The awards, which provide $1.5 million in direct costs for a 5-year project, enable unusual flexibility, says Dr. Basavappa. Researchers receive the entire sum in the first year, enabling them to spend the funds as they see fit during the grant period. Both Drs. Yang and Janelsins are pleased to have received grants that will help them continue their research into combatting cancer and the side effects of treatment, respectively.
Cognitive Issues Related to Chemotherapy
NIH Program Encourages Early-Career Researchers Innovative researchers delve into ways to attack cancer, reduce side effects of chemotherapy.
M
ichelle Janelsins, PhD, MPH, is exploring the causes and potential solutions to the cognitive problems associated with chemotherapy, often referred to as “chemo brain.” On the other side of the country, Lili Yang, PhD, is investigating new ways to genetically engineer special killer immune cells to attack cancer. Both researchers are among 50 recipients of the 2014 National Institutes of Health (NIH) Director’s New Innovator Awards, announced in October 2014. The program was developed in 2007 as a way to support exceptionally creative investigators in the early stages of their careers who propose to pursue unusually innovative research with broad potential impact. “The purpose is two-fold,” says Ravi Basavappa, PhD, program director for the award program. “First, it is to provide opportunities for advancing science in leaps rather than the more typical incremental steps, and second, it is to provide a complement to other NIH efforts to support early-career investigators.”
Cancer CANCER
February 15, 2015 FEBRUARY 15, 2015
“One of the questions I ask myself is why they picked me,” says Dr. Janelsins, an assistant professor at the University of Rochester Medical Center in New York. “And I think one of the strengths I have is training in both basic science and clinical research.” Indeed, her project addresses both areas in an attempt to understand the causes of and possible interventions for cognitive problems related to chemotherapy in patients with breast cancer. These problems generally manifest themselves as difficulty with memory, attention, concentration, and organization, and they can occur during and after treatment. They also can persist for years, come and go, and vary in severity at different times. One hypothesis is that both chemotherapy and the disease itself contribute to cognitive problems, she says. “The majority of these problems will go away, but there is a subset of patients who will have long-term issues,” Dr. Janelsins says.
There have been clinical studies about physical activity, but one of the key reasons why we’re doing the research in animal models is because I’m also interested in learning about the minimal possible dose we can give a patient. —Michelle Janelsins, PhD, MPH Her research involves first understanding the mechanisms driving this cognitive impairment in an animal model. Next, using these pathways as a guide, she hopes to develop interventions that could lead to human clinical research studies. “It looks like inflammation is playing a role, but we don’t know if it’s a causative role or more of an association,” she says. She hopes that her research can help identify a collection of inflammation biomarkers that could identify which patients are likely to develop cognitive impairment. If these patients can be identified, scientists potentially could develop early psychological testing or interventions to prevent them from experiencing severe or long-term cognitive issues. Such interventions could 487 1
© CIFOTART / FOTOLIA.COM
Oncology Issues in Focus | BY CARRIE PRINTZ
include both behavioral and pharmacological methods, such as physical activity, vitamin supplements, or antiinflammatory agents, she says. “There have been clinical studies about physical activity, but one of the key reasons why we’re doing the research in animal models is because I’m also interested in learning about the minimal possible dose we can give a patient,” she says. “We don’t know if there’s a difference between exercising 2 days a week versus walking every day.” Dr. Janelsins, who has conducted research in this area for the past 5 to 6 years, has always focused on cognition and immune function. Her previous work dealt with Alzheimer disease, but because several friends and family members were diagnosed with cancer, she decided to switch scientific paths. Although the funding difficulties associated with medical research remain challenging, she believes that “the key is to have innovative ideas that are clinically relevant.”
Genetic Engineering of Blood Stem Cells Dr. Yang, an assistant professor of microbiology, immunology, and molecular genetics at the University of California at Los Angeles (UCLA), is applying genetic engineering methods in blood stem cells to generate therapeutic levels of special types of immune cells known as invariant natural killer T cells “These cells exist in extremely low numbers in humans and are highly variable between individuals,” she says, noting that the numbers can vary from 1 in 100,000 to 1 in 100 in human blood. “They are very rare, but very potent.” Unlike conventional T cells, they can begin to attack disease immediately on activation. They also are considered universal agents because
Likely, the most effective immunotherapy for targeting cancer will be a combination therapy with more than one component of the immune system—Lili Yang, PhD they can target multiple types of cancers, says Dr. Yang, Her research is building on her past work in genetically engineering human blood stem cells to become normal T cells. Now, she and her colleagues hope to develop ways to generate and increase the numbers of invariant natural killer T cells in patients, with the goal of maintaining those numbers throughout a lifetime. Her project will include proof-of-principle studies in a mouse model, followed by directly proving the method using human blood stem cells in a mouse model. “Likely, the most effective immunotherapy for targeting cancer will be a combination therapy with more than one component of the immune system,” Dr. Yang says. Trained as an immunologist, she received her doctorate at the California Institute of Technology in Pasadena before moving to UCLA, which is conducting clinical trials in the method she developed of genetically engineering T cells. Although the national funding environment for research is challenging, she credits both UCLA for supporting junior faculty as well as the California Institute for Regenerative Medicine in San Francisco for helping fund her stem cell research along with the NIH New Innovator grant. DOI: 10.1002/cncr.29268
Cancer Programs Develop Own Guidelines to Measure Quality n increasing number of cancer programs are developing their own guidelines to measure and track the quality of care provided, rather than waiting to be told to do so by payers, according to a survey conducted by the Association of Community Cancer Centers. The organization’s annual survey of trends in cancer programs found that, although the use of metrics to track and measure quality is increasing, only 28% of respondents say that their payers require quality measures. Nevertheless, the majority of respondents believe that requirement will happen in the future. Approximately 24% of survey respondents report that they are involved with an accountable care organization that has an oncology component, which is up from 5% in 2013. Another 22% of oncology providers say they plan to participate in an accountable care organization in the future. In addition, an increasing number of cancer programs are working to ensure they are ready for the American College of
488
Surgeons Commission on Cancer standards, which go into effect in 2015, including requirements involving palliative care, clinical trials, patient navigation, cancer survivorship, and genetic counseling. Patient-centered care also is leading to an increase in the number of supportive services being offered, the survey found. These services include integrative and complementary therapies as well as financial advocacy. Regarding the latter, approximately 90% of respondents note that they offer financial assistance services whereas 84% say they have financial specialists on staff. DOI: 10.1002/cncr.29269
Cancer
February 15, 2015
© ROB BYRON / FOTOLIA.COM
A
Copyright of Cancer (0008543X) is the property of John Wiley & Sons, Inc. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use.
Cognitive Issues Related to Chemotherapy
NIH Program Encourages Early-Career Researchers Innovative researchers delve into ways to attack cancer, reduce side effects of chemotherapy.
M
ichelle Janelsins, PhD, MPH, is exploring the causes and potential solutions to the cognitive problems associated with chemotherapy, often referred to as “chemo brain.” On the other side of the country, Lili Yang, PhD, is investigating new ways to genetically engineer special killer immune cells to attack cancer. Both researchers are among 50 recipients of the 2014 National Institutes of Health (NIH) Director’s New Innovator Awards, announced in October 2014. The program was developed in 2007 as a way to support exceptionally creative investigators in the early stages of their careers who propose to pursue unusually innovative research with broad potential impact. “The purpose is two-fold,” says Ravi Basavappa, PhD, program director for the award program. “First, it is to provide opportunities for advancing science in leaps rather than the more typical incremental steps, and second, it is to provide a complement to other NIH efforts to support early-career investigators.”
Cancer CANCER
February 15, 2015 FEBRUARY 15, 2015
“One of the questions I ask myself is why they picked me,” says Dr. Janelsins, an assistant professor at the University of Rochester Medical Center in New York. “And I think one of the strengths I have is training in both basic science and clinical research.” Indeed, her project addresses both areas in an attempt to understand the causes of and possible interventions for cognitive problems related to chemotherapy in patients with breast cancer. These problems generally manifest themselves as difficulty with memory, attention, concentration, and organization, and they can occur during and after treatment. They also can persist for years, come and go, and vary in severity at different times. One hypothesis is that both chemotherapy and the disease itself contribute to cognitive problems, she says. “The majority of these problems will go away, but there is a subset of patients who will have long-term issues,” Dr. Janelsins says.
There have been clinical studies about physical activity, but one of the key reasons why we’re doing the research in animal models is because I’m also interested in learning about the minimal possible dose we can give a patient. —Michelle Janelsins, PhD, MPH Her research involves first understanding the mechanisms driving this cognitive impairment in an animal model. Next, using these pathways as a guide, she hopes to develop interventions that could lead to human clinical research studies. “It looks like inflammation is playing a role, but we don’t know if it’s a causative role or more of an association,” she says. She hopes that her research can help identify a collection of inflammation biomarkers that could identify which patients are likely to develop cognitive impairment. If these patients can be identified, scientists potentially could develop early psychological testing or interventions to prevent them from experiencing severe or long-term cognitive issues. Such interventions could 487 1
© CIFOTART / FOTOLIA.COM
Oncology Issues in Focus | BY CARRIE PRINTZ
include both behavioral and pharmacological methods, such as physical activity, vitamin supplements, or antiinflammatory agents, she says. “There have been clinical studies about physical activity, but one of the key reasons why we’re doing the research in animal models is because I’m also interested in learning about the minimal possible dose we can give a patient,” she says. “We don’t know if there’s a difference between exercising 2 days a week versus walking every day.” Dr. Janelsins, who has conducted research in this area for the past 5 to 6 years, has always focused on cognition and immune function. Her previous work dealt with Alzheimer disease, but because several friends and family members were diagnosed with cancer, she decided to switch scientific paths. Although the funding difficulties associated with medical research remain challenging, she believes that “the key is to have innovative ideas that are clinically relevant.”
Genetic Engineering of Blood Stem Cells Dr. Yang, an assistant professor of microbiology, immunology, and molecular genetics at the University of California at Los Angeles (UCLA), is applying genetic engineering methods in blood stem cells to generate therapeutic levels of special types of immune cells known as invariant natural killer T cells “These cells exist in extremely low numbers in humans and are highly variable between individuals,” she says, noting that the numbers can vary from 1 in 100,000 to 1 in 100 in human blood. “They are very rare, but very potent.” Unlike conventional T cells, they can begin to attack disease immediately on activation. They also are considered universal agents because
Likely, the most effective immunotherapy for targeting cancer will be a combination therapy with more than one component of the immune system—Lili Yang, PhD they can target multiple types of cancers, says Dr. Yang, Her research is building on her past work in genetically engineering human blood stem cells to become normal T cells. Now, she and her colleagues hope to develop ways to generate and increase the numbers of invariant natural killer T cells in patients, with the goal of maintaining those numbers throughout a lifetime. Her project will include proof-of-principle studies in a mouse model, followed by directly proving the method using human blood stem cells in a mouse model. “Likely, the most effective immunotherapy for targeting cancer will be a combination therapy with more than one component of the immune system,” Dr. Yang says. Trained as an immunologist, she received her doctorate at the California Institute of Technology in Pasadena before moving to UCLA, which is conducting clinical trials in the method she developed of genetically engineering T cells. Although the national funding environment for research is challenging, she credits both UCLA for supporting junior faculty as well as the California Institute for Regenerative Medicine in San Francisco for helping fund her stem cell research along with the NIH New Innovator grant. DOI: 10.1002/cncr.29268
Cancer Programs Develop Own Guidelines to Measure Quality n increasing number of cancer programs are developing their own guidelines to measure and track the quality of care provided, rather than waiting to be told to do so by payers, according to a survey conducted by the Association of Community Cancer Centers. The organization’s annual survey of trends in cancer programs found that, although the use of metrics to track and measure quality is increasing, only 28% of respondents say that their payers require quality measures. Nevertheless, the majority of respondents believe that requirement will happen in the future. Approximately 24% of survey respondents report that they are involved with an accountable care organization that has an oncology component, which is up from 5% in 2013. Another 22% of oncology providers say they plan to participate in an accountable care organization in the future. In addition, an increasing number of cancer programs are working to ensure they are ready for the American College of
488
Surgeons Commission on Cancer standards, which go into effect in 2015, including requirements involving palliative care, clinical trials, patient navigation, cancer survivorship, and genetic counseling. Patient-centered care also is leading to an increase in the number of supportive services being offered, the survey found. These services include integrative and complementary therapies as well as financial advocacy. Regarding the latter, approximately 90% of respondents note that they offer financial assistance services whereas 84% say they have financial specialists on staff. DOI: 10.1002/cncr.29269
Cancer
February 15, 2015
© ROB BYRON / FOTOLIA.COM
A
Copyright of Cancer (0008543X) is the property of John Wiley & Sons, Inc. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use.
