Siteman Cancer Center at Barnes-Jewish Hospital and Washington University School of Medicine in St. Louis announces several leadership changes, including a new Deputy Director, Associate Directors of Translational Research and Shared Resources, and a Deputy Associate Director of Shared Resources.

Appointed in the role of Deputy Director of Siteman Cancer Center is Daniel C. Link, MD, a highly regarded physician-scientist who treats patients with leukemia and conducts innovative research aimed at developing better treatments for all forms of leukemia.

“We are excited to have Dr. Link in this leadership role at Siteman Cancer Center,” said Siteman director Timothy J. Eberlein, MD, the Spencer T. and Ann W. Olin Distinguished Professor and Senior Associate Dean for Cancer Programs at Washington University School of Medicine and BJC HealthCare. “He is essential in leading Siteman’s overall research enterprise, while overseeing and driving tremendous clinical trial productivity within the areas of medical oncology and bone marrow transplant.”

Link also serves as chief of the Division of Oncology in the Department of Medicine at Washington University School of Medicine in St. Louis. Over the past 10 years, he has helped to develop the hematopoietic development and malignancy program at Siteman Cancer Center into one of the top scientific research programs in the country, all while making key advances in the treatment of blood cancers in his own laboratory. As the principal investigator of a prestigious Specialized Program of Research Excellence (SPORE) in Leukemia, Link leads efforts aimed at boosting translational research and moving promising investigational treatments – developed at Washington University and Siteman – into clinical trials.

Link is continuing the work of John F. DiPersio, MD, PhD, who served as Siteman’s first deputy director and led the Division of Oncology since 1997. Dipersio, a world-renowned physician- scientist specializing in the treatment of leukemia with immunotherapies and stem cell transplants, has stepped down from these leadership roles to return to full time research and patient care.

“It goes without saying that, since its inception, Dr. DiPersio has been an instrumental and foundational leader for Siteman Cancer Center,” Dr. Eberlein said. “Our partnership over the past 25 years proved to be complimentary and pivotal as we operationalized the vision of having world class cancer care at Siteman Cancer Center. John’s passion and talent for innovative science and clinical care is unparalleled.”

DiPersio, the Virginia E. and Sam J. Golman Professor of Medicine and a professor of pediatrics and of pathology and immunology, is continuing to treat patients and conduct research to improve strategies for stem cell transplantation, treat graft-versus-host disease and develop novel types of CAR-T cell therapies for blood cancers.

In addition, Ramaswamy Govindan, MD, the Anheuser-Busch Endowed Chair in Medical Oncology and a physician-scientist specializing in lung cancer, now serves as associate chief of the Division of Oncology at Washington University School of Medicine and has been named Associate Director of Translational Research at Siteman Cancer Center. Govindan will join Siteman’s Senior Leadership Committee, where he will help identify new strategies to optimize the center’s translation of research discoveries into new therapies that help cancer patients in the clinic.

Finally, Siteman Cancer Center has named an Associate Director of Shared Resources, Ben Garcia, PhD, FRSC, who also serves as head of the Department of Biochemistry and Molecular Biophysics at Washington University School of Medicine in St. Louis. In his new role with Siteman Cancer Center, Garcia, who sits on the Siteman Cancer Center Senior Leadership Committee, leads ongoing evaluations of Siteman Cancer Center’s shared resources, identifying new opportunities, and then determining targeted investments. Joining Garcia as Deputy Associate Director of Shared Resources is Ben Major, PhD, a professor of cell biology and physiology at Washington University School of Medicine in St. Louis.Siteman Cancer Center is fortunate to be able to rejuvenate its Senior Leadership with exceptional individuals who will maintain Siteman’s impressive scientific trajectory and continued positive impact on the patients we serve.

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Siteman Cancer Center Names New Deputy Director Among Other Leadership Appointments

Metastatic breast cancer has no cure and has proven stubbornly resistant to one of the most innovative and promising new cancer treatments: immunotherapy.

Now, researchers at Washington University School of Medicine in St. Louis have identified a way to treat the area surrounding breast tumors that have spread to bone so that such tumors become vulnerable to attack by the body’s immune system. When the researchers boosted the activity of certain immune cells, called T cells and macrophages, these immune cells worked together to clear metastatic breast tumors that had spread to the bones of mice, and continued to eliminate tumor cells that eventually returned.

The study is published March 8 in Cancer Discovery, a journal of the American Association for Cancer Research.

Macrophages are myeloid immune cells that attack cancer cells through the body’s innate immune response to general threats, such as tumors or viruses. Such macrophages further activate T cells by showing the T cells what they should be looking for, thereby harnessing the adaptive immune response as well. In this case, these macrophages present T cells with bits of recognizable tumor — called tumor antigens — from dead cancer cells, and the antigens direct the killing activities of T cells.

“After breast cancer has spread to other parts of the body, it becomes extraordinarily difficult to treat; current therapies can only try to slow it down,” said senior author 

, the Gerty Cori Professor of Cell Biology & Physiology. “About 70% of patients with metastatic breast cancer have tumors that have spread to their bones. Our study suggests we may be able to use two treatments — one to sensitize the myeloid tumor microenvironment to immunotherapy, and one to activate T cells — to target these bone metastases in a way that eliminates the tumor, prevents the cancer from returning and protects against bone loss in the process.”

Stewart, also a research member of Siteman Cancer Center at Barnes-Jewish Hospital and Washington University School of Medicine, and her colleagues found that blocking a molecule called p38MAPK reprograms the tumor microenvironment to become more vulnerable to attack by the immune system, including by immune cells and signaling molecules called anti-tumor cytokines. While a p38MAPK inhibitor alone reduced tumor size, it didn’t eliminate the tumor entirely. So, the researchers investigated whether adding another therapy that activates T cells and boosts their ability to find and destroy the tumor cells could be more effective at eliminating the metastatic cancer cells.

Common immunotherapies — called immune checkpoint inhibitors — are often described as “taking the brakes off” immune T cells, ushering them into battle against cancer. In this case, Stewart described the new approach as “hitting the gas” on T cells, supercharging them to be more effective against the cancer.

The researchers investigated two models of human metastatic breast cancer in mice and found that the metastatic tumors were eliminated in mice that received a p38MAPK inhibitor and an immune therapy called an OX40 agonist, which binds and activates T cells. All these mice were still alive and tumor-free at least 80 days after treatment. Among mice receiving either of the two treatments alone, only about half of them were still alive 60 days after treatment.

“If we targeted the microenvironment to make it more sensitive to T cells and simultaneously hit the gas on the T cells, all of the mice were cleared of the metastatic tumors,” Stewart said. “If we came back after two weeks and challenged the mice again with the same tumor cells, their immune systems could clear those cells as well. It appears that their immune systems developed long-term memory and knew to attack those returning cancer cells. The mice look like they’re basically vaccinated against the cancer.”

Three different OX40 agonists are being investigated in phase 2 clinical trials for cancer, including breast cancer. And p38MAPK inhibitors have been investigated in a number of inflammatory disorders, including rheumatoid arthritis and chronic obstructive pulmonary disease.

“We are hopeful that our study will interest companies that make these drugs, so that we can work toward developing a clinical trial that could investigate this strategy in patients with metastatic breast cancer,” Stewart said.

Researchers at Washington University School of Medicine in St. Louis have identified a way to treat the area surrounding breast tumors that have spread to bone so that such tumors become vulnerable to attack by the body’s immune system.

Two-Pronged Immunotherapy Eliminates Metastatic Breast Cancer in Mice

New research involving 28 National Cancer Institute (NCI)-Designated Cancer Centers, including Siteman Cancer Center at 

 and Washington University School of Medicine in St. Louis, indicates it’s both possible and helpful to get cancer patients who smoke into evidence-based tobacco-treatment programs as part of their cancer care.

Studying data involving almost 700,000 patients at the 28 NCI-Designated Cancer Centers, a team of researchers found that it’s beneficial to integrate tobacco treatment into cancer centers’ routine cancer care.

The findings are published Dec. 6 in the Journal of Clinical Oncology.

“We know that people are more likely to quit smoking when they receive treatment, and we know that quitting smoking improves survival and makes cancer treatment more effective; what we didn’t know until now was whether smoking-cessation treatment could be delivered to these patients in cancer centers successfully,” said senior author 

, an associate professor of psychiatry at the School of Medicine.

After screening cancer patients to learn whether they smoke, the researchers identified more than 44,000 smokers at the cancer centers. The researchers discovered that if they could get those patients into evidence-based therapy — such as nicotine replacement, counseling or both — they could help nearly one in five kick the habit and, in doing so, improve the effectiveness of their cancer therapy and boost the patients’ cancer survival rates. Quitting smoking doubles the survival rate for cancer patients and lowers the risk of cancer recurrence, no matter the stage of the cancer.

“Patients receiving tobacco treatment were two to three times more successful in quitting than untreated people, and cancer treatment was significantly more likely to succeed in those who quit smoking,” said first author Sarah D. Hohl, PhD, of the University of Wisconsin – Madison.

 project. In this new study, researchers successfully screened 96% of cancer patients at the 28 NCI-Designated centers participating in the initiative.

“This is the first time that we have gathered this kind of evidence from so many cancer centers,” said Chen. “We didn’t attempt to impose a one-size-fits-all treatment program but instead encouraged centers to do what they thought would work best to get their patients into treatment for smoking.”

There’s still a long way to go. Overall, only about one in seven (15%) patients ends up receiving treatment to curtail tobacco use. But among those who did, almost one in five (18%) succeeded in quitting or severely curtailing tobacco use.

“Tobacco has been kind of a back burner issue at many cancer centers, where the main focus is on treating the consequences of cancer, but we know that quitting smoking helps, regardless of the cancer’s stage, and we believe there are low-burden, cost-effective strategies to help patients do that,” Chen said.

She recently led a single-center effort at Siteman Cancer Center in which researchers used a point-of-care model and electronic health records to identify smokers and then offered them smoking-cessation interventions during regular appointments to receive cancer treatment. That effort increased the percentage of patients receiving smoking-cessation treatment at Siteman from about 2% at the start of the study to nearly 30%. Meanwhile, the percentage of cancer patients at Siteman who quit successfully — meaning they went at least six months without smoking — increased from about 12% to more than 17%.

Chen said the Siteman program demonstrated it was possible for the point-of-care model to help cancer patients quit smoking. She said the goal of this larger, national study was to allow cancer centers to design strategies that work best for their particular patient populations – urban or rural cancer patients, for example, or patients from specific racial or ethnic groups — to see whether specific approaches might work better at one cancer center than another. Chen said it’s unlikely a cookie-cutter approach to smoking cessation would work at each of the nation’s dozens of centers.

“We’re poring over data from the individual centers in this study to look at exactly what they’ve done and to determine what seems to work and what seems not to work,” Chen explained. “We want to identify strategies that can be tailored to specific cancer centers to best help their specific patient populations.”

New research including Siteman Cancer Center at Barnes-Jewish Hospital and Washington University School of Medicine in St. Louis indicates it’s both possible and helpful to get cancer patients who smoke into evidence-based tobacco-treatment programs as part of their cancer care.

Washington University School of Medicine in St. Louis

Articles

Siteman Cancer Center Names New Deputy Director Among Other Leadership Appointments

Two-Pronged Immunotherapy Eliminates Metastatic Breast Cancer in Mice

Study Supports Urging Smoking-Cessation Treatment to Patients in Cancer Care