cm away from the nipple • The tissue around the nipple must show no signs of cancer according to pathology taken at the time of surgery
“Results are clearly superior when we use the patient’s own tissue for reconstruction. We can maintain a more natural breast shape following a nipple-sparing mastectomy.” Pierre Chevray, MD, PhD Reconstructive Plastic Surgeon
To refer a patient for a nipple-sparing mastectomy call, 713.790.3333
Houston Methodist Cancer Center
8
Leading Medicine: An Overview
Breaking New Ground
Pursuing Medical Discoveries Advancing Technology Delivering Better Outcomes Educating For Tomorrow
ear ly -phase research : Bringin g tria l s f rom bench to bedside faster No other disease in the world has the resources, funding and cautious optimism associated with it more than cancer. Houston Methodist Hospital is one of the leaders in this crusade to predict, treat and ultimately eradicate this health menace. At Houston Methodist, we are establishing the requisite framework to conduct intricate and sophisticated Phase I drug trials. We are leading the practice to genetically alter a patient’s immune cells to target and attack a specific cancer. Our researchers are developing new tools that can detect biomarkers for disease and the risk for certain cancers. All of our tests, developments and treatment algorithms have one priority in mind: offering better treatments and outcomes to our patients. The Cockrell Center for Advanced Therapeutics and the New Drug Development Program provide researchers with a sophisticated infrastructure to conduct early-phase clinical research and “first in human” studies. The Cockrell Center is also staffed with specialized nursing teams that have experience with complex investigational drug protocols. Current studies at the Cockrell Center include Phase I trials for leukemia, lymphoma, solid tumors, Crohn’s disease and sickle cell disease.
Over the course of 2013, the Cockrell Center added capabilities and expertise to support a growing portfolio of research. The center recruited Kapil Bhalla, MD to serve as medical and scientific director. Dr. Bhalla is a scientific leader in the field of translational medicine. Eileen Dickman, PhD, joined the center as director of Phase I Clinical Trials. Her basic science background and clinical research experience provide strength for translational research. As part of the New Drug Development Program in Cancer, led by Swaminathan Iyer, MD, the Houston Methodist Cancer Center brought next-generation genetic sequencing capabilities in-house and recruited Bryce Portier, MD, to serve as medical director of solid tumor molecular diagnostics. Dr. Portier’s research centers on the identification and validation of novel molecular biomarkers. This combination of technology and specialized expertise will provide highly personalized genetic research and diagnostics for patients.
To learn more about our early-phase research, call 713.790.3333
9
Houston Methodist Cancer Center
Leading Medicine: An Overview
Breaking New Ground
Pursuing Medical Discoveries Advancing Technology Delivering Better Outcomes Educating For Tomorrow
Cell and gene therapies attack cancer from the inside The Center for Cell & Gene Therapy (CAGT), a partnership of Houston Methodist, Baylor College of Medicine and Texas Children’s Hospital, is one of the country’s leading centers for the development of cellular and genetic treatments for adults and children with cancer. At the CAGT, researchers genetically engineer patients’ own immune system T-cells to selectively attack and kill lymphomas, leukemias, brain cancers and cancers of the bone marrow. The early-phase trials are showing promise. Helen Heslop, MD, director of the Adult Stem Cell Transplant Program, and her team are advancing this type of research by adding new growth factors to make modified cells more active and to reduce side effects.
grants The Leukemia and Lymphoma Society awarded CAGT
6.25 million
$
grant as a Specialized Center of Research (SCOR).
The National Cancer Institute renewed an
11 million
$
grant to the CAGT for the study of pancreatic, nasopharyngeal, and sarcoma cancers.
genetically-modified T-cell studies
CAGT investigators transfer an artificial receptor called a chimeric antigen receptor (CAR) of the patient’s T-cell, to enable the T-cells to recognize cancer cells. To learn more, visit houstonmethodist.org/cagt
11
Houston Methodist Cancer Center
11
ongoing trials
50
patients participating
Houston Methodist is one of the
3 largest sites in the country for this type of research.
Leading Medicine: An Overview
Breaking New Ground
Pursuing Medical Discoveries Advancing Technology Delivering Better Outcomes Educating For Tomorrow
5 0 tests in a sin g l e dro p : ne w V - chi p measures biomar k ers on the s pot Scientists from the Houston Methodist Research Institute were awarded $4.2 million from the National Institutes of Health to develop a small, low-cost device for rapid, highly accurate, point-of-care blood testing that was invented by Department of Nanomedicine faculty member Lidong Qin, PhD. Dr. Qin’s volumetric bar-chart chip, or “v-chip,” can detect biomarkers in a single drop of blood at the time a doctor sees the patient. The chip quickly measures insulin and other blood proteins, cholesterol, and signs of viral or bacterial infection. It can even determine a patient’s risk for hepatocellular carcinoma, the most common type of liver cancer. Its speed, flexibility and accuracy also make it useful in an emergency setting to quickly diagnose and treat patients with substance abuse disorders.
“The v-chip is accurate, cheap, and portable. It requires only a drop of blood, not a vial, and can do 50 different tests in one go.” Lidong Qin, PhD Associate Member, Houston Methodist Research Institute Department of Nanomedicine
Learn more about our Cancer Research at houstonmethodist.org/ourresearch
12
Houston Methodist Cancer Center
Leading Medicine: An Overview
Breaking New Ground
Pursuing Medical Discoveries Advancing Technology Delivering Better Outcomes Educating For Tomorrow
Advanced ma p p ing o f the brain helps preserv e human f unctions In an effort to make medicine more personalized and improve outcomes, physicians at Houston Methodist Hospital are using all the imaging data that the patient has received to make surgical and radiation therapy decisions that could lead to better outcomes and provide fewer side effects for patients.
Surgical deficits in the brain, head and neck can lead to long term side effects that dramatically diminish the quality of life of the patient. It is important for physicians to be able to visually understand where critical or eloquent pathways exist in the brain or in the head and neck area, and to have a predetermined idea of where blood vessels and cranial nerves lie. Eloquent areas in the brain include speech, visual and motor fiber tracts. The brain and the head and neck area are the most complex in having a 3-D and stereoscopic understanding of indiv idual patients. Using technologies integrated in a Computer Augmented Virtual Environment (CAVETM) called Plato’s CAVETM, surgeons and radiation oncologists are able to plan surgery and radiation therapy by understanding the precise location of the safest corridors of approach for their radiation beam or surgical scalpel. Gavin Britz, MD, chair of the Department of Neurosurgery, David Baskin, MD, vice chair of the Department of Neurosurgery and director of the Kenneth R. Peak Center for Brain and Pituitary Tumor Treatment and Research, Donald Donovan, MD, chair of the Department of Otolaryngology, Mas Takashima, MD, member of the Department of Otolaryngology, and Brian Butler, MD, chair of the Department of Radiation Oncology, use this visual decision-making platform to design the best and safest strategy for the patient and to plan therapies well in advance of delivering them. “For those of us in the neurosurgical spectrum, Plato’s CAVETM provides a preoperative way to delineate the important fiber tracts in the brain and determine the best surgical corridor to access lesions,” says Britz.
13
Houston Methodist Cancer Center
“It is absolutely one-of-a-kind.”Houston Methodist physicians are developing techniques that better preserve the most important human functions –the very things that make us who we are and enable us to communicate with our world. By advancing the art of functional avoidance, we can better treat patients with brain, ear, nose and throat tumors which lie close to the eloquent pathways that create or store memories, fetch words, make our fingers feel and our ears hear. Anatomic avoidance techniques are well defined, using images of structures such as the brain stem or the spinal cord. Functional avoidance goes several steps further, identifying and avoiding the electronic and chemical circuitry in the brain that brings to life essential activities such as speech, thought process, word recall, or meaningful gestures of a hand or an eye. Drs. Butler, Britz, Baskin, Donovan and Takashima have integrated a functional map of the brain that identifies “safe” corridors through which surgeons a n d radiation oncologists can navigate for the best outcome. On a case-by-case basis, physicians use the functional map, reference markers and a triangulating GPS-like system to safely work within millimeters of a critical functional pathway. The map also identifies which pathways are serial or parallel. Serial pathways have no redundancy, so there is no recovery if they are disrupted. This vital information further helps determine the safest approach to a tumor.
Leading Medicine: An Overview
Breaking New Ground
S a f e ly nav i g atin g a b rain ma p to de l i v er innovati v e , p in p oint treatments
Pursuing Medical Discoveries Advancing Technology Delivering Better Outcomes Educating For Tomorrow
With the pinpoint accuracy provided by mapping functional pathways in the brain comes the need for microsurgical technology to help surgeons maneuver along those tiny corridors to the tumors. Surgical microscopes magnify a ¼-inch section into a huge visual world for a surgeon, and there has been an explosion of surgical instrumentation such as micro-scalpels and other micro tools. Still, many tumors can be challenging to access. David Baskin, MD, director of the Kenneth R. Peak Center for Brain and Pituitary Tumor Treatment and Research at Houston Methodist, has collaborated with Rice University’s Nanoscience Department to invent several of these tools including a nano-syringe, which selectively kills brain cancer cells by delivering chemotherapy drugs directly into the cells, and a mitochondrial “smart bomb” that targets mitochondria in glioblastoma cells and destroys mitochondrial activity.
To safely reach dangerous tumors, Dr. Baskin uses a mapfor neural navigation, and manipulates a tiny 2.8 millimeter endoscope that provides a high-definition, real-time view into the front base of the patient’s skull, the brain stem and the spinal cord, all through the patient’s nostril, with no incisions. He also uses a technology called BrainPath to safely pass microscopic tools and treatments into deep, hard-to-reach places in the patient’s brain. The combination of neural imaging, functional avoidance, microsurgical tools and pinpoint radiation technology continues to propel advancements in treatment for tumors of the brain, ear, nose and throat. Physicians and researchers at Houston Methodist are in the driver’s seat on pushing these advancements forward.
“Using fusion technology accurately combines multiple high-resolution images; we can see fiber tracks in the brain, along with arteries, veins and the tiny corridors we can navigate in without damaging functional capacity for the patient. We can actually see where we are in the brain with one millimeter accuracy.” David S. Baskin, MD Professor, Vice Chairman and Residency Director Department of Neurosurgery Director, Kenneth R. Peak Center for Brain and Pituitary Tumor Treatment and Research Learn more at houstonmethodist.org/peakcenter
15
Houston Methodist Cancer Center
Leading Medicine: An Overview
Breaking New Ground
Pursuing Medical Discoveries Advancing Technology Delivering Better Outcomes Educating For Tomorrow
Houston Methodist I nstitute for Technolo gy, I nnovation & E ducation (M I TI E sm ) Leading Medicine
One of the largest and most comprehensive education and research facilities in the world, MITIE is leading the practice of medicine for physicians and health care providers. MITIE offers multi-disciplinary, hands-on learning opportunities using advanced imaging systems and robotics. Surgeons and other health professionals are able to continually refine and acquire new skills that allow them to perform at optimal levels throughout their careers. Using procedural laboratories and sophisticated simulation tools, our research programs are focused on the development and assessment of emerging technologies and technical skills to improve the care of patients through less invasive therapies. At MITIE, the finest researchers and clinicians are building on our legacy of ingenuity and accelerating the discovery and delivery of better care and better cures.
Houston Methodist INSTITUTE for Technology, Innovation & Education 2013 At a Glance
More than
6,300 learners in 2013
40,000 square feet of education and research space
26 More than
Surgical specialties from across the world
20,000
learners since inception Learn about our education and training offerings at mitietexas.com
16
Houston Methodist Cancer Center
Leading Medicine: An Overview
Breaking New Ground
Pursuing Medical Discoveries Advancing Technology Delivering Better Outcomes Educating For Tomorrow
Early detection w ith lo w - dose CT reduces lun g cancer mortal it y 2 0 percent The Lung Cancer Screening Program at Houston Methodist Hospital provides at-risk individuals with the most effective and progressive screening tools available for early stage lung cancer diagnosis. In 2011, the National Lung Screening Trial, funded by the National Cancer Institute, showed that low-dose helical computed tomography (CT) significantly reduced the number of lung cancer deaths compared to a standard chest x-ray. The Lung Cancer Screening Program was launched as a result of the study’s findings. “Breathing symptoms become evident when a tumor impedes the airway or pain occurs as a result of tumor growth into the chest wall.” Shanda Blackmon, MD, MPH Thoracic Surgeon and Director, Lung Cancer Screening Program
17
“Low-dose CT has the advantage of locating an early nodule with the least amount of radiation. This is the only method currently available that can screen for early lung cancer,” says Shanda Blackmon, MD, MPH, associate professor in the Department of Surgery and Cardiothoracic Surgery at Weill Cornell College of Medicine in Houston at Houston Methodist Hospital, and associate member of Houston Methodist Research Institute.
Breathing symptoms become evident when a tumor impedes the airway or pain occurs as a result of tumor growth into the chest wall,” says Dr. Blackmon. Further studies show that most findings on CT are nodules that are 10 millimeters or less in size; within this group, more than 95 percent are benign. “If the nodule is smaller than eight millimeters, it may be too small to be evaluated,” she says. “We will be careful to watch those who do not yet need a biopsy and make sure we do not over-biopsy benign nodules.”
A significant problem in the early diagnosis of lung cancer is its asymptomatology in the initial stages. “If the lung cancer manifests in the periphery of the lung, for example, it will not impact breathing or cause a cough.
Researchers in the National Lung Screening Trial concluded that the use of low-dose CT reduced lung cancer mortality by 20 percent compared with individuals who received standard chest x-rays.
Houston Methodist Cancer Center
de finin g treatment protoco ls for E N D O M E T R I AL CAN C E R There is no effective treatment protocol for women with highgrade endometrial cancers. To help determine the best course of adjuvant therapy in these patients, the gynecological oncology group at Houston Methodist is participating in a clinical trial for women with advanced-stage endometrial cancer. “It is a randomized, Phase III trial that compares two treatment regimens in patients with advanced-stage endometrial cancer,” says Aparna Kamat, MD, associate professor and director of gynecological oncology. Initial treatment of endometrial cancer calls for removal of the uterus and ovaries. There is no general agreement as to what constitutes the best adjuvant therapy post surgery for patients with metastatic disease, as very few Phase III studies have been done comparing different regimens.
“We use a combination of chemotherapeutic agents because each drug impedes cancer cell growth in different ways. This study will help us determine if radiation therapy offers more benefit for these patients in addition to chemotherapy.” Aparna Kamat, MD Gynecological Oncologist
Currently, standard treatment for advanced-stage endometrial cancer consists of six cycles of carboplatin, a platinum-based antineoplastic agent that interferes with DNA repair, and paclitaxel, a mitotic inhibitor in the taxane class of antineoplastic drugs that is used to interfere with cell division. In this standard treatment, there is no radiation therapy. “The objective of our phase III trial is to study the efficacy of combination chemotherapy and radiation. Women will first be given cisplatin, a platinum-based agent, and radiation therapy. This will be followed by additional chemotherapy with carboplatin, another platinum-based drug, and paclitaxel for four cycles,” says Dr. Kamat. Houston Methodist will enroll five women. A total of 840 patients will be involved at more than 350 locations in the United States, Canada and South Korea. Houston Methodist Cancer Center
18
Leading Medicine: An Overview
Breaking New Ground
Pursuing Medical Discoveries Advancing Technology Delivering Better Outcomes Educating For Tomorrow
S etting radiation onco lo gy p rotoco ls and quality standards in E astern E uro pe Physicians and physicists at the Houston Methodist Hospital, under the direction of Brian Butler, MD, chair of the Department of Radiation Oncology, are leading the way in helping countries in Eastern Europe establish high-quality, consistent standards for treating patients using Intensity Modulated Radiation Therapy (IMRT). Dr. Butler and his team worked with local physicians and physicists in Poland, Bosnia and Herzegovina to build a quality standards and protocol initiative. As part of this pioneering program, Dr. Butler created a comprehensive protocol resource manual which establishes the underpinning of a consistent standard for high-quality care and treatment for the patient. Approximately 30 physicians across the eight centers in Eastern Europe currently participate in this initiative. They have created a way of standardizing IMRT across multiple locations in countries that have not yet developed the expertise in treating patients with this highly specialized treatment. Each center will send patient images to the central hub in Warsaw, where radiation oncologists and physicists with experience in IMRT work — virtually and in person — with local physicians to identify the best treatment plans. Every week, Dr. Butler holds an interactive video conference to review these cases. Participants present cases to Dr. Butler and his team to review staging procedures, treatment planning, target delineation, criteria for radiation dosing and side effects. They discuss specific cases and ways to avoid critical pathways, such as the spinal cord or optical nerves. In addition to web-based interactive medicine, the European physicians and physicists come to Houston Methodist to train with our team of experts. Correspondingly, Dr. Butler and his team visit the Eastern European sites twice per year to further exchange ideas and expertise with a broader audience. This initiative brings hope to patients across Eastern Europe by providing experience, expertise and advanced treatment skills to places they didn’t exist. It also educates physicians and physicists, enabling them to grow the pool of experience and training in their own communities and countries.
19
Houston Methodist Cancer Center
• • •
• • POLAND
BOSNIA & HERZEGOVINA
Houston Methodist is standardizing IMRT protocols across multiple locations in Eastern Europe.
I nte g rated T rainin g f or Future Fello ws and Residents In 2014, Houston Methodist will make two slots available for physicians wishing to join a new ACGME-accredited Hematology-Oncology Fellowship program. The fellowship was given impetus by Alexandria T. Phan, MD, gastrointestinal medical oncologist, who recently came to Houston Methodist from MD Anderson Cancer Center. “As the number of elderly grows, and people live longer, so will the number of patients with age-sensitive conditions like cancer, which is almost 100 times higher,” says Dr. Phan. “Educating and training physicians takes up to a decade. Graduate medical education must be expanded now to ensure timely access for high-quality services. We cannot expand adequate care and optimal treatments without specialists, but we can be better prepared for the future by acting now to meet this growing demand and train the next generation of oncologists,” she says. Houston Methodist has put in an application for an integrated six-year cardiothoracic surgery program which, if approved, will begin in July of 2014. Customized from the standard eight-year cardiothoracic residency, the six-year program condenses the curriculum and reduces rotations that are not essential to cardiothoracic surgery. Houston Methodist is distinctively positioned to offer this program, which is only operational in approximately 20 facilities, according to Shanda Blackmon, MD, MPH, attending physician in the Department of Surgery. “We are uniquely suited to train integrated thoracic residents because of our tight link to research, cancer care, benign disease and transplant. There are very few institutions across the nation that can provide residents with such exposure at such high volume,” says Dr. Blackmon.
houston methodist hospital
33
239
ACGME-accredited
ACGME residents
(plus 5 non-ACGME) residency programs
(plus 5 non-ACGME residents) Houston Methodist Cancer Center
20
HOUSTON METHODIST Leading Medicine yesterday, today, and tomorrow At Houston Methodist, we’ve built a legacy of ingenuity that spans multiple decades and disciplines. In the last 95 years, we’ve transformed from a humble 19-bed community hospital to a global leader in health care, treating patients from 90 countries in more than 8,150 visits last year. In 2004, Houston Methodist established a long-term affiliation with Weill Cornell Medical College and New York-Presbyterian Hospital in New York City. Through this affiliation, three internationally renowned institutions collaborate to bring tomorrow’s advances to our patients today. Together, we provide cutting-edge clinical and biomedical research, and education and training for future physicians and scientists. One of the nation’s top research medical schools, Weill Cornell Medical College ranked No. 15 in the 2015 U.S. News & World Report Best Medical Schools list. For Houston Methodist clinicians and researchers, “leading medicine” is a holistic call for excellence in every aspect of patient care. We consistently rank among the best hospitals in the country. In 2013, U.S. News & World Report named Houston Methodist the “Best Hospital in Texas” for the second consecutive year, with 12 specialties recognized in the Best Hospitals list. Houston Methodist is consistently recertified to Magnet status for exceptional nursing. Because of our reputation, the finest researchers and clinicians from around the world are joining us to build on our legacy of ingenuity and accelerate the discovery and delivery of better care and better cures. That’s the difference between practicing medicine and leading it.
FAST FACTS* 132 Operating Rooms
2,157
Licensed Beds (1,721 operating beds)
4,471
Affiliated Physicians
8,150
International Patient Encounters (from 90 foreign countries)
15,791 Employees
85,042 Inpatients in 2013
234,944
Emergency Room Visits in 2013
616,317
Outpatient Visits in 2013 *Houston Methodist data includes five hospitals in Greater Houston
FORTUNE is a registered trademark of Time Inc. and is used under license. From FORTUNE Magazine, February 3, 2014 ©2014 Time Inc. FORTUNE and Time Inc. are not affiliated with, and do not endorse products or services of, Licensee.
Leaders in Research Accelerating discovery and delivery to patients
At Houston Methodist, we are dedicated to defining the future of medicine. We engineer discoveries in the lab to become clinically useful products, channel the best innovations through early stage clinical trials and actively transition those innovations to our industry partners. Our commitment to the full cycle of discovery and delivery sets us apart as leaders who provide patients from around the world access to the latest health care advances.
More than 840 active clinical protocols $55m TOTAL RESEARCH funding in 2013 See all the ways we’re leading medicine at hmleadingmedicine.com
Photo courtesy of WHR Architects, Inc. Š Aker/Zvonkovic Photography, Houston, Texas
22
Houston Methodist Cancer Center
Houston Methodist Hospital 6565 Fannin Street Houston Texas 77030
LEADING MEDICINE YESTERDAY, TODAY AND TOMORROW. At Houston Methodist we have a proud tradition of revolutionizing medicine. Our past achievements have built a legacy that spans multiple decades and disciplines, and that same culture of excellence inspires us to be the pioneers of tomorrow.
houstonmethodist.org/cancer