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November 3, 2014

MESSAGE FROM THE DIRECTOR

Sharifi Appointed Co-Leader of GU Malignancies Program

Dr. Nima SharifiNima Sharifi, MD has been appointed as co-leader of the Genitourinary Cancer (GU) Program for the Case Comprehensive Cancer Center. Joining Program co-leader Dr. Brian Rini, they presented the program at the recent External Advisory Board (EAB) meeting. Richard Cote, a member of the EAB, commented on the progress made in the program and on the importance of keeping together the research base in prostate, kidney and bladder cancers and the effort in clinical trials. Dr. Sharifi's own interests in prostate cancer will complement the interests of Dr. Rini in kidney cancer and clinical trials.

Dr. Sharifi is the Kendrick Family Endowed Chair for Prostate Cancer Research at the Cleveland Clinic. He is a professor of cancer biology at the Cleveland Clinic Lerner College of Medicine at Case Western Reserve University, and a member of the Department of Cancer Biology and the Glickman Urologic Institute. He studies the process of steroid metabolism and androgen receptor function in prostate cancer. Standard treatment for patients with advanced prostate cancer involves androgen deprivation therapy (ADT), as androgens are the driving force in the progression of this disease. His work helps to explain why conventional treatments result in clinical responses that are almost always temporary because tumors learn to make their own androgens. Dr. Sharifi discovered the metabolic pathway and genetic variance that is the root of this clinical observation, opening the door for clinical testing to identify patients at risk and new therapeutic targets.

Dr. Sharifi's laboratory recently discovered a genetic mutation in an androgen synthesizing enzyme present in drug-resistant prostate cancer tumors. (Chang, et all, Cell, 2013), and he contributed a review on this subject for the New England Journal of Medicine in 2014. The mutation makes it possible for tumors to create their own supply of androgens that fuel the growth of cancer even after androgen deprivation therapy.

Review of the First Adolescent & Young Adult (AYA) Cancer Symposium in Cleveland

Guest Message by John Letterio, MD, Chief, Division of Pediatric Hematology/Oncology, UH Rainbow Babies and Children's Hospital

Dr. John LetterioThis past week, the Case Comprehensive Cancer Center hosted the first biannual Adolescent & Young Adult (AYA) Cancer Symposium in Cleveland, which was held at the Wolstein Research Building Auditorium. The symposium started on a high note with the Annual Angie Fowler Lecture on Adolescent & Young Adult Cancer, given by Dr. Nita Siebel, Head of the Solid Tumor Section at the National Cancer Institute (NCI) Cancer Therapy and Evaluation Program (CTEP), and clearly set the stage for the Cancer Center's new scientific initiative focused on research in AYA Cancer.

The conference was organized in a collaborative effort by faculty and staff in the Angie Fowler AYA Cancer Institute at UH Rainbow Babies & Children's Hospital together with faculty from Doernbecher Children's Hospital and the Knight Cancer Center at Oregon Health Sciences University (OHSU), with the support of Cancer Center central administration. The conference attracted nearly 200 participants from academic medical centers, major non-profit organizations, patients and commercial vendors, who came from as far away as Texas, Oregon, Boston and Florida.

Those who attended were treated to an inspirational and informative two days of talks by national leaders in the field. With a goal to raise awareness about AYA Cancer, the symposium speakers spoke of strategic opportunities for research specific to cancer in the AYA population as well as opportunities to improve clinical and behavioral outcomes. Leaders from two major AYA Cancer nonprofit organizations collaborated in a session in which Heidi Adams, an AYA cancer survivor and the CEO of Critical Mass, reviewed nearly two decades of effort that have brought this field into the spotlight, and Simon Davies, CEO of Teen Cancer America, led a discussion on the opportunities that lie ahead. Mr. Davies treated the audience to a preview of a video that his organization created to highlight the great work underway at the UH Angie Fowler Institute, featuring interviews with very special two-time survivors of AYA cancer who received their care at Angie's Institute.

A Way Forward in a Challenging Environment
The symposium had two tracks, including a psychosocial track focused on information for patients, survivors and caregivers that delved into the psychosocial complexities of the AYA oncology population. The scientific track covered specific advances in targeted tumor-based therapy. Lectures by Dr. John Perentesis, Professor and Oncology Division Director at Cincinnati Children's Hospital, and by Deborah Morosini, Vice President of Clinical Development at Foundation Medicine, highlighted advances in pharmacogenomics and how they are beginning to inform treatment modalities and clinical trials objectives for cancers common to AYA patients.

Lectures by Dr. Brandon Hayes-Latin, Director of the AYA Cancer Program at OHSU, and by Dr. Lindsay Frazier of the Dana Farber Cancer Institute shed light on how reorganization of the NCI infrastructure supporting the clinical trials process is enhancing collaborations between the Children's Oncology Group and those cooperative groups developing clinical trials for adult cancer patients. The hope is that this type of collaboration will have an impact on the current and unacceptably low participation of AYA cancer patients in clinical trials.

The symposium ended with an incredibly inspirational and insightful lecture by Clifton Leaf, Deputy Editor of Fortune Magazine, AYA cancer survivor, and author of The Truth in Small Doses: Why We are Losing the War on Cancer and What We Need to do to Win It. Mr. Leaf challenged us to consider how the scientific community may have forgotten lessons from our predecessors, using the story of the Irish one-eyed surgeon Denis Burkitt and his 10,000 mile journey to solve the mystery of "African Lymphoma" to contrast the challenges to our progress, then and now. The statistics that Leaf provides in his book, and presented in brief in his lecture, not only back up his assertion that we're "losing the war," but also challenge us to work as advocates from within the "dysfunctional cancer culture" to push for real change in how science is funded and in how institutions, investigators and industry collaborate, which must happen if we are to save our next generation of scientists...and the many patients whose lives will ultimately depend on them.