COG Fall Meeting

This past week was the Children's Oncology Group Fall meeting.  Normally, the COG meets twice a year to discuss design and results (when available) of the latest clinical trials.  This was a particularly special meeting, in that founding COG Chair, Dr. Gregory Reaman, was recognized for his phenomenal legacy of work with COG & CureSearch, and physician-scientist Dr. Peter Adamson took the leadership position moving forward.  This meeting was well attended by pediatric oncology medical caregivers and the public alike.  Our lab's contributions were a rhabdomyosarcoma presentation to the Soft Tissue Sarcoma Biology Special Session, as well as chairing (with the help of Maryam Fouladi) the CNS new therapeutics session.  
  
[ above right:  Charles and Ross Vick, advisory director member of QuadW, discussing sarcoma research ]

Legislation and Childhood Cancer

Groups like CureSearch, foundations and individuals approach childhood cancer advocacy through hard work in lobbying for executive and legislative initiative that improve the research and care of childhood cancer patients.  One example is that September is "Childhood Cancer Awareness Month" by Presidential Proclamation.  Nancy Goodman is a childhood cancer parent and founder of KidsvCancer.org who regularly lobbies on behalf of childhood cancer causes.  Another advocacy group for increasing drug availability for cancer patients is the Abigail Alliance.  These groups certainly deserve our thanks and support in their efforts.  
  
  
  
[ 9/15/10   For a touching story about a little girl named Joanna whose memory is bringing awareness and rallying a community around childhood cancer patients, click here.  ]
  
[ 9/16/10   See Nancy Goodman's testimony before the House at  http://www.kidsvcancer.org/pediatric-cancer-caucus/ ]

   

speeding the pace of Phase I studies

We'd like to acknowledge nurse Rae Acosta who is coordinator for the Pediatric Oncology Phase I program at Doernbecher Children's Hospital, with whom we team to design preclinical trials that address special populations of pediatric cancer patients most in need of drug development.  Dr. Suman Malempati is overall leader of this COG-affiliated Phase I program, and it is the cross talk that we develop with Rae and Suman that makes what we do in the research lab seem all the more tangible. 
   
[ above right:  Jen (left) and Rae (right) next to some new equipment in the lab ]
   

The Seattle - Portland Connection

We are grateful to the basic scientist and clinical researchers at the University of Washington, Seattle Cancer Care Alliance and the Fred Hutchinson Cancer Research Center for meeting with our OSHU team (Suman Malempati, Chris Ryan and I) to discuss areas of synergy between our research programs.  We found strong common interests, particularly in the areas of (1) understanding how medulloblastomas grow and spread, (2) defining the basic biology of the differentiation defect for rhabdomyosarcoma and (3) translating recent studies of adolescent and adult sarcoma biology to clinical trials.  The opportunity to explore immunotherapy for sarcomas is especially strong, too.  We are thankful to the laboratories of Dr. Jim Olson, Dr. Stephen Tapscott, Dr. Michael Jensen and the clinical trials researchers Doug Hawkins, Robin Jones, Eve Rodler - and especially surgeon-scientist Chappie Conrad, for taking the time to explore and initiate these dual city collaborations in the Pacific Northwest.  
    
Charles
  

Tissue Banking - Demystified

A question sometimes asked is how research can be advanced, and contributing tissue to a tumor bank for research is a key element (money, yes, is nice... but high quality tissue from patients with tumors for which little is know is more valuable).  And if it can be put in a gentle way, tumor tissue from the patients that researchers and clinicians so far have failed is the most valuable.  That is, tissue from patients with relapses... even post-mortem biopsies from patients that have failed our best treatments.


How does one enroll to give tissue? In the case of soft tissue sarcomas, the Children's Oncology Group (COG) has had a tumor bank protocol called "D9902" open since March 1999.  The consent form for this study is usually presented to families at the time a child is diagnosed and is being considered for a COG treatment study.  Most people think of D9902 as a study for collecting tissue from the original untreated tumor, but... the protocol does already allow tissue to be collected from biopsies done at the time of relapse, as well as tissue taken after death (autopsies, partial autopsies and post-mortem biopsies).  In practice, relapse samples rarely are collected (there are practical reasons not to subject children to extra procedures).  Post-mortem samples are scarce... maybe none, with recent notable exceptions.


Where does the tissue go?  well, a really good tumor bank!  The COG contracts the Pediatric Cooperative Human Tissue Network (pCHTN) to store COG sample studies.  Their Director is Dr. Nilsa C. Ramirez, and she and the Biopathology Center for the pCHTN are at the Nationwide Children's Hospital in Columbus, Ohio.  Nilsa succeeds the late Dr. Stephen Qualman, who himself was taken by pancreatic cancer.  Dr. Qualman was a leader in rhabdomyosarcoma pathology research, but Nilsa keeps this tradition in sarcomas strong, and she was recently joined by rhabdomyosarcoma researcher Dr. Peter Houghton who is building an exciting pediatric cancer research program at Nationwide.


What happens with the tissue?  It gets used, hopefully!  Dr. Stephen Skapek at the University of Chicago leads the Soft Tissue Sarcoma Biology subcommittee of the COG.  Researchers send the pCHTN/COG applications to use the tissue. The applications are reviewed by Steve and others on his committee (such as myself).  If the study looks promising, a few samples are sent.  If the researcher shows promising results, many more samples can be sent.  In fact, for the best studies we even consider, "emptying the bank".  (important notes:  the researchers only have de-identified samples... they won't know each patient's name.  Also, statistical rigorousness is another important judging criteria for proposed studies).  


How much does it cost?  In theory, it shouldn't.... the tissue collection kits are meant to be a part of the existing COG D9902 protocol.  However, there have been cutbacks in what the NIH/NCI gives COG for its studies. If there were a sudden 'flood' of samples, the pCHTN and I estimate it would cost  $150 total (70 for the kit, 30 to ship the kit to the child's hospital, 50 to ship it back on dry ice).  I've talked with a few foundations on whether they'd sponsor kits, and while we don't have any definite commitments, I think if the need arose we could find a way that patients wouldn't need to use their own money to contribute to research through the tumor bank.


I hope this helps with some of the questions arising lately. Feel free to comment on this blog or email me for more information.  


Sincerely,
Charles




   

Welcoming Nicolle!

We are proud to welcome Dr. Nicolle Hofmann to the Keller laboratory as our 2010/2011 Scott Carter Foundation Fellow at OHSU.  Nicolle will be pioneering an osteosarcoma therapeutics study between OSU (Corvallis) and OHSU (Portland).  To this project Nicolle brings a background in plant genetics, which is probably very appropriate for certain kinds of therapeutics we will be exploring.  


Nicolle's bio, in her own words:


" I received my B.Sc. in Animal Sciences at the University of Illinois. After taking a couple years off from school to work as a research assistant in the Nutrition and Food Science laboratory of Dr. John W. Erdman, I went on to pursue a Ph.D. in Plant Breeding and Genetics. Since completing my Ph.D., I have held two post-doctoral positions, one in the Soybean Genomics and Improvement Laboratory at the USDA in Beltsville, Maryland and one in a plant metabolic engineering laboratory at Virginia Tech in Blacksburg, Virginia. Now that I am here in Portland, I am very excited to enter a very important area of research in the Pediatric Cancer Biology Program at OHSU."


Welcome, Nicolle!
   

Scott Carter Foundation Big Show! and Golf Tournament

Jinu and I were privileged to attend and participate in the Scott Carter Foundation fundraiser events this weekend in Tulsa, Oklahoma.  This is an all-volunteer driven two part event, the Big Show dinner and auction, and the Indian Springs Golf Tournament.  It was my pleasure to meet the numerous proactive benefactors of the SCF in Tulsa, including some special parents of childhood cancer survivors including Amy White, a tireless advocate of families in her role as Pediatric Oncology Coordinator of the Oklahoma Family Network.  In its 17th year, this event exemplifies the commitment of a Scott's Family, and his community, to honor his memory by building a stronger foundation of research in childhood cancers. We are grateful that Jinu could be the 2009/2010 Scott Carter Fellow at OHSU.  
  
Charles


[ above right:  John Grant, Paula Carter, Jinu Abraham ]
[ below right:  Jinu Abraham, Cason Carter, Charles Keller ]