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UCSF HDF Cancer Center Newsletter

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First redesigned newsletter for the newly branded Cancer Center at UCSF.

First redesigned newsletter for the newly branded Cancer Center at UCSF.

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  • 1. u From the director ~ 2 u Personalized breast treatment ~ 6 u Clinical trials pace progress ~ 3 u Targeting melanoma genes ~ 7 u Cancer research building opens ~ 4cancerreport Summer 2009 > Clinical Services > Perspective When cancer runs in families Does cancer run in your family? If you or a close family member has been diagnosed with an early cancer – breast cancer at age 45 or younger, colon cancer at age 50 or younger, prostate cancer at age 60 or younger, or ovarian cancer at any age – you may want ‘‘ We see ourselves as pioneers in transformative, to consider the services offered by the UCSF Cancer Risk Program. Members of the Cancer Risk Program at UCSF – including genetic interdisciplinary cancer counselors, oncologists, surgeons, clinical geneticists and primary research and its translation care physicians – identify and counsel individuals and families at into improved prevention, high risk for cancers caused by inherited, abnormal genes. detection and treatment. Frank McCormick, Director, UCSF Helen Diller Family ’’ Counselors examine medical histories and the pattern of cancers within the family tree. When appropriate, they offer testing for spe- Comprehensive Cancer Center > page 2 cific genetic abnormalities called mutations. Counselors work with family members to help them make decisions about being tested, and to develop personal cancer screening and prevention plans. > page 51> cancer.ucsf.edu information, visit us at ~ For more > cancer.ucsf.edu
  • 2. > Perspective From the director Today, there are more than 11 million research and medical practice. About US cancer survivors. They are living one-quarter of UCSF’s full-time faculty proof that science and medicine have members work in cancer research and made real progress against this most patient care. Based on measures such feared disease. We are making great as merit-based research funds awarded strides in developing treatments that through the National Cancer Institute, offer more than chemotherapy and NCI Comprehensive Cancer Center radiation therapy. status, the success of our clinical care programs, and the qualifications and At the UCSF Helen Diller Family Com- achievements of our students and resi- prehensive Cancer Center, we see dents, I believe the level of excellence we ourselves as pioneers in transformative, have achieved – and that we are com- interdisciplinary cancer research and mitted to building upon – is unsurpassed. its translation into improved prevention, detection and treatment. Twenty years ago, UCSF scientists were awarded the Nobel Prize for showing The Cancer Center joins together top that cancer growth is driven by certain scientists with exceptional medical genes that undergo abnormal changes. practitioners. This culture of interdisci- Their work opened the floodgates. plinary teamwork enables us not only Hundreds of genes that can become to make key discoveries, but also to abnormal and foster tumor growth now Frank McCormick, PhD ensure that this new knowledge leads have been identified. to better treatment matched to the individual patient. We have learned that even tumors of the same type in different patients may Discoveries and inventions by UCSF rely on different, abnormal genes to faculty already have resulted in the cre- grow and survive. Some of these ab- ation of dozens of new companies that normal genes are proving to be suitable make better products available for drug targets. Cancer Center members are collaborat- > Our mission ing and consulting with pharmaceutical The UCSF Helen Diller Family Comprehensive Cancer Center is dedicated industry partners to identify the most to conquering cancer worldwide through innovation and education. promising new drug candidates. These are being clinically evaluated in patients stricken by tumors with specific genetic profiles. We expect that these new partnerships will result in faster prog- ress and greater success in making new drugs available for clinical practice.2 ~ cancer.ucsf.edu
  • 3. { A Comprehensive Cancer Center } Any cancer center can call itself compre- hensive, but the UCSF Helen Diller Family Comprehensive Cancer Center has earned that designation from the National Cancer Institute (NCI). “Comprehensive” signifies national leadership in advancing cancer treatment, and in research and education. It is the highest ranking, awarded through a rigorous evaluation with approval of the NCI Cancer Advisory Board appointed by the US president. As this news- letter goes to press, there > Clinical Trials are 40 NCI-designated Comprehensive Cancer Centers nationwide, but only one in Clinical trials pace progress against cancer Northern California – the UCSF Helen Diller Family Comprehensive Cancer Center. u The percentage of people who survive five years or more fol- lowing a cancer diagnosis has nearly doubled in the past 40 years. Millions of long-term cancer survivors living full lives today are a testament to improved treatments. Yet hundreds At first, some novel treatments may only of thousands still succumb to cancer each year. We still be available to UCSF patients through have far to go. clinical trials. Even so, by engaging fully The development of drugs has played a key role in improv- in the global communities of biomedical ing cancer survival. But no new cancer drug is approved research and health care policy, and by for standard medical practice without first being tested educating future generations of research- through clinical trials in carefully selected patients. ers and medical caregivers, we aim to advance medical practice worldwide. Each cancer is different. Tumors rely on any of several bio- chemical pathways – involving many genes and proteins – to In these pages, we welcome you to abnormally survive, grow and spread. Different tumors may glimpse some of the continuing prog- be vulnerable to different treatment approaches. ress we have made in tracking down and targeting abnormal genes in cancer, The aim is to better know the enemy – and to use the best in preventing and diagnosing cancers, weapons against each tumor to increase the likelihood of and in growing the ranks of cancer cancer-free survival for each patient. survivors. u “We are designing clinical trials at UCSF that will be more focused and targeted,” says breast cancer oncologist Pam Munster, MD, who also is director of early-phase clinical Frank McCormick, PhD, Director, UCSF Helen Diller trials for the Cancer Center. Family Comprehensive Cancer Center Researchers and physicians at the Cancer Center are lead- ers in making new discoveries of distinctive tumor profiles. They are shedding light on the ways in which these tumor > page 4 cancer.ucsf.edu ~3
  • 4. > New Facilities Helen Diller Family Cancer Research Building opens On June 2, 2009, UCSF cel- designed by noted architect ebrated the opening of the Rafael Viñoly, the five-story new Helen Diller Family Can- building provides a largely cer Research Building. The open research space. At full 162,000-square-foot building build-out, it will house 46 now emerges as an integral principal investigators and part of UCSF Mission Bay, at a total community of 475 the heart of San Francisco’s researchers and staff. Investi- biggest urban development gators have already taken up push since the construction residence to begin working of Golden Gate Park. to identify cancer risks, to UCSF Mission Bay is a far Mission Bay campus has explore how cancers arise, Centrally located at 3rd cry from the abandoned rail quickly become a magnet and to develop new ideas Street and Mission Bay yards that covered the site a for biotech development. for cancer prevention and Boulevard South, and few short years ago. The treatment. Plans are also well underway for this to become the future> See photos of the new facilities online at cancer.ucsf.edu/diller Clinical trials from page 3 characteristics might be optimally target- Clinical trials may represent an especial- ed with new or existing drugs – or com- ly important opportunity for individuals binations of drugs. Major Cancer Center with advanced cancers who no longer research programs with this aim engage benefit from standard treatment. dozens of scientists and physicians, as well as collaborators from industry who Few take part work on developing new drugs. Even so, less than 5 percent of cancer patients nationwide participate in clini- “We can bring together our scientists cal trials. As a result, it takes longer to who work on particular cancer path- evaluate anti-tumor treatments and to Even patients on standard therapies ways with scientists from pharmaceuti- get the best ones into standard practice risk side effects. For drugs still under cal companies or the National Cancer to improve cancer outcomes for all the investigation in clinical trials, the risks Institute who work on drugs that target patients who might benefit. may not all be known ahead of time. molecules in those pathways,” Munster But no trial begins without laboratory, says. “We want to include in clinical The reasons few participate are complex, cellular and animal studies on the safety trials patients who are most likely to Munster says. Some people may be and cancer-fighting ability of the drug in benefit – the ones with tumors that we unaware of the opportunity. In addition, question. Clinical trial researchers and think will be vulnerable to the treatment.” Munster says, individuals with advanced sponsors do not begin a study without disease tend to be too hopeful about Patients who elect to participate in clini- prior evidence that a new drug will be the standard of care for their condition, cal trials have the first chance to benefit better than – or at least as good as – and to underestimate the potential ben- from effective new therapy. Opportuni- existing treatments for many patients. u efits of drug candidates being evaluated ties to receive the newest treatments in clinical trials. are available for patients with many types of cancers at different stages. > To find cancer clinical trials at UCSF Call 877/827-3222 (toll-free) or email clinicaltrials@cc.ucsf.edu4 ~ cancer.ucsf.edu
  • 5. Scientists at the new cancer discoveries that inform think- research building are well ing about new ways to treat placed to engage in collabo- all forms of the disease. rations that will help move Construction of the building new discoveries into clinical began in 2006, thanks to an applications. indispensable gift of $35 mil- The new building allows lion from the Helen Diller Fam- consolidation of research ily Foundation of the Jewish programs in brain tumors Community Endowment Fund. and prostate cancer, as The building is already a hive well as in population sci- of research activity, and with ences – a broad field that its beautiful atrium and open includes epidemiology, design, provides an ideal chemoprevention, screen- environment that fosters ing, health communication, collegiality and idea sharing. behavioral science, health The building enhances services, policy, surveillancehome of the first new hos- urgent and emergency care ongoing cancer research and survivorship research.pital to be built in the city in and pediatric ambulatory programs at UCSF Mount It also is the new home ofdecades. The 289-bed proj- care facilities, and a women’s Zion and Parnassus, greatly scientists who make funda-ect will include a hospital for hospital for specialty care, expanding the existing space mental discoveries about theadult cancer surgery patients, with a center for women dedicated to cancer research biological causes of cancer –a children’s hospital with and newborns. at UCSF. uClinical services from front coverAbout 5 percent to 10 percent of cancer But BRCA mutations also increase risks associated with an 80 percent lifetimecases are due to inherited mutations that for other cancers. Among men, muta- risk for colon cancer. Women with Lynchrun in families. Each member of such a tions confer a 16 percent to 22 percent syndrome also have an elevated risk forfamily has a 50-50 chance of inheriting lifetime risk for prostate cancer, usually endometrial and ovarian cancers.the mutation from an affected parent. occurring before age 65. UCSF oncologists were among the first Sadly, men diagnosed with prostate to routinely screen all newly diagnosedLarge benefit cancer may not suspect that they carry colon cancer patients age 50 and under“If you can identify older individuals in the a BRCA mutation until a daughter is with a new pair of lab tests that can be family who have had cancer at a rela- diagnosed with advanced-stage breast used to identify tumors that are almost tively young age, and who carry a muta- cancer. “It’s very important for men with certainly the result of Lynch syndrome. tion, then you can make a real difference prostate cancer to inform their health for their brothers, sisters and children,” Tests to detect Lynch syndrome gene care providers about any family his- says Beth Crawford, director of clinical mutations in carriers before they devel- tory of breast cancer, ovarian cancer, services for the Cancer Risk Program. op cancer also are available. If someone prostate cancer, melanoma or pancre- is found to carry a Lynch syndrome mu-One set of inherited cancer genes – atic cancer – and to ask for a referral to tation, colon cancer screening is recom-called BRCA genes – is most closely genetic counseling,” Crawford says. mended, starting at age 22. Physiciansassociated with breast and ovarian Inherited colon cancer most often is use colonoscopy to detect and removecancer. Up to 80 percent of women due to Lynch syndrome, which arises polyps, usually before they have had awho inherit a BRCA mutation from their from mutations in any of three related chance to become cancerous. umother or father will develop breast genes – MLH1, MSH2 and MSH6. It iscancer at some point. Up to 60 percentwill develop ovarian cancer if they havea mutation in BRCA1; up to 27 percent > For more information Call 415/885-7779 or (toll-free) 877/747-5422,if they have a mutation in BRCA2. or visit ucsfhealth.org/cancerriskprogram cancer.ucsf.edu ~5
  • 6. > InitiativesPersonalized breast cancer treatmentLaura van ’t Veer, PhD, has changed Van ’t Veer was determined to see thatthe way physicians look at breast her research did not languish in a lab. Laura van ’t Veer, PhDcancer. Tumors differ from each other To make sure that MammaPrint reachedgenetically. And thanks to van ’t Veer’s the clinic, she started her own company.pioneering vision, oncologists now use Now, in collaboration with researchers Van ’t Veer now has chosen UCSF for aa new generation of genetic tests to and physicians at UCSF, van ’t Veer research sabbatical – prized time whenhelp make treatment decisions. sees new opportunities to develop ad- dedicated researchers can work free ofFewer women with low-risk breast can- ditional clinical applications to benefit competing administrative duties.cer are being treated unnecessarily with breast cancer patients, based on new She is collaborating with Gray to lookdrugs that may have side effects. More knowledge of genetic abnormalities and for genetic patterns in tumors that canwomen with high-risk disease are re- molecular markers in cancer. help predict the combinations of stan-ceiving appropriate, aggressive therapy. Van ’t Veer, who chairs the Division of dard or experimental drugs that may Diagnostic Oncology at the Netherlands best target each tumor.Lab on a chip Cancer Institute, originally came toVan ’t Veer led the bench-to-bedside Van ’t Veer also is collaborating with UCSF in 2003 at the invitation of patientdevelopment of the MammaPrint. The Esserman to prepare the next phase of advocates to speak at an Avon Founda-MammaPrint is a lab test on a chip. a major, unique clinical trial. During the tion breast cancer symposium.It detects patterns of gene activity in course of the study, knowledge of howsamples prepared from breast tumors. early genetic and imaging measure- More creative timeThe various patterns of gene activity ments are associated with treatment re- During her first UCSF visit, van ’t Veerdetected by the MammaPrint indicate sponses will be used to direct patients established key connections with leadersa better or worse likelihood of breast to the treatments that are predicted to of the Cancer Center’s Breast Oncol-cancer’s returning despite surgery. work best for them individually. ogy Program, Joe Gray, PhD, and LauraResearch shows that for early-stage Esserman, MD. Like van ’t Veer, Gray is “The breast cancer program is a goodbreast cancer, the MammaPrint is a a leader in developing techniques widely instrument for integrating basic researchmore accurate gauge of breast cancer used to probe genes. Esserman leads with patients’ needs, and with the capa-prognosis than previously established clinical trials that aim to quickly evaluate bility to evaluate new clinical approach-measures. the effectiveness of treatments for indi- es,” van ’t Veer says. For her, that makes vidual patients prior to surgery. UCSF a home away from home. u > To reach our world-class breast care center The UCSF Carol Franc Buck Breast Care Center provides specialized services, including individual counseling as well as support groups that focus on every stage that you and your family may experience. For information about services or appointments, call 415/353-7070 or visit ucsfbreastcarecenter.org.cancer.ucsf.edu
  • 7. Adil Daud, MD, (far left) and Boris Bastian, MD, (left) work together, applying new research knowledge to better match patients to new treatments for melanomas. > Partners Targeting melanoma genes for treatment success The most deadly skin cancer, melanoma, is Bastian recently identified a previously unsuspect- becoming more common. Fortunately, a sea ed genetic abnormality that drives an aggressive change is at hand in the development of tailored form of melanoma – one that arises within the treatment to target these tumors. eye. Bastian and Daud now are working with Alnylam Pharmaceuticals on a clinical trial to Cancer Center pathologist Boris Bastian, MD, specifically target the gene culprit with a new type now has identified distinct genetic abnormalities of drug. There currently is no effective standard that distinguish different subtypes of malignant therapy to treat this eye cancer once it spreads. melanomas. With this new knowledge, Bastian is leading efforts to redefine the different forms Similarly, standard therapies do little to improve of the disease, and he has set the stage for long-term survival of advanced forms of more the identification and testing of better targeted common melanomas. But Bastian has discov- treatment. ered that some of these melanomas seem to rely on an abnormal gene that should make Bastian’s work also has made it easier to them vulnerable to an already standard targeted diagnose melanomas and to distinguish these therapy, called Gleevec. Gleevec had previously potentially deadly cancers from harmless moles. been tried and rejected for melanoma because it Better yet for patients, Bastian recently teamed failed in most cases. up with Adil Daud, MD, an oncologist who treats Now, in early studies by Bastian and others, skin cancers exclusively. Daud has a wealth of Gleevec again is being tried to treat patients experience in designing and leading early-stage with melanomas driven by this particular genetic clinical trials of novel therapies. Daud has seen mutation. Some patients have shown no signs firsthand how some patients can have remark- of any remaining cancer after treatment, dem- able responses to new treatments, even after onstrating the power of targeted therapy. More standard therapies have failed them. studies are in the works. “We have planned a rationally based panel of> To learn more about skin cancer clinical trials that take into account the individual and its prevention characteristics of a given patient’s tumor, to Visit dermatology.medschool.ucsf.edu/skincancer to match them with the appropriate drug,” Bastian find out about melanoma, sun protection, self-exams and says. “That’s the vision.” u our clinics. cancer.ucsf.edu ~7
  • 8. UCSF Helen Diller Family Comprehensive Cancer Center Nonprofit organization Communications Unit U.S. Postage University of California, San Francisco PAID San Francisco, CA 94143-1297 University of California San Francisco ADDRESS SERVICE REQUESTED UCSF Helen Diller Family Comprehensive Cancer Center Cancer Report Summer 2009 An information resource for patients, caregivers, advocates, donors, volunteers and members of the community> How to get in touch Obtain our world-class care For personal help finding a doctor, call 888/689-8273 (toll-free) or email referral.center@ucsfmedctr.org. Assistance is available Monday through Friday, 8 a.m. to 5 p.m. Get support The Ida & Joseph Friend Cancer Resource Center offers information on treatment options, free classes, support groups and referrals to community resources. Call 415/885-3693 or visit cancer.ucsf.edu/crc. Find cancer clinical trial opportunities Clinical trials are listed online at cancer.ucsf.edu/trials. For more information, call 877/827-3222 (toll-free) or email clinicaltrials@cc.ucsf.edu.> Tell us what you think This newsletter is designed to reflect your needs and interests. We want to hear from you: The first 50 people who complete our online survey will receive a free iTunes gift card. To take the survey, visit bitly.com/brjn. > cancer.ucsf.edu If you do not want to receive further newsletters, please write to the Records Manager, UCSF Box 0248, San Francisco, CA 94143-0248, email HIPAAOptOut@support.ucsf.edu or call 888/804-4722. If you have other questions about this publication, email us at communications@cc.ucsf.edu. Produced by UCSF Public Affairs. Edited and written by Jeffrey Norris. Designed by Nada Salam. Photos: Noah Berger, pp. 1, 2; Susan Merrell, p. 6; Mark Estes, p. 7 This publication is printed on New Leaf paper made with 100 percent recycled fibers, 50 percent post-consumer waste and processed chlorine-free.8 ~ cancer.ucsf.edu © 2009 The Regents of the University of California PR722