In order to effectively battle cancer, you must have a well-organized army made up of compassionate oncology professionals who fight the frontline battles alongside cancer patients and diligent scientists gathering intelligence reports in the hope of developing better treatment strategies. In between lies the next generation of motivated clinicians and researchers in training, compelled to join the fight against cancer soon.
Through the UC Cancer Institute, this figurative army is working every single day to improve cancer care, advance science and train tomorrow’s oncologists.
Founded in 2010 and under the direction of George Atweh, MD, the UC Cancer Institute
is making significant progress in its tripartite mission of patient care, education and research. The institute is currently in the middle of a strategic planning process that will identify priorities for the next several years. Learn more about the institute’s recent progress below.
Research Infrastructure Changes
New infrastructure has been implemented across the cancer research enterprise, aimed at establishing central oversight as well as shared resources, to reduce inefficiencies and accelerate research from bench to bedside.
This includes introducing an integrated, central cancer clinical trials office organized into groups of research nurses and coordinators who focus on particular cancers.
"Previously, there was no mechanism for central oversight and coordination. Every department had its own team for clinical trials support,” explains Atweh. "Now we have a single office that supports all the cancer clinical trials in different departments.”
A Protocol Review and Monitoring committee (PRMC) and Data Safety Monitoring Board (DSMB) have also been established. The PRMC ensures the scientific merit of proposed cancer clinical studies. It also monitors recruitment of research participants, prevents the launch of competing studies and allocates institutional resources. All cancer-related studies that utilize patients or patient samples/data now require PRMC review and approval prior to submission to the Institutional Review Board. The DSMB provides an additional layer of oversight for high-risk, investigator-initiated studies.
"Recruiting clinical trial participants is a difficult, slow process. It has to be done right—the first time—or valuable time and resources are wasted,” says Frank Smith, MD, who is leading the PRMC and DSMB effort. "These committees add additional layers of quality data assurance that will produce scientifically solid data to support new treatment approaches in the future. It’s also a key element for achieving designation by the National Cancer Institute.”
Similar to the clinical trials enterprise, the UC Cancer Institute’s tissue banking program
has been transformed into a robust, strictly organized and structured operation that gives researchers access to thousands of human tumor specimens—malignant and paired normal tissues, blood and urine—as well as associated clinical data. Previously, there were numerous individual efforts to collect tumor specimens but no coordinated, institution-wide process to ensure quality, consistency and access to specimens. The operation is led by Hassana Fathallah, PhD.
"This new structure has established standard operating procedures, quality control, utilization guidelines and a database for linking samples to clinical data—all critical components of a successful, sustainable tissue bank for research,” adds Atweh.
Fathallah also leads a new translational research core, which has the mission of accelerating the process of applying discoveries generated during research in the laboratory and preclinical studies to clinical trials in humans. This core will help facilitate collaboration and data sharing between clinicians, basic scientists and clinical investigators.
To help combat one of the biggest challenges to conducting innovative new cancer research—funding—the UC Cancer Institute offers two new pilot grant programs: the Marlene Harris–Ride Cincinnati pilot grant program
for breast cancer and the Brain Tumor Molecular Therapeutics pilot grant initiative. Together, these two programs annually offer $400,000 in pilot grants to UC cancer researchers.
New Patient Care, Research Programs
Patients now have access to an interdisciplinary patient support services team that includes master’s prepared social workers, a nurse practitioner, chaplain and board certified palliative care physician—focuses on enhancing quality of life by tackling the physical, spiritual and emotional needs of patients with chronic or life-threatening illnesses. Under the direction of Kelly Rabah, the program places emphasis on pain and symptom management as well as communication and coordination of care.
The launch of an experimental therapeutics
/phase 1 clinical trials program offers patients access to treatments only available in experimental clinical trials. UC is one of three centers in the United States offering these first-in-human clinical trials. The program is led by Olivier Rixe, MD, PhD, and currently has 10 clinical trials open for enrollment. The UC Neuroscience Institute and UC Cancer Institute have also partnered to launch a molecular therapeutics research program for brain tumors
. The subspecialized team is aimed at understanding the biological mechanisms of cancer’s spread to the brain and developing more effective ways to treat the condition.
An adult bone marrow transplant service for hematologic malignancies has also been established at University Hospital. Frank Smith, MD, serves as interim director; a permanent director for the program and two additional medical oncologists who specialize in treating blood diseases are currently being recruited. The program fills a gap in adult care offerings and will bring new clinical trials for hematologic malignancies to Cincinnati.
A new adult survivorship program is also being established in collaboration with Cincinnati Children’s Hospital Medical Center, which has a nationally recognized program to support childhood cancer survivors into adulthood. Jonathan Tolentino, MD, a UC primary care physician, is conducting survivorship research with colleagues at Cincinnati Children’s.
"Building a top-notch adult cancer program benefits residents through direct patient care but also benefits the community at large through job creation and advancement of science,” adds Atweh, who also serves as Koch Chair and professor of internal medicine at the UC College of Medicine.
Fellowship Training Revamped
The hematology oncology fellowship
has been revamped with the specific aim of creating top-notch medical oncologists who are equipped with the skills—and desire—to pursue careers in academic medicine. The program has also expanded from nine to 12 fellows for the 2012 year in response to the American Society for Clinical Oncology’s prediction that by 2020 the demand for oncology services will outpace the supply of oncologists.
"For the past two years, we have made an aggressive effort to recruit additional hematology oncology faculty—particularly senior-level people like Rixe, and John Morris, MD—who can serve as mentors to our fellows,” adds Atweh.
Former chief hematology oncology fellow Shalaan Beg, MD, says this shift to focus on both patient care and translational research made his fellowship experience more intellectually stimulating and engaging.
"It’s one thing to be told how to set up a clinical trial—it’s a much more valuable experience to be a part of the process from start to finish, which is what the new fellowship program allowed me to do,” says Beg. "The fellowship program has a higher prestige than it did just a few years ago. Cincinnati is on the cancer radar at oncology meetings now.”