Innovations - Winter 2013

LEADING THE CURE FOR CANCER • WINTER 2013

THE

DNA DETECTIVE

Genetic clues provide new hope for cancer cure

INNOVATIONS

FACULTY INSTITUTE FACULTY Garni Barkhoudarian, MD Assistant Professor of Neuroscience and Neurosurgery Anton J. Bilchik, MD, PhD Professor of Surgery Chief of Medicine Interim Chief of Science Chief of Gastrointestinal Research Lisa Chaiken, MD Assistant Professor of Radiation Oncology Maureen Chung, MD, PhD Professor of Surgery Director of Margie Petersen Breast Center Director of Breast Oncology Fellowship Program Director of Margie and Robert E. Petersen Breast Cancer Research Program Rebecca Crane-Okada, PhD, RN, CNS, AOCN Professor of Oncology Director of Breast Cancer Navigation Program, Margie Petersen Breast Center L. Andrew Di Fronzo, MD, FACS Professor of Surgery Maggie DiNome, MD Assistant Professor of Surgery Associate Director of Margie Petersen Breast Center Chief of General Surgery, Saint John’s Health Center

Mark B. Faries, MD Professor of Surgery Director of Complex General Surgical Oncology Fellowship Director of Melanoma Research and Therapeutic Immunology Leland J. Foshag, MD Surgical Oncologist Dave S.B. Hoon, MSc, PhD Professor and Director of Molecular Oncology Chief of Scientific Intelligence Director of Genomic Sequencing Center Sharon Huang, PhD Assistant Professor of Molecular Oncology Reiko F. Irie, MD Director of Biotechnology John R. Jalas, MD Assistant Professor of Pathology Daniel F. Kelly, MD Professor of Neuroscience and Neurosurgery Director of Brain Tumor Center and Pituitary Disorders Program Delphine J. Lee, MD, PhD Professor of Immunology Director of Translational Immunology Laurent Lessard, PhD Assistant Professor of Molecular Oncology

Donald L. Morton, MD Distinguished Professor of Surgery Chief of Melanoma Program Sebastian J. Sasu, MD Associate Professor of Pathology Jaime M. Shamonki, MD Associate Professor of Pathology Peter A. Sieling, PhD Professor of Immunology Assistant Director of Translational Immunology Myung-Shin Sim, MS, DrPH Associate Professor and Director of Biostatistics Frederick Singer, MD Director of Endocrinology and Bone Disease Program Hitoe Torisu-Itakura, MD, PhD Assistant Professor of Immunology Roderick Turner, MD Professor of Pathology Jinhua Wang, PhD Assistant Professor of Molecular Oncology

Omid Hamid, MD Medical Oncology Vivanti N. Jain, MD Adjunct Associate Professor of Plastic Surgery J. Arthur Jensen, MD Plastic Surgery Peter Jones, MD Adjunct Associate Professor of Surgery David Krasne, MD Pathology Ronald S. Leuchter, MD Gynecologic Oncology Brian D. Madden, PhD Adjunct Assistant Professor of Palliative Care Ali Mahtabifard, MD Adjunct Assistant Professor of Thoracic Surgery Silvana Martino, DO Medical Oncology

Lisa C. Moore, MD Adjunct Assistant Professor of Endocrinology Carol Nishikubo, MD, FACP Medical Oncology Steven J. O’Day, MD Medical Oncology Jay S. Orringer, MD Plastic Surgery Lawrence D. Piro, MD Medical Oncology Lauren L. Reager, MD Dermatology Ira Smalberg, MD Radiology Marilou Terpenning, MD, FACP Adjunct Professor of Medical Oncology Robert C. Wollman, MD Radiation Oncology Paul S. Yamauchi, MD, PhD Adjunct Professor of Dermatology

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Acting President and Chief Executive Officer Michael L. Wall Chief of Medicine Anton J. Bilchik, MD, PhD Vice President, Public Affairs and Development Andy Trilling Director of Marketing, Public Relations & Communications Andrea R. Salazar Marketing Manager Tabitha Ji

INSTITUTE ADJUNCT FACULTY Stan Alfred, MD Adjunct Professor of Dermatology Peter Boasberg, MD Medical Oncology Stanley A. Brosman, MD Urology Sant P. Chawla, MD Medical Oncology Alistair Cochran, MD Pathology David Elashoff, PhD Biostatistics Robert Elashoff, PhD Biostatistics Joshua Ellenhorn, MD Adjunct Professor of Surgery Clark B. Fuller, MD Cardiovascular/Thoracic Surgery Edwin Glass, MD Nuclear Medicine Chester Griffiths, MD Otolaryngology

JOHN WAYNE CANCER INSTITUTE EDITORIAL STAFF

VP, Branded Media Emily S. Baker Art Director Ajay Peckham Editor Shari Roan Copy Editor Laura Watts Contributors Linda Marsa Jeannine Stein Photographers Randi Curby, Lauren Pressey President & CEO Charles C. Koones Chairman & Founder Todd Klawin If you have a change of address or would like to be removed from our mailing list or any fundraising communication, please contact the Public Affairs and Development Office at 310-315-6111.

WINTER 2013

INSIDE

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6

17

4

7

36

16

42

JWCI Faculty Listing Letter from the Chairman of the Board

5

Welcome from the Institute

9

In the News At the Forefront

Memorable Events

Seeds of Innovation

Philanthropy

34

Diane Feldman and Jackie Banchik are veteran Institute volunteers.

PROFILES

What’s Happening

Dr. Daniel F. Kelly trains young neurosurgeons, including Dr. Wei "Harvey" Hua.

FEATURES

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18

Her work is a family affair.

Molecular techniques are making individualized cancer care possible.

Ilene Eisenberg

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Facing the Risk

A new clinic supports women with higher odds of developing breast cancer.

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Gene Sequencing's Time Has Come

By exploring molecular pathways, researchers aim to pinpoint cancer’s causes and to personalize treatments.

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The Duke’s Legacy Lives On

His family remains dedicated to the cause.

Davida Lettiere: In Memoriam

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Researchers seek accurate biomarkers.

A strong will to help launched the influential ABCs.

ON THE COVER

Improving Prostate Cancer Detection

Learning About Brain Tumors and Keyhole Surgery Fellowships focus on the latest neurosurgical techniques.

WINTER 2013, INNOVATIONS

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LETTER FROM THE CHAIRMAN OF THE BOARD

A Family’s Commitment

Each of us has found ways to help fight cancer and to support others in finding a cure for it.”

When my father was diagnosed with cancer, it changed my world as well as each member of our family. Despite the best care possible, cancer took my father’s life when he still had dreams to fulfill and so much to give. But through our family’s tragedy, we resolved to support cancer research in his name.

Together with the Institute's many supporters, we have found ways to help fight cancer. The story beginning on page 24, illustrates how deeply we feel about the legacy of my father and our commitment to the kind of groundbreaking research made possible at the Institute.

We take enormous pride in the evolution of the Institute.

Our faculty members are on the leading edge of oncology research, evidenced by the scores of scientific papers they author each year. They are pioneers

in their respective fields and participate in several of the largest and most authoritative research collaborations in the world.

It’s no surprise then that the Institute attracts top surgical oncology and research fellows.

These individuals are the best and brightest among the young generation of cancer researchers and physicians.

We are most grateful for the support and contributions of the many donors who share our family’s fervent desire to advance cancer prevention and treatment.

Together, we will succeed in alleviating the burden of this all-too-common disease.

Patrick Wayne hairman of the C Board of Directors

REMEMBERING THE DUKE THE SEARCHERS, 1956

Photo courtesy mptvimages.com

John Wayne starred in The Searchers as a Civil War veteran on a mission to rescue his niece from a Comanche Indian tribe. Film critic Roger Ebert later called the performance one of Wayne’s finest, giving life to a highly conflicted character. One of Wayne’s That'll be lines, “That’ll be the day,” is among the most-quoted in movie history. The actor’s costars included Jeffrey the day.”

Hunter, Vera Miles and the young Natalie Wood.

The film was directed by John Ford, the dean of Hollywood Westerns, who worked with Wayne on more than a dozen films. Not widely praised when it was first released, The Searchers was named by the American Film Institute in 2008 as the greatest Western of all time.

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WELCOME FROM THE INSTITUTE

JOHN WAYNE CANCER INSTITUTE BOARD OF DIRECTORS

Patrick Wayne CHAIRMAN

Anton J. Bilchik, MD, PhD

Jay B. Lichter, PhD

Michael L. Wall

Michael I. Wayne

Changing How Cancer is Detected and Treated It is an exciting time for us at the John Wayne Cancer Institute. It was recently announced that Providence Health & Services, Southern California, and SCL Health System reached a definitive agreement for Providence to assume sponsorship of Saint John’s Health Center and the John Wayne Cancer Institute.

We are excited about this new relationship and the opportunities and partnerships it brings.

Even with this change in sponsorship, some things will never change at the Institute, such as our continued commitment to staying at the forefront of cancer research. Our researchers are changing the way cancer is detected, diagnosed and treated around the world. For example, Fredrick Singer, MD, is currently studying the link between vitamin D levels and survival of patients with melanoma. Or one can look at the amazing work being done by Dave S.B. Hoon, PhD, professor and chief of molecular oncology, and distinguished professor of surgery Donald L. Morton, MD, who are utilizing the Institute’s gene sequencer to learn more about the influence genes have on cancer and how to use this information to create personalized cancer treatment plans. Then there is the leadingedge work of researchers such as Laurent Lessard, PhD, on using biomarkers to create better screening tools for prostate cancer.

Our research faculty works closely with the scientists in the laboratory to develop new programs and services that improve patient outcomes and

care while teaching the next generation of surgical oncologists.

We’re proud to announce we have a new High-Risk Clinic at the Margie Petersen Breast Center that is being championed by Maggie DiNome, MD. And we offer a neurosurgery fellowship program led by the Brain Tumor

Lettiere and the Associates for Breast and Prostate Cancer Studies (ABCs), the late Bud Erhardt, and of course all of you. If you are looking for additional ways you can get involved at the Institute, turn to page 7 to learn about our Seeds of Innovation Program and how you can help turn our faculty’s novel

Our research faculty works closely with the scientists in the laboratory to develop new programs and services that improve patient outcomes and care while teaching the next generation of surgical oncologists.”

Center’s Daniel F. Kelly, MD, and Garni Barkhoudarian, MD. None of this would be possible without the generous support of donors such as Ilene Eisenberg, Jackie Banchik and Diane Feldman and the Auxiliary, the late Davida

Michael L. Wall

Acting President and CEO

ideas into large, promising research projects that may save lives in the fight against cancer.

Thank you for your unwavering support as we continue with our mission of leading the quest in the cure for cancer.

Anton J. Bilchik, MD, PhD

Professor of Surgery Chief of Medicine and Chief of the Gastrointestinal Research Program

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IN THE NEWS

Faculty in the News At the forefront of cancer research, the faculty of the John Wayne Cancer Institute are frequently asked to discuss their research or provide expert commentary on medical news.

Here are some of our recent appearances.

ABC News asked Maggie DiNome,

KTLA 5 News interviewed Mark B.

MD, assistant professor of surgery and

Faries, MD, director of melanoma

associate director of the Margie Petersen

research and therapeutic immunology

Breast Center, to comment on a study

and director of the Surgical Oncology

suggesting that working night shifts for

Fellowship Program at the John Wayne

30 years can double a woman’s risk for

Cancer Institute, about curbing the

breast cancer.

risk of melanoma.

Actress Angelina Jolie’s revelation

Radio station KFI-AM interviewed

regarding her prophylactic doublemastectomy made international news this summer. Maureen Chung, MD, PhD, director of the Margie and Robert E. Petersen Breast Cancer Research Program, was asked by both the Los Angeles Times and CBS News about breast cancer detection and testing for gene mutations linked to the disease.

Anton J. Bilchik, MD, chief of medicine, interim chief of science and chief of the gastrointestinal research program, who shared his opinions on the rapid evolution of cancer research and the likelihood that more targeted therapies may one day make chemotherapy treatment obsolete.

Widespread media coverage followed a recent study from Dave S.B. Hoon, PhD, and Jinhua Wang, PhD, on advances in understanding a form of breast cancer known as triple-negative. The study, which appeared in the prestigious Proceedings of the National Academy of Science Journal, was performed in collaboration with investigators from the Genome Institute of Singapore and Princeton University. Triplenegative breast cancer is difficult to treat. However, the study identified an epigenetic protein that might be useful as researchers develop therapies for this specific type of breast cancer.

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AT THE FOREFRONT

At the Podium Cancer-related medical and research conferences take place almost every day somewhere around the world. The faculty members of the John Wayne Cancer Institute are invited to participate in many of the preeminent scientific conferences on cancer research and to present recent discoveries or discuss emerging research with collaborators and colleagues. Such travels keep our researchers at the forefront of scientific developments in cancer diagnosis and treatment, and communicate the Institute’s work to a large international audience.

Anton J. Bilchik, MD, PhD, traveled to San Francisco in January to attend the prestigious Gastrointestinal Cancers Symposium sponsored by the American Society of Clinical Oncology. He reported preliminary results of an international clinical trial on ultrastaging of colon cancer.

Mark B. Faries, MD, presented a sentinel node research update at the Canadian Melanoma Conference in Banff, Alberta, Canada, in February.

In November, Dr. Faries also reported on the Institute’s experience with liver resection for metastatic melanoma at the annual meeting of the Western Surgical Association in Salt Lake City. Study collaborators include both Dr. Bilchik and Donald L. Morton, MD.

Delphine J. Lee, MD, PhD, traveled to the International Congress of Immunology in Milan in August to present the first report of the breast cancer microbiome.

Maureen Chung, MD, PhD, coauthored a study, presented at the American Society of Breast Surgeons meeting in Chicago in May, showing that shorter radiation regimens for breast cancer patients haven't increased the number of women getting the treatment.

Dr. Hoon presented on the clinical utility of circulating nucleic acids in blood at the International Minimal Residual Disease meeting in Paris in September.

He traveled to Osaka, Japan, in November to speak to the Japanese Dermatology Society on melanoma epigenetics.

In June, Dave S.B. Hoon, PhD, presented new data on genomic sequencing in melanoma at the annual Human Genome and International Congress of Genetics meeting in Singapore.

His research was also shared at the world’s largest hepatology congress in Singapore that same month.

In August, Daniel F. Kelly, MD, director of the Brain Tumor Center, was invited to present on the latest minimally invasive keyhole neurosurgery techniques as part of the University of Naples Visiting Professor series in Italy.

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AT THE FOREFRONT

Institute Researchers Awarded Highly Competitive Grants Prestigious grants affirm researchers’ investigations Philanthropic donations and government grants fund cutting-edge research taking place at the John Wayne Cancer Institute. In recent years, the federal government’s research budget has declined significantly, and competition for National Institutes of Health (NIH) grants among researchers nationwide has become even more challenging.

In order to determine the most promising research projects, the NIH forms a team of experts to rank each application in a “peer reviewed” process. Previously, the top 15% of research projects would receive funding, but today only the top 5% to 7% of projects might be awarded.

Despite this challenging climate, the John Wayne Cancer Institute continues to be recognized for its innovation in cancer research and has received two significant, five-year, National Cancer Institute (NCI) Research Project Grants (R01) this year, a strong testament to the high level of our scientists’ research and an acknowledgement of the promise of their research proposals. The R01 grant allows an investigator to define the scientific focus of research based on a particular area of interest and competence.

The Institute’s two recent NCI R01 grants are:

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Predictive Epigenomic Biomarkers in Rectal Cancer Patients Receiving Treatment: Dave S.B. Hoon, PhD, is studying how to improve prediction of response to rectal cancer treatment. His team’s research focuses on finding prognostic molecular biomarkers that will suggest which treatment will work most effectively. This work is aimed at providing much-needed improvements in the treatment of rectal cancer. The study is a joint program with the Dutch Colorectal Cancer Cooperative Trial Group at Leiden University Medical Center in the Netherlands.

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Identification of Melanoma Brain Metastasis Tumor Biomarkers: Dr. Hoon and a team of co-investigators (the Brain Tumor Center and Daniel F. Kelly, MD) are examining why early stage melanomas spread to the brain and how to predict brain metastasis using molecular genetics. This study is important because it aims to identify biological changes that indicate whether a melanoma is likely to spread to the brain. This research makes use of the Institute’s valuable melanoma bio-repository and engages researchers at melanoma centers around the world.

Institute researchers have earned additional competitive grants: The Cancer Genome Atlas grant from the NIH: Donald L. Morton MD, and Dr. Hoon are co-principal investigators representing a team of Institute researchers participating in this exciting project funded by the federal government.

Under the auspices of the National Cancer Institute, The Cancer Genome Atlas is a multimillion-dollar study involving many prestigious institutions around the nation. The study seeks to improve our understanding of the molecular profiling of individual cancers as related to their clinical characteristics. The Institute’s role will include research on melanoma, breast and brain cancer.

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Entertainment Industry Foundation’s Women’s Cancer Research Fund: This study, directed by Maggie DiNome, MD, seeks to address a major problem in breast cancer treatment: the difficulty in treating patients with a type of cancer called triple-negative. One-quarter of breast cancer patients have this form of the disease, which means that the three most common types of receptors known to fuel most breast cancer growth–estrogen, progesterone, and the HER-2/neu gene–are not present in the tumor. This study, which will lead to a clinical trial at the Margie Petersen Breast Center, will explore whether estrogen-negative tumors can be turned into estrogen-positive tumors, giving patients access to additional treatments.

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AT THE FOREFRONT

A Dynamic Duo Sparked

By Friendship

Diane Feldman, left, and Jackie Banchik

rapidly, and the volunteer program was begun.

Shortly thereafter, Jackie joined the group. Her grandmother had died of cancer, and she admired the work of Donald L. Morton, MD, and the physicians of the clinic. She eventually started volunteering in the clinic every Wednesday, escorting patients to their examination rooms. Jackie was also drawn to the Auxiliary members’ care and dedication.

“Although we didn’t know each other initially, we became a tight knit group, working together and sharing our goals. We all had a history of someone in our family having cancer.”

Jackie became the Auxiliary's fourth president and, during her tenure, the John Wayne Clinic at UCLA moved to Saint John’s Health Center, becoming the John

Photographed by Randi Curby

When Jackie Banchik and Diane Feldman were introduced 40 years ago, they would never have guessed that the meeting would result in an enduring friendship and a partnership that would leave a mark on the John Wayne Cancer Institute.

They were young women living in Los Angeles, pursuing careers, caring for their families and still finding time to do volunteer work.

Jackie, born in Chicago and raised in LA, worked as an occupational therapist. Diane was an elementary school teacher in Chicago where she was born and raised, and she became an interior designer after moving to Los Angeles.

They met in the early 1970s at a charity event and became friends. Through the challenges and joys of working and raising children, the two women shared experiences, supported each other and cherished their friendship.

When Diane’s father was diagnosed with cancer, Sandy Cohen, co-founder and first president of what was to become the Auxiliary, recommended the John Wayne Cancer Clinic.

Diane’s father eventually died of cancer, but she was awed by the work of the Auxiliary and joined this small group of women.

“I was impressed with the intimacy of the John Wayne Cancer Clinic,” Diane recalls.

“We saw that it was a hands-on organization. The patients weren’t just numbers; everyone was treated as a unique individual.”

Diane became the Auxiliary’s second president, the group grew

Wayne Cancer Institute.

Six years after joining the Auxiliary, Jackie was diagnosed with cancer and was successfully treated by Dr. Morton. On her 50th birthday, grateful for her health and Dr. Morton’s care, she and her husband, Howard, started the Banchik Family Library.

“I wanted a place for women to go and sit and have material to read,” says Jackie. “They could watch tapes and talk with their family. A nurse or doctor could come in, and they could chat. I wanted that very much. Over the years, I can’t tell you how many people would come up and say, ‘It’s so comforting to have that room.’”

Moved by the Banchik family’s gift, Diane and her husband, Danny, provided funds to start the Feldman Audio-Visual Center, dedicated to Diane’s father and

mother-in-law.

“We wanted a center with materials for all types of cancer—a place with every kind of resource: print materials, videos, pamphlets.

In addition, physicians would have another place to meet privately with their patients.”

Among their Auxiliary projects, Diane and Jackie are very proud of the “Circles of Distinction” which they created to honor the Institute’s donors.

“We wanted to have each and every person who contributed recognize how much their gift was appreciated. " They cherish the time they spend together as friends and Auxiliary members.

"The truth of the matter is, there is no one that we know who has not been touched by cancer.

It’s something that concerns us all.”

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AT THE FOREFRONT

Introducing the Post-Docs The Institute attracts top international research fellows.

The John Wayne Cancer Institute attracts talented post-doctorate fellows from around the world. These individuals already have a medical degree or PhD when they arrive for additional study, performing basic science research under the Institute’s highly regarded faculty. At the conclusion of their fellowship, they have numerous career options that include accepting an academic position, such as an assistant professor; returning to their original institute to practice medicine or conduct research; taking a position in the pharmaceutical or biotech industry; or participating in a fellowship at another institution. Three current fellows share their thoughts about their studies.

Keisuke Hata, MD, PhD

molecular oncologist Ruth and Martin H. Weil Laboratory Dr. Hata earned his medical degree at the prestigious University of Tokyo and trained in surgery focused on early detection of colorectal cancer. He worked at the Imperial Household Agency as a court physician for Their Majesties, the Emperor and the Empress in Japan, for two years before becoming an assistant professor at the University of Tokyo.

Why he came to the Institute:

“I was satisfied with my surgery life to some degree but was also disappointed with the fact that we could not cure all the cancer patients. I was looking for an opportunity to work abroad as a cancer researcher, and out of several candidates across the countries, I chose the John Wayne Cancer Institute because as a clinician, I am more interested in ‘translational’ medical research, which could be applied to bedside patients, rather than pure biology.”

The problems his research is designed to address:

“I’m focusing on characterizing mutations in mucosal melanoma as well as gastric and colorectal cancers using a next-generation sequencer in our sequencing center in order to seek individualized therapies. Mucosal melanoma is a special type of melanoma arising in the mucosa including gastrointestinal tract, nasal cavity and so on. This type of melanoma is relatively rare but is more aggressive than common cutaneous melanoma. In addition, mucosal melanoma usually lacks the common gene mutation seen in cutaneous melanoma, which can be targetable by a newer approved drug. The advent of the next-generation sequencer enables us to see many mutations at a time, which had not been available until recently. Hopefully, we can find new druggable mutations in these cancers.”

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AT THE FOREFRONT

Caiyun Xuan, PhD

research scientist specializing in oncology and immunology Dirks/Dougherty Laboratory for Cancer Research Dr. Xuan completed her graduate studies at UCLA, focusing on identifying novel therapeutic molecules, specifically antibodydrug fusion proteins for treatment of lymphoma. This research was published in the leading hematology journal Blood. The fusion proteins she worked on as a graduate student are in preparation to enter clinical trials.

Why she came to the Institute:

“After graduate school, I wanted to gain more experience working with human specimens. The collaborative relationship between Saint John’s Health Center and the John Wayne Cancer Institute gives us the opportunity, as researchers, to gain access to a wide variety of specimens.”

The problems her research is designed to address:

“The main focus of my research, working with Dr. Delphine J. Lee in the Dirks/Dougherty Laboratory for Cancer Research, is studying how bacteria present in breast tissue may influence breast cancer development or progression. Our current knowledge suggests that hormones, genetics and certain lifestyle factors—such as diet and exercise—can affect a woman’s risk of developing breast cancer. However, it is estimated that only 20% to 40% of breast cancers can be explained by known factors, while the majority of cases have unknown origins. Though most of us associate bacteria with infection, there are actually diverse communities of bacteria that inhabit our bodies. The questions I’m seeking to answer are which types of bacteria live within breast tissue and secondly, what are they doing there?”

Diego Marzese, PhD

molecular biologist Ruth and Martin H. Weil Laboratory Dr. Marzese earned his doctorate in molecular biology from the National University of Cuyo, Argentina, focusing on the epigenetic deregulation of cancer-related genes in breast carcinomas. The results of this research were distinguished by the Argentine Senate and awarded with the 2008 Fiorini–LALCEC award, the 2010 UNC Young Investigator award and the 2010 ASCO Cancer Foundation Merit award. His research is focused on the discovery of genomic and epigenomic aberrations in genes that regulate melanoma brain metastases and triple negative breast carcinomas, the most aggressive and brain-metastatic subtype of breast cancer.

How he became interested in cancer research:

“When I was 16, I was diagnosed with cancer. After one year of treatment, I knew I wanted to become a cancer researcher, and since that moment, I have put all my energy in making this come true.”

Why he came to the Institute:

“It’s a unique place where cutting-edge basic and high-quality translational research coexist. During 2011, I had the opportunity to perform an internship in the molecular oncology department under Professor Dave Hoon’s supervision. In that period, we applied the knowledge learned from my PhD thesis to a large cohort of melanoma patients. In this internship, I realized how innovative and intense the clinical and translational research was at the Institute. With the recent incorporation of the next-generation technological approaches, the quality of the research that can be performed at the Institute has increased to the highest level.”

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AT THE FOREFRONT

Ilene Eisenberg

Communicating the Institute’s work is her priority.

After nearly 30 years of involvement with the John Wayne Cancer Institute, Ilene Eisenberg feels a deep connection to the staff and her friends on the Institute’s Auxiliary. “The John Wayne Cancer Institute is like a second family. The doctors, the women of the Auxiliary—it’s a unique group,” she says.

Ilene joined the Auxiliary after her father died of cancer. She performed many duties in support of the group over the years and served as its co-president from 2006 to 2008. In 2011, she received the Angel Award for her service. The Angel Award is presented each year by the Auxiliary to a woman who has made a significant contribution to the Institute and serves as a role model to women everywhere.

Ilene is known for the grace in which she handles life’s challenges. Her husband, Juels, was diagnosed with advanced colon cancer in 1998 and died two years later at the age of 59.

After his passing, she honored him with a gift that supports the Institute’s publication of a biannual magazine, now called Innovations.

“After he died, I wanted to do something, but I didn’t want to put his name on a plaque or wall or something,” Ilene recalls. “Joyce Green [former JWCI senior vice president of development and public affairs] said, ‘Why don’t you fund the magazine in memory of him?’ My husband always said the John Wayne Cancer Institute was a well-kept secret. He thought it was important to get the message out to people.”

The Institute has remained a big part of the Eisenberg family’s lives. Ilene was diagnosed with breast cancer in 2001 and was successfully treated by doctors here. Now her children, Michael, Stephanie and Craig, and grandchildren have joined the cause, supporting the Institute’s work. Each of her

My husband always said the John Wayne Cancer Institute was a well-kept secret. He thought it was important to get the message out to people.” grandchildren donated some of the gifts from their bar mitzvah and bat mitzvah celebrations to the Institute in honor of their grandfather, Juels.

“It’s a family affair,” Ilene says. “They realize how important it is to give back. We are so fortunate to have the Institute.”

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AT THE FOREFRONT

Vitamin D: What Role Does it Play in Melanoma?

Research at the John Wayne Cancer Institute has discovered a possible paradox involving Vitamin D, the so-called “sunshine” vitamin, and skin cancer. Frederick Singer, MD, director of the endocrinology and bone disease program at the John Wayne Cancer Institute, is collaborating with Donald L. Morton, MD, to study an intriguing link between vitamin D levels and survival in patients with melanoma.

Vitamin D has received a lot of scrutiny in recent years. Studies show many Americans are deficient in the nutrient—perhaps because they are being more careful about sun exposure or are using sunscreen to prevent skin cancer. Vitamin D is naturally manufactured by the body from sun exposure. That’s why it’s important to get at least some sun exposure or take vitamin D supplements.

While vitamin D is known for its importance in bone health, studies over the past decade suggest the nutrient also plays a role in the function of many other organs and disease processes. That means that people who are deficient in vitamin D—about 42% of U.S. adults—may be affected by the deficiency in a variety of ways.

Since some studies suggest vitamin D deficiency can play a role in cancer, Dr. Singer utilized the Institute’s tumor repository to examine vitamin D levels in 360 people with melanoma. The data is still being compiled. So far, his research suggests that people with lower levels of vitamin D have worse outcomes in melanoma survival.

“It’s a conundrum,” Dr. Singer says. “You get too much sun— damaging your skin and your immune system—and then you get melanoma. But there’s also evidence that vitamin D deficiency may make some cancers worse.”

Future research should explore optimum levels of vitamin D.

THE IMPACT OF VITAMIN D Vitamin D is known for being critical to healthy bone mass. But emerging research suggests that low levels of the nutrient may play a role in a range of diseases, including the survival of people with melanoma.

Bones — osteoporosis Colon, breast, prostate, skin (melanoma) — cancer Heart — cardiovascular disease Pancreas — diabetes Immune system — multiple sclerosis Joints — rheumatoid arthritis Intestines — Crohn's disease Lungs — tuberculosis, asthma Brain — depression Uterus — preeclampsia

Source: Dr. Frederick Singer

+ Dr. Singer’s research receives generous support from The Lois Rosen Family and The Eli and Edythe L. Broad Foundation.

+ Dr. Morton’s research receives generous support from the

Dr. Miriam & Sheldon G. Adelson Medical Research Foundation.

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AT THE FOREFRONT

Leaders Made Here David W. Ollila, MD, says his fellowship at JWCI came at just the right time.

WRITTEN BY LAURA ROE STEVENS

David W. Ollila, MD, says the timing of his surgical oncology fellowship at the John Wayne Cancer Institute couldn’t have been any better. In 1995, on the heels of sentinel node procedure discoveries for melanoma and breast cancer, Dr. Ollila joined “the giants” at the Institute “who were proving that sentinel node research and treatment was important. It was a really exciting time,” he recalls.

Between 1995 and 1998

cancer and melanoma program at the UNC Lineberger Comprehensive Cancer Center.

He is currently a member of the breast committee of the Alliance for Clinical Trials in Oncology.

Dr. Ollila’s breast cancer research interests include work derived from his expertise in sentinel node biopsy—a technique for identifying the lymph node most likely to contain cancer metastasis. He was one of the first researchers to examine

Believe it or not, back then, there were a lot of critics regarding sentinel node research, and at the Institute, we were proving that this work was biologically relevant.

It just doesn’t get any better than that.” while at the Institute, Dr. Ollila developed his areas of special interest: clinical trial development and translational research in breast cancer and melanoma patients. Recently named the James H. and Jesse E. Millis Distinguished Professor of surgery at the University of North Carolina-Chapel Hill, he also serves as the associate director of the North Carolina Cancer Hospital. His experience at the Institute has been integral in his current role at UNC. Today, Dr. Ollila is the surgical director for both the multidisciplinary breast program and the multidisciplinary skin

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the use of sentinel lymph node biopsy as a method to assess the extent of a tumor, an advance that can minimize surgery in women undergoing neoadjuvant, or preoperative, chemotherapy.

“The experience at the John Wayne Cancer Institute was incredible, based on what I was learning and what I was getting exposed to,” he says. “Believe it or not, back then, there were a lot of critics regarding sentinel node research, and at the Institute, we were proving that this work was biologically relevant. It just doesn’t get any better than that.”

“Dr. Ollila is emblematic of one of the best things about the

John Wayne Cancer Institute: the training of new generations of clinicians and researchers who change and improve the care of cancer patients,” says Mark B. Faries, MD, director of the complex general surgical oncology fellowship and director of melanoma research and therapeutic immunology. “He continues to collaborate with us in current research as part of a network of alumni who contribute to the ongoing success of the Institute. He is also an excellent teacher, having gone on to train another generation of surgeons at his current institution, allowing the benefits of his

education here to multiply far beyond the Institute’s original investment.”

In recent years, Dr. Ollila has received grants for sentinel node studies involving novel approaches for patients with large breast cancer tumors. He is currently conducting a study attempting to identify which melanoma patients may have a poor prognostic based on genetic characteristics. He speaks both nationally and internationally on melanoma and breast cancer care and treatment. Dr. Ollila lives in Chapel Hill with his wife, Mary, and their two daughters, Elizabeth, 14, and Francine, 11.

AT THE FOREFRONT

Surgical Oncology Fellows Part of a Long Tradition The current class of fellows includes: Back row, L–R: Victoria Stager, MD (Harold McAlister Charitable Foundation fellow); Joslyn Albright, MD (Tarble Foundation fellow); Robert G. Louis, MD (Neurosurgery fellow).

Middle row, L–R: Elizabeth A. Arena, MD; Nefertiti A. Brown, MD (JWCI Auxiliary breast fellow); Gary B. Deutsch, MD, MPH; Daniel D. Kirchoff, MD. Front row, L–R: Manabu Fujita, MD, PhD (William Randolph Hearst Foundations fellow); Simon Lavotshkin, MD.

The Surgical Oncology Fellowship Program at the John Wayne Cancer Institute is one of the most comprehensive courses for advanced training in the United States. It was the first program on the West Coast accredited for complex surgical oncology by the Accreditation Council for Graduate Medical Education. The fellowship prepares general surgeons to be highly educated, inspired and compassionate future leaders in surgical oncology. It is one of the largest programs in the country, with more than 135 fellows counting themselves as graduates. More than 75% of the graduates have academic appointments, and 39% are chiefs of divisions, chairs or deans.

The renowned Surgical Oncology Fellowship Program at the John Wayne Cancer Institute receives generous support from individuals and foundations. There is no better investment to make a lasting impact in the fight against cancer than by training leaders who will save lives as surgeons and researchers and who will go on to mentor future generations to become leaders in cancer research.

For more information about how you can support the Surgical Oncology Fellowship Program, please contact the Institute Development office at 310-315-6111 or email development@jwci.org.

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SEEDS OF INNOVATION

Your Support Can Help Launch Promising Research Projects The John Wayne Cancer Institute’s Seeds of Innovation Program collects funds to stimulate innovation and advancement in cancer research. While government grants are typically restricted to pre-established projects, funding from Seeds of Innovation ignites our team’s capacity to explore new ideas and promising leads.

Thanks to the Seeds of Innovation Program, the Institute’s doctors and scientists have transformed novel ideas into remarkable breakthroughs and fully-funded projects that continue to improve the way we diagnose, treat and prevent cancer around the world.

Projects in need of funding include:

• Using nanotechnology to treat estrogen negative breast cancers. Maggie DiNome, MD, proposes a novel treatment for triple negative breast cancer using ceramide and tamoxifen.

Packaging this agent into tiny particles called nanoliposomes allows the delivery into cancer cells without harming normal cells and with fewer side effects. The Institute will be the first team to bring this unique treatment approach to practice in a clinical trial.

• Search for novel biomarkers and new therapeutic targets in melanoma. It may be possible to improve the treatment of patients with melanoma by identifying biomarkers—substances that can provide clues about the behavior of the disease. Sharon K. Huang, PhD, is analyzing patient tissue samples to look for biomarkers. She has also performed high-throughput screening, which rapidly identifies compounds of patient blood samples to evaluate the response to treatment. This may lead to discoveries of potential targets for therapy.

• Prostate Cancer Research Project. Physicians need better ways to determine whether a patient with prostate cancer has an aggressive form of the disease or a slow-growing form that doesn’t require immediate treatment.

Laurent Lessard, PhD, is studying how prostate tumors differ at early stages of the disease by analyzing subtle genome defects that may help discriminate between aggressive cancers that are likely to spread and non-threatening forms of the disease.

• Reprogramming your immune system. Peter A. Sieling, PhD, has spent more than 20 years studying how T-cells effectively protect us from microbes. Dr. Sieling is new to the Institute, and his focus is on breast cancer and melanoma. He is studying how microbes reprogram paralyzed immune cells at the site of tumors. Dr. Sieling's work is aimed at fighting cancer by utilizing one’s own immunity.

• Epigenetic biomarkers in basal-like breast cancers.

An aggressive form of breast cancer called basal-like cancer is associated with greater odds that the disease will spread to the brain and lung. Jinhua Wang, PhD, is pursuing studies to better understand basallike breast cancer and to identify clues that suggest epigenetic changes, which are chemical alterations that can switch genes on or off and impact the progression of the disease.

The research will lead to a better understanding of this type of breast cancer with the potential to improve diagnosis and treatment.

If you would like more information on how to support breakthrough research at its earliest stage, please contact the John Wayne Cancer Institute Development office at 310-315-6111 or email development@jwci.org.

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WHAT'S HAPPENING

November 23 Associates for Breast and Prostate Cancer Studies (ABCs) Annual “Talk of the Town” Fundraising Gala

Beverly Hilton Hotel, Beverly Hills, CA The ABCs’ most extraordinary evening takes place each November when the organization recognizes individuals who have made a difference in the fight against cancer. This year the organization will recognize Roseann and Bill Patterson with the prestigious Spirit of Hope award and honor Saint John's Foundation life trustee Robert Wagner with the Spirit of Hollywood award. Patrick Wayne will present Ann-Margret with the Spirit of Entertainment award. A glittering, black-tie event, the party attracts more than 600 guests as well as major media attention. Celebrities and supporters alike gather to raise much-needed funds for the Institute’s breast and prostate cancer research.

The evening includes dinner, dancing, guest performances and a boutique.

December 8 John Wayne Cancer Institute Benefactors Dinner

The Four Seasons Hotel, Los Angeles, CA As an integral part of the John Wayne Cancer Institute, the benefactors help us carry out the Institute’s mission. We will honor our generous annual and major donors who have supported innovative cancer research at the highest levels of giving in 2013. Attendees will be provided with updates and research highlights for the year and have an opportunity to mingle with the Institute’s faculty and fellows.

April 5, 2014 SAVE THE DATE 29th Annual JWCI Auxiliary Odyssey Ball

Spirit of Entertainment honoree Ann-Margret.

Beverly Wilshire, Beverly Hills, CA The annual benefit organized by the John Wayne Cancer Institute Auxiliary will honor the Mandela Family with the “True Grit” Award for continuing the mission of former president of South Africa and Nobel Peace Laureate Nelson Mandela who helped bring an end to apartheid. Anton Bilchik, MD, PhD, will be presented with the “The Duke” Special Service Award. Dr. Bilchik, a native of South Africa, professor of surgery and chief of medicine at the Institute, is an internationally recognized oncologist who has pioneered techniques to improve staging in colon cancer and minimally invasive treatment approaches for liver and pancreatic cancer. The Odyssey Ball is the signature annual event of the Auxiliary, currently led by Anita Swift, the granddaughter of John Wayne.

To date, the Auxiliary has raised more than $18 million to fund research, the prestigious Surgical Oncology Fellowship Program and the purchase of vital new laboratory equipment.

For more information on any of the events, please contact us at development@jwci.org or 310-315-6111.

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2.

Prior to devising a treatment plan, specimens such as blood or tumor tissue are taken for analysis.

TARGETING CANCER WITH PRECISION TREATMENT A number of gene mutations and other aberrations have been identified in breast, prostate, colorectal, lung, skin and other types of cancer. Studies, such as wholegenome sequencing, are pushing researchers to reclassify tumors based on their genetic makeup rather than their location in the body.

1.

Cancer is diagnosed.

Studies show targeted cancer treatments can be more effective than other types of treatment, including chemotherapy and radiation, and less harmful to normal cells.

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4.

The results of the testing lead to a personalized approach to cancer care. Targeted therapies are medications selected to act specifically on the molecular and cellular changes related to that type of cancer.

On the

HUNT Dave S.B. Hoon, PhD, uses molecular techniques to decipher cancer’s mysteries.

WRITTEN BY SHARI ROAN

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T G C T T C G G C A A

3.

Using sophisticated laboratory technologies, scientists screen for gene mutations as well as other molecular and cellular changes—called tumor biomarkers—that are usually specific to cancer.

o understand the progress witnessed in the research labs at the John Wayne Cancer Institute over the past three decades, it’s helpful to look at how people viewed cancer back then. In the early 1990s, many medical researchers were still searching for a single cure for the disease. Cancer deaths in the United States were at their highest rates ever, and few genes linked to a specific cancer type had been identified.

Against this backdrop, Dave S.B. Hoon, PhD, chief of scientific intelligence at the John Wayne Cancer Institute, joined his good friend Donald L. Morton, MD, at the Institute and launched research to explore the fundamental mysteries surrounding cancer, such as why the disease develops in some people and not others and why some treatments work and others fail. The Institute’s quest to understand the basics of cancer has paid huge dividends.

Today, researchers know that cancer is a collection of many diseases and that each patient’s disease is unique. In personalizing cancer care, doctors treat the specific causes of cancer that relate to an individual’s own genetic makeup. Sophisticated techniques, such as gene sequencing, help identify key factors affecting long-term survival.

“We’ve been doing this since the day I came here,” says Dr. Hoon, sitting in his sun-filled office on an August morning. “We started this. The focus has always been on molecular, translational research.

The Institute researchers were basically pioneers. Now everyone is doing it.”

Molecular research studies cancer as a disease of the genome—the package of DNA that makes each of us who we are. Gene sequencing is a technique used to read and decipher the genetic information in DNA to find aberrations linked to cancer.

New techniques have made gene sequencing much faster and simpler than it used to be, paving the way for the rapid evolution of knowledge and interest in personalized medicine. The National Cancer Institute recently established a Center for Cancer Genomics in order to help move advances in genomic science to patients as rapidly as possible, what is known as “translational” medicine.

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THE SEQUENCING CENTER DRIVES PERSONALIZED CARE

In 2012, the John Wayne Cancer Institute Sequencing Center was established with the mission of supporting cancer research, developing novel sequencing research methodologies and driving advances in personalized medicine and cancer care. Under the directorship of Dave S.B. Hoon, PhD, the Sequencing Center is keeping pace with the swiftly progressing field of next-generation sequencing and cancer medicine.

The Human Genome Project, which was the first international research effort to sequence the entire human genome, began in 1990 and took more than 10 years to complete. Since then, the field of next-generation sequencing has been advancing at an extremely rapid rate with innovative approaches.

Today, the John Wayne Cancer Institute Sequencing Center is equipped with the latest state-of-the-art sequencing technology that has reduced the sequencing time of the entire human genome to a mere 14 days. With generous support from renowned philanthropist and medical entrepreneur Patrick Soon-Shiong, MD, the Sequencing Center pairs the ability to sequence the human genome

“Personalized medicine is about how your tumor or your situation is a little different than another person’s disease,” says Dr. Hoon, who also serves as director of molecular oncology and director of genomic sequencing at the Institute. “I believe you need to know all the genomic information to treat cancer effectively.”

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with high speed, depth and accuracy—and with an equally cutting-edge capacity to analyze and understand the massive amounts of information generated from the human genome.

The Sequencing Center is connected to the National LambdaRail (NLR), a high-performance, 12,000-mile, fiberoptic computer network headed by the Chan Soon-Shiong Institute for Advanced Health. The NLR links research and medical institutions from around the nation, permitting accelerated sharing and storing of genomic data. By working with genomic analysis specialists connected to the NLR network, such as Five3 Genomics, the Sequencing Center is helping doctors and researchers obtain information on personalized cancer care faster than ever before. + The Sequencing Center receives generous support from the

Ruth and Martin H. Weil Fund, and The Carole Zumbro and George Adler family. The Dr. Miriam and Sheldon G. Adelson Medical Research Foundation also supports the Sequencing Center as part of the melanoma cooperative program in epigenomic analysis. The Sequencing Center has also been assisted through a grant from Novartis Pharmaceuticals to assess pituitary tumors sequencing in response to drug treatment.

GENE TESTING FOR THE BRCA MUTATIONS SAVES LIVES Personalized medicine is already available for some types of cancer prevention and treatment and is making a big difference for thousands of cancer patients each year. Genetic testing utilizes a patient's blood

sample or cells from a cheek swab to look for gene mutations that provide information on that individual’s risk of developing a particular type of cancer. Genetic testing can also provide information on a cancer patient’s risk of getting a second cancer.

For example, in the early 1990s, mutations in two genes—BRCA1 and BRCA2—were identified. These mutations account for about 5% to 10% of all breast cancer cases.

“One of the best applications of genetic testing allows women with a family history of breast cancer to determine whether they carry a deleterious mutation in the BRCA1 or BRCA2 genes,” says Maureen Chung, MD, PhD, director of the Margie and Robert E. Petersen Breast Cancer Research Program. “This test looks at a person’s risk of developing a cancer; it’s available now and will become even more accessible in the next few years.”

Another type of personalized gene sequencing available now to some breast cancer patients analyzes the tumor itself to determine what harmful genes are being over expressed and helps guide decisions as to whether the patient should get chemotherapy.

A DETECTIVE ON THE HUNT In the research realm, scientists are looking at sequencing the entire genetic code of a tumor sample, a test called whole genome sequencing.

“We interrogate a cancer patient's blood and tissues to get the most out of it,” Dr. Hoon explains. “It’s like forensic pathology—like the CSI TV drama. Over the years, the Institute researchers have developed techniques to perform tests on very little blood or tissue and get the maximum amount of information to help make decisions on the patient’s treatment.”

Dr. Hoon’s lab excels in discovering new genetic information on a wide range of cancer types through pioneering investigations of genomic, RNA and epigenetic biomarkers found in tissue and blood samples. These biomarkers can be used to diagnose cancer or yield information on a patient’s prognosis. He likens the work to how a detective goes about trying to solve a crime.

Researchers have debated the effectiveness of whole genome

We interrogate a cancer patient's blood and tissues. . .It's like forensic pathology—like the CSI TV drama.” molecular sequencing—looking at a person’s entire catalog of DNA— because sometimes the search turns up nothing. But Dr. Hoon believes it’s important to turn over every stone in the search for clues.

While many of the gene mutations won’t matter, some could reveal critical information about the best medications for treating the cancer, possibly saving a patient’s life.

“Because you did the whole genome sequencing, you found these common and unique mutations,” Dr. Hoon says. “That is where sequencing becomes personalized.”

Dr. Hoon has also pioneered methods to find free DNA circulating in the blood that can provide information on whether an individual’s cancer is spreading. Those techniques “tell you: (1) that you have

Dr. Maureen Chung expects the use of genetic testing for breast cancer to grow.

disease present, and (2) if it’s spreading. When it recurs, you can tell by biomarkers how aggressive it will be.”

Sometimes these DNA snippets reveal epigenetic changes—changes that are caused by mechanisms other than alterations in the DNA sequence. It’s important to use several methods to search for the disease because cancer cells are always changing.

Dr. Hoon and his colleagues, including many international research collaborators, have published scores of scientific papers chronicling these advances. Recently, he and his colleagues looked at circulating tumor cells in patients with stage III or IV melanoma who were treated with the melanoma vaccine, chemotherapy or surgery and had cancer that had spread to sentinel lymph nodes.

If you did sequencing five or 10 years ago, we didn’t have information on many gene mutations. Now, every month, we find new information.”

“We showed circulating tumor cells could predict disease recurrence and were able to adjust treatments accordingly—just from a patient’s blood sample,” he says.

THE FUTURE OF PERSONALIZED CANCER CARE Genomic tests are still not a service that every cancer patient receives— far from it. But Dr. Hoon expects that to change as scientists uncover more genetic aberrations.

“If you did sequencing five or 10 years ago, we didn’t have information on many gene mutations. Now, every month, we find new information,” he says. “I think it will be a standard in the future as we find new drugs targeted to specific genes or identify certain genes that block a drug or promote aggressive tumors. People are going to say, ‘This is worth doing.’”

It may not be long before whole genome testing will be routinely used in assessing most cancer cases to accurately classify and personalize treatments, Dr. Chung adds. “It’s not that far away. In the future, we’ll look for multiple things, not just specific genes.” + Dr. Hoon’s research receives generous funding from the Ruth

and Martin H. Weil Fund, NIH and NCI grants, and the Dr. Miriam & Sheldon G. Adelson Medical Research Foundation.

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PROFILE

Dr. Maggie DiNome will oversee the new High-Risk Clinic. Below, Veronica Vera, a breast cancer survivor, and husband, Vince on their wedding day.

Beating the Odds Prevention and screening measures are game-changers for women at high risk of breast cancer WRITTEN BY LAURA ROE STEVENS

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Already a leader in breast cancer treatment, the Margie Petersen Breast Center at Saint John’s Health Center will open a clinic in early 2014 aimed at serving patients with the greatest odds of developing the disease. The clinic is a natural step in the John Wayne Cancer Institute’s goal of providing personalized care by thoroughly assessing individual risk, says Maggie DiNome, MD, the clinic’s director and associate director of the Margie Petersen Breast Center.

“The High-Risk Clinic is a new addition that will help us to identify those patients at significantly increased risk for breast cancer, either based on family history or personal history, and provide them the appropriate tools and resources

they need to reduce their risk and get the appropriate screening,” explains Dr. DiNome.

Preventive measures can lower the risk of breast cancer in many women. While some women will still develop the disease, enrollment in a high-risk clinic should improve the odds that any cancers will be detected early, when the disease is most curable.

Preventive strategies can be as simple as adhering to a healthy diet and exercise regimen to the decision to undergo prophylactic mastectomy. The clinic will have a nutritionist, nurse navigator and genetic counselor available to assist patients.

Anyone will be able to come to the clinic for an assessment of breast cancer risk. Those with a family history of cancer or other risk factors that increase their risk, such as women who carry the BRCA1 or BRCA2 gene mutations, will have the full array of resources available to them.

“It’s not only for patients who are BRCA-positive but also for those who have high risk based on other risk factors,” Dr. DiNome explains.

There are many risk factors to

material. When either of these genes is mutated, or altered, so that its protein product is not made or does not function correctly, DNA damage may not be repaired properly. As a result, cells are more likely to develop additional genetic alterations that can lead to cancer.

Inherited mutations in BRCA1 and BRCA2 increase the risk of female breast and ovarian cancers and account for about 20% to 25% of hereditary breast cancers and about 5% to 10% of all breast cancers.

Veronica Vera wishes she’d had access to a high-risk clinic earlier in life. In 2011, the Los Angeles woman was 33 and had been married to husband Vince only three weeks when she learned she had breast cancer and carried the BRCA1 gene mutation.

“I had never heard of the BRCA gene,” Vera says. “Now, after Angelina Jolie announced she has it, more people realize how important it is to get tested.

But when I was younger, no one really knew about it. Even today, few young people test for it. Cancer runs in my family, so I certainly would have benefited

The High-Risk Clinic is a new addition that will help us to identify those patients at significantly increased risk for breast cancer, either based on family history or personal history, and provide them the appropriate tools and resources they need.” assess, but due to the aggressive nature of BRCA-related cancers— which can develop at earlier ages—it’s important to identify those with inherited mutations as soon as possible, she says.

BRCA1 and BRCA2 are genes that produce tumor suppressor proteins, which help repair damaged DNA and play a role in the stability of a cell’s genetic

from a high-risk clinic earlier in life.”

Vera had no time to settle into married life before undergoing a double mastectomy, reconstructive surgery, in vitro fertilization and chemotherapy.

The couple chose to have IVF and to freeze embryos before cancer treatment in case the treatments caused sterility or

ARE YOU AT RISK? One in eight women develop breast cancer at some point in life.

However, certain risk factors increase those odds, including:

 Being younger when you first had your menstrual period  Starting menopause at a later age  Being older at the birth of your first child  Never giving birth  Long-term use of hormone-replacement therapy  Getting older  P ersonal history of breast cancer or some non-cancerous breast diseases

 Family history of breast cancer  Mantle chest wall radiation as teenager or young adult  Dense breasts by mammogram  B eing overweight (increases risk for breast cancer after menopause)

H aving changes in the breast cancer-related genes BRCA1 or BRCA2

 Not getting regular exercise there were reproductive health problems later on. However, the couple conceived naturally and is expecting a baby early next year.

“It’s a happy ending to the beginning of a bumpy story,” Vera says. “Our first year was spent with surgery, complications, reconstruction, IVF, chemo— phew! It’s a miracle that I’m now pregnant. I’m so thankful to Dr. DiNome and all the physicians who worked with me.”

While her life has returned to normal, Vera says she will remain vigilant to reduce her risk of a cancer recurrence. Being

BRCA-positive means she is still at higher-than-normal risk for ovarian and reproductive cancers.

She will adhere to a schedule of prevention checkups and will likely undergo future salpingooophorectomies. Prophylactic removal of the ovaries and fallopian tubes lowers the risk of ovarian cancer.

This past Labor Day, Vera enjoyed a day at the beach and reflected on the “wonderful” care she received from Dr. DiNome and the confidence she has placed in her healthcare team. The future is bright.

The High-Risk Clinic is part of the Margie Petersen Breast Center at Saint John’s Health Center. Considered one of the nation’s top facilities, the Breast Center provides a comprehensive approach to diagnosing and treating breast disease with state-of-the-art diagnostic and therapeutic technology. The Breast Center offers the latest in breast cancer screening, diagnosis and treatment. By providing multidisciplinary care to patients with breast disease, women are assured of receiving the most advanced treatment.

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John Wayne with son Ethan.

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THE MAN Behind the Name

John Wayne's family carries out his greatest wish.

WRITTEN BY JEANNINE STEIN

M

elinda Wayne Muñoz is certain that her father, John Wayne, would be proud of the cancer breakthroughs accomplished in his name. “I think he’d be thrilled that he gave his name to such a fine Institute.”

When he was asked to lend his name to a cancer clinic, the actor saw an opportunity to help others.

The family of the actor and cancer activist didn’t walk away once the sign was in place, either. Each generation of Waynes is heavily involved with and committed to fighting cancer in their father’s name. Each person contributes however they can, says Melinda, from being part of a board to participating in a 5K run. Melinda, 72, and a resident of Orange County, serves on the John Wayne Cancer Institute Auxiliary's board of directors.

She’s not worried about the involvement of future generations, either.

“Everybody fills the cup,” she says. “They do what they can.”

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he speaks like a proud parent when ticking off the Institute’s accomplishments, including the sentinel lymph node biopsy technique developed by Donald L. Morton, MD, and the Institute’s Surgical Oncology Fellowship Program, which offers physicians specialized training.

“John Wayne is responsible for a lot of the cancer research that helps people all over the world,” adds Ethan Wayne, 51, the actor’s youngest son and chief executive officer of the John Wayne Cancer Foundation, headquartered in Newport Beach, and president of John Wayne Enterprises. “The Institute is a big part of that story. We have a mountain of a man in Dr. Donald Morton. As we transition into the future, there is a lot of talent at the Institute.”

Marisa Wayne, 47, the actor’s youngest daughter, knows the Institute well. She serves on the Auxiliary’s board of directors. In addition to assisting in fundraisers, she actively supports the Institute’s Surgical Oncology Fellowship Program and serves as an ambassador for the Institute. Over the years, Marisa has discovered a variety of ways to pitch in. “I do basically whatever they ask me to do,” she says. “I’ve been involved, one way or another, since the Institute was founded.”

Working with various boards or committees has given each family member a greater appreciation of the Institute’s mission, says Michael Wayne, 46, John Wayne’s grandson and chairman of the board of advisors at the John Wayne Cancer Institute.

“Every year I’ve gotten to know more and more about what’s being done by the physicians and scientists, and that’s been critical in understanding better how I can help,” he says.

Michael heaps praise upon those on the front lines. “These doctors are great people—many are practicing physicians who have an interest in trying to wipe cancer out or, until then, extending the lives of people who have it.”

It was John Wayne’s admiration of Dr. Morton that led to the naming of the Institute. During his treatment, he gave Dr. Morton permission to attach his name to the clinic, and the late Michael Wayne, the actor’s eldest son, became the Institute’s first chairman of the board.

“My dad clearly asked us, his children, to use his name to benefit the public, the people who were so loyal to him and his films,” Melinda explains.

The family’s decision to carry on his grandfather’s legacy with the Institute was the right choice, Michael adds.

“The biggest reason we did this is because cancer took him away from all of us when he was 72,” says Michael, a partner at the Los Angeles law firm Gibbs Giden. “He was a big, strong guy, and I think if he

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had lived, we would have seen more John Wayne movies.”

Adds Ethan: “I feel like I’m facilitating his work.

He’d be honored that this work is getting done. He’d be amazed that he still resonates with people in a substantial way.”

Entire Wayne families are involved in carrying on the actor’s mission to improve cancer treatment.

Michael’s wife, Christine, serves on the Auxiliary’s board of directors. Moreover, Michael says, he discusses the Institute’s work with their 14and 16-year-old sons. The teens participate in community work, such as giving talks to their peers about the importance of using sunscreen to help prevent skin cancer.

“They understand the idea about helping others who are less fortunate,” he says. “I’m hopeful they’ll want to carry this on.”

Other Wayne great-grandchildren participate in activities to support cancer research, such as the Orange County Marathon’s 5K, which raises money for the John Wayne Cancer Foundation, says Anita Swift, one of Wayne’s grandchildren. Anita is on

We put our money where it needs to be for cancer—for education and research.”

—Anita Swift the Auxiliary’s board of directors and serves as its current president.

“We tell them about my grandfather,” says Anita, 55, whose husband, Tim, joins her in support of Institute activities. “We all truly believe in this. Not only did my grandfather die of cancer but also my mother and my grandmother. As I travel the United States for the Institute and the John Wayne Cancer Foundation, I haven’t met anybody who hasn’t been touched by cancer in some way.”

The actor's fans may not realize that a portion of the profits from branded merchandise are directed to specific causes. “We put our money where it needs to be for cancer—for education and research,” she says. “That’s what he wanted.”

The actor remains a symbol of strength. In annual Harris Polls asking people to name their favorite movie star, John Wayne is consistently in the top 10.

Decades after John Wayne made his last film, his son Patrick, 74, knows his father is anything but gone from the public eye.

“I don’t think any of us had any idea that his popularity and celebrity would be as strong as it is

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1. Molly Muñoz Rigdon (grand­ daughter) and friend Sherry Leysen 2. Aissa, Pilar, Patrick and John Wayne 3. Wayne grandchildren and great grandchildren 4. Patrick Muñoz (grandson) 5. The Wayne family and the John Wayne Cancer Foundation announce a $1 million gift to the Institute.

6. Walter Knott with John and Ethan Wayne, Log Ride opening, Knott’s Berry Farm, 1969 7. Matt Swift (great grandson) 8. Patrick, Marisa and Ethan Wayne; USPS CFO Richard Strasser; Aissa Wayne and Melinda Wayne Muñoz 9. Anita Swift 10. Patrick and Michael Wayne with a model of the proposed statue of their father, John Wayne, to be placed at John Wayne Airport, circa 1981.

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today,” he says.

Adds Marisa: “It just amazes me that no matter where I go, people have a story about how my father touched their lives or the lives of their parents and grandparents.”

The late actor still resonates with people, which has helped draw awareness and support to what the Institute is doing, says Patrick, chairman of the board of directors of the Institute. “It makes you get up in the morning; it makes you want to do more.”

His wife, Misha, serves on the Auxiliary’s board of directors and is involved in the planning of the annual Benefactors Dinner.

The family’s presence is felt at the Institute on a daily basis, says Anton Bilchik, MD, PhD, professor of surgery, chief of He was medicine and chief of very happy in the gastrointestinal research program at his own skin, the Institute. and I think that “The family doesn’t just talk showed in the about supporting way he treated the Institute, they take action to make people. It was things happen,” Dr. great having a Bilchik says. “They are keenly interested dad like that.” in how the Institute —Marisa Wayne develops, and then they ask what they can do to make our goals a reality.”

Patrick, who lives in Toluca Lake, says his father set an example for being proactive. He recalls that his father’s battle with cancer “didn’t slow him down at work at all. He also talked more publicly about the fact that he had cancer.” He did it “to give hope to other cancer patients. Even in the last few weeks of his life, he’d get out of his hospital bed and talk to people.”

And that, he says, personifies courage. “He was in a lot of pain, and for me, the most courageous I ever saw him was in his last days.”

Seeing his beloved grandfather ill no doubt fueled a fire in Michael to help others. “I recall seeing him be kind of a shell of what he was. It’s tough to have that image in your mind, but it didn’t make me forget about the good times.”

Those include accompanying his grandfather to cattle sales in Arizona and being with him on film sets. “I’d sit on his lap while he was playing cards, and he’d let me roll the dice for him,” Michael recalls. “He was just an amazing guy to be around. He had a great way of making you feel special.”

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Ethan was only 17 when his father died. “I loved my dad,” he says. “He was older by the time I was born. We were sort of pals. He was easy-going. He guided people gently.”

Marisa remembers her father, who died when she was just 13, as gracious and hardworking. “He had a zest for life—everything was fun, and he had a big personality. When he walked in a room, you knew he was there. He was very happy in his own skin, and I think that showed in the way he treated people. It was great having a dad like that.”

John Wayne was a loving father with a great sense of humor who raised his children to be humble, responsible adults, assigning them chores when they were young, Melinda says. “When you’re given so much in life, you need to give back.”

So many years after the actor’s death, the Wayne family members are overjoyed to see the scientific accomplishments of the Institute. They commend the Institute’s many supporters and outstanding faculty and staff. ¾

John Wayne loved his family. Pictured here with his first grandchild Anita Swift.

PROFILE

In Memoriam A strong will to help launched the influential ABCs. The Associates for Breast and Prostate Cancer Studies (ABCs) has long supported efforts to improve the diagnosis and treatment of breast and prostate cancer.

Its long partnership with the John Wayne Cancer Institute was fostered by the leadership of Davida Lettiere who passed away in September.

“Davida’s life was never about herself,” says ABCs president Gloria Gebbia. “It was always about others. Volunteering gave her a great sense of satisfaction in helping others.”

Davida was born and raised in Brooklyn, New York, the oldest of three children, but lived much of her adult life in Los Angeles.

She was married for 53 years to husband Donald and had two children: David and Debi. She was also the proud grandmother of four.

With a strong desire to serve others, she helped found the ABCs and immersed herself in the details of volunteer work, planning events with cheerfulness and optimism. Over the years, members of the ABCs have raised more than $14 million to support the Institute’s research. Hugely successful events chaired by Davida have drawn such entertainers as Diana Ross, Michael McDonald and Lionel Richie.

“For more than 23 years, Davida was a driving force in supporting innovative cancer

Davida Lettiere helped found the ABCs.

research at the Institute through the ABCs,” shared Patrick Wayne, chairman of the board of directors. “The Institute has lost a dear friend to an illness we are all desperately trying to eradicate. Davida’s courage, leadership and philanthropic spirit will continue to inspire us in our mission, and her legacy will forever be with us.”

She showed deep compassion for others.

“She opened her hands to the needy and extended her hands to the poor,” Gloria says.

“She always spoke with wisdom and strength,

and her tongue was guided by kindness.”

Although diagnosed with cancer three years ago, Davida did not back away from her goals for the ABCs. Nothing stopped her. “Going to food tastings for the Gala, invitations, auction houses, the decorations. She worked harder and harder,” Gloria says. “Her will to help raise money to find a cure was stronger than ever.”

Friends praised Davida for her generosity and her yearning to be of service to others.

Says Gloria: “When you speak of a woman of valor, that describes Davida.”

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FIRST, DO NO HARM Researchers strive to develop prostate cancer screening tests with clear-cut benefits.

WRITTEN BY LINDA MARSA

I

n an era when guidelines for cancer screening have come under increased scrutiny, many men are wondering what to do about testing for prostate cancer—which has become controversial. While screening can save lives, it often picks up non-life threatening cancers that never would have caused trouble, and many men with these types of innocuous tumors undergo treatments that aren’t necessary.

But research at the John Wayne Cancer Institute may help change that by devising a much more precise screening tool. Scientists are investigating biological markers that would distinguish between dangerous cancers that need to be aggressively treated and slow-growing tumors that are relatively benign.

The current prostate cancer screening test is a blood test that measures levels of prostate-specific antigen (PSA), which is a substance made by the prostate that can be elevated in men who have prostate cancer. But there are a host of problems with the test.

First, PSA levels can rise because of other conditions that affect the prostate, such as infections, certain medications or even simply age and race. Plus, elevated PSA markers lead men to have unnecessary biopsies, which can be painful and cause infection. Such

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1 in 6

men will be diagnosed with prostate cancer.

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GET THE FACTS biopsies also may uncover many cancers that would never be harmful, yet many men are treated with invasive surgery or radiation that can cause serious side effects like incontinence and erectile dysfunction.

Finally, the test itself can be unreliable. Up to 75% of tests that indicate a man has cancer produce false positive results—which means that while the test is positive, the person doesn’t have cancer.

Other patients with low PSA levels actually have an aggressive form of the disease.

Still, screening has proven beneficial. Before the test became widely used, more men were dying because their cancers weren’t detected until advanced. Today, doctors are able to diagnose the disease at a much earlier, more treatable stage. The fact that screening has saved lives has raised difficult questions about who really benefits from the test.

“If you look at the statistics, it’s like trying to find a needle in the haystack—one in six men will be diagnosed during their lifetime, but one in 36 men will actually die from prostate cancer,” says Laurent Lessard, PhD, an assistant professor in the department of molecular oncology at the John Wayne Cancer Institute. The department, under the direction of Dave S.B. Hoon, PhD, is internationally recognized for the development of cancer biomarkers.

“What that means is that anywhere from 85% to 90% of men who are diagnosed with prostate cancer have relatively harmless tumors that may not need to be treated. What we need are better biomarkers that can be used in concert with the PSA test and other clinical parameters to pinpoint which prostate cancers are clinically significant, so that patients can be stratified better for immediate curative treatment—or non-curative alternatives such as active surveillance,” explains Dr. Lessard.

He is proceeding along two parallel paths that have promising screening and diagnostic potential. One area of research, supported by the Associates for Breast and Prostate Cancer Studies (ABCs), involves devising a novel blood test to detect cancer-related changes in tiny fragments of genetic material, known as microRNAs, long before a metastatic tumor can be seen on a scan.

He and his team use a technique that can detect these bits of RNA in a single drop of blood, compared to other methods that require approximately three tablespoons. If researchers can prove that specific circulating microRNAs are linked to aggressive cancers, they may be able to identify markers that help spot the more dangerous tumors.

Another research project is looking at changes in DNA methylation, an epigenetic event that does not affect the DNA sequence but nonetheless disrupts the expression of genes involved in cancer progression. Growing evidence indicates that these subtle changes may, in fact, be one of the drivers that trigger aggressive prostate cancers. Right now, Dr. Lessard’s research team is using genome-wide, cutting-edge approaches to uncover the distinct patterns of changes in footprints between aggressive and nonaggressive tumors.

If these epigenetic markers are indeed warning signs that a cancer is dangerous, they could be used in a more sensitive blood test that would be minimally invasive and cost-effective. Such biomarkers

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More than

238,000 U.S. men are diagnosed with prostate cancer each year.

Only men between the ages of

55 to 69 should get tested.

While most tumors are slow-growing, some

For more than 20 years, doctors routinely ordered PSA screening tests for men 40 and older, usually as part of an annual men die of the physical check-up. But in disease annually.

2011, the United States Preventive Services Task Force recommended against wide-scale screening because the risks outweighed the benefits—more men would be harmed by unneeded treatments than would be saved by screening.

In the past year, the American Urological Association has come to similar conclusions and now advocates testing only for men aged 55 to 69. Testing is not advised for healthy men younger than 54 years old who are at average risk of getting prostate cancer or for men 70 and older. But men with greater risks—African-Americans or men with a family history—should discuss with their doctors whether to start screening before age 55.

28,000

PROSTATE CANCER IS A DISEASE OF OLDER AGE From 2006 to 2010, the median age at death for cancer of the prostate was 80 years of age.

Death rates by age: 0%

20-34 years old 0.1%

35-44 years old 1.6%

45-54 years old 8.3%

55-64 years old 20%

65-74 years old 37.6%

75-84 years old 32.5%

85+ years old Source: SEER data, cancer.gov

RISK FACTORS

50+

AGE The risk rises significantly after age 50.

FAMILY HISTORY Approximately 15% of men with prostate cancer have a first-degree relative with prostate cancer, compared with approximately 8% of the U.S. population.

RACE The risk is highest in African-American men and lowest in Asian-American men.

GENES Inherited mutations in the BRCA1 and BRCA2 genes may increase risk.

DIETARY FAT Men in populations with higher-fat diets have a greater risk compared to men in countries with lowfat diets. High-calcium diets may also raise risk.

Source: American Cancer Society

Laurent Lessard, PhD

could also provide a way of monitoring disease progression and the efficacy of treatments.

“Once you find a molecular signature, you can see if it’s predictive of whether the disease is lethal or slow-growing and nonthreatening,” says Dr. Lessard. “Our goal is to develop a molecular test that will measure these DNA changes to distinguish aggressive from indolent tumors and guide patients and physicians in their choice of treatment.” The great thing about these alterations, he adds, is that scientists know they can be reversed by different drugs, and that could eventually pave the way toward targeted treatments that halt the action of these renegade fragments of DNA. + Dr. Lessard’s research receives generous support from the Associates for Breast and Prostate Cancer Studies.

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PROFILE

34 INNOVATIONS, WINTER 2013

Daniel F. Kelly, MD, left, with Wei "Harvey" Hua, MD, PhD.

The Fellows Who Follow Dr. Daniel F. Kelly’s innovative work attracts neurosurgeons from around the world. WRITTEN BY ZOE SOPHOS

The fellowship programs at the John Wayne Cancer Institute have impacted neurosurgeons and medical communities globally from China to Chile to Nigeria.

As director of the brain tumor center at the Institute and an internationally recognized leader in neurosurgical research and training, Daniel F. Kelly, MD, receives dozens of applications for the clinical and observational fellowship programs every year.

One type of fellowship, the clinical fellowship, is designed for physicians who have already completed their neurosurgical residency. They receive an additional year of training focused on minimally invasive surgery for brain,

There is a great need to improve our ability to understand how the tumors get into the brain and effective treatments to halt their growth.” pituitary and skull base tumors. The program is focused on teaching the latest techniques in endonasal (through the nose) and keyhole (small openings into the skull) approaches, and the overall care of patients with intracranial tumors.

The clinical fellow also participates in research projects and teaching conferences. Five clinical fellows have completed the program since it began in 2008.

Another training program, called the observational fellowship, is for foreign-trained neurosurgeons who want to gain additional experience in

minimally invasive keyhole techniques.

They typically spend six to 12 months at the Institute and Saint John’s Health Center observing in the operating room and attending neurosurgery clinic where new patients are evaluated.

These fellows have the opportunity to work on some of the biggest challenges in neurosurgery. For example, they participate in brain tumor research projects and learn new surgical dissection techniques in the microdissection lab. Led by neurosurgeon Garni Barkhoudarian, MD, the lab is one of the newest developments at the John Wayne Cancer Institute and brain tumor center.

“The average survival for patients with metastatic melanoma tends to be less than a year,” Dr. Kelly states. “There is a great need to improve our ability to understand how the tumors get into the brain and effective treatments to halt their growth.”

Dr. Kelly also oversees the Fudan Neurosurgical Fellowship, established earlier this year after he, Chester Griffiths, MD, and Dave S.B. Hoon, PhD, visited Fudan University in Shanghai, China. The resulting collaboration provides Fudan University neurosurgeons, such as current fellow Wei "Harvey" Hua, MD, PhD, with six to 12 months of study with Dr. Kelly and Dr. Hoon. This collaboration also includes the Institute’s researchers gaining access to Fudan’s extensive brain tumor tissue bank.

“We like the observational fellows to come for six to 12 months so they can gain a sufficient understanding of the indications, technical details and complication avoidance techniques of these newer approaches,” Dr. Kelly

explains. “Many neurosurgeons feel they need the extra experience with these advanced procedures before they can go out and do them on their own.”

Currently, there are three observational fellows at the Institute who train for a six-month period of time.

They hail from China, Nigeria and Chile. Pablo Villanueva, MD, arrived as a visiting observational fellow in April 2013 and completed his fellowship this fall. Originally from Santiago, Chile, he studied neurosurgery at Pontificia Universidad Católica de Chile before completing a fellowship in pituitary surgery at the University of Melbourne in Australia. He now directs the pituitary tumor program and is an assistant professor at Pontifica Universidad Católica.

“You don’t just come here and do the surgeries and then you go home,” Dr. Villanueva says. “By being exposed to many of these surgeries, you have the chance to learn a lot about minimally invasive surgery and microdissection techniques as well as getting involved in research. From this experience, you eventually get the chance to get involved in writing articles and learn some skills and specific skull base surgical anatomy.”

Beyond the extensive scope of research taking place at the Institute, it’s the dedication and humility of Dr. Kelly that helps make the fellowship program so valuable, he adds. + The brain tumor program

receives generous support from The Carole Zumbro and George Adler Family, Ruth K. March and Family, Danielle Brown Ross and Ronald Ross, and Jeff and Carole Schwartz.

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MEMORABLE EVENTS JWCI Auxiliary Odyssey Ball The 28th annual Odyssey Ball, the yearly fundraising event benefiting the John Wayne Cancer Institute at Saint John’s Health Center, was held on April 13 at the Beverly Wilshire. Since its inception, the Auxiliary has raised more than $18 million to support the Institute’s life-saving cancer research and treatment programs. This year’s gala honored Michael S. Sitrick, chairman and chief executive officer of Sitrick And Company, with “The Duke” Special Service Award. The evening also featured a special performance by singer and voice actress Rachael MacFarlane.

Susan Veerman and Cynde Wilen co-chaired.

Proceeds from the ball supported the Institute’s Surgical Oncology Fellowship Program, founded by Donald L. Morton, MD, more than 30 years ago. Through the John Wayne Cancer Foundation, the family of John Wayne generously pledged $500,000 to the fellowship program, one-third of which was used to match this year’s contributions to the Odyssey Ball.

Many thanks to the individuals and organizations that have coordinated special events to benefit the John Wayne Cancer Institute.

PHOTOS

1. Ina and Bernard Lewis 2. Diane Feldman and Teddi Gilderman 3. Auxiliary past presidents: Shirley Lipstone, Jackie Banchik, Diane Feldman, Anita Swift, Ruth Weil, Ilene Eisenberg, Lois Rosen, Hollace Brown and Roberta Novick 4. Dr. Anton Bilchik introduces the surgical oncology fellows 5. Michael and Christine Wayne, Melinda Wayne Muñoz, Marisa Wayne, Anita Swift and Patrick Wayne 6. Michael and Nancy Sitrick, Anita Swift and Patrick Wayne 7. Hollace Brown and Sonny Wallensky 8. Isabelle Stehley, Marisol Zarco, Colleen Pennell, Kathleen Duncan, Katie Lewis and Andrea Zuckerman 9. Event co-chairs Cynde Wilen and Susan Veerman 10. Michael Wall, Michael Sitrick and Patrick Wayne 11. Michael and Robyn Altman and Jackie Banchik 12. Retired Lieutenant General H Steven Blum 13. Nicole Faries and Dr. Mark Faries, Dr. Donald Morton and Ruth Weil 14. “The Duke” Award honoree Michael Sitrick 15. Dr. Myles Cabot, Dr. Frederick Singer, Dr. Delphine Lee, Dr. Mark Faries, Dr. Jinhua Wang, Dr. Roderick Turner, Dr. Sharon Huang, Dr. Anton Bilchik and Dr. Hitoe Torisu-Itakura 16. Dr. Anton Bilchik, Dr. Mark Faries, Dr. Donald Morton and Ethan Wayne 17. Roger Howard and guests of the Glaser Weil law firm 1

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MEMORABLE EVENTS ABCs Mother’s Day Luncheon The Associates for Breast and Prostate Cancer Studies (ABCs) hosted its annual, star-studded Mother’s Day Luncheon at the Four Seasons Hotel in Beverly Hills on May 8 to benefit breast and prostate cancer research at the John Wayne Cancer Institute. Holly Robinson Peete and her mother, Dolores Robinson, received the Mother and Daughter of the Year award while celebrated model Amber Valletta was honored with the Woman of Achievement award. Actor and comedian Mike Epps was recipient of the Man of Achievement award. Beverly Cohen and Sheri Rosenblum co-chaired.

ABCs president Gloria Gebbia and honorees Amber Valletta, Dolores Robinson, Holly Robinson Peete and Mike Epps

Sheri Rosenblum, Patrick Wayne and Beverly Cohen

Nicole Murphy and Mike Epps

ABCs Check Presentation On June 11, the ABCs presented a check to the Institute leadership in the amount of $200,000 to support innovative breast and prostate cancer research at the John Wayne Cancer Institute. To date, the ABCs have raised more than $14 million for life-saving cancer research at the Institute.

1. Spirit of Hope plaque 2. John Gebbia with Marty Greenberg accepting the Spirit of Hope award on behalf of Shelly and Donald Sterling 3. Elaine and Jack Lerman 4. Dr. Elliot and Joni Alpert, Stanley and Marcia Lauffer 5. Dr. Anton Bilchik, Gloria Gebbia and Michael Wall 6. Andy Trilling, Ada Sands, Michael Wall, Gloria Gebbia and Dr. Delphine Lee 7. Dr. Maureen Chung, Dr. Laurent Lessard, Dr. Maggie DiNome and Dr. Delphine Lee 8. Wanda Pressburger, Shana Forman and Francesca Daniels 6

38 INNOVATIONS, WINTER 2013

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MEMORABLE EVENTS Fellowship Graduation

1

Six graduates of the Surgical Oncology Fellowship Program were recognized at a June 25 ceremony at the beautiful home of Ruth Weil, a longtime Institute benefactor. More than 100 guests mingled with Dr. Anton Bilchik, Dr. Maureen Chung, Dr. Daniel Kelly, Dr. Donald Morton and Dr. Mark Faries—the incredible team who train our fellows. The keynote address was provided by Dr. Steven Chen, MBA, associate professor at City of Hope National Medical Center and a previous Carolyn Dirks fellow at the John Wayne Cancer Institute. Dr. Chen, who now leads City of Hope’s Fellowship Program, spoke passionately about the value of passing the knowledge he gained from the Institute to the fellows he now trains and encouraged each fellow to “carry on the mission of innovative cancer research and make a difference.”

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PHOTOS

1. Top row (from left): Michael Wayne, Anita Swift, Dr. Danielle Hari (William Randolph Hearst Foundations fellow), Patrick Wayne and Dr. Aaron Cutler (neurosurgery fellow) Bottom Row (from left): Dr. Julie Billar (JWCI Auxiliary breast fellow), Dr. Anna Leung (Harold McAlister Charitable Foundation fellow), Ruth Weil, Dr. Connie Chiu, Marisa Wayne and Dr. Junko Ozao-Choy 2. Dr. Steven Chen, MBA, Carolyn Dirks fellow 2005–2007 3. Dr. Maureen Chung, Dr. Julie Billar and Dr. Maggie DiNome 4. Jordan Friedberg and Janine Gershon Friedberg 5. Danielle Brown Ross and Ronald Ross 6. Ruth Weil and Dr. Donald Morton 7. Marcia Hobbs and Sister Maureen Craig 8. Dr. Mark Faries 9. Norma Bilchik and Dr. Anton Bilchik

Los Angeles Sparks Breast Health Awareness Night The Institute was proud to partner with the Los Angeles Sparks on August 13 for Breast Health Awareness Night. A portion of ticket sales for the game was donated to breast cancer research at the Margie and Robert E. Petersen Breast Cancer Research Program at the John Wayne Cancer Institute. Special thanks to Los Angeles Sparks owners Paula and Roosevelt Madison and president Vinnie Malcolm.

8

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Michael Wall, Michael Wayne, Anita Swift, Dr. Nefertiti Brown ( JWCI Auxiliary breast fellow), Dr. Maggie DiNome, Dr. Maureen Chung and Patrick Wayne WINTER 2013, INNOVATIONS

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MEMORABLE EVENTS Avon Walk for Breast Cancer

Team Duchess from left to right: Susie Gesundheit, Teddi Gilderman, Griselda Rodriguez, Cynde Wilen, Sue Emmer and Dana McCormick

Fans take a moment to be photographed with “The Duke.”

John Wayne Cancer Institute at Saint John’s Health Center was once again a proud partner of the Avon Walk for Breast Cancer on September 7–8 in Santa Barbara. The Institute served as the medical sponsor for the two-day, 39-mile walk led by Maggie DiNome, MD, associate director of the Margie Petersen Breast Center, and JWCI Auxiliary breast fellow Nefertiti A. Brown, MD. Several surgical oncology fellows, Saint John’s Health Center nurses and volunteers provided support in the medical tent. Institute staff and volunteers also hosted a cheer booth along the route to offer encouragement. They distributed pink John Wayne Cancer Institute bandanas and offered walkers a chance to be photographed with “The Duke.”

Walkers included many Institute supporters, led by “Team Duchess,” who have raised tens of thousands of dollars over the years. Special thanks to Teddi Gilderman, Cynde Wilen, Dana McCormick, Griselda Rodriguez and all of the dedicated walkers. Proceeds from previous Avon Walks have helped support innovative breast cancer research led by Delphine J. Lee, MD, PhD, director of translation immunology in the Dirks/Dougherty Laboratory for Cancer Research.

Walkers visiting our cheer booth received ice cold JWCI bandanas.

Avon Walk medical team: nurses Lidice Cea, Helen Blohm and Irene Bristol, Coco Garcia, nurse Amanda Rodriguez, Dr. Maggie DiNome and Dr. Stanley Zusman

Premier Girl’s Fastpitch National Championships John Wayne Cancer Institute was the beneficiary of the Premier Girl’s Fastpitch (PGF) national championships in Huntington Beach.

Dan Hay, president and chief executive officer of PGF, donates a portion of registration fees to life-saving breast cancer research at the Institute. Addressing the enthusiastic players and their families at opening game ceremonies were Marisa Wayne, Anita Swift and Maureen Chung, MD, PhD. Institute staff as well as volunteers were onsite at the games to raise awareness about the Institute’s mission and distribute information.

Dr. Maureen Chung, PGF president and CEO Dan Hay and Anita Swift

40 INNOVATIONS, WINTER 2013

MEMORABLE EVENTS Tustin Brewery Golf Tournament Tustin Brewing Company and brewery owner, Jason Jeralds, hosted the 16th annual Tustin Brewing Company Charity Golf Tournament on September 23 to benefit the John Wayne Cancer Institute.

Jeralds and his staff have been committed to raising money to find a cure for melanoma after he lost his father to the disease. Thanks to generous support from their customers, friends and families, Tustin Brewing Company has donated more than $80,000 to the Institute.

FFANY Shoes on Sale The John Wayne Cancer Institute was proud to be a partner at the 20th annual QVC Presents “FFANY Shoes on Sale” event on October 1 at the Waldorf Astoria in New York City. The Fashion Footwear Association of New York Charitable Organization has contributed more than $5 million to the Institute to support breast cancer research.

Chris and Becky Buehrle, Mark Rypien and Sandy Pinkstaff

Joe Moore, chairman of FFANY, and Patrick Wayne

Buehrle Golf Classic On Saturday, August 3, the Buehrle Family Foundation hosted the 23rd annual Buehrle Golf Classic in memory of Sharon Buehrle and all family and friends lost to cancer.

Former Washington Redskins quarterback Mark Rypien was the recipient of this year’s Alan J. Pinkstaff service award, dedicated to the memory of co-organizer Becky Buehrle’s father, who lost his battle with colon cancer in 2005. Held at The Missouri Bluffs Country Club, a portion of the tournament proceeds benefits breast cancer research at the John Wayne Cancer Institute.

Michael Atmore, Anita Swift and Julianne Hough with winners

Planned Giving Donor Recognition Luncheon The John Wayne Cancer Institute was pleased to honor our planned giving donors, Guardians of the Future, on September 18 at the Riviera Country Club. Guardians of the Future is a distinctive group of individuals who have provided for the Institute through their estate and/or charitable plans. The group enjoyed an update from John M. Robertson, MD, Foundation chairman-elect, who shared the latest news on our sponsorship change to Providence Health & Services and his unique insights regarding the recent meeting between the Saint John’s Foundation Board of Trustees and Providence leadership. Also attending were the Saint John’s Health Center Foundation’s Friends for the Future.

Victoria Pushee and Ruth Weil

Betty Andelson and Diane Sweet

Gloria Miller, Mary Ann Weiss and Marvin Weiss WINTER 2013, INNOVATIONS

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PHILANTHROPY

Guardians of the Future

Joseph "Bud" Erhardt left a legacy in the battle against cancer. organizations. One of his two children, daughter Wendy— Harrison’s wife—was diagnosed with malignant melanoma in 2000 and was successfully treated at the Institute. Mickey Erhardt also suffered from cancer and was treated at the Institute. Mickey and Bud had been married 60 years when she died in 2009. The couple also have a son, Terry, and four grandchildren.

While Erhardt conducted his philanthropy quietly, he was resolute about making his wishes known to his survivors. He knew that a single sentence in a will could impact the future and allow an individual to determine his or her legacy.

“Bud’s unwavering generosity for more than a decade helped further innovative cancer research at the Institute,” said Andy Trilling, vice president of development. “We are truly grateful to the Erhardt family for making this significant bequest to the Institute in their estate plans, which will further their legacy of helping cancer patients today and well into the future.”

Planned giving is the easiest gift to make and costs nothing now; those who choose this option have the satisfaction of knowing they’ve provided for the John Wayne Cancer Institute in the future. We thank the individuals who share with us their intentions about their estate plans, so we can recognize them as a member of the Institute’s legacy society, the Guardians of the Future. ¾

Bud Erhardt with granddaughters Emily, left, and Trisha.

J

oseph “Bud” Erhardt lived life to its fullest, and that also meant giving to others so that they, too, could overcome challenges and make the most of opportunities. Erhardt, a long-time friend and donor to the John Wayne Cancer Institute, died earlier this year at age 90.

“He was dedicated to his family, and he was beloved by not only his immediate family but the extended family,” says Craig Harrison, Erhardt’s son-in-law. “Because of his success in business, he was able to share and support extended family members. He was always there for people. He never took credit.

You wouldn’t find out anything he had done for someone unless it slipped out in a conversation.”

Erhardt was born in 1922 in Chicago. After serving in World War II, he and his wife, Mickey, moved to Los Angeles.

In 1949, Erhardt became a salesman for the Pacific Paper Box Company, which makes rigid paper boxes that are used in a variety of industries.

Erhardt rose up the ranks to become president and never retired. Even in his later years he came into the office for a few hours on most days. Always a charitable man who gave to many organizations, Erhardt focused on a handful of special causes later in his life.

“Bud believed that it was your responsibility to give back as much as you could,” Harrison says.

The John Wayne Cancer Institute was one of Erhardt’s favorite

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BECOME A GUARDIAN OF THE FUTURE FOR THE JOHN WAYNE CANCER INSTITUTE. When you designate a planned gift to the John Wayne Cancer Institute, you empower our physicians and scientists to advance the frontiers of scientific knowledge and cancer care for future generations.

Most planned gifts are through a will or living trust. You can name the John Wayne Cancer Institute as a beneficiary, designating a specific amount, real property and/or a percentage of your estate.

Other planned gifts, such as charitable trusts or gift annuities, can earn you and your family income and can help avoid capital gains. With the charitable IRA rollover or designation, you can save significant income and estate/gift taxes, which can be taxed up to 70% or more.

If you would like additional information, sample language or illustrations for you and your financial advisors, please call Tanya Lopez at 310-582-7095, who would be pleased to provide information without any commitment.

To ensure proper fulfillment of your bequest, the correct legal description of the Institute is: John Wayne Cancer Institute 2200 Santa Monica Blvd., Santa Monica, CA 90404 Federal ID #95-429-1515

Your Greatest

L E GACY BE N E F I T S th e L I V E S of OT H E RS.

Your life is filled with generosity – toward family, friends and your community. Remembering the John Wayne Cancer Institute at Saint John’s Health Center in your estate plans ensures that the legacy you have created is never lost. By including the Institute in your Will or Trust, you make it possible for us to continue as a leader in cancer research resulting in significant breakthroughs. All of this can be done without impacting resources during your lifetime. You will create a lasting legacy of giving and make a significant difference for generations to come.

If you would like additional information or sample bequest language, please call Tanya Lopez at 310.582.7095 or email at Tanya.Lopez@StJohns.org or visit www.jwcigiving.org

www.JWCI.org

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PAID LOS ANGELES, CA PERMIT NO. 31327

Public Affairs and Development Office 2200 Santa Monica Boulevard Santa Monica, CA 90404 USA

www.jwci.org

INNOVATIONS is made possible by the generous support of The Juels

Eisenberg Fund.

FEATURE:

The Wayne Family

John Wayne and son Patrick in The Searchers. p.24

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OUR MISSION John Wayne Cancer Institute at Saint John’s Health Center is a cancer research institute dedicated to the understanding and curing of cancer in order to eliminate patient suffering worldwide.

Our mission is accomplished through innovative clinical and laboratory research and the education of the next generation of surgical oncologists and scientists.