Archive for September, 2017

Revolutionary Cancer Care that’s the Right Care for Your Patient

When you have a patient who has been diagnosed with cancer, you want to make sure he or she is not only receiving the best and most cutting-edge care, but also the right care. Roger Belohlavy is a case in point.

Belohlavy was critically ill. All treatments for his acute lymphoblastic leukemia had failed. Until he came to Nebraska Medicine. The therapy he received here is one of the most cutting-edge treatments now available to fight his type of cancer.

Belohlavy qualified for a clinical trial using an immunotherapy called CAR T-cell therapy. The treatment targets cancer cells by homing in on specific molecular changes seen primarily in those cells and then engineering a patient’s own immune cells to recognize and attack the cancer. The therapy saved Belohlavy’s life. Twenty-eight days after the infusion, Belohlavy was declared cancer-free.

The development of new cutting-edge cancer treatments like immunotherapy is just one of the many treatments the specialists and researchers at Nebraska Medicine are developing to win the battle against cancer. Personalized cancer therapies based on a person’s DNA also are play a growing role in diagnosis and treatment and Nebraska Medicine researchers and clinicians are at the forefront of these advances bringing the latest clinical trials and breakthroughs to our patients.

Nebraska Medicine provides the most comprehensive cancer care in the region using the most advanced and innovative treatments. It is one of only sixty nine National Cancer Institute (NCI)-designated cancer centers in the United States. NCI-designated Cancer Centers are recognized for their scientific excellence and commitment to cancer treatment and research that focuses on the development of more effective approaches to cancer prevention, diagnosis and therapy.

Patients come from across the state and around the world to see many of the internationally renowned cancer specialists at Nebraska Medicine, many of whom have dedicated training in specialty areas of cancer. This includes areas such as breast cancer, lymphoma and leukemia, multiple myeloma, ovarian and cervical cancer and thyroid cancer. This ensures our patients receive the most advanced and up-to-date care and treatment.

Nebraska Medicine is also making cancer care more personal and accessible than ever with cancer clinics available at Bellevue, Village Pointe and Nebraska Medical Center.

Our new multidisciplinary breast cancer clinic at Village Pointe streamlines appointments for the patient and brings a multidisciplinary team of breast cancer experts together to provide a comprehensive approach to cancer care based on a woman’s personal preferences. The clinic is also one of a few health care centers in the region offering cutting-edge 3-D mammography that can increase detection rates by 40 percent and reduce callback rates by 20 to 40 percent.

Opening this spring on the Nebraska Medical Center campus, is the Fred & Pamela Buffett Cancer Center. The Fred & Pamela Buffett Cancer Center will integrate high-tech clinical medicine with research to accelerate new therapies for patients. Scientists and clinicians will be working together in one building as a team to collaborate on the development of new cancer treatments.

“Our goal is to be a national leader in cancer research and clinical care and one of the leading cancer centers in the country,” says Ken Cowan, MD, PhD, director of the Fred & Pamela Buffett Cancer Center. “We’re not content with just being a part of these exciting developments in cancer care, we want to be pioneering and leading these new advances.”

Nebraska Medicine Earns Elite National Quality Award

Excellence Award from Vizient, Inc. for Quality Leadership Performance

Nebraska Medicine is honored to announce its recognition by Vizient, Inc., as a recipient of the 2016 Bernard A. Birnbaum, MD Quality Leadership Award. The award recognizes Nebraska Medicine’s performance among more than 100 academic medical centers participating in Vizient’s Quality and Accountability Study. Thirteen academic medical centers were recognized this year.  Nebraska Medicine is ranked tenth and is the only health system in the region to earn this recognition. The others are:

  1. University of Utah Hospitals and Clinics
  2. NYU Langone Medical Center
  3. Mayo Clinic Hospital-Rochester
  4. Froedtert Health-Froedtert Hospital
  5. Rush University Medical Center
  6. WVU Medicine West Virginia University Hospitals
  7. Penn State Milton S. Hershey Medical Center
  8. Cedars-Sinai Health System
  9. Houston Methodist
  10. Nebraska Medicine
  11. The Ohio State University Wexner Health System
  12. University of Michigan Hospitals and Health Centers
  13. University of Vermont Medical Center

“This is truly a special honor for everyone at Nebraska Medicine,” said Dan DeBehnke, MD, MBA, CEO of Nebraska Medicine. “Achieving a Five Star ranking took a tremendous amount of dedication and work from many, many people here.”

This year, more than 100 academic medical centers and 124 community hospitals were included in the study, which reviewed performance data from a variety of sources, including Vizient’s Clinical Data Base, the core measures data base, the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey, and the Centers for Disease Control and Prevention’s National Healthcare Safety Network.

“Nebraska Medicine is dedicated to providing our patients with the highest quality, safest, most efficient and compassionate care available,” said Michael Ash, MD, Chief Transformation Officer, “To achieve a top ten Vizient Quality Leadership rank, among our nation’s elite academic medical centers, is a reflection of our colleagues and their devotion to extraordinary patient care.”

Study aims to improve pancreatic cancer therapies

Image with caption: Pankaj Singh, Ph.D.

Pankaj Singh, Ph.D.

Pankaj Singh, Ph.D., professor in the Eppley Institute for Research in Cancer and Allied Diseases, is the corresponding author of a paper published this month in the journal “Cancer Cell.”Dr. Singh’s paper, “MUC1 and HIF-1alpha Signaling Crosstalk Induces Anabolic Glucose Metabolism to Impart Gemcitabine Resistance to Pancreatic Cancer,” is visible on the journal’s website until Aug. 29.

This is the first study published in the journal that originated from UNMC. “Cancer Cell” is a top-tier journal in the field of cancer research with a 27-impact factor.

Pancreatic cancer strikes more than 53,000 people in the U.S. each year. The one-year survival rate of people with pancreatic cancer who do not have surgery is 29 percent and the five-year survival rate is 7 percent.

Poor survival in pancreatic cancer is due in part to modest response to the existing therapies. Current therapies include mimetics of nucleosides, which get modified and make DNA.

One such mimetic is gemcitabine, which has been used as a therapy, alone or in combination with other drugs, for decades. Studies from Dr. Singh’s lab establish a novel, widely-prevalent mechanism describing how cancer cells respond poorly to therapy by developing resistance.

Resistance to gemcitabine is mediated by a protein called Hypoxia-Inducible Factor1 (HIF1) alpha that changes how cancer cells take up nutrients and increase the levels of nucleosides in cancer cells. Such increased levels of nucleosides dilute the therapy levels in cancer cells and tumors respond poorly.

The recent study in “Cancer Cell” demonstrates that combining gemcitabine with other therapeutic treatments, specifically digoxin or Leflunomide, will decrease resistance to therapy in pancreatic cancer patients. Additionally, imaging for sugar uptake by tumors also demonstrates that pancreatic tumors with high sugar uptake respond poorly to chemotherapies and perhaps would benefit from the novel combination therapies tested in the manuscript in pre-clinical models.

In addition, the manuscript was selected as the issue highlight and received a special commentary from Chi Van Dang, M.D., Ph.D., an eminent scientist in the field of cancer biology.

“The published studies were truly inter- and intra-institutional collaborative studies and would not have been feasible without contributions from each of the basic and clinical investigators who are coauthors on the paper,” Dr. Singh said. “I really appreciate the supportive research environment at the Fred & Pamela Buffett Cancer Center, especially the Specialized Program of Research Excellence (SPORE) leadership by Dr. Tony Hollingsworth and overall support by Dr. Ken Cowan.”

The research also highlights the role of MUC1 mucin protein in causing therapy resistance in pancreatic tumors. An array of technological platforms, such as mass spectrometry-based steady-state metabolomics and kinetic flux metabolomics of stable isotopes, patient-derived xenografts, and CRISPR techniques, which are routine in the lab, were utilized in these studies.

This research was supported by a grant through the American Association for Cancer Research (AACR) and the Pancreatic Cancer Action Network (PanCAN) as well as multiple National Cancer Institute grants.

Glaucoma breakthrough featured in journal Stem Cells

by Lisa Spellman, UNMC public relations

Image with caption: Postdoctoral scholar Pooja Teotia, Ph.D., and Iqbal Ahmad, Ph.D., a professor in the department of ophthalmology and visual sciences.

Postdoctoral scholar Pooja Teotia, Ph.D., and Iqbal Ahmad, Ph.D., a professor in the department of ophthalmology and visual sciences.

A UNMC researcher has discovered that a common form of glaucoma that strikes adults may have early origin. The discovery, which is detailed in the August 9 issue of the journal Stem Cells, could result in earlier diagnosis and treatment of the disease that is the second leading cause of irreversible blindness and affects more than 3 million people in the United States and 60 million people worldwide.

Thanking the team

“The success of the project is greatly owed to the dedication and hard work of Pooja Teotia, Ph.D., a postdoctoral scholar in my lab and we are excited as she moves on to the next challenge to correct the RGC defect in the dish.” Dr. Ahmad said. “We also are thankful to Rand Alligham, M.D., of the Duke Eye Center at the Duke University School of Medicine in Durham, N.C., for providing blood samples; and Mathew Van Hook, Ph.D., an assistant professor in the department of ophthalmology and visual sciences at UNMC, for helping with functional analysis of the cells.”

Iqbal Ahmad, Ph.D., a professor in the department of ophthalmology and visual sciences at UNMC, led the team of investigators. He has spent more than a decade studying the stem cell approach to understand and treat glaucoma, which is called a silent robber of vision because it strikes without warning or any noticeable symptoms.

“There are several forms of glaucoma but all have two things in common – the progressive degeneration of retinal ganglion cells (RGCs) and the irreversible loss of vision,” Dr. Ahmad said.

The primary function of RGCs is to tell the brain through a series of synapses and connections what the eye sees, he said. Without RGCs, there is no perception of vision.

Since glaucoma is generally a late onset disease and RGCs are formed during gestation, Dr. Ahmad’s team had to find a way to study the degeneration process, which they hypothesized was because of a developmental abnormality.

Using blood from patients carrying a specific gene variation and also suffering from primary open angle glaucoma (POAG), one of the more common forms of the disease, Dr. Ahmad and his team created a pluripotent stem cell-based model of POAG to understand why and how RGCs degenerate.

Dr. Ahmad’s team was able to show that RGCs from POAG patients were different from those generated from healthy donors.

“They were developmentally abnormal in form, function and gene expression,” he said, adding that knowing the molecular basis of the defect and its biomarkers will allow early diagnosis and treatment.

“We are excited, as it is an important first step toward early diagnosis and treatment of this debilitating disease,” Dr. Ahmad said.

Shane Havens, M.D., a glaucoma specialist at UNMC’s Truhlsen Eye Institute, said, “Dr. Ahmad’s work could help us better understand the pathophysiology of degenerative conditions and in turn, reveal new treatment targets and cell replacement therapies.”