Promise & Progress Winter 2010

PROMISE& PROGRESS T H E S I D N E Y K I M M E L C O M P R E H E N S I V E C A N C E R C E N T E R AT J O H N S H O P K I N S

LEADING THE WAY BILL NELSON steers the Kimmel Cancer Center

through the next era of cancer medicine

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PROMISE&PROGRESS

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Promise & Progress is published by The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins Office of Public Affairs 901 South Bond Street Suite 573 Baltimore, Maryland 21231 (410) 955-1287

The Science of the Invisible Our researchers use new technology to understand the complex genetic language of the cancer cell, uncovering new treatment targets and opening the door t0 personalized therapies.

William G. Nelson, M.D., Ph.D. Director Amy Mone Director of Public Affairs Valerie Matthews Mehl Editor and Sr. Writer Michelle Barnett Editorial Assistant Steve Rossman Proofreader Peter Howard, Joe Rubino, and Keith Weller Photography Cover Photography Peter Howard MSK Partners, Inc. Design and Production For additional copies of this publication or further information about the Kimmel Cancer Center, please call (410) 955-1287 or email mehlva@jhmi.edu

ON THE WEB

HOPKINSKIMMELCANCERCENTER.ORG B R EAK I N G N EWS: O U R E X P E RTS R E S P O N D TO TH E U N ITE D STATE S P R EVE NTIVE TAS K FORCE G U I DE LI N ES ON SCR E E N I NG MAM MOG RAPHY FO R B R EAST CAN C E R.

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Departments 1 Director’s Letter

TARGETING CANCER A REPORT ON THE SCIENTIFIC ACCOMPLISHMENTS OF THE

2 Leading the Way One on one with the Cancer Center’s Director

18 In the News

20 Honors and Awards

22 Philanthropy

4 Headline Makers Information on our latest cancer discoveries

SIDNEY KIMMEL COMPREHENSIVE CANCER CENTER AT JOHNS HOPKINS

[ D I R E C T O R’ S L E T T E R ]

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William G. Nelson, M.D., Ph.D. Marion I. Knott Professor and Director The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins

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PROMISE & PROGRESS I Fall 2009–Winter 2010

“Our work is very much your work. In this issue, you’ll read about research projects that simply would not have been possible without the support of private donors, foundations, and corporations. This support keeps the Kimmel Cancer Center strong.”

AM HUMBLED WHEN I CONSIDER that, as the director of the Kimmel Cancer Center, I am following two of the greatest figures in cancer medicine, Albert Owens and Martin Abeloff. Dr. Owens helped found the discipline of oncology and Dr. Abeloff led our Center through a period of rapid growth, not only in physical structure, but also in discovery.

And, now it is my turn to lead the Center through the next era of cancer medicine as we simultaneously face tremendous opportunities as well as equal challenges.

Our Center remains strong, even in these difficult economic times, attracting the best and brightest minds in the field and continuing as leaders in cancer research and treatment. Our donors are steadfast in their support of our mission.

Our work is very much your work. In this issue, you’ll read about research projects that simply would not have been possible without the support of private donors, foundations, and corporations. This support keeps the Kimmel Cancer Center strong.

You’ll also read about our scientists who are using new technologies and unique collaborations to further decipher the complex genetic code of cancer cells and make personalized cancer treatment a reality. Therapies that we imagined more than a decade ago—those that target the genetic defects of the cancer cell—are now becoming a mainstay in cancer treatment. Pathology is no longer just about distinguishing the cancer cell from the normal cell, but identifying the genetic weaknesses of each cancer so that we can attack it with treatment regimens that work directly against cancers and leave healthy cells unharmed.

I have said this before, but it bears repeating: There is no more exciting time to be a part of cancer medicine than now. The benefits of decades of research have truly begun to payoff in the form of new ways to prevent, diagnose, and treat cancer.

[BILL NELSON Q&A]

LEADING THE WAY ON E ON ON E WITH TH E CAN CE R CE NTE R’S D I R E CTOR

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PROMISE & PROGRESS I Fall 2009–Winter 2010

VER THE LAST DECADE the Johns Hopkins cancer program has undergone major growth. It went from occupying one building, incorporating clinical care and research, to having the largest footprint on the medical campus with three buildings—a new clinical facility and two cancer research buildings. Now, it has a new leader.

WILLIAM NELSON, 51, was chosen after a national search to be director of the Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins.

He shared his thoughts on the cancer problem in the United States, what he brings to the job, and his vision for the Cancer Center.

Q. Why do you want to be director of the Kimmel Cancer Center?

If it were any other cancer center, I probably wouldn’t want the job. This place is special. This is a challenging position, but I’m committed to doing the best that I can. I’ve been a researcher trying to invent new treatments and take them into the clinic.

I’ve been a clinician working directly with people with cancer. I understand the promise and limitations before us. I think the time is right to really take some major shots at the cancer problem.

Q. What made you decide to become an oncologist?

I was a chemistry major at Yale, but I had no plans to go into medicine. I went there to play soccer. St. Louis, where I was raised, was to soccer what Baltimore is to lacrosse, and the Ivy League was the premier league of college soccer teams in the country. I thought I would eventually become a lawyer. One summer I worked in the laboratory of a cell biologist looking for molecular biomarkers of a rare skin disorder called ichthyosis. There were clinical trials of some new drugs, and so I was in contact with many of the participants. I was

Q. What is your background, and how does it help you as director of the Center?

I have focused almost entirely on prostate cancer in my research and in the clinic. Prostate cancer is a great story for all of the common cancers.

When I started in oncology, men were commonly diagnosed at an advanced stage. We had some limited success with treatments, but death rates were far too high. Since that time, we’ve gotten PSA (prostate specific antigen), a blood test that made it possible to diagnose men far earlier, so they could benefit from surgery and radiation therapy. We’ve also developed new treatments. This whole system of surgeons, medical oncologists, pathologists, and radiation oncologists, all working together,

“I’ve been a researcher trying to invent new treatments and take them into the clinic. I’ve been a clinician working directly with people with cancer. I understand the promise and limitations before us. I think the time is right to really take some major shots at the cancer problem.”

“There were 750 cancer drugs in clinical trials in 2008 with a 95 percent failure rate, and most of the time, we don’t find out until late in the trial that they don’t work. We need to use science to provide sound evidence so that we don’t invest a billion dollars into a drug that doesn’t work.”

“The challenge the field of cancer medicine is facing is embraced in the term translational research. It is the idea of more efficiently taking what we learn in the lab—which everyone will tell you is very exciting with great promise and opportunity—but getting it from the lab to the clinical setting faster.”

PETER HOWARD

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struck by how well they understood their disease and their reason for joining the trial. They knew it was an experimental therapy that may not help them but could help others.

That’s when I decided this is what I wanted to do.

is a modern paradigm that has allowed us to cut prostate cancer death rates almost in half in the last 15 years. This is the type of progress we need to make in all cancers.

Q. You are one of Johns Hopkins’ home grown faculty members.

Does this help you as director?

I am home grown—more home grown than usual. I went to medical school here, was a graduate student, a resident, a fellow, and my whole faculty life has been here. I have never delivered any health care of any kind as anything other than a Johns Hopkins physician. My daughters were born in the hospital. I can’t be anymore home grown than I am.

By being around the institution for so long I’ve ended up a professor in six departments, which helps me bring people together across the institution. I know everyone here and have a good sense of how great we can be when we work together across departments. The challenge is not to think about medical oncology in isolation but rather how medical oncologists, pathologists, radiologists, surgeons, and radiation oncologists can work together across disciplines to take on a cancer.

Q. The Kimmel Cancer Center is known as a leader in genetic discoveries. How has this improved cancer diagnosis and treatment?

There are two ways these discoveries have made a difference. We know that people carry genetic vulnerabilities that they inherit from their parents; and many cancers, about 15 percent of all cancers, occur in people who seem to have these genetic predispositions. It doesn’t mean they are fated to get cancer just that they are more susceptible to getting a cancer.

What is newer are tests for some of these genes that predict increased risk for a cancer so that we can use early detection and screening strategies to intervene and diagnose people at the very earliest stage. It also means that we can tell who is not as likely to develop cancer and economize our use of these tests, and leave those people alone a little bit.

In terms of therapy, gene alterations in cancers may predict which treatments will be successful and which will not. In this current era, the newest kind of drugs hit specific targets that are the products of cancer-related genes. For example, if a breast cancer makes the HER2 protein, the drug Herceptin is most likely to be effective. Testing for these genes allows us to get the right treatments to the right people.

Q. What role does prevention play?

There are about 1.4 million new cases of cancer each year, and this number is expected to increase as our population ages. Cancer is a major health

concern, not just in the United States, but worldwide. So, I think an ounce of prevention is worth a pound of cure is going to be true in cancer medicine. If we can prevent people altogether from having some of these devastating diseases, we won’t be so much concerned about how expensive it is to treat them when they have them.

Look at screening and early detection that we already do—Pap smear, mammography, colonoscopy, PSA. Their use led not only to improvements in survival but to treatments that are far less deforming and have fewer side effects. I think we have some exciting things we are working on in the laboratory, like new epigenetic drugs, which will hopefully be able to both prevent and treat cancer. We also need to address behaviors and underlying causes of cancer like chronic inflammation and infection.

Q. Why should someone with cancer come to Johns Hopkins for their treatment?

The major difference at a place like the Kimmel Cancer Center is that the state-of-the-art is just the starting point of what we can offer. That kind of treatment opportunity, the latest plus some, is what we have and always will deliver. Our mission, our brand, if you will, is to have better than the state-of-the-art cancer therapy.

Q. What is your vision for the Cancer Center?

The challenge the field of cancer medicine is facing is embraced in the term translational research. It is the idea of more efficiently taking what we learn in the lab—which everyone will tell you is very exciting with great promise and opportunity—but getting it from the lab to the clinical setting faster. Not just lackadaisically faster, but moving therapies to the clinic more efficiently and economically.

We believe that the tools being developed in the lab can help us perform this way. We can figure out whom to treat, how to treat them, and do it much more rapidly. If a treatment is not effective, let’s abandon it, and if a treatment is effective, lets develop it further, but let’s figure it out far earlier on in the development process, before $1 billion is spent.

There is so much we have accomplished here already, but there is much more we can do. We have the perfect discovery engine here and tremendous opportunities. This is a great place to be and the right time to be here. ■

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Q. These are tough economic times. How do you maintain progress with limited resources?

Since 2003, federal funding has been flat, and in some years when inflation is taken into consideration, it has decreased. Getting funding can be a terrible stress on researchers undertaking a career in cancer research, particularly our young researchers.

The challenge for us is to focus on the right problems that lead to deliverables that can be recognized in the population at large, so that people will appreciate the value of cancer research and want to invest.

We need to look for new opportunities and be smarter about the way we use limited resources. The development of more cancer therapies being administered in pill form has brought large pharmaceutical companies into the development of cancer treatments in a way they really had not been before. For them, the problem is that, in cancer, they are developing drugs for very specific and smaller fractions of the population than they typically would. They estimate it costs them about $1 billion to discover, develop and get a cancer drug FDA approved. These costs are passed on to people with the disease

in the form of high costs for treatments. We worry that, in the future, there will be patients that could benefit from a drug but cannot afford it; and this is an unacceptable premise to all Americans and will be a significant stress on our overall health care system. I think our Cancer Center can be a part of the solution. We have the discovery engine that can help pick the winners from the losers before large sums of money are spent.

There were 750 cancer drugs in clinical trials in 2008 with a 95 percent failure rate, and most of the time, we don’t find out until late in the trial that they don’t work. We need to use science to provide sound evidence so that we don’t invest a billion dollars into a drug that doesn’t work. I think pharmaceutical companies will see better payoffs with this approach, and when they do, they will be more willing to invest.

HEADLINE MAKERS CANCER NEWS from the KIMMEL CANCER CENTER AT JOHNS HOPKINS

N E W A N T I CA N C E R DRUG FOR SKIN AND BRAIN CA N C E R S

PROMISE & PROGRESS I Fall 2009–Winter 2010

New England Journal of Medicine and Science Express, September 3, 2009

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As more is understood about the genetic mutations of specific cancers, new therapies that target these factors responsible for malignant growth are being developed and tested.

The Hedgehog signaling pathway, normally active Rudin only in embryonic development, gets reactivated in some cancer types. An experimental drug that blocks this pathway has shown impressive activity in patients with advanced basal cell skin cancer and with a cancer called medulloblastoma. Basal cell skin cancer is the most common malignancy in adults, and medulloblastoma is the most common brain cancer in children.

In the study, 33 basal cell skin cancer patients were given the new drug.

Eighteen patients had advanced disease that had spread to other organs, and half of them saw reductions in tumor size by 50 percent or more.

Nine of 15 patients with inoperable recurrences at the original tumor site also had favorable responses, including two with complete disappearance of the tumors.

“We know that basal cell skin cancers and medulloblastomas have mutations in Hedgehog pathway genes. The favorable responses we are seeing with Hedgehog inhibitors could lead to new therapies for these intractable cancers,” says Charles Rudin, M.D., Ph.D., who helped direct the multi-center study.

Rudin and team gave the drug to a 26-year-old patient, with advanced medulloblastoma, whose cancer had recurred after standard therapy and did not respond to other treatments.

“Within a few weeks of treatment, this patient went from being nearly bedridden and in significant pain to exercising and pain-free.” Rudin says.

Sadly, two months later, the drug stopped working, and the patient died later that year. Rudin and team

have since uncovered what caused the patient’s cancer to become resistant to the new drug in the form of another gene mutation that prevents the drug from hitting its target. The team is working on ways to manage the acquired drug resistance that will allow patients to maintain the initial good response.

Clinical trials of the experimental drug in children with medulloblastoma and in adults with advanced basal cell skin cancer have begun in cancer centers throughout the U.S. Genentech funded the research. ■

BREAST CANCER TEST UPDATE

CA N C E R C E L L S REVEALED IN A DROP OF FLUID Clinical Cancer Research, June 1, 2009 Researcher Saraswati Sukumar, Ph.D., imagined that it might be possible to detect breast cancer from a tiny drop of breast fluid, and now she has proven that it can be done.

In a small clinical study, six of seven cancers were detected by QM-MSP, a test developed in her laboratory in 2003. By comparison, just two cancers were detected by cytology, the current standard of care which involves using a microscope to look for abnormal cells in breast fluid.

Sukumar’s study focused on a small group of 64 women who had abnormal nipple discharge and were undergoing a procedure known as a ductoscopy. Using a tiny fiberoptic tube inserted through the nipple into the leaky breast duct, clinicians can look inside the duct for a cause of the discharge. Often, it is a benign condition known as a papilloma, but it also can be an early stage cancer. The problem is, there is currently no way to tell the difference between the two. Cytology is done on the fluid discharged from the breast, but frequently misses cancers, says Sukumar. As a result, all women must have surgery to get the duct removed.

Using her test on a tiny amount of breast fluid (about the size of a pinhead) left behind in the tube following ductoscopy, her team identified all but one cancer. The test simultaneously determines the percentage of a biological process known as methy-

lation in each of four to five known breast cancer genes. Too much methylation is known to turn off key tumor suppressor genes. The percentages are added together for a cumulative score, which is then compared to a threshold value. A score above the threshold indicates the presence of cancer cells, Sukumar explains.

“This preliminary study provides proof of principle that detecting breast cancer with QM-MSP is feasible,” says Sukumar, Barbara M. Rubenstein Professor of Oncology and co-director of the breast cancer program. Her plan now is to confirm her results in a larger study of 400 to 500 women. “If we can confirm these findings,” she says, “it would be possible for many women to avoid surgery.”

This research was funded by the National Cancer Institute Breast Cancer SPORE program. ■

LAB-ON-A-CHIP S H OWS H OW CA N C E R S P R E A D S Nature Methods, March 18, 2009 Cancer spreads from organ to organ when cells break free from one site and travel to another. Understanding this process, known as metastasis, is critical for developing ways to prevent the spread and growth of cancer cells.

Peter Searson, Searson Ph.D., Reynolds Professor of Materials Science and Engineering in the Whiting School of Engineering and director of the Institute for NanoBioTechnology, led a team of engineers who have developed a method to specifically measure detachment in individual cells.

The method, which uses lab-on-achip technology, allows researchers to observe and record the exact point when a cell responds to electrochemical cues in its environment and releases from the surface upon which it is growing. Better knowledge of the biochemistry of cell detachment could point the way to better cancer therapies.

This research was funded by the National Institutes of Health, National Science Foundation, and the Howard Hughes Medical Institute. ■

C O LO N CA N C E R N E E D S A SUGAR FIX

B E YO N D COLON OS COPY

CA N C E R - CAU S I N G BACTE R IA

Science Express, August 6, 2009

Cancer Research, June 1, 2009 Clinical Cancer Research, June 15, 2009 Journal of the National Cancer Institute, July 1, 2009

Nature Medicine, August 23, 2009

Kimmel Cancer Center researchers were part of an international team to uncover four biomarkers of colon cancer detectable in cells shed into stool.

Abnormal methylation, an Ahuja alteration that can turn off key tumor suppressor genes, allowing cancers to form, was identified in four genes. These alterations occurred early and frequently in colon cancers and were detected in stool samples of patients with colorectal cancer but were rarely seen in people who did not have cancer. A stool test to check for the altered genes could be useful in the early detection of colorectal cancer, says Nita Ahuja, M.D., a director of the study. Currently, colonoscopy is the standard method for detecting colon cancer and is recommended starting at age 50. However, only half of adults have the procedure. Ahuja says, “We’re hoping that if we can’t get patients to get a colonoscopy, then this could be another means of testing for what is a preventable disease.”

Ongoing research is focused on developing an accurate and sensitive stool test for abnormal methylation of these and other genes. ■

Bacteria that causes diarrhea have been linked to some colon cancers.

The colon is home to the greatest concentration of bacteria in the body, and researchers have long thought that perhaps they could play a role in the development of colon cancer.

Investigators Cynthia Sears, M.D., and Drew Pardoll, M.D., Ph.D., have homed in on one particular culprit called Bacteroides fragilis. People with a toxin-secreting form of the bacteria can have diarrhea and chronic Pardoll inflammation of the colon. The persisting inflammation and the immune system’s reaction to it conspire to bring about genetic changes in colon cells that remove important restraints on cell growth and can ultimately lead to tumors.

In animal studies, the team found that mice infected with the toxinsecreting strain of the bacteria recovered quickly from the diarrhea but soon developed inflammation, and within a month the colons were pockmarked with tumors. Mice infected with the non-toxic strain of the bacteria did not have diarrhea, inflammation, or tumors.

The research team is working on blood tests that detect whether a person has been exposed to the toxin-secreting strain of the bacteria and, as a result, may be at higher risk for developing colon cancer. They also are exploring therapies that neutralize the bacteria and prevent it from inflaming the colon.

Funding for the study was provided by the Crohn’s and Colitis Foundation, the National Institutes of Health, Bernard Schwartz, William and Betty Topercer, Dorothy Needle, Bud Swartz, and the Commonwealth Foundation. ■

ON THE WEB

See videos of investigators Cynthia Sears and Nickolas Papadopoulos

as they explain their research.

HOPKINSKIMMELCANCERCENTER.ORG

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PROMISE & PROGRESS I Fall 2009–Winter 2010

Starving colon cancer cells of sugar may make them die—not the kind of sugar bought in the grocery store, but the nutrient glucose, a critical component, or fuel, of normal cellular function. Researchers in our Ludwig Center for Cancer Genetics and Therapeutics found that colon cancer cells hijack a gene called GLUT1, to improve their ability to soak up glucose, allowing them to grow and thrive in sugar-depleted environments that would otherwise be inhospitable to cell growth.

“We think increased GLUT1 is a survival adaptation that makes cancer cells very efficient at gathering what little circulating sugar exists in the nutrient-scarce inner layers of tumor cells,” says Nickolas Papadopoulos, Ph.D. Specifically cancer cells with the common cancer-associated KRAS and BRAF gene mutations were found in laboratory studies to survive in sugar-depleted environments while cells without these mutations died. As a result, mutant cells become the predominant cell. “These gene mutations clearly give colon cancer cells the ability to grow,” says Papadopoulos.

In mice, the team used an experimental drug that blocks glucose metabolism to stop cancer growth without any toxic side effects. The investigators are working to further develop this therapy.

Glucose is the body’s primary source of energy and is produced from carbohydrates. The research team cautions that limiting the consumption of dietary sugar will not impact cancer development and growth.

The research was funded by the Virginia and D.K. Ludwig Fund for Cancer Research and National Institutes of Health. ■

HEADLINE MAKERS L U N G CA N C E R I N N E V E R S M O K E R S A DIFFERENT DISEASE WITH D I F F E R E N T T R E AT M E N T S

PROMISE & PROGRESS I Fall 2009–Winter 2010

Clinical Cancer Research, September 15, 2009

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“It’s becoming increasingly clear that the genetic, cellular, and molecular nature of lung cancer in people who have never smoked is different from smoking related lung cancers.Now there is good evidence that the treatment and prevention strategies should be different as well.”

We usually think of lung cancer as a smoker’s disease, but about 15 percent of cases occur in people who never smoked, and researchers are finding there is more than just the smoking component that sets them apart.

“It’s becoming increasingly clear that the genetic, cellular, and molecular nature of lung cancer in people who have never smoked is different from smoking related lung cancers,” says Charles Rudin, M.D., P.h.D. “Now there is good evidence that the treatment and prevention strategies should be different as well.”

Rudin, a lung cancer expert and associate director of clinical research at the Kimmel Cancer Center is part of a scientific committee that recently published a guide on the biology, diagnosis, and treatment of lung cancer in people who have never smoked.

The group met in 2007 and reviewed data from several hundred studies

published by experts in public health, population science, molecular biology, pathology, and oncology to identify the distinct characteristics of lung cancer in people who have smoked less than 100 cigarettes in their lifetimes.

Rudin and team found lung cancers in people who never smoked more often had mutations of the EFGR gene than those of smokers.

As a result, never-smokers benefitted most from drugs that block or inhibit EGFR signaling. Other gene alterations more prevalent among never smokers also were identified, and Rudin says a genomewide study of this population could reveal still more. The group’s guide calls for lung cancer clinical trial participants to be classified by smoking status so scientists can better evaluate the success of therapies among smokers and never smokers.

“Second-hand smoke exposure remains the most easily preventable

cause of lung cancer,” says Rudin.

“Efforts to continue to reduce workplace, home, and public space exposure are very important.”

Radon gas exposure also was found to be a leading cause of non-smoking related lung cancers in the U.S. (Radon results from the natural decay of uranium contained in nearly all soils.

It makes its way into homes through cracks and holes in the foundation.)

Asbestos, indoor wood-burning stoves, and tiny airborne oil particles created when cooking food also were identified as risk factors. However, a specific risk factor has not been found to explain at least half of all lung cancers in never-smokers. The team recommends further research focused on this unique subset of lung cancers.

The research and guide were funded by the Flight Attendant Medical Research Institute. ■

Using Nanotechnology to Find Cancer Using tiny crystals called quantum dots, researchers have developed a highly sensitive test to look for DNA attachments that often are early warning signs of cancer. The test, which detects both the presence and quantity of certain DNA changes, could help identify people at risk of developing cancer and help doctors measure the effectiveness of cancer treatment.

Genome Research, August 17, 2009.

Funding by the National Cancer Institute, the National Science Foundation, The Hodson Trust, and the Flight Attendant Medical Research Institute. ■

Single Rogue Cell Responsible for Prostate Cancer Spread One cell—one initial set of genetic changes—is all it takes to set in motion the cascading events that lead to metastatic prostate cancer. In a 14year study, researcher G. Steven Bova, M.D., worked from autopsies of 33 men who died of prostate cancer, examining some 150,000 slides and 30,000 blocks of tissue and traced the origin of each person’s cancer to a single cell source.

Nature Medicine, April 15, 2009.

Funding provided by Pirkanmaa Cancer Foundation, Maud Kuistila Foundation, Finnish Medical Foundation, Medical Research Fund of Tampere University Hospital, Academy of Finland, Cancer Society of Finland, Reino Lahitkari Foundation, Sigrid Juselius Foundation, CaPCURE Foundation,

HEADLINE MAKERS

IN BRIEF For more information on this research news, visit Latest News at

H O PKI N S KI M M E LCAN C E R C E NTE R.O R G

Epigenetic Cancer Triggers Epigenetic changes, or those alterations that occur to the environment of cells rather than directly to its DNA, may trigger as many as half of all cancers.

Hypermethylation of genes is a chemical process known to shut down tumor suppressor genes, but demethylating agents, so named for their ability to reverse the process, may also trigger new cancers, says investigator Joseph Califano, M.D. “While we can’t yet say for certain, some patients could be at risk for additional primary tumors,” he says. “We may need a molecular profile of their cancer before starting demethylating therapy.”

Califano’s findings were based on studies of normal and cancer cells from human mouth, nose, and throat tissue.

PLoS One, March 23, 2009.

Funding provided by the Flight Attendant Medical Research Institute, the National Institute of Dental and Craniofacial Research, and the National Cancer Institute. ■ Two Mutant Genes Linked to Brain Cancer Scientists at the Kimmel Cancer Center and Duke University Medical School linked mutations in two genes, IDH1 and IDH2, to nearly three-quarters of gliomas, one of the most common types of brain cancers. They found

that certain patients that carry these mutations survive at least twice as long as those who do not have the mutations. Additional research on the genes could lead to more precise diagnosis and treatments for the cancer.

New England Journal of Medicine, February 18, 2009. Funding provided by the Pediatric Brain Tumor Foundation Institute, The Damon Runyon Foundation, The Southeastern Brain Tumor Foundation, Alex’s Lemonade Stand Foundation, The V Foundation for Cancer Research, the Virginia and D.K. Ludwig Fund for Cancer Research, The Pew Charitable Trusts, The American Brain Tumor Association, The Brain Tumor Research Fund at Johns Hopkins, Beckman Coulter, and the Accelerate Brain Cancer Cure Foundation. ■

Two Prestigious Honors for the Kimmel Cancer Center Leading the Way The Johns Hopkins Hospital has once again — for the 19th consecutive time — earned the top spot in U.S. News & World Report’s annual rankings of more than 4,800 American hospitals. The Kimmel Cancer Center also continued to rank among the top three cancer centers in the nation. ■ Leaders in Epigenetics With 341 papers cited a total of 21,384 times, Johns Hopkins topped the ScienceWatch list of international leaders in the field of epigenetic research. More than half of the Johns Hopkins citations were the research of Kimmel Cancer Center investigators Stephen Baylin, M.D. and James Herman, M.D. Johns Hopkins was credited with 10,000 more citations than the 2nd ranked Harvard.

Among other prestigious institutions outpaced by the Kimmel Cancer Center team were the National Cancer Institute, MIT, the University of Virginia, the University of California, Cold Spring Harbor Laboratory, and the UK’s University of Cambridge. ■

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Predicting Prostate Cancer A study tracking 774 prostate cancer patients for a median of eight years has shown that the combination of three measurements—PSA (prostate specific antigen), Gleason score (a numeric indicator of prostate cancer aggressiveness), and interval between surgery and the first detectable PSA—most accurately estimates the risk that a prostate cancer has spread. The measurements also help identify those patients who will most benefit from additional therapy.

Annual Meeting of the American Society of Clinical Oncology, July 1, 2009. Funding provided by the National Cancer Institute, The Prostate Cancer Foundation, and the Department of Defense Prostate Cancer Research Program. ■

John and Kathe Dyson, David Koch, National Cancer Institute, Prostate Cancer Research and Education Foundation, U.S. Department of Defense, Grove Foundation, and the American Cancer Society. ■

HEADLINE MAKERS

Internet Hoax Revealed PROMISE & PROGRESS I Fall 2009–Winter 2010

TH E TR UTH ABOUT TH E “ CA N C E R U P DAT E ”

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T HAS BECOME such a problem, that the National Cancer Institute, American Cancer Society, and individual cancer centers like the Johns Hopkins Kimmel Cancer Center have posted warnings on their Web sites. Emails offering easy remedies for avoiding and curing cancer are the latest Webinfluenced trend. To gain credibility, the anonymous authors falsely attribute their work to respected research institutions like Johns Hopkins. This is the case with the so-called “Cancer Update from Johns Hopkins.”

The gist of this viral email is that cancer therapies of surgery, chemotherapy, and radiation therapy do not work against the disease, and people should instead choose a variety of dietary strategies.

Traditional therapies, such as surgery, chemotherapy, and radiation therapy, work. The evidence is the millions of cancer survivors in the United States today who are alive because of these therapies. We recognize that treatments don’t work in every patient, or sometimes work for awhile and then stop working, and there are some cancers that are more difficult to cure than others. These problems are the focus of ongoing cancer research.

We’ll go through each statement in the email hoax and provide real responses from Johns Hopkins Kimmel Cancer Center experts.

EMAIL HOAX CLAIMS #1 AND 2:

Everyone Has Cancer Cells Cancer is a genetic disease resulting from a variety of mutations and alterations either inherited from our parents or, more commonly, acquired over time due to environmental exposures and behaviors, such as smoking and poor diet. These alterations turn off important cell growth regulators allowing cells to continually divide unchecked, explains Luis Diaz, a clinician-scientist in the Ludwig Center for Cancer Genetics.

This type of cell is called a malignant or cancer cell. Among the trillions of cells in the human body, inevitably everyone has some abnormal or atypical cells that possess some of the characteristics of cancer cells; most resolve themselves and never result in cancer, says Diaz.

There is no single or standard test for cancer. There are ways to screen for certain cancers with tests such as colonoscopy for colon cancer, mammography for breast cancer, PSA for prostate cancer, and the Pap smear for cervical cancer, and these tests

can detect cancers in a very early and curable stage. For many cancers, there are currently no screening tests, and they are diagnosed when they begin to cause symptoms.

Diaz and other Kimmel Cancer Center researchers are working on new tests that detect abnormal DNA shed by cancer cells into blood and body fluids and have the ability to find cancers before they cause any symptoms. Approaches like this could lead to a broad-based screening test for cancer.

Tests like these also are being used to detect cancer recurrences and malignant cells left behind following surgery, and can find cancers that are not detectable under the microscope or in X-rays.

Other researchers are studying cancer stem cells. They are stealth cells that make up just a tiny fraction of a tumor. While small in number, investigators believe they may be the cells that drive certain cancers and lead to cancer recurrence. Therapies that target these cells are now being tested in clinical trials.

A team of our breast cancer researchers has developed a method that could make it possible to detect breast cancer from the DNA contained in a single drop of blood or body fluid.

Although evasive cancer cells are a challenge and the focus of ongoing research, it does not mean, as the email contends, that all patients, even those treated successfully for cancer, have cancers-in-waiting— undetectable but still there. People are treated and completely cured of cancer everyday.

EMAIL HOAX CLAIM #3:

A Strong Immune System Destroys Cancer When it comes to cancer and the immune system, it is not a matter of strong or weak as the fictional report contends, but rather an issue of recognition. The immune system simply does not recognize cancer. In

its complexity, the cancer cell has learned to disguise itself to the immune system as a normal cell. Infected cells send out danger signals setting the immune system in action. Cancer cells do not, explains Elizabeth Jaffee, co-director of cancer immunology and leading expert on cancer and the immune system. By deciphering the methods cancer cells use to make them invisible to the immune system, Jaffee and team have developed cancer vaccines that have successfully triggered immune reactions against prostate cancer, pancreatic cancer, leukemia, and multiple myeloma.

EMAIL HOAX CLAIMS #4 AND #5:

EMAIL HOAX CLAIMS #6, 7, 8, 9, AND 10: Chemotherapy and

Radiation Therapy Harm Normal Cells. Surgery Causes Cancer to Spread: Chemotherapy and radiation therapy kill cancer cells with remarkable selectivity, says Nelson. There are some temporary and reversible side effects common to cancer therapies, including hair loss and low blood counts. Limiting and managing these side effects is an integral part of treatment.

Surgery is the first line of treatment for many types of cancer. It does not cause cancer to spread. Cancers spread to other tissues and organs as a tumor progresses and cancer cells break away from the original tumor and travel through the bloodstream to other body sites.

EMAIL HOAX CLAIMS #11, 12, 13, AND 14: Cancers Feed on Certain

Foods The premise is that cancer cells feed on certain foods, and if a person refrains from eating these foods, the cancer will die. According to our experts, a poor diet and obesity associated with a poor diet is a risk

and foods processed with salt (sodium).

8. Don’t use supplements to protect against cancer.

Our experts recommend that people meet their nutritional needs through their food choices. While vitamin supplements can be helpful in people with nutritional deficiencies, evidence suggests that supplementation above what the body can use provides no added health benefit.

EMAIL HOAX CLAIM #15:

Cancer is a Disease of Mind, Body, and Spirit Cancer is a disease caused by genetic alterations. Many times, these alterations occur through our own behaviors—cigarette smoking, a poor and unbalanced diet, virus exposures, and sunburns, says cancer prevention and control expert John Groopman.

How stress, faith, and other factors influence this is largely unknown. We would like people to be happy, loving, and stress free, simply because it is a nice way to live and can contribute to an overall feeling of well being, says Platz. There is no evidence, however, that a person prevents or causes cancer based on his or her state of mind.

Still, we understand that a cancer diagnosis can make patients and families feel stressed and anxious, and these are not pleasant feelings. So, we offer extensive patient and family services, including a cancer counseling center, pain and palliative care program, chaplain services and a meditation chapel, an image recovery center, and the Art of Healing art and music program.

EMAIL HOAX CLAIM #16:

Oxygen Kills Cancer Cells Platz recommends regular exercise as a part of any healthy lifestyle, but says there is no evidence that breathing deeply or receiving oxygen therapy prevents cancer.

On its Web site, the American Cancer Society includes the following statement about oxygen therapy, “Available scientific evidence does not support claims that putting oxygenreleasing chemicals into a person’s body is effective in treating cancer.

It may even be dangerous. There have been reports of patient deaths from this method.” Read more at www.cancer.org Please pass this information on to family and friends. ■

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PROMISE & PROGRESS I Fall 2009–Winter 2010

Cancer is Caused by Nutritional Deficiencies and Supplements Will Correct Them Dietary habits and lifestyle choices, such as smoking, contribute to the development of many human cancers, says Kimmel Cancer Center director William Nelson. Our experts recommend a balanced diet (see response #11) as a way of reducing cancer risk. In terms of supplements, Nelson points out that while they may help mediate vitamin deficiencies, taking doses above what the body needs provide no added benefit.

factor for the development of cancer.

However, there is no evidence that certain foods alter the environment of an existing cancer, at the cellular level, and cause it to either die or grow.

Although there is such a thing as tumors that produce mucus, the mucus made by a tumor does not result from drinking milk. And, eating less meat, while a good choice for cancer prevention, does not free up enzymes to attack cancer cells, explains cancer prevention and control expert Elizabeth Platz.

Moderation is key, says Platz.

As part of a balanced diet, sugar, salt, milk, coffee, tea, meat, and chocolate—the foods the “Update” calls into question—are all safe choices, she says. The real concern with many of these, particularly sugar, is that they add calories to a diet and can lead to obesity, and obesity is a major risk factor for cancer. A balanced nutritious diet, healthy weight, physical activity, and avoiding alcoholic drinks may prevent as many as a third of all cancers. Platz recommends eating at least five servings of fruits and vegetables per day and limiting red and processed meats, such as hot dogs.

Several Johns Hopkins experts participated in the World Cancer Research Fund - American Institute for Cancer Research report Food, Nutrition, Physical Activity, and the Prevention of Cancer: A Global Perspective, published in November 2007, which is considered by cancer prevention experts to be an authoritative source of information on diet, physical activity and cancer. Their recommendations for cancer prevention and for good health in general are: 1. Be as lean as possible without becoming underweight.

2. Be physically active for at least 30 minutes every day.

3. Avoid sugary drinks. Limit consumption of energy-dense foods (particularly processed foods high in added sugar, or low in fiber, or high in fat).

4. Eat more of a variety of vegetables, fruits, whole grains and legumes such as beans.

5. Limit consumption of red meats (such as beef, pork and lamb) and avoid processed meats.

6. If consumed at all, limit alcoholic drinks to two for men and one for women a day.

7. Limit consumption of salty foods

PROMISE & PROGRESS I Fall 2009–Winter 2010

[ F E AT U R E S T O RY ]

10

THE

SCIENCE OF THE

INVISIBLE S CI E NTI STS U S E N EW TE CH N OLOGY TO R EVEAL TH E I N N E R WOR K I N G S OF TH E CAN CE R CE LL

by Valerie Matthews Mehl P H O T O BY J O E RU B I N O

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PROMISE & PROGRESS I Fall 2009–Winter 2010

Sarah Wheelan

[THE SCIENCE OF THE INVISIBLE]

“What is taking so long?”

PROMISE & PROGRESS I Fall 2009–Winter 2010

It is a question frequently asked by a weary public that hears almost daily of new cancer discoveries yet continues to live in a world where cancer remains one of the deadliest diseases.

12

THE ANSWER, say experts, is technology. Cancer is very complex. It is a disease of many broken parts. In order to fix the broken parts, researchers need to understand them in detail.

Yet these parts, contained within the DNA of a cell, are so small they cannot be seen even with the strongest of microscopes.

But, a new technology called next generation sequencing is now allowing researchers to see inside the cancer cell in a way that was not possible before. It is speeding the pace of discovery and already yielding new diagnostic and therapeutic tools to fight cancer.

In the past, it could take decades of research—an entire career—for a scientist to identify and isolate just one cancerrelated gene hidden within the DNA of a cancer cell. This painstaking and difficult research has been frequently equated to finding the proverbial needle in the haystack. Well if that’s the case, then experts say next generation sequencing is the technology that can quickly look at every piece in the stack and tell whether it’s hay or a needle. As a result, cancer research that used to take decades can now be completed in months.

Kimmel Cancer Center researchers, who have consistently led the field in cancer gene discoveries, are poised to use the new technology to speed their progress against the disease.

Unprecedented research led by Bert Vogelstein more than two decades ago revealed cancer as a genetic disease, caused by mutations to growth promoting and growth suppressing genes. Stephen Baylin uncovered epigenetic alterations, cancer-initiating mistakes made to the way genes are packaged within the cell. Their discoveries became the most frequently cited in the field; yet, amazingly, much of their work was accomplished without the benefit of today’s technology.

It is this example of ingenuity and progress, in the face of what seems like insurmountable odds, that leads many to believe that Johns Hopkins—with its convergence of some of the most brilliant minds in science, medicine, and engineering—is best positioned to use this technology to benefit people.

The Instrument That Sees Like many of the great advances in cancer that occur beyond what the eye can see, the box-like machine and its accompanying computer are rather unassuming. One could never imagine, simply by looking at it, the magnificence of what it does or its potential to revolutionize cancer therapy.

The technology harnesses into one powerful piece of equipment the most advanced technology in imaging, optics, molecular biology, chemistry, computer science, and engineering to simultaneously sequence millions of gene targets. Try to imagine a pathology slide with 200 million things on it. It is virtually impossible, but this sophisticated equipment is able

to do it, quickly seeing each of these 200 million elements and differentiating one from another.

Since 1965, one trillion of the base pairs that form our DNA and that of other organisms have been sequenced and stored in public databases. With next generation sequencing, what took a half century can now be completed in less than one year in a single, modest-sized laboratory.

The instruments don’t come cheaply, however. One next generation sequencing instrument costs about $500,000. The computers that collect the data run another $200,000. As a result, the Kimmel Cancer Center currently owns just one, located in the Vogelstein laboratory and donated by the Ludwig Fund. An additional two machines are being leased from the manufacturer to create a next generation sequencing laboratory that will make this crucial technology available to more Kimmel Cancer Center researchers.

It has become essential to ensuring the pace of cancer research. “There are six billion bases in the human genome and five separate changes may be needed for cancer to develop. We will simply not find all of these critical changes using small-scale methods,” says Vasan Yegnasubramanian, Co-director of the Center’s new next generation sequencing lab.

While high up-front costs hinder widespread availability to the technology, it has dramatically slashed the overall cost of genetic research. In 1985, the cost of genetic sequencing was approximately $10 per base pair. Currently, with the advent of next generation sequencing technology, it has plunged to 1/1,000 of one cent per base pair and is still declining.

“In five to ten years, people could potentially have their entire genome sequenced for what it costs to have routine bloodwork done,” says Yegnasubramanian. It is this limitless potential that causes many experts to say that the real challenge is no longer in sequencing genes but in knowing what to do with the information.

“It opens the door to questions of extraordinary scale,” says Yegnasubramanian. He smiles broadly when he discusses the possibilities. It is clear that he is genuinely excited about the potential and what it could eventually mean for cancer patients. “There really are no boundaries to what we can learn now,” he says. “Time, imagination, and money are the only limitations.”

The Mathematics of Cancer If the DNA from one cell was stretched out end to end, it would be nearly two yards long, yet it is tiny enough to fit inside a single cell. Despite decades of discovery, what we don’t know about our DNA far exceeds what we do know. To use a football analogy, what we know would take us to the

JOE RUBINO

measured by who is best able to interpret and use the massive two-yard line, but next generation sequencing is pushing us amounts of data to make a difference in patients. the remaining 98 yards into the exploration of areas of the Like a card catalog system in a library, the technology helps human genome that have never before been studied. The goal researchers understand how a canis new therapies specifically targeted cer cell is organized and how the cell to the unique genetic characteristics A N E W T E C H N O LO GY changes its organization. A genome of each person’s cancer.

Working with Yegnasubramanian CALLE D N E XT G E N E RATI ON is not sequenced in one big piece, but in tens of millions of small and taking charge of the daunting S E Q U E N C I N G I S N OW chunks that have to be matched up analysis is computational biology expert Sarah Wheelan. She is unde- A L LOW I N G R E S E A R C H E R S to where they came from. A computer cluster, or group of linked terred by the amount of biological TO S E E I N S I D E T H E computers working so closely data this technology produces—more CA N C E R C E L L I N A WAY together that they essentially form than 80 billion pieces of information per study—and the knowledge that it T H AT WA S N OT P O S S I B L E one super computer, then explores exceeds the capacity of even the most B E F O R E . I T I S S P E E D I N G these sequences, finding genes that are over expressed and under sophisticated computers. Scientists T H E PAC E O F D I S C OV E RY expressed. Because the genome have never before seen this amount of A N D A L R E A DY Y I E L D I N G sequence is just one layer of the candata, but it is a challenge that seems cer cell’s complexity, researchers custom made for her. Wheelan has N E W D I AG N O S T I C A N D like Wheelan must then examine taken on math calculations for fun T H E R A P E U T I C TO O L S TO the interplay between genetics that most people would not even begin (alterations directly to the DNA) and to know how to solve. She once calcuF I G H T CA N C E R . epigenetics (alterations to the way lated that the DNA from all 60,000 DNA is packed into a cell). Finally, and perhaps the most Johns Hopkins employees stretched out end to end would reach pressing challenge is to figure out whether or not any of these to the edge of our solar system and back. things make a difference in cancer—what is significant and The ability to make sense of the billions of data points generwhat is not. ated by next generation sequencing is probably more about “Think of a sweater,” says Wheelan. “Imagine if you could human ingenuity than hardware, and it’s where Kimmel Cancer unravel the sweater thread by thread, put it in a dryer, and Center researchers like Wheelan are already ahead. “In five to ten have it come out whole again,” she says. “That’s what this techyears, it will be commonplace to sequence every cancer genome,” nology does for us. It allows us to unravel the human genome says Yegnasubramanian. Real progress, he says, will then be

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PROMISE & PROGRESS I Fall 2009–Winter 2010

Vasan Yegnasubramanian, co-director of the Center’s new next generation sequencing lab.

14

PETER HOWARD

PROMISE & PROGRESS I Fall 2009–Winter 2010

Victor Velculescu

solve a problem. I’ve spoken to my colleagues at other places. and gives us back something that makes sense.”

This kind of collaboration does not happen elsewhere.”

Wheelan has received a grant from the Johns Hopkins Provost to start a computational genomics center, and her interdisciplinary team is hard at work on innovative analysis The Most Complex Disease techniques that complement the groundbreaking experimenEvery cancer is unique. As cancers develop over time, tal work being performed at the Kimmel Cancer Center and multiple genes are involved and contributing factors, such as throughout Hopkins. “These collaborations are critical to inflammation and environmental assaults, help create a progress in fighting cancer,” says Wheelan. cellular environment for tumor progression. This diversity is While other research institutions have been stymied by the what makes cancers so hard to treat. immense amount of data, she has put the Kimmel Cancer The hope is that the new next generation sequencing techCenter ahead developing solutions and technology on the fly. nology and the computations that accompany it will help With billions of measurements that can be done for each make sense of this complex process that leads to cancer. tumor sample, the real skill comes “It allows us to understand indiI T WA S T H E R E N OW N E D vidual cancers at a level that was not in sifting through the data to determine what needs to be kept and possible before,” says leading next T E A M O F V E LC U L E S C U , looked at, and what can be put generation sequencing expert Victor VO G E L S T E I N , A N D aside. It is the first time since the Velculescu.

KE N N ETH KI N Z LE R, WHO development of computers that bioIt was the renowned team of logical data has surpassed the com- W I T H F E W E R R E S O U R C E S Velculescu, Vogelstein, and Kenneth puter’s ability to handle it. “We conKinzler, who, with fewer resources AN D FEWE R PEOPLE, sidered this going in and began and fewer people, became the first to B E CA M E T H E F I R S T TO developing analytical tools,” says map the cancer genomes of colon, Wheelan. She is getting some breast, pancreatic, and brain cancers.

M A P T H E CA N C E R advice from particle physicists at On their heels were larger and better G E N O M E S O F C O LO N , the Johns Hopkins Applied Physics funded teams at the National Laboratory, the only other people Institutes of Health and the UK’s B R E A S T, PA N C R E AT I C , on the planet that work with data Wellcome Trust Sanger Institute.

A N D B R A I N CA N C E R S . sets this large.

This is one example where ingenuON TH E I R H E E LS WE R E “That is what is so special about ity in fact beat hardware. “Because of this place,” says Kimmel Cancer the great minds we have working LARG E R AN D B ETTE R Center Director William Nelson. together in the Kimmel Cancer FU N D E D TEAM S. “There is no other institution where Center, we are able to do more with you can pick up the telephone and get the leading expert in a less and keep a rapid pace of discovery,” says Center Deputy particular field, and pick his or her brain for two hours to help Director Stephen Baylin. (continues on page 16)

C O N S I D E R C A N C E R ’ S YO U N G E S T V I C T I M S

The opportunity to explore the cancer genome is exciting to researchers like Donald Small who runs the Center’s pediatric cancer program. Even the most common of pediatric cancers are rare among the general population and research and corresponding research dollars are focused on the numbers—adult cancers. “There are just so many more cases of adult cancers —hundreds of thousands per year versus 10,000 to 12,000 per year,” says Small. “As a result the National Institutes of Health (NIH) cancer genome priorities have been in adult cancers.”

He believes the Center’s next generation sequencing laboratory will give the pediatric cancer team an opportunity to begin looking at cancer genes involved in childhood cancers.

“EVERYONE IS LOOKING at the big

could be taken out surgically by Weber.

To kill any microscopic cancer cells that may have broken away from the tumor, Megan received another seven rounds of chemotherapy.

Megan McNeal

Despite this and the 8-inch scar on her leg, she remained strong. In fact, she viewed her cancer as more of an inconvenience than an illness. “I’m not sick,” said Megan. “I feel fine most of the time. When you say someone is sick you think they are in bed and can’t do anything.” She stayed focused on finishing her treatment and returning to school and the softball field. Not at all happy about being sidelined, she finagled permission from her oncologist David Loeb to rejoin her softball team and shag a few fly balls.

“I can’t say enough about this hospital; the doctors, the nurses, everyone.” says Megan’s dad Tim McNeal. The McNeals drove an hour and 20 minutes each way from their home on Maryland’s Eastern Shore for Megan’s therapy. “You hear and read about this place, but until you experience this caliber of care yourself, you can’t really appreciate how lucky we are to have this place,” he says.

“It’s a tough unit. You know that some of these kids will never go home, but then you also see miracles every day,” says McNeal. He prayed that his daughter would be one of the miracles.

It is the true tragedy of childhood cancers. Most of these children are active and otherwise healthy, until their worlds are turned upside down with a diagnosis of cancer.

In Megan’s case, just making the diagnosis was a challenge. While her cancer looked like Ewing’s sarcoma under the microscope, it also had similarities to a different type of sarcoma called synovial sarcoma. The therapy for these two types of sarcomas are very different, so, Loeb says, more information on the biology of the cancer obtained through next generation sequencing would help greatly with diagnosis and treatment.

“There are a slew of chromosomal abnormalities associated with this cancer, but we don’t know anything about their significance,” says Loeb. “We know that chemotherapy works better in some patients than others, but we understand so little about the molecular biology of the cancer, we don’t know why. Clearly there are genetic differences among patients, and we need to learn what they are.”

Right now, there is one therapy, and it is given to everyone with Ewing’s sarcoma. “We can’t intelligently choose other therapies or develop new targets because we don’t know enough about the biology of the cancer,” says Loeb. “If we did, we could identify genetic markers and distinguish those patients who can be cured with standard therapy from those who will not.”

Despite early good news, Megan ended up among the latter group— those not cured with standard therapy.

In May, follow up tests revealed that a small speck on her lung was cancer.

Additional radiation therapy and chemotherapy could not stop the progression of Megan’s cancer, and sadly, in October, she lost her battle.

Her story underscores the urgency of this research. Loeb and Small believe that sequencing the genomes of Ewing’s sarcoma and other pediatric cancers could reveal the unique genetic characteristics that cause certain cancers to grow and spread even when treated with the strongest therapies. It is knowledge that could help them save the lives of patients like Megan. ■

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PROMISE & PROGRESS I Fall 2009–Winter 2010

cancers,” says Small. “By turning our attention to the pediatric cancers, the Kimmel Cancer Center can make a great contribution to the understanding of these diseases.”

Small is among an elite group of scientists. He uncovered a pediatric cancer culprit without the benefit of today’s sophisticated machinery and technology when he isolated and implicated the FLT3 gene in acute myeloid leukemia.

Patients whose leukemias have this mutation do not respond well to therapy.

Small’s discovery has allowed researchers to turn the tables, leading to drugs that target the mutant gene and make the cancer cells succumb to treatment.

“I would love to be able to find other genetic targets,” he says. “For most pediatric cancers, there are no known common genetic changes, so any information will be more than what they have now.” Small believes it could change the course of some relentless childhood cancers.

Consider Ewing’s sarcoma and patients like 13-year-old Megan McNeal.

Last winter, she noticed a lump on her thigh. An avid softball player, she thought she must have pulled a muscle, and her pediatrician agreed. But soon, she noticed it had gotten much larger. The next day a return trip to her pediatrician and further tests led to the devastating news that she may have cancer.

Instead of preparing for softball season, she was meeting with Kimmel Cancer Center surgeon and sarcoma expert Kristy Weber and having a surgical biopsy of the tumor in her thigh. It was cancer, but there was some good news. The cancer appeared to be limited to her thigh, and this meant she had a much better chance to be cured.

The next week, Megan began chemotherapy. “It was rough. I felt very nauseous for days,” she says. Four months and six rounds of chemotherapy later, her grapefruit-sized tumor had shrunk to the size of an orange and

He worries, however, that his investigators will not be able to maintain this pace without greater access to this leading technology.

KEITH WELLER

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Imagine the Possibilities

Baylin knows it is key to revealing the unique genetic fingerprints Genetic research has uncovered mutations that have led to of cancers and gaining a new understanding of the disease. new screening tests for cancers, to new cancer therapies Traditionally, cancers have been defined by the place in the that target malignant cells while leaving normal cells body where they occur, and treatment decisions have been unharmed, and to ways to predict patients’ responses to guided by this principle. Genome sequencing has led scientists particular drugs. to believe that how a cancer behaves and responds to treatment Investigators have found that mutation to a gene called is more about its genetic profile than its physical location.

K-ras makes patients’ cancer completely resistant to certain Kimmel Cancer Center experts expect the paradigm to targeted therapies. With one month’s treatment with the begin shifting with clinical trials for new therapies directed targeted drug Erbitux, for example, costing $16,000, this at groups of patients whose cancers have similar genetic information can spare patients unnecessary treatments and and epigenetic characteristics rather than similar locations costs. “There is no point in giving a costly drug that in the body. science proves will not work,” Using the new knowledge to says Velculescu. “This technoloorganize clinical trials, so that gy allows us to be smarter about drugs are being tested in patient identifying which patients will populations based on like genetic benefit from targeted therapies.” traits in their cancers instead of In a market where there are 750 like locations of their cancers, will new drugs in clinical trials in each quickly reveal if a drug works year—approximately 57 drugs for before millions of research dollars each known target—with nearly $1.5 are spent, says Nelson. billion spent per drug and a 95 perIn their survey of the colon cent failure, the information next cancer genome, Velculescu and generation sequencing can provide team revealed a complex landis truly priceless, Nelson says. scape for cancer containing a variAnd, it doesn’t stop there. ety of different and less frequently Think of prostate cancer, AS TH E N EW occurring mutations that vary from Wheelan says. Despite 30 years of T E C H N O LO GY I S U S E D patient to patient. These new findresearch, recent data calls into quesings explain why seemingly similar tion the value of population-wide TO LO O K AT T H E cancers—originating in the same prostate cancer screening. Some G E N O M E S AC R O S S A L L organ—often respond very differargue that it has led to more surgery, ently to therapy. “Though cancers T U M O R T Y P E S , PAT T E R N S more unpleasant side effects, but not from different patients may look the W I L L B E G I N TO D E V E LO P saved more lives. Wheelan believes same, genetically they are very difthat next generation technology T H AT W I L L H E L P ferent,” says Velculescu. could lead to better tests that will Wheelan says that as the new allow investigators to compare E X P E R T S TA R G E T technology is used to look at the tumor samples from many patients T H E R A P I E S TO T H E genomes across all tumor types, patand pinpoint the genetic signature G E N ETIC AN D terns will begin to develop that will that makes one prostate cancer more help experts target therapies to the lethal than another. With this E P I G E N E T I C D E F E CT S genetic and epigenetic defects that clinicians will be able to T H AT CAU S E T H E CA N C E R information, cause the cancer to originate, grow, differentiate tumors that must be TO O R I G I N AT E , G R OW, and spread. treated from those that could be The biggest promise lies in those monitored over time. This then helps AN D S PR EAD. cancers, like lung, brain, and pancreaccomplish the real goal, not just atic cancers, where current therapies are largely unsuccessful. better detection of prostate cancer but also better outcomes.

Investigators believe this type of research will lead them to a Experts also say the technology makes preventing cancer, genetic explanation for how these tumors evade current treatwhat many of them refer to as the only real cure, realisticalments. With this information in hand, they can begin to find ly attainable. “As we begin to understand more and more the each cancer’s genetic weakness and go after it. genetic patterns of cancer, we could potentially find Already the team’s genetic blueprint for brain cancer has something in a person’s genome that tells if and when a revealed mutations in two genes, IDH1 and IDH2 that repreperson is likely to develop cancer,” says Wheelan. Similarly, she says, observing the genomes of healthy people over time sent a clinically and biologically distinct subtype of the cancer. could help researchers understand what exposures “New treatments could be designed to target the enzymatic and behaviors cause the gene alterations that lead to the activity that is altered by these mutations,” says Velculescu. development of cancer.

He says that discoveries like these will be easier to make in the Acting before a per- O N T H E W E B future using next generation sequencing technology. “No one See videos about this research. son develops a cancer would have ever suspected this mutation in this cancer,” says HOPKINSKIMMELCANCERCENTER.ORG ultimately saves both Velculescu. “We wouldn’t have found it without this tool, and lives and money. ■ now we know it is key to prognosis and treatment response.”

JOE RUBINO

PROMISE & PROGRESS I Fall 2009–Winter 2010

It’s More About the Genes than the Organ

Likewise, investigators performed a personalized genome sequencing of a patient with a hereditary form of pancreatic cancer and uncovered the mutated gene responsible for initiating the patient’s disease.

KEITH WELLER

RESEARCH BECOMING REALITY

IMAGINE DETECTING CANCER with a simple blood test.

Ivelisse Page, a young and vibrant wife and mother of four young children and colon cancer survivor, can.

Despite having regular colonoscopies, her colon cancer went undetected. Her journey begins long before her diagnosis. Her grandmother and father both died of colon cancer when they were in their late thirties. She knew family history put her at higher risk of developing the disease at a young age and she was diligent about getting regular colonoscopies. She developed colon cancer more than a year before

she was due for her next colonoscopy.

Now, Page is part of a clinical trial to study a simple blood test, developed

by Vogelstein, Velculescu and team and taken to the clinic by physicianscientist Luis Diaz. It is based on the unique genetic fingerprint contained within the genome of every cancer.

The investigators believe the test could have uncovered Page’s cancer in its earliest stage.

Every cancer has a set of mutated genes that are present in cancer cells, but not in normal cells. Using next generation sequencing technology to reveal these genes opens the door to new clin-

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PROMISE & PROGRESS I Fall 2009–Winter 2010

Ivelisse Page

ical possibilities. “Just as DNA has been used to detect, measure, and manage chronic viral infections, like HIV, measuring circulating tumor DNA could similarly enhance the management of cancer,” says Diaz.

As the discoveries of Vogelstein and team have revealed, virtually all cancers arise through the mutation of genes that control cell growth. As the cancer grows, they shed tiny fragments of DNA, biological evidence of the mutant genes, into the blood stream. It can pinpoint and track a cancer before a tumor develops and begins to cause symptoms and long before the cancer is visible on X-rays and CT scans.

The test could help physicians detect new cancers in the earliest stage and also determine patients who may have cancer cells remaining after surgery and who could benefit from additional therapy. “We know that not all patients need intensive adjuvant therapy, and this test could help us decide who would benefit and who could be spared the additional treatment,” says Diaz.

The blood test could also alert doctors to early signs that a treated cancer has come back.

Page knows all too well the urgency of this research. Time is both friend and enemy to cancer patients. Upon diagnosis, the unsettling awareness of an uncertain future makes them wish time could stand still. And yet time cannot move swiftly enough as they await the delivery of promising research discoveries to patient care.

Page will not benefit from the new test, but she is participating in the research study in hopes that what scientists learn from her will help future patients.

Five weeks after surgery to remove her colon cancer, a CT scan revealed that the cancer had spread to her liver. The good news about a place like the Kimmel Cancer Center is that, at once, our experts are delivering the most advanced cancer therapies available today and working to develop even better treatments for the future. Surgeons were able to remove the tumors in her liver, and for now Page remains cancer free.

“How great would it have been if this test had been available and caught my cancer earlier,” says Page. “Even if this research doesn’t help me, maybe it will help my children or another patient. We all need to work together to cure cancer. If I can spare another family from going through what my family has gone through, it will be worthwhile.” ■

IN THE NEWS N OTEWORTHY

A HEALING PLACE THE HACKERMAN-PATZ PATIENT

PROMISE & PROGRESS I Fall 2009–Winter 2010

AND FAMILY PAVILION

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Through the vision and generosity of Mr. Willard Hackerman and Mr. Sidney Kimmel, the Cancer Center opened the Hackerman-Patz Patient and Family Pavilion, a new home-away-from-home for cancer patients and their families who travel to the Kimmel Cancer Center for treatment. The five-floor building provides affordable lodging for 39 families in specially-designed suites and apartments.

Spacious kitchens, family rooms, a garden, library, guest computer center, and integrative medicine suite are just a few of its many amenities. ■

CARDUCCI IS FIRST AEGON PROFESSOR

SMALL NAMED PEDIATRIC ONCOLOGY DIRECTOR

Michael Carducci, M.D., F.A.C.P., was installed as the inaugural recipient of the AEGON Professorship in Prostate Cancer Research.

Carducci is Professor of Oncology and Urology, Co-Leader of the Prostate Cancer/Genitourinary Oncology Program, and Co-Leader of the Chemical Therapeutics Program.

His laboratory focuses on the reexpression of epigenetically silenced genes in cancer cells, and he manages a portfolio of clinical trials introducing new drugs into cancer treatment.

AEGON, one of the largest life insurance and pension groups in the world, has been a long-time supporter of the Kimmel Cancer Center, funding fellowships in prostate cancer and breast cancer research and other cancer initiatives. The professorship was established to honor AEGON CEO Donald J. Shepard, who retired in 2008. ■

Donald Small, M.D., Ph.D., Kyle Haydock Professor of Oncology and nationally recognized leader in the research and treatment of childhood blood cancers, has been selected to head the Pediatric Oncology Division of the Kimmel Cancer Center. He has been the acting director since September 2006 and has been a faculty member for the last 19 years.

“Don has the talent and energy to ensure our pediatric oncology program moves forward as a premier center of excellence and innovation for discovery and treatment,” says George Dover, M.D., Director of the Johns Hopkins Children’s Center.

Kimmel Cancer Center pediatric oncology faculty already lead many of the national studies in childhood cancer, and Small says he will draw upon their expertise to expand pediatric cancer clinical trials and laboratory research.

“Don embodies the philosophy and mission of Johns Hopkins in everything he does,” says Kimmel Cancer Center Director William G. Nelson, M.D., Ph.D. “He’s a dedicated physician, teacher and mentor, and among the nation’s best researchers in his field.” ■

Small and his team were the first to clone the human FLT3 receptor gene, the most frequently mutated gene in acute myelogenous leukemia (AML), one of the most common blood cancers in adults and children.

Clinical trials testing FLT3-targeted therapies in both adults and children are now underway.

STUDENTS SUPPORT OUR SARCOMA PROGRAM The Maryland Association of Student Councils (MASC) selected the Kimmel Cancer Center’s sarcoma program as the state charity for the 2009-2010 school year.

Each year, MASC raises money and awareness for a state charity to help students strengthen their personal leadership skills and commitment to their communities and state.

The MASC is a group of student representatives from nearly all the counties in Maryland. Their mission is to foster a statewide environment for all secondary school students to express and exchange opinions and ideas, develop leadership skills and promote student representation and involvement in all groups and organizations affecting the lives of students.

In the past, the group has raised more than $40,000 for their selected charities. ■

STAND UP TO CANCER KIMMEL CANCER SCIENTISTS PART OF CANCER RESEARCH “DREAM TEAMS” THE STAND UP TO CANCER telethon held just over a

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PROMISE & PROGRESS I Fall 2009–Winter 2010

year ago raised nearly $100 million for cancer research.

The mission was to quickly channel the funds to research that showed clinical promise and could be brought to patients within three years.

Johns Hopkins Kimmel Cancer Center scientists were selected for two of five multi-institutional cancer research “dream teams” earning grants for more than $6 million to be used for pancreatic cancer and epigenetic research.

A 20-member panel of scientists, physicians, and patient advocates sifted through 237 applications to select the five final research awards totaling $73.6 million. The money was raised during the telethon which was organized and hosted by the Entertainment Industry Foundation.

An additional $20 million will be distributed to individual scientists at a later date.

“The goal was to get the money to the best people with the best ideas,” says William G. Nelson, director of the Kimmel Cancer Center. “All of the grants were superb, so we are especially honored that the work of Kimmel Cancer Center scientists was recognized.”

Epigenetics is an emerging area of interest in cancer, a disease characterized by genetic mistakes. Many of these mistakes occur through direct mutations to genes, but Stephen Baylin and team have found that genes also can be altered--without mutation--by the way the DNA is packaged within the cell.

Baylin is a leading expert in the field of cancer epigenetics and will help lead a group that will be looking for signature alterations in the genomes of leukemia, lung, breast, and colon cancer cells. These signatures can help pinpoint patients whose cancers are likely to respond to a particular therapy and can help clinicians monitor a tumor’s response to anticancer drugs.

In the pancreatic cancer research, investigators will test and develop drugs that target faulty enzymes that process glutamine and glucose and fatty acids in some pancreatic cancers. They will be evaluating drugs already approved for diabetes management that have evidence of antitumor effects as well as new experimental drugs, alone and in combination with other therapies. Kimmel Cancer Center genetics experts Victor Velculescu and Kenneth Kinzler will scan patients’ genomes for gene targets that would indicate their cancers would be susceptible to glutamine and glucose-blocking drugs.

Other members of the Kimmel Cancer Center epigenetics and pancreatic cancer “dream teams” are Nita Ahuja, Nilofer Azad, Malcolm Brock, Robert Casero, Leslie Cope, Chi Dang, Edward Gabrielson, James Herman, Ralph Hruban, Rosalyn Juergens, Daniel Laheru, Anirban Maitra, William Matsui, Martin Pomper, Charles Rudin, Vered Stearns, Jeff Wang, and Cynthia Zahnow. ■

“The goal was to get the money to the best people with the best ideas. All of the grants were superb, so we are especially honored that the work of Kimmel Cancer Center scientists was recognized.”

IN THE NEWS H O N O R S A N D AWA R D S

PROMISE & PROGRESS I Fall 2009–Winter 2010

Stephen B. Baylin, M.D., was awarded the Kirk A. Landon-AACR Prize for basic and translational cancer research. He was selected for his pioneering work in the field of cancer epigenetics. The prize is considered one of the most prestigious international awards in cancer research.

The Damon Runyon Foundation has awarded its first ever continuation grants. Patrick Brown, M.D., and Andrea L. Cox, M.D., Ph.D., were among the recipients and will each receive an additional two years of funding totaling $300,000.

Leisha Emens, M.D., Ph.D., earned the Greater Baltimore Area YWCA President’s Award for her work in developing a breast cancer vaccine.

The award recognizes women who exemplify the YWCA’s tradition of leadership by combining professional excellence with a personal commitment to helping others.

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The Kimmel Cancer Center Patient Education Coordinator, Joanne Finley, R.N., M.S., was appointed to the Board of Directors of the Education Network to Advance Cancer Clinical Trials (ENACCT).

The Ramzi Cotran Young Investigator Award was presented to Christine Iacobuzio-Donahue, M.D., Ph.D. The award is given by the United States and Canadian Academy of Pathology to researchers who have contributed significantly to the diagnosis and understanding of human disease.

Sian Jones, Ph.D., received the Alfred Blalock Research Award for her project Signaling Pathways in Pancreatic Cancer Revealed by Global Genomic Analyses. Kenneth Kinzler, Ph.D., was her sponsor.

Breast cancer survivor, advocate, and fund raiser Harriet C. Legum was inducted into the Maryland Women’s Hall of Fame. The honor is given to Maryland women who have made unique and lasting contributions to the economic, political, cultural and social life of the state, and who provide visible models of achievement for tomorrow’s female leaders.

Legum is a member of the Kimmel Cancer Center Advisory Council and chaired the committee that raised the money for the Center’s Breast Cancer Research Chair and Fellowship.

Jonathan Schneck, M.D., Ph.D., will lead a team of researchers, including Jonathan Powell, M.D., Ph.D., to determine precisely how the human immune system works. The research is funded by a $10.3 million NIH grant—the largest basic immunology grant ever received by Johns Hopkins.

Lillie Shockney, R.N., B.S., M.A.S., received the Oncology Nursing Society’s Excellence in Survivor Advocacy Award. The award recognizes her achievements and involvement in breast cancer patient advocacy.

Shockney also received the Health Network Foundation Service Excellence Award.

Pediatric Oncology Director Donald Small, M.D., Ph.D., received the Frank A. Oski Award from the American Society of Pediatric Hematology/ Oncology. The award honors leading pediatric hematology and oncology clinicians and basic scientists.

Victor Velculescu, M.D., Ph.D., won the 2009 Outstanding Achievement Award in Cancer Research from the American Association of Cancer Research. The award recognizes young investigators who have made significant cancer discoveries.

The American Society for Blood and Marrow Transplantation Lifetime Achievement Award was presented to Georgia Vogelsang, M.D., for advancing treatment against chronic graft-versus-host disease. Vogelsang was the first woman to receive the award.

The American Society of Clinical Oncology’s Science of Oncology Award went to Bert Vogelstein, M.D. He was selected for his role in discovering the specific genes and mutations responsible for colorectal cancer and for establishing a genetic model that explains how most solid tumors form and progress.

Stephen Yang, M.D., received the first Arthur B. and Patricia B. Modell Professorship in Thoracic Surgery.

Yang’s research interests include using molecular techniques to screen for lung cancer and to predict cancer recurrence following surgical resection.

The Kimmel Cancer Center’s Fellows Research Day Awards for basic research were presented to Karen S. Sfanos, first prize, Angelo De Marzo, M.D., Ph.D. preceptor; Cheryl M. Koh, honorable mention, Angelo De Marzo, M.D., Ph.D., preceptor; and Vivian Weiss, honorable mention, Elizabeth Jaffee, M.D., preceptor. Clinical and Translational Awards went to Kathleen Greenberg, first prize, Donald Small, M.D., Ph.D., preceptor; Eric Lutz, first prize, Elizabeth Jaffee, M.D., preceptor; and Anjali Mishra, first prize, Barry Nelkin, Ph.D., preceptor.

The Center’s Director’s Teaching Awards in Clinical Oncology went to Richard F. Ambinder, M.D., Ph.D., hematologic malignancies program, Allen R. Chen, M.D., Ph.D., pediatric oncology program, Deborah Frassica, M.D., department of radiation oncology and molecular radiation sciences, and Rosalyn Juergens, M.D., lung cancer program. Kenneth Kinzler, Ph.D., cancer biology program, received the Director’s Teaching Award in Laboratory-Based Cancer Research.

IN THE NEWS N E W A P P O I N T M E N T S A N D A R R I VA L S

David Cosgrove, MBBCh, assistant professor of oncology, has joined the Gastrointestinal Cancer Program and will be developing a clinical research program for liver cancer.

Margaret Showel, M.D., has joined the hematologic malignancies program as an instructor in oncology. She will focus on the biology of leukemia, with a particular focus on cancer stem cells.

Hans Hammers, M.D., Ph.D., assistant professor of oncology, will be working to decipher the factors associated with antiangiogenesis treatment (treatments that cut off the blood supply to tumors) resistance and is developing several clinical trials for prostate and kidney cancers.

Stephanie Terezakis, M.D., has joined the Department of Radiation Oncology and Molecular Radiation Sciences to lead the pediatric radiation oncology program She also will join the sarcoma program and lead a study on the role of PET/CT radiation treatment planning for patients with lymphoma.

Robert S. Miller, M.D., F.A.C.P., has joined the Kimmel Cancer Center as a clinical associate at the Green Spring location where he will be treating patients with breast cancer.

A national expert on long term effects of cancer therapy, Kathryn Ruble, N.P., Ph.D., instructor in oncology and nurse practitioner, will further develop research projects related to these late effects and cancer survivorship.

Carol Greider and previous Nobel winner Peter Agre

Lei Zheng, M.D., Ph.D., assistant professor of oncology, will be developing multidisciplinary and adjuvant therapies for patients with pancreatic cancer.

Hao Wang, Ph.D., assistant professor in oncology, has joined the Biostatistics Program to manage unusual data types related to cancer research and help clinical investigators with clinical trial and biomarker development and epidemiologic research.

NOBEL EFFORT

Carol Greider, Ph.D., Daniel Nathans Professor and Director of Molecular Biology and Genetics, was a 2009 recipient of the Nobel Prize in Physiology or Medicine.

Greider was honored for her pioneering research of telomeres, tiny caps that protect the ends of chromosomes. Greider discovered telomerase, an enzyme that restores telomeres and protects them from damage. The connection of telomeres and telomerase to cancer development is a major area of research.

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PROMISE & PROGRESS I Fall 2009–Winter 2010

As a new member of the hematologic malignancies program, Keith Pratz, M.D., assistant professor of oncology, will be developing a pharmacologybased clinical investigation program for acute leukemia and is designing clinical studies of new, molecularlytargeted agents for adults with treatment-resistant leukemia.

The Department of Radiation Oncology and Molecular Radiation Sciences welcomes Phuoc Tran, M.D., Ph.D., assistant professor. He will focus on the treatment of genitourinary malignancies.

PHILANTHROPY

PROMISE & PROGRESS I Fall 2009–Winter 2010

GIFTS AND DONATIONS to the KIMMEL CANCER CENTER AT JOHNS HOPKINS

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THINK PINK Avon Walk for Breast Cancer They trudged through pouring rain, but the Johns Hopkins “pink-scrub cheerleaders,” said it was worth it, bringing home $850,000 for the Johns Hopkins Avon Foundation Breast Center.

As breast health educator Debby Stewart stood on stage with Breast Cancer Program co-director Saraswati Sukumar awaiting the check presentation, she saw the Hopkins contingency, 30-members strong, at the front of the crowd.

“Our team of rain-soaked members was right in front wearing their pink, dripping wet cowboy hats and cheering a n d a p p l a u d i n g . I t w a s q u i t e a m o m e n t ,” says Stewart.

The Breast Center walkers and their supporters contributed more than $96,000 towards the $6.8 million raised during the 2009 annual Avon Walk for Breast Cancer in Washington, D.C. More than $4 million in grants were awarded to six local organizations, including the Kimmel Cancer Center, to advance access to care and breast cancer research.

ROCKING THE CAUSE The 10th Anniversary of the Paul Reed Smith (PRS) Guitars Charity Weekend was held in October and featured concerts and golf tournaments across Baltimore.

A highlight of the weekend’s activities was an auction of custom made PRS guitars autographed by celebrities, including Bruce Springsteen, Carlos Santana, Buddy Guy, and Olympic swimming gold medalist Michael Phelps (pictured). The events raised $200,000 for the Kimmel Cancer Center’s Harry J. Duffey Family Patient and Family Services Living with Cancer Resource Program.

CONGRESSIONAL CHARITY TENNIS CLASSIC BENEFITS KIMMEL CANCER CENTER This year’s Congressional Charity Tennis Tournament brought in more than $70,000 for charities, including the Kimmel Cancer Center. The annual tournament, which features members of Congress and tennis legends, has raised more than $500,000 for hematology research at the Center.

The event is sponsored by local businesses, including Boeing and Pfizer.

From left to right: Owen Davidson, Tom Gorman, Ross Case, Kathy Rinaldi, Ken Bowler, Virginia Wade, Cliff Drysdale, Sherwood Stewart, Fred McNair, Dick Stockton

GIANT GAME YIELDS $1.5 MILLION FOR CHILDHOOD CANCER RESEARCH

BREAST CANCER ENDOWMENT

HYUNDAI’S HOPE ON WHEELS

For Frank and Charmayne Dierker, fighting breast cancer is a family affair. The Chestertown, Md., couple recently made a $1 million gift to establish the Frank and Charmayne Dierker Endowed Leadership Fund in Breast Cancer. They were inspired by their daughter, Lillie Shockney, administrative director of the Johns Hopkins Avon Foundation Breast Center and two-time survivor of breast cancer.

The endowment funds Shockney and those that follow her as administrative director of the Breast Center.

“My parents promoted leadership in their children and are proud of the pioneering work I’ve done in the field of breast cancer, and they want to make sure it continues,” says Shockney. A force in the battle against breast cancer, Shockney has dedicated her career to breast cancer patient advocacy and education. Her work has earned many honors and awards, including becoming the first nurse to receive a Johns Hopkins University distinguished service professorship.

Hyundai’s Hope on Wheels returned to the Kimmel Cancer Center for the fourth year, donating $35,000 for pediatric cancer research.

The money supports the research of 2009 Hyundai Hope on Wheels Scholar Heather Symons, M.D.

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PROMISE & PROGRESS I Fall 2009–Winter 2010

The 2009 Triple Winner Game, sponsored by Giant Food, raised $1.25 million for childhood cancer treatment and research at the Kimmel Cancer Center. An additional $250,000 was donated to the Children’s Cancer Foundation.

The Triple Winner game is a scratch card promotion. Participants purchase a card for $1 and can win a free product, gift card, or cash prizes up to $10,000.

Tom Cormier, Vice President for Giant Food, is pictured here with Kimmel Cancer Center pediatric oncology patients and Triple Winner game ambassadors Alexis, Joe and Dustin.

PHILANTHROPY MARK MOLESKY

CARING COLLECTION

PROMISE & PROGRESS I Fall 2009–Winter 2010

TH E K I M M E L CANCE R CE NTE R’S ANG E LS

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The Kimmel Cancer Center has a guardian angel—in fact it has tens of thousands of them. In homes, offices, and hospitals around the world, Bobbie Burnett’s stained glass angels have become a symbol in the ongoing fight against cancer. The Caring Collection—her name for the collection of angels she has designed and sold for more than two decades and the people who come together to make them— is approaching $1 million in donations to the Kimmel Cancer Center and other local institutions.

“I thought it was a miracle when we reached $100,000.

We were just an ordinary group of people, but we are doing something extraordinary,” says Burnett. “Now I want to reach $1 million.”

The Caring Collection began in 1982 when stainedglass artist Bobbie Burnett created Susie’s angel to help a friend who was battling leukemia.

Every year since, she has designed a new angel for the collection. Over the last 25 years, the soft-spoken Burnett and her 90 volunteers have been a blessing to cancer patients and the scientists searching for cures, turning more than 175,000 pounds of stained glass into 36,000 angels and raising nearly $800,000 for cancer research equipment.

Each angel is painstakingly handcrafted, taking about 20 hours to make. “Every one is a symbol of hope and caring,” says Burnett. Children of cancer patients, a young man working court-ordered community service, a blind woman who strings fishing line on suncatchers, student service clubs, retirees, and church groups work side by side in Burnett’s Annapolis, Md. studio assembling and

Bobbie Burnett

packaging angels. Much to the relief of patients and researchers, Burnett, 70, says she has no plans to retire.

“This is isn’t my work,” she says. “It’s my life.”

The Caring Collection includes a variety of one-of-akind stained-glass pieces, including table-top sized freestanding angel statues, suncatchers, and pins and range in price from $15 to $85. To view or purchase angels, visit www.caringcollection.org The Caring Collection purchased quality control equipment for the next generation sequencing facility.

This device alerts investigators to problems with genetic samples and ensures that a $20,000 experiment is not ruined by poor quality samples.

LOCAL TEEN BREAKS GUINNESS WORLD RECORD Raises Money for Prostate Cancer Research Evan Wollman, 19, of Edgewater, Md. set the Guinness World Record for most distance traveled on a personal watercraft, riding for more than six hours and 231 nautical miles on a Jet Ski. The local teen took on the challenge to raise money for the research of Kimmel Cancer Center prostate cancer expert Mario Eisenberger. Wollman’s father died last year of prostate cancer.

What if we could cure cancer with a simple blood test?

It may be possible. Our researchers are using the latest technology to develop tests that detect the DNA from cancer cells from a small sample of blood, stool or body fluids. They can detect cancer in its very earliest stages, before a patient has any symptoms.

But, we need your help to make these tests a reality. Private giving has provided us with the opportunity to make real advances and it has provided critical support to our young investigators.

Your Donation Is More Important Than Ever.

Your gift will support: • The scientists and clinicians developing these tests • cutting-edge gene sequencing technology • necessary laboratory equipment • research nurses and data analyzers needed to complete clinical trials There are several ways to donate: 1) Call us at 410-516-4203 2) Mail your donation to: Johns Hopkins Kimmel Cancer Center 100 North Charles Street, Suite 234 Baltimore, MD 21201, USA 3) Use our online giving form at www.hopkinskimmelcancercenter.org Click on “Make a Gift”, then “Online Giving Form.”

4) Email us at lengel2@jhmi.edu Together, we can cure cancer.

One North Charles Center 100 N. Charles Street Suite 234 Baltimore, Maryland 21201

PERFORMING ARTS• SERIES The Art of Healing Performing Arts Series encourages and promotes an uplifting treatment environment for our patients, families, visitors and staff. For a schedule of performances, visit www.hopkinskimmelcancercenter.org THE ART OF HEALING SERIES IS MADE POSSIBLE BY THE G E N E R O U S S U P P O R T O F T H E E M M E R T H O B B S F O U N D AT I O N , I N C .