Miracles in the Heartland


[dropcap]The[/dropcap] Stephenson Cancer Center is Oklahoma’s only comprehensive, academic cancer center, and it’s bringing the latest technologies and most advanced therapies to the state. Since opening its doors in 2011, the Stephenson Cancer Center has earned national recognition for its patient-centered care and pioneering research.

Located at the University of Oklahoma Health Sciences Center campus in Oklahoma City, the Stephenson Cancer Center supports research in the basic, translational, clinical, behavioral and populations-based sciences. For patients, multidisciplinary teams work together to create the most optimal and individualized treatment plans.

“According to the Centers for Disease Control, Oklahoma has the fifth-highest cancer mortality rate in the nation. This is based on the number of cancer deaths per 100,000 people,” says Dr. Robert Mannel, director of Stephenson Cancer Center. “The mission of the Stephenson Cancer Center is to reduce the heavy burden of cancer in the state and improve patient outcomes.”

Since Opening Its 2011, the Stephenson Cancer Center has earned national recognition for its patient-centered care and pioneering research. Photos courtesy Stephenson Cancer Center.

Dr. Mannel shares the many ways the Stephenson Cancer Center is fulfilling its mission. These include: 1) conducting innovative cancer research and translating laboratory discoveries into better cancer therapies, 2) providing patients with opportunities to participate in clinical trials for new cancer drugs, 3) providing patients with access to multidisciplinary specialty oncology clinics, and 4) educating the next generation of cancer health professionals.

For the second year in a row, the Stephenson Cancer Center ranks third in the nation for participation in National Cancer Institute (NCI)-sponsored treatment trials and was the top enroller in the NCI’s most prestigious medicine trial in the country – the NCI-Molecular Analysis for Therapy Choice (NCI-MATCH). Under the umbrella of ‘precision medicine,’ the NCI-MATCH trial “analyzes patients’ tumors to determine whether they contain genetic abnormalities for which a targeted drug exists and assigns treatment based on the abnormality.”

“Precision medicine is an emerging approach for disease treatment and prevention that takes into account individual variability in genes, environment and lifestyle for each person,” Dr. Mannel says. “Precision medicine is particularly relevant in cancer medicine because of the genetic variability in tumors. For example, two women may have a diagnosis of breast cancer, but their tumors might respond very differently to the same cancer therapy. This is because their cancers may have different genetic mutations that respond differently to different drugs. By using genetic analysis to detect known mutations, a doctor may be able to tailor a treatment that’s been proven effective against that particular tumor. While there is still much work to be done in the field of precision medicine, many cancer researchers and clinicians have high hopes that it will lead to better treatments and patient outcomes.”

The Stephenson Cancer Center also offers the only Phase I clinical trials program in the state. Dr. Mannel adds that many of the Phase I drugs are based on a precision medicine approach.

“By participating in a clinical trial that’s testing a Phase I drug, a cancer patient has the opportunity to access the very latest in promising, experimental treatments,” he says. “Most cancer patients participating in a Phase I trial have advanced, late-stage cancer and have failed the standard frontline therapies. Participating in a Phase I trial is a next step for those patients who want to continue to fight their disease.”

Advancements in Immune-Directed Treatment

Immunotherapy is another advancing cancer treatment that is personalized to a patient’s cancer. Immunotherapy takes the body’s natural defense system, the immune system, and helps it fight disease.

“There are several different immunotherapies that we use to fight cancer,” says Dr. Kelly Stratton, a fellowship-trained urologic oncologist at Stephenson Cancer Center.  “Some of the treatments supercharge our immune system so that it is better prepared to fight the cancer. Other drugs prevent the cancer cells from hiding from the immune system. There are several drugs that are currently being studied that hold great promise for improving treatment in cancer patients.”

The Stephenson Cancer Center Urologic Oncology Clinic has been a leader in bringing immunotherapy to Oklahomans with cancer.

“We have worked with researchers who developed a new treatment that pulled genetic material from cancer cells we removed and then used that sequence to teach a patient’s immune cells how to fight the cancer,” says Dr. Stratton.

One form of immunotherapy is treatment (or therapeutic) vaccines such as the prostate cancer vaccine. Dr. Stratton explains how cancer vaccines differ from the public’s general understanding of how a vaccine works.

“Most vaccines are used to prevent infection,” he says. “The goal is to prepare the immune system so that if the patient encounters the disease, they will be able to fight it off. However, in prostate cancer, we use therapeutic vaccines. These treatments stimulate the patient’s own immune system to fight the cancer. Prostate cancer was the first cancer to be successfully treated with a therapeutic vaccine.”

The NCI-match trial analyzes tumors to determine whether they contain genetic abnormalities for which a targeted drug exists. Photo courtesy Stephenson Cancer Center.

Revolutionizing Brain Cancer Surgery and Treatment

Working to improve the lives of patients with brain tumors, Stephenson Cancer Center offers the most advanced, evidenced-based approaches for diagnosis, treatment and symptom management.

Dr. Michael Sughrue, a neurosurgeon with Stephenson Cancer Center, recently performed “wide awake” brain surgery on a patient with stage IV glioblastoma, an aggressive brain cancer. During the five-hour surgery to remove the tumor, the patient played the mandolin as Dr. Sughrue used electric stimulation to turn off the areas of the brain he needed to remove. By playing the mandolin, the patient helped determine which areas controlled essential functions.

The Stephenson Cancer Center is also one of only a few institutions in the nation to offer electrical field therapy to target glioblastoma. This new treatment uses a device to deliver low-intensity electrical fields to the tumor site through electrical transducers positioned on the head. Because cancer cells thrive through rapid replication and division, the transducers are strategically placed to scramble the tumor cell’s internal messaging and cause it to self-destruct.

The device is worn more than 18 hours a day for best results and has been approved by the Food and Drug Administration for the treatment of glioblastoma as a first line therapy in combination with standard surgery, radiation and chemotherapy. While not all patients may be eligible for this new therapy, it’s a promising treatment. Researchers recently found that patients using the device lived longer than those offered standard treatments alone.

Oklahoma Tobacco Research Center

The Stephenson Cancer Center houses the Oklahoma Tobacco Research Center (OTRC), a research initiative funded by the Tobacco Settlement Endowment Trust (TSET).

According to the 2014 State of the State’s Health Report, smoking is Oklahoma’s leading cause of preventable death, and each year approximately 4,400 Oklahoma children become new daily smokers.

“The mission of the Oklahoma Tobacco Research Center at the Stephenson Cancer Center is to reduce the burden of tobacco-related cancers and other diseases in Oklahoma’s most vulnerable and underserved populations,” says Jennifer Vidrine, PhD, director of OTRC. “We hope to accomplish this mission through conducting research that involves the development and evaluation of novel treatments, understanding mechanisms that drive tobacco dependence and disseminating our research findings to high-need communities in Oklahoma.”

An example of OTRC’s work includes a study published in January 2015 that found exposure to even minimal levels of secondhand tobacco smoke causes significant DNA damage in human cells. The authors of the study developed a new and highly sensitive detection process to measure damage to human cells induced by exposure to various doses of mainstream and sidestream tobacco smoke – main components of secondhand smoke. This new method also may have other potential uses such as the prediction of cancer risk in individuals, treatment outcomes and prognoses and DNA damage in aging-related changes and neurological disorders.

The study noted that while the repair of most forms of DNA damage occurs naturally in living cells, the damage from very low doses of secondhand smoke persists unrepaired for at least 16 hours. These findings suggest that the body’s natural process for DNA repair is not activated for this level of DNA damage or is not able to fully repair the damage. The study shared that although further research is needed, this may indicate a disproportionate carcinogenic effect from exposure to very low levels of secondhand smoke.

The Stephenson Cancer Center and OTRC also recently welcomed Francesco Versace, PhD to their team. Versace is an experimental psychologist who specializes in the neuroscience of tobacco and other addictions. Using electroencephalography (EEG) and functional MRI, he studies the cognitive and affective processes in nicotine addiction, as well as obesity. This type of neuroscience research may be used to examine why some children are more prone to addiction.

While OTRC’s research continues to break new ground, the center’s comprehensive approach affects change throughout the state.

“Our mission extends beyond research in many important ways,” Vidrine says. “It includes the delivery of evidence-based tobacco cessation treatment to Oklahomans, the provision of tobacco policy expertise to help inform decision makers in Oklahoma and training the next generation of tobacco researchers through providing fellowships to students and postdoctoral fellows.”