News

Breast cancer prevention drug benefit varies among at-risk women, study finds

After weighing the risk of serious side effects with the benefits of a breast cancer prevention drug, a study led by a University of North Carolina at Chapel Hill researcher found that the drug’s benefits outweighed risks for most, but not all women.

The study’s findings may help women and their doctors make decisions about who may get the most benefit out of taking the drug tamoxifen, which has been shown to have been adopted by only a slim margin of women eligible to take it.

“It’s important because it highlights that the estimated benefit is not the same for all women, and so women need to go and have a very specific conversation with their providers about what their health looks like at that time, and whether this is a reasonable option for them,” said Hazel Nichols, PhD, an assistant professor of epidemiology in the University of North Carolina Gillings School of Public Health.

Nichols was the lead author of the study, which was published online in the Journal of the National Cancer Institute in December, and in print in January. 

Part of the drive for doing the analysis, Nichols said, is the fact that few women eligible to take tamoxifen for breast cancer prevention are actually choosing to take it, although it’s been shown to reduce invasive breast cancer risk. A panel of U.S. health experts has encouraged doctors to offer chemoprevention drugs to women at higher risk for breast cancer and at low risk for side effects. Tamoxifen was first approved in 1998 for women older than 35 with those characteristics. 

“Tamoxifen is very good at preventing breast cancer, but it also has to be weighed against an increased risk of uterine cancer, stroke or blood clotting negative effects,” Nichols said.

Nichols said that one of the biggest takeaways from the analysis she led is that it shows that there are tools that can help women and their doctors determine whether preventive drugs like tamoxifen are right for them.

Using a mathematical tool developed at the National Cancer Institute, the researchers were able to weigh the risks and benefits of taking the drug for a group of 788 women who were taking tamoxifen and did not have a history of breast cancer. The analysis took the women’s age, race, breast cancer risk, and risk for serious side effects such as stroke, uterine cancer, and cataracts from taking tamoxifen into account.

They found that the drug’s benefits outweighed the risks for 74 percent of the women included in the analysis, but not for another 20 percent, or one in five women. Women who had hysterectomies before starting the drug were more 11 times more likely to have a favorable risk-to-benefit profile. Younger women were also more likely to benefit, but African-American women were 65 percent less likely than white women to see their benefits exceed risks associated with taking the drug. 

The study also found that many women stopped taking the drug before the recommended five years were up. Out of the788 tamoxifen users in the study, 46 percent stopped taking the drug before the recommended five years, the study found. While the study looked at several factors such as age, race and breast cancer risk, she said none of those were strong predictors of who decided to stop taking tamoxifen early.

Dr. Nichols said the study’s finding that the benefits did not outweigh the risks for one in five women is a “reminder” that factors like a woman’s age and her hysterectomy status should be considered when making decisions about chemoprevention.

“I think we have seen that not all women who take tamoxifen for chemoprevention will have equivalent evidence that the risks outweigh the benefits, but the risk-benefit tool is easy to apply to estimate whether a woman’s benefits are likely to outweigh the risks,” she said.

For the study, the researchers drew upon The Sister Study, a National Institute of Environmental Health Sciences-led study that explored risk factors for breast cancer. More than 50,000 U.S. and Puerto Rican women aged 35 to 74 years joined the study. Women were eligible if they were breast cancer-free, but had a sister diagnosed with breast cancer. The Sister Study gave the researchers an opportunity to evaluate a large group of women at higher risk for breast cancer outside of a clinical trial, Nichols said.

The UNC-Chapel Hill-led study was supported by the Intramural Research Program of the National Institutes of Health, the National Institute of Environmental Health Sciences and the National Center for Advancing Translational Sciences.

Study co-authors included Lisa A. DeRoo of the Department of Global Public Health and Primary Care at the University of Bergen in Norway; Daniel R. Scharf of Westat; and Dale P. Sandler of the National Institute of Environmental Health Sciences Epidemiology Branch.


Breast cancer prevention drug benefit varies among at-risk women, study finds
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Hazel Nichols, PhD



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Breast cancer prevention drug benefit varies among at-risk women, study finds

After weighing the risk of serious side effects with the benefits of a breast cancer prevention drug, a study led by a University of North Carolina at Chapel Hill researcher found that the drug’s benefits outweighed risks for most, but not all women.
Breast cancer prevention drug benefit varies among at-risk women, study finds click to enlarge Hazel Nichols, PhD

The study’s findings may help women and their doctors make decisions about who may get the most benefit out of taking the drug tamoxifen, which has been shown to have been adopted by only a slim margin of women eligible to take it.

“It’s important because it highlights that the estimated benefit is not the same for all women, and so women need to go and have a very specific conversation with their providers about what their health looks like at that time, and whether this is a reasonable option for them,” said Hazel Nichols, PhD, an assistant professor of epidemiology in the University of North Carolina Gillings School of Public Health.

Nichols was the lead author of the study, which was published online in the Journal of the National Cancer Institute in December, and in print in January. 

Part of the drive for doing the analysis, Nichols said, is the fact that few women eligible to take tamoxifen for breast cancer prevention are actually choosing to take it, although it’s been shown to reduce invasive breast cancer risk. A panel of U.S. health experts has encouraged doctors to offer chemoprevention drugs to women at higher risk for breast cancer and at low risk for side effects. Tamoxifen was first approved in 1998 for women older than 35 with those characteristics. 

“Tamoxifen is very good at preventing breast cancer, but it also has to be weighed against an increased risk of uterine cancer, stroke or blood clotting negative effects,” Nichols said.

Nichols said that one of the biggest takeaways from the analysis she led is that it shows that there are tools that can help women and their doctors determine whether preventive drugs like tamoxifen are right for them.

Using a mathematical tool developed at the National Cancer Institute, the researchers were able to weigh the risks and benefits of taking the drug for a group of 788 women who were taking tamoxifen and did not have a history of breast cancer. The analysis took the women’s age, race, breast cancer risk, and risk for serious side effects such as stroke, uterine cancer, and cataracts from taking tamoxifen into account.

They found that the drug’s benefits outweighed the risks for 74 percent of the women included in the analysis, but not for another 20 percent, or one in five women. Women who had hysterectomies before starting the drug were more 11 times more likely to have a favorable risk-to-benefit profile. Younger women were also more likely to benefit, but African-American women were 65 percent less likely than white women to see their benefits exceed risks associated with taking the drug. 

The study also found that many women stopped taking the drug before the recommended five years were up. Out of the788 tamoxifen users in the study, 46 percent stopped taking the drug before the recommended five years, the study found. While the study looked at several factors such as age, race and breast cancer risk, she said none of those were strong predictors of who decided to stop taking tamoxifen early.

Dr. Nichols said the study’s finding that the benefits did not outweigh the risks for one in five women is a “reminder” that factors like a woman’s age and her hysterectomy status should be considered when making decisions about chemoprevention.

“I think we have seen that not all women who take tamoxifen for chemoprevention will have equivalent evidence that the risks outweigh the benefits, but the risk-benefit tool is easy to apply to estimate whether a woman’s benefits are likely to outweigh the risks,” she said.

For the study, the researchers drew upon The Sister Study, a National Institute of Environmental Health Sciences-led study that explored risk factors for breast cancer. More than 50,000 U.S. and Puerto Rican women aged 35 to 74 years joined the study. Women were eligible if they were breast cancer-free, but had a sister diagnosed with breast cancer. The Sister Study gave the researchers an opportunity to evaluate a large group of women at higher risk for breast cancer outside of a clinical trial, Nichols said.

The UNC-Chapel Hill-led study was supported by the Intramural Research Program of the National Institutes of Health, the National Institute of Environmental Health Sciences and the National Center for Advancing Translational Sciences.

Study co-authors included Lisa A. DeRoo of the Department of Global Public Health and Primary Care at the University of Bergen in Norway; Daniel R. Scharf of Westat; and Dale P. Sandler of the National Institute of Environmental Health Sciences Epidemiology Branch.

Wang published in Nanoscale

Andrew Zhuang Wang, MD, of the UNC Lineberger Department of Radiation Oncology, was published in the journal Nanoscale. The paper, "Nanoparticle delivery of chemosensitizers improve chemotherapy efficacy without incurring additional toxicity," was accepted by the journal Jan. 4. Wang and other researchers demonstrated proof of the principle of using a nanoparticle formulation for drugs that improve the sensitivity of tumors to chemotherapy.
Wang published in Nanoscale click to enlarge Andrew Z. Wang, MD

Emily’s gifts

Eight year old Emily McCann of Apex came to the N.C. Cancer Hospital at the end of December bearing gifts. She brought money to help meet the needs of pediatric cancer patients, but she also brought cheer, comfort and hope.

Inspired by her church to do something to make the world a better place, Emily decided to use her time and talent to earn money to buy wigs for children going through cancer treatment.

Emily’s mother Stephanie McCann recalls that while discussing how she would like to help, Emily simply said, “I would like to help kids who don’t have any hair be able to get wigs.”  Stephanie explained to her daughter that those are children who have cancer, and Emily said she understood that and wanted to help.  

Emily earned money by doing odd jobs for family, friends and neighbors in exchange for donations. Her work included serving as a mother’s helper, yard work and cleaning windows.  Many people, including groups from the family’s church, made donations simply because they were so moved by Emily’s effort to serve others. Before long, she had raised over $1,600.

On December 30th, Emily and her family visited the N.C. Cancer Hospital’s Patient and Family Resource Center (PFRC) and presented a check for $1,685 to be used to purchase wigs for pediatric cancer patients.  They decorated some wig boxes with cheerful stickers and made cards with good wishes for patients.

Johanna Valera, 18, came to the PFRC to pick out a wig during Emily’s visit. The two girls spent some time talking while Johanna tried on wigs. There were smiles all around as Emily helped Johanna select the perfect wig with beautiful long dark brown hair.

Tina Shaban, RN, manager of the PFRC explains, “Emily’s gift has allowed us to purchase some wigs with youthful styling and coloring that closely resemble the natural hair of our young patients.” Shaban added, “It was a real privilege to meet this young lady who worked so hard to help others in need.”

Emily encourages others to reach out in service to others saying, “If you have a feeling in your heart that you should help someone you should do it."


Emily’s gifts
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Emily McCann and Johanna Valera

Emily’s gifts
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Emily decorating the boxes with her mother, Stephanie McCann

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Emily’s gifts

Eight year old Emily McCann of Apex came to the N.C. Cancer Hospital at the end of December bearing gifts. She brought money to help meet the needs of pediatric cancer patients, but she also brought cheer, comfort and hope.
Emily’s gifts click to enlarge Emily McCann and Johanna Valera
Emily’s gifts click to enlarge Emily decorating the boxes with her mother, Stephanie McCann

Inspired by her church to do something to make the world a better place, Emily decided to use her time and talent to earn money to buy wigs for children going through cancer treatment.

Emily’s mother Stephanie McCann recalls that while discussing how she would like to help, Emily simply said, “I would like to help kids who don’t have any hair be able to get wigs.”  Stephanie explained to her daughter that those are children who have cancer, and Emily said she understood that and wanted to help.  

Emily earned money by doing odd jobs for family, friends and neighbors in exchange for donations. Her work included serving as a mother’s helper, yard work and cleaning windows.  Many people, including groups from the family’s church, made donations simply because they were so moved by Emily’s effort to serve others. Before long, she had raised over $1,600.

On December 30th, Emily and her family visited the N.C. Cancer Hospital’s Patient and Family Resource Center (PFRC) and presented a check for $1,685 to be used to purchase wigs for pediatric cancer patients.  They decorated some wig boxes with cheerful stickers and made cards with good wishes for patients.

Johanna Valera, 18, came to the PFRC to pick out a wig during Emily’s visit. The two girls spent some time talking while Johanna tried on wigs. There were smiles all around as Emily helped Johanna select the perfect wig with beautiful long dark brown hair.

Tina Shaban, RN, manager of the PFRC explains, “Emily’s gift has allowed us to purchase some wigs with youthful styling and coloring that closely resemble the natural hair of our young patients.” Shaban added, “It was a real privilege to meet this young lady who worked so hard to help others in need.”

Emily encourages others to reach out in service to others saying, “If you have a feeling in your heart that you should help someone you should do it."

Katy Sims

When Katy Sims enters the first-year class at the UNC School of Medicine this fall, she will already have extensive medical experience. Her decision to become a doctor came as she was undergoing treatment for Ewing sarcoma, a type of childhood cancer.

Katy had just begun her freshman year at Davidson College when the tumor was found. Following a surgery to remove three ribs, she underwent 14 cycles of chemotherapy. She turned 19 two days after her surgery in November of 2007.

A dual language major, she had thought about a career as a medical interpreter, but it was a challenge from a nurse that caused her to change majors. She remembers, “This nurse had been with me at my first hospital admission and had always been there when I was having chemotherapy.  She asked me what I was going to do when I finished my therapy. I said, ‘I’m going to get back to my life. Make it exactly the way it was before.’ And she asked, ‘Really? So all of this was for nothing? You’re not changing anything?’ I asked her, ‘What do you think I should change?’ And she said, ‘I think you should be a doctor.’

“I thought about it and told her at my next visit that I was going to become a doctor. I switched to a pre-med biology major. It was a difficult transition. But now I’m coming to medical school. I have worked in labs both as an undergraduate at Davidson and now at UNC in the Center for AIDS Research core imunology lab. It’s hard to say what I’ll specialize in because the only thing I’ve experienced is oncology, but I’m probably going to end up in young adult oncology.”

Katy says that being a young adult oncology patient is challenging. “It’s like a forgotten group. Video games in the pediatric ward, but not in the adult’s. This age is a major transition point in your life.  Lots of times this is the first serious thing your friends have had to deal with: you being really sick or possibly dying.  They’ll listen to you for a while, but then they say, ‘Okay. That’s enough. You don’t have cancer anymore.’ And I have to say, ‘You don’t understand. I’ll always have cancer. I may not have a malignancy, but I’m always going to have cancer in my life.’”

This summer she had a remarkable experience at First Descents, a national program that offers young adult cancer fighters and survivors a free outdoor adventure experience.

Her medical oncologist, Dr. Juneko Grilley-Olson, is a physician volunteer for the program. Katy says, “Dr. Grilley-Olson urged me to participate since it was one of my last free summers for a while.  I was accepted to the program and from the very first day, it was like all of us had cancer and because all of us had cancer, none of us had it. The idea of First Descents is the first successful kayaking trip down a river that has never been kayaked before. For us, cancer was our first descent, the first time we had been down that river that no one else had gone down before because everyone’s cancer is such a unique experience.”

Katy describes her time in the ocean with the surfing instructors. ‘They were willing to do anything to make sure we had the experience of getting out in the waves and basically giving up our control to the ocean. After flipping over and having this enormous mass of water pouring over you, you realize that it doesn’t really matter whether or not you’re standing on the board, riding a wave or have the board under your control because the most fun is actually trying. Once you get up on the board it’s not really exciting. It’s the process of getting up on your board and learning about yourself and what does and doesn’t work and how you can actually go forward. You don’t need control to do that. You just need acceptance of yourself and acceptance of the idea that you may not end up where you want to be, but at least you got somewhere.”

Katy thinks that her cancer experience will shape her medical education for the better. “I understand what the patients are going through. I know pain, I know death, I know fear and I know illness. Many of my classmates are coming to medical school from a different point of view. I am in it for being able to take care of patients and taking care of myself by taking care of people.”

Richard Westin

Most cancer patients jump up and down after finishing therapy, but Richard Westin did much more. He jumped out of an airplane on a skydive to celebrate completing his chemo and radiation therapies and now jumps into water taking scuba diving lessons.

In February of 2012, Richard, a junior engineering major at North Carolina State University, was having difficulty chewing his food and opening his mouth. A dentist told him he was probably clenching his teeth. In May he left for a six-week engineering internship in China. During the flight he experienced the sensation of water in his ear. Three weeks into his internship he was finding it more and more difficult to open his mouth and the water in his ear remained.

He went to see a doctor who looked down his throat, saw that half of it was closed, and ordered an MRI. Richard flew home and saw an ENT physician who referred him to UNC where Dr. Mark Weissler performed a biopsy and determined it was cancer, a parotid tumor (the parotid gland is the largest of the salivary glands).

Richard’s father came with him to the UNC appointment and then his whole family gathered to support him, flying in from Sweden and New York. They met with Drs. Weissler, medical oncologist Juneko Grilley-Olson and radiation oncologist Bhisham Chera to develop a treatment plan.

Due to the location of the tumor, surgery was ruled out. Instead the team proposed a 40-week course of chemotherapy followed by 28 days of radiation.

Richard explains, “They suggested that I take a year off from school because I’d be really tired and not able to do as much as I usually could. For the most part I just kept going. Throughout the course of treatment, I was able to go to some classes and to the gym. I usually scheduled my chemo treatment for Fridays. If it was a three-drug day, I would take it easy, and on Monday I was pretty much back to normal activities and classes.”

Richard had been a defense player on the NCSU roller hokey team for three years and played tennis as well. “I definitely think that me being in good shape and trying to keep up my strength and conditioning helped out through treatments. It helped keep my mind off cancer and something to work for.”

When he finished therapy in April he had a plan for how to celebrate. His brother had skydived and enjoyed it. “I asked myself, ‘What can I do to celebrate that’s something really cool and out of the ordinary?’ I decided on a sky dive with my friends. It was an incredible experience.”

He is now learning to scuba dive. “I wasn’t sure I’d be able to do it because of the location of the tumor and the problems with equalizing when you go down, but I haven’t had any trouble, so I’m really looking forward to keep going with that.” He’ll begin his final year of school this fall.

Richard says, “My care at UNC was as good as I could have asked for. Everyone at UNC was amazing. Whether it was at registration or getting my port accessed or the nurses in infusion and my doctors as well they always had my best interest in mind and I'm forever grateful to each and every one of them.”

Richard’s perspective on his cancer experience is positive. “I guess I had a ‘grab the bull by the horns’ attitude. I know when people get cancer, they often think the worst. I felt, ‘Let’s get me better.’  That was the only outcome.”

After graduation, Richard would like to work in the automobile or aerospace industry with companies such as BMW, GE, or Boeing for a few years, and then he plans on furthering his education with an MBA.

Lynn Latchford

In early 2013, while pursuing a doctoral degree in theological anthropology at Trinity College in Dublin, Ireland, Lynn Latchford began to experience some puzzling symptoms. Routine academic tasks suddenly became difficult. Mental fogginess was accompanied by fatigue, weight gain and changes in her sense of smell, taste and hearing. Doctors attributed her symptoms to a chronic thyroid disorder and stress.

As her symptoms worsened, Lynn took leave from her studies and moved back to the United States, settling in Durham. Her symptoms persisted but no answers were found. In March of 2014, she came to UNC Hospital thinking she was having a heart attack, but a thorough assessment revealed a different diagnosis: a tumor on her brainstem. The mass was wrapped around several nerves and an artery. It was causing dangerous disruptions in her endocrine system. And it was inoperable.

“The tumor was in the least accessible part of my brain,” says Latchford. “The Tumor Board at the N.C. Cancer Hospital reviewed my case carefully, and they told me it was too dangerous even to biopsy. But radiation oncologist Dr. Joel Tepper told me they had one option for me: 3D Conformal Radiation Therapy.”

3D Conformal Radiation Therapy (3D-CRT) uses a set of CT images to identify both the tumor and the critical normal tissue structures that need to be avoided. Radiation beams of varying shapes are designed to enter the patient from multiple angles and “hit” the tumor while avoiding nearby healthy tissues.

In Latchford’s case, a specialized form of 3D-CRT treatment known as Intensity-Modulated Radiation Therapy (IMRT) was ultimately used.  With IMRT, the shapes of the radiation beams are varied as well as their “strengths” or intensities.  This further guarantees that the tumor receives the maximum amount of radiation, while the surrounding normal tissues receive the least possible exposure.

IMRT delivered radiation to Latchford’s tumor in a way that minimized exposure of the delicate nerves and the artery it enveloped. A custom-molded mesh helmet was necessary to immobilize her head and maintain it in the same position throughout each treatment.

“The first time I saw the radiation machine was when I walked in for my first treatment, and I was overwhelmed,” recalls Latchford. “Although I had read pamphlets about what to expect, that did not prepare me for the sensory overload I experienced when I saw that enormous machine.”

Latchford explains the role that N.C. Cancer Hospital staff played in alleviating the stress she experienced during her treatment. “I didn’t have any family here with me,” she says. “I can’t begin to tell you how important the caring staff was for me. My entire experience was one of gentle caring. They turned a frightening time into an almost positive experience.”

With radiation treatment behind her, Latchford is now busy with the work of recovery. She still suffers from some short term memory problems and deficits in attention and processing. She is grateful for the resources of UNC Lineberger’s Comprehensive Cancer Support Program such as integrative medicine and survivorship counseling. “I’m working with Dr. Leeza Park to process my feelings and adjust to the reality of my situation,” she says. “Starting small and going slowly, I am learning what I still can do.”

Among the many things that Latchford can still do is tell a story with photographs and video. She is currently producing a video to help explain IMRT to other patients facing this type of treatment.

“The anxiety I experienced at the start of my treatment was significant, and the helmet I had to wear to immobilize my head was frightening. The pamphlets about IMRT were great, but it was difficult for me to process and absorb written material following my diagnosis. I thought that a video about the experience might help a patient coming after me.”

With the help of Dr. Tepper and the team of N.C. Cancer Hospital radiation therapists, Latchford filmed her treatment from a variety of perspectives. Some wide angle shots show the enormity of the radiation machine, others show Latchford’s view of the machine via a camera on her chest. A camera strapped to the machine as it rotates 360º around her body shows the machine’s point of view.

Latchford hopes the video will help patients coming after her, but right now, it’s helping her recover some of the person she was before the tumor interrupted her life. “I was using my photography and videography skills for my research in Dublin, and I am still able to use those skills,” she says happily. “Working on this project is helping me recover some of the cognitive function that diminished during my illness. I am building a new life around the new me.”

Daniel Fischler

Daniel Fischler remembers the call. “When a doctor calls you at 10:30 on a Friday night, it’s not going to be good news.” He had undergone an MRI for a herniated disc, but when the test revealed a shadow on his left bowel, a CT was ordered. Then came the call from his doctor. “He told me that it was very likely a tumor. I was knocked out, shocked by the bad news.”

Daniel and his wife, Jeannie, called their friend, Jean Kitchin, and days later they came to UNC Lineberger.

 The Fischlers are both 1990 UNC graduates. They met the night before second semester began during their junior year, and discovered the next morning that they were in the same business finance class. They’ve been together ever since, married for 21 years.

Jeannie says, “We received quick attention at UNC, had the biopsy done and a treatment plan developed: a 20-round course of chemotherapy followed by surgery. We felt at home at UNC and have a lot of confidence in our care team.” She compliments Melissa Holt and the other nurse navigators. “Anytime I called, someone was always there for me.”

During the time leading up to Daniel’s diagnosis of testicular cancer, they met with Dr. H.J. Kim, a UNC GI surgeon. Jeannie says, “Daniel was a little old for testicular cancer, so for a time Dr. Kim was trying to prepare us for other possible diagnoses. After he talked with us, he put his hand on my shoulder and said, ‘One day at a time.’ That was the perfect thing to say.”

They next met with Dr. Matt Milowsky, their urologic medical oncologist. “He was very positive," Jeannie says. "He told us that it was testicular cancer, and the cure rate was 95 percent. After he said that Daniel commented that he was waiting for the ‘but.’ Dr. Milowsky replied that there was no ‘but.’”

Daniel was able to work during much of his treatment. “I would have treatment and take some days off to recover. It helped me keep my mind off things and made me feel normal.” Daniel had his chemotherapy in the Raab Clinic in Morehead City. ”They took great care of us.”

After 20 rounds of chemotherapy, Daniel and Jeannie celebrated with a ski trip. And the family got some good news via email about daughter, Hannah. She was accepted early admission to UNC. Jeannie videoed the family’s noisy, happy celebration, complete with Daniel’s bald head. “It was a good moment, extra special because we had gone through so much.”

Next up was a successful surgery to remove the tumor, performed March 1 by Dr. Eric Wallen, a UNC urologic surgeon. Now they’ll have their follow-up care at UNC.

The Fischlers had lots of community support. Jeannie says, “We received many encouraging notes from family and friends, offers of meals and had numerous people praying for us. Teachers of our son, Daniel, and of Hannah were very understanding. Everyone was rooting for us. We had a group of friends who had been through a cancer experience with a family member. We called them our cancer angels. Once you go through it, you learn what to do and how to assist. One of them urged us to take the ski trip to get our minds off things before the surgery. Another advised us, ‘Don’t go down any dark roads when you’re getting the information. Listen to what your health care professionals are saying and follow that advice.’”

Daniel describes cancer as “a big perspective check as far as what’s important and what’s not so important. As a result, I’ve changed. I’ve learned to be more tolerant."

Jeannie says, “I have told our children over and over that gratitude is the secret to happiness - that no matter what happens, you can always be grateful for something. We don't know why my ‘healthy’ husband got cancer, but we are so grateful and so fortunate: grateful for doctors and nurses and technology and treatments and health insurance. Grateful to friends and family and people we don't even know! You can't go through something like that and remain unchanged. Yes, things are getting back to normal, but ‘normal’ will never feel the same as it once did. That's for sure.”

Tricia Prestia

In 2011, Tricia Prestia was wearing a lot of hats. A wife, a mother and a busy women’s health nurse practitioner in Cary, Tricia drew on her training and experience as a cytologist - the person who studies cellular changes that may indicate cancer - in her nursing practice.

But then, Tricia was forced to wear a new hat when she was diagnosed with a rare form of leukemia called acute promyelocytic leukemia, a subtype of acute myeloid leukemia. She explains, “Even though you have all this medical knowledge, this is the moment when you become the patient who has questions, fears, doubts and concerns. I was the health care provider, the wife and the mother and now the patient. And at that instant, instead of taking care of and explaining things to your patients, you have to absorb what’s happening to you, translate the medical terms for your family, and take care of yourself. It was a challenging time on many levels.”

Tricia was a serious athlete, involved in tennis and golf, but she had to stop tennis because of fatigue. Then, bruises and a fever caused her to visit her doctor who sent her to the Emergency Department after her blood counts showed that she had leukemia. She was brought to UNC by ambulance in serious condition. “They told Charlie, my husband, that he might want to say goodbye to me since they didn’t know if I would make it through the night. Charlie called our son in Washington, DC.”

Tricia came to UNC because Dr. Matt Foster was a principal investigator for a clinical trial to treat APL. “I started the study, but was taken off because the cancer had spread to my spine. Metastasis to the spine was not what anyone expected, so they modified the study for me.  After multidrug chemotherapy in the hospital, I had daily chemotherapy for the leukemia from December until February 2012. I had weekly chemo for the spinal metastasis along with the daily from February until May 2012. Then 2 x 1 week stays in house with multi drug chemo twice a day and a dose of spinal chemo each week. I was finally done by the beginning of August 2012”

But her medical challenges were not over yet. October 2012 she was diagnosed with a rare, life-threatening fungal infection she contracted from being in her backyard during the time she was immune-compromised. “UNC surgeons Dr. Deb Bhowmick, who removed portions of my spine which was destroyed by the fungus and then needed to place a Pedicle Screw Fixator to the weakened spine, and Dr. Benjamin Haithcock who had to remove the lower right lobe of my lung invaded by the same fungus. I finished my last dose of medication for the Mucormycoses in August 2013. They weren’t sure I’d survive this either, but I did.”

Tricia is now in remission.

In 2013 Tricia joined the Patient and Family Advisory Board for the N.C. Cancer Hospital and is serving as a rounder and a member of the Emergency Room Committee. Rounding involves visiting with patients in waiting areas and the infusion clinic to listen to their concerns and get feedback on the cancer hospital’s services.  Her UNC training in nursing and as a nurse practitioner as well as her time spent at Memorial Sloan-Kettering Cancer Center as a cytologist informs her work with the Board.

She says, “Rounding is a wonderful way to really work with patients and to make sure they know that this hospital is here for them. The Emergency Room Committee is already working on a number of ways to improve the patient and family experience. I used to work in an emergency room as a nurse, so to see this group being proactive is great.”

Tricia’s outlook remains upbeat despite the enormous health challenges she has faced. “My motto is ‘the sun is out even when it’s raining.’ There are two paths people can choose if they have cancer or a life-altering event. One path brings you to despair and to ask why me. Those vibes don’t help your body, your mind or your strength in any way. That negativity does not allow your body to heal. The other path, the path of light, sustains you even on a day when you might be feeling a little bit blue. Your friends, your family, the trees, your dog, the birds, the rain, it doesn’t matter; you’re taking a breath, a breath that you would not normally have had. That will get you through the day. That’s what makes the fact that even when it’s raining the sun is out. It’s those things that people forget in their daily life. Just in an instant, take a look around you and take a deep breath.”

She has used her cancer experience to help others. Employees at Charlie’s company, Lenovo, have become UNC platelet donors. Charlie and Tricia established a charitable foundation called Lickin’ Leukemia that raises funds through tennis and golf events at Cary’s Prestonwood Country Club to help patients and families affected by leukemia. “The fundraising events were established in honor of my friend, and me, since we were diagnosed with leukemia six months apart and were both treated at UNC.”

She vows, “If even for a moment there’s anything I can do, to help somebody else, I just want to do that.” This new member of the Patient and Family Advisory Board is doing just that.

 

Tomma Hargraves

Eight years after her diagnosis, lung cancer survivor Tomma Hargraves is training to become a lay navigator with UNC Lineberger, giving back to the hospital that she credits with saving her life.

In October of 2006, Tomma Hargraves found a small lump in her neck.  Although she felt very healthy, she went to her doctor to have the lump checked out.  A few days later, she received a diagnosis that shocked her: Stage 3B non-small cell lung cancer. The tumor was in the right lobe of her lungs, and the cancer had spread to the lymph nodes on the left side of her neck.  

“I wish I had known that non-smokers and people who had quit long ago could get lung cancer,” says Hargraves. I thought I had done everything right, and I still got lung cancer.”

After seeking several opinions and researching her treatment options, Hargraves decided on UNC Lineberger Comprehensive Cancer Center. Two things set UNC Lineberger apart for her. “I was offered an aggressive clinical trial that included chemo, radiation and a targeted oral medication,” she says. “But what I really loved about UNC was the team approach. I didn’t have to go from doctor to doctor. They all came to me in my room and talked to me about their roles: the radiation oncologist; the thoracic oncologist; the nurse navigator. The N.C. Cancer Hospital has such a warm atmosphere, and I feel like the people really care about me.”

The treatment lasted nine months, and it got her into remission – or as she prefers to say, it got the cancer “under control.” Although the cancer reappeared a few years later in her lymph nodes and brain, it is once again under control. Now eight years after her initial diagnosis, Hargraves is a survivor giving back to the hospital that she credits with saving her life.

Recently retired from a 42 year career as a speech-language pathologist, Hargraves is now training to become a lay navigator for lung cancer patients at the N.C. Cancer Hospital. This new program trains volunteers to offer practical and emotional support to patients and families journeying through cancer treatment. “I am so eager to get started as a lay navigator,” she says. “It’s a good avenue to work on the personal side. I can’t do anything medically – we have our experts for that – but I can help with support services.”

Hargraves is also an active lung cancer advocate. She serves on the board of directors of the Lung Cancer Initiative of North Carolina (LCINC) working to increase awareness and research for lung cancer. “Lung cancer is the number one cancer killer,” she explains. “It kills more women than breast cancer. Breast cancer has done a wonderful job with advocacy, and we want that with lung cancer. It’s not just a smoker’s disease, but we carry that stigma.”

She met UNC Lineberger’s Jared Weiss, MD, at a lung cancer advocacy summit. “We were friends and advocates together before he came to UNC Lineberger in 2010. When I came out of remission, he became my physician,” she explains. “He is very knowledgeable, and he really works hard to make a difference for lung cancer patients.”

November is Lung Cancer Awareness Month, and LCINC is holding 5K events in Raleigh and Greensboro. Hargraves says the money they raise in North Carolina stays in North Carolina, and hopefully that money will support lung cancer research at UNC Lineberger.

Hargraves understands that some cancer survivors want to get as far away from cancer as they can after finishing treatment, but she found she could not walk away. “It’s part of who I am now,” she says. “I’m still a patient, but I’m also an advocate trying to make things better for other lung cancer patients.” 

Sherdinia Thompson-Dunn

Leading an active life can help women treated for breast cancer live longer and healthier lives. Just ask Sherdinia Thompson-Dunn of Carrboro, NC. Thompson-Dunn, a 1967 graduate of UNC, found some pleasant surprises when she began a self-directed walking program in October 2013 following treatment for breast cancer.
Sherdinia Thompson-Dunn click to enlarge Sherdinia Thompson-Dunn

Thompson-Dunn participated in a UNC Lineberger pilot study to test the Arthritis Foundation’s Walk With Ease self-directed walking program, which was adapted for breast cancer patients. The study was conducted by UNC Lineberger Geriatric Oncology Program Director, Hyman Muss, MD in collaboration with other UNC researchers. 

“When I first started the walking program, I was having some pain and stiffness in my joints, and I wasn’t sure I would be able to find the time to walk,” said Thompson-Dunn. “I started slow – walking four blocks around my neighborhood, then gradually I worked up to eight blocks. After a while, I was surprised to find that I would look forward to walking.”

Although retired, Ms. Thompson-Dunn has a busy life helping to care for her mother and taking care of four young grand-nieces after school during the week. She says her husband, Sinatra Dunn, encouraged her to make time for herself and stick with the walking program, and she is glad she did. “Walking gives me a mental clarity,” she explains. “It’s like a wind-up that gives you energy for the whole day.”

For this pilot study, Dr. Muss and his colleagues were particularly interested in testing the feasibility and benefits of a walking program among older breast cancer survivors.

 “Breast cancer is a disease of aging. In fact, most people in the U.S. with breast cancer are now 65 and older,” said Muss. “We know that incorporating simple, routine exercise—like walking—into a patient’s treatment plan helps maintain function and improve overall quality of life.”

Last February, The Kay Yow Cancer Fund®, in partnership with The V Foundation for Cancer Research, awarded a $1 million women’s cancer research grant to UNC Lineberger to evaluate the impact of physical activity among breast cancer survivors. This grant will facilitate an expansion of a well-established base of research being conducted at UNC Lineberger on aging and breast cancer. Dr. Muss says,“we are thrilled to have the opportunity to grow this program, help more breast cancer patients and see it realized on a national scale.”

The research project will be conducted as a national, multi-site collaboration with the Cancer and Aging Research Group, UNC Hospitals, affiliated community clinics and the Alliance for Clinical Trials and Oncology.

Tumor microenvironment is a rough neighborhood for nanoparticle cancer drugs

Researchers look at area around tumors to help personalize treatment for triple-negative breast cancer
Tumor microenvironment is a rough neighborhood for nanoparticle cancer drugs click to enlarge William Zamboni, PharmD, PhD

(Chapel Hill, N.C. – Jan. 13, 2015) – Nanoparticle drugs—tiny containers packed with medicine and with the potential to be shipped straight to tumors—were thought to be a possible silver bullet against cancer. However new cancer drugs based on nanoparticles have not improved overall survival rates for cancer patients very much. Scientists at the University of North Carolina at Chapel Hill now think that failure may have less to do with the drugs and tumors than it does the tumor’s immediate surroundings.

The work, published in Clinical Cancer Research, merges relatively old and new ideas in cancer treatment, on one hand underscoring the importance of personalized medicine and on the other, reinforcing a relatively new idea that the tumor microenvironment might affect the delivery of drugs to tumors – a factor that may alter drug delivery from person to person, from cancer to cancer and even from tumor to tumor.

“Tumors create bad neighborhoods,” said William Zamboni, the study’s senior author and an associate professor at the UNC Eshelman School of Pharmacy. “They spawn leaky, jumbled blood vessels that are like broken streets, blind alleys and busted sewers. There are vacant lots densely overgrown with collagen fibers. Immune-system cells patrolling the streets might be good guys turned bad, actually working for the tumor. And we’re trying to get a large truckload of medicine through all of that. 

In their work, Zamboni and colleagues from the UNC Lineberger Comprehensive Cancer Center and the UNC School of Medicine joined forces to see how much of the standard small-molecule cancer drug doxorubicin and its nanoparticle version, Doxil, actually made it into two varieties of triple-negative breast-cancer tumor models created by UNC’s Chuck Perou, the May Goldman Shaw Distinguished Professor of Molecular Oncology at the UNC School of Medicine and a professor at UNC Lineberger. Triple-negative breast cancer accounts for 10 to 17 percent of cases and has a poorer prognosis than other types of breast cancer.

At first, what they saw was no surprise: significantly more of the nanodrug Doxil made it into both triple-negative breast-cancer tumors compared with the standard small-molecule doxorubicin. “That’s nothing new,” Zamboni said. “We’ve seen that for twenty years.” They also saw the same amount of doxorubin in both tumors.

What did surprise them was that significantly more of the nanodrug Doxil – twice as much – was delivered to the C3-TAg triple-negative breast cancer tumor than to the T11 triple-negative breast cancer tumor.

“These tumors are subtypes of a subtype of one kind of cancer and are relatively closely related,” said Zamboni. “If the differences in delivering nanoagents to these two tumors are so significant, we can only imagine what the differences might be between breast cancer and lung cancer.”

Zamboni and his team suggest that better profiling of tumors and their microenvironments would allow doctors not only to better identify patients who would most benefit from nanoparticle-based cancer therapy, but also that clinicians may need to learn more about a patient’s tumor before prescribing treatment with one of the newer nanoparticle drugs.

“It looks like the tumor microenvironment could play a big role in cancer treatment,” said Zamboni. “It may be the factor that could point us in the right direction for personalized care not only for triple-negative breast cancer but for any type.”

—Carolina— 

UNC Eshelman School of Pharmacy contact: David Etchison, (919) 966-7744,david_etchison@unc.edu

Communications and Public Affairs contact: Thania Benios, (919) 962-8596, thania_benios@unc.edu

Statewide network established to support cancer survivors

The Duke Endowment awards $461,750 grant to UNC Lineberger’s Comprehensive Cancer Support Program.

Chapel Hill, NC – UNC Lineberger’s Comprehensive Cancer Support Program (CCSP) announces the creation of a statewide cancer survivorship network to implement programs and services to support the growing number of cancer survivors across the state of North Carolina.

With a new $461,750 grant from The Duke Endowment, CCSP will create the N.C. Cancer Survivorship Provider Action Network (NC-CSPAN). Through training and outreach across the state, this new network will substantially improve access to survivorship care by creating a statewide workforce trained to implement cancer survivorship programs.

“Our response to the challenge of the growing needs of North Carolina cancer survivors is to create an enduring statewide network of health care professionals trained in providing survivorship programs for cancer patients,” said Donald Rosenstein, MD, CCSP director, UNC Lineberger member and founder of the new network.

Led by Rosenstein, the grant will be used to train health care professionals and educators across the state in delivering a group psycho-educational and wellness intervention called Cancer Transitions®. This evidence-based program for cancer survivors will provide education on nutrition, exercise, medical and stress management. By using the “train the trainer” approach to educate health care providers across the state, NC-CSPAN will provide direct survivorship care and build the capacity to deliver additional survivorship programs in the future.

“As the only public comprehensive cancer center in North Carolina, UNC Lineberger has an obligation to address the needs of underserved cancer survivors. These funds will allow us to train bilingual health care professionals and educators, carefully selected with geographic consideration, to help meet those needs.”

About The Duke Endowment

Based in Charlotte and established in 1924 by industrialist and philanthropist James B. Duke, The Duke Endowment is a private foundation that strengthens communities in North Carolina and South Carolina by nurturing children, promoting health, educating minds and enriching spirits. Since its founding, it has distributed more than $3 billion in grants. The Endowment shares a name with Duke University and Duke Energy, but all are separate organizations.

About the UNC Lineberger Comprehensive Cancer Center

One of only 41 NCI-designated comprehensive cancer centers, the University of North Carolina Lineberger Comprehensive Cancer Center brings together some of the most exceptional physicians and scientists in the country to investigate and improve the prevention, early detection and treatment of cancer. With research that spans the spectrum from the laboratory to the bedside to the community, UNC Lineberger faculty work to understand the causes of cancer at the genetic and environmental levels, to conduct groundbreaking laboratory research, and to translate findings into pioneering and innovative clinical trials. For more information, please visit www.unclineberger.org.

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Statewide network established to support cancer survivors
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Statewide network established to support cancer survivors

The Duke Endowment awards $461,750 grant to UNC Lineberger’s Comprehensive Cancer Support Program.

Chapel Hill, NC – UNC Lineberger’s Comprehensive Cancer Support Program (CCSP) announces the creation of a statewide cancer survivorship network to implement programs and services to support the growing number of cancer survivors across the state of North Carolina.

With a new $461,750 grant from The Duke Endowment, CCSP will create the N.C. Cancer Survivorship Provider Action Network (NC-CSPAN). Through training and outreach across the state, this new network will substantially improve access to survivorship care by creating a statewide workforce trained to implement cancer survivorship programs.

“Our response to the challenge of the growing needs of North Carolina cancer survivors is to create an enduring statewide network of health care professionals trained in providing survivorship programs for cancer patients,” said Donald Rosenstein, MD, CCSP director, UNC Lineberger member and founder of the new network.

Led by Rosenstein, the grant will be used to train health care professionals and educators across the state in delivering a group psycho-educational and wellness intervention called Cancer Transitions®. This evidence-based program for cancer survivors will provide education on nutrition, exercise, medical and stress management. By using the “train the trainer” approach to educate health care providers across the state, NC-CSPAN will provide direct survivorship care and build the capacity to deliver additional survivorship programs in the future.

“As the only public comprehensive cancer center in North Carolina, UNC Lineberger has an obligation to address the needs of underserved cancer survivors. These funds will allow us to train bilingual health care professionals and educators, carefully selected with geographic consideration, to help meet those needs.”

About The Duke Endowment

Based in Charlotte and established in 1924 by industrialist and philanthropist James B. Duke, The Duke Endowment is a private foundation that strengthens communities in North Carolina and South Carolina by nurturing children, promoting health, educating minds and enriching spirits. Since its founding, it has distributed more than $3 billion in grants. The Endowment shares a name with Duke University and Duke Energy, but all are separate organizations.

About the UNC Lineberger Comprehensive Cancer Center

One of only 41 NCI-designated comprehensive cancer centers, the University of North Carolina Lineberger Comprehensive Cancer Center brings together some of the most exceptional physicians and scientists in the country to investigate and improve the prevention, early detection and treatment of cancer. With research that spans the spectrum from the laboratory to the bedside to the community, UNC Lineberger faculty work to understand the causes of cancer at the genetic and environmental levels, to conduct groundbreaking laboratory research, and to translate findings into pioneering and innovative clinical trials. For more information, please visit www.unclineberger.org.

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Keku published in American Journal of Physiology

Temitope Keku, MSPH, PhD has published a review in The American Journal of Physiology—Gastrointestinal and Liver Physiology titled “The Gastrointestinal Microbiota and Colorectal Cancer.” Coauthors include Drs. Santosh Dulal, April Deveaux, Biljana Jovov, and Xuesong Han. This article provides an overview on the role of resident gut microbiota in the development of human colorectal cancer and explores its association with diet and inflammation.
Keku published in American Journal of Physiology click to enlarge Temitope Keku, MSPH, PhD

John Isner’s Ebix Charity Challenge to feature Bryan Brothers, benefit UNC Lineberger

Ebix, Inc., today announced that the annual Ebix Charity Challenge, will be held in Greensboro, North Carolina on February 7, 2015. All proceeds from the 5th Annual Ebix Charity Challenge will benefit the UNC Lineberger Comprehensive Cancer Center, where America No. 1 John Isner’s mother, Karen, was successfully treated during her two battles with colon cancer.

Joining Isner will be the ATP World No. 1 Doubles team of Bob and Mike Bryan. The Bryan Brothers are coming off a historic 2014 season after finishing No. 1 in the year end rankings for the 10th time in their careers. The Bryans won 10 tournaments this past season, including the US Open, ATP World Tour Finals and six ATP Masters 1000 titles. The twins further solidified their place as the greatest doubles team in tennis history after winning their 16thcareer Grand Slam title and groundbreaking 100thcareer team title at the 2014 US Open. Wayne Bryan, the father and former coach of the Bryan Brothers, will serve as the event emcee.

The event will kick-off with an exclusive youth clinic at Piedmont Indoor Tennis Center, giving kids the once-in-a-lifetime chance to play and learn from Isner and the Bryan Brothers. Following the clinic, a tennis exhibition will be held at Fleming Gymnasium on the University of North Carolina at Greensboro campus.

John Isner said, "I am really looking forward to bringing the Ebix Charity Challenge back to my hometown of Greensboro. Our last challenge was our best event yet and I hope we can build upon last year’s success. I am also thrilled Bob and Mike will join me in Greensboro. I hope we can put on a great show for everyone and raise money for UNC Lineberger, which is a cause very close to my heart.”

Robin Raina, Chairman and CEO of Ebix said, "Ebix is excited to support John’s 5th Annual Ebix Charity Challenge. As our brand ambassador, we are proud of John’s continued passion to fight cancer by raising funds for cancer research at UNC Lineberger.”

UNC Lineberger was nominated by Isner and is one of nine charities around the world to receive a 2014 ATP Aces for Charity grant. Donations can be made online at www.crowdrise.com/JohnIsner.

Isner is kicking off his 2015 season representing the United States at the Hopman Cup, an international mixed team event in Perth, Australia. Isner and partner Serena Williams advanced to Saturday’s championship match on Thursday with a 3-0 sweep of the Czech Republic. Currently ranked no. 18, Isner had a solid 2014 season after compiling 39 match wins and capturing his eighth and ninth career ATP World Tour singles titles in Auckland and Atlanta respectively. His Atlanta title run propelled Isner to his second straight Runner-Up finish in the prestigious Emirates Airline US Open Series. Isner’s career accolades also include reaching the Quarterfinals of the 2012 London Olympics, leading the U.S. to the 2012 Davis Cup Semifinals and winning the longest match in tennis history 70-68 in the fifth set over Nicholas Mahut at Wimbledon in 2010.

About the Event

Tickets start at $20 while exclusive VIP packages and youth clinic spots for the 5th Annual Ebix Charity Challenge hosted by John Isner are all on sale at www.isnercharitychallenge.com.For information regarding sponsorship packages please contact Cameron Thaney at cthaney@lagardere-unlimited.com.

About UNC Lineberger

One of only 41 NCI-designated comprehensive cancer centers, UNC Lineberger Comprehensive Cancer Center brings together some of the most exceptional physicians and scientists in the country to investigate and improve the prevention, early detection and treatment of cancer. With research that spans the spectrum from the laboratory to the bedside to the community, UNC Lineberger faculty work to understand the causes of cancer at the genetic and environmental levels, to conduct groundbreaking laboratory research, and to translate findings into pioneering and innovative clinical trials. For more information, please visit www.unclineberger.org.

About Ebix, Inc.

A leading international supplier of On-Demand software and E-commerce services to the insurance, financial and healthcare industries, Ebix, Inc., (NASDAQ: EBIX) provides end-to-end solutions ranging from infrastructure exchanges, carrier systems, agency systems and BPO services to custom software development for all entities involved in the insurance industry.

With 40+ offices across Brazil, Singapore, Australia, the US, New Zealand, the UK, India and Canada, Ebix powers multiple exchanges across the world in the field of life, annuity, health and property & casualty insurance while conducting in excess of $100 billion in insurance and re-insurance premiums on its platforms. Through its various SaaS-based software platforms, Ebix employs hundreds of insurance and technology professionals to provide products, support and consultancy to thousands of customers on six continents. For more information, visit the Company’s website at www.ebix.com.

DeSimone, Ting published in PNAS

UNC Lineberger members Joseph DeSimone, PhD and Jenny Ting, PhD, along with other researchers at the UNC-Chapel Hill and North Carolina State University have uncovered a novel approach to creating inhalable vaccines using nanoparticles that shows promise for targeting lung-specific diseases, such as influenza, pneumonia and tuberculosis. The findings, published in the Proceedings of the National Academy of Sciences, also have broad public health implications for improving the accessibility of vaccines.
DeSimone, Ting published in PNAS click to enlarge Joseph DeSmone, PhD and Jenny Ting, PhD

Researchers at the University of North Carolina at Chapel Hill and North Carolina State University have uncovered a novel approach to creating inhalable vaccines using nanoparticles that shows promise for targeting lung-specific diseases, such as influenza, pneumonia and tuberculosis.

The work, led by Cathy Fromen and Gregory Robbins, members of the DeSimone and Ting labs, reveals that a particle’s surface charge plays a key role in eliciting immune responses in the lung. Using the Particle Replication in Nonwetting Templates (PRINT) technology invented in the DeSimone lab, Fromen and Robbins were able to specifically modify the surface charge of protein-loaded particles while avoiding disruption of other particle features, demonstrating PRINT’s unique ability to modify particle attributes independently from one another.

When delivered through the lung, particles with a positive surface charge were shown to induce antibody responses both locally in the lung and systemically in the body. In contrast, negatively charged particles of the same composition led to weaker, and in some cases undetectable, immune responses, suggesting that particle charge is an important consideration for pulmonary vaccination.

The findings, published in the Proceedings of the National Academy of Sciencesalso have broad public health implications for improving the accessibility of vaccines. An inhalable vaccine may eliminate the need for refrigeration, which can not only improve shelf life, but also enable distribution of vaccines to low-resource areas, including many developing countries where there is significant need for better access to vaccines.

Joseph DeSimone is Chancellor’s Eminent Professor of Chemistry at UNC and William R. Kenan, Jr. Distinguished Professor of Chemical Engineering at NC State and of Chemistry at UNC. Jenny Ting is William Rand Kenan Professor of Microbiology and Immunology in UNC’s School of Medicine; she also directs UNC’s Center for Translational Immunology, co-directs the UNC Inflammatory Diseases Institute and is the immunology program leader at the Lineberger Comprehensive Cancer Center.

This work is supported by the National Institute of Allergy and Infectious Diseases-funded Center for Translational Research as well as the Defense Threat Reduction Agency.  

Read the paper.

Communications and Public Affairs contact: Thania Benios, 919-962-8596, thania_benios@unc.edu. View the Press Release from UNC News.

New approach may lead to inhalable vaccines for influenza, pneumonia

Researchers at the UNC-Chapel Hill and North Carolina State University have uncovered a novel approach to creating inhalable vaccines using nanoparticles that shows promise for targeting lung-specific diseases, such as influenza, pneumonia and tuberculosis. The work was led by Cathy Fromen and Gregory Robbins, members of the DeSimone and Ting labs at UNC Lineberger, and reveals that a particle’s surface charge plays a key role in eliciting immune responses in the lung.
New approach may lead to inhalable vaccines for influenza, pneumonia click to enlarge Cathy Fromen and Gregory Robbins

Priceless Gem

Carolina legend Danny Talbott performed at the highest level on both the football field and baseball diamond during his years as a Tar Heel. Since 2010, he’s been back in Chapel Hill, battling the toughest opponent he’s faced: multiple myeloma. He can’t imagine going anywhere else to do it.
Priceless Gem click to enlarge UNC quarterback Danny Talbott vs. NC State at Kenan Stadium, Sept. 19, 1964. Hugh Morton Collection. Copyright North Carolina Collection, Wilson Library, University of North Carolina at Chapel Hill Library.
Priceless Gem click to enlarge Dr. Peter Voorhees (L) and Danny Talbott joke during a recent appointment. Photo by Hannah Crain/UNC Health Care.

By Zach Read, UNC Health Care & School of Medicine

It’s the day before Thanksgiving and Danny Talbott is resting in the Outpatient Infusion Center on the third floor of the N.C. Cancer Hospital. He’s been receiving treatment for multiple myeloma, a cancer of a type of white blood cell called a plasma cell. The condition is nothing to laugh at, yet Danny is able to muster a smile and crack a joke any time someone enters the room. He even makes light of his condition.

“If I die, then I go to heaven,” says Danny, a Rocky Mount, North Carolina, native and resident and a 2003 inductee in the North Carolina Sports Hall of Fame. “If I beat this, then I get to stick around and give my friends a hard time. It’s a win-win.”

A few minutes pass. Then, a nurse pokes her head through the curtain in the room and looks down at Danny.

“What are you doing?” she asks, surprised that she didn’t hear his voice in the hallway. “Behaving? Actually behaving?”

 Danny and his wife, Myrlene, immediately burst into laughter. They’re used to the give-and-take with hospital staff – they enjoy the ribbing. After all, Danny is usually the one who initiates the good-natured exchanges, often from the moment he sets foot in the hospital.

“That’s his M.O.,” says Myrlene, who spent 17 years as a nurse in the intensive care unit at Nash General Hospital before retiring to aid with Danny's care. “Everyone’s a friend. He talks the same way to his buddies on the golf course.”

The Talbotts have found a comfort zone at the N.C. Cancer Hospital since Danny’s diagnosis in 2010 – a place where they can laugh. The staff members at the hospital – everyone from the volunteers to the nurses to the physicians – have become their friends. And for the Talbotts, that’s been important as they’ve taken on the challenges of Danny’s disease. 

Read the full story.