Hirshberg Foundation 2011 Spring Newsletter

HIRSHBERG FOUNDATION FOR PANCREATIC CANCER RESEARCH Foundation Newsletter 2011

What a year it has been for advancing pancreatic cancer research! Many of you have noticed the number of news releases in 2010 on our website and in main stream media. Change is happening and I am most proud of this issue that you are about to read.

The pages begin with our 7th Symposium, held at UCLA. New to our program this year were speakers from the FDA and the pharmaceutical industry, which I must say, completed the total picture towards the road to a cure.

Lively discussions among our speakers were challenging, motivating and energizing to patients and scientists alike. The difficulty of getting clinical trials started due to unknown toxicity, caused my friend with pancreatic cancer to stand up and say, “My options for treatments have now been exhausted, please ask me to be the mouse you need to test.” The shock of these words is the frightening reality of the good people living with pancreatic cancer. I can tell you honestly that there were no dry eyes in the audience.

It is difficult to talk about advances in research when the cure is not in our hands today, this very hour and this very minute… but the progress we are making is so encouraging.

I learned this year that pancreatic cancer is not a fast growing cancer that appears at late stage 4, but in fact, takes fifteen to twenty years to develop. With this extra time patients of the future will not have to race against time, will be detected early and will live healthy lives. Time gives us an opportunity to develop accurate early detection tests and early diagnosis can be the cure for pancreatic cancer. To take advantage of this extra time, we need research and research requires money. We know that private money will be the engine that drives research, just like it has with breast, colon and prostate cancers. We need your help this time, to fund pancreatic cancer research and help our family and friends just in time.

In addition to the research recaps within these pages, you’ll see highlights of our work at the foundation. We meet so many wonderful families who join our fundraising efforts, adding their own passions and energy to the cause. Please take time and read what your friends and fellow supporters are making happen today.

Pancreatic cancer is relentless, but fortunately, so are we.

Agi Hirshberg Founder and CEO

Agi with our special guests: Howard Kayton, Janet Ito, Virginia Elderkin-Thompson, Linda Pinson, Charlotte Rae, Michelle Hackbarth, Irene Lainer

Foundation Mission statement

To find a cure for pancreatic cancer in honor of Ron Hirshberg and the thousands of people who are diagnosed with this disease each year.

To create a premier Pancreatic Cancer Center where all needs of pancreatic cancer patients can be met in one location with the most advanced treatment options.

To be recognized as a patient support reference source for pancreatic cancer patients and their families.

To fund new projects and programs designed to improve patient care, treatment and, ultimately, pancreatic cancer survival rates.

To integrate and unite generations, young and old, through physical fitness participation, while creating public awareness and raising money to find a cure for pancreatic cancer.

DIRECTORS & Trustees Agi Hirshberg, President & Founder Lisa Manheim, Director Jon Hirshberg, Trustee Michael Berliner, Trustee

Our Foundation Team Keeps Growing

Join us as we welcome Karen Affinito to the Hirshberg Foundation team. As a successful development executive in nonprofit communities, Karen brings her experience in building fund solutions to her Director of Development position. Her goal is to increase funds and support, to advance our mission for pancreatic cancer research and patient care. No stranger to cancer diagnosis, her sister was diagnosed with intestinal cancer in 2000. Karen’s personal mission is to help fund successful pancreatic cancer research so that patients and their families can live their best life possible.

Known for her work across a diverse community, Karen looks forward to meeting Foundation supporters and joining in our relentless and passionate efforts for pancreatic cancer patients and families; phone 310-473-5121 or kaffinito@pancreatic.org.

Also joining our team this past year is Elaine Reber, our new Director of Technology. Elaine comes to us from Cal Tech where she was director of the administrative systems. Also, she was Director of Computing at UCLA School of Medicine where she created the fiber optic backbone for all of the departments in the school.

Our Team Captain Coordinator Shay Downey is currently in New Zealand and will return this summer to continue her vital role in the LACC. In her absence, we welcomed two new interns from UCLA, Nicole DeMartinis and Claire Josephson.

Karen, Elaine, Claire and Nicole are joined in the office by Elissa Oblath, our operations coordinator, Allison Miller, who handles Patient & Family Support, along with Agi Hirshberg and Lisa Manheim. We are a small but mighty team and look forward to speaking with you.

Stephen C. Prince, CPA Michael Scott, LLP

SCIENTIFIC ADVISORY BOARD Vay Liang W. Go, MD, Chair Laszlo G. Boros, MD Murray Korc, MD Laurence J. Miller, MD Stephen J. Pandol, MD Howard A. Reber, MD Lee S. Rosen, MD Diane M. Simeone, MD

UCLA Center for Pancreatic Diseases hosts Nobel Prize Winner Nobel Prize Winner Dr. James Watson, 82, one of the pioneering researchers who discovered the structure of DNA, was the guest lecturer, hosted by The UCLA Center for Pancreatic Diseases. Dr. Howard Reber, Director of Ronald S. Hirshberg Translational Pancreatic Cancer Research Laboratory , introduced the famed scientist to an enthusiastic audience on campus. Watson spoke about the early 70’s War on Cancer, and felt that not enough was known about cancer then. In his lecture he said, “We should stop our total preoccupation with learning about cancer to actually having as our main focus curing cancer. … I don’t think we have to wait much longer. “ He added, “We might actually be able to show that we can cure most cancers over the next 10 years.”

back row (left to right): Hideyuki Ishiguro, Stephanie Esquivel, Mura Assifi, Barbara Clerkin, Diane Harris, Monica Chen, Hung Pham, Agi Hirshberg, Howard Reber front row (left to right): Dr’s Steve Pandol, Richard Waldron, David Dawson, James Watson, Ilya Gukovsky, Bill Go, Guido Eibl, Anna Gukovskaya, Joe Hines, Tim Donahue

Agi Hirshberg Honored With Help & Hope Award at Gotham Hall in New York City

For the last 14 years, “You can hope or you can help” has been the trademark of the Hirshberg Foundation for Pancreatic Cancer Research and the driving force for Founder, Agi Hirshberg. Agi accepted the 2011 Help & Hope Award that recognized the foundation for its innovative research that focuses on causes, diagnosis, treatment and prevention of pancreatic cancer and its long-standing support of the CancerCare Financial Assistance Program. In 2010, the foundation helped 270 patients from 42 states through their CancerCare partnership. The Award was presented at the annual Partnerships in Hope Awards Dinner held on February 24th at Gotham Hall in New York City.

Known for her many accomplishments, Agi’s relentless efforts of bringing awareness and education to the public’s eye were recognized by her peers. “I’m truly honored to have received the Help & Hope Award on behalf of the Hirshberg Foundation, “said Hirshberg. “It’s not about me, but about the (from left to right), CancerCare CEO Helen Miller, Host S. Epatha Merkerson, dedicated efforts that the foundation’s supporters, researchers Agi Hirshberg, Lisa Manheim and volunteers have demonstrated and I’m proud to head up an organization with such devotion. We are all partners in finding a cure for pancreatic cancer. ‘You can hope or you can help’ is not only our slogan, it’s our mantra. We choose to help!”

Sponsored by CancerCare (www.CancerCare.org), a national nonprofit organization that provides free, professional support services for anyone affected by cancer, the Help & Hope Award recognizes Agi as an outstanding industry and advocacy leader who has improved the lives of people with pancreatic cancer and their loved ones.

UCLA-Hirshberg Laboratory Updates Active Research at the Hirshberg Translational Pancreatic Cancer Research Laboratory at UCLA Howard A. Reber, MD Director Two of the active projects are funded by the NCCAM and are part of the UCLA Center for Excellence in Pancreatic Diseases (Principle Investigator Vay Liang W. Go, MD).

Their purpose is to determine the effects of Scutellaria

Another project involves detailed studies of the signaling mechanisms of PGE2. It is known that overexpression of cyclooxygenase-2 (COX-2) and prostaglandins E2 (PGE2) is linked to the development and progression of pancreatic cancers. We reported earlier that PGE2 increased cell proliferation in pancreatic cancer. However, the molecular mechanism of PGE2-induced cell proliferation is unknown. We have first assessed the expression of COX-2, PGE2, and PGE2 receptors (EP1, EP2, EP3, EP4) in pancreas cancer cell lines. Next, we are planning to assess the effect on pancreas cancer cell lines through the inhibition of COX-2 and PGE2 and PGE2 receptor expression.

A project titled “Vitamin D3 Induces 15-Hydroxyprostaglandin Dehydrogenase to Suppress Pancreatic Cancer Cell Proliferation,” focused on up-regulating the tumor suppressor 15-hydroxyprostaglandin dehydrogenase (PGDH) expression in pancreatic cancer. We found previously that pancreatic cancer exhibited diminished levels of PGDH expression. PGDH expression has been (left to right): Mura Assif, Stephanie Esquivel, Hideyuki Ishiguro, Monica Chen, Guido Eibl reportedly up-regulated by vitamin D3 (VD3) in Baicalensis (SB), a traditional Chinese and Japanese mediprostate cancer cells but has not been confirmed in pancrecine, and certain SB polyphenols (wogonin, baicalin, and atic cancer cells. Our results demonstrated that pancreatic baicalein) on pancreatic cancer cell proliferation and death. cancer cells expressing vitamin D receptors responded to Since Prostaglandin E2 (PGE2) synthesis is a key inflamVD3 treatment and that the response to VD3 correlated matory process linked to the development of cancer, we are with an increase in PGDH expression, coupled with a also evaluating the effect of these polyphenols to inhibit a decrease in COX-2 expression. precursor of PGE2 production. Other studies in experimental animals study the therapeutic role of SB on pancreatic The final project investigates the Human Equilibrative cancer proliferation and tumor formation. The studies will Nucleoside Transporter 1 (hENT-1) as a potential site for delineate the molecular mechanisms for the effects of SB in gemcitabine resistance. Gemcitabine is a widely used causing the death of pancreatic cancer cells. chemotherapeutic drug to treat pancreatic cancer, but many A major project is supported by the NCI, and is titled “Role of Polyunsaturated Fatty Acids in Pancreatic Cancer” (Principle Investigator Guido Eibl, MD.) We have previously reported that the omega-3 polyunsaturated fatty acid (PUFA) eicosapentaenoic acid (EPA) exhibited antitumor activities in pancreatic cancer. However, the mechanisms of the antiproliferative effect of EPA on pancreatic cancer (PaCa) cells remain elusive. We have now demonstrated that the antiproliferative effect of EPA on PaCa cells involves induction of apoptosis (programmed cell death), a major development.

patients are resistant to this drug. This transporter (hENT1) is found on the cell membranes of most cells, and has been found to mediate gemcitabine uptake by the cancer cell. Cells deficient in hENT-1 are resistant to nucleoside transporter proteins, and it is known that patients with pancreatic adenocarcinoma who have increased hENT-1 expression also survive longer.

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UCLA-Hirshberg Laboratory Updates Research from the Ronald S. Hirshberg Chair in Translational Pancreatic Cancer Research at UCLA Enrique Rozengurt, PhD Director In recent years, many epidemiological studies have linked obesity and long-standing type 2 diabetes mellitus (T2DM) with increased risk for developing clinically aggressive cancers, notably pancreatic cancer. Given the escalating incidence of obesity and T2DM in the western world, these associations are important for guiding efforts in preventing and treating pancreatic cancer. A team of investigators supported by the Hirshberg Foundation and headed by Dr. Rozengurt has demonstrated that metformin, the most widely prescribed drug for the treatment of T2DM, inhibits pancreatic cancer growth in preclinical animal models and the proliferation of human pancreatic cancer cells in culture. The discovery of the effects of metformin on pancreatic cancer has opened a novel field in pancreatic cancer research. The initial studies have appeared in the prestigious journal Cancer Research as the first publication on the mechanism of metformin in human pancreatic cancer and have been further extended by studies using single human pancreatic cells.

The new results assume an added importance because metformin is an FDA-approved drug currently used in the treatment of T2DM and other conditions, including prediabetic states. Consequently, rapid translational research is a tangible possibility. The work of the team headed by Dr. Rozengurt is demonstrating that metformin disrupts a crosstalk between insulin receptor and other growth-factor signaling systems in human pancreatic cancer cells. The most interesting piece of new information is that administration of metformin markedly inhibits the growth of human pancreatic cancer cells in animal models. A new article, published in Clinical Cancer Research, has posited a new conceptual framework for these ideas. The new results provide a plausible mechanism for the beneficial effect of metfomin seen in diabetic patients and provide a rationale for influencing clinical practice in the management of conditions (including obesity and T2DM) that

increase pancreatic cancer risk. Specifically, in the light of the new research, metformin should be considered not only for the treatment of T2DM but also as prevention for developing pancreatic cancer in potentially susceptible patients.

(left to right); Robert Kwi, Enrique Rozengurt, Jim Sinnett-Smith

The research team has also been identifying another potential target in pancreatic cancer, a molecule termed protein kinase D (PKD) originally discovered and subsequently, intensely investigated in the laboratory of Dr. Rozengurt.

A recent series of studies demonstrate that PKD promotes proliferation of human pancreatic cancer cells and in collaborative effort, new studies show that a chemical inhibitor of PKD inhibits the growth of pancreatic cancer growth in culture and in preclinical animal models. The identification of new targets in pancreatic cancer is an essential step for developing new therapeutics and PKD is emerging as an attractive novel target. In contrast to metformin, the lack of an FDA-approved PKD inhibitor implies that a considerable time will be needed for research and development before these new discoveries can be translated into clinical trials.

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Seventh Annual Agi Hirshberg Symposium on Pancreatic Cancer

Vay Liang W. Go, MD

UCLA Department of Medicine

This year’s 7th annual Agi Hirshberg Symposium on Pancreatic Cancer was held at the UCLA Faculty Center on February 18, 2011. There were over 250 participants from academic industries, government, and patient and family support groups. Agi Hirshberg opened the meeting thanking the organization committee and added a brief history of the Symposium and the role of the Foundation. She then introduced Dr. A. Eugene Washington, Vice Chancellor of Health Sciences and Dean of the School of Medicine. Dean Washington recalled his first year at UCLA and expressed his gratitude of what the Foundation contributed to the research mission of the medical school and the overall research agenda towards the Foundation’s vision for the cure of pancreatic cancer.

This year’s Symposium was divided into three sessions. The morning scientific session was on new strategies in targeted therapy. The invited speakers were the awardees of the Foundation’s Seed Grant, including Dr. Andrea Viale from Dana-Farber Cancer Institute Harvard University, Dr. Ying Ma from University of Texas MD Anderson Cancer Center, Dr. Larry A. Karnitz from Mayo Clinic, and Dr.’s Guido Eibl and Krisztina Kisfalvi both from UCLA. This session was followed by the patient and family session with invited UCLA speakers including Dr.’s James Farrell, Ka-Kit Hui, Antronette Yancey, and Howard Reber. The Symposium program concluded with a workshop on glucose-tracer based metabolomics, chaired by Dr. Paul Lee with invited speakers including Dr.’s Pedro Beltran from Amgen Inc., Richard Beger from National Center for Toxicological Research FDA, and Laszlo Boros from SIDMAP. This year’s program was enriched by 15 poster presentations conducted by investigators at the UCLA Center for Excellence in Pancreatic Diseases, VA Greater Los Angeles Healthcare System, Hirshberg Laboratory for Pancreatic Cancer Research, Harbor-UCLA Medical Center, and Southern California Research Center for Alcohol Liver and Pancreatic Diseases.

The Hirshberg Foundation newsletter is supported by unrestricted educational grants from:

The highlights of this year’s Symposium are presented in this newsletter with topics ranging from the characterization of pancreatic cancer stem cells, new innovative immunotherapy and drug development, western diet induced pancreatic cancer, to antidiabetic therapy in the treatment and prevention of pancreatic cancer. The quality of life and physical activity in the prevention of cancer and the clinical and surgical approaches to patients with pancreatic cancer was the focus of the patient and family session. The metabolic evaluation of pancreatic cancer patients, the use of metabolomics approaches in personalized medicine, and the barriers in pancreatic cancer research and management was the key discussion at the workshop.

The scientific communities are extremely grateful to the Foundation’s continued support to their education and research missions.

T o v i e w th e c o m p l e t e S ym p o s i u m V i d e o a n d P o w e r P o i n t P r e s e n tat i o n s , v i s i t o u r w e b s i t e .

Symposium Recaps

Role of Oncogenic K-RAS in Self-renewal and Maintenance of Cancer Stem Cells in Pancreatic Tumor Andrea Viale, MD

New Strategies in Targeted Therapy for Pancreatic Cancer

Dana-Farber Cancer Institute

the expression of KRAS oncogene and kinetics of pancreatic tumor development (i.e. initiation and regression) can be controlled tightly upon feeding of tetracycline analog. At the Symposium, we exploited this genetically tractable model system to assess the impact of KRAS oncogene extinction upon antibiotics withdrawal on the CSCs and to gain in depth understanding of the KRAS signaling pathway in CSC through various state-of-the-art technologies to identify points of therapeutic intervention that will lead to regression of pancreatic cancer.

Mast Cell Blockade as Immunotherapy for Pancreatic Cancer Ying Ma, MD, PhD Pancreatic cancer remains incurable despite advances in our understanding of its pathogenesis. Oncogenic KRAS gene has been demonstrated to be the most important one in pancreatic cancer development. We and others have generated experimental evidence indicating

UT MD Anderson Cancer Center

Implication for cancer treatment Current therapies have been developed to decrease the bulk of the tumor mass, Implication for cancer treatment thus they are unlikely to result in long-term remissions if the rare CSCs are not targeted Current therapies have been developed to decrease the bulk of the tumor mass, as well thus they are unlikely to result in long-term remissions if the rare CSCs are not targeted as well

that a rare population of tumor cells, the so called Cancer Stem Cells (CSCs), has the capability to initiate pancreatic cancer in animal models. We have recently developed a sophisticated inducible pancreatic cancer animal model where

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Most pancreatic cancer patients die shortly after being diagnosed, and the disease is difficult to treat. Increasing evidence indicates that the tumor microenvironment surrounding the cancer cells plays an important role in the tumor’s development and subsequent behavior. This is particularly the case for pancreatic cancer, which is characterized by a dense cancer stroma that contains a rich cellular population; this population includes fibroblasts, endothelial cells, macrophages, and other

Ying Ma, continued

immune cells. The lack of an effective treatment for pancreatic cancer is largely the result of a lack of understanding of its biologic characteristics and tumorigenesis. Immunotherapy may be a fourth strategy for treating this disease, supplementing surgery, chemotherapy, and radiation therapy. Cellular immunotherapy, which is most often used in cancers for which existing therapies have limited effectiveness, is the administration of specialized cells that kill cancer cells or lead to disease immunity. We have found that mast cells, a type of immune cell, suppress the immune systems of cancer patients and

encourage tumor growth.

Currently, the inability to activate immunologic effector cells in the tumor microenvironment is one of the greatest bottlenecks in the development of cancer immunotherapy.

In the proposed study, we will use different strategies to block mast cells and thus strengthen immune system integrity and cellular immunotherapy trafficking against pancreatic cancer.

The goals of this study are (1) to determine whether pharmacologic inhibition of mast cell function inhibits mast cells’ suppressive activities and (2) to determine the combined effects of immunotherapy and mast cell-targeted therapy on the tumor microenvironment and anti-tumor response in pancreatic cancer. We will adapt modern immunologic tools to maximize therapeutic response and reduce the deleterious side effects associated with treatment while gaining preclinical and clinical insight into pancreatic cancer immunotherapy, which may finally lead to a new treatment and save patients’ lives.

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An Innovative Drug Combination for Pancreatic Cancer

Checkpoint signaling pathway overview

Larry M. Karnitz, PhD Mayo Clinic

Pancreatic cancer is the fourth leading cause of cancer-related death in the United States, with over 35,000 expected to die of the disease in the United States in 2009. Fewer than 20% of patients present with potentially curable disease, and the overall 5-year survival rate is less than 5%. Decades of work have contributed to an extensive understanding of the biology of the disease; however, only modest gains have been made in treatment and no highly active chemotherapy regimens have yet been discovered. Given these dismal statistics and the lack of significant progress in identifying effective therapies, there is a pressing need to develop better treatments for this devastating disease. Based our basic laboratory studies examining the roles of DNA repair and signaling in pancreatic cells treated with fluoropyrimidines, we propose to test a novel drug approach that combines a fluoropyrimidine with an emerging class of chemotherapy agents that are now in phase I-II clinical trials. In these collaborative studies we will test the antitumor activity of the innovative drug combination in a mouse xenograft model of pancreatic cancer. Given that the proposed therapy combines an approved drug with a drug class that is undergoing widespread clinical trials, if we obtain positive results in our xenograft model, we will be able to rapidly mount an innovative clinical trial for this deadly disease by taking advantage of the close working ties we have forged with basic and clinical scientists at the Mayo Clinic.

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Western Diet-induced Pancreatic Cancer Guido Eibl, MD

David Geffen School of Medicine at UCLA

The typical Western-style Diet, rich in calories and fats, is thought to partially or even largely be responsible for many diseases of the Western Civilization, including obesity, type2 diabetes, cardiovascular disease, and cancer. The tumor promoting effect of obesity is thought to comprise hyper-insulinemia with an associated elevation of insulin-like growth factor and local and systemic inflammation. Using a high fat, high calorie diet and the conditional KRAS mouse model of pancreatic carcinogenesis, which recapitulates many features of the human disease, several investigators at UCLA and the VA put together

Tribute to our Champions The Hirshberg Foundation Donor Wall honors our most generous supporters whose gifts of $100,000 or more have helped the Foundation continue in our relentless and passionate pursuit to find the cure. Located in the lobby of the Macdonald Medical Research Lab at the UCLA School of Medicine, where our Laboratories are located, the Hirshberg Foundation recognizes these individuals who have joined us in the fight against this dreadful disease.

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Guido Eibl, continued

Pancreatic cancer is well documented to be associated with DM2 and up to 80% of pancreatic cancer patients have overt DM2 or impaired glucose intolerance. Overt DM2 is characterized by hyperglycemia, hyperinsulinaemia and high insulin-like-growth-factor-1 (IGF-1), and all three characteristics are known to promote pancreatic cancer proliferation.

We have identified crosstalk mechanisms between insulin/ IGF-1 receptors and G protein-coupled receptor (GPCR) signaling systems that potently stimulate DNA synthesis, cell proliferation and anchorage-independent growth in human pancreatic cancer cells. Mitogenic crosstalk between these signaling systems depended on the function of the mammalian target of rapamycin (mTOR) complex 1 (mTORC1). Metformin, one of the most widely used drug in DM2, negatively regulates mTORC1. Thus we examined whether metformin inhibits the growth-promoting signaling in pancreatic cancer cells. Our results demonstrated that metformin directly acted on human pancreatic cancer cells and potently blocked mitogenic signaling in vitro.

Effect of metformin on tumor growth in mice on Western or control diet Body weight

Krisztina Kisfalvi, MD, PhD

A large number of epidemiological studies linked long standing type 2 diabetes, obesity, and metabolic syndrome with increased risk for developing a variety of cancers.

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Antidiabetic Therapy in the Treatment and Prevention of Pancreatic Cancer

Our results show a strong beneficial effect of metformin on the inhibition and prevention of pancreatic tumor growth.

These data suggest that this antidiabetic agent can offer a novel approach for the prevention and treatment of pancreatic cancer and other solid malignancies.

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a Program Project Grant investigating the tumor promoting effects of a Western-style Diet on pancreatic cancer development. It is necessary to explore the impact of the high fat, high calorie diet on inflammatory processes, signal transduction pathways, cell death mechanisms, and tumor-host interaction.

Extensive epidemiologic data now suggests that diabetic patients who had taken metformin, especially those with >5 years of use, had a significantly lower risk of developing pancreatic cancer compared with those who had not taken metformin. In contrast, diabetic patients who had taken insulin or insulin secretagogues had a significantly higher risk of pancreatic cancer compared with diabetic patients who had not taken these drugs. These population-based cohort studies raise the possibility that metformin might have a significant role in the prevention of the development of pancreatic cancer in this high risk DM2 patient group.

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Tracer-based Metabolomics and Systems Biology W. Paul Lee, MD

Harbor-UCLA Medical Center

Molecular biology (biochemistry) has been the main experimental tool for studying biological processes. Despite the large number of discoveries of importance in molecular biology, knowledge of molecular biology still fails to predict biological behavior of living cells/organisms. This is because a system of pathways (signaling and metabolic) is more than the sum of its parts. To understand genotype/phenotype correlation requires the tools of systems biology.

The biological system of a cell is comprised of a network of metabolic processes (reactions). The basic property of the system is that every reaction is connected to every other reaction in the network by sharing common substrates, co-factors or enzymes. Because of the sharing of common substrates, co-factors and enzymes by the reactions of the network, the properties of the network (metabolic phenotype) can only be defined in the context of the system of cellular biochemical reactions and its nutrient environment.

S ignaling pathways

Metabolic pathways

Signaling pathways and gene expressions together with metabolic pathways form an extended metabolic network.

The properties of this extended network constitute the phenotype of the living organism. The metabolic phenotype can be defined by the balance of fluxes at steady state (quasi-steady state) and by the dynamics of its metabolic response (within and through the system) when it is perturbed (non-steady state) using a combination of metabolomics, proteomics and transcriptomics approaches.

Ganitumab (AMG 479) – Targeting IGF1R Signaling in Pancreatic Cancer Pedro J. Beltran, PhD Amgen Oncology Research

The insulin-like growth factor receptor (IGF1R) axis has been implicated in the growth and survival of pancreatic tumor cells, the maintenance of the K-ras transformed phenotype and the proliferation of metastases in the liver microenvironment. Ganitumab, a fully human monoclonal antibody that binds and inhibits IGF1R, is currently being developed for the treatment of pancreatic cancer. Preclinical results show that ganitumab binds to IGF1R, blocks IGF-1 and IGF-2 mediated receptor activation, drives receptor internalization and degradation, and does not cross-react with the insulin receptor (INSR). In two human models of pancreatic cancer (BxPC3 and MiaPaCa2), ganitumab completely inhibits ligand induced IGF1R homodimer and IGF1R/INSR heterodimer activation (but not INSR homodimer) resulting in reduced cellular viability. Treatment of established xenograft tumors of BxPC3 and MiaPaCa2 tumor cells with ganitumab blocks activity of the PI3K/Akt pathway and inhibits tumor growth (~ 80%) in a dose dependent manner. Tumor growth inhibition is associated with both induction of apoptosis and inhibition of proliferation. Importantly, addition of ganitumab to agents approved for use in pancreatic cancer (gemcitabine and erlotinib) results in enhanced anti-tumor activity.

These results support the current clinical development strategy of ganitumab for the treatment of pancreatic cancer.

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Bioinformatics of Glucose-tracer Based Metabolomics Laszlo G. Boros, MD

Harbor-UCLA Medical Center

Alarming rates of new drug failures and sparse drug development pipelines of the pharmaceutical industry, left behind by the genetic era of medical research, call for new approaches and reliable tests of cell function. New drug targets need to be validated using detailed analyses and understanding of the metabolic network along with its function in promoting uncontrolled cell growth

and driving substrates for such process. Stable non-radiating tracer substrates, including 13C labeled glucose, are capable of labeling thousands of metabolite products during the new cell formation process. The specific details of participating enzymes and their strength in controlling pathologic growth can also be revealed using tracer substrate methods. Main challenges however come from handling, logging, archiving and most importantly understanding multiple metabolite synthesis patterns of malignant pancreatic cancer cells. Positional 13C labeling from tracer glucose of multiple metabolites with multiple origins in pancreatic cancer cells introduces a complexity and increased permutations for data interpretation of every single product of the metabolic network. In order to evaluate outcomes of genetic data for cancer we need to address some of the most critical tasks in metabolite spectra handling, data downloads, cohort characteristics, visual interface preparation, reproducibility and data interpretations of functional metabolomics.

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Metabolomic Evaluation of Pancreatic Cancer Richard D. Beger, PhD

National Center for Toxicological Research

The National Center for Toxicological Research (NCTR) Center of Excellence for Metabolomics is using NMR and MS platforms to evaluate metabolite profiles in biofluids and tissues and relate them to health to disease status of the individual. A general overview of the research strategies of the Center for Metabolomics will be given. A clinical metabolomics study on pancreatic cancer used patients and age matched healthy controls. The 1D NMR spectra of lipophilic plasma extracts were used to develop partial least squares discriminate function (PLS-DF) models that can classify whether a spectrum from an unclassified patient belongs to the group of controls or pancreatic cancer. Partial least squares discriminant function (PLS-DF) models of NMR data from lipophilic extracts of plasma from 163 patients were

able to classify samples as belonging to the pancreatic control group or to the pancreatic cancer group with 98% sensitivity, 94% specificity, and 96% overall accuracy. Mass spectrometric profiling of phospholipids in plasma found three phosphatidylinositols that were significantly lower in pancreatic cancer patients than in healthy controls (Beger et al. Metabolomics, 2006). We plan to follow up this study with a metabolomics and proteomics analysis of blood samples from 60 controls, 50 atypical and 50 diagnosed pancreatic cancer patients that will be age-matched. From the diagnosed cancer patients, we will also be able to obtain and analyze pancreatic juice, tumor and tumor-adjacent normal tissues for genetic mutation of K-RAS, metabolomic and open and focused proteomic methods. Longitudinal blood and pancreatic juice samples will be evaluated to ascertain the re-emergence of disease.

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Symposium Recaps Patient and Family Sessions

How Integrative East-West Medicine Can Improve the Quality of Life for Patients with Cancer Ka-Kit Hui, MD, FACP UCLA Center for East-West Medicine David Geffen School of Medicine at UCLA

In recent years in the U.S., change in patient preferences and growing usage of some common complementary and alternative medicine (CAM) therapies have led to an interest in the study and application of blending different healing traditions for the benefit of patients with cancer and their loved ones. Traditional Chinese Medicine (TCM) is a representative of CAM that takes a holistic approach to patient care. TCM practitioners diagnose and treat patients with cancer as they would patients with other diseases. Pathogenic factors such as external noxious stimuli, psychological and emotional factors, as well as lifestyle can interact with the patient’s predetermined genetic susceptibility resulting in the development of cancer and other diseases. Any factor that directly or indirectly increases the noxious

stimuli and/or decreases the body’s resistance would present problems that can lead to cancer or promote cancer progression. TCM techniques involve education of self-care, acupuncture, acupressure, therapeutic massage, dietary and herbal remedies, and mind-body exercises such as Taichi and Qigong. While evidence of acupuncture and massage in symptom management for pain and nausea-vomiting is strong, further research is needed to determine the role of herbal medicine and other TCM modalities during oncologic care under physician supervision in the US, despite China’s clinical experience in this area. Institutions in China have integrated both medicines into its clinical approach on the prevention and treatment of diseases, including cancer, for several decades. In the integrative approach to cancer management, during the early stages, when the patient’s functional reserve is still sufficient and the cancer is more localized, the local problem is addressed while using TCM to enhance the healing process at the same time.

During further progression, integration of both medicines is used to reverse the cancerous process and provide support against side effects during toxic conventional treatments. In more advanced stages, when the functional reserve is low, the emphasis is on boosting this reserve, facilitating innate self-regulating mechanisms, and improving the quality of life.

This synergistic interaction optimizes the balance between the quality and quantity of life of the patient undergoing therapeutic interventions. Furthermore, improved communication and global collaboration among all stakeholders and healing traditions will take integration to a more advanced level in finding solutions for issues confronting patients with cancer and their family and community.

Patient and Family Sessions, continued

Physical Activity in the Etiology and Prevention of Cancer Toni Yancey, MD, MPH

School of Public Health, UCLA

Regular physical activity has been associated with lowered cancer incidence by 10% to 50% across many types, including breast, colon, endometrial, and lung. It is difficult in most epidemiological studies to disentangle the contributions of sedentariness, physical inactivity, and obesity to cancer risk.

However, physical activity clearly exerts its protective influence both directly, for example, by decreasing gastrointestinal transit time, consuming calories needed for tumor growth, improving immune system functioning, and/or postponing pubertal development, and indirectly, by decreasing fat stores, favorably altering fat distribution and preventing weight gain.

incorporating environmental changes with promising results, particularly in integrating short bouts of physical activity into organizational routine. Integrating physical activity-promoting practices and policies into the regular conduct of “business” within key organizational settings is a promising intervention approach for reducing obesity and sedentary behavior, and improving productivity and employee wellness.

Sociocultural norms may be influenced through the adoption of organizational “push” strategies that make activity the default option or path of least resistance such as daily short activity or breaks at a certain time of day and during lengthy meetings on paid time. The key element is using social expectations and peer pressure to directly involve captive audiences unlikely to voluntarily engage in physical activity.

This presentation provided a brief overview of existing physical activity intervention research. Their modest effects and abysmal sustainability have led to the emergence of models

Missing Slide Data

Surgical Strategies in Pancreatic Cancer Howard A. Reber, MD

David Geffen School of Medicine at UCLA

For surgeons, pancreatic cancer is the most challenging of the gastrointestinal malignancies.

The tumor has spread in 80% of cases even before the diagnosis is made, so that surgical resection is an option in only about 20%. The operation (Whipple procedure) is the most complex of general surgical procedures, and is done competently only in major Centers and by experienced surgeons; but it cures less than 20% of those who undergo it. Nevertheless, some patients are cured by surgery (and additional medical therapy), and all patients who have ever been cured have had the tumor surgically removed. Thus, surgical resection will remain a central feature in the management of this disease for the foreseeable future.

We reviewed the history and development of the Whipple operation and the “modified� version now most commonly performed, its increasing safety (operative mortality rates have decreased from 20-25% to less than 1%), its side effects, and current approaches to the management of patients with locally extensive cancers that involve major blood vessels. The role of neoadjuvant therapy [chemotherapy (+/-) radiation] given for several weeks before the operation was discussed.

The rationale for adjuvant therapy [chemotherapy (+/-) radiation] given after the operation was also presented.

Localized cancer in tail of pancreas

Localized cancer in head of pancreas

Resectable

Find us online www.pancreatic.org

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Resectable

Patient and Family Sessions, continued

Clinical Approaches to Pancreatic Cancer James J. Farrell, MD

David Geffen School of Medicine at UCLA

Pancreatic cancer remains the fourth leading cancer death in the USA, affecting both sexes.

We now have appropriate clinical tools in making the diagnosis of pancreatic cancer.

These clinical tools include blood tests (CA19-9 and genetic markers), radiology imaging (abdominal ultrasound, CAT scan, MRI scan, PET scan) and endoscopic imaging (ERCP, endoscopic ultrasound). Using these tools, a clinical algorithm has been developed in the diagnosis of suspected pancreatic cancer patients with excellent accuracy and has been used to establish the treatment approaches based on the stage of the disease.

Exciting future development is toward developing a screening protocol diagnosing early pancreatic cancer in patients with increased risk as in Peutz-Jeghers, FAMMM, hereditary pancreatitis, familial breast/ovarian cancer, pancreatic cystic neoplasms, HNPCC and FAP. The results of such screening studies so far have yielded encouraging results. However, several questions remain to be considered. These include: Why screen for pancreatic cancer? What do we screen for? Who do we screen? When do we start screening? How often do we screen? How do we screen?

What do we offer “abnormal” screens?

The future direction for further improvement on the clinical outcome in the management of pancreatic cancer lies in the screening for early pancreatic cancer such as development of better biomarkers such as in saliva and personalized medicine in predicting responses to chemotherapy and other therapeutic approaches.

How do we screen?

• Blood

• Pancreatic Juice • Stool

• Saliva

How You Can Help Style & Fun for a Cure Starts Here!

Help spread awareness with our new vintage inspired gear. We’ve just added a fitted sporty unisex hoody, a ladies vintage feel T-shirt, and a unisex distressed logo T-shirt, all from American Apparel. We’ve also added silk-string awareness jewelry, note card sets and postage stamps. And we still have our best-selling wristbands, embossed with our motto “You can hope or you can help”.

Help fight pancreatic cancer today by making a purchase in the Hirshberg Foundation e-store.

Doctor In the Spotlight

Matthias Lohr, MD TITLE: Professor of Gastroenterology & Hepatology BORN:

Frankfurt/Main, Germany

RAISED:

On the coasts of Germany

EDUCATION:

Studies in theology& anthropology; Medical School in Germany (Würzburg and Hamburg); MD thesis in pancreatic pathology; PhD equivalent in pancreatic cancer molecular biology. Postdoc at Scripps Clinic, La Jolla, CA.

MARRIED TO: Isabel, the most wonderful woman CHILDREN: Two girls and twin boys HOBBIES: The central organ (pancreas), sailing

MOST VALUABLE THING YOU HAVE LEARNED SO FAR:

To be humble – and honest to my patients NOTABLE QUOTE:

“Pancreatic cancer is a disease left behind for a variety of reasons, compared to the publicity and funding of other cancers. To find a cure is a real challenge. It takes a combined effort of many dedicated scientists working in a team. Pancreatic cancer needs the best thinkable support and awareness as is exquisitely provided by the Hirshberg Foundation.”

Dr. Mathias Lohr (right) with Dr. Bill Go

Matthias Lohr

By Agi Hirshberg Last summer I attended the 42nd annual meeting of the European Pancreatic Club (EPC) in Stockholm, Sweden. I was approached by one of the event organizers, Dr. Matthias Lohr, who said, “I received the first ever Hirshberg Award at the APA meetings in 1999 for my abstract in Gene Therapy. The award was handed to me by Dr. Reber, who was then the treasurer of the APA (American Pancreatic Association). My group, at that time from Rostock, Germany, developed a therapy from bench to bedside including all the preclinical experiments. But we could not proceed with this therapy because it was not possible to standardize the manufacturing process in a way to satisfy the FDA. But we continue to work with other novel therapies against pancreatic cancer.” These words were music to my ears because a single award, just $750.00, given to Dr. Lohr continues to evolve ten years later and because it shows that relentless determination is needed to defeat this cancer.

Matthias is a wonderful caring clinician and a valued partner for the Foundation. Just recently we were contacted by a patient living near Rome who needed an expert surgeon immediately.

I called Matthias, who referred us at once to the right doctor.

Within 24 hours, the pancreatic patient was in good hands in Rome, Italy. Our thanks to our friends at APA, JPS (Japan Pancreas Society) and the EPC who help us serve patients on a global basis, in need of immediate and compassionate care!

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Volunteer In the Spotlight:

Martin Fung

I started volunteering for the Hirshberg Foundation because Agi asked me to help with the first run event back in 1999 – The adidas Three Stripe Challenge. I showed up early and was assigned to help with registration. Agi came by, took my hand, led me to the tee shirt and pledge prize booth and said “We need you to help here – make it work!” And so I did. After all these years, I am still on the LACC Planning Committee. Running the T-Shirt & Pledge Prize Booth is still my gig, and is affectionately referred to as Martin’s Booth.

The best part about being on the planning committee is getting there the morning of the run (at 5:00 a.m.!) and knowing that the event is about to start after all of the planning, meetings and hard work. The energy builds and builds – it is always a great day. Personally exciting for me this past year was the new and improved Gift Bag/Tee Shirt/ Pledge Prize/Info Booth. It is always a challenge to successfully help and service all of the wonderful runners and walkers and this was the first big re-vamp in over ten years. We received great feedback on the new set-up and location and all went well. I am already thinking and planning for the 2011 LACC. In 2008, the year I was turning 49 years old, I joined the Hirshberg Training Team and completed my first 13.1 mile race, The Country Music Half Marathon in Nashville, TN. It was a challenging goal to set for myself, but I did it and got great donations too. I am committed to volunteer for the Hirshberg Foundation as long as they need me. I am in it until there is a cure for Pancreatic Cancer. Agi is committed to find the cure and so am I.

“The best part of volunteering for the Hirshberg Foundation is that I am helping with a great foundation that is doing great things. I know that my time and efforts help the Foundation with their mission to find a cure for Pancreatic Cancer.”

Patient In the Spotlight

Tyler Noesen It was July 5, 2006, I was 25 when I received the news. My life had been very full up to this point. I had recently been promoted at work, was looking forward to marrying the love of my life, Eva, I was playing sports and travelling when time allowed.

Then one day I felt like I had a tweaked muscle from playing soccer, but the hardness on the left side of my stomach did not resolve.

I went to the family doctor. After scans and an ultrasound with a fine needle aspiration, they found stage IV adenocarcinoma of the pancreas.

Because there was a lesion on my liver, I was not a surgical candidate.

I began chemotherapy almost imme-

Today I am a four year survivor! While riding through the diately.

ups and downs I have had some pretty amazing moments like going back to work, hiking from the south rim to the bottom of the Grand Canyon, spending a night at Phantom Ranch and hiking back out the next day, and finishing up my private pilot’s license and passing my check ride.

I participated in my first LA Cancer Challenge after my diagnosis in 2006.

Each year friends and family walk by my side as I participate in the 5K. Their positive energy is what carries me through. Last year we had quite a showing… seriously, everywhere you looked, you would see someone in a purple Team Tyler shirt. I started along the 5K route. It sure did feel like a long 3.1 miles. Not only did I finish, but my time was seven minutes faster than in 2009. We took the 5K Team title for the 4th year in a row! My friend Shannon came through fabulously with some awesome jerseys and Big Dennis and my dad made adorable kiddie Team Tyler shirts. Actually, I am pretty sure our edge was the few small children that were a part of the team - essential ingredients for any feel good story. I think it is safe to say that we were the most stylish team out there. We raised

over $8,000 which I found particularly impressive considering the current economic climate. This will certainly help in pushing research forward. Past donations that have come from the Hirshberg Foundation have led to UCLA being designated as a comprehensive pancreatic cancer center and have also funded a study performed by my endocrinologist which was published earlier this year. I think the highlight of the day for me was seeing so many old and new friends and getting to talk a bit with so many people. I also had the honor of starting the 10K shot gun.

It was a fun day. I treasure every fun day I get.

A lot has happened since the last race - foot drop, AFOs, strength improvement, extensive neuropathy, walker, wheelchair, walker, gradual improvement, a couple minor surgeries, more strength, and finally a cane- and I really didn’t know if it was going to happen. My family and friends have helped to get me through my emotional and physical rollercoaster that I have been on. I would like to take a moment to truly thank all of you that have been a part of my life. I have been given an opportunity to fight this disease and spread awareness in the community.

in that fight!

Please join me

“Each year friends and family walk by my side as I participate in the 5K. Their positive energy is what carries me through.”

Patient Programs Update Editor’s Note: Bellah Care Chronicles Patient Symptom Management Workbook was created by two sisters who were caretakers for their mom after her diagnosis of pancreatic cancer. Their books are a tool aimed to help patients and family members gain control over symptoms, side effects, nutrition, medication, appointments and blood and scan results.

In collaboration with the Bellah Care Chronicles, we have created a customized, comprehensive and complete Patient Symptom Management Workbook for pancreatic cancer patients. Thanks to a generous educational grant, The Hirshberg Foundation is gifting the notebook to newly-diagnosed patients. It is our hope that patients and families will be able to take control of their treatment and their well being and be able to focus on what really matters most to them.

Two Sisters Create Patient Symptom Management Workbook

By Sarah and Carmelle Banks

Our names are Sarah and Carmelle Banks. We are sisters, 2nd-generation caregivers, and cancer activists. In 2006, our lives took a dramatic turn when we became primary caregivers to our mom, Jane, who was diagnosed with pancreatic cancer at the young age of 57.

At the time, we lived on separate coasts, one of us living on the east coast and one on the west. When our mom told us she had cancer, we immediately returned home to live with her and put our heart and soul into taking care of her. While most people in their twenties are transitioning into careers and family life, we were getting ready to embark on the biggest role of our lives, warriors against pancreatic cancer, with our mom leading the way. Our mom was a single parent, a registered nurse and health educator for 37 years. She taught us about being women of integrity by stressing the importance of service and helping others. She always made sure we were taken care of. Years later, as she was facing the biggest challenge of her life, it was our turn to make sure she was loved, supported, and was well taken care of.

Throughout treatment mom endured a variety of chemotherapy drugs, surgeries, integrative treatments and took many medications. In an effort to be better caregivers and understand how her body was handling treatments, medications and new food regimens, I designed a book which would keep track of her daily needs and what we refer to as the “new normal”.

I created the book specifically so it was small enough to travel in a purse or bag back and forth to doctor appointments, but large enough to hold the pertinent information that your doctor may ask. The book also contains refillable pages with detailed charts for medication, daily food intake, symptoms, doctor’s notes, phone numbers and other medical information.

Carmelle Banks, Sarah Banks, Agi Hirshberg and Allison Miller at the Hirshberg Foundation booth at the LA Cancer Challenge.

Our mom fought courageously for 2 1/2 years overcoming the bleak statistics that gave her only six months to live. Today, though we can no longer fight this disease beside our mom, we continue to stand up for cancer by dedicating our lives to helping other families manage their cancer care. We‘ve made it our mission to stand up for all patients, caregivers, and loved ones by spreading cancer awareness and helping to raise thousands of dollars for cancer research.

Our family was first introduced to the Hirshberg Foundation after going to one of their annual educational Symposiums at UCLA. We were eager to collaborate with them by creating a customized book for pancreatic cancer patients and their loved ones. The Hirshberg Foundation helped to pioneer the first customized Symptom Management Workbook for people facing pancreatic cancer. Agi has shown her unyielding support for the book’s launch and the entire Hirshberg Foundation family has supported the two of us as both caregivers and as an organization. We have high hopes of contributing to the cancer community using the Foundation as a guiding source of inspiration. We are so happy and proud to be a part of the Hirshberg family and their ongoing efforts to find a cure for pancreatic cancer. We know our mom would be too.

With the help of an educational grant, the Hirshberg Foundation is generously gifting the customized workbooks to individuals touched by pancreatic cancer. Helping other pancreatic cancer patients and caregivers manage their care better is a special way to honor our mom’s memory, continue her legacy of love and generosity and help make a positive difference in the lives of other families like ours.

Events Spotlight Each year we are fortunate to be the beneficiary of events organized by people who have been touched by pancreatic cancer. These events are planned by dedicated individuals who want to honor or memorialize someone who has been affected by pancreatic cancer and help find a cure at the same time. We have chosen a few recent events to highlight as they show the vastly different ways people are making a difference. We are grateful to everyone who hosted an event to benefit the Hirshberg Foundation this past year. To learn more about hosting a fundraising event, visit our website and click on How You Can Help.

On November 6, 2010, the day after Dale’s 59th birthday, more than 30 dear friends, family, neighbors, co-workers, and dogs gathered for the inaugural Dale H. Burton Alligator Walk, a 5K loop beginning at his home.

Participants proudly wore purple and carried balloons and smiles as we walked (and ran) through the neighborhood where Dale grew up.

Through generous sponsorships, we reached our $3,000 goal and have already made plans to continue the event annually on Dale’s birthday weekend. In this way, we

look forward to honoring his loving spirit, while doing our part to keep the hope alive so that other families won’t have to suffer such an enormous loss.

The Dale H. Burton Alligator Walk

By Lauren Eberle

For more information about upcoming Alligator Walks, visit http://www.pancreatic.org/memorial/alligatorwalk.

Dale Burton was a cherished uncle to 10 nieces. When we were young, he would take us on “Alligator Walks” around his Winston-Salem, North Carolina neighborhood to teach us about nature and animals, two of his passions.

My Uncle Dale lost his battle with pancreatic cancer in June, 2010. While searching for a way to honor this phenomenal man,

I came across the Hirshberg Foundation website and immediately knew that this Foundation would become a special cause for our family.

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I want to put an end to pancreatic cancer, now and forever. The only way

to do that is through research.

Research requires funding.

Why is pancreatic cancer one of the least funded cancers? I know there are other cancers that receive better funding because they affect a larger portion of the population, but still too many people are stricken with pancreatic cancer.

Real Results Fitness 5K and Kids Dash

By Sharon Rosenberg Why does anyone commit themselves to long hours, frequent rejection, and no monetary compensation? Certainly, there is satisfaction when all the hard work finally culminates in an event that you can be proud of, but still that is not the reason.

It is simple. I want to fight something that has shattered

my life and torn my heart. That something is pancreatic cancer.

I lost my husband, Irving Rosenberg, to this disease. We were married for 41 years. He was not perfect. None of us are. He was my world. There is not a day that I don’t miss him. As I write this, tears come to my eyes, and all the hurt, frustration, and longing for him is as fresh as the day I lost him on our anniversary, September 3, 2007.

No one should have to experience pancreatic cancer and, for that matter, any cancer. I guess you could say my husband was lucky because he survived 20 months with it. Sometimes I think that he held on by sheer will. What he went through during those 20 months would test the strongest person. Endless tests, a Whipple procedure, chemotherapy, radiation, experimental drugs, CyberKnife, unbelievable pain, and suffering. I was there for him through all of this, watching him, caring for him, and dealing with the medical and insurance community, both good and bad. It has forever changed me, but also has lit a passion in me that will last my lifetime.

So my son, Paul and I, through his company, Real Results Fitness, decided to put on a 5K and Kids Dash to benefit the Hirshberg Foundation. We chose the Hirshberg Foundation because my husband was diagnosed at UCLA by Dr. Howard Reber, but mostly because the people involved with this organization are a pleasure and a joy to work with on so many levels. They are so understanding and helpful. We do this for another reason. In the Las Vegas / Henderson community there has never been a fundraising event that calls attention to pancreatic cancer. We want the people in Clark County that have been touched by this disease to have an outlet to fire their passion in fighting for a cure. A fundraising event can give

people stricken with pancreatic cancer and their families an opportunity to vent their frustrations and put a positive in their life.

Our 3rd Annual 5K and Kids Dash at Green Valley Ranch in Henderson, Nevada was bigger than last year! SUCCESS‌ we had over 400 people attend and raised more than $12,000!

We were also honored to have two pancreatic cancer survivors participate in the walk. We are already looking towards next March for the 4th Annual 5K and Kids Dash in 2012! For more information about our race, please go to www.realresultsfitness.com to register for next year. We welcome you to join us at our event.

my best friend; I could not imagine not being able to talk to her every day. I spent so many hours on the internet trying to absorb every piece of information on every procedure and every treatment option. I went to every doctor appointment and was disappointed by the lack of decisive action.

I was so saddened by her oncologist’s passive attitude and lack of urgency. The memo line of every follow up email was MY MOM, ROSANNE WAYMAN, in hopes that every doctor and nurse who treated her felt like she was their mother. Six short weeks later, she passed away. My mom was only 56.

Salon 828 holds event in memory of Rosanne Wayman

By Holly Grist My husband, Don and I had just had the best moment of our lives…the birth of our son. Everything was going wonderfully, and my mom was elated that she finally had a grandchild. The look on her face when she held him and sense of pride when she spoke about him made me so happy and grateful that I had such great parents.

A few months later our lives were changed completely.

My mom had a rash on her arms and legs that just wouldn’t go away. We thought that it was an allergic reaction to laundry detergent or lotion. The doctor recommended cortisone cream. A few weeks later, my mom was having heartburn and lack of appetite.

She knew someone in their early 40’s that had the same mild symptoms and was diagnosed with pancreatic cancer, so she made another appointment. When she mentioned her symptoms to the doctor his reaction was “That is the worst case scenario but I will send you home with some Nexium and we can follow up with an ultrasound to ease your concern.”

I felt helpless in those six short weeks. After her passing, I knew that I immediately wanted to help raise awareness for early diagnosis and help fund the research for this awful disease. I wanted to honor my

mom’s courageous battle by trying to help others.

I own a salon and spa, so my first thought was to just write a check to the Hirshberg Foundation. As I was mentioning this to my staff, they suggested that they donate their time and plan an event in an effort to make a bigger impact and raise more money as well as awareness. We began to plan the

event and it seemed that this became more therapeutic for me each day with every detail we planned out.

The event was haircuts and blow outs for clients as well as a raffle, food and entertainment. My staff was booked through the day. Businesses offered to donate large gift baskets and gift certificates for a raffle. Clients who could not make it in for our event asked if they could make a donation anyway. I was blown away by all this generosity. I felt such an outpouring of love and support from my staff, family, clients and friends while planning this event. We managed to raise over $4,000 during our four-hour event, and hopefully next year’s will be bigger and better! I miss my mom, but this

A few days later, we got the diagnosis…stage 4 pancreatic cancer. As I struggled with her diagnosis, I was saddened by the thought of my son not knowing his Mommom. I was devastated at the idea of my dad losing his wife of 38 years. My mom was

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event has helped me feel like I am going to be able to help others going through the same situation and hopefully bring us closer to finding the cure. To find out more about our February 2012 event, contact holly@ salon828.com.

From Kick Pancreatic Cancer to Purple Palooza

By Catherine Moore

home, he passed away on November 6, 2010, just seven days before Palooza. I had a great group of friends and co-coordinators who took the reins for me and continued to plan for the couple of days I took to be with family.

Questions of whether we should cancel or reschedule came about but my Dad was someone who made things happen no matter what and I couldn’t cancel something he and I started and worked very hard at creating. With that mind-set, we rushed like crazy to make up for some of the time lost. The morning of November 13th came and it was time for us to set up our hall for the event. We had so much to do scaffolding, tulle, balloons, center pieces, coffee mugs, decorations, auction items and more - but with the help of more friends and family, we were able to set up for our start time of 5:00pm.

On October 3, 2009, my senior year of college, I was able to start a fundraiser in honor of my father called Kick Pancreatic Cancer (K.P.C.). The event was a soccer match held at Waynesburg University.

My soccer team played in purple and raised money for the Hirshberg Foundation.

The first year we raised over $12,000. Since then Waynesburg University Soccer Team has made K.P.C. an annual event and continues to raise money and awareness for pancreatic cancer.

As the nerves and tension were at their highest, the doors opened, people came in and the check-in table became flooded. The turnout was greater than expected and it was one of my proudest moments.

Once everyone was seated and the silent auction and dinner were underway, I looked to my family. I

I started K.P.C. as a way to deal with the pancreatic cancer diagnosis of my Dad in August, 2009. I have since graduated and needed another way to express my concern and raise awareness, so three Catherine Moore, Kristin Johnson L-R: Annie Campbell, Kenny Cline, close friends (Kenny Cline, knew that my dad was smiling Kristin Johnson, and Annie and that we all had made him proud. We had three games Campbell) and I created Purple Palooza. It was to be a formal running throughout the evening, as well as a mystery box raffle night of dinner, dancing, games, and silent auctions. This was and a 50/50 raffle. Our photographer for the evening, who going to swing our fundraising in a different direction but was donated her time, took outstanding photos so we were able to sure to catch the eye of our local community. document our night in a scrapbook and create a slideshow to My dad, Ken Moore, was a large figure in many different orgacapture our smiles and outstanding moments. nizations in my local community and in a variety of businesses.

Prizes were won and memories were made. All in all it was a Once the news of his condition was heard and felt, the support great night in charity and fellowship. That evening we raised was behind us. We met with our local hospital, local paper, radio over $8,000 and through additional donations reached a grand station, and several businesses where we began our advertising total of $20,000. The co-coordinators of the event all shared a and our invitation list. The donations of items for our auction personal relationship with my dad, who was our boss at Fort and our game prizes came in double what we were expecting Steuben Scout Reservation, our mentor, close friend, and role and they came from all sorts of donors. model. We were all touched by the turn-out, shocked by the Without hesitation our event was on its way to being a hit, amount raised, and are excited to report that we will be holding but then my family situation began to cause our planning and another Purple Palooza on November 19, 2011 at the St. Florian preparation process to be put on hold. My dad had gone in Hall in Wintersville, Ohio. for a normal procedure but complications arose in the healing process causing him to stay hospitalized. This situation was confusing and heart breaking and before we could get him

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FORE a Cure

By Kim Pope In November of 2010, the 1st Annual FORE a Cure 50/50 Raffle was held in memory of Dr. Steven Fore.

A 50/50 raffle is simply a raffle where we sell tickets, and half of the money collected goes to the Foundation while the other half is given to the winner (with the request to donate the entire amount back to the Foundation). We sold 500 tickets and raised $1,250 for the Hirshberg Foundation.

In April of 2009, my stepfather, Dr. Steven Fore was given the devastating diagnosis of Pancreatic Cancer. Steven was a husband, a father, a grandfather, and a physician who gave of himself to so many and never wanted anything in return.

His life, both professionally and personally, was devoted to good health. The diagnosis of Pancreatic Cancer was shocking because the risk factors associated with this cancer did not apply to Steven. Within days of his diagnosis, he had the Whipple procedure, followed by chemo and radiation but ultimately lost his battle on August 16, 2009.

treatments, and ultimately, prevention, will replace the current grim statistics for individuals diagnosed with Pancreatic Cancer. If you, or someone you love, has been affected by this disease educate, advocate, and donate today!

Scotty Fest

By Raymond Shively Since its inception in 2005, Scottyfest has continued to grow both in size and popularity. The Ferguson Corporation continues to support the golf tournament with their resources and its personnel. Under the guidance of their district manager Nick Colletti and their Bay Area manager Michelle Kujawski, the family is looking forward to its next Scottyfest to be held in September of 2011. Ferguson continues to take care of the green fees, cart fees, buffet dinner, box lunches and tee prizes, all in keeping with Scott’s wishes to have a day on the course with his friends. Scott’s family, Ray and Joan, brother Gary, sisters Susan and Jennifer, daughters Cambria and Erin and their spouses also support the tournament by manning different holes, serving refreshments and selling raffle tickets or participating in the tournament itself. The Shively family is deeply appreciative for the efforts of the Ferguson Corporation for keeping our Scott in their memory and raising money for pancreatic research so that maybe someone else doesn’t have to suffer the way Scott did.

In spite of his seemingly good health, he lived only four months after his diagnosis.

Although we are grateful for those months, he suffered terribly during the various treatments. Losing a loved one is difficult, but watching a vibrant, healthy person become ravaged by cancer is indescribable. Our

goal is to raise awareness for this silent but deadly disease and continue raising money for research. Steven strived

to educate his patients, family, and friends on health issues. We know he would want others educated about Pancreatic Cancer and spared the typical progression of this disease. Our hope is that researchers are provided the funding so that early detection, more successful

L-R Ray Shively, Gary Shively, Steve Bergerhouse and Mike Boehrer

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Tribble – Thrill in D-Ville Race

By Janet Francis Attending Tift College, in Forsyth, Georgia, I first learned of and admired a former graduate of this institution known only to me as Tribble. Her reputation for fun and adventure was not only known to those who attended college with her, but was also passed on to all rookie freshmen who entered Tift College halls.

It was through a mutual friend and former graduate of Tift that I learned that Tribble was actually a last name and that her first name was Nancy. Over the years, Tribble became a fixture in my life and in the lives of those with whom she developed friendships not only through college, but through her work as well. Tribble entered the teaching profession, a career path taken by many who graduated from Tift College, and was ever the teacher. In any scenario, Tribble created ‘teachable moments’ about science, cooking, and travel. Each lesson was given with gusto and quite often, much humor.

When Tribble was diagnosed with pancreatic cancer, she began researching the symptoms, cause and treatment. She was tireless in her research for facilities with expertise in the area of pancreatic cancer. She survived over a decade with a

malignant cancer that is normally characterized by a much shorter survival period. Tribble created many humor-

ous moments with each procedure and surgery performed to remove or reduce metastasized cancer cells. One such moment was during a radiofrequency ablation of damaged liver cells when friends were urged to eat liver on her behalf.

Though knighted during her senior year at Tift, she carried the essence of Sir Anton with her through every battle and to the very end.

Tribble will remain in the hearts of all those she touched – her friends, her students and her family.

The Thrill in D-Ville Annual Labor Day Road Race originated in the fall of 2009 with a small group of friends and family in Dawsonville, GA. They raised $700.00. The Second Annual event was bigger and better than the first, bringing in over $1500.00! We are looking forward to our Third Annual Thrill in D-Ville Labor Day Road Race on September 3, 2011 in an effort to raise money for the Hirshberg Foundation in the name of Nancy Faye Tribble.

I truly believe her passion and enthusiasm for life, her continued optimism for a cure, as well as her love of family and friends, extended her life beyond the amount of time normally ‘given’ to such patients. She exemplified love of life, as characterized by Sir Anton, Lover of Life, in the traditional Round Table Ceremony performed annually at Tift College. The qualities she exhibited during her college years followed her throughout her life.

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Hirshberg Fund Spotlights Hirshberg Funds are created by individuals to honor or memorialize someone who has been affected by pancreatic cancer and help find a cure at the same time. Each Hirshberg Fund has a standing page on our website where the creator of the fund can upload pictures, share their story, and allow friends and family to donate securely to their fund. Our funds also provide the opportunity to honor or remember someone during times of celebration, such as a wedding or birthday, or while participating in a sporting event, such as a marathon or triathlon. Funds can be created for any reason, event or occasion. To learn more about each of our Hirshberg Funds, visit our website and click on How You Can Help.

and those frequent visits meant his overall health was monitored quite closely. His early diagnosis would prove to be key. They suggested the Whipple surgery and early on my Dad decided he was going to “whip the whipple”. He is a fighter and has plenty to live for. A little more than two weeks after being diagnosed he had the surgery.

Tessa’s Fund: Shaving My Head for Pancreatic Cancer

By Tessa Todd

In December 2009 my mom was initially diagnosed with bile duct cancer. On January 14, 2010, her diagnosis changed to pancreatic cancer after a new biopsy was performed. She was given six months to live without chemotherapy and nine months with chemotherapy and surgery.

After further investigation, it was found that mom was not a surgical candidate because they found one metastasis in her liver. She began a chemotherapy regimen while seeking out other surgical options. She had a liver ablation to remove the one spot in her liver in April and in August found a surgeon that would attempt a Whipple procedure. The doctor opened mom up and found that the cancer had spread so they closed her up and surgery was no longer an option. Mom stayed on chemotherapy until she passed away on January 12, 2011. She endured a few set backs; infections that ended her up in the hospital, an allergic reaction to chemotherapy, but through it all g-d was beside her.

I wanted to do something to honor my mom and raise awareness and money for pancreatic cancer research. I decided to create a Hirshberg Fund and raise money to shave my head. I raised $830 for research! My mom was there with me through the whole process. I miss my mom and wish there was a cure for this horrible disease!

Whip The Whipple – Alcatraz Invitational Swim 2011

By Mark Allen Church My Dad is “whipping the whipple”.

Yes, it is true.

An avid swimmer and rower in the San Francisco Bay area for most of his life, Dad was diagnosed with pancreatic cancer in early September, 2009. He had a pretty regular schedule of doctor appointments related to heart trouble

When my Dad was in his late 40s, he started swimming and rowing in the San Francisco Bay area. He is a long time member of the South End Rowing Club at Aquatic Park and they sponsor an Alcatraz swim every year. As a young boy I was amazed and impressed watching him finish that Alcatraz swim, having grown up with the understanding that it wasn’t possible to swim from Alcatraz to the shore. Sharks, cold water, tides, all that! He was not fast, but he did finish. And he did NOT wear a wetsuit.

After I learned my Dad had pancreatic cancer I started looking into the disease.

I was horrified to learn how rare it is for someone to live years past a diagnosis.

I found the Hirshberg Foundation quite by chance. I was just looking for a 10k to keep in general shape and came across the LA Cancer Challenge. When I learned it was an event focused on raising money for Pancreatic Cancer Research I had a

to the ER, where we would get the diagnosis that changed our lives forever.

I had only known one other person who had been diagnosed with pancreatic cancer. Quickly and painfully he also lost his battle with this horrible disease. I have to admit I never thought of or really heard about this disease before then.

Little did I know it would creep into my life again, affecting me forever.

“lightbulb” moment. Wow, I could run AND raise money for this important cause which suddenly was quite important to me personally.

I was very impressed with the Hirshberg Foundation. Any time I had a question, someone would contact me directly. This is a very accessible and warm organization. The event was amazing, inspiring and very well organized. When I posted a picture of my run on Facebook, Agi herself contacted me with words of encouragement and I knew then that I had found a cause that I could take pride in and raise money for.

who has meant so much to me through the years. I am so thankful to be able to take on this swim and raise money for pancreatic cancer research at the same time. I am so thankful that he will be around to watch me take on this challenge and that his continued success can be an inspiration to others fighting this horrible disease. It can be beat! With your help and the help of the Hirshberg Foundation, I am not just hoping…I am helping.

Never give up…You can Hope, or you can Help…Help Us Whip The Whipple!!!

signed up for the Alcatraz Invitational Swim taking place on September 17th, 2011.

A lifetime goal! I

I soon realized it was a perfect opportunity to raise money for the Hirshberg Foundation.

When I talked to my Dad about the swim, his first question was, “Are you using a wetsuit”? I had to break the news to him that I was indeed going to be suited up, knowing that some light-hearted teasing would follow (and you can be sure it has!), but he was excited that I was planning on doing the swim. In fact, he plans on being in a pilot boat, helping support me during the actual swim!

Yes, my Dad is “whipping the whipple” and just received another all-clear report.

He is still cancer-free more than one year after his surgery and is starting to put on some weight. I am so thankful to have more time with this man, my father,

In Memory of Pamela Martens Boughton

By Lisa Boughton

My mom was diagnosed with pancreatic cancer in July of 2010. She had not been feeling well for a few weeks. Finally, my father noticed that she was jaundiced.

He called his doctor, who then asked my mom a few questions. After that telephone conversation my dad rushed her

The irony in all of this is that my mother was a nurse. She spent ten years as an oncology nurse at the same hospital where her Whipple procedure was eventually performed. She survived the surgery, two weeks in the hospital, and one round of chemo. We only got five months. The cancer spread to her liver.

My mom, my hero, died on November 27, 2010 at just 64 years old.

Anyone who reads this knows how devastating this disease is. I watched her suffer, yet she never let on how much pain she was in. Was that because she was a nurse, had seen people die of cancer and knew what was coming?

Did she want to spare us more grief and pain than we already had? Knowing her, the answer is “yes” to all of the above. I would ask her every day, “How are you feeling today mom?” She always replied “so-so”. I could tell she was putting on a brave face. She never complained; never let it get the best of her. She refused our help, whether it was bathing, getting up and down stairs, or urging her to take the pain meds she so desperately needed.

My friend Kelly found the Hirshberg Foundation online and directed me to the website. It has been a God send. In lieu of flowers, we directed that donations be sent to the Hirshberg Foundation and to date we have raised $870.00. In doing so, it was my hope that more people would become aware of pancreatic cancer. I hope and pray that someone else can be spared the pain and devastation this disease inflicts on families and patients alike.

This year’s LA Cancer Challenge was nothing short of amazing.

With 4,170 registered participants, this was the largest and most successful LACC to date. Everyone came together in pursuit of our common goal: to fight Pancreatic Cancer.

And together, we raised more than $585,000 for cancer research. We could not have accomplished this without the help of our entire LACC community, including our team captains, volunteers and participants. Thank you for spreading awareness and helping raise funds to end pancreatic cancer. Preparations are well underway for the 14th Annual LA Cancer Challenge, to be held on Sunday, October 30, 2011. After a record-breaking 13th year, our 2011 goals are to exceed 5000 participating runners and raise $750,000 so we can continue critical research for family and friends facing Pancreatic Cancer. We need your help and are counting on you in 2011. Thank you for fighting with us. We will not stop until we find a cure! To register or get more information, please visit www.

LACancerChallenge.com.

Y o u C A n H o p e o r Y o u C a n H e l p TM

It’s challenging enough to run 26.2 miles on a sunny day. But on March 20, 2011 the members of the Hirshberg Training Team had to endure strong winds, heavy rain, and cold temperatures while running the 26th LA Marathon. In addition to the physical challenge, they also were running to raise awareness and funds for pancreatic cancer research. The 2011 Hirshberg Training Team all crossed the finish line in honor or in memory of a loved one touched by pancreatic cancer and raised a combined total of more than $20,000.

While the runners were battling torrential rains and shin-deep puddles, about fifty volunteers helped the Hirshberg Foundation host a Cheer Station at Mile 21. Our volunteers, deemed the “Purple People Party”, wore purple hats and tees, waved purple pom poms, held purple signs and cheered for the 23,000 runners who passed by. DJ Phillip was on our stage playing great music and reminding the marathoners that they were “stronger than the rain, stronger than the wind”. You can hope, or you can HELP! Join us in Los Angeles in 2012 as we travel from the Stadium to the Sea for pancreatic cancer! Visit www.HirshbergTrainingTeam.com for more information.

HIRSHBERG FOUNDATION

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FOR PANCREATIC CANCER RESEARCH

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FOUNDATION Newsletter

2011 2011 Calendar of Events DATE: EVENT: LOCATION: CONTACT:

April 16, 2011 The Pursuit of Wellness Walk/Run Manchester, VT thepursuitofwellness@gmail.com

DATE: EVENT:

LOCATION: CONTACT:

July 23, 2011 3rd Annual Dal Bon Memorial Golf Tournament Alta Sierra Country Club - Grass Valley, CA www.dbmemorial.ning.com

DATE: EVENT: LOCATION: CONTACT:

September 3, 2011 3rd Annual Thrill in D’Ville Dawsonville, GA bballjanet@bellsouth.net

DATE: EVENT: LOCATION: CONTACT:

September 17, 2011 John V. Taylor Poker Ride Mesa, AZ info@johnsride.com or www.johnsride.com

DATE: EVENT:

LOCATION: CONTACT: DATE: EVENT:

November 5, 2011 2nd Annual Dale H. Burton

Alligator Walk LOCATION: Winston-Salem, NC CONTACT: alligatorwalk@gmail.com or www.pancreatic.

org/memorial/alligatorwalk DATE: EVENT: LOCATION: CONTACT:

October 10, 2011 4th Annual Kevin Miya Golf Classic Pittsburg, CA silvanic@pacbell.net

DATE: EVENT:

LOCATION: CONTACT:

October 30, 2011 14th Annual LA Cancer Challenge 5K/10K Walk/Run and Kids Can Cure Fun Run Los Angeles, CA www.lacancerchallenge.com

November 19, 2011 2nd Annual Purple Palooza Wintersville, Ohio purplepalooza2010@gmail.com

DATE: EVENT:

November 2011 Glenda Jane Koffler Memorial Golf

Tournament LOCATION: Pasadena, CA CONTACT: kjamkoffler@gmail.com

DATE: September 24, 2011 EVENT: 7th Annual Scotty Fest Golf Tournament LOCATION: Sunol, CA DATE: EVENT: LOCATION: CONTACT:

October 2011 3rd Annual Kick Pancreatic Cancer – Soccer Match at Waynesburg University Waynesburg, PA hnweaver@gmail.com

DATE: EVENT: LOCATION: CONACT:

Pancreatic Cancer Awareness Month November 2011 EVENT: 2nd Annual 50/50 raffle LOCATION: High Point, NC CONTACT: mepjan24@triad.rr.com

DATE:

November 2011 2nd Annual Don Dorosh 5K Fun Run Beacon Falls, CT rlewis304@gmail.com