Cancer Update May 2014

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Jon Strasser, M.D., Lana de Souza-Lawrence, M.D., Karen Karchner, RN, OCN, and Christopher Koprowski, M.D., MBA, review a patient file in the Graham Cancer Center.

IN T H IS ISSU E 5 RESEARCH: Discoveries and collaborations

The Helen F. Graham Cancer Center & Research Institute offers safe, precise, state-of-the-art radiation oncology therapy

9 OUTREACH: Bringing insurance access to Latino and Chinese Delawareans

Recognized leader in the region for advanced treatment

11 CLINICAL TRIALS: Powerful new drugs treats advanced

She met Radiation Oncologist Lana de Souza-Lawrence, M.D., at her first appointment with the Helen F. Graham Cancer Center & Research Institute’s Head and Neck Cancer Multidisciplinary team. That meeting was the first step along a continuum of personalized care and treatment that is helping Wright recover from the challenges of a rare nasal melanoma.

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When Sharon Wright sat down to discuss her treatment plan with her radiation oncologist, she already felt a connection.

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“After suffering for eight months with nasal congestion and sinus problems I was relieved to finally have a diagnosis,” Wright recalled. “But the prospect of facing treatment for cancer was overwhelming.”

After surgery, she had four weeks of external beam radiation to target any remaining cancer cells. “Dr. de Souza-Lawrence prepared me every step of the way,” Wright said. “I could have gone elsewhere for a second opinion, but I was highly confident in my physicians and in the resources and expertise at the Graham Cancer Center, closer to home and family. We are all walking this walk together, my doctors and I along with family and friends.”

Patients are the heart of our team Every day, as many as 100 patients come to the Graham Cancer Center for radiation oncology therapy from a compassionate, skilled, dedicated professional staff.

Radiation oncologists, nurses, physics staff, radiation therapists and clinic personnel are partners in the Graham Cancer Center’s multidisciplinary approach to treating a wide range of cancers: breast, brain, gastrointestinal, gynecological, head and neck, lung, spine, prostate cancer and others. Each member of the team plays an important role to assure accurate delivery of all aspects of the radiation treatment prescription.

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Advanced & Individualized Care

Each radiation oncologist partners with a registered nurse who is specially trained to assist patients undergoing radiation therapy and who is responsible for ongoing assessment, evaluation and education of the patients in their care. Typically, each physician-nurse team sees their patients weekly, but the nurse is available throughout treatment to triage patients’ immediate needs and to connect them with psychological, well-being, nutritional and other support services, working closely with the Graham Cancer Center’s Care Management team.

The Radiation Oncology nurse practitioner coordinates with the Graham Cancer Center’s Medical Support Multidisciplinary Center to help patients manage any side effects of treatment and to avoid preventable hospital admissions.

“Maintaining patient comfort and safety throughout the treatment continuum is paramount,” said Karen Karchner, RN, OCN. “Supporting Ms. Wright and her family and helping her cope successfully with her treatment is an example of what makes my job so rewarding.”

“The Radiation Oncology Department is committed to delivering the highest quality treatment that our state-ofthe-art technology has to offer in a robust culture of safety and responsibility,” said Department Chair Christopher Koprowski, M.D., MBA. “Ours is a multidisciplinary approach that incorporates peer review and expert consensus on the most appropriate treatment strategies for each individual Supporting Ms. Wright patient.”

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and her family and helping her cope successfully with her treatment is an example of what makes my job so rewarding.

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K AR E N K ARCHNER, RN, OCN

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Ours is a multidisciplinary approach that incorporates peer review and expert consensus on the most appropriate treatment strategies for each individual patient.

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CHRI STOPHER KOPROWSKI, M . D . , M BA

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TARGETING CANCER CELLS The LINAC, a linear accelerator, beams radiation therapy directly to cancerous growths for the most effective outcomes.

Allison Mitchell, MS, resident physicist, Firas Mourtada, MSE, Ph.D., D.ABR., FAAPM, chief clinical physicist and Hank Chen, M.S., D.ABR, senior medical physicist.

Technologically advanced therapy

Promising new clinical trials

Graham Cancer Center radiation oncologists are leaders in adapting the latest imaging and treatment advances into clinical practice. Newest generation linear accelerators deliver external beam radiation using 4D adaptive software and the latest RayStation® treatment planning that can adjust and control for anatomical changes that occur in tumors and surrounding tissue during treatment. Their arsenal to search and destroy cancer cells includes image-guided intensity modulated radiation therapy, stereotactic radiosurgery and high-dose-rate brachytherapy, now available to treat skin cancers.

As part of the department’s commitment to clinical excellence, Radiation Oncology participates in patientfocused research. Their work has led to multiple publications in peer-reviewed journals.

Radiation Oncology offers Delaware’s first and only CyberKnife robotic radiosurgery system that targets hard-totreat tumors, particularly in the brain, lung and spinal cord, with pinpoint accuracy. At a new location in the Concord Health Center, VMAT (volumetric modulated arc therapy) is used to dramatically reduce treatment times and optimize radiation doses to precisely target cancer cells.

Last year, the American Society of Clinical Oncology recognized Radiation Oncologists, PA, for enrolling the largest number of patients in National Cancer Institute (NCI) trials. In addition, the department was recognized for being fifth in North America for overall quality. Emerging studies show that centers with the highest participation in clinical trials offer the best outcomes.

Multiple trial opportunities exist for patients through the NCI-funded Radiation Therapy Oncology Group. These trials integrate radiation therapy with a variety of new drugs, systemic therapies and surgery to treat brain, head and neck, lung, gastrointestinal, genitourinary, cervical and breast cancers.

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Advanced & Individualized Care

Therapy for childhood cancers A strong collaboration with the Nemours/Alfred I. duPont Hospital for Children in Wilmington enables pediatric cancer patients to have radiation therapy at Christiana Care.

Radiation Oncologist Jon Strasser, M.D., participates in the weekly pediatric tumor board and on duPont Hospital’s Cancer Committee. Joint participation in the NCI Children’s Oncology Group brings access to the latest and most promising therapies for childhood cancers closer to home and family through national pediatric clinical trials.

Training tomorrow’s specialists “We believe that our efforts to provide the highest quality care for patients also prepare us to be teachers and mentors to the next generations of those who practice in our specialty,” said Dr. Strasser, chief of Education for Radiation Oncology. “All of us in the department have a keen interest in education as part of a teaching health system and our life-long learning experience.”

Dr. Mourtada and Dayee Jacob, MS, D.ABR., senior medical physicist.

Medical students rotate through the department each year from Jefferson Medical College in Philadelphia, and residents and interns from Christiana Care’s own residency programs may choose to spend elective time learning about the role of radiation oncology in multidisciplinary cancer care.

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We believe that our efforts to provide the highest quality care for patients also prepare us to be teachers and mentors to the next generations of those who practice in our specialty.

J ON ST R ASSE R , M.D.

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Two or three Jefferson residents rotate in Radiation Oncology, focusing on advanced technologies, such as high dose rate brachytherapy or stereotactic radiosurgery with Cyberknife, that complement Jefferson’s capabilities.

Every year, a dosimetry student from Jefferson trains in the department, as do radiation therapy and nursing students from other area universities.

The Christiana Care residency program in radiation oncology physics, one of only a few accredited programs in the country, will have two residents in training this year, under the direction of Christiana Care’s Chief of Clinical Physics Firas Mourtada, MSE, Ph.D., D.ABR, FAAPM. In addition, the department is one of only six sites in North America to offer one-week fellowship training in high dose rate brachytherapy for physicians and physicists from around the world. ¤ Radiation Oncology offices are located in the East Pavilion of the Graham Cancer Center and just over the Delaware state line in Elkton, Md., and Chadds Ford, Pa. For information or referrals, call 302-623-4800.

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The Center for Translational Cancer Research

Researchers tailor the human genome, leading to more personalized cancer treatments CHANGING THE CODE Scientists use TALENS to change the human genetic code in order to stimulate cells to repair themselves, leading to effective treatments.

Eric Kmiec, Ph.D., (center) and Research Associates Bryan Strouse and Pawel Bialk in the Center for Translational Cancer Research.

The Center for Translational Cancer Research (CTCR) at Christiana Care’s Helen F. Graham Cancer Center & Research Institute is among fewer than 35 companies and institutions in the world producing “designer” proteins capable of tailoring genetic material to develop personalized treatments for cancer and other genetic diseases.

State University in Dover. Dr. Kmiec is also director of the Genome Customization Core, a research group at the CTCR.

The Core custom designs TALENs for researchers around the country, including a number from the Wistar Institute of Philadelphia, a research partner with the Graham Cancer Center. The Core also is working with the University of Delaware, Delaware State University and area biotech Transcription Activator-Like Effector Nucleases or TALENs are synthetically engineered to precisely break DNA sequences companies. at targeted sites along the human genome. Scientists can use “This technology is on the cutting edge of translational TALENs to change the genetic code by cutting out a gene or science,” said Nicholas J. Petrelli, M.D., Bank of America ferrying in a new one and then stimulating the cell’s own endowed medical director of the Graham Cancer Center. repair mechanisms to complete the job.

“Dr. Kmiec and I see this as only the beginning of the types of partnerships that can be accomplished in the CTCR. “The potential of this technology lies in its capacity to precisely recapitulate the genetic profile of a tumor, extracted Bringing together scientists and clinicians under one roof continues to be successful and technology like TALENs will from the patient, in cells that can be used in the laboratory skyrocket translational cancer research.” for screening the effectiveness of anti-cancer drugs,” said Chemistry Department Chair Eric Kmiec, Ph.D., at Delaware CONTINUED May 2014

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The Center for Translational Cancer Research TALENs technology also has dramatically reduced the time required to recreate genetic sequences in the lab, from 18 months to about six weeks.

“This approach is an important step forward in developing a personalized treatment regimen for an individual so that we can provide the primary physician with information about which drugs might work best against a specific cancer,” Dr. Kmiec said. The challenge, he added, is to identify the specific DNA changes that account for a particular tumor’s genetic makeup, and that is what cancer researchers continue to work on.

For example, CTCR Senior Clinical Scientist Jennifer Sims-Mourtada, Ph.D., is using TALENs technology to study biological pathways associated with the loss of the BRCA1 gene known to increase the risk for hereditary breast cancer.

“Working with normal tissue samples we have banked at our Tissue Procurement Center, I can use TALENs to model what might happen in a normal, healthy patient when the BRCA1 gene is turned off and then study the pathways affected,” she said. “Understanding these mechanisms potentially will lead us to more individualized treatments and less invasive preventive alternatives to mastectomies for this very aggressive breast cancer.”

Jennifer Sims-Mourtada, Ph.D. Latonya Mann, RN, OCN

“We are on the threshold of being able to identify the genetic changes that lead to cancers and other diseases that are unique to a specific minority or ethnic group, and the Graham Center’s Tissue Procurement Center is a valuable resource in this process,” Dr. Kmiec said. TALENs can be helpful to researchers of genetic diseases, such as sickle cell anemia, which affects one out of every 625 African-Americans.

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Bringing together scientists and clinicians under one roof continues to be successful and technology like TALENs will skyrocket translational cancer research.

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N I C H O L A S J . P E T R E L L I, M.D.

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“In the big picture, it’s especially significant for DSU, an historically black college and university, to partner with the Graham Cancer Center, which has worked so hard and already has been so successful in reducing disparities for African-Americans,” he said. “We want to go further and faster.”

The TALENs Core, the first jointly shared core in Delaware, receives a portion of its funding from an IDeA Networks of Biomedical Research Excellence (INBRE) grant to improve the caliber of research. The Graham Center and DSU share the grant with the University of Delaware, Nemours/Alfred I. duPont Hospital for Children and Wesley College. ¤

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The Graham Cancer Center — Wistar Partnership

Graham Cancer Center partners with Wistar scientists to advance next generation of cancer medicines The Helen F. Graham Cancer Center & Research Institute’s partnership with The Wistar Institute in Philadelphia aims to crack the codes for diagnosing and treating many different types of cancer.

This historic collaboration, begun in 2011, is the first-ever bringing together the Graham Cancer Center, one of the first National Cancer Institute (NCI) selected community cancer centers, with The Wistar Institute, one of the first NCIdesignated cancer research centers in the United States.

“Partnerships such as ours with The Wistar Institute are key to accelerating the pace of discovery in cancer medicine,” said Nicholas J. Petrelli, M.D., Bank of America endowed medical director of the Graham Cancer Center.

“We know that 80 percent of cancer care is delivered at the community level. With Wistar, we are working to speed translation of discoveries made in their labs to clinical trials to benefit patients here at the Graham Cancer Center and in communities everywhere.”

including the acquisition of tissue microarray capabilities essential for tissue analysis.

According to Pat Swanson, BSN, research coordinator for the Wistar-Christiana Care collaboration, “We continue to look for new opportunities to assist these scientists with the highest quality specimens of all types, customized to their research needs. At the Graham Cancer Center’s Tissue Procurement Center, we are building our reputation on quality.”

New discoveries in the making Characterized by NCI in its CCSG renewal as “extraordinary and innovative,” the Wistar-Christiana Care partnership has fostered opportunities for education and collaboration between scientists and clinicians. Several joint projects in basic science and translational cancer research are underway, which have already led to jointly authored publications on their findings. What follows are some examples.

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As part of the Wistar-Christiana Care collaboration, Dr. Petrelli was recently director for Franknamed Beardell,associate M.D., and Donna Kerr, RN, BSN, Translational examine Research at Wistar’s Center. a patient on the Cancer Bone Marrow Transplant Unit.

Wistar Cancer Center’s director, Dario Altieri, Ph.D., who also serves as Wistar’s chief scientific officer and the Robert and Penny Fox distinguished professor, credits the successful track record of the partnership with contributing to an overall “Exceptional” impact score on Wistar’s $14.9 million NCI Cancer Center Support Grant (CCSG) renewal.

“The Graham Cancer Center has been an ideal partner in our mission,” Dr. Altieri said. “Our scientists at Wistar have access to clinically annotated primary patient specimens of the highest quality.”

In addition to the fresh specimens hand delivered to Wistar within hours of collection, the Graham Cancer Center’s Tissue Procurement Center has banked more than 4,000 quality tissue specimens for study. The Tissue Procurement Center was one of the highest contributors of tissues collected for the Cancer Genome Atlas Project that is changing what we know and how we think about the genetic makeup of many different cancers. Wistar funding has supported upgrades to the Tissue Procurement Center,

Wistar’s Dmitry Gabrilovich, M.D., Ph.D., examines tissue from the Graham Cancer Center.

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The Graham Cancer Center — Wistar Partnership

Lung Cancer Thoracic surgeons, led by Thomas Bauer, M.D., and Brian Nam, M.D., at the Graham Cancer Center are working with Louise C. Showe, Ph.D., a professor in Wistar’s Molecular & Cellular Oncology program and director of Wistar’s genomics facility, to develop a blood test for lung cancer.

“We have shown it is possible to detect early stage non-small cell lung cancer by examining changes in gene activity in white blood cells,” Dr. Showe said. Using blood samples contributed by lung cancer patients through the Tissue Procurement Center, she is now working on a simpler test that uses whole blood, which could be drawn from a needle stick in the doctor’s office.

“The quality of the samples from Christiana Care has been excellent,” Dr. Showe said. “As a bench scientist, I have found it particularly rewarding to have insight from the clinicians who are very engaged in this project.”

Graham Cancer Center clinicians collaborating on this project include Christopher Koprowski, M.D., Gregory Masters, M.D., Jon Strasser, M.D. and Gerald O’Brien, M.D.

Melanoma Graham Cancer Center patients undergoing melanoma surgery have the opportunity to donate tumor samples for study at Wistar’s Melanoma Research Center, home to the world’s largest melanoma cell collection.

“Access to tissues from these patients is our lifeline,” said Melanoma Research Center Director Meenhard Herlyn, D.V.M. D.Sc. ”We are getting some outstanding tumor samples from Christiana Care that represent subgroups of the disease that we didn’t have in our portfolio.”

Wistar’s Melanoma Research Center scientists are studying patients’ tumors to identify the genetic drivers of the many different melanoma subtypes and to find out why some tumors are resistant to treatment.

Graham Cancer Center clinicians collaborating on this project are Joseph Bennett, M.D., and Randall Ryan, M.D. “We are becoming increasingly successful in developing new ways to target melanoma.” Dr. Herlyn said. “We are still not ready to talk about a cure, but the community is hard at work to get there.”

According to Graham Cancer Center Pharmaceutical Clinical Trials Director Michael Guarino, M.D., several new studies

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are offered through the NCI Christiana Care Delaware Community Clinical Oncology Program testing new combinations of drugs for advanced or recurrent melanoma.

There is a promising new pharmaceutical trial open here that is testing an immune-boosting, injectable drug for skin and other accessible tumors and an individualized tumor vaccine trial offered at the NCI in Bethesda, Md. There are more drugs in the pipeline, Dr. Guarino said, with the hope that new and more promising combinations can be tested.

“The cell lines grown in animal models at Wistar from tissue we supply offer an infinite number of ‘surrogate patients’ to test these new therapies,” he said, “and can save years of work in finding the ones that could be most effective in humans.”

Ovarian Cancer and Immunity Gynecologic oncologists Mark Borowsky, M.D., and Mark Cadungog, M.D., at Christiana Care are collaborating on ovarian cancer research with José Conejo-Garcia, M.D., Ph.D., professor and program leader for Tumor Microenvironment and Metastasis at Wistar.

Dr. Borowsky, who is director of the Division of Gynecology at Christiana Care, and Dr. Cadungog are co-authors of two papers related to this work, submitted recently for publication by Dr. Conejo-Garcia and his team.

“Right now there is no good screening test for ovarian cancer, and it is very difficult to treat,” Dr. Borowsky said.

“Most patients will not be cured with current therapy. Our patients want to see this disease eradicated.”

At Wistar, Dr. Conejo-Garcia is using ovarian tumor samples from the Graham Cancer Center’s Tissue Procurement Center to verify that previous findings in animal models reflect what actually happens in human disease.

“Substantiating the relevance of mechanisms found in mouse models is particularly important when investigating inflammatory mechanisms and tumor-specific immune

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The quality of the samples from Christiana Care has been excellent. As a bench scientist, I have found it particularly rewarding to have insight from the clinicians who are very engaged in this project.

responses, as mice have been shown to behave differently from humans in the past,” he said.

Dr. Conejo-Garcia is working to uncover more details about how ovarian cancer acts on the body’s natural defenses to enable tumor growth and to try to identify tumor surface L O U I S E C . S H O WE , P H .D. markers that could become targets for early detection.

With Wistar’s Rugang Zhang, Ph.D., the scientists also are culturing ovarian tumor cell lines in the lab that can be used to study tumor progression and to test new drugs. “These projects would not be feasible without our collaborators and could result in improved diagnostic and therapeutic interventions in the long-run,” Dr. Conejo-Garcia said.

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Cancer Program in Translational Tumor Immunology, led by the noted expert in cancer immunology and immunotherapy, Dmitry Gabrilovich, M.D., Ph.D. His team is looking at various types of myeloid cells and how cancer impacts their role in the body’s immune response. Some of the therapeutic strategies they have proposed to overcome these actions are now being tested in clinical trials.

Graham Cancer Center clinicians collaborating in this area of research include Head and Neck Multidisciplinary Center leaders Neil Hockstein, M.D., and Robert Witt, M.D., along with Gregory Masters, M.D., Michael Guarino, M.D., Raafat Abdel Misih, M.D., and others.

All of the participating Graham Cancer Center clinicians play a key role in these research projects with The Wistar Institute. In addition to facilitating collection of high quality, viable tissue samples, they actively participate in concept development, sharing with the scientists their unique understanding of the needs and concerns that arise from the everyday patient experience. ¤

In March, the Christiana Care Tissue Procurement Center began sending blood and tissue samples to Wistar’s new

Cancer Center’s Outreach team helps with health insurance in Mandarin and Spanish With language expertise in Spanish and Mandarin, the Community Health Outreach and Education team at the Helen F. Graham Cancer Center & Research Institute is partnering with Christiana Care’s marketplace guides to boost health insurance enrollment in Delaware’s Latino and Chinese communities.

The marketplace guides program, developed by the Christiana Care Department of Family & Community Medicine, includes 12 specially trained employees who counsel Delawareans about their insurance options under the Affordable Care Act. “We’ve made it a goal to work across programs and bring the value of what each of us is doing directly to our patients,” said Nora C. Katurakes, RN, MSN, OCN, manager of Community Health Outreach and Education.

With two Spanish speakers on staff, the marketplace guides are partnering with the multilingual staff at the Graham Cancer Center to bring insurance access within closer reach for Latino and Chinese Delawareans.

The guides meet with individuals and families at the Graham Cancer Center and have joined the Community Health Outreach and Education team in visits to churches, community centers and the New Castle Farmers Market, raising awareness about both cancer screenings and health insurance.

Since the U.S. Health Insurance Marketplace opened in October, the marketplace guides have reached more than 17,000 people and enrolled more than 340 Delawareans in health plans. ¤

“Assisting Delawareans with health insurance is an important complement to their care.

The rate of death from cancer in Delaware continues to drop twice as fast as the U.S. rate as a whole. That’s tremendous progress.

As more people receive health coverage and cancer screenings, we should do even better in the fight against cancer and improve the overall health of our Delaware neighbors.”

NICHOLAS J. PETRELLI, M.D.

Bank of America endowed Medical Director The Helen F. Graham Cancer Center & Research Institute May 2014

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Specialists in your corner

Meet the newest members of the Helen F. Graham Cancer Center & Research Institute Team Jenia Jenab-Wolcott, M.D., Ph.D., joined the practice of Regional Hematology & Oncology, PA, at the Graham Cancer Center in August 2013. After graduating from Tufts University School of Medicine (2003), she completed her residency in Internal Medicine at Yale New Haven Hospital (2006), and fellowship training in hematology/oncology at the University of Pennsylvania Hospital (2010).

While in private practice in Pennsylvania, Dr. Jenab-Wolcott developed expertise in the treatment of gastrointestinal cancers and clinical cancer genetics. This interest led her to launch and co-direct a Universal Lynch Syndrome Screening Program in 2011, as a quality-of-care initiative for all newly diagnosed colorectal and endometrial cancers at the Crozer-Keystone Medical Center. She recently wrote The Physician’s Guide to Hereditary Colorectal Cancer Syndromes available on the University of Pennsylvania Division of Gastroenterology website.

“I have always been impressed by the outstanding reputation in cancer care and clinical cancer genetics at the Helen F. Graham Cancer Center & Research Institute,” she said. Meeting Bank of America endowed Medical Director Nicholas J. Petrelli, M.D., and learning of his personal dedication to cancer genetics and prevention, as well as having the opportunity to work with Medical Director of Cancer Genetics and Stem Cell Biology Bruce Boman, M.D., Ph.D., MSPH, FACP, and admiring the leadership of the Cancer Genetic Risk Assessment Program were further incentives for Dr. Jenab-Wolcott to bring her expertise to Delaware.

And she is just getting started with a long list of ideas for collaborations that include further development of early diagnostic and prevention clinical trials for high-risk individuals and their families; assessing the challenges of genetic counseling in the era of rapidly evolving novel molecular technology; exploring racial disparities, social attitudes and behaviors surrounding genetic testing; and examining access and knowledge of reproductive options for individuals affected by an inherited cancer syndrome. ¤

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Lana de Souza-Lawrence, M.D., is an attending physician in the Department of Radiation Oncology. “The radiation oncology practice here at the Helen F. Graham Cancer Center & Research Institute has an excellent reputation in our professional field,” she said. “I love the fact that this is a community-based practice but with a very strong focus on evidence-based care, and besides that, the facility is gorgeous!”

Dr. de Souza-Lawrence earned her medical degree from Howard University and completed her residency in radiation oncology at Johns Hopkins University. During her residency, she won the American Society of Clinical Oncology fellow’s award for her research on breast cancer treatments and subsequently became the co-author of a Phase II trial now underway that compares chemotherapy and partial breast irradiation to standard therapy for patients with a particular breast cancer subtype (triple negative).

Last year, she participated as a reviewer for the 2013 International Journal of Radiation Oncology Biology Physics. Her other clinical interests include lung and gynecological cancers. ¤

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Renie Mullaney

Danielle Press, M.D., is boardcertified in general surgery and has a particular interest in endocrine cases with extensive experience in the management of complex diseases of the thyroid, parathyroid and adrenal glands, as well as in the evaluation and treatment of pancreatic neuroendocrine tumors.

She is also fellowship trained in endocrine surgery, with expertise in minimally invasive laparoscopic techniques and robotic surgery.

Dr. Press is a graduate of Drexel University College of Medicine (2007) and of the Lehigh Valley

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Health Network General Surgery residency program (2012).

Following her fellowship at the Cleveland Clinic (July 2013), Dr. Press joined the private practice of Raafat Z. Abdel-Misih, M.D., and Joseph Bennett, M.D. Her research is published in several peer-reviewed journals, and she is a contributor to educational smartphone apps designed to assist residents in preparing for the American Board of Surgery In-Training Examination.

“Minimally invasive procedures are a large component of our general surgery practice, and I anticipate using my expertise on a regular basis, performing such operations as laparoscopic cholecystectomy, laparoscopic appendectomy and laparoscopic hernia repair,” said Dr. Press.

“Through my fellowship training, I also have advanced skills in laparoscopic and robotic adrenalectomy.” ¤

New class of drugs offers targeted therapy for advanced cancers

Administrative Director, the Christiana Care Breast Center at the Helen F. Graham Cancer Center & Research Institute.

A designated Breast Imaging Center of Excellence by the American College of Radiology.

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Most women come to the Breast Center for a mammogram and they are done. Others come for additional imaging or a referral to a surgeon, or they come knowing they have breast cancer and rely on our expertise. We know how important we are to our patients and will accept nothing short of excellence in providing the most advanced imaging and compassionate services to meet their needs, and in some cases to save their lives. We are passionate about the care we provide here. I wouldn’t want to work anywhere else.” ¤

Two new trials from Immunomedics, Inc., underway at the Helen F. Graham Cancer Center & Research Institute, are testing a new class of heavy-duty drugs called antibody-drug conjugates. The trials (Immunomedics 130 and 132) are open to late-stage metastatic cancer patients with multiple solid tumor types, including advanced colorectal cancer, who have already tried standard chemotherapy unsuccessfully.

The study drugs combine the unique ability of monoclonal antibodies to bind to the surface of cancer tumors with the cancer killing ability of a powerful anti-cancer drug, in this case, one called irinotecan. Unlike traditional chemotherapy drugs, ADCs target and attack just the cancer cells, minimizing risk to healthy tissue. ¤

The Graham Cancer Center is a top enroller nationally in clinical trials, which may offer the best options for treatment to qualified patients. To learn more, contact Cancer Research at 302-623-4450.

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PRSRT STD U.S. POSTAGE PAID WILMINGTON DE PERMIT NO. 357

P.O. Box 1668 Wilmington, DE 19899-1668

One of the original 14 cancer centers in the nation selected for the National Cancer Institute Community Cancer Centers Program.

The Multidisciplinary Cancer Centers at the Helen F. Graham Cancer Center & Research Institute offer comprehensive care and treatment.

Over a decade of saving lives.

Breast Cancer Bone Sarcoma Genetic Risk Assessment Genitourinary Cancer Head & Neck Cancer/Thyroid Hepatobiliary/Pancreatic Cancers Lymphoma

Medical Support Melanoma/Soft Tissue Sarcoma Mind, Body & Spirit Wellness Neuro/CyberKnife Ostomy Care Rectal/Anal Cancers Skin Screening Spinal Tumor & Metastatic Lesion Thoracic/Esophageal Cancers Young Adult Follow-up

Learn how we are transforming cancer care and treatment at www.christianacare.org/cancer Christiana Care is a private, not-for-profit regional health care system that relies in part on the generosity of individuals, foundations and corporations to fulfill its mission. To learn more about our mission, please visit christianacare.org/donors.

Cancer Update is produced by Christiana Care Health System. Š Christiana Care Health System, 2014. All rights reserved.

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