Bradley E. Bernstein, M.D., Ph.D., professor of pathology at Massachusetts General Hospital and Harvard Medical School and director of the Broad Institute’s Epigenomics Program, will present “Epigenetic Plasticity and the Hallmarks of Cancer” Friday, November 30 as the inaugural speaker of the UAB Comprehensive Cancer Center Grand Rounds.
Bernstein’s lecture will begin at noon in the Margaret Cameron Spain Auditorium. Lunch will be provided.
“Dr. Bernstein is an internationally recognized expert in epigenetics in cancer. He has led this emerging field with a particular attention to clinically impactful discoveries,” said Michael J. Birrer, M.D., Ph.D., Evalina B. Spencer Chair in Oncology and director of the UAB Comprehensive Cancer Center.
The lecture is the first in the annual Cancer Center Grand Rounds, which will bring premiere cancer researchers from across the country to UAB. “The Cancer Center Grand Rounds series will connect UAB research with cutting edge technical and scientific discoveries in cancer. This will ensure our researchers are well informed and poised to help move the field forward,” Birrer said. “Further, this series will inform leaders in cancer research to the wonderful scientific environment at UAB.”
Bernstein is the Bernard and Mildred Kayden Research Institute Chair and Professor of Pathology at Massachusetts General Hospital, and a Broad Institute Member. Bernstein’s research focuses on epigenetics – changes in gene activity governed by influences outside the genes themselves – and specifically how modifications to the protein scaffold called chromatin contribute to mammalian development and human cancer. His work is notable for the identification of specialized chromatin structures that underlie stem cell pluripotency and aberrant epigenetic mechanisms that drive tumor initiation and drug resistance. He currently directs the Broad Institute’s Epigenomics Program, and is a leader of the NIH’s ENCODE project that aims to map all regulatory sequence elements in the human genome.
Bernstein received his B.S. from Yale University and his M.D. and Ph.D. from the University of Washington, before completing a residency in clinical pathology and postdoctoral research at Harvard University. Honors include an Early Career Scientist Award from the Howard Hughes Medical Institute, a Career Award in the Biomedical Sciences from the Burroughs Wellcome Fund, the NIH Director’s Pioneer Award, an American Cancer Society Professorship and the Paul Marks Prize for Cancer Research.
Helen Krontiras, M.D., director of the Division of Surgical Oncology at the University of Alabama at Birmingham, and Chrystal Rutledge, M.D., assistant professor in the Department of Critical Care Pediatrics, have been named two of Alabama Media Group’s 2018 Women Who Shape the State.
Krontiras, a breast surgical oncologist and professor in the Department of Surgery, joined UAB as an assistant professor 15 years ago and now serves as director of the UAB Division of Surgical Oncology and as medical director of the UAB Breast Health Center.
“I’m honored to be named one of the 2018 Women Who Shape the State and to be in such great company with Dr. Beierle and Dr. Locke, as well as the other 29 women who received this award this year,” Krontiras said. “The work we do within the Division of Surgical Oncology, the UAB Breast Health Center and the UAB Comprehensive Cancer Center has such an impact on so many patients, directly and as a result of our cancer research.”
Krontiras’ research focuses primarily on the chemoprevention of breast cancer. She is a senior scientist at the UAB Comprehensive Cancer Center and also serves as the clinical investigator on a new drug in development at UAB that hopes to reduce the risk of developing breast cancer, called UAB30.
Rutledge, a graduate of the UAB School of Medicine in 2008, also serves as medical director for the Critical Care Transport Team at Children’s of Alabama. Her research focuses on the use of simulation to teach the entire spectrum of health care providers using simulation to improve preparedness of community health care workers for sick children.
“This award means the work I am doing is meaningful and is impacting communities around the state, much like the one I grew up in,” Rutledge said.
Rutledge is helping to improve the care of children across the state through the Children’s of Alabama Community Healthcare Education Simulation (COACHES) Program.
“This free program gives me the opportunity to go to community hospitals across the state and provide educational training to hospital staff, as well as assess the hospital to make sure they have the appropriate infrastructure, policies, protocols and equipment to care for children,” she said.
Every year, AMG presents 30 Alabama women with the Women Who Shape the State award. These women are considered by their peers to be leaders within their respective communities and professional industries and are nominated in recognition of their efforts to advance Alabama through their work in philanthropy, commerce, advocacy or public service, as well as their work in the nonprofit or small-business sectors. Since its creation in 2015, the Women Who Shape the State list has included the Division of Pediatric Surgery’s Elizabeth Beierle, M.D., who was named in the 2016 list, and the Division of Transplantation’s Jayme Locke, M.D., who was named in the 2015 list.
It all started with a phone number listed in a newspaper article in 2004. Sally Graul, who had recently been diagnosed with breast cancer, called the number, unaware the call would ultimately change her life.
“I saw a newspaper article about a group of women battling breast cancer who had just been to Montana on a fishing trip, and I thought that sounded like it was right up my alley,” Graul said. “I dialed the number, and from there, I joined a family.”
The family Graul is referring to is called The Sisters, a diverse group of women ranging from 30-80 years old, who have one thing in common — breast cancer. Some of the women are currently fighting the disease, while others are survivors or co-survivors.
“Breast cancer is the common thread, but we do not let it define us,” said Kay Argo, one of The Sisters and the partner of Kathy Kemp, a Birmingham journalist who died from breast cancer in 2010.
It was Kemp’s article in the Birmingham News that led Graul to call the number in the paper, leading her to Madeline Harris. Harris, who was a coordinator in the Interdisciplinary Breast Cancer Center at the University of Alabama at Birminghamat the time, had arranged a trip for women battling breast cancer and their loved ones to travel to Montana to fly fish for a week. She reached out to Kemp, whom Harris met while Kemp was undergoing cancer treatments at UAB, and invited her and Argo to join them.
“We embarked on this trip with these women we barely knew, and when we came home, it left us with this feeling that we had a sisterhood,” Argo said. “That’s how we came to refer to each other as The Sisters. It was the most beautiful bonding experience.”
Since that trip, The Sisters have remained by one another’s sides, supporting one another through the most challenging times and celebrating one another’s milestones.
“If someone in our group has been seriously ill or in her last journey, we are with her,” Harris said. “We have lost survivors who were part of our group, and we have gained survivors, like my daughter, who was diagnosed at a very young age. We are an evolving group, and we do anything we can to have fun, have joy. Sally is very easy to do that with. She is so full of joy.”
Last radiation treatment
In late September, the group attended Graul’s last radiation and 80th cancer treatment since she was diagnosed. Graul, who is battling metastatic breast cancer and recently had a hip replacement after the cancer spread to her bones, arrived at her appointment dressed in a hot pink, bedazzled bra over a pink turtleneck, ballerina pink parachute pants, and a tiara on her head. Or as she calls it, her “princess outfit.”
“I have a philosophy called the princess theory,” Graul explained. “When you get a cancer diagnosis, especially when the cancer has metastasized, you don’t automatically understand that you are going to have to ask for help, especially women because we are usually the caregivers, the ones who take charge. But, princesses don’t have to ask for things; they can just tell someone what they need, and I think every woman facing a serious illness should act like a princess. So, this is my princess outfit.”
While her outfit turned heads, it was the women surrounding her that are her most cherished accessories.
“These are my sisters; they are my sisters at heart,” Graul said. “This has been a rough road. and lately it’s been a little rougher than usual; but to have them here today with me, and the fact that I can dress up and everyone can laugh, it is so special.”
Support for co-survivors
It is not just the patients who are cared for in this group. The co-survivors are equally important and are fully embraced by the women. Argo says, as a co-survivor, the love, support and joy she and Kemp experienced from the group are some of her happiest memories.
“A cancer diagnosis is sorrowful and sad, but the years Kathy and I had together when she had cancer were our sweetest years,” Argo said. “We had a ball. We traveled, we laughed, we were surrounded by wonderful medical caregivers and the sweetest of friends who are all walking the same walk that we were. That all came from The Sisters.”
Argo has remained a part of The Sisters since Kemp’s death. And while seeing loved ones experience what Kemp went through brings back sad memories, it is The Sisters who keep her going.
“After Kathy died, The Sisters were there for me all of the time. Whatever I needed help with, they were there. I don’t know how I would have gotten through that without them,” Argo said. “I feel like part of being in The Sisters is that I love them; but also, this is a way for me to honor Kathy. I feel like Kathy is there doing this with me, and that makes my heart feel good and full.”
When Harris’ daughter Kristen Noles was diagnosed with breast cancer at age 35, the women were there to care for Noles and her husband and three young children.
“Because they had experienced what being diagnosed with cancer was like, going through treatment and having surgery, they anticipated what I would need without my ever having to ask,” said Noles, a nurse manager and adjunct instructor in the UAB School of Nursing. “They did that for my children, for my husband — for all of us.”
Noles says Argo played a critical role when it came to providing support to her husband.
“Initially, I didn’t pick up on his needs,” Noles said. “I was really focused on the kids and getting well, and so he was left just taking care of the kids, of me. It was The Sisters who reached out to him, supported him. Kay really met my husband where he was during that time and helped him in so many ways because she understood what it was like to be the partner to someone battling this disease.”
The greatest gift The Sisters give to one another is their ability to celebrate life and find joy, even during the darkest times.
From vacations to Antigua to day trips to nearby lakes, these women have not let cancer slow them down.
“I didn’t see myself as sick, and a huge part of that is because of them,” Noles said. “For The Sisters, it was like nothing because some were living with metastatic disease, others had lost loved ones to the disease, yet they were still thriving. I saw that, and because of them, I didn’t worry.”
The sheer will to celebrate life was demonstrated a week after Graul’s last radiation treatment when the ladies traveled to Orange Beach, Alabama, to celebrate one of the members’ 80th birthday.
As they were getting ready to go out to dinner, Graul’s newly replaced hip popped out of the socket. Instead of ending the trip early and missing their dinner plans, Noles and a few others took Graul to the emergency room, while the rest of the group went to dinner.
“We were in and out of the ER, we beat the rest of our friends home, and we partied until 1 a.m. because we just celebrate life,” Noles said. “You would never have known there was a medical emergency. We celebrate life — we are here together, and we celebrate that.”
“That is what we do,” Argo said. “You may be down, but nobody is out. We just keep on going, always together.”
Center for Palliative and Supportive Care
Another piece of the puzzle that helped and united The Sisters was the Center for Palliative and Supportive Care at UAB. Each woman has encountered the unit, whether while caring for a loved one or being a patient. All say the center’s work and methods changed their lives.
“I really encourage all survivors and co-survivors to participate in UAB’s palliative and supportive care center,” Harris said. “I tell people don’t wait for palliative care, start at day one. It is not just for end of life. Cancer is a chronic family disease. In palliative care, the family members are treated as the patients, too. It’s not just the person that they are treating; it is everyone that they love.”
“When Madeline first mentioned palliative care to Kathy and me, I had a very visceral reaction,” Argo said. “I thought, ‘we aren’t doing that, she’s not dying.’ I didn’t understand what it was.”
Palliative and supportive care is a medical specialty that uses a comprehensive approach to caring for people with serious illness by focusing on the whole patient, addressing the physical, emotional, social and spiritual suffering of disease. Beginning at the moment of diagnosis, palliative care can help address symptoms and set goals for care, focusing on quality of life, dignity and respect.
“Our program has learned from these ladies, and we are a better program because of them,” said Jennifer Hicks, the administrative director of the Center for Palliative and Supportive Care at UAB. “They have shown us how groups can provide practical, emotional and social support to one another while also feeling supported. We share their experience with others who are looking to provide support to people dealing with serious illness.”
When Kemp started seeing a palliative care physician to manage her pain, Argo says, it made a significant difference. She continued to receive care and support from the palliative care team up until her death.
“Kathy’s last 10 days were on the palliative care unit, and I hope when my time comes, I am also lucky enough to be there,” Argo said. “We felt safe and protected. Her death was very intimate. I never imagined your loved one’s death could have any redeeming qualities, but it did. It was very bittersweet. She died the way she lived the last years of her life, surrounded by her sisters.”
The University of Alabama at Birmingham Comprehensive Cancer Center is working in partnership with Lung Cancer Alliance through a $1.6 million grant they received from the Bristol-Myers Squibb Foundation to reach underserved Alabamians who are most at-risk for lung cancer. The three-year grant establishes the Alabama Lung Cancer Awareness, Screening and Education program (ALCASE) which aims to address the widespread racial and socioeconomic disparities with regard to lung cancer, especially predominant in Alabama and in the Deep South.
Lung cancer is the leading cause of cancer deaths in both men and women across the United States, killing more people than colon, breast and prostate cancers combined. In Alabama, lung cancer is the No. 1 cause of cancer deaths and is No. 3 in the number of new cases diagnosed each year.
The ALCASE program combines Lung Cancer Alliance’s expertise in lung cancer screening and expands the Cancer Center’s successful Deep South Network Community Health Advisor model to decrease lung cancer disparities in underserved Black Belt counties and in Jefferson County. Through education and awareness, the purpose of the program is to encourage participation and increase screenings by providing community-based support to local health care facilities.
“As the only NCI-designated comprehensive cancer center in the Deep South, UAB has an obligation to address our region’s cancer burden,” said Michael J. Birrer, M.D., Ph.D., director of the UAB Comprehensive Cancer Center. Lung cancer screening holds the greatest promise for finding the disease early, when the possibility of a cure is greatest. However, only 4 percent of individuals nationally are screened for lung cancer each year.
“There is a great lack of awareness about the potential benefits of screenings and, for many, a reluctance to engage in the screening process. We hope using the successful CHA model will help improve screening rates among these at-risk individuals.”
The CHA model is a proven, community-based health promotion approach that identifies and trains “natural helpers” from the community who then seek to improve the health status of individuals from that community. For more than 20 years, the Cancer Center’s Deep South Network has trained more than 1,200 CHAs and has had significant success in the areas of breast, cervical and colon cancers. ALCASE expands the use of these trusted and trained community leaders to lung cancer.
ALCASE intends to improve the knowledge and awareness of lung cancer and is committed to increase lung cancer screenings in six rural Black Belt counties — Sumter, Green, Hale, Marengo, Choctaw and Dallas — as well as in Jefferson County.
“The goal of ALCASE is to reduce the burden of lung cancer among high-risk, underserved communities through capacity building, outreach, education, screening and support,” said Claudia Hardy, MPA, director of Community Outreach in the UAB Comprehensive Cancer Center.
ALCASE program leaders will partner with existing community resources, like Alabama’s smoking cessation programs, identify Screening Centers of Excellence, and provide financial and transportation assistance to help eligible individuals access and afford lung cancer screenings.
The Cancer Center will begin recruiting and training up to 150 CHAs in the seven-county program area in February 2019. “We are recruiting men and women of all races and backgrounds over the age of 19 to join us in these efforts,” Hardy said.
“Lung Cancer Alliance is excited to be working with the UAB Comprehensive Cancer Center on this important effort,” said Maureen Rigney, LICSW, director of Support Initiatives for Lung Cancer Alliance. “We recognize the great burden of lung cancer in an area with limited resources, and are committed to working with partners at the state level to establish a sustainable infrastructure to improve access to lifesaving screening and high-quality care where it is critically needed.”
The UAB Comprehensive Cancer Center Community Outreach Staff will host events in the targeted counties in the month of November to bring awareness of November as Lung Cancer Awareness Month and to introduce the ALCASE program to the communities.
Nov. 5: Hale County
11 a.m.-noon at the Third Street Church of God (Fellowship Hall), 1102 Third Street, Greensboro.
Nov. 7: Sumter County
Noon-1 p.m. at the Sumter County Health Department Conference Room, 1121 North Washington Street, Livingston.
Nov. 8: Jefferson County
10-11 a.m. at the JCCEO Headquarters, 300 Eighth Ave. W, Birmingham.
Nov. 8: Marengo County
1-2 p.m. at the Bryan Whitfield Memorial Hospital Conference Room, 105 Highway 80 East, Demopolis.
Nov. 8: Greene County
10-11 a.m. at the Green County Health Department, 412 Morrow Ave., Eutaw.
Nov. 9: Choctaw County
9 a.m.-noon at Choctaw General Hospital, 401 Vanity Fair Drive, Butler.
To learn more about the ALCASE program, community events or becoming a community health advisor, contact Claudia Hardy at 205-975-5454 or firstname.lastname@example.org.
The fifth annual Blazer Bolt for Brain Cancer 5K and 1-mile fun run/walk, held Saturday, Oct. 20, in Homewood, Alabama, nearly doubled participation from previous years. The event, sponsored by Blazer Bolt Inc., raises funds for brain cancer research at the University of Alabama at Birmingham and Children’s of Alabama. This year’s run featured 32 teams and 908 registrants, up from 577 last year.
“Our inaugural Survivor Walk was truly a deeply moving and heartfelt experience as brain cancer survivors, family and loved ones were honored and cheered as they crossed the finish line,” said Rhodemarie Maron, D.O., associate professor in the Department of Neurology and event organizer. “Each individual and team brought genuine empathy and hope to those battling brain cancer. We are so grateful to our patients, their loved ones, and those supporting them at home and in the clinic for making this event possible.”
Prior to the start of the event, individual team statements were shared and sponsors were recognized. An invocation was given by Eric Thomas. The Hoover Army Recruiting Center served as honor guard for the presentation of the colors, while Carmen Atkinson sang the national anthem.
Funds raised this year will directly benefit the brain tumor tissue bank biorepository, which stores and prepares specimens for research from brain cancer patients. These funds will advance the much-needed understanding of brain tumor biology and the development of future treatments for brain cancer. Go to www.blazerbolt.com for more information.
Written by: Challis Wells
Smita Bhatia, M.D., MPH, director of the University of Alabama at Birmingham’s School of Medicine Institute for Cancer Outcomes and Survivorship and vice chair for Outcomes Research in the Department of Pediatric Oncology, has received the Outstanding Investigator Awardfrom the National Cancer Institute. The highly competitive award will enable Bhatia and her team to continue making promising advancements in pediatric oncology.
Additionally, Bhatia received a seven-year, $6.2 million grant to continue her research into how personalized treatment of childhood cancer can further minimize toxicity.
The award provides funding to investigators with exceptional records of productivity in cancer research to continue or embark upon new projects of unusual potential in cancer research. Award recipients are cancer researchers who have served as principal investigators on an NCI grant for the last five years and have demonstrated outstanding productivity.
“This award provides me with the necessary resources to undertake a high-risk but potentially high-reward project,” Bhatia said. “The ultimate goal is the ability to minimize long-term toxicity while optimizing cures for children with cancer. I am very excited to embark on this project and am very grateful to the NCI for this award.”
If Bhatia’s research is successful, her findings would provide evidence for a personalized therapeutic approach to childhood cancer. The two leading causes of premature mortality in childhood cancer survivors are radiation-related subsequent neoplasms, or SNs, and anthracycline-related cardiac dysfunction, or CD. Bhatia seeks to develop a risk prediction model for radiation-related SN and anthracycline-related CD in childhood cancer survivors, replicate the optimized model in an independent cohort of childhood cancer survivors, apply the model to newly diagnosed children with cancer to predict the risk of incident SN/CD, and determine the functional relevance of the genetic signatures. Findings from this application will help reduce the burden of morbidity in this population.
A research team led by the University of Alabama at Birmingham is launching a study to find a better model for glioblastoma, a particularly devastating type of brain tumor, to help determine the most appropriate treatment modality. The $3.6 million, five-year U01 grant award is funded by the National Cancer Institute, one of the National Institutes of Health. The UAB team will join four other institutions with similar U01 awards — University of California-San Francisco, Duke University, University of Utah, and Cold Spring Harbor Labs/Jackson Labs, to form the Patient-derived Models Consortium, or PDMC.
For years, the NCI had recommended using a set of cancer cell lines, called the NCI-60, which did include glioblastoma cells, for pre-clinical testing. Pre-clinical testing can provide researchers and physicians with important information on the makeup of tumors, guiding the development of new treatment approaches through clinical trial design and implementation. Unfortunately, the clinical success rate following NCI-60 panel testing was not as effective as desired, particularly for glioblastoma.
Use of the NCI-60 has been phased out in favor of patient-derived xenografts, or PDX, in which a patient’s own tumor cells are grown in a mouse model. Xenograft models permit cancer cell interactions with other cells and conditions that are not currently fully replicated in a laboratory dish. Creating and testing patient-derived xenografts is a slow and expensive process, so the NCI is looking for the most effective ways to use the xenografts and related models to identify new ways to fight cancer.
The UAB-led research team is examining two new technologies, neurospheres and microtumors, and will compare them with PDX.
“Neurospheres are self-assembling groups of cells that can be grown in defined media conditions,” said Christopher D. Willey, M.D., Ph.D., associate professor, Department of Radiation Oncology in the School of Medicine. “Microtumors involve embedding the same type of tumor cells into a matrix material in a three-dimensional structure. Both allow for high-throughput screening of potential drugs, which should produce a cheaper and quicker way to identify compounds that might have therapeutic benefit.”
The study will attempt to better understand how the various models — neurospheres, microtumors or PDX animal models — are influenced by their growth conditions in terms of their molecular signaling and sensitivity to cancer treatments.
“Our intent is to see how these systems respond to typical therapies, such as chemotherapy or radiation,” said Yancey Gillespie, Ph.D., professor emeritus in the Department of Neurosurgery. “We will be able to directly determine which genes are being expressed and which enzymes are active in the same tumor cells growing in three different environments. This data will allow us to change the models or their environments to mimic the brain tumor environment in the patient and then assess how each model responds to therapy. The idea is to make a more accurate, patient-like model or models for human brain tumors.”
“Some treatments we thought would work well in brain tumor patients have not been as effective as we’d hoped. We believe that we can identify better therapies if we have a model that most closely represents actual tumors in a human brain,” said Anita Hjelmeland, Ph.D., associate professor in the Department of Cell, Developmental and Integrative Biology. “Using the improved model, we can better understand which drugs will work best for a particular patient with a particular type of cancer.”
The team acknowledges that there may not be one “best” model.
“To characterize these PDX models, we plan to apply an array of new computational tools,” said Jake Chen, Ph.D., professor in the departments of Genetics, Computer Science and Biomedical Engineering and chief bioinformatics officer of the UAB Informatics Institute. “Genomic, transcriptomic and kinomic data will be systematically collected from these glioblastoma PDX models. We will develop new bioinformatics and systems biology techniques to integrate all these quantitatively measured signals — hundreds of thousands of them for each model — to build ‘in silico’ models. These models can then be manipulated in computers rapidly and help us predict each tumor’s subtype and drug sensitivity behaviors before actual experiments are performed.”
The study’s findings could help to guide better therapies in the future for brain cancers such as glioblastoma, the kind of tumor that affected John McCain and Ted Kennedy. Glioblastoma is the most common and most aggressive primary malignant brain tumor, with an expected survival of less than 15 months.
Other investigators on this project are Xiangqin Cui, Ph.D., at Emory University and Raj Singh, Ph.D., at LifeNet Health.
The University of Alabama at Birmingham has established the first multidisciplinary program in the state to treat diseases of the pancreas and bile ducts with the creation of the Pancreatobiliary Disease Center within the School of Medicine.
The center will link medical professionals from across UAB Medicine involved in managing pancreatobiliary diseases, including pancreatic cancers, pancreatic cysts, pancreatitis, bile duct and gallbladder cancers, bile duct injuries and complex benign disease of the bile duct.
“While malignancies of the pancreas and bile duct present their own unique challenges to treatment, so do the litany of benign disease affecting these organs,” said J. Bart Rose, M.D., assistant professor in the Department of Surgery and director of the center. “Both acute and chronic pancreatitis can be very difficult to treat. We have designed an infrastructure to support and treat patients with these diseases with cutting edge techniques and minimally invasive approaches.”
The Pancreatobiliary Disease Center is made up of advanced gastroenterologists, interventional radiologists, medical and radiation oncologists, critical care intensivists, surgeons, pathologists, genetic counselors and specialty support staff.
“Our multidisciplinary approach ensures patients with complex benign or malignant problems involving the pancreas or bile duct will be offered appropriate and modern treatment, in an expedited fashion, all done in conjunction with their local providers,” Rose said.
The pancreas is an endocrine gland that produces important hormones, including insulin. It also aids in digestion by producing several enzymes that function in the small intestine. The bile duct is a system of tubes that carry bile, which is essential for digestion, from the liver. Cancer in these organ systems are among the most deadly and difficult to treat malignancies.
Rose said the program will be a statewide referral center. Since pancreatobiliary diseases can be challenging and difficult to treat, many are best seen at a major academic medical center such as UAB, which can provide cutting edge treatments and services that may not be available in local hospitals. UAB also offers access to genetic testing and research opportunities, including participation in innovative clinical trials.
“As a referral center, our role will be to fill the gaps from local medical providers,” Rose said. “UAB will be able to offer the latest in surgical and medical treatment approaches, as well as tumor sequencing. We will also be doing data collection and outcomes research, so we will be able to select the best therapeutic approach for each patient based on the accumulated data available, ensuring that we offer each patient the best option for their situation.”
For more information on the UAB Pancreatobiliary Disease Center, call 1-833-UAB-4PDC (1-833-822-4732).
Richard Whitley, M.D., Distinguished Professor in the University of Alabama at Birmingham Department of Pediatrics, has been named the 2018 recipient of the Infectious Diseases Society of America’s Alexander Fleming Award for lifetime achievement.
According to the IDSA, the Alexander Fleming Award for lifetime achievement is given “in recognition of a career that reflects major contributions to the acquisition and dissemination of knowledge about infectious diseases.”
“To be recognized by the IDSA, my peers and the infectious diseases community for my commitment to the study and field of infectious diseases is humbling and overwhelming,” Whitley said. “Receiving this prestigious award affirms the commitment I made to the study and development of therapies for emerging diseases, mentoring of fellows, and serving of patients that I have been proud to be a part of and look forward to continuing to do.”
An expert on how antiviral therapies fight infections in children and adults, throughout his four-decade career, Whitley has published more than 373 articles on pediatric infectious diseases, was appointed by President Barack Obama to an advisory panel surrounding preparations for the pandemic flu, served as past president of the IDSA, and treated thousands of patients at UAB and Children’s of Alabama.
He is also responsible for the NIH-funded Antiviral Drug Discovery and Development Center, whose purpose is to discover potential new drugs that could be used to treat infections such as West Nile virus and influenza that routinely infect United States citizens and for which there are limited or no treatments.
Whitley also serves as vice chairman of the Department of Pediatrics, co-division director of Pediatric Infectious Diseases, and associate director of Drug Discovery and Development in the UAB Comprehensive Cancer Center.
According to a study published in Cancer Epidemiology, Biomarkers & Prevention, adolescents and young adults (AYA) ages 15-39 with acute lymphoblastic leukemia (ALL) are more likely to relapse than are their pediatric ALL counterparts ages 1-14, with contributing factors ranging from a lower rate of enrollment in available clinical trials to shorter durations of treatment.
Published by Julie A. Wolfson, M.D., MSHS, assistant professor and member of the Institute for Cancer Outcomes and Survivorship at the University of Alabama at Birmingham and associate scientist in the Cancer Center Control and Population Sciences Program in UAB’s Comprehensive Cancer Center, the study looked at data from 184 patients ranging from ages 1-39 and treated for ALL at City of Hope Hospital from 1990-2010. The analysis covered relapse risk during therapy and after completing therapy for these populations.
In both cases of on-therapy and post-therapy relapses, AYA patients had an increased risk as compared to pediatric patients. Investigators were able to account for clinical factors, along with those related to health care delivery or treatment, including whether they were treated with a “pediatric-inspired” or “adult-style” regimen. Among AYA patients, they found patients had an increased risk of having a relapse while on therapy if they had not been enrolled on a clinical trial. They also found that AYA patients were more likely to relapse after completing therapy if they had received a shorter duration of maintenance or consolidation therapy.
“What this analysis reminds us is how unique this AYA population is, and how they continue to face challenges,” Wolfson said. “We recognize that often AYA patients are treated differently just depending on which hospital door they open. They are sometimes treated like pediatric patients, and at other times like adult patients. There are circumstances when this can affect their outcome, and we want to continue to identify factors that impact this group, the challenges they face and ways we can bridge the gap for AYA patients moving forward.”
As outlined in the study, health care delivery — meaning access to and enrollment in clinical trials — plays a role in the potential for relapse in AYA patients.
Wolfson explains that national guidelines encourage AYA patients with cancer to join a clinical trial whenever possible. The study’s findings support that recommendation, and although it is often challenging to find an open or appropriate study, national research groups are working to expand ways for AYA to participate.
“This, combined with the role of treatment factors such as duration of treatment in relapse of AYA patients, led us to suggest that more attention is needed on factors that inhibit AYA patients from seeking or continuing care, or from having access to innovative therapies,” Wolfson said. “The AYA age range is broad, but what is common among these patients is they are often at a place in life that poses unique challenges related to relapse, including being uninsured, under-insured or in a fragile socioeconomic place.”
Future studies will help researchers identify additional areas that need to be addressed in order to support long-term survival rates for AYA patients, as well as ways to maximize treatment options and retention.