Dr. Larry Corey

Dr. Larry Corey, M.D., president and director of Fred Hutchinson Cancer Research Center, has been elected to membership in the American Academy of Arts and Sciences.

The Academy is one of the nation’s oldest and most prestigious honorary societies and independent policy-research centers.

The current membership includes more than 250 Nobel laureates and more than 60 Pulitzer Prize winners.

Dr. Corey has led the Hutchinson Center since January 2011 and has held other leadership positions there since 1996, first as head of infectious disease sciences in the Clinical Research Division and later as senior vice president and co-director of the Center’s Vaccine and Infectious Disease Division.

Dr. Corey is an expert in virology, immunology and vaccine development. His research has focused on herpes viruses, HIV and other viral infections, particularly those associated with cancer.

He also is principal investigator of the Hutchinson Center-based HIV Vaccine Trials Network, an international collaboration of scientists and institutions that combines clinical trials and laboratory-based studies to accelerate the development of HIV vaccines.

Dr. Corey is a professor of laboratory medicine and medicine, adjunct professor of pediatrics and microbiology, and holder of the Lawrence Corey Endowed Chair in Medical Virology at the University of Washington. He is also an infectious disease physician at Seattle Cancer Care Alliance.

Dr. Corey is the Hutchinson Center’s second president to be elected to the Academy. Yeast geneticist Lee Hartwell, Ph.D., a 2001 Nobel laureate, was elected in 1998. He led the Center from 1997 until 2010.

Corey is among 220 leaders in the sciences, social sciences, humanities, arts, business and public affairs who have been elected to the American Academy of Arts and Sciences 2012 class of fellows.

Since its founding in 1780, the Academy fellows have included: George Washington and Benjamin Franklin in the eighteenth century, Daniel Webster and Ralph Waldo Emerson in the nineteenth, and Albert Einstein and Winston Churchill in the twentieth.

The new class will be inducted at a ceremony Oct. 6 at the Academy’s headquarters in Cambridge, Mass.

Pancreas (head, body, and tail of the pancreas, and the pancreatic duct) and nearby organs and structures (duodenum, common bile duct, and small intestine). - Don Blis/NCI

From the NCI Cancer Bulletin

Researchers have discovered a physical mechanism that prevents chemotherapy from reaching pancreatic cancer cells, as well as a way to reverse that mechanism.

Dr. Sunil Hingorani of the Fred Hutchinson Cancer Research Center and his colleagues reported their results March 19 in Cancer Cell.

Pancreatic adenocarcinoma, the most common type of pancreatic cancer, is notoriously resistant to chemotherapy and radiation therapy, leading to an overall 5-year relative survival rate of less than 5 percent.

Using mice with tumors that are genetically similar to human pancreatic adenocarcinomas, the researchers found that, as the tumors grow, a thick matrix develops and surrounds the tumors’ cells.

The matrix exerts tremendous pressure on the tumors—pressure that greatly exceeds the normal pressure found within blood vessels—causing the tumors’ blood vessels to collapse.

This collapse prevents chemotherapy drugs in the blood stream from reaching the tumor cells.

Dr. Hingorani and his colleagues identified a substance called hyaluronic acid that forms a large part of this pressurized matrix.

When they treated the mice with an enzyme called PEGPH20, which breaks down hyaluronic acid, the pressure within the tumors returned to normal, and the blood vessels regained their normal shape and function.

When the researchers treated mice with a combination of PEGPH20 and the chemotherapy drug gemcitabine, 83 percent of tumors within the pancreas shrank after only one cycle of treatment, and all tumors shrank after three cycles.

Similar responses were seen in metastatic tumors. Mice that received the combination therapy survived almost twice as long as mice that received PEGPH20 plus a placebo.

“When able to penetrate the tumor bed, gemcitabine can indeed be an effective agent against this disease,” wrote the authors. An early phase clinical trial is testing the combination of PEGPH20 and gemcitabine in people with metastatic pancreatic cancer.

To learn more about pancreatic cancer read the NCI pamphlet What You Need to Know About Cancer of the Pancreas.

The NCI Cancer Bulletin is an award-winning biweekly online newsletter designed to provide useful, timely information about cancer research to the cancer community. The newsletter is published approximately 24 times per year by the National Cancer Institute (NCI), with day-to-day operational oversight conducted by federal and contract staff in the NCI Office of Communications and Education. The material is entirely in the public domain and can be repurposed or reproduced without permission. Citation of the source is appreciated.

By Merrill Goozner, The Fiscal Times
This story comes from our partner 

Julie Grabow, an oncologist at the Fred Hutchinson Cancer Center in Seattle, recently prescribed an exciting new therapy for a 60-year-old woman with metastatic breast cancer.

Three-and-a-half years into her battle against the disease, the patient had already exhausted three different anti-estrogen therapies, each of which only put a temporary check on the spreading tumors.

The newly prescribed drug, Novartis’ Afinitor, is one of the recently approved targeted therapies that have generated a lot of excitement among cancer patients and oncologists in recent years.

Drugs that target just the cancer cells promise the same or better results as toxic chemotherapy, but with far fewer side effects.

There was a catch, though. Like many of the latest cancer drugs, Novartis is charging exorbitant amounts for the treatment – in this case, $10,000 per month.

That quickly put an end to that possibility for Grabow’s patient. Her monthly co-payment, even after her insurance company agreed to pay its share of the off-label use the drug (the Food and Drug Administration has only approved Afinitor for kidney and pancreatic cancer, not breast cancer), was $2,900.

“She can’t afford this, even though it’s potentially a less toxic and potentially equally effective regimen,” Grabow said. “Chemo will help her, and it’s a reasonable choice. But that choice is 100 percent driven by economics.”

Over the past year, official Washington and candidates on the campaign trail have locked horns over the best way to curb rising health insurance costs. The public has been bombarded with dueling slogans – Republicans vowing to fight the “death panels” and “rationing” of Obamacare while Democrats promise “guaranteed access” and “affordability” with the Affordable Care Act.

But an economic drama that neither side wants to confront is playing itself out in cancer wards and oncologists’ offices across the country.

Unaffordable new drugs, even when they’re covered by insurance, are being rationed by price as patients, doctors and hospital officials struggle with what is likely to be the most pressing problem for the nation’s health care system over the next decade: how to pay for the spectacular rise in the cost of cancer care, especially drugs and diagnostic tests.

“In the real world of private practice where most care is delivered, it would be a mistake to say rising costs haven’t affected care,” said Eric Nadler, a head, neck and lung cancer specialist at Baylor University Medical Center.

The growing cost of cancer care will impose its greatest burden on the nation’s Medicare system, since 55 percent of all cancers are diagnosed in individuals 65 or older.

A recent study by the National Cancer Institute projected the cost of treating the 29 most common cancers in men and women will rise 27 percent by 2020, even though incidence of the disease is going down due to successful public health campaigns like the war on smoking.

The study pointed out that its projections were based on 2006 Medicare claims data, which predated the development of most of the latest targeted therapies.

There’s no doubt that there will be many new therapies for cancer coming to market in the years ahead. The nation’s $150 billion public investment in understanding the biology of cancer – the science side of the War on Cancer launched by President Richard Nixon in 1971 – is beginning to bear fruit.

The pharmaceutical industry, which draws on that publicly funded science to develop drug candidates, now has 887 new cancer drugs in development, over 30 percent of its total portfolio of new drug candidates, according to the Pharmaceutical Research and Manufacturers of America, the industry trade group. That’s up from 646 or 26 percent of the total devoted to cancer in 2006.

The industry is pouring increased research and development resources in cancer therapeutics in hopes that it will replace the revenue being lost from the expiration of patents on blockbusters like Lipitor.

However, since there are fewer cancer patients than there are people with chronic conditions like elevated cholesterol, and many don’t live very long, the prices needed to support the industry’s current size and structure, and profits must be substantially higher.

“They’re trying to maximize profits given their incentives,” said Peter Neumann, director of the Center for the Evaluation of Value and Risk in Health at Tufts Medical Center, which receives funding from the drug industry.

Possible solutions, he said, include letting Medicare set prices based on the medical value of adding extra months to life. That’s a variation on Great Britain’s cost-effectiveness model, which has been roundly condemned by most U.S. politicians and the press.

The other path is to turn to a bundled payment for every for every episode of cancer care and let the health care delivery organizations and private insurers sort it out. (Bundled payments account for all medical services associated with a given episode of care—doctors, nurses, technicians, etc.) That approach, in essence, would force the marketplace to execute the rationing.

“Bundled payment isn’t a panacea, but it does create incentives,” Neumann said. Some private insurers are experimenting with bundled payments for cancer care.

A quick review of the new cancer drugs approved by the Food and Drug Administration last year reveals how fast drug prices are rising.

Most of the older chemotherapy regimens for cancer, some of which have been around since the 1950s, are generic and relatively inexpensive.

But among the six new drugs approved in 2011, the cheapest – Johnson & Johnson’s Zytiga for advanced prostate cancer – cost $44,000 a year. The drug extended life by an average of less than 5 months to 16 months, according to a company spokesperson.

At the high end of the spectrum was Adcetris, a biotech product from Seattle Genetics that treats recurrences of Hodgkin’s lymphoma. A highly curable disease when initially treated in the 8,830 mostly middle-aged patients who get the disease every year, it is usually fatal if a drug-resistant strain emerges later in life.

Adcetris, the first new treatment to come along since 1977, kept the cancer in check for nearly 7 months in the single small trial that led to its quick FDA approval. It’s price tag: $216,000 for a full course of treatment.

Skin cancer specialists had a lot to cheer about in 2011 with two new therapies coming on the market for metastatic melanoma, which is fatal within one year for about 75 percent of the 10,000 people stricken each year.

But Roche/Genentech’s Zelboraf cost $61,400 a year and Bristol-Myers Squibb’s Yervoy, which nearly doubled the one-year survival rate from 25 percent to 46 percent, cost $120,000 for a four-month course of treatment.

“We price our medicines based on a number of factors including the value they deliver to patients and the scientific innovation they represent,” said Sarah Koenig, a spokeswoman for Bristol-Myers. “We have one of the most robust patient assistance programs for cancer patients in the industry.”

Most drug companies have patient assistance programs for poor or struggling patients, but many only come into play if patients are poor or families have exhausted their savings.

And since many of the latest therapies, like the older chemotherapies they are replacing or supplementing, extend life for brief periods of time, patients wind up weighing whether they want to deplete their children’s inheritances for a couple extra months of being very, very sick.

A study released at last June’s annual conference of the American Society of Clinical Oncology, which represents the nation’s 25,000 oncologists, revealed that patients with co-payments over $500 a month were four times more likely to refuse treatment than those whose co-payments were under $100 a month.

“The price of drugs can’t be set so outrageously high,” study author Lee Schwartzberg told Reuters. Schwartzberg is the chief medical officer at Acorn Research, which conducted the study.

“All stake holders have to get together and compromise to translate this great science into great patient care without breaking the bank.

This article was reprinted from kaiserhealthnews.org with permission from the Henry J. Kaiser Family Foundation. Kaiser Health News, an editorially independent news service, is a program of the Kaiser Family Foundation, a nonpartisan health care policy research organization unaffiliated with Kaiser Permanente.

The talks will be held 7 p.m. to 8:30 p.m. every Thursday of the month.

What’s Stress Got to Do with It? — February 2

Dr. Bonnie McGregor is a behavioral medicine pioneer interested in how psychological factors affect the health of our bodies and our minds. Hear how stress influences our vulnerability to disease, and how stress management techniques can help you reduce your own disease risk.

Stem-cell Therapy: The Hope, the Hype and the Real Potential – February 9

Join Drs. Beverly Torok-Storb, Tony Blau, Phil Horner and Chuck Murry in a discussion of stem-cell research. Learn about the different types of stem cells, common misunderstandings about stem-cell work, clinical therapies being explored and what these researchers envision for the future.

Cancer and Infectious Diseases: Making a Global Impact – February 16

Did you know that nearly a quarter of cancers around the world are infection caused or related? Meet Dr. Corey Casper, the force behind the Hutchinson Center’s research on infection-related cancers in Uganda. By focusing efforts in a country with a higher disease burden, we hope to understand how chronic infections lead to cancer, including why this happens in some of us and not in others.

Influenza: A Study in Evolution – February 23

Soon personal genomic sequences will be cheaper than personal computers. But genomic sequences don’t come with instruction manuals, so revealing what they tell us about evolution and disease remains a challenge. Dr. Jesse Bloom will take us on a journey along the evolutionary path followed by one influenza gene over the last 40 years, and reveal the obstacles and forces that shape genetic change as we attempt to understand evolution at the molecular level.

When:

Thursdays
February 2-23
7-8:30 pm

 Where:

Fred Hutchinson Cancer Research Center
1100 Fairview Ave. N., Seattle
Thomas Building
Pelton Auditorium

To Register go HERE.

Each year, about 70,000 young people in the U.S. aged 15 to 39 years are diagnosed with cancer.

In the series, a group of teens and young adults from Children’s Adolescent Young Adult Oncology Program talk about their experiences with the disease – from treatments and hair loss, to dealing with school, friends and family.

Producers of the series hope that seeing other teens and young adults with cancer talk about their experiences will help other young patients struggling with the diagnosis of cancer cope.

“It is so important for these teens and young adults with cancer to know that there is a peer out there that understands what they are going through and that support is available,”  Dr. Rebecca Johnson, medical director of the Adolescent and Young Adult Oncology Program at Seattle Children’s Hospital.

The discussion group was facilitated by Teen Talking Circles, a nonprofit organization that offers teens “a safe place to tell their truth,” and trains adults to start Teen Talking Circles in their communities.

• To view the complete series go to:  ”Good Times and Bald Times” or click on individual episodes listed below.

• To learn more visit the website of the Children’s Adolescent Young Adult Oncology Program.

To learn more about the challenges facing teens and young adults with cancer read our series from the NCI Cancer Bulletin.

Series Episodes:

• Good Times and Bald Times – Meet the Circle
• Good Times and Bald Times – Family, Friends & Cancer
• Good Times and Bald Times – How Did it Feel?
• Good Times and Bald Times – Treatment and Medication
• Good Times and Bald Times – Eggs
• Good Times and Bald Times – Fertility Preservation
• Good Times and Bald Times – Food, Appetite & Cancer
• Good Times and Bald Times – Feeding Tubes
• Good Times and Bald Times – Losing Your Hair
• Good Times and Bald Times – PICC Lines, Hickman Lines & Ports, Oh My!
• Good Times and Bald Times – Dealing with School
• Good Times and Bald Times – What If