News

Dr. Lisa Carey authors editorial on neoadjuvant trials for breast cancer

Lisa Carey, MD, authored an editorial, titled “Neoadjuvant Trials of Human Epidermal Growth Factor Receptor 2 Targeting: How Many Drugs Do We Need?”

The editorial appeared in the June 1 issue of the Journal of Clinical Oncology.

Dr. Carey is the Richard and Marilyn Jacobs Preyer Distinguished Professor of Breast Cancer Research and Associate Director of Clinical Research for UNC Lineberger.

“Neoadjuvant” therapy means that the medical therapy (for example chemotherapy or biologic therapy) is given before surgery, when the tumor is still present in the breast so the response to treatment can be measured directly.  She outlined several reasons for the intense interest in neoadjuvant trials: 1) compared with adjuvant (postoperative treatment) trials, neoadjuvant trials are smaller and give results in months, not years; 2) they provide fertile ground for genetic and molecular efforts to figure out why some tumors respond and others do not; and 3) because we can measure the tumor growth or shrinkage during the course of the trial, the trial can be adapted in real-time  in a way that adjuvant studies cannot.

Dr. Carey’s editorial focused on a recent series of neoadjuvant trials examining the benefits of attacking the human epidermal growth factor receptor 2 (HER2) protein using HER2-targeted drugs.   Each trial used chemotherapy to which was added HER2- targeted drugs either one at a time or two together. The drugs included lapatinib, trastuzumab, or pertuzumab.   In all of the studies she described, chemotherapy plus dual HER2 targeting outperformed chemotherapy plus a single HER2-directed agent.  The only oral drug, lapatinib, was less effective and had more side effects when used by itself compared with the other drugs; she predicted that this drug will no longer be studied alone.   Dr. Carey is the lead investigator of a recently completed NCI-sponsored national cooperative group trial that actually allows doctors to limit the chemotherapy component of the treatment if the tumor responds extremely well to the HER2-targeted part of the treatment. This is one step towards what all doctors and patients want – personalized medicine.

Dr. Carey stated, “It is likely that future generations of trials in HER2-positive disease will now include dual targeting as the norm.”

She also posed a question, asking, “Paradoxically, the need now is for these studies to help us tailor therapy more thoughtfully- do we really believe that all HER2-positive breast cancers need multiple HER2-targeted agents?” She added that the laboratory studies within the clinical trials will be key to developing truly personalized therapy; scientific discovery requires equal commitment to the biologic questions and the clinical ones.”

Dr. Carey concluded that “we can and should use the neoadjuvant studies to help us more carefully choose the question, the trial design, and the patient population.”

Two UNC Lineberger faculty honored by Damon Runyon Cancer Research Foundation

Carey Anders, MD, and William Kim, MD, were awarded grants from the Damon Runyon Cancer Research Foundation.

Dr. Anders received a 2012 Clinical Investigator Award and Dr. Kim received a continuation of his 2011 Clinical Investigator Award. Both are assistant professors of medicine and members of UNC Lineberger Comprehensive Cancer Center.

Dr. Anders’ award is one of six made by the Damon Runyon Cancer Research Foundation. She will receive a three-year $450,000 grant to support the development of her cancer research program.  

Her work is focused on improving survival for women with breast cancer brain metastases. Her goals are to provide a novel therapy for women, who, at present, have few therapeutic options, while laying the foundation for future clinical trials incorporating biomarkers to enhance therapeutic response and survival for women with HER-2-positive breast cancer brain metastases. Dr. Anders will be mentored by Lisa Carey, MD, UNC Lineberger associate director for clinical research and Richardson and Marilyn Jacobs Preyer Distinguished Professor in Breast Cancer Research, and by Charles Perou, PhD, the May Goldman Shaw Distinguished Professor of Molecular Oncology.

Dr. Kim will receive an additional two years of funding totaling $300,000 to complete a promising avenue of research. His grant is made possible through the William K. Bowes, Jr. Foundation, and Connie and Robert Lurie.

His work is focused on renal cell carcinoma, a type of kidney cancer that has poor prognosis when diagnosed at later stages.  He will use the continuation grant to identify new drug combinations by applying novel proteomic technologies in collaboration with Dr. Gary Johnson with a goal of rapidly moving these findings to the clinical setting for improved treatment of renal cell carcinoma.  Gary Johnson, PhD,  is professor and chair of the department of pharmacology in the UNC School of Medicine.

Dr. Kim will be mentored by Norman Sharpless, MD, UNC Lineberger associate director for translational research and Wellcome Distinguished Professor in Cancer Research and Charles Perou, PhD, the May Goldman Shaw Distinguished Professor of Molecular Oncology.

The Damon Runyon Cancer Research Foundation provides today’s best young scientists with funding to pursue innovative research. Eleven scientists supported by the Foundation have received the Nobel Prize, seven others have received National medals of Science, and 61 have been elected to the National Academy of Sciences. Since its founding in 1946, Damon Runyon has invested more than $245 million and funded more than 3,300 young scientists.

Genetic pattern predicts response, metastasis in melanoma

A gene known to be mutated in many different cancers, but thought to be relatively unimportant in melanoma, may be a key indicator of how the disease will respond to radiation therapy and whether it will spread.

A UNC-led team reported their laboratory findings in the April 27, 2012 online edition of Pigment Cell & Melanoma Research.

William Kaufmann, PhD, professor of pathology and laboratory medicine and senior study author, explains, “p53 is the most commonly mutated gene in cancer. What’s unusual in melanoma is that it’s not commonly mutated and was therefore thought  unimportant. But when we investigated p53 signaling function in melanoma, we discovered that it is dysfunctional in lots of melanoma.

“Cells that have defective signaling pathways have different gene expression patterns  than cells that have effective signaling pathways. Using microarray technology, we developed a method to estimate p53 signaling function in melanomas by looking at specific patterns in gene expression. We found that the distinct patterns predicted the development of distant metastases in patients with melanoma and decreased sensitivity of melanoma cells  to radiation therapy.

“Our finding has clinical implications that should be further explored. For the vast majority of primary melanomas, general surgical excision is curative.

What makes melanoma problematic is that even a small primary melanoma can recur later in a distant lymph node or become metastatic. Metastatic melanoma is very hard to treat.”

“If we could better identify primary tumors that are likely to have metastasized at the time of surgery or have increased probability of metastasizing later, we might be able to include post-surgery adjuvant therapy before metastasis arises.”

“Our next step is to complete additional, larger pre-clinical studies,” he adds. Dr. Kaufmann is a member of UNC Lineberger Comprehensive Cancer Center.

Funding for the research was provided by National Institutes of Health Public Health Service grants.

UNC authors were: Craig Carson, PhD; Yingchun Zhou, BS; Maria Sambade, PhD; Eldon Peters, BS; Patrick Tompkins, BS; Dennis Simpson, PhD; Nancy Thomas, MD, PhD; Cheng Fan, MS; Janiel Shields, PhD; and Joseph Ibrahim, PhD.

Additional authors are from the University of South Carolina Upstate in Spartanburg, South Carolina, the University of Minnesota,  and the Institut Gustave Roussy in Villejuif, France.

A Summer Final Four: Help Cornucopia House Win $25,000

Votes, not baskets, will propel Cornucopia House to the Final Four in a national competition for a $25K mobile technology grant from AtlanticBT.

Cornucopia House, a UNC Lineberger partner, is a Triangle-based center where anyone touched by cancer can find support and resources to live life to the fullest.

If they win, Cornucopia House will use the funds to support and grow their radio show called “That Cancer Show.”

Vote now until July 2 from your cell phone, PC, iPad, Mac, etc. Click here to vote: http://poll.fm/3q2ie

Listen to a sample Sunday night radio show podcast.  (Hear a young Dad - a member of a UNC Lineberger support group for widowed fathers, talk about his wife’s cancer journey and death, and how difficult it is for him and many other men to be an ONLY parent – not just a single parent. )

Dibbert elected president of National Association of Cancer Center Development Officers

Chapel Hill, NC – Debbie C. Dibbert, Director of External Affairs at UNC Lineberger Comprehensive Cancer Center, has been elected president of the National Association of Cancer Center Development Officers (NACCDO). She will serve a two-year term.

Now in its 22nd year, NACCDO is the nation's premier professional development organization in the cancer field, providing its members with unparalleled opportunities and benefits. The organization’s guiding mission is to relieve the burden of cancer by addressing the needs unique to development officers in its member cancer centers - bringing together over 400 development professionals representing 71 cancer centers throughout the United States. In 2011 alone, more than $1.2 billion was raised by member institutions to further cancer research and patient care. Membership in NACCDO is open to all National Cancer Institute-designated and/or NCI funded cancer centers and member benefits are shared by member center development professionals.

Dibbert has served as Director of External Affairs at UNC Lineberger Comprehensive Cancer Center since 2003.  She oversees a comprehensive development and communications program and supervises a staff of 10. She also serves as Vice President of The Medical Foundation of NC, Inc., the fundraising arm of UNC Hospitals and the UNC School of Medicine. In her nine years at UNC, Dibbert has overseen major growth in the Cancer Center’s Development program and she played a lead role in the $81 million campaign for UNC Lineberger that ended in 2007.  Prior to joining UNC Lineberger, Dibbert was director of development, alumni affairs and public relations at Durham Academy in Durham, N.C., for 10 years. Dibbert graduated from Tufts University with a B.A. in political science.

Dibbert is also active in the Chapel Hill community and currently serves as a Board member of Family House, a hospitality house for seriously ill patients being treated at UNC Hospitals.

Combination therapy for triple-negative breast cancer disappointing

CHAPEL HILL, N.C. – A recent clinical trial testing a combination therapy for basal-like (also known as triple-negative) breast cancer demonstrates that a combination of two drugs with promising preclinical results is not as effective as researchers had hoped.

“This trial tested a drug that inhibits the Epidermal growth factor receptor (EGFR) in combination with a standard therapy for Stage IV triple-negative breast cancer,” said Lisa A. Carey, MD, who led the study. Carey is the Preyer Professor of Breast Cancer Research and medical director of the UNC Breast Center. She also serves as Associate Director for Clinical Research at UNC Lineberger Comprehensive Cancer Center.

“While we were disappointed that the combination of cetuximab plus carboplatin produced responses in fewer than 20 percent of the patients, the study provides important data about how cancers can resist EGFR inhibition and provides direction for future research,” she added.

The results were published in the Journal of Clinical Oncology.

The randomized phase II trial enrolled 102 patients with Stage IV triple-negative breast cancer. Some patients received the combination therapy from the beginning of the trial and others received it only if their disease continued to progress. The investigators chose EGFR inhibition triple negative breast cancer is that in laboratory studies, this kind of breast cancer is dependent on EGFR for growth.

Phase II trials are the first step in evaluating both the safety and efficacy of new drugs or new drug combinations. In clinical trials for patients with cancer, new treatments are tested in addition to or in combination with the standard of care. But sometimes just watching the tumors isn’t enough. “Because we were able to do laboratory studies examining the effect of the drug on the patients’ tumors both before and after therapy, we gained important insight about the genetic patterns of the EGFR pathway in these tumors and their response to therapy,” Carey said.

“Triple-negative breast cancer remains difficult to treat but with each clinical trial we learn more about how these tumors work that allows us to develop smarter approaches to treatment,” she added.

Multiple research projects – including several studies conducted at the University of North Carolina at Chapel Hill – have used DNA microarray analysis to identify biologically different breast cancer subtypes, including luminal A, luminal B, basal-like and HER2-enriched. Simple tests are being developed to help doctors identify these subtypes and to treat their patients in a more biologically-based way. In the UNC Gillings School of Global Public Health-based Carolina Breast Cancer Study, researchers found that the basal-like, or triple negative breast cancer, affects African American women far more than white women. It is likely that this plays a role in racial differences in breast cancer survival.

Other members of the research team included Anastasia Ivanova, PhD, Wing-Keung Chio, MS, Madlyn Ferraro, RN, Emily Burrows, MPH, Katherine A. Hoadley, PhD, and Charles M. Perou, PhD, from the University of North Carolina at Chapel Hill; P. Kelly Marcom, MD, from Duke University; Hope S. Rugo, MD, from the University of California at San Francisco; Erica L. Mayer, MD, and Eric P. Winer, MD, from the Dana-Farber Cancer Institute; Francisco J. Esteva, MD; from the University of Texas MD Anderson Cancer Center; Mothaffar F. Rimawi, MD, from Baylor University College of Medicine; Cynthia X. Ma, MD, from Washington University in St. Louis; Minetta C. Liu, MD, from Georgetown University; Anna Maria Storniolo, MD, from Indiana University; Andrew Forero-Torres, MD, from the University of Alabama, Birmingham; Antonio C. Wolff, MD, from Johns Hopkins, University; Timothy J. Hobday, MD from the Mayo Clinic; and Philip S. Bernard, PhD, from the University of Utah.

The project was funded by the UNC Breast Cancer Specialized Program of Research Excellence, funded by the National Cancer Institute and by an additional grant from the National Institutes of Health. Other funders include Bristol-Myers Squibb and Avon Partners-for-Progress. The Translational Breast Cancer Research Consortium, which collaborated on the study, is supported by the Breast Cancer Research Foundation, the Avon Foundation, and Susan G. Komen for the Cure.

Gene inactivation drives spread of melanoma

Chapel Hill, NC – Why do some cancers spread rapidly to other organs and others don’t metastasize? A team of UNC researchers led by Norman Sharpless, MD, have identified a key genetic switch that determines whether melanoma, a lethal skin cancer, spreads by metastasis.

Treating melanoma is extremely challenging.  The cancer spreads rapidly and to sites in the body that are remote from the original cancer site.  Melanoma is the most deadly form of skin cancer, and advanced melanoma kills more than 8600 Americans each year.  It is the most common form of cancer in young adults, aged 25-29 and the incidence of people under 30 developing melanoma is increasing fast – more than 50 percent in young women since 1980.

In a paper published today in the journal Cancer Cell, a team from UNC Lineberger Comprehensive Cancer Center demonstrates that inactivating a gene called LKB1 (or STK11) causes non-aggressive melanoma cells to become highly metastatic when tested in a variety of models using tumors from humans and mice.  While Sharpless and his colleagues showed a role for LKB1 inactivation in lung cancer metastasis, the effects of LKB1 loss on melanoma spread is even more dramatic.

“Although we are not totally certain how LKB1 loss promotes metastasis in multiple cancer types, one important effect is the loss of LKB1 starts a chain reaction, activating a family of proteins called SRC kinases, which are known to drive  metastasis,” said Sharpless, who is associate director for translational research at UNC Lineberger.

“Loss of LKB1 occurs in about 30 percent of lung cancer and 10 percent of melanoma, and ongoing studies at UNC and elsewhere will determine if these LKB1 deficient tumors have a worse prognosis.  These data suggest LKB1 deficient cancers will be more likely to metastasize, and therefore more likely to be incurable.”

“The work is exciting because the laboratory model reliably replicates distant metastases, helping us better understand what treatments may work for melanoma that has spread.  While several targeted drugs have recently been approved by the FDA for metastatic disease, these targeted mutations don’t indicate whether the disease is likely to metastasize,” said Stergios Moschos, MD, clinical associate professor of hematology/oncology.  Moschos works in the area of drug development for melanoma but was not involved in this research project.

Other members of the research team from UNC-Chapel Hill include Wenjin Liu, PhD; Kimberly Monahan, PhD; and Jessica Sorrentino, BS, from the department of genetics; Adam Pfefferle, BS, and Ryan Miller, MD, from the department of pathology and laboratory medicine; Keefe Chan, PhD, David Roadcap, PhD, and James Bear, PhD; from the department of cell and developmental biology; David Ollila, MD, from the division of surgical oncology and endocrine surgery; and Charles Perou, PhD, of the departments of genetics and pathology and the Carolina Genome Sciences Center.  Dr. Miller, Bear, Ollila, and Perou are also members of UNC Lineberger Comprehensive Cancer Center and Dr. Bear is a Howard Hughes Medical Institute investigator.

Kwok-Kin Wong, MD PhD, from the Dana-Farber Cancer Institute and Harvard Medical School and Diego Castrillon, MD PhD, from the University of Texas Southwestern Medical Center also contributed to the finding.

The research was funded by the National Cancer Institute and the NCI’s Mouse Model of Human Cancer Consortium (MMHCC), the National Institute on Aging and the National Institute of Environmental Health Sciences (all part of the National Institutes of Health.

See related coverage on WRALExternal Site.

Treating melanoma is extremely challenging.  The cancer spreads rapidly and to sites in the body that are remote from the original cancer site.  Melanoma is the most deadly form of skin cancer, and advanced melanoma kills more than 8600 Americans each year.  It is the most common form of cancer in young adults, aged 25-29 and the incidence of people under 30 developing melanoma is increasing fast – more than 50 percent in young women since 1980.

In a paper published today in the journal Cancer Cell, a team from UNC Lineberger Comprehensive Cancer Center demonstrates that inactivating a gene called LKB1 (or STK11) causes non-aggressive melanoma cells to become highly metastatic when tested in a variety of models using tumors from humans and mice.  While Sharpless and his colleagues showed a role for LKB1 inactivation in lung cancer metastasis, the effects of LKB1 loss on melanoma spread is even more dramatic.

“Although we are not totally certain how LKB1 loss promotes metastasis in multiple cancer types, one important effect is the loss of LKB1 starts a chain reaction, activating a family of proteins called SRC kinases, which are known to drive  metastasis,” said Sharpless, who is associate director for translational research at UNC Lineberger.

“Loss of LKB1 occurs in about 30 percent of lung cancer and 10 percent of melanoma, and ongoing studies at UNC and elsewhere will determine if these LKB1 deficient tumors have a worse prognosis.  These data suggest LKB1 deficient cancers will be more likely to metastasize, and therefore more likely to be incurable.”

“The work is exciting because the laboratory model reliably replicates distant metastases, helping us better understand what treatments may work for melanoma that has spread.  While several targeted drugs have recently been approved by the FDA for metastatic disease, these targeted mutations don’t indicate whether the disease is likely to metastasize,” said Stergios Moschos, MD, clinical associate professor of hematology/oncology.  Moschos works in the area of drug development for melanoma but was not involved in this research project.

Other members of the research team from UNC-Chapel Hill include Wenjin Liu, PhD; Kimberly Monahan, PhD; and Jessica Sorrentino, BS, from the department of genetics; Adam Pfefferle, BS, and Ryan Miller, MD, from the department of pathology and laboratory medicine; Keefe Chan, PhD, David Roadcap, PhD, and James Bear, PhD; from the department of cell and developmental biology; David Ollila, MD, from the division of surgical oncology and endocrine surgery; and Charles Perou, PhD, of the departments of genetics and pathology and the Carolina Genome Sciences Center.  Dr. Miller, Bear, Ollila, and Perou are also members of UNC Lineberger Comprehensive Cancer Center and Dr. Bear is a Howard Hughes Medical Institute investigator.

Kwok-Kin Wong, MD PhD, from the Dana-Farber Cancer Institute and Harvard Medical School and Diego Castrillon, MD PhD, from the University of Texas Southwestern Medical Center also contributed to the finding.

The research was funded by the National Cancer Institute and the NCI’s Mouse Model of Human Cancer Consortium (MMHCC), the National Institute on Aging and the National Institute of Environmental Health Sciences (all part of the National Institutes of Health.

See related coverage on WRALExternal Site.

Jennifer Bowman named Hometown Hero for June 11

WCHL named Jennifer Bowman a Hometown Hero for June 11, 2012. Each weekday the station selects a Hometown Hero who goes “over and above the call of duty,” exemplifying excellent service and dedication to others in the community.

Bowman is the Special Events Coordinator at UNC Lineberger Comprehensive Cancer Center and talks about UNC Lineberger's annual ball which was themed "Fire & Ice" this year. "It's a great place for mingling and interacting," she says.

She also explains that funds from this special event, as well as others held by UNC Lineberger throughout the year, benefit not only the local community and the state of North Carolina but make an impact "well beyond our state borders."

Listen to her Hometown Hero interview Icon indicating that a link will open an external site..

Mayer appointed to term on Cancer Survivorship Committee

Deborah Mayer, PhD, RN, AOCN, FAAN, associate professor in the UNC School of Nursing, has been appointed to a three-year term on the Cancer Survivorship Committee of the American Society of Clinical Oncology.

Dr. Mayer is a member of UNC Lineberger Comprehensive Cancer Center.

The Cancer Survivorship Committee identifies strategies for increasing collaboration between oncologists and primary care professionals in the provision of healthcare services for cancer survivors; develops clinical tools, resources and guidance needed to provide optimal care for survivors, including tools to enhance coordination of care among providers as well as to assess and manage psychosocial issues for survivors and their families; develops a cancer survivorship curriculum to supplement existing oncology training; and participates in developing a model for survivorship care that is integrated, comprehensive, and patient-centered.

UNC Lineberger member James Evans quoted in Nature

James P. Evans, MD, PhD, Bryson Distinguished Professor of Genetics and Medicine, is quoted in an article discussing the fetal genome and the possibility of clinic procedures being introduced in the next couple of years.

In the article "Fetal genome deduced from parental DNA" published in the June 6, 2012 issue of the journal Nature, Dr. Evans notes that "the stakes are high" when it comes to offering such a test in the clinic. 

Dr. Evans is a clinical professor in the UNC Department of Genetics and leader of the Clinical Cancer Genetics Program. He is also a member of UNC Lineberger Comprehensive Cancer Center.

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UNC Lineberger member Kurt Ribisl co-authors study assessing online alcohol sales to minors

Kurt Ribisl, PhD, is co-author of the article “Internet Alcohol Sales to Minors” published online ahead of print in the May 2012 issue of the Archives of Pediatrics & Adolescent Medicine.

This study is also featured in the June 2012 issue of endeavors magazine in an article titled “The Ease of Buying Booze.”

Ribisl is an associate professor of health behavior and health education in the UNC Gillings School of Global Public Health. He is also a member of UNC Lineberger Comprehensive Cancer Center.

Rebecca Williams, MHS, PhD, a research associate at UNC’s Center for Health Promotion and Disease Prevention, led the study.

Read article in Archives of Pediatrics & Adolescent MedicineIcon indicating that a link will open an external site..

Read article in endeavors magazineIcon indicating that a link will open an external site..

Bae-Jump receives grant to study impact of obesity on ovarian cancer

Victoria Bae-Jump, MD, PhD, has received a two-year $200,000 grant from the Department of Defense, to study “Preclinical and Clinical Investigations of the Impact of Obesity on Ovarian Cancer Pathogenesis.”

Dr. Bae-Jump is an assistant professor of gynecologic oncology and a member of the UNC Lineberger Comprehensive Cancer Center.

Dr. Bae-Jump and her co-investigator, Liza Makowski, PhD, assistant professor of nutrition in the UNC Gillings School of Global Public Health and UNC Lineberger faculty member, will study whether the metabolic and endocrine effects of obesity play a contributing role in the development of ovarian cancer, leading to biologically different cancers than those that arise in leaner women. They will conduct research to define characteristics unique to obesity-driven ovarian cancers using pre-clinical models and will assess whether two novel chemotherapeutic agents (i.e. metformin and mTOR inhibitors) have improved efficacy among obese patients with this disease.

Other UNC collaborators are UNC Lineberger faculty members Neil Hayes, MD, MPH, Chuck Perou, PhD and Pei-Fen Kuan, PhD as well as Wei Jia, PhD, professor, department of nutrition, University of North Carolina at Greensboro and Xiuxia Du, PhD, assistant professor, department of bioinformatics & genomics, University of North Carolina at Charlotte.

Dr. Bae-Jump and her co-investigator, Liza Makowski, PhD, assistant professor of nutrition in the UNC Gillings School of Global Public Health and UNC Lineberger faculty member, will study whether the metabolic and endocrine effects of obesity play a contributing role in the development of ovarian cancer, leading to biologically different cancers than those that arise in leaner women. They will conduct research to define characteristics unique to obesity-driven ovarian cancers using pre-clinical models and will assess whether two novel chemotherapeutic agents (i.e. metformin and mTOR inhibitors) have improved efficacy among obese patients with this disease.

Other UNC collaborators are UNC Lineberger faculty members Neil Hayes, MD, MPH, Chuck Perou, PhD and Pei-Fen Kuan, PhD as well as Wei Jia, PhD, professor, department of nutrition, University of North Carolina at Greensboro and Xiuxia Du, PhD, assistant professor, department of bioinformatics & genomics, University of North Carolina at Charlotte.

N.C. Children's Hospital achieves high rankings in several specialties including cancer

Congratulations to the N.C. Children’s Hospital for receiving top rankings in 10 out of 10 clinical categories in U.S. News & World Report’s 2012-13 “America’s Best Children’s Hospitals” list. The N.C. Children’s Hospital is ranked 26th in cancer.

It is also ranked 8th in pulmonology, 25th in gastroenterology, 29th in orthopaedics, 31st in nephrology, 32nd in endocrinology and diabetes, 36th in urology, 37th in neonatology, 42nd in cardiology and heart surgery, and 47th in neurology and neurosurgery.

“North Carolina Children’s Hospital deserves high praise for its accomplishments,” said Health Rankings Editor Avery Comarow. “North Carolina Children’s Hospital has a reservoir of dedication and expertise that helps the sickest kids. Our goal at U.S. News is to identify and call attention to pediatric centers like this one.”

The full rankings and methodology are available onlineIcon indicating that a link will open an external site.. The rankings will also be published in the U.S. News Best Hospitals 2013 guidebook, which will be available in August.

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Over 150 attend UNC Lineberger's annual scientific retreat

More than 150 faculty, students, and fellows gathered in the Alumni Center to hear talks on HPV and Cancer given by UNC Lineberger scientists from basic, translational science, clinical, population science, and global perspectives.

In the featured talk Dr. Barbara Rimer, dean of the UNC Gillings School of Global Public Health and new chair of the President’s Cancer Panel, spoke about the Panel’s first-year initiative of increasing the rate of HPV vaccinations.Adobe pdf file

Other retreat speakers were ( please click on hyperlink to view the presentation) :

Dr. Cary Moody, assistant professor of microbiology and immunology: “Studying the HPV Life Cycle to Understand Viral Pathogenesis.”Adobe pdf file

Dr. Dirk Dittmer, professor of microbiology and immunology, and co-leader of UNC Lineberger’s Global Cancer Program: “Hunting Cancer Viruses across Continents.” Adobe pdf file

Dr. Neil Hayes, associate professor of medicine: “Will the real HPV Please Stand Up?”

Dr. Wendy Brewster, associate professor of obstetrics and gynecology and director of the UNC Center for Women’s Health Research: “HPV Testing and Cervical Cancer Screening.” Adobe pdf file

Dr. Noel Brewer, associate professor of health behavior: Sex, Death and the American Way: What Behavioral Science Says about Low HPV Vaccine Uptake.Adobe pdf file

The program concluded with Dr. Shelley Earp, UNC Lineberger director, who gave a “State of the Cancer Center” talk, reporting that it’s “pretty darn good.” Adobe pdf file

The presentations were followed by a poster session featuring more than 60 posters from students, fellows, and residents. Judges selected 1st, 2nd, and 3rd place awards in each of the three categories. View poster winner chart. Adobe pdf file

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Science, surgery, and start-ups - in depth with Dr. Nancy DeMore

UNC surgeon-scientist Dr. Nancy DeMore says, “As a physician, I’m acutely aware of how much more we need to learn about breast cancer and how urgently we need better therapies. It really gives me hope to be in the lab and to know that I’m working towards something that may make things better for patients.”

Dr. DeMore is an associate professor of surgery at UNC and a member of the UNC Breast Center. With Cam Patterson, MD, MBA, she co-founded Enci Therapeutics, Inc., a start-up company that is developing a monoclonal antibody therapy for cancer that works by blocking the growth of blood vessels that tumors need to grow, a process called angiogenesis.

She has studied angiogenesis since her undergraduate days at Wheaton College in Massachusetts. After earning her medical degree from the University of Health Sciences, Chicago Medical School and completing her internship and residency at Boston University, Dr. DeMore completed a surgical research fellowship in the lab of renowned physician-scientist Judah Folkman, MD, of Children’s Hospital Boston, who pioneered the field of angiogenesis.

Dr. DeMore came to UNC 10 years ago. “I was truly amazed at the opportunities at UNC. What I like about UNC is that the people I work with- medical and radiation oncologists and radiologists - all have strong research interests. Everyone is trying to move the field forward. I have been very happy here.”

She began working with Dr. Cam Patterson on reasons why blockade of VEGF, a protein that is very important in tumor angiogenesis, does not completely halt tumor growth. The drug Avastin neutralizes VEG-F., Although Avastin is effective, there are still many patients who don’t respond to it, and of those that respond, many tumors ultimately become resistant.

“We thought there were probably other angiogenesis factors that continue to stimulate tumor growth, even when VEG-F is being blocked, so we began to look for novel angiogenesis targets.” Using molecular techniques they developed, they found a number of genes that were highly expressed in tumors, but not in normal cells.

“With an Innovations grant from the University Cancer Research Fund, we developed an antibody that in the lab neutralizes SFRP2 in triple-negative breast cancer and angiosarcoma, a rare cancer of blood vessels. To do the necessary testing and refine the antibody, we formed Enci Therapeutics. It’s encouraging to have the University be supportive of faculty start-up companies.”

When she’s not in the clinic or the lab, Dr. DeMore delights in her family. She and her husband, Ed, a retired Air Force Master Sergeant, have a daughter, and her mother lives in the Chapel Hill area. Her father, a longtime internist and role model for Dr. DeMore, died in 2011 at the age of 102. The microscope used in the video of Dr. DeMore belonged to her father.

She cites the support of her family and her lab members as key to her ability to manage so many responsibilities. “You cannot do science alone. Their support is critical.”

UNC Oncology Chaplain Named North Carolina Chaplain of the Year

Chapel Hill - Patricia Cadle, MRE, BCC, Oncology Chaplain at UNC Health Care’s Department of Pastoral Care, was honored as the 2012 Chaplain of the Year by the North Carolina Chaplains’ Association. This award is presented annually at the Association’s spring conference in recognition of “distinguished ministry in pastoral care” to a chaplain “who serves patients, community and colleagues with grace and innovation.”

Chaplain Cadle said, “Receiving such an award is both humbling and affirming; it is an affirmation that what I’ve done here, providing spiritual support and care, makes a difference for cancer patients, families and staff.”

 “The staff here is exceptional.  I value our team approach and being a part of that team,” continued Chaplain Cadle.  “Healing comes in different ways, and through the team approach patients are cared for not just physically, but also emotionally and spiritually.” 

 One of her nominators, a medical oncologist, said, “If a new patient is beginning treatment, this chaplain is there to walk with them through their journey,” and that “she is a great resource in helping patients face End of Life decisions.” Another nominator, an oncology nurse, noted that “this minister handles very difficult situation with a gentle calmness, keen insight, and deep respect for all beliefs and faiths.”

 A cancer patient’s caregiver wrote, “The most incredible meeting of the day was with one of the chaplains. She did a most wonderful thing for me. She helped facilitate conversation and extracted from my partner and me things that needed to be said for us to get clear on some of our concerns. It was a truly emotional, spiritual and therapeutic 20 minutes. She then said a heartfelt prayer which brought much some needed peace in a time filled with angst and crisis.”

 Chaplain Cadle earned her BS in therapeutic recreation from UNC-Greensboro, her master’s in religious education from Duke Divinity School and completed her chaplaincy training at Alamance Regional Medical Center.  She came to UNC Hospitals in 1998 and began serving as the oncology chaplain in 2001. Chaplain Cadle has served as an ordained minister in the United Church of Christ (UCC) for 21 years.  She is endorsed by the Western Association of the Southern Conference of the UCC to provide chaplaincy services to UNC Hospitals.

 “The best part of working with patients and families is hearing their stories, being invited on their journey, and working with them to make that journey a little more joyful, a little more peaceful, a little more manageable,”   Chaplain Cadle explained.

 “I have found my ministry here, for the past 14 years, to be both meaningful and rewarding.   I am grateful to this institution for the freedom to provide a variety of spiritual resources to an ever changing community of people.”

BCBSNC Names Dr. Lisa Carey to Board of Trustees

CHAPEL HILL, N.C. – Blue Cross and Blue Shield of North Carolina (BCBSNC) has announced Dr. Lisa Carey, Medical Director of the University of North Carolina at Chapel Hill (UNC) Breast Center and Associate Director of UNC Lineberger Comprehensive Cancer Center, as the newest member of its board of trustees.

BCBSNC’s board consists of community leaders across North Carolina with varied backgrounds in health care, education, business and finance.

“Lisa’s years of experience in clinical research and deep knowledge of the health care industry make her an excellent addition to our board,” said BCBSNC President and CEO, Brad Wilson. “Along with her notable medical accomplishments, Lisa is a leader in her community and is devoted to improving the lives of North Carolinians. These strengths will benefit our company and our customers.”

A member of UNC’s faculty since 1998, Dr. Carey is a leading figure in North Carolina’s breast cancer research efforts. She and her colleagues at UNC have written widely on racial disparities in breast cancer development and mortality, and she has led multiple clinical trials, in North Carolina and nationally, investigating new drugs and approaches in breast cancer.  Dr. Carey also serves on several national cancer committees, such as the National Cancer Institute (NCI)’s Breast Cancer Steering Committee. She was awarded a Doris Duke Clinician Scientist Award in 1999, a Career Development Award from the National Cancer Institute in 2000, was inducted into Johns Hopkins Society of Scholars in 2008, and received the NCI Director’s Service Award in 2011.

Dr. Carey attended Wellesley College, and received her MD from the Johns Hopkins School of Medicine. She completed her residency and fellowship in Medical Oncology at Johns Hopkins.

About Blue Cross and Blue Shield of North Carolina:
Blue Cross and Blue Shield of North Carolina is a leader in delivering innovative health care products, services and information to more than 3.6 million members, including approximately 900,000 served on behalf of other Blue Plans. For 78 years, the company has served its customers by offering health insurance at a competitive price and has served the people of North Carolina through support of community organizations, programs and events that promote good health. Blue Cross and Blue Shield of North Carolina was named one of the World’s Most Ethical Companies by Ethisphere Institute in 2012. Blue Cross and Blue Shield of North Carolina is an independent licensee of the Blue Cross and Blue Shield Association. Visit BCBSNC online at bcbsnc.com.

“Lisa’s years of experience in clinical research and deep knowledge of the health care industry make her an excellent addition to our board,” said BCBSNC President and CEO, Brad Wilson. “Along with her notable medical accomplishments, Lisa is a leader in her community and is devoted to improving the lives of North Carolinians. These strengths will benefit our company and our customers.”

A member of UNC’s faculty since 1998, Dr. Carey is a leading figure in North Carolina’s breast cancer research efforts. She and her colleagues at UNC have written widely on racial disparities in breast cancer development and mortality, and she has led multiple clinical trials, in North Carolina and nationally, investigating new drugs and approaches in breast cancer.  Dr. Carey also serves on several national cancer committees, such as the National Cancer Institute (NCI)’s Breast Cancer Steering Committee. She was awarded a Doris Duke Clinician Scientist Award in 1999, a Career Development Award from the National Cancer Institute in 2000, was inducted into Johns Hopkins Society of Scholars in 2008, and received the NCI Director’s Service Award in 2011.

Dr. Carey attended Wellesley College, and received her MD from the Johns Hopkins School of Medicine. She completed her residency and fellowship in Medical Oncology at Johns Hopkins.

About Blue Cross and Blue Shield of North Carolina:
Blue Cross and Blue Shield of North Carolina is a leader in delivering innovative health care products, services and information to more than 3.6 million members, including approximately 900,000 served on behalf of other Blue Plans. For 78 years, the company has served its customers by offering health insurance at a competitive price and has served the people of North Carolina through support of community organizations, programs and events that promote good health. Blue Cross and Blue Shield of North Carolina was named one of the World’s Most Ethical Companies by Ethisphere Institute in 2012. Blue Cross and Blue Shield of North Carolina is an independent licensee of the Blue Cross and Blue Shield Association. Visit BCBSNC online at bcbsnc.com.

Discovery Suggests New Combination Therapy Strategy for Basal-Like Breast Cancers

Chapel Hill, NC – Multiple research projects – including a 2006 study conducted at the University of North Carolina at Chapel Hill – have used DNA microarray analysis to identify several breast cancer subtypes, including luminal A, luminal B, basal-like and HER2-enriched. Simple tests are being developed to help doctors identify these subtypes and to treat their patients in a more biologically-based way. In turn, these tests have made several studies possible that indicate that basal-like, or triple negative breast cancer, is more prevalent in African Americans than their Caucasian counterparts.

A new study led by UNC Lineberger scientist Charles Perou, PhD, and Sean Egan, PhD, from The Hospital for Sick Children in Toronto, Ontario, demonstrates that deletion of a sugar transferase called LFNG (nicknamed “lunatic fringe”), promotes cell proliferation and tumor formation of basal-like breast cancers. 

In a laboratory model, the deletion of LFNG not only caused tumors to form but also activated two cellular signaling pathways thought to be important in tumor formation.  The team found increased activation of both notch signaling (a receptor found on the surface of cells that is involved in stem cell differentiation and development) and increased expression of the Met oncogene. 

Taking the laboratory model a step further, the team examined these same genes and signaling pathways in basal-like tumors and found the same genetic signature.

“This is exciting because there are drugs in development that target each of these pathways.  While targeting each pathway alone might work, our findings suggest that combination therapy could be a promising strategy for treating these basal-like tumors,” says Dr. Perou, who is the May Goldman Shaw Distinguished Professor of Molecular Oncology and professor of genetics, and pathology & laboratory medicine at the UNC School of Medicine.

Basal-like breast cancer tends to be more aggressive and have a poorer prognosis than other types, making up about 15 percent of all breast cancers.  In young African-American women who develop breast cancer, the subtype makes up about 39 percent of all diagnoses.  It is primarily treated with chemotherapy, although newer targeted drugs are being tested in clinical trials.

In addition to Dr. Perou, other UNC scientists involved included Jerry Usary, Aleix Prat, and Wei Zhou. Members of Dr. Egan’s group included scientists from a number of institutions affiliated with the University of Toronto, the Center for Comparative Medicine at the University of California, Davis, and the Jackson Laboratory in Bar Harbor, Maine.

The research was supported by the Canadian Cancer Society Research Institute, Susan G. Komen for the Cure, Genome Canada, the NCI Breast SPORE Program, and the Breast Cancer Research Foundation.

PSA test discussed, Brewer quoted

Noel T. Brewer, PhD, is quoted in the article "Prostate cancer and the PSA test: It's hard to understand risk," published May 21, 2012 in the Health section of The Los Angeles Times.

Dr. Brewer is an associate professor in the UNC Gillings School of Global Public HealthIcon indicating that a link will open an external site., an adjunct professor in the UNC Psychology DepartmentIcon indicating that a link will open an external site. and director of Cervical Cancer-Free NCIcon indicating that a link will open an external site.. He is also a member of UNC Lineberger and a member of the U.S. Food and Drug Administration’s Risk Communication Advisory Committee.

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Quest to understand Hepatitis C link with liver cancer receives $2.35 million boost

Chapel Hill, NC – Does hepatitis C cause liver cancer due to inflammation associated with the disease, or does the virus interact with host cells in a different way to promote the development of cancer?

Two UNC scientists have received $2.35 million to combine the power of technologies developed in each of their laboratories to answer this question.

Lishan Su, PhD, is a professor of microbiology and immunology and a member of UNC Lineberger Comprehensive Cancer Center and the UNC Center for Infectious Disease.  His team has developed a laboratory model of hepatitis C that more faithfully replicates the course of the disease in humans, both in terms of inflammation, immune response and other factors.

Stanley M. Lemon, MD, is a professor of medicine and microbiology and immunology and a member of UNC Lineberger Comprehensive Cancer Center, the Center for Translational Immunology, and the UNC Center for Infectious Disease.  His laboratory’s recombinant DNA virus technology will help the team understand how genetic changes in hepatitis C virus may affect disease progression, including liver cancer.

The researchers are both principal investigators on the five-year grant from the National Cancer Institute, a member institute of the National Institutes of Health.

“Chronic hepatitis C infection is now the leading cause of hepatocellular carcinoma (HCC) in the U.S., but how it causes liver cancer is not well understood because of the lack of a small animal model for hepatitis C.  This multi-PI project will allow us to further refine a recently developed mouse model that develops a human immune response to HCV and human liver diseases when infected with HCV.  The project will combine the expertise of the Su group in human immunology and humanized mouse models with that of the Lemon group in HCV viral genetics and liver cancer to elucidate mechanisms of HCV-induced liver cancer,” said Dr. Su.

“A number of studies have documented that inflammation plays a role in liver cancer.  But there is evidence that there is more to the story of virus-cell interaction in the development of cancer.  We believe that the virus is interacting specifically with host cell tumor suppressor pathways to promote cancer and we want to understand what drives this progression from infection to cancer in order to figure out how to stop it,” said Dr. Lemon.

According to the Centers for Disease Control and Prevention, hepatitis C is the most common chronic blood borne infection in the United States, affecting approximately 3.2 million people.  The disease accounts for the deaths of more Americans each year than HIV/AIDS.   Liver cancer is the third leading cause of death from cancer worldwide and the ninth leading cause of cancer deaths in the United States.  Chronic hepatitis virus infections account for more than two-thirds of these cases.

Two UNC scientists have received $2.35 million to combine the power of technologies developed in each of their laboratories to answer this question.

Lishan Su, PhD, is a professor of microbiology and immunology and a member of UNC Lineberger Comprehensive Cancer Center and the UNC Center for Infectious Disease.  His team has developed a laboratory model of hepatitis C that more faithfully replicates the course of the disease in humans, both in terms of inflammation, immune response and other factors.

Stanley M. Lemon, MD, is a professor of medicine and microbiology and immunology and a member of UNC Lineberger Comprehensive Cancer Center, the Center for Translational Immunology, and the UNC Center for Infectious Disease.  His laboratory’s recombinant DNA virus technology will help the team understand how genetic changes in hepatitis C virus may affect disease progression, including liver cancer.

The researchers are both principal investigators on the five-year grant from the National Cancer Institute, a member institute of the National Institutes of Health.

“Chronic hepatitis C infection is now the leading cause of hepatocellular carcinoma (HCC) in the U.S., but how it causes liver cancer is not well understood because of the lack of a small animal model for hepatitis C.  This multi-PI project will allow us to further refine a recently developed mouse model that develops a human immune response to HCV and human liver diseases when infected with HCV.  The project will combine the expertise of the Su group in human immunology and humanized mouse models with that of the Lemon group in HCV viral genetics and liver cancer to elucidate mechanisms of HCV-induced liver cancer,” said Dr. Su.

“A number of studies have documented that inflammation plays a role in liver cancer.  But there is evidence that there is more to the story of virus-cell interaction in the development of cancer.  We believe that the virus is interacting specifically with host cell tumor suppressor pathways to promote cancer and we want to understand what drives this progression from infection to cancer in order to figure out how to stop it,” said Dr. Lemon.

According to the Centers for Disease Control and Prevention, hepatitis C is the most common chronic blood borne infection in the United States, affecting approximately 3.2 million people.  The disease accounts for the deaths of more Americans each year than HIV/AIDS.   Liver cancer is the third leading cause of death from cancer worldwide and the ninth leading cause of cancer deaths in the United States.  Chronic hepatitis virus infections account for more than two-thirds of these cases.