Research

No Patient Left Behind: Tracking Cancer Disparities

Veronica Reynolds' multiple myeloma is now in remission. She says Dr. Leon Bernal-Mizrachi "walked with me every step of the way. He's a great spirit. It doesn't matter who you are, you will be treated the same way."

Veronica Reynolds’ multiple myeloma is now in remission. She says Dr. Leon Bernal-Mizrachi “walked with me every step of the way. He’s a great spirit. It doesn’t matter who you are, you will be treated the same way.”

Why are some individuals more likely to develop cancer or to develop a more aggressive form of cancer? Winship clinicians and researchers confront such disparities daily – and are working to understand and change them.

Genetic research is a key to understanding how either race or ethnicity affect the incidence of different cancers and how these factors may contribute to different responses to the same treatments. Multiple myeloma, a blood cancer of the immune system’s plasma cells, occurs two to three times more often in African Americans than in Caucasians. Finding out why could lead to better therapies for all. Winship researchers couldn’t do it without people like Veronica Reynolds.

In her mid-50s, the busy realtor developed severe pain. She asked herself if she had strained her back, driving back and forth showing houses or picking up grandchildren? She told herself it would go away. It got worse. One doctor told her she looked too well to hurt as much as she claimed. Another believed her but his pills barely helped. After two years, she feared her heart would stop from pain. At Grady Memorial Hospital, imaging revealed fractured bones, due to bone destruction. Other tests provided the multiple myeloma diagnosis – and led Reynolds to Dr. Leon Bernal-Mizrachi, a Winship hematologist/oncologist who sees patients at Grady.

Reynolds credits God for sending her to Bernal-Mizrachi and to Dr. Jonathan Kaufman, director of Winship’s ambulatory infusion center, who oversaw her stem cell transplant following high dose chemotherapy. She credits herself for following the complex treatment regimens. And she’s “ecstatic,” she adds, about being part of her doctors’ research. “I hope I have enough fight in me to live to see it help many people like me.”

Reynolds – and her genes – are part of a massive multi-institutional study to sequence the entire genome (more than three billion DNA base pairs) of 1,049 African Americans with multiple myeloma and another 7,084 without the disease. The Winship component, headed by Drs. Sagar Lonial, Bernal-Mizrachi, and Ajay Nooka, has gathered almost a third of the study’s participants, thanks to the researchers’ commitment and Georgia’s high African-American population. Although still in process, the study is already producing valuable insights. Winship physicians routinely take tissue cells from multiple myeloma patients, looking for genetic variants that indicate who is at higher risk of relapse. They hope this new study will help identify why this disease occurs more frequently among African Americans and determine if there are treatments that may be specific to these patients.

The incidence of multiple myeloma in the African-American community is just one of the cancer disparities that Winship researchers are aggressively investigating. This blog is excerpted from a more comprehensive magazine article about health disparity research at Winship which can be accessed at https://winshipcancer.emory.edu/magazine/issues/2015/summer/features/no_patient_left_behind/index.html.

Reclassifying Brain Tumors with Precision

8-24 cancerGroundbreaking study will change the way brain tumor patients are diagnosed.

Winship cancer researcher and neuropathologist Dan Brat is the first author of a groundbreaking study that will change the way patients with diffuse gliomas, a form of brain tumor, will be diagnosed and treated in the future.

Brat and 306 other researchers from 44 institutions studied a group of six related brain tumors that has been surrounded by diagnostic confusion for decades. They used a large number of advanced molecular platforms capable of examining the genetic make-up of brain tumors (e.g. mutations, gene deletions, and other genetic changes) and were able to determine that there are three well-defined types of tumors based on this analysis, rather than six as previously thought.

Brat explains, “The use of the biomarkers in the diagnosis of these forms of brain tumors will lead to a much more consistent manner of diagnosis and patient management. It will also allow us to investigate these tumors as unified groups in a way that should advance our understanding.”

Brat will join an international group of neuropathologists in Heidelberg, Germany, meeting this summer to revise the World Health Organization classification of brain tumors based on new molecular findings. This is a major step in starting to classify and treat brain tumors more precisely based on their genetic makeup.

RELATED RESOURCES:
Brain Tumor Treatment at Winship
Battling this brain tumor takes a combination of powerful tools Emory News Center 7/31/14
Progesterone could become tool versus brain cancer Emory News Center 6/18/14
New York Times story: http://nyti.ms/1GgdQ66

A New Method to Find the Site of Returning Prostate Cancer

prostate cancer diagram

The yellow arrow and the white arrows on the pictures above indicate areas of prostate cancer that were invisible to previously available imaging techniques. Instead, they were detected using a new positron-emission tomography (PET) test called FACBC, which was developed and is being tested at Emory University.

A voluntary research study is being conducted to help men with recurring prostate cancer by using advanced imaging technology called FACBC to guide radiotherapy and determine the best possible course of treatment. This study would be added as an extra layer in your ongoing cancer treatment.*

We are looking for patients to participate in this clinical trial.

“By participating in this study, patients may have the opportunity to have an FACBC scan. The precision of this type of scan could help guide more effective treatment for patients whose cancer has returned,” says Ashesh Jani, MD, radiation oncologist and principal investigator.

Have you previously had surgery to treat prostate cancer, but think the cancer has returned? Has your doctor recommended radiation therapy as the next step in your care?

Participants must meet specific eligibility criteria:
• You are over 18 years of age.
• You had surgery (prostatectomy) to treat your prostate cancer.
• Your doctor suspects that the cancer has returned (as indicated by a rising PSA).
• Radiation therapy is now being considered as the next step in your care.

The trial is open at these locations: Winship Cancer Institute on the Clifton Road campus, Winship at Emory University Hospital Midtown, Winship at Emory Saint Joseph’s Hospital and Georgia Cancer Center for Excellence at Grady.

*You will be followed for a minimum of three years, with PSA levels checked every six months, in addition to having study-related lab work. There is no cost for the FACBC scan or the Food & Drug Administration (FDA) required lab work. All other imaging, lab work, biopsies (if any), radiation therapy and any other therapy will be billed to your insurance provider or paid out of pocket by you. You may be eligible for a travel voucher if you are chosen to undergo the FACBC scan.

For more information or to enroll, contact Ashesh Jani, MD, at (404) 778-3827 or abjani@emory.edu.

Learn more about Winship’s approach to Prostate Cancer Treatment
Read Winship’s Brochure on FACBC

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RELATED RESOURCES:

Recurrent Prostate Cancer: Where is it?

Tiffany Dunphy and Van Jackson, radiation therapists at Winship at Emory Saint Joseph's Hospital, work with prostate cancer patients undergoing radiation treatment.

Tiffany Dunphy and Van Jackson, radiation therapists at Winship at Emory Saint Joseph’s Hospital, work with prostate cancer patients undergoing radiation treatment.

“It’s a lot easier to plan the attack, if we know where the enemy is,” says Winship urologist Peter Nieh, MD. “If a cancer is still localized, we may want to try salvage therapy, either radiation or surgery, before advancing to something systemic.”

Depending on how primary treatment took place, a prostate cancer often comes back in the prostate bed (where the prostate gland was), and may appear in nearby lymph nodes. In advanced cases, the cancer may spread to the bones.

Emory radiologist and Winship member David Schuster, MD and radiochemist and Winship member Mark Goodman, PhD have been developing a PET (positron emission tomography) imaging probe that shows considerable potential for detecting recurrent prostate cancer.

Usually in PET imaging, radioactive glucose is injected into the body, and since cancer cells have a sweet tooth, they take up a lot of the radioactive tracer. But the tracer also appears in the urine, complicating prostate cancer detection efforts since the prostate is so close to the bladder. In contrast, the probe 18F-FACBC, based on amino acids, is taken up by prostate cancer cells but doesn’t appear as much in urine.

FACBC has its limitations. It also may be taken up in benign prostate hyperplasia or inflammation. This means it probably won’t be as useful by itself for evaluating primary prostate cancers, but it has a lengthening track record in recurrent cancer.

In a 2011 publication, Schuster and his colleagues compared FACBC to ProstaScint, a commercially available probe. FACBC showed superior sensitivity and specificity in detecting tumors outside the prostate bed. Schuster is now collaborating with Winship radiation oncologist Ashesh Jani, MD to study FACBC’s benefits in designing radiation treatments for patients with recurrent prostate cancer after prostatectomy.

In Jani’s clinical trial study for recurrent prostate cancer, which lasts until 2017, one group of patients is examined using FACBC, while another gets conventional imaging. The question is whether using information gleaned from FACBC to direct the radiation results in a longer lasting remission than with the control group.

Marble countertop salesman Paul Reckamp, who was a participant in Jani’s study, keeps a file on his phone noting his PSA levels for the last several years. Reckamp had a radical prostatectomy in July 2010 at Emory Saint Joseph’s Hospital, but the cancer appeared to come back a year and a half later. FACBC imaging confirmed that the cancer had appeared in nearby lymph nodes but not elsewhere, and doctors could then plan radiation treatment that drove his PSA levels back down again.

“I couldn’t have been more pleased with the study,” he says. “It told me and the doctors what we wanted to know.”

As a National Cancer Institute (NCI) designated cancer center, Winship Cancer Institute of Emory University’s participation in clinical trials ensures our prostate patients have access to progressive resources and technology. For men with recurrent prostate cancer, there are newer methods of imaging such as magnetic resonance imaging (MRI) and positron emission tomography (PET). 

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RELATED RESOURCES:

New Tests to Improve Decision Making in Prostate Cancer Treatment

This blog was originally posted June 3, 2015 AACR Press Office.

Prostate Cancer Cells

Prostate Cancer Cells

A diagnosis of prostate cancer can often result in difficult choices for both patients and physicians. Prostate cancer is the most common non-skin cancer diagnosed in American men, with over 200,000 diagnosed cases and almost 28,000 deaths per year. A major reason why prostate cancer is diagnosed so frequently is that the FDA-approved blood test for prostate-specific antigen (PSA) is widely used and is highly sensitive. However, the PSA test cannot distinguish prostate cancers that are aggressive from indolent cases that will not spread if left untreated.

It has been estimated that about 50 percent of men who are diagnosed with prostate cancer as a result of PSA testing would remain asymptomatic if left untreated. Furthermore, the side effects of surgery or radiation therapy can be significant, and include urinary incontinence and sexual dysfunction. These side effects from overtreatment without clear survival benefit led the U.S. Preventive Services Task Force (USPSTF) to recommend against PSA screening. As a result, there is a pressing clinical need for new prostate cancer biomarkers that can discriminate aggressive from indolent disease to prevent overtreatment of indolent cases and undertreatment of aggressive cases. This is one example of how precision medicine can both improve cancer care and reduce overall health care expenditures.

While single biomarkers can be useful, quite often using a panel of many genes is more robust, predictive, and informative than a single biomarker such as PSA. Moreover, RNA is generally much easier to detect and quantitate than protein, even at low amounts, and RNA-based assays can test many targets simultaneously. RNA-based approaches to prostate cancer biomarker discovery include the analysis of which genes are switched on and off in a cancer cell, as well as measurement of previously unappreciated RNAs that do not code for proteins, and detection of known genetic mutations.

Biopsies themselves carry some risk of infection, discomfort, and expense. Consequently, less invasive biomarkers that can use blood or urine samples are more desirable, and likely to be adopted more broadly, resulting in better patient compliance and follow up. Many researchers are thus looking for prostate cancer biomarkers that can be readily measured from biofluid specimens.

There are several different clinical questions that new biofluid biomarkers for prostate cancer could potentially address. First, if I have a high PSA, do I really need a biopsy? Second, if my biopsy looks indolent, am I a good candidate for active surveillance, or do I really need surgery or radiation? And third, if I do need surgery or radiation, will it be curative, or should I think about enrolling in clinical trials? These are all important questions that many scientists and physicians are currently pursuing in their biomarker research.

Recent research in our lab has identified a gene panel that can predict whether a patient is likely to have a recurrence after surgery, and we are currently working on determining if this panel can also identify good candidates for active surveillance. This research is using advanced sequencing technologies on both urine and biopsy samples, and could make it easier for patients and their doctors to safely decide that surgery or radiation are unnecessary, reducing side effects and unnecessary treatments. A number of other commercially available panels are already in use including Prolaris, Oncotype Dx, and Decipher, though none are currently FDA approved. Hopefully, with additional research to determine the best biomarkers of cancer aggressiveness and approval of such tests, patients and physicians can be confident in the treatment decisions that they make, leading to the best possible health outcomes.

About Dr. Moreno

carolos moreno, phdCarlos S. Moreno, PhD, is an associate professor in the Departments of Pathology & Laboratory Medicine, and Biomedical Informatics at the Emory University School of Medicine. He is a member of the Cancer Genetics and Epigenetics research program at Winship Cancer Institute. Moreno specializes in cancer bioinformatics and systems biology, cancer genomics, cancer biomarkers, and transcriptional networks. He is the informatics project leader for the Emory Molecular Interaction Center for Functional genomics (MicFG) as part of the Cancer Target Discovery and Development (CTD²) Network to identify protein-protein interaction networks.

Moreno has been a member of the American Association for Cancer Research since 2003 and received an AACR Minority Scholar Award in 2006.

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Scientists of the Next Generation

As children we have all been to the doctor, visited the dentist, perhaps even sat in the cockpit of a plane. Anyone ever sit in front of a cryo-electron microscope, play with the dials on a mass spectrometer, or manipulate the genetic code? Most of us probably did not have that opportunity. I surely did not. So how will children, that is, our next generation of scientists, even consider being a scientist without ever knowing what a scientist does?

I am a cancer biologist with a lab focused on cancer metastasis (spread of the cancer). We study how cancer metastasis occurs in subtypes of patients to develop new treatments designed for these particular patients. On the side, I have also traveled throughout Georgia visiting over 3,000 students in K-12th grade to teach them about science and scientists. I have had the fortunate experience of visiting over 40 schools ranging from urban to rural, and public to private. I can state with 100% certainty that children are extremely interested in real science. Whether it has been high school assemblies or elementary school STEM fairs, students (adults too) are excited, enthusiastic, and most of all curious. They are curious not just about science itself, but what a scientist is and what a scientist does.

This signals to me that we need to make science more accessible. City wide science fairs, STEM fairs in school, career days, Twitter chats (#scistuchat), and experiential science in the classroom are excellent approaches. But scientists too need to open up their labs to reach out as well. We, as a professional group, need to show that we are not a bunch of mad scientists in the lab running through billows of smoking Erlenmeyer flasks trying to cure cancer. Instead we are well-coordinated teams of researchers and clinicians, working in fields that include math, engineering, informatics, surgery, and genetics that share a common goal of helping humans.

So, to all scientists out there, I propose to just take out your phone and record a 1-minute, impromptu lab tour, and send it to social media (#labtour). This gives anyone access through the locked lab doors to see what we do and who we are. My lab’s really quick video is posted here and embedded below.

The next generation of scientists are sitting out there right now learning in our classrooms. Within their minds are new treatments for cancer, novel screening approaches for neurodegenerative diseases, ideas for space exploration, and new robotic technologies. It is up to teachers, scientists, families, and communities to engage these students, make science more accessible, and let them know what is out there. I believe that if they can know the names and abilities of every single super-hero, princess, and cartoon character by age 7, they can surely know the parts of a cell. Let’s challenge them and see what we get!

About Dr. Marcus


Adam Marcus, PhDAdam Marcus received his PhD in cell biology from Penn State University in 2002 and went on to do a post-doctoral fellowship in cancer pharmacology at Emory University. Dr. Marcus is an Associate Professor at Emory University School of Medicine and has developed his own laboratory which focuses on cell biology and pharmacology in lung and breast cancer. Dr. Marcus’ laboratory studies how cancer cells invade and metastasize using a combination of molecular and imaging-based approaches. For more information about Dr. Marcus and his outreach and research efforts, please use the related resources links below. You can also follow Dr. Marcus on Twitter @NotMadScientist.

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Kidney-Saving Robotics & Education

Saving kidneys from cancerous tumors and stones using minimally invasive techniques is my specialty. I’ve performed nearly 200 kidney operations in the last year alone and I recently launched a robotic kidney tumor program for Winship Cancer Institute at Emory Saint Joseph’s Hospital. Kidneys are essential to life but most people aren’t aware of their extraordinary function until there’s a problem. As a vital organ, kidneys are a filter for the body and they make urine to rid the body of waste toxins.

How would you know if you have a possible kidney concern? Check for a change when going to the bathroom. Kidney cancers in the early stages usually do not cause any signs or symptoms, but patients will sometimes experience signs that should be brought to a doctor’s attention, such as:

  • Noticing blood or very dark urine
  • Flank/back pain on one side (not caused by injury)
  • A mass (lump) on the side or lower back
  • Fatigue (tiredness)
  • Loss of appetite
  • Weight loss not caused by dieting
  • Fever that is not caused by an infection and doesn’t go away

Contact your doctor if you see changes like these. Recognizing your body’s warning signals can reduce your risk of serious disease, but the best option of all is prevention.

Kidney cancer prevention starts with smoking cessation and being aware of any history of kidney cancer in your family. The National Cancer Institute also identifies obesity as a known risk factor for kidney cancer, so take steps to manage your weight, exercise as a doctor prescribes for your individual condition, and eat whole foods that are rich in nutrients. Everyone should get regular check-ups.

When tumors or stones do develop, my job is to preserve this vital organ by using a minimally invasive procedure such as laparoscopic or robotic surgery (see video below). Not every tumor in the kidney is cancerous so options other than removing the entire kidney should be evaluated. Emory surgeons have been pioneers in using technologies like these to do organ-sparing cancer surgeries and complex stone surgeries.

As a specialist, I typically see patients after they are found to have a tumor or mass in the kidney or start experiencing symptoms. Let’s make prevention a part of your routine.

See Dr. Pattaras discuss this special type of organ-sparing robotic surgery:

About Dr. Pattaras

pattarasJohn G. Pattaras, MD, FACS, is an Associate Professor of Urology at the Emory University School of Medicine, Chief of Emory Urology services at Saint Joseph’s Hospital and Director of Minimally Invasive Surgery.

As the Director of Minimally Invasive Surgery, Dr. Pattaras started laparoscopic and robotic urologic surgery program at Emory University. Over the past 14 years, the program has expanded to become the premier laparoscopic and robotics program in Atlanta serving patients from Georgia, neighboring states as well as international patients. The program offers highly specialized minimally invasive surgery that includes organ-sparing cancer surgery and complex stone surgery. Patients attending Emory Urology for cancer treatment have the unique opportunity to be cured of their disease while at the same time preserve their vital organs, their functionality and quality of life.

Dr. Pattaras is a diplomate of the American Board of Urology (2002) a Fellow of the American College of Surgery.

In addition to his dedication to Emory patients, Dr. Pattaras is also involved in humanitarianism outside Emory. On an annual basis, he volunteers his time to organize and head a team of Emory medical students to Haiti. The team provides free urologic care including surgical treatment to indigent Haitian patients with urologic conditions.

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Cancer Clinical Study Leads to Video Tool for Prostate Cancer Patients

At Emory, research plays a key role in the mission to serve our patients and their families. Medical advances and improvements to patient care have been made possible by research and volunteer participation in clinical trials. More than 1,000 clinical trials are offered at Emory, making a difference in people’s lives, today.

Recently, a clinical study initiated by Winship Cancer Institute of Emory University, found that providing prostate cancer patients with a video-based education tool significantly improved their understanding of key terms necessary to making decisions about their treatment.

The breakthrough study was led by three Winship at Emory investigators; Viraj Master, MD, PhD, FACS; Ashesh Jani, MD; and Michael Goodman, MD, MPH; and is the feature cover story of this month’s Cancer, the peer-reviewed journal of the American Cancer Society.

In 2013, Master, Jani and Goodman released an Emory study that showed that prostate cancer patients (treated at Grady Hospital in Atlanta) experienced a severe lack of understanding of prostate key terms. The original study showed only 15 percent of the patients understood the meaning of “incontinence”; less than a third understood “urinary function” and “bowel habits”; and fewer than 50 percent understood the word “impotence.”

In response to their findings, the three principle investigators jumped to find a solution to the problem. The latest study explored using a video-based tool to educate prostate cancer patients on key terminology. The physicians predicted that with a better understanding of terms linked to disease, patients would be able to participate in shared and informed decision-making throughout the prostate cancer treatment process.

About the Prostate Cancer Video Trial:

  • 56 male patients were recruited from two low-income safety net clinics and received a key term comprehension test before and after viewing the educational video.
  • The video software (viewed by participants on iPads) featured narrated animations depicting 26 terms that doctors and medical staff frequently use in talking with prostate cancer patients.
  • Learn more by watching this video:

clinical trials for prostate cancer

Results of the Prostate Cancer Video Trial:

Participants who viewed the educational video demonstrated statistically significant improvements in comprehension of prostate terminology. For instance, before viewing the application, 14 percent of the men understood “incontinence”; afterward, 50 percent of them demonstrated understanding of the term.

“This shows that video tools can help patients understand these critical prostate health terms in a meaningful way. The ultimate goal is to give patients a vocabulary toolkit to further enable them to make shared and informed decisions about their treatment options,” says Viraj Master. “Our next goal is to improve the tool further, and study this tool at different centers.”

Learn more about clinical trials at Emory >>

Find a clinical trial at Emory >>

 

Additional Information about the Prostate Cancer Trial:

The research for this study was made possible by a Winship Cancer Institute multi-investigator pilot grant and the contributions of faculty and students from Winship, the Rollins School of Public Health and the Emory School of Medicine.

This study was led by three Winship at Emory investigators: Viraj Master, MD, PhD, FACS, Winship urologist and director of clinical research in the Department of Urology at Emory University; Ashesh Jani, MD, professor of radiation oncology in the Emory School of Medicine; and Michael Goodman, MD, MPH, associate professor of epidemiology with the Rollins School of Public Health.

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Fundamental Science Can Transform Cancer Care Worldwide

World Cancer Day is February 4, and it is an important reminder that cancer is one of the leading causes of death worldwide. According to the World Health Organization, the number of new cases is expected to rise by about 70% in the next two decades. This gives us all the more reason to recognize the progress that has been made because of discoveries by fundamental, or basic, cancer researchers. Our task now is to bring the benefits of that work to patients around the world. Check out this short video where Fadlo R. Khuri, MD, Deputy Director of Winship Cancer Institute discusses these discoveries in fundamental cancer research:

The theme of this year’s World Cancer Day, “Not Beyond Us,” highlights solutions that are within our reach. In that spirit, we celebrate 2014 as a landmark year for cancer research, discovery, treatment and prevention. Important progress was made in a number of areas: screening and prevention of cancers, development of novel targeted therapies for cancers, and immunotherapy of a number of previously resistant diseases. Over the past year, we saw at least a half dozen new approvals by the U.S. Food and Drug Administration (FDA) and the European Medicines Agency (EMA) of new, improved, potent targeted therapies, chemotherapies, and immunotherapies for cancer, whose impact is most acutely felt in societies in North America, Europe, Eastern Asia, Australia and South America. Our therapeutic resources have been significantly advanced by these discoveries, all of which spring from major biologic breakthroughs in the laboratory. What should the next steps be in ensuring that the powerful tools of genomic medicine, immunology, and molecular imaging continue to flourish and impact cancer patients worldwide? How do we make sure that personalized, precision medicine can be practiced to benefit oncology patients globally?

Fundamental to progress in cancer diagnosis, treatment and prevention is continued investment in fundamental cancer research. In a decade in which the growth of real federal funding for basic and translational research in cancer has slowed noticeably in the United States, this challenge has been counterbalanced on some levels by substantial increases in investment in basic and translational research in Asia (China and India in particular), Europe (Germany and Great Britain in particular), and Australia. Nonetheless, research conducted in United States laboratories remains the major driver of cancer discovery in the areas of genomics, immunology, and prevention, and in the translation of these discoveries from the bench to the bedside, aided by accelerated developments in the biotech and pharmaceutical world. On-going support for researchers in the fundamental sciences will ensure that these new discoveries will continue to substantially enhance our therapeutic and preventive arsenal against cancer. Fundamental science is vital to the global war against cancer.

As discoveries accelerate, and increasing numbers of affordable new treatment modalities are brought into the clinic, making an impact on diseases from Africa and Australia, through Asia and Europe, and all the way to the Americas, we must continue to support, guard, and mentor our treasure trove of outstanding scientists and clinical investigators. Over the next several decades, these individuals will be the key to sustaining and accelerating the major advances that are being made against cancer. Discoveries in the labs of outstanding scientists in basic immunology, genomics, glycomics and metabolomics, and in understanding the biologic behavior of normal, pre-malignant, and cancerous cells, pave the way for clinical translations that improve the prevention and therapy of our global population as a whole.

About Dr. Khuri

Fadlo Khuri, MDFadlo R. Khuri, MD, deputy director of the Winship Cancer Institute of Emory University, professor and chairman of the Department of Hematology & Medical Oncology, Emory University School of Medicine, and executive associate dean for research of Emory University, is a leading researcher and physician in the treatment of lung and head and neck cancers. He is Editor-in-Chief of the American Cancer Society’s peer-reviewed journal, Cancer.

Dr. Khuri’s contributions have been recognized by a number of national awards, including the prestigious 2013 Richard and Hinda Rosenthal Memorial Award, given to an outstanding cancer researcher by the American Association for Cancer Research.

An accomplished molecular oncologist and translational thought leader, Dr. Khuri has conducted seminal research on oncolytic viral therapy, developed molecular-targeted therapeutic approaches for lung and head and neck tumors combining signal transduction inhibitors with chemotherapy, and has led major chemoprevention efforts in lung and head and neck cancers. Dr. Khuri’s clinical interests include thoracic and head and neck oncology. His research interests include development of molecular, prognostic, therapeutic, and chemopreventive approaches to improve the standard of care for patients with tobacco related cancers. His laboratory is investigating the mechanism of action of signal transduction inhibitors in lung and aerodigestive track cancers.

Plugging Cell Biology Into a Genomic World

(This blog was originally posted on January 15, 2014 on the American Association for Cancer Research website)

Personalized oncology epitomizes the concept of interdisciplinary research where pathologists, bioinformaticians, oncologists, and biologists work together to identify and ultimately target drivers of cancer. We gather at tables to collaborate across disciplines and try to speak the same language with the goals of advancing knowledge and helping patients. As a cancer cell biologist at the Winship Cancer Institute, I have been privileged to be a part of these conversations and to contribute to our efforts to understand tumor biology.

When most researchers talk about personalized (or precision) oncology, genomics is usually an important part of the conversation. Genomic technologies can yield tremendous amounts of information in a relatively unbiased and high-throughput manner. Cell biology, on the other hand, which has interested me for over 15 years, provides a powerful and focused approach to probe the behavior and function of cells, organelles, and proteins. Tremendous leaps have been made over the last two decades that have enhanced our ability to “see” biology due to the advent of technologies such as genetically encoded fluorescent proteins and new imaging modalities. In fact, the Nobel Prize has been awarded twice in the last decade to imaging-based technologies, most recently this past October to the inventors of super-resolution imaging.

Despite these differing approaches, cell biology and genomics are not mutually exclusive; cell (and molecular) biology data are routinely combined with genomic data as a means to validate results. But can cell biology and genomics be more than validation partners? Could a marriage between the focused spatial and temporal power of cell biology with the throughput of genomics create a “best of both worlds” scenario to enhance personalization of cancer treatment?

Watch Dr. Marcus’ TEDx Peachtree talk, “Every Cancer Is Personal.”

As we move into a world of single-cell genomics, we are beginning to unravel the importance of obtaining information from one cell, and consequently yielding tremendous insight into tumor biology, especially tumor heterogeneity and rare cell types. Several strong lines of evidence now suggest that it may be rare cell types, such as cancer stem cells, that are required for initiation and progression of cancer. The ability to develop new methods that can precisely select these rare cell types, perhaps even while the cells are alive using cellular imaging-based approaches, would allow these rare genomes to be extracted. Perhaps, down the road, approaches rooted in cell biology may help provide more temporal -omics where researchers can monitor changes in the transcriptome of single cells or groups of cells over time to understand single tumor cell evolution during initiation, progression, and treatment.

It is not that cell biology is so unique; rather, it is the concept of marrying two research approaches to create a scientific synergy. The advances that are made through interdisciplinary research in the laboratories will not only provide new insight into the biology of cancer but can ultimately impact patients through personalized oncology. The late Steve Jobs said, “Creativity is just about connecting things.” We need to continue to connect things in the lab to create new opportunities in the clinic.

About Dr. Marcus


Adam Marcus, PhDAdam Marcus received his PhD in cell biology from Penn State University in 2002 and went on to do a post-doctoral fellowship in cancer pharmacology at Emory University. Dr. Marcus is an Associate Professor at Emory University School of Medicine and has developed his own laboratory at Winship Cancer Institute, which focuses on cell biology and pharmacology in lung and breast cancer. His laboratory studies how cancer cells invade and metastasize using a combination of molecular and imaging-based approaches. Marcus has been a member of the American Association for Cancer Research since 2003. You can follow him on Twitter at  @NotMadScientist.

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Every Cancer Is Personal