C3: Collaborating to Conquer Cancer Fall 2015 Edition

C O L L A B O R AT I N G

T O

C O N Q U E R

C A N C E R

WI NTER 2015

‘I HAVE A F UTU R E AGAI N’

04: CAUSE, CURE, CONUNDRUM 16: THE DILEMMA OF STAGE 0 BREAST CANCER 10: Q&A WITH CATHY J. BRADLEY, PHD 11: C3 MD LAVANYA KONDAPALLI, MD 18: SEEING DIAGNOSIS FROM BOTH SIDES

ANSCHUTZ MEDICAL CAMPUS

C U C ANC E R C E NT E R

N3WS N EW LEAS E ON LI FE F O R WA S TAT E S E NATO R A N DY H I L L Andy Hill, a state senator in Washington State, is a father of three, a husband of 22 years, and an outdoor activity aficionado.

Hill is also a lung cancer survivor.

“In late 2008 I went to the doctors after my headaches and a lingering cough would not go away.

They thought I had pneumonia and started treating me for that,” Hill explains. “It was not until I started

HI LL

coughing up blood that I got the real diagnosis.”

UNIVERSITY OF COLORADO CANCER CENTER AMONG THE BEST IN THE NATION

In March of 2009 Hill was diagnosed with

Again! 2015 U.S. News and World Report data show that University of Colorado Cancer Center’s clinical

stage III lung cancer after a CT scan. A never

practice sites on the Anschutz Medical Campus are once again ranked among the best in the country

smoker and life-long health enthusiast, he was

for cancer care. The University of Colorado Hospital (UCH), is ranked No. 15 in cancer care for adults.

shocked. In October of 2009 positive thinking and

Children’s Hospital Colorado is ranked No. 9 in pediatric cancer. The report analyzed data from nearly

hours of research paid off when Hill was accepted

5,000 adult hospitals and 184 pediatric hospitals, recognizing those that excel in treating rare conditions

into a clinical trial at the CU Cancer Center. Only

and the most challenging patients. Rankings are driven by physician reputation by their peers and

five locations in the United States were accepting

measures including patient outcomes and patient safety.

patients for a new drug called crizotinib.

“High performing clinical practice sites at UCH and Children’s Colorado are critical to success of the

Within one week of starting treatment many of

cancer center since most of our physicians see our cancer patients there,” says Dan Theodorescu,

the symptoms disappeared. Within two weeks his

MD, PhD, director of CU Cancer Center. “The patient experience is driven by clinical outcomes and by

voice, which had been gone for quite some time,

interaction with the hospital as a whole.”

came back. Within three weeks Hill was back to jogging with his wife, Molly. By February of 2010 his scans showed no detectable cancer and he

NATURE: STUDY CREATES CELL IMMUNITY TO PARASITE THAT INFECTS 50 MILLION There are two common approaches to protecting humans from infectious disease: Antibiotics and stopping

had regained his strength.

“The advice I have for cancer patients that are

transmission. A paper published in the journal Nature Scientific Reports demonstrates the effectiveness

facing a grim prognosis is to never give up, get to

of a third strategy: Adjusting the landscape of the human body to remove the mechanism that allows

a research institution like the CU Cancer Center,

pathogens to cause disease.

and call me,” says Hill.

Working with collaborators at the University of Virginia, CU Cancer Center Director Dan Theodorescu, to the parasite E. histolytica, which infects 50 million people and causes 40,000-110,000 deaths via severe diarrhea worldwide.

“We do this all the time in cancer research,” Theodorescu says. “Commonly, we’re looking for genes that, when silenced, will make cells more susceptible to chemotherapy.”

After testing, the small number of cells that survived the parasite were the ones in which genes essential to something called “potassium transport” had been turned off. A follow-up experiment showed that new intestinal cells treated with E. histolytica showed potassium efflux - the flow of potassium from inside a cell out through the cell wall - directly before cell death.

“This is a major finding with translational implications for this infection that causes so many deaths worldwide, but also proof that this cancer-science approach can be used to explore genetic mechanisms of resistance in the field of infectious disease,” Theodorescu says.

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FLICKR / M ICHAEL WUN D ERLI

MD, PhD, silenced genes in human cells to discover if the loss of any single gene would confer immunity

2015 FACTS & F I GU R E S

ONT-380 HAS STAGE IV HER2+ BREAST CANCER PATIENT “WORRYING ABOUT NORMAL STUFF AGAIN” C U C ANC E R C E NT E R

Promising clinical trial results show activity of the investigational anti-cancer agent ONT-380 against HER2+ breast cancer, in one case specifically against brain metastases and in another case in overall survival of heavily pretreated HER2+ breast cancer patients.

$79 $22

“I am thrilled to have been able to offer this therapy to a patient in her early 40s. She didn’t have any other great treatment options that we would have expected to have any meaningful impact, especially on her brain. Now she’s been on the study over a year. The mets in her body are gone and the brain

MILLION

MILLION

in direct annual cancer

in direct annual NCI

the family business and how the kids are doing – normal stuff,” says Virginia

research funding

research funding

Borges, MD, MMSc, director of the Breast Cancer Research Program and

197 full members, average $399,903 per capita funding

Includes all academic NCI-funded researchers in Colorado

$178 19% MILLION

of PATIENTS

institutional investment

diagnosed at the

in cancer research

Center are enrolled in

since 2005

treatment trials

6 scientific programs and 10 shared resources

9,446 new adult oncology patients at University of Colorado Hospital

560 publications, 39% collaborative

68,909 oncology clinic visits

lesion has shrunk down to a little nubbin. She’s living a normal life, fretting about BO RGES

Young Women’s Breast Cancer Translational Program at CU Cancer Center.

NATURAL SELECTION NOT JUST MUTATION DRIVES DEVELOPMENT OF CANCER A CU Cancer Center paper published in the Proceedings of the National Academy of Sciences argues for a model of oncogenesis that depends on as much on evolution as on mutation. Basically, the paper states that the ecosystem of a healthy tissue landscape lets healthy cells outcompete ones with cancerous mutations; it is when the tissue ecosystem changes due to aging, smoking, or other stressors, that cells with cancerous mutations can suddenly find themselves the most fit, allowing their population to expand over generations of natural selection.

This new thinking about oncogenesis has profound implications for cancer therapy and drug design.

“We’ve been trying to make drugs that target mutations in cancer cells. But if it’s the ecosystem of the body, and not only cancer-causing mutations, that allows the growth of cancer, we should also be prioritizing interventions and lifestyle choices that promote the fitness of healthy cells in order to suppress the emergence of cancer,” says James DeGregori, PhD, associate director for basic science at CU Cancer Center.

We can avoid some of these tissue changes by lifestyle choices, such as by not smoking. Unfortunately, we can’t put off aging forever. But there may be features of the tissue landscape that, with new therapies

NEW DRUG HELPS TREAT AND

PROMISING TRIAL RESULTS OF BRIGATINIB SHOW THAT ALL NEXT-GEN ALK

PREVENT MOUTH SORES DURING

INHIBITORS MAY NOT BE CREATED EQUAL

CANCER TREATMENT

Phase I/II clinical trial results reported at the American Society for Clinical

Radiation therapy destroys

Oncology (ASCO) Annual Meeting 2015 show promising results for investiga-

cancer cells but also dam-

tional drug brigatinib against ALK+ non-small cell lung cancer (NSCLC), with

ages healthy cells like the

58 of 78 ALK+ patients responding to treatment, including 50 of 70 patients

rapidly dividing cells in the

who had progressed after previous treatment with crizotinib, the first licensed

mouth, making it difficult for

ALK inhibitor. Progression-free survival (PFS) in patients previously treated with

the mouth to heal and fight

crizotinib was 13.4 months.

germs. This may lead to sores and infections.

“Although still only in an early phase trial, brigatinib is showing an objective

A new drug currently in testing at CU Cancer

response rate in approximately 70 percent of ALK-positive patients post-

Center treats and prevents these painful sores.

crizotinib and it’s showing about a year of progression-free survival. These

“We have found that the drug seems to block

CU CANCER CENTER

FLICKR / M ICHAEL PERECK AS

and new understanding, could be reinforced in ways that resist cancer better, longer.

results are among the best in the field, offering a lot of hope to people with

critical inflammatory that play a role in regulating

ALK-positive lung cancer,” says D. Ross Camidge, MD, PhD, director of thoracic

the immune response to infection,” explains David

oncology at CU Cancer Center and the trial’s principal investigator.

C AMI DGE

Raben, MD, investigator at the CU Cancer Center.

“This helps to protect cells in the mouth and prevent oral sores from occurring.”

“This drug could significantly improve the quality of life for patients undergoing intensive radiation treatments,” says Raben.

Get more CU Cancer Center news on our blog: www.coloradocancerblogs.org. Sign up for our bimonthly newsletter, Colorado Cancer News.

3 C3: WINTER 2015

{ CANNABIS AND CANCER }

CAUSE, CURE, CONUNDRUM

BY GA RT H S U N D E M

W

ithin two miles of the University of Colorado Cancer Center are at least seven recreational marijuana dispensaries with names like Pink House, Terrapin Care Station, Sweet Leaf, Lightshade and Starbuds. And the influence of what happens off campus doesn’t stay off campus. Our patients are using marijuana – some recreationally, some to alleviate the symptoms of cancer and cancer treatments, and some with the belief that cannabis and cannabis-based products could improve or cure their disease.

We can’t ignore the fact that here on the Anschutz Medical Campus we are at the absolute epicenter of cannabis in the United States. So for a few minutes let’s put aside the pot jokes. Let’s put aside the moral, societal and political right and wrong of medical and recreational marijuana legalization in Colorado and beyond. Let’s even put aside the negative and positive health effects of marijuana in conditions beyond cancer.

For a few minutes, let’s focus on what we know, what we don’t know, and what we would desperately like to know about cannabis specifically in the context of cancer.

H OW CAN NAB I S WO R K S To understand the effects of cannabis on cancer, we first have to know how the chemicals inside the cannabis plant work.

Every cell in your body bristles with little mailboxes, each shaped to receive a different kind of letter. One kind of mailbox accepts adrenaline (which makes you energized), another accepts dopamine (which makes you pleasantly happy), and another accepts caffeine (which makes it possible to exist on Tuesdays). In fact, there are hundreds of these mailboxes – called “receptors” – and thousands of chemicals that are like the letters that fit inside (called “ligands”).

When a receptor receives a ligand, it triggers the cell to act in a certain way. In short, this system of mailboxes and letters (receptors and ligands) helps your body eat, sleep, love, fight, learn and, basically, function.

One group of these paired receptors and ligands makes up what is called the endocannabinoid system. This system of cell communication is involved in regulating things like memory, appetite, energy, stress, sleep and pain. If this sounds like a behavioral checklist from a Cheech and Chong film, that’s because the chemicals in marijuana directly affect the endocannabinoid system.

In fact, many chemicals activate our cell signaling systems by looking enough like a ligand to fit a receptor. Caffeine stimulates receptors that usually watch for a ligand called adenosine. The breast cancer drug tamoxifen blocks receptors that watch for the ligand estrogen. And the tetrahydrocannabinol (THC) in marijuana stimulates receptors of the endocannabinoid system that naturally watch for the ligand anandamide. THC is the ingredient in marijuana responsible for the feeling of being high, but it’s far from the only active ingredient.

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T H INKST OC K

Every cell in your body bristles with little mailboxes (receptors), each shaped to receive a different kind of letter (ligands). One group of these paired receptors and ligands makes up what is called the endocannabinoid system.

CASEY CASS

Many more chemicals inside the cannabis plant look enough like anandamide to activate the endocannabinoid system. There are 66 different cannabinoids that interact with the endocannabinoid system. Like THC, the full chemical names are long and un-pronounceable, but each one delivers a slightly different message and has a slightly different effect on the endocannabinoid system.

So now the question is…what are these effects?

D O E S CA N NA B I S CAU S E CAN C E R? Some cancers learn to manufacture more receptors or more ligands in ways that tell cells to survive and replicate beyond their natural bounds. This bad cell signaling is a common cause of the disease. But according to current knowledge, it doesn’t look like the endocannabinoid system is related to cell survival and growth, so on a cellular level, cannabis-based drugs seem unlikely to cause cancer.

However, there’s another aspect of cannabis use that is 100 percent proven to increase cancer risk: Inhaling smoke from burning plant products.

“Over 95 percent of cannabis users smoke it. There are the same products in marijuana smoke as there are in tobacco cigarettes, so they’re in effect smoking cigarettes without the nicotine. It’s not that marijuana is somehow more natural and so healthier.

You would expect marijuana to have the same impact on the development of lung cancer,” says Ellen Burnham, MD, MS, pulmonologist and medical director for the University of Colorado Hospital Intensive Care Unit.

Burnham came to marijuana research in an interesting way.

“Most of my research has to do with alcohol’s effect on the lung,” Burnham says.

When enrolling people in her studies, her group asked about marijuana use. “And, maybe due to increased use or due to increased social acceptability of use, we saw many more patients in our studies admitting they used marijuana.” Burnham realized that data she was already collecting would allow her to explore the effect of marijuana smoking on the lung. “We were looking at what alcohol does and now we could look at what cannabis does too,” she says.

Robert C. Doebele, MD, PhD, associate professor of Medical Oncology at the CU School of Medicine, studies kinase inhibitor drugs.

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C U C ANC E R C E NT E R

Here is what she found: “Modest consumption of cannabis may have minimal impact to lung health,” Burnham writes in a May 2015 review of the effects of cannabis on lung health in the journal Chest. However, she also writes that, “mainstream cannabis smoke contains substantially higher quantities of ammonia, hydrogen cyanide, NO, and NOx than comparable cigarette smoke, implying a more toxic effect from cannabis.”

Burnham’s review matches most publications that explore the influence of marijuana on lung cancer risk, which (very generally) find a slight but not extreme increase in lung cancer among marijuana smokers. The reason may be that most cannabis users inhale less smoke per day than most tobacco users. To further decrease the risk, some patients who use cannabis in medical settings use vaporized dosing and/or edibles.

“What worries me is that recent legislation legalizing marijuana makes it seem safe,” Burnham says. “Until we know more, I would have a hard time as an oncologist recommending it.”

CA N CA N NA B I S C O N T R O L CA N C E R SY M P TO M S ?

THINKSTOCK

About one-third of cancer patients will experience chronic pain. This pain can come from the cancer itself as it destroys tissue or as masses put pressure on nerves, bone and muscle, or pain can come from cancer treatments like surgery and radiation. It can be sharp or dull, intermittent or ever-present. Cancer pain may be controlled by overthe-counter meds or it may require heavy-duty, opioid-based painkillers like morphine, oxycodone or fentanyl, which carry the risk of addiction and other side effects. Some researchers hope that cannabis-based drugs could provide another option for controlling cancer pain. Some doctors and patients think that cannabis already does.

“For pain, nausea and appetite, there’s pretty good evidence that cannabinoids are effective,” says Tim Byers, MD, cancer epidemiologist and co-program leader in Cancer Prevention and Control at the CU Cancer Center.

Ellen Burnham, MD, MS, pulmonologist and medical director for the University of Colorado Hospital Intensive Care Unit.

“What worries me is that recent legislation legalizing marijuana makes it seem safe,” Burnham says. “Until we know more, I would have a hard time as an oncologist recommending it.”

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Just like opioids, the question is at what cost. On a basic level one very likely side effect of cannabis use in a pain-control setting is that the patient will get high. Many cancer patients need a 24/7, long-term solution for their pain and for some people it may be undesirable or impractical to be constantly stoned. “People say they don’t want to feel high all the time, but will accept it instead of being in pain,” Byers says.

One solution may be drugs derived from cannabis that include the chemicals that control pain but exclude the chemicals that cause disorientation, light-headedness, or euphoria.

“Even now, people pick strains of cannabis based on how they want to feel. For those people who use it medicinally to improve sleep or PTSD or chronic pain or seizures, they don’t want to be high all the time and so they take forms that are high in cannabidiol (CBD) and lower in THC,” Byers says.

Many modern pharmaceuticals are derived from or synthesized to replicate the properties of plant-based products. In fact, 11 percent of the 252 drugs considered basic and essential by the World Health Organization are derived from flowering plants. Many researchers hope that similar potential exists for pain medications derived from cannabis.

“There’s potential for marijuana pharmaceuticals derived from cannabinoids.

Right now they don’t appear to be as effective as the plant product itself but I’m sure there will be new formulations in the future,” Byers says.

Before moving on, let’s tally the score: Does cannabis cause cancer? When used in moderation, maybe a little but almost certainly not a lot. Can cannabis or cannabisbased drugs control cancer-associated pain? Yes, and they’ll probably get better in the future. Now onto the question that has probably kept you reading this article:

CAN CANNABIS CURE CANCER? “I had a patient, a young guy with metastatic head and neck cancer. There were treatment options available but instead this guy insisted on treating himself with cannabis oil,” says Daniel Bowles, MD, assistant clinical professor of medical oncology at the CU School of Medicine.

Some evidence supports this patient’s opinion that cannabis could cure his cancer.

In fact, there are papers published in the respected, peer-reviewed journals Oncogene, The Proceedings of the National Academy of Sciences, The British Journal of Cancer and many more showing that THC or cannabinoids of various sorts kill cancer cells. The thing is, there are many things that kill cancer cells (a flamethrower is one of them), and many therapies that are slam dunks in mice don’t pan out in humans.

Unfortunately, it’s easy to Google for studies of cannabis-based products that seem promising against cancer, but it’s horribly difficult to read between the lines of scienceese to know what these studies actually mean. And in that space of ambiguity, it’s easy to read into a study what you want to hear. That’s how a paper titled “The Combination of Cannabidiol and 9-Tetrahydrocannabinol Enhances the Anticancer Effects of Radiation in an Orthotopic Murine Glioma Model” (Molecular Cancer Therapeutics, 2014) becomes a news article titled “Marijuana Drastically Shrinks Aggressive Form of Brain Cancer, New Study Finds” (Huffington Post, 2014). The first is a study of cancer cells pretreated with THC and/or cannabidiol before irradiation. The second implies that smoking pot will kill brain cancer. Beyond these promising early studies, the National Cancer Institute writes that, “No clinical trials of Cannabis as a treatment for cancer in humans are identified.”

Tim Byers, MD, cancer epidemiologist and co-program leader in Cancer Prevention and Control at the CU Cancer Center.

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C U C ANC E R C E NT E R

Call it hash oil, Simpson oil, phoenix tears or any other name: Dr. Bowles’ patient with metastatic head and neck cancer who chose self-medication with marijuana rather than the established cancer treatment died.

“The most unfortunate slice of our population is the people moving here under the impression that cannabis oil will cure their children,” says Nicholas Foreman, MD, pediatric neuro-oncologist at Children’s Hospital Colorado. “Based on the current evidence, I would say there is no potential for curative therapies. Hope comes from a few number of feeble studies that are then passed up and down the internet. This is how we end up with great enthusiasm for something with no evidence at all.” (Bookmark this quote in your mind – we’ll hear more from Foreman later.)

Of course, and let’s be fair here, some therapies discovered in a dish and tested on mice do go on to save human lives. In fact, this is (generally) the workflow of modern medicines: Work with basic biology creates a hypothesis, the hypothesis is tested on cells in a dish, a possible medicine based on this hypothesis is discovered or designed, the drug is tested in mice, the drug enters human clinical trials, the drug is approved by the FDA, then it becomes a common treatment. Only, right now the progression of cannabis-based drugs is stalled partway along this continuum of research and testing.

Here’s why:

WHAT THE GOVERNMENT DOESN’T WANT YOU TO KNOW

Daniel Bowles, MD, assistant clinical professor of medical oncology at the CU School of Medicine.

THIN KS TOCK

CASEY CASS

Lindsey Davis, MD, assistant professor of Medical Oncology works on another application of the K-MAP database in colorectal cancer.

How’s that for an inflammatory headline? Hey, you’ve probably heard it before: It doesn’t take a lot of Internet digging to find people who think the government has been suppressing the curative powers of cannabis. And in fact, they’re partly right.

“Even the pharma industry is handicapped by the federal government. For us to do any proper research with cannabis or cannabis-based medicines, there are incredible hoops to jump through – a year or more to get federal approval, then we have to use a product grown by the federal government, out of Mississippi, which is very different than the marijuana grown in the Colorado retail market,” says Tim Byers.

Brian Reid. PhD and his team at the HTS/ HCS Core strive to find new combinations drug therapies that can treat currently untreatable cancers.

“Based on the current evidence, I would say there is no potential for curative therapies.” says Foreman. “Hope comes from a few number of feeble studies that are then passed up and down the internet. This is how we end up with great enthusiasm for something with no evidence at all.”

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Federal restrictions on the manufacture, handling and use of cannabis-based products leaves research stuck in the limbo of knowing the questions, knowing the techniques, but being barred from doing the research that could lead to answers.

But according to everyone quoted in this article, it’s not that the government is withholding a lifesaving cancer medicine; it’s just that federal restrictions on the manufacture, handling and use of cannabis-based products leaves research stuck in the limbo of knowing the questions, knowing the techniques, but being barred from doing the research that could lead to answers.

Nicholas Foreman is as close as we currently get to a human clinical trial of cannabis in the context of cancer. “We are not prescribing a new cannabis product or anything like that,” he says. “We have patients with brain tumors who are moving here from other states due to the legality of cannabis and cannabis oils, and we’re looking at the quality of life in these children in a systematic way.”

In other words, Foreman, who is at the cutting edge of cannabis research, in the state that has become the poster child for cannabis, can’t test cannabis. Instead, he watches a system already in motion to see what happens. In fact, Foreman also hopes to explore dangerous, possible fungal contamination in cannabis oils used by his already immunocompromised pediatric patients…and to do so, he must have patients ship samples of their oil to a third-party laboratory that can do the testing and report the results, without ever handling the oil himself for fear that interacting with the oil might jeopardize federal funding for his research.

However, In Foreman’s opinion, it is specifically the impossibility of research with cannabis-based products that allows the misplaced hope we saw in the previous section.

The thing is, whether or not marijuana, THC, cannabidiol or any other cannabis-based product works in palliative or curative settings, it would be really nice to know. The lack of research allows the conspiracy theory of government suppression, which allows people to believe that cannabis is a miracle cure for cancer…which leads to people mistakenly self-medicating with cannabis instead of seeking proven treatment that could cure their disease.

“I think we in Colorado are part of a movement that will inevitably tip public opinion so that Congress will have to take marijuana off of the list of drugs most tightly regulated,” Byers says. “As the movement grows and public opinion changes, we’ll get past some sort of a tipping point that allows us to more effectively explore the uses of cannabinoid-based drugs.”

Let’s revisit the score sheet. Smoking cannabis may increase cancer risk. Cannabisbased drugs are promising in the treatment of cancer symptoms. To the best of our knowledge, there is little hope that cannabis will treat cancer. And in all these cases, it would be darn nice to know more.

In Colorado, the state that has become the poster child for cannabis, researchers can’t test cannabis for fear of jeopardizing federal funding.

9 C3: WINTER 2015

A CONVERSATION WITH CATHY J. BRADLEY, PhD

BY GA RT H S U N D E M

C ASE Y C ASS

Associate Director for Cancer Prevention and Control Professor, Department of Health Systems, Management and Policy at Colorado School of Public Health

C3 spoke with Cathy Bradley on a stormy August afternoon, the day she moved into her new office on the 6th floor of The Anschutz Medical Campus’s Building 500, the old Fitzsimmons Army Medical Center.

paint with metal cabinets. The wind had chosen that morning to blow a small pane of glass from her window onto the air conditioning unit of a flat roof a couple floors below. Someone from Facilities was coming to replace the glass but until then Bradley had duct-taped a small rectangle of cardboard in its place.

Despite the storm that was testing the stay-

“The goal of cancer prevention and control research is to explore how the ways we live affect our health and, even more broadly, our wellbeing,” —cathy bradley, phd

THINK STOCK

The office walls were still bare – think eggshell-white

ing power of duct tape, Bradley was upbeat as she talked about her plans to relocate her family

Cathy Bradley has had plenty of experience

from their home near the University of Virginia to

with that. As Associate Director for Cancer

Denver’s sometimes-unpredictable climate. See,

Prevention and Control at the Virginia Common-

Bradley is a fighter. Despite being smaller than

wealth University Massey Cancer Center, Bradley’s

boxing’s lightest weight class, she trains regularly.

research focused on the influence of cancer on

“It helps sometimes when dealing with the NIH grant process,” she says.

employment, and she has become a leading

the executive leadership team with the purpose

expert on the experience of breast cancer survivors

of promoting collaborations between researchers

in the workplace. Much of her work focuses on the

at CU and with other institutions around the

experience of underserved and minority popula-

country and the world. Bradley is also the

tions. For example, an important paper in the

David F. and Margaret Turley Grohne Endowed

Journal of the National Cancer Institute showed

Chair for Cancer Prevention and Control Research

that African-American women are diagnosed later

at the CU Cancer Center, and is appointed a

and die more often from breast cancer than white

professor in the Department of Health Systems,

women, regardless of socioeconomic status.

Management and Policy at Colorado School of

Another article, in the American Journal of

COURTESY OF CATHY BRADLEY

Preventative Medicine, showed that properly nose and treat colorectal cancer could save more

everything from the air we breathe to what we

than 100,000 lives over 15 years, saving $33.9

choose to put into our bodies to the rules we

billion dollars in lost productivity. (The biggest

make – affect our health and, even more broadly,

problem is getting people to follow the guidelines!)

our wellbeing,” she says.

“Large-scale policy change offers the opportunity to discover how these policies affect health.

You have a before and an after, and it’s a unique

WWW.COLORADOCANCERCENTER.ORG

“The goal of cancer prevention and control research is to explore how the ways we live –

Recently, Bradley has been focusing on the

10

Public Health.

applying what we already know to prevent, diag-

labor supply effects of the Affordable Care Act.

Bradley brings fighting spirit to CU as incoming Associate Director for Prevention and Control

At the CU Cancer Center, Bradley will join

chance to compare the two,” she says.

By the time you’re reading this, you can assume that Bradley’s wellbeing is greatly increased by the addition of new glass to her office window.

CLINICAL

CARE C ASE Y C ASS

MD A Scientist With Heart D R KO N DA PA LLI NAVI GATE S TH E DATA- S CAR C E WO R L D O F CAN C E R TR EATM E NTS F O R PATI E NT W I TH H E A RT C O N D I TI O N S

BY GA RT H S U N D E M There are volumes of research studies related to

can have cardiac side effects down the road. For

the heart. As a result, we know a lot about risk fac-

people with existing heart conditions, cancer treat-

tors and the prevention of cardiovascular disease.

ment can present some additional challenges.

The same cannot be said of data about cancer

“When a patient gets a cancer diagnosis, it’s

treatments and their effects on the heart. That’s

important that they get first line treatment. You

because people with heart conditions are tradition-

can’t just say “this chemo has cardiac implications,

ally excluded from cancer clinical trials and people

let’s just switch.’” says Kondapalli. “I explain to the

with cancer are excluded from cardiac studies.

patient how we may be able to balance the risk and

Enter Lavanya Kondapalli, MD.

overall benefit because we want people to get the

Kondapalli, an investigator with University of Colorado Cancer Center, grew up in Cleveland the

best treatment they can.”

Chemotherapies that have been around for

daughter of a pulmonologist and a stay at home

decades aren’t the only treatments with side-

mom where ambition was not in short supply.

effects. Newer targeted cancer agents have

“I have wanted to be a doctor for as long as I can

direct cardiac side effects because they target the

remember,” Kondapalli says.

vasculature of a tumor and blood vessels. The side

She did her undergraduate studies at Harvard

effects are manageable but Kondapalli says they

LAVANYA KONDAPALLI, MD

and moved on to the University of Chicago for

are the reason oncologists and cardiologists need

Investigator, University of Colorado

medical school and residency.

one another.

Cancer Center

“I was doing a surgical rotation during medical

Kondapalli came to University of Colorado

school and I remember getting out of my car really

School of Medicine to help remedy the lack of data

early in the morning and I was so relieved that I

and to University of Colorado Hospital to build the

really liked what I was doing,” says Kondapalli with

cardio-oncology program. The goal is to create a

a laugh. “I love what I do. I love that I get to help

registry that follows patients long-term and gathers

people every day.”

information years after treatment. That may help

She chose cardiology as a specialty and while Kondapalli loved living in Chicago, she headed to University of Pennsylvania for fellowship.

“There are certain treatments we know are react to them,” says Kondapalli. “We are working

Kondapalli was drawn to cardiology because of the

on predictive tests but there’s not enough data.”

abundance of data. She does, however, see the

The data, or lack of it, also drives Kondapalli

irony in the fact that in her chosen sub-specialty,

when it comes to helping people who are years out

cardio-oncology, data is scarce. With the goal of

from their diagnosis, whether they had cancer as a

helping to change that, Kondapalli entered the clini-

child or an adult. survive,” says Kondapalli. “Close to ninety percent

in an emerging aspect of oncology care.

of breast cancer patients are alive at five years. We

While the heart is forgiving and it can heal, many people with cancer find the treatments aren’t so forgiving. Some chemotherapies and radiation

Director, Cardio-Oncology, University of Colorado Hospital

“I never want to see someone’s cardiac history prevent the treatment that the oncologist thinks is best for them.”

—lavanya kondapalli, md

“Over eighty percent of children who get cancer

its kind in the country. Now, Kondapalli is an expert “It’s an exciting time to be in oncology,” says

University of Colorado School of Medicine

those issues may surface.

I T ’ S A L L A B O U T T H E DATA

Kondapalli.

Department of Cardiology,

physicians know what issues to look for and when

cardiotoxic but we don’t know in advance who will

cal cardio-oncology fellowship at Penn, the first of

Assistant Professor of Medicine,

don’t have guidelines for what we should be doing to protect the cardiac health of these women in the long term.

“I never want to see someone’s cardiac history prevent the treatment that the oncologist thinks is best for them.”

11 C3: WINTER 2015

T RE VR ME RC H ANT

‘I HAVE A F UTU R E AGAI N’ A new drug opens new horizons for mother of three, Nichol Miller

T

ears stream from behind Nichol Miller’s glasses as she studies the latest CAT scan of her torso. Where just four months ago tumors covered both lungs, now only a few tiny dots appear.

“It’s a dramatic change,” Robert Doebele, MD, PhD, assistant professor of medicine, CU School of Medicine, says to his patient, who wears a beaming smile.

Miller, a 42-year-old wife and mother of three, has grown accustomed to seeing improvement during her monthly visits to the University of Colorado Cancer Center, but this scan is especially stunning. “Ah, that’s music to my ears. ... Dramatic is such an understatement,” she says, reaching for a tissue. “There needs to be a bigger word for the transformation of me (in March) and me now. I kind of always sit around waiting for the other shoe to drop — is it going to continue to work? We’re in uncharted waters.”

12

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BY C H R I STO P H E R CAS EY

Miller is one of the first patients in a clinical trial of LOXO-101, a targeted-therapy drug developed in a short period of time — just three years — through the work of Doebele and his research team at the CU Cancer Center. The drug inhibits a gene, NTRK1 (neurotrophic tyrosine kinase receptor), that, by fusing to a different gene, results in a mutation that causes tumors.

So far, in Miller’s case, the results couldn’t be much better.

From week one, Miller has shown improvement on the drug; she currently takes the pill orally twice a day. Just like the shrinking tumors in her lungs, Doebele says, tumor markers in her blood continue to show dramatic declines. Miller updates Doebele on her recent activity: She walked six miles in a Relay-for-Life event and enjoyed a camping trip with her family.

“I walked all over — never felt out of breath.”

As Doebele elaborates on the test results, Miller’s eyes well up again. “It’s amazing. It’s given me back my future,” she says.

“I have three kids. They’re young — 14, 12 and 10. They need their mom; I need them. I wasn’t ready to be done.”

‘GAV E M E H O P E’ Early last March, Miller and her husband drove from their home in Portland, Ore., to Aurora. Miller knew she was dying: Her lungs were filled with tumors, pain radiated through her chest, and breathing was almost impossible without five liters of oxygen a minute.

Her cancer is a metastatic sarcoma that originated in her hip-flexor muscle. She underwent chemotherapy and was to also undergo radiation therapy. But radiation was not an option because too much tissue in vital organs — her small and large intestines — would be destroyed trying to reach the large tumor.

The tumor was surgically removed at Oregon Health & Science University in December 2014, but soon it was discovered that the cancer had spread.

Lara Davis, MD, an oncologist at OHSU, recommended that Miller participate in the clinical trial at the CU Cancer Center.

“Coming here was our hail Mary,” Miller said. “Everyone here — doctors, nurses, the entire staff — has been amazing. Through the whole process they gave me hope.”

As test results kept coming out positive, it dawned on Miller that she could start to make plans again with friends and family.

“I can make plans for two, three years down the road, it feels like,” she said. “It’s not the inevitable like it was in March.”

patient gave Doebele a sample of her tumor to grow an immortal cell line that could be used for further research and to test drugs against this type of cancer.

In a broad search of hundreds of potential oncogenes his team found the abnormal gene NTRK1 in her cancer. “That really accelerated the development of drugs that can treat this type of tumor, because that was the initial proof we needed to convince companies to pursue these drugs in clinical trials,” Doebele said. “We’re really grateful that this patient’s allowance to use her cells has really helped another young mother treat her cancer better, and hopefully will help many, many patients in the future.”

A local pharmaceutical company — Array Biopharma in Boulder — produced a drug that showed promise in blocking the activity of this gene. Loxo Oncology, Inc., subsequently acquired the license to conduct clinical trials using the drug; the trial began in 2014, with the CU Cancer Center being the closest trial site to Miller’s home in the Pacific Northwest.

Targeted cancer therapies give physicians confidence of their effectiveness, while offering the added benefit of reduced side effects, Doebele said. “We’re actually matching the drug to the patient’s tumor, and when we use this strategy, we can expect that patients have probably a 60 to 70 percent chance of a dramatic tumor shrinkage and probably about a 90 percent chance of having control of their tumor in some ways,” he says. “Whereas with chemotherapy, the percentages range from 10 to 20 to 40 percent at most.”

TREVR MERCHAN T

‘TH E Y N E E D TH E I R M O M ’

A M OT H E R ’ S LE GACY TO AN OTH E R The medical journey that has given Miller hope actually began three years ago.

In 2012, Doebele was treating a 46-year-old never-smoker who had metastatic lung cancer. Unfortunately, at the time, there were no drugs available or even in clinical trials that could treat the patient, also a mother of three children. Before she died, the

Bearer of good news, Robert Doebele, MD, PhD, assistant professor of medicine, CU School of Medicine, with Nichol.

13 C3: WINTER 2015

T RE VR ME RC H ANT

Miller’s lungs show a remarkable improvement since she started the clinical trial of LOXO-101, a targeted-therapy drug, earlier this year.

Doebele said other patients with the NTRK1 gene are starting to enroll in the clinical trial (clinicaltrials.gov NCT02122913).

He is hopeful that within a couple years the current clinical trial of LOXO-101 will lead to a drug physicians can prescribe.

G E N E T I C TE STI N G I S C R ITI CAL Miller underwent extensive genetic testing which allowed physicians to identify the abnormal gene in her tumor. The NTRK1 mutation occurs in a small percentage many different cancers, Doebele said.

“It speaks to the issue of the importance of getting broad genetic testing because it may be that a sarcoma, lung or breast cancer — or any type of cancer — can probably have this type of alteration. And we won’t know unless we’re testing,” he said.

“The old paradigm was that a mutation in a particular gene would only happen in one type of cancer, but that’s not really true anymore.”

Through it all — including the grim period just four months ago — Miller has maintained a positive outlook. “I believe being positive has a lot to do with how things pan out.” She now has her sights on taking her children to Disneyland, traveling to see family members in the Midwest, and going on a cruise with her husband to celebrate their 15th wedding anniversary next year.

“We never had a honeymoon.”

Also high on the list is a plan to finish her training become a licensed lactation consultant.

Do you have an inspirational story? Tell your story at http://story.coloradocancercenter.org or contact Garth.Sundem@ucdenver.edu.

14 WWW.COLORADOCANCERCENTER.ORG

‘ I HAV E A F UTU R E’ Miller is currently enjoying relatively smooth sailing — albeit in the “uncharted waters” of a clinical trial. Doebele says solid tumors remain difficult to cure unless they are caught at a very early stage. Long-term control of these types of cancers is becoming increasingly feasible through multi-drug treatments.

“This is a rapidly emerging field that allows us to test patients’ tumors and perhaps identify this gene or other genes that may allow them either FDA-approved therapies or clinical trials that are very likely to help them control their cancer,” Doebele says.

“I think a lot of us think about HIV as a model. Although we’re not typically curing HIV with multi-drug regimens, we are controlling it for decades so that people can live a relatively normal life. So I think that might be a closer goal.”

After her most recent clinical update, an elated Miller steps into a CU Cancer Center hallway to call family members with the good news. She tells her ecstatic husband about the tumors that are now barely visible on the CAT scan. “They’re like specks,” she says.

As the dots shrink in her lungs, Miller sees more life unfolding on her horizon. “It was during these last couple months when we started to see this dramatic change — this amazing change — that’s when it really hit home: I have a future again.”

ST RY INSIDE

Discovery Timeline for a Promising Cancer Drug Developing a drug, testing it in the lab and then for safety and efficacy in humans can take years and cost approximately $800 million. Since acquiring rights to the drug candidate from Array just two years ago, Loxo has moved LOXO-101 through preclinical development, initiated the first human clinical trials and treated a patient with TRK fusion cancer who achieved a dramatic response.

D I S C OV E R I N G TH E TR K O N C O G E N E

1982–1986

The TRK oncogene initially discovered in colon cancer

1982–2012 TRK translocations identified in thyroid and breast cancers 2013–2014 Next-generation sequencing finds TRK fusions in lung cancer and at least 10 other tumor types

1980

82

86

1990

2000

2010

12 13 14

2020

D EV E LO P I N G TAR G ETE D TR EATM E NT October 2012 Patient with lung cancer donates NTRK cells, immortal cell line created

October 2013 NTRK1 proven to cause a subset of lung cancers Compound identified to kill NTRK cancer cells in the lab

2012

OCT

2013

OCT

2014

May 2014 Compound begins testing in human clinical trial

MAY

March 2015 Patient with NTRK driven sarcoma enrolls in trial and has dramatic response

2015 MAR

2016

Watch the video to learn more about CU Cancer Center clinical trials. Visit www.coloradocancercenter.org and click “Clinical Trials”

15 C3: WINTER 2015

BY TAY L O R B A K E M EY E R

THE DILEMMA OF

BREAST CANCER

I

CASEY CASS

magine your annual screening shows a lump – not the big lump of an invasive breast cancer, but a less-than-pea-sized mass of ductal carcinoma in situ (DCIS), aka stage 0 breast cancer. Your doctor tells you that it’s harmless right now but has the potential to turn into something more serious down the line. Of course, your first thought is to get it out – further testing, surgery, radiation, targeted therapy...the whole nine yards. But treatment carries significant health risks. With all of this in mind, what are your next steps?

All of a sudden a simple answer looks a lot more complex.

In fact, when we asked women on the 6th floor of Building 500 here at the University of Colorado Cancer Center what they would do in this situation, some thought they would choose to have the precancerous lump out as soon as possible, no matter what treatments they had to endure, others wanted to “watchfully wait” in hopes of avoiding unnecessary treatment, and others felt they didn’t know enough to have an opinion either way. Clearly the next steps after a stage 0 diagnosis are far from black and white.

DC IS: WH AT YOU SH OU LD K N OW According to the American Cancer Society about 60,000 cases of DCIS are diagnosed each year in the United States, accounting for about one out of every five new breast cancer diagnoses.

“In DCIS, the cancer cells arise from women’s ducts, but haven’t yet penetrated through the basement membrane of the duct to become invasive,” explains Wei Shin Wang, MD, a breast-imaging director at the CU Cancer Center.”

Currently the standard is to treat all patients diagnosed with DCIS regardless of their risk of developing invasive breast cancer, which tends to include “lumpectomy, radiation and chemo depending on the type of cancer cells found,” explains Wang.

However, a twenty-year study recently published in JAMA Oncology found that women diagnosed with DCIS had a 3.3 percent chance of dying of breast cancer. This is about the same as an average woman’s chance of dying of the disease without a DCIS diagnosis. In other words, diagnosis or not, treated or not, the risk of dying of breast cancer is unchanged.

“The problem is we do not yet have the tools to tell us which cancers are going to progress,” says Betsy Risendal, PhD, assistant research professor at the CU Cancer Center. Mammograms, which account for 80 percent of DCIS diagnoses, cannot determine if the abnormal cells in the ducts will actually turn into cancer.

“We need to focus on determining who is truly at high risk for developing breast cancer. We can do this by continuing to study mutations and oncogenes,” says Risendal. “If we can figure out which changes will turn into cancer it will help to determine who will benefit from treatment after a DCIS diagnosis.”

TO TREAT OR NOT TO TREAT: HOW GENETIC TESTING MAY I N F L U E N C E YOU R DEC ISION Treating stage 0 breast cancer may offer peace of mind, but treatment carries risk. Have you decided what you would do?

Another factor may be your personal risk for breast cancer.

Do you have a high prevalence of the disease in your family?

Do you have genetic predisposition to the disease?

“For women who are diagnosed with DCIS at age 45 or younger, the National Comprehensive Cancer Network (NCCN) guidelines recommend that they seek genetic counseling,” Betsy Risendal, PhD, assistant research professor, CU Cancer Center

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D CIS O N T H E M I ND So far we’ve been talking about your body: Does treating DCIS do more harm or more good in the long run? But your body isn’t the only part of you affected by a cancer diagnosis.

“A DCIS diagnosis can be very distressing because of the ‘what if’ mentality patients may have,” says Kristin Kilbourn, PhD, health psychologist at the University of Colorado at Denver.

“Questions such as ‘what if it progresses to be invasive cancer?’ or ‘what if exposure to unnecessary radiation and chemotherapy affect me later on?’ may overwhelm the patient. Women should feel comfortable expressing their concerns with their doctor and finding a professional, such as a social worker or psychologist, who can help them manage their anxiety while deciding what their next course of action will be.”

In other words, a DCIS diagnosis can be distressing and distress is its own, very real factor to take into account when choosing to treat or not treat stage 0 breast cancer. If you have DCIS, can you live with it or will it keep you up at night? In the same situation, would it create more stress than it’s worth to introduce treatments like surgery, radiation and anti-estrogen therapy into your body? Irrespective of what’s “right” and “wrong” from a purely medical perspective, each woman will have to make her own decision, respecting how her choice will affect her mental wellbeing, with consultation from her doctor.

columnist for the Washington Post. She has decided to opt out of mammograms.

“Studies have shown that mammograms are not as helpful as originally thought to be,” Aschwanden explains. “If mammography worked as promised, then every cancer found early by a mammogram would correspond to one less cancer found in an advanced stage. But that’s not what’s happened. The number of women with metastatic breast cancer has remained fairly flat, despite a huge increase in the number of early cancers being detected.”

In other words, there’s a paradox: If mammography catches dangerous cancers early, then we should see fewer dangerous cancers detected late. However, as rates of mammography and treatment for early cancers have gone up, we’ve seen no corresponding drop in the diagnosis of late-stage breast cancers. How can that be? One answer is that perhaps the early cancers found by mammography aren’t the ones that turn into dangerous, invasive disease. Maybe the early breast cancers we’re detecting and treating don’t require detection and treatment after all?

At the beginning of this article you were asked “what would you do with a stage 0 breast cancer diagnosis?” The answer, of course, is that you should do the right thing. But what is that right thing? Is it treating the cancer aggressively as soon as possible, or is it watchfully waiting to see if the early cancer becomes a relevant health problem? The real answer is that to the best of our knowledge, there is no universal answer. The best course of action comes down to age, genetics, family history, tumor type, and factors of mental wellbeing that make the “right thing” unique for each individual woman.

CASEY CASS

explains Michelle Springer, Instructor and Certified Genetic Counselor at the CU Cancer Center.

“If a woman discovers that she does carry a mutation in a gene that increases the risk of developing cancer, such as BRCA1 or BRCA2, she may choose a more preventative or aggressive approach when it comes to her treatment,” says Springer. “On the other hand, having an uninformative (negative) result may influence her decision-making as well. We have found that it really depends on the woman as an individual.”

M AM M O G RA M S AND DCI S With all this confusion and controversy, maybe a better question than what you would do if you were diagnosed with DCIS is whether you would want the chance of being diagnosed at all.

The standard way to screen for breast cancer in the United States is through mammography, as well as clinical breast exams.

Mammograms are an X-ray of the breast used to identify and diagnose abnormal areas that may indicate the presence of cancer.

In many cases, DCIS shows up as a dark area on the scans.

“In an ideal world mammograms would be able to distinguish between cancers that are harmful and cancers that are not going to progress into anything,” says Nicole Kounalakis, MD, surgical oncologist at the CU Cancer Center. “At this time they can only show us abnormalities in the breasts.”

Christie Aschwanden is the lead writer for science at FiveThirtyEight, a statistical analysis website, and a health

Michelle Springer, instructor and certified genetic counselor, CU Cancer Center

17 C3: WINTER 2015

S U P P O R T E R

F CUS

Seeing Diagnosis from Both Sides AFTE R S E E I NG CANCE R U P CLOS E LE S LI E CAPI N, M D, GIVE S BACK

BY TAY L O R B A K E M EY E R One week before speaking with this magazine,

Capin’s involvement with the University of

Leslie Capin, MD, lost her sister to cervical sarcoma.

Colorado Cancer Center started when she moved

By the time her sister was diagnosed the disease

to Colorado from Arizona to attend medical school

had metastasized. Eleven days later she was gone.

at the University of Colorado School of Medicine.

“My sister’s passing proves that gynecologic

“I fell in love with not only my spouse but also

cancers can be very silent, and that’s what makes

the mountains, the fishing, and everything about

them so scary,” says Capin.

the state,” says Capin. “It didn’t take too much

This was not Capin’s first experience with gynecologic cancer. In fact it was her third. Tragically

time to make it my home.”

the University of Colorado Cancer Center would be as good or better than anywhere else.”

Goldstein also contacted her sister, a professor of pediatrics at the Rochester School of Medicine, to ask the same question. Her sister also advised her to stay in Colorado.

“It was the best decision I ever made,” says Goldstein.

Soon after she started her practice, Capin met

Now both Capin and Goldstein hope to support

her aunt passed away from ovarian cancer after a

Carol Goldstein. They have forged a close friend-

the next generation of gynecologic cancer scientists

late diagnosis a few years ago. Shortly after that,

ship over many years. In 2012 Goldstein was

by funding the gynecologic oncology fellowship

Capin’s very good friend Carol Goldstein, RN, PhD,

diagnosed with ovarian cancer.

endowment at the CU Cancer Center.

was also diagnosed with the same cancer.

Capin has seen cancer from both sides of the

“Even as a PhD nurse I overlooked symptoms

“Carol is very involved in the gynecologic cancer

of ovarian cancer,” Goldstein explains. “I was

program at CU and she introduced me to it,” says

diagnosis. As a dermatologist, she had treated the

treated for abdominal discomfort for almost a year

Capin. “I was immediately inspired by what is

disease as it appears on the skin. As someone who

before an ultrasound confirmed I had cancer.”

happening in the program – it is truly leading the

has lost loved ones to cancer, she is very familiar

As soon as she was diagnosed, Goldstein

way in gynecologic cancer care and the fellowship

with the pain and heartbreak that comes with a

contacted her brother, a professor of medicine at

program ensures that more physicians will special-

diagnosis.

Baylor University, who has many contacts in the

ize in the field.”

“It is such a terrible disease that has touched me in so many ways. I knew I had to get involved somehow,” says Capin.

community of cancer treatment.

Kian Behbakht, MD, is the director of the

“I asked where I should go for treatment,” says Goldstein. “He told me that the care I would get at

gynecologic oncology fellowship program.

“The fellowship program trains physicians to do

COURTES Y OF LESLIE CAPIN

what we do,” explains Behbakht. “We recognized about five years ago that there are few people that specialize in gynecologic oncology in the Rocky Mountain Region. Because of that we decided to ask if we could start the fellowship program here at the CU Cancer Center and were honored to be selected as a training location.”

The gynecologic oncology fellowship is a three year, highly involved program. Fellows receive the country’s best training and education alongside some of the most renowned oncologists in the world. Not only do they focus on the latest research in gynecological oncology but also learn to incorporate affiliated therapies such as cancer nutrition, genetic counseling, and complementary and alternative medicine. They are immersed in all aspects of gynecologic oncology to ensure that patients receive the highest level of care possible.

“If I am going to fund something it has to be something that I believe in,” says Capin. “I believe that if we can train more fellows there will be better

Leslie Capin, MD (far right) teamed up with Kian Behbakht, MD, and cancer survivor Carol Goldstein, PhD, to support the gynecologic oncology fellowship program.

education, better treatment, and more awareness about the silent killer that is gynecologic cancer.

It is really a win-win for everyone involved.”

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C O M M U N I T Y

N E W S

GOLFERS AGAINST CANCER EVENT RAISES $140K FOR RESEARCH AT CUCC C OURT E SY OF GOLFE RS AGAINST C ANC E R

Golfers gathered at the Pinehurst Country Club in C OURT E SY OF WINGS OF H OPE

July 2015 to tee off and support cancer research at the University of Colorado Cancer Center at the seventh annual Golfers Against Cancer tournament and gala. Golfers Against Cancer is a national organization founded in 1997 by a group of Houston golfers who lost two close friends to cancer. The Denver chapter of Golfers Against Cancer was founded by Scott Pearson.

A spectacular gala kicked off the two day event on July 26. Guests were able to participate in both a PANCREATIC CANCER RESEARCH AT

silent and live auction while listening to the tunes of

UNIVERSITY OF COLORADO GETS A

Steve Azar. There were numerous live auction items

LIFT FROM WINGS OF HOPE

such as an Avalanche Suite, a Masters flag autographed by Jordan Spieth, a trip to Hawaii, and trip to

Wings of Hope for Pancreatic Cancer Research

Scotland to name a few. There was also a silent auction with many other prizes. The next morning golfers

is relatively new in the crowded world of nonprofit

took to the green early for the tournament.

“We are thrilled to announce that we exceeded our goal of $125,000 by raising just over $140,000

organizations, but is already making an impact by creating the first endowed fund for pancreatic

between both events,” says Pearson. “The board will be meeting with the researchers in the next couple

cancer research at the University of Colorado. To

of weeks to hear their presentations and then select the projects that will receive the money.”

date, Wings of Hope has contributed more than moving forward. The most recent donation of $95,000 was made April 10, 2015.

“While Wings of Hope will always be my personal tribute to my brother and mother, the effort is truly for every pancreatic cancer patient, their families and friends, in the hope that the

DINNER IN WHITE STEALS THE SHOW IN DENVER On August 8 more than 300

COURTESY OF DINNER IN WHITE

$150,000 to keep pancreatic cancer research

people dressed in their best white attire came together to support the University of Colorado Cancer Center at the 2015 Dinner in White.

Dinner in White is an awarenessbuilding event benefiting the CU

ongoing research taking place at the University

Cancer Center and created for a

of Colorado Cancer Center will lead to early

new generation of people concerned

diagnostic methods, more effective treatments

about cancer care. Utilizing social

and ultimately a cure,” says Maureen Shul,

media and word of mouth to spread

founder of Wings of Hope.

the message, guests must be “in the know” to attend. The location is not revealed until an hour before the event starts, which ticket holders find out via social media and email.

UPCOMING EVENTS •

The highlight of the night was an intimate speech by Joel Sartore, renowned National Geographic

January?: Let’s Knockout Cancer Gala

photographer and CBS Sunday Morning contributor, who shared personal stories about his family’s trials,

http://knockoutcancergala.org.

triumphs and hopes in facing cancer.

May?: Gift of Life and Breath

This year’s Dinner in White brought the highest level of attendance than any previous event. That is good

http://giftoflifeandbreath.com.

news for its ultimate goal- to raise awareness of the research at the CU Cancer Center.

COURTESY OF HEID I S KIBA

•

“The CU Cancer Center is such a valuable asset in our community and Dinner in White is an excellent way to introduce a different audience to the important work happening at the CU Cancer Center,” says Weygandt, the chair of Dinner in White.

2015 UNDY 5000 HUGE SUCCESS Whether it was the giant inflatable colon or massive boxers a whole team could fit into, passersby could not miss this year’s Undy 5000. More than 1000 runners, walkers, and furry friends sported blue and yellow undies for a good cause on June 27, 2015 at City Park in Denver.

The Undy 5000 supports the University of Colorado Cancer Center’s Colorado Colorectal Cancer Screening Program (CCSP). The program provides underserved Coloradans colonoscopies at a low cost, in partnership with community clinics and community gastroenterologists.

“We had a great turn-out for the race, with about 40 participants supporting the University of Colorado Cancer Center/University of Colorado Hospital Team!” says Lindsey Davis, MD, assistant professor of medical oncology and team captain. “It was a great way to raise awareness for colorectal cancer and to support the important programs provided by the Colon Cancer Alliance.”

19 C3: WINTER 2015

UNIVERSITY OF COLORADO DENVER

WI NTER 2015

13001 EAST 17TH PLACE, MSF434 AURORA, CO 80045-0511

www.coloradocancercenter.org

Non-profit organization U.S. POSTAGE PAID Denver, CO Permit No. 831

R ET U R N S E RV I C E R E Q U E ST E D

C3: Collaborating to Conquer Cancer Published twice a year by University of Colorado Denver for friends, members and the community of the University of Colorado Cancer Center.

(No research money has been used for this publication.)

Editor: Garth Sundem | 303-724-6441 | garth.sundem@ucdenver.edu Contributing Writers: Taylor Bakemeyer, Erika Matich Photos: Casey Cass The CU Cancer Center Consortium Members UNIVERSITIES

Colorado State University University of Colorado Boulder University of Colorado Denver INSTI TUTIONS

University of Colorado Hospital Children’s Hospital Colorado Denver Veterans Affairs Medical Center Visit us on the web: www.coloradocancercenter.org The CU Cancer Center is dedicated to equal opportunity and access in all aspects of employment and patient care.

T H E

CU Cancer Center hosts patient-researcher sitdowns at the World Lung Conference

M E S S A G E

the International Association for the Study of Lung Cancer

I

research that comes from the laboratories in our research build-

(IASLC). More than 7,000 delegates from over 100 countries

ings forms the basis of drugs that are designed by researchers in

attended the nearly week-long meeting to learn about and

the School of Pharmacy, which in turn are tested in clinical trials

share their discoveries in the understanding and treatment of

that we offer through our hospitals in the University Health system.

n September, Denver hosted the 16th Annual Meeting of

At the CU Cancer Center, this is what we do. The basic

the disease. In the past, the meeting has been held in Sydney, Amsterdam, Seoul, Barcelona and more, but this summer was a homecoming: The first director of our Cancer Center, Paul Bunn, Jr., founded the IASLC and CU Cancer Center researcher Fred Hirsch, MD, PhD, is the organization’s current CEO. In Denver, CU Cancer Center researchers not only presented our latest find-

FROM THE DIRECTOR DAN THEODORESCU, MD, PhD

ings, but took leadership roles, acting as discussants for panels and volunteering their times on organizing committees.

As part of the World Lung Conference, the CU Cancer Center hosted a small event where our doctors and researchers had

“Two years or ten years from now, or maybe tomorrow afternoon, a discovery in one of our labs could point the way to a new treatment for lung cancer or one of the hundreds of other cancers and cancer subtypes that we study and treat here.”

a chance to meet face-to-face with patients and patient-advocates. One of these patients was a young man from Boston who

Despite recent advances in prevention and treatment, lung

had booked a last-minute flight to Denver on the Saturday before

cancer remains the biggest cancer killer, worldwide. The young

the conference after hearing on social media that the confer-

gentleman at our event has a difficult road ahead of him. This is

ence was “patient-friendly.” At our event, he was able to sit at a

why with your help we continue the tradition of Paul Bunn and

two-person table with Dr. Ross Camidge, MD, PhD, CU Cancer

Fred Hirsch and Ross Camidge. Two years or ten years from now,

Center investigator and one of the world’s leading authorities on

or maybe tomorrow afternoon, a discovery in one of our labs

targeted treatments for non-small cell lung cancer. Dr. Camidge

could point the way to a new treatment for lung cancer or one

was instrumental in researching and testing the drug crizotinib,

of the hundreds of other cancers and cancer subtypes that we

which targets ALK-positive lung cancer and continues to test

study and treat here at the CU Cancer Center.

drugs against lung cancers defined by their genetic abnormali-

Even beyond the collaborations that turn basic biology into

ties. At this informal get-together, Dr. Camidge spent at least

new medicines, with your help we will continue to connect

half an hour with this young patient.

compassionate experts with patients – and patients with hope.

20

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