2015 CANCER PROGRAM ANNUAL REPORT

WITH 2014 STATISTICS TABLE OF CONTENTS

1 MESSAGE FROM THE DIRECTOR

2 CANCER REGISTRY

4 CANCER COMMITTEE MEMBERS/ CANCER REGISTRY STAFF

5 CANCER ACTIVITIES

25 CANCER DATA

31 PUBLISHED ABSTRACTS Boris Pasche, MD, PhD, FACP Director, Comprehensive Cancer Center

Comprehensive Cancer Center AT WAKE FOREST BAPTIST MEDICAL CENTER

The Comprehensive Cancer Center lung, melanoma, pediatrics and clinical and research oncology at Wake Forest Baptist Medical sarcoma. operations, including acute care Center started in the early 1960s, The Cancer Center recognizes oncology inpatient beds and an and became a National Cancer the importance of building cross- oncology intensive care unit, all Institute (NCI)-designated cancer departmental and transdisciplinary outpatient oncology services, as center in 1974, shortly after the team approaches to advance the well as clinical trial management, National Cancer Act became law. science and treatment of cancer. nursing, pharmacy and administration The Cancer Center then received an In addition to the disease-oriented staff. This new building provides an NCI “comprehensive” designation in teams, which are comprised of exceptional environment for patients, 1990, indicating excellence in patient clinicians, population scientists and family and caregivers. With an care, research (basic, clinical and basic scientists, other interdisciplinary average of 250 clinical trials available population sciences), training and research interest groups have formed. each year, patients have ready education, and outreach. It is one of Topics include cancer genomics access to cutting-edge research and the earliest cancer centers to receive and precision medicine, the tumor precision medicine. an NCI designation and has been microenvironment, nanotechnology, The Cancer Center strives to continuously funded for more than imaging, novel anticancer drugs, serve the needs of its community, 40 years. We are proud to be part of novel anticancer devices, cancer focusing on cancer risk factors with a very distinguished group of only survivorship, tobacco control and elevated incidence in the area, such 45 NCI-designated comprehensive cancer health disparities. as smoking rates and obesity, and cancer centers in the country. In building initiatives to reduce cancer addition, the Cancer Center is Collaborations with other centers and schools within the institution are an health disparities. The Cancer Center currently ranked the #1 cancer works closely with the Maya Angelou hospital in the state of North Carolina essential element to the success of this research. The Cancer Center has Center for Health Equity at Wake and in the Southeast by U.S. News & Forest Baptist, which was founded World Report. strong connections with the Wake Forest Baptist Medical Center Clinical by the renowned poet to address The mission of the Cancer Center and Translational Science Institute, health disparities across the region is to reduce cancer incidence, the Virginia Tech-Wake Forest and the nation. We also established a morbidity and mortality in the University School of Biomedical Cancer Health Equity initiative in 2012 region, nationally and internationally Engineering and Sciences, the Wake with the sole mission of addressing through cutting-edge research and Forest Center for Human Genomics the needs of our patients in both treatments, education and outreach, and Personalized Medicine, the culturally and linguistically relevant and multidisciplinary training. The Sticht Center on Aging, Wake Forest ways. As an example, we hired a Cancer Center is comprised of more Innovations and the Wake Forest Hispanic Clinical Trial Navigator than 125 faculty members from 36 Institute for Regenerative Medicine. in mid-2014 to provide navigation departments. The Center’s research services, clinical trial education and is divided into four programs: Tumor The Cancer Center is the main community outreach specifically to Progression and Recurrence, Cancer tertiary referral center for patients our Hispanic population. Biology and Biochemistry, Clinical in a large geographic region of the Research, and Cancer Prevention and Piedmont and southern Appalachia “Our Comprehensive Cancer Center has Control. To facilitate the scientific and that extends into portions of Virginia, made tremendous strides in this past year translational goals of the programs, West Virginia and Tennessee. by offering cutting-edge research, clinical the Cancer Center has established The Cancer Center provides a trials, and new discoveries such as those 12 disease-oriented teams: brain, multidisciplinary approach to in precision medicine with the goal of breast, gastrointestinal, genitourinary, treatment in a recently expanded, delivering the best care possible to our geriatrics, gynecology, head and state-of-the-art facility. The 11-story patients, their families and caregivers.” neck, hematologic malignancies, Cancer Center houses the Institution’s Boris Pasche, MD, PhD, FACP

2015 CANCER PROGRAM ANNUAL REPORT 3 The Cancer Registry is involved in managing and analyzing clinical cancer information for the purpose of education, research and outcome measurement.

CANCER REGISTRY The Cancer Registry works neoplasms. The registry also collects The Cancer Registry maintains with physicians, administration, selected benign neoplasms and data management and regulatory researchers and health care metastatic squamous cell and basal reporting on cancer statistics for planners to provide support for cell carcinoma of the skin approved various health care agencies. As cancer program development, by the Cancer Committee. The required by law, cancer cases are ensure compliance with reporting cancer data set includes patient reported to the North Carolina standards and serve as a valuable demographics, cancer identification, Central Cancer Registry (NC-CCR). resource for cancer information, extent of disease (stage), prognostic The data submitted is shared with with the ultimate goal of preventing indicators, treatment, recurrence the North American Association of and controlling cancer. and outcome information. Effective Central Cancer Registries (NAACCR) January 1, 2012, the registry began and the U.S. Centers for Disease The Cancer Registry functions in the collection of the provider-based Control and Prevention’s National accordance with guidelines set by clinics’ cancer cases. The registry Program of Cancer Registries the American College of Surgeons began the collection of cancer (CDC-NPCR). In addition, newly (ACoS). It plays an important cases diagnosed on or after January diagnosed cancer cases are role in ensuring that the cancer 1, 2013, for Wake Forest Baptist submitted to the Commission on program is accredited by the Health Lexington Medical Center. Cancer’s National Cancer Data Commission on Cancer and that the Base (NCDB). The NCDB is a Breast Care Center is accredited Follow-up is performed annually on comparative database for ongoing by the National Accreditation patients in the registry. Follow-up assessment of cancer patient care Program for Breast Centers. directly benefits patients and and is a joint project of the American physicians by reminding them of The Cancer Registry is involved College of Surgeons (ACoS) and the need for medical checkups. in managing and analyzing the American Cancer Society. Continued surveillance ensures early clinical cancer information for the detection of possible recurrence or a The Association of North Carolina purpose of education, research new primary. Outcome data provides Cancer Registrars helps cancer and outcome measurement. The survival information reflecting the registrars in the state maintain their primary functions of the Cancer effectiveness of treatment modalities. continuing education hours by Registry are to collect relevant data, The Cancer Registry fulfills requests providing up-to-date educational conduct lifetime follow-up and for cancer data from staff physicians, workshops. The National Cancer disseminate cancer information. allied health professionals, outside Registrars Association serves as the The registry also participates in institutions and requests for premier education, credentialing hospital-based, state and national follow-up information from other and advocacy resource for studies and research projects. cancer registries. All data requests cancer data professionals. The Cancer Registry collects all are handled with the utmost care malignant neoplasms and benign for the patient’s confidentiality. brain and central nervous system

4 2015 CANCER PROGRAM ANNUAL REPORT CANCER COMMITTEE The Cancer Committee is one of the major components of being an approved cancer program of the American College of Surgeons (ACoS). The committee is responsible for planning, initiating, stimulating and assessing all cancer-related activities. The committee must be a multidisciplinary, standing committee that meets at least quarterly.

ACTIVITIES ▶▶ The Cancer Program Annual Report is compiled and ▶▶ The College of American Pathology’s scientifically published as an educational activity of the committee. validated data elements outlined on the surgical case Published journal articles and abstracts are included. summary checklist of the CAP publication, Reporting on Cancer Specimens, are reviewed and monitored. ▶▶ Quality management activities/improvements are planned, reviewed and implemented each year. ▶▶ The Cancer Registry data and activities are evaluated and monitored for casefinding, accuracy of data ▶▶ Studies that measure quality and outcomes are completed so that patients receive care that is collection, abstracting timeliness, follow-up and data comparable to national standards. reporting. ▶ A subcommittee monitors the activities of the Breast ▶▶ The AJCC TNM staging by the managing physician is ▶ monitored. Care Center. ▶▶ Cancer conferences are reviewed and monitored for frequency, multidisciplinary attendance, total case presentation and prospective case presentation.

2015 CANCER PROGRAM ANNUAL REPORT 5 CANCER COMMITTEE MEMBERS

Edward Levine, MD, Chair \ Surgical Oncology Joseph Bonkowski, PharmD, MHA, MS \ Pharmacy, Oncology Service Line Dale Browne, MD \ Otolaryngology Wendy Cox \ Operational Coordinator, Cancer Center Nursing Administration Karen Craver, MT, MHA \ Associate Director Clinical Operations and Nursing Inez Inman, BS, RHIT, CTR \ Cancer Registry Audrey Bell Farrow, MBA, MHA \ Community Engagement Coordinator Ronda Granger, MSW, LCSW, ACM \ Care Coordination Kathryn Greven, MD \ Radiation Oncology Sally Hauser, MSN, ANP-BC \ Breast Care Center Marissa Howard-McNatt, MD \ Surgical Oncology \ Breast Care Center \ Cancer Liaison Physician Carrie Klamut \ American Cancer Society Nadja Lesko, MD \ Diagnostic Radiology Glenn Lesser, MD \ Hematology and Oncology Richard McQuellon, PhD \ Cancer Patient Support Program Judith Messura, DMD \ Dentistry Donna Morris, RN \ Director of Nursing, Hematology Oncology Lisa Odom, MBA, MHA, RHIA \ Health Information Management Samantha Ogle, RN, MSN, OCN \ Oncology Quality Program Manager Susan Poindexter, RN \ Nursing Education Coordinator, Hematology Oncology Shadi Qasem, MD \ Pathology Rebecca Rankin \ Director of Administration, Comprehensive Cancer Center Carolyn Scott, MBA, BSN, RN \ Administrative Director, Clinical Operations and Nursing Cameron Thomason \ Administrative Director, Department of Pathology and Laboratory Medicine Cathleen Wheatley, MS, RN, CENP \ Chief Nurse Executive and Vice President, Clinical Operations

CANCER REGISTRY STAFF Inez Inman, BS, RHIT, CTR \ Manager Janice Boggs, RHIT, CTR \ Oncology Data Analyst Jenean Burris, RHIT, CTR \ Oncology Data Analyst Adele Nissen, RHIT, CTR \ Oncology Data Analyst Pamela Childress-Obenauf \ Oncology Data Analyst Kimberly Ortiz, CTR \ Oncology Data Analyst Shawnetta Peebles, RHIT, CTR \ Oncology Data Analyst Michael Serwint, MD, CTR \ Oncology Data Analyst Patricia Spry, CTR \ Oncology Data Analyst Terri Swan, CTR \ Oncology Data Analyst

6 2015 CANCER PROGRAM ANNUAL REPORT 2015 CANCER ACTIVITIES more than 2,000 patients received transplants

BLOOD AND MARROW TRANSPLANT PROGRAM The Blood and Marrow Transplant review process allows us to develop our mission of improving the (BMT) program celebrated its 25th a multidimensional care plan for each success of hematopoietic stem cell year of providing transplants this patient. Our multidisciplinary team transplantation. We participate in year. During the past 25 years, the includes our physicians, advanced studies sponsored by the Blood BMT program at Wake Forest Baptist practice providers, pharmacists, nurse and Marrow Transplant Clinical has performed transplants on more coordinators, financial coordinator, Trials Network (BMT-CTN) and than 2,000 patients in the region and psychologist, social worker, tissue- other multi-institutional studies surrounding states — an extensive typing specialist, stem cell processing through the Alliance cooperative catchment area capturing part of the team, stem cell procurement team, group trials. We also have underserved Appalachian area. We dietitian and physical therapists. clinical trials that are the result of also celebrate 25 years of progress transplant clinicians partnering As a program, we continue to grow in BMT. For patients of all ages, with laboratory and social scientists and expand the quality service to the survival of BMT has never been within the Wake Forest Baptist’s our patients expected of a top tier better. Cures are more attainable for Cancer Center community. program. Many initiatives this year are patients transplanted earlier in the helping us reach our quality goals: ▶▶ In collaboration with scientific and course of their disease, in remission clinical colleagues in the Cancer and with post-transplant modulation ▶▶ We provide information about Center, we have expanded our of minimal residual disease. facilities, personnel, diseases BMT clinical program to include treated, transplant experience and In 2015, 119 patients received hematopoietic stem cell transplant survival in a transplant education transplants using autologous or from haplo-identical donors class given by our BMT nurse allogeneic stem cells. The number (“half-matched transplants”), coordinators that all patients are of patients transplanted reflects a widening donor availability for encouraged to attend. large population of patients with patients needing a transplant. hematologic malignancies for whom ▶▶ To improve patient experience This reflects recent advances in transplant is an important modality and decrease length of stay in HLA typing and new combinations of care, in many cases improving the hospital, we offer outpatient of immunosuppressive agents, disease-free and overall survival. high-dose chemotherapy and stem including post-transplant cyclo- The program’s goal is to provide cell transplant for patients with phosphamide for graft-versus-host state-of-the-art care for our patients. multiple myeloma. Patients come disease (GVHD) prevention. All new cases are reviewed by our daily to the Outpatient BMT Clinic ▶▶ We are dedicated to improving multidisciplinary team; as a group, in the Cancer Center to receive the quality of life for bone we review every patient’s case their care from a team of trans- marrow and stem cell transplant individually, identifying psychosocial plant-trained nurses and providers. recipients. This year we began factors, co-morbid conditions and ▶▶ We participate in a variety of a survivor clinic run primarily by disease risk factors that can interfere clinical trial activities to accomplish BMT advanced-practice providers with a successful transplant. Our peer applying the post-transplant care

8 2015 CANCER PROGRAM ACTIVITIES recommendations published ▶▶ We believe that pharmacists can regiments. This improves patient by the Center for International impact the clinical and economic satisfaction through drug education Blood and Marrow Transplant outcome of patients undergoing and improves management of Research (CIBMTR) organization hematopoietic stem cell transplant. symptoms. in partnership with the National Having a PharmD in the various Marrow Donor Program (NMDP)/ settings where care is delivered Be The Match. This clinic focuses improves patient understanding of on the screening and preventive medication regimens, streamlines practices for long-term survivors medical management and helps after hematopoietic stem cell patients be more engaged in their transplant and provides infor- care. This year, we have included mation to help other providers an outpatient PharmD in patient understand the specialized care care to help with adherence and needs of transplant recipients. compliance in complex medical

2015 CANCER PROGRAM ACTIVITIES 9 more than

450patients were seen in the Survivor’s clinic

BREAST CARE CENTER The multimodality Breast Care Center from multiple angles. Tomosynthesis celebrated its 15th anniversary in provides a more accurate view of the January 2015. In 2015, 421 new breast breast and allows doctors to more cancer patients were seen throughout effectively pinpoint the size, shape the Cancer Center, making this and location of any abnormalities. our highest number of patients This can lead to better detection and seen to date. The center’s goal is fewer callbacks. to provide state-of-the-art care for Marissa Howard-McNatt, MD, the the full spectrum of breast diseases Director of the Breast Care Center, in a patient-focused environment. was awarded “The National Breast All new cases are reviewed by Cancer Patient Navigation Program” our multimodality team with the through a grant by Susan G. Komen mammographers prior to being seen and Walgreen’s. The grant enabled in clinic. Typically, patients are seen by us to fund a new Breast Patient a multidisciplinary group consisting Navigator, Carrie Galloway. With the of a surgeon, radiation oncologist, additional help of the Cancer Center’s plastic surgeon, genetic counselor Hispanic Navigator, Maria Alejandra and medical oncologist, if necessary. Combs, all new breast cancer patients The Breast Care Center is certified receive assistance in navigation. by the National Accreditation The Breast Cancer Survivor’s Clinic in Program for Breast Centers. This Clemmons is thriving. More than 450 year we passed our re-accreditation patients were seen in the Survivor’s for another three years. This clinic, making it the busiest year to accreditation is the product of date. Run by nurse practitioners, the expertise from a variety of disciplines clinic sees patients who are more than working together for the benefit of two years out from their initial breast education to community providers patients. cancer diagnosis. The survivor’s clinic with the goal of improving health care This Breast Care Center’s 3D not only provides monitoring of these for those with breast disease. Tomosynthesis mammography patients, but in-depth psychosocial Research is a key component of the unit, the latest breakthrough in and health maintenance of these Breast Care Center, which actively mammography, continues to thrive high-risk women. supports cooperative group breast at our Medical Plaza – Clemmons The Breast Care Center hosted trials from the NRG Oncology, the and Outpatient Imaging locations. the Ninth Annual Breast Cancer Alliance and SWOG. The Breast Screening and diagnostic imaging Symposium at Wake Forest Care Center also has a variety of are offered on the unit. The number University’s Bridger Field House institutional research initiatives that of mammograms increased in 2015 in September 2015. Lectures have led to several publications in due to the use of tomosynthesis. covered a wide range of topics from prestigious journals and presentations Breast tomosynthesis minimizes the genetics to imaging to treatment at national meetings. effect of overlapping breast tissue and survivorship issues for breast during imaging because the camera cancer patients. The annual event moves over the breast, taking images is intended to provide continuing

10 2015 CANCER PROGRAM ACTIVITIES CANCER PREVENTION AND CONTROL RESEARCH PROGRAM The Cancer Prevention and Control Some of the major ongoing projects include: (CPC) Research Program is focused on scientific discovery across the PRIMARY PREVENTION SURVIVORSHIP cancer continuum—from primary ▶▶ Effective Communication on ▶▶ A Prospective Study of the Impact prevention to survivorship—that Tobacco Product Risk and FDA of Breast Cancer on Symptoms and translates into clinical, community Authority Functioning and policy strategies to improve cancer outcomes. The CPC Program ▶▶ Implementing Evidence-based ▶▶ Reducing Lung Cancer Survivor has 25 members in 13 departments Tobacco-cessation Strategies in Anxiety with Brief Device-guided led by Kristie Foley, PhD, Program Oncology Clinics Breathing Leader and Associate Director for ▶▶ The National Coalition Network ▶▶ Acupuncture in the Treatment of Population Sciences, and Kathryn for Tobacco and Cancer-free Living Hot Flashes Weaver, PhD, Program Co-leader Centers for Disease ▶▶ Preventing Anthracycline and Assistant Director of the Office ▶▶ Building Capacity for Tobacco Cardiovascular toxicity with Statins of Cancer Health Equity. The Research in Romania CPC Program conducts rigorous, ▶▶ Early Imaging Detection of CV hypothesis-driven and translatable ▶▶ SipSmarter: A Nutrition Literacy Injury After Cancer Approach to Reducing Sugar- research that is responsive to two ▶▶ Understanding and Predicting areas of inquiry: sweetened Beverages Fatigue, CV Decline & Events after 1) Improve modifiable risk factors ▶▶ The Wake Forest Center for Breast Cancer Treatment Botanical Lipids and Inflammatory that will reduce cancer incidence, ▶▶Evaluation of Inflammation and morbidity and mortality, with a Disease Prevention Mediators of Cardiovascular Aging strategic focus on tobacco control ▶▶ Brenner FIT Kohl’s Family in Childhood Cancer Survivors and obesity. Collaborative ▶▶ Community Hospital Identification of Cardiovascular Risk of Patients 2) Enhance survivorship outcomes, REDUCING CANCER DISPARITIES with a focus on quality of life, while During Cancer ▶▶ A Primary Care Multilevel mHealth incorporating patient-reported ▶▶ Meta-analysis of Positive Colorectal Cancer Screening outcomes into survivorship care Psychology Interventions for Intervention and addressing the symptoms and Cancer long-term effects of cancer treatment. ▶▶ Evaluation of the Geographic ▶▶ End of Treatment Transition to Health Equity Alliance Our program is also dedicated to Follow-up Care Among Early Stage reducing cancer disparities across Lung Cancer Survivors programmatic aims. Program members have over $6.8 million in extramural cancer-related research funding to achieve these aims.

DEPARTMENT OF CARE COORDINATION Nurse case managers and social care are handled by the case have the services of a social worker workers are integral members of manager or social worker. Services available to them. The social worker the health care team, providing may include crisis intervention and follows patients who may need services to patients and families. counseling, and referrals for home counseling or crisis intervention, Staff members work collaboratively health or DME (durable medical assistance with transportation to with other team members to equipment), hospice or other local and from medical appointments, assure that patient and family resources. referrals to local resources and members’ needs are addressed. Patients being followed in the information regarding medication Arrangements for post-discharge outpatient oncology clinics also assistance programs.

2015 CANCER PROGRAM ACTIVITIES 11 HEAD AND NECK ONCOLOGY Head and neck cancer continues to Porosnicu, MD, and Marcelo to maximize cure rates while constitute a significant proportion Bonomi, MD preserving function. Surgeons have of cancers seen at Wake Forest expertise in free tissue transfer ▶▶ Dentistry: Judith Messura, DMD Baptist Medical Center. In 2014, with microvascular reconstruction, 429 patients were seen with tumors ▶▶ Pathology: James Cappellari, MD allowing restoration of form and of the oral cavity, oropharynx, ▶▶ Diagnostic Radiology: Daniel function that may be disrupted larynx, salivary gland, sinonasal Williams, MD during large head and neck cavity, thyroid, and other head and ablative surgeries. Minimally Consultations with nutritionists, neck sites. invasive surgical techniques include speech/language pathologists endoscopic resection techniques The number of patients treated and other adjunctive services are such as transoral robotic surgery represents a large incidence of oral coordinated. Each new patient (TORS), and have proven cavity and oropharyngeal tumors, is evaluated by appropriate invaluable in treatment of tumors as well as laryngeal cancers treated team members, and a treatment of the pharynx and larynx for many relative to national incidence plan is recommended to the patients. Endoscopic resection of figures. These figures confirm the patient and referring physician. selected skull-base tumors through recognition of excellence and Resident attendance at the clinics a nasal approach is also offered. confidence in care delivery of the is encouraged for educational Advanced protocols utilizing the head and neck cancer team at benefits. In addition to discussion most up-to-date strategies for Wake Forest Baptist. of new cases, related clinical radiotherapy and chemotherapy research projects and didactic are offered to appropriate patients A multidisciplinary Head and topics of interest are presented. Neck Oncology Tumor Board in either definitive or adjunct meets weekly, and is staffed by The coordination of multiple treatment settings. The Gamma representatives of the following disciplines in the care of head and Knife stereotactic radiation unit is departments: neck cancer patients is essential. nationally known and available as These conferences allow for better well for select patients. ▶▶ Otolaryngology: J. Dale Browne, patient convenience and timing of Multiple research trials are under MD, Christopher Sullivan, MD, and appointments, as well as closer and way, an important component of Joshua Waltonen, MD (general more effective physician consultive the treatment and surveillance of head and neck oncology/skull base planning and management head and neck cancer patients. surgery/ thyroid tumors/head and decisions in such a setting. neck cancer reconstruction) Several publications in prestigious Current surgical, radiation and journals and presentations at ▶▶ Radiation Oncology: Kathryn chemotherapeutic strategies national meetings result each year Greven, MD, and Bart Frizzell, MD emphasize state-of-the-art from these trials. ▶▶ Medical Oncology: Mercedes techniques that are designed

12 2015 CANCER PROGRAM ACTIVITIES more than

4,222 new patient encounters

HEMATOLOGY AND ONCOLOGY

The Section on Hematology and apheresis program and Special ▶▶ To meet the medical, emotional Oncology emphasizes clinical Hematology lab, in addition to and informational needs of patients and translational research and the managing a busy protocol support and their families. multidisciplinary care of patients with laboratory and maintaining ▶▶ To enhance the opportunity for cancer and hematologic diseases. multidisciplinary clinics for patients focused clinical and translational The full spectrum of Hematologic with a variety of benign hematologic research. and Oncologic disorders are expertly conditions. A nationally recognized treated by the Section’s faculty while Psychosocial Oncology program, Forty-two MD and PhD members areas of special multidisciplinary established more than two decades compose the full-time faculty of focus include the Prostate, Breast and ago, continues to be led and staffed the Section of Hematology and Brain Tumor Centers of Excellence by Section faculty as well. In 2015, a Oncology, and the clinical mission within the Cancer Center. Other multidisciplinary Precision Oncology of the Section is also supported areas of particular programmatic program was begun to leverage by 25 Physician Assistants and expertise include clinical and state-of-the-art tumor genome Nurse Practitioners. During the research programs involving patients sequencing technology in order to 2014–2015 academic year, this with leukemia and lymphoma, identify and match specific genetic group accounted for a total of 4,222 myelodysplasia, myeloma, lung abnormalities present in patients’ new patient encounters and 88,837 cancer, head and neck cancers, tumors with currently available return and outpatient treatment gastrointestinal cancers, genitourinary therapeutic agents that target those visits. In 2015, the marrow transplant cancers, sarcoma, melanoma, and abnormalities. The goals of these and service provided 119 patients those requiring marrow and stem cell other team efforts are to: with potentially life-saving bone transplants or specialized geriatric marrow or stem cell transplants. ▶ To optimize and personalize the oncologic care. Hematology faculty ▶ In addition, the Section maintains care of patients with cancer and in the Section lead the institution’s a longstanding commitment to blood disorders. training the Hematology and Oncology practitioners of the future; 12 clinical fellows are contin- uously enrolled in our three-year, ACGME-accredited Hematology and Oncology Fellowship training program. The training program also participates in and is compliant with the QOPI initiative — a program instituted by the American Society of Clinical Oncology to ensure patient- centered quality care and provide a mechanism for continuous quality assessment and quality improvement within our patient care programs. Hematology and Oncology faculty members remain committed to the educational mission of the Medical Center at large and play major

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2015 CANCER PROGRAM ACTIVITIES 13 teaching roles in the medical student delivery research protocols within understanding the mechanisms curriculum and the Internal Medicine a network of community oncology of resistance of current leukemia resident and physician assistant practices across the country) therapies. student training programs. They In 2014 – 2015, Section members ▶▶ Understanding and enhancing the also serve as clinical and research enrolled almost 1,000 patients oncolytic activity of the vesicular mentors for a large number of on a full spectrum of treatment, stomatitis virus and using this virus medical students, residents, graduate non-treatment and ancillary clinical as part of a multitargeted strategy students and post-doctoral fellows trials including phase I, II and III for patients with head and neck involved in cancer-related bench or cooperative group, investigator-ini- cancers. clinical research activities. tiated and industry-sponsored ▶▶ Evaluating novel therapeutics to As a group, Section of Hematology studies. As part of our educational prevent and treat graft-versus-host and Oncology faculty remain mission, Section faculty continue to disease. committed to providing state- lead the Charles L. Spurr Piedmont Hospital-based activity for the of-the-art novel therapies to our Oncology Symposium, which was Section continues to be centered patients. Multiple faculty members established over 30 years ago as the around five inpatient services: two serve in leadership positions within Piedmont Oncology Association by general Hematology and Oncology a variety of national oncology Dr. Spurr, the founding director of services, a leukemia service, a blood cooperative trial groups including: our Cancer Center. The symposium occurs semiannually and brings and marrow transplant (BMT) service ▶▶ The Alliance for Clinical Trials together regional and national and a hospitalist-run service that in Oncology (a merging of the experts to provide CME updates pairs hospitalists and hematologist/ cooperative groups CALGB for Hematology and Oncology oncologist consultants to care for [Cancer and Leukemia Group B], physicians, fellows, nurses and patients with medical complications NCCTG [North Central Clinical research staff throughout the of their malignant and hematologic Trials Group] and ACOSOG Southeast. disorders. In addition, Hematology [American College of Surgeons and Oncology faculty continuously Oncology Group]) A number of faculty members also staff a busy inpatient consult service. maintain active funded basic and A smooth transition between ▶▶ ABTC (Adult Brain Tumor translational science laboratories in inpatient and outpatient care is a goal Consortium) addition to their clinical duties. The of our efforts to provide excellent ▶▶ The Wake Forest NCORP Research focus of these lab efforts include: patient care. Base (a National Cancer Institute- funded cooperative group ▶▶ The development of new treatment In addition to the inpatient and headquartered at Wake Forest strategies for patients with outpatient activities at Wake Forest Baptist that develops and leads melanoma. Baptist Medical Center, Hematology cancer prevention and control ▶▶ Finding novel therapeutics for and Oncology faculty also maintain clinical trials and cancer care patients with acute leukemias and full-time, full-service practices in Clemmons, Elkin, Lexington, Mount Airy and Statesville. A regional practice based at the Veterans Hospital in Salisbury is staffed by multiple faculty members, and new outpatient VA clinics will soon be open in Kernersville and Charlotte. These locations allow military service members and their dependents to receive cancer and blood disorder care much closer to home than was previously possible.

14 2015 CANCER PROGRAM ACTIVITIES DEPARTMENT OF OPHTHALMOLOGY The Wake Forest Baptist Health implant is sutured to the eye wall to minimize eyelid and facial tissue Eye Center and the Department overlying the tumor, delivering a loss with tumor removal, that, in of Ophthalmology, part of the dose of radiation to the melanoma turn, minimizes the complexity Division of Surgical Sciences at in order to shrink it. This procedure of oculofacial repairs, enhancing Wake Forest School of Medicine, is performed by Craig Greven MD, functional and cosmetic outcomes. offer comprehensive ophthalmic in conjunction with the Department Malignant tumors of the ocular tumor diagnosis and treatment to of Radiation Oncology. Also, surface are treated not only by people in western North Carolina, transpupillary thermotherapy is a Dr. Yeatts but also by Matthew South Carolina, eastern Tennessee, new laser procedure that can be Giegengack, MD, a corneal southwestern Virginia and West used to treat melanomas of the and external disease specialist. Virginia. Primary and secondary choroid. Malignancies of ocular surface neoplasms of the eye, ocular Tumors of the eyelids and orbit may be treated surgically, with adnexa and orbit are evaluated are managed by Patrick YYeatts, cryotherapy or with topical and treated using state-of-the-art MD, and Molly Fuller, MD, of the chemotherapy. Treatment regimens technology. Orbital and Oculoplastic surgery are tailored to the individual The most common primary service. Lymphoma, a malignancy patient and may include one or malignant intraocular neoplasm with frequent orbit involvement in all three modalities in an effort in adults is choroidal melanoma. adults, and rhabdomyosarcoma, to preserve vision and limit The incidence of choroidal the most common primary complications of treatment. A focus melanoma is about six people malignant orbital tumor in of Dr. Yeatts’ current investigation per 1 million population, and childhood, often present to the is the use of topical chemotherapy 12 to 20 new patients with this orbital service for evaluation. agents in treating ocular surface diagnosis are evaluated and Our surgeons work closely with neoplasms. In addition to treated annually at the Eye Center. physicians in the Department of treatment of neoplasms, Dr. Previously, intraocular melanomas Neurosurgery and Otolaryngology, Giegengack is an expert in ocular were treated by enucleation, providing a multidisciplinary surface reconstruction. removal of the eye. Although approach to tumors occurring in Eye Center physicians use a some melanomas still need to be the sinuses and anterior cranial multidisciplinary approach in the treated by this modality, many fossa that may encroach upon management of ocular and orbital eyes can now be salvaged and the eye and orbit. For tumors that neoplasms. The collaborative treated by Iodine 125 radioactive occur on the eyelids and face, Drs. efforts of the Eye Center and other plaque application. This treatment Yeatts and Fuller work closely with specialists at Wake Forest Baptist is a combined surgical-radiation colleagues in the Department of allow state-of-the-art oncologic modality in which a radioactive Dermatology, who use techniques treatment for patients.

2015 CANCER PROGRAM ACTIVITIES 15 ORTHOPAEDIC ONCOLOGY Orthopaedic Oncology, part of accuracy of identifying exactly where close working relationship with faculty the Cancer and Musculoskeletal the tumor is in multiple dimensions. members from the musculoskeletal Service Lines, is committed to the Limb-sparing operations, where radiology section of the Department comprehensive and specialized care resection of malignant bone tumors is of Radiology. of patients with tumors. Within the followed by innovative reconstruction Because of the complexity of tumors, department, there are two fellowship- techniques — including modular interdepartmental communication trained orthopaedic oncologists, endoprostheses, allograft utilization, is critical. This has led not only to Scott Wilson, MD, and Cynthia Emory, and free vascularized bone and tissue improved patient care but also to MD, who see adult and pediatric transfers — are often performed. innovative research with colleagues patients in the Comprehensive They have allowed limbs to be saved in several other departments. Cancer Center three days a week that previously would have required Current clinical trials include the and make every attempt to see new amputation. Patients with these surgical treatment of metastatic patients within 72 hours of referral. tumors are routinely treated with limb tumors in the arm with an innovative Colleagues in Medical Oncology, salvage techniques due to advances and minimally invasive implant to Radiation Oncology, Musculoskeletal in earlier detection and adjuvant improve patients’ pain and function. Radiology and Pathology are treatment with chemotherapy and Regular orthopaedic oncology immediately available for consultation or radiotherapy. An extremely close teaching conferences are part of and collaboration, contributing working relationship with faculty from the core curriculum to train the greatly to the team approach. Drs. both medical oncology and radiation next generation of orthopaedic Wilson and Emory facilitate the oncology has further developed our surgeons in addition to an annual needs of patients, often collaborating team approach for the treatment of orthopaedic oncology review course. with other surgical specialists at the bone and soft tissue sarcomas. Regularly scheduled multidisciplinary medical center — including general Benign lesions of bone and soft conferences enable the Orthopaedic surgical oncologists, spine surgeons, tissues are encountered more Oncology team to review the clinical pediatric surgeons and plastic frequently than primary malignant findings in conjunction with the surgeons — to maximize patient tumors and account for many of the radiology and pathology of tumors outcomes and the treatment of surgeries performed. However, many with colleagues from other disciplines complex conditions. benign bone and soft tissue lesions so that the team can make optimal There are three primary categories can be treated without surgery, with treatment recommendations for of tumors treated by Orthopaedic the diagnosis obtained by a variety patients. Oncology: Benign and malignant soft of studies including radiographs, A special effort is made to see all tissue tumors, benign and malignant nuclear bone scans, CT scans, MR new tumor patients within one week, bone tumors, and metastatic bone imaging, and needle or open biopsy. and most can be seen within 24 to 48 lesions. This reliance on sophisticated hours for urgent referrals. radiographic imaging has led to a Every year, more than 400 operations are performed for orthopaedic tumors or tumor-related conditions. Initiation of treatment starts with a biopsy to determine the type of tumor. Most biopsies are now performed as small needle biopsies in the office, avoiding the cost, risk, pain and inconvenience of an open biopsy in the operating room. Patients will often know their diagnosis on the same day as their office biopsy, facilitating rapid implementation of treatment.

New technologies are routinely embraced. The orthopaedic oncology surgeons use intraoperative CT and computer navigation for complex pelvic tumor surgery, improving the

16 2015 CANCER PROGRAM ACTIVITIES PEDIATRIC ONCOLOGY The Pediatric Oncology program is a weekly Pediatric Oncology oncology services, and is also a sees 60 – 70 new oncology patients team meeting as well as a pediatric mentor for the medical school’s per year. It accepts newly diagnosed tumor conference every other week, learning communities (“houses”). Dr. patients through age 18. A dedicated which includes pediatric surgeons, Dixon is the director of the pediatric hematology/oncology unit in Brenner radiation oncologists, pathologists, hemoglobinopathy and hemophilia Children’s Hospital contains 16 radiologists, residents and medical programs. Her primary interests are private inpatient beds, five outpatient students. in pediatric hematology; specifically clinic rooms and a day hospital/ anemia, general non-malignant There is a dedicated, long-term observation area. Patients come from hematology, hemoglobinopathies, follow-up program with a focus the Piedmont and central/western and thrombotic and hemorrhagic on education and cancer control North Carolina, as well as southwest disorders in children. Dr. Buckley’s for adolescent and young adult Virginia and southern West Virginia. interests include general pediatric survivors. The Children’s Cancer Most referrals come from pedia- hematology/ oncology, infections in Support Program (CCSP) is staffed tricians and family practitioners. immunocompromised populations with a full-time counselor/director, and immune reconstitution after Pediatric Oncology is staffed by five with the focus being patient non-myeloablative chemotherapy. pediatric hematologists/oncologists: education as well as many levels In addition to pediatric hematology/ Marcia Wofford, MD, Tom McLean, of individual and group social and oncology, Dr. Buckley is also board MD, Natalia Dixon, MD, Kevin psychological support for active and certified in pediatric infectious Buckley, MD, and Thomas Russell, off-therapy patients and families. diseases. Dr. Russell practices general MD. It has four pediatric nurse The CCSP conducts a support pediatric hematology/oncology. He practitioners, a physician’s assistant, group for adolescents and has a has a wide range of clinical interests a doctor of pharmacy, two clinical Pediatric “PAL” program that pairs and is also a dedicated and enthu- research associates and a patient interested medical students with siastic educator. He is an Associate navigator. There are numerous specific patients for emotional and Director of the Pediatrics Residency dedicated pediatric hematology/ psychosocial support. Pediatric Program. In addition to the pediatric oncology nurses for clinic and Oncology is an active member of the hematologists/oncologists, Pediatric hospital work, as well as a home Children’s Oncology Group (COG). Oncology has active COG members and school visitation program for Dr. Wofford, the former section chief, from the disciplines of surgery, children with cancer. The Pediatric is now Associate Dean for Student pathology, radiation oncology, Oncology Psychosocial Team Affairs for Wake Forest School of radiology, nursing, pharmacy, cytoge- is composed of a social worker, Medicine. She continues to practice netics and data management. counselor, child life specialist, art pediatric hematology/oncology. Dr. therapist and chaplain. Pediatric McLean serves as the section chief of Oncology receives professional Pediatric Hematology/Oncology, is support from therapists, nutritionists the medical director of the inpatient and pediatric pharmacists. There and outpatient pediatric hematology/

2015 CANCER PROGRAM ACTIVITIES 17 PHARMACY The Pharmacy Department combines pharmacy students and clinical clinical, educational and research pharmacists present research projects missions in its services to patients and at regional and national professional the Cancer Program. Pharmacists and meetings. pharmacy technicians are involved The Pharmacy Department is a global in ensuring safe medication-related leader in adoption of automated transitions of care through medication intravenous medication preparation reconciliation and patient education. through its partnership with Loccioni. Pharmacists optimize pharmaceutical Since 2012, more than 20,000 care through active participation doses have been compounded on the patient care team. The team on the Italian-made APOTECA in 2015 prepared more than 33,000 chemotherapy compounding doses of intravenous chemotherapy robot. Using high-precision robotics across both inpatient and outpatient helps ensure safety in preparation care areas. for patients, family members and The Wake Forest Baptist Health employees. Through this partnership, Pharmacy and Specialty Pharmacy a new device that assists technicians provide drug-specific pharmaceutical in making chemotherapy that cannot care plans and routine patient be made on the robot was created, follow-up. Pharmacists secure access leveraging the same safety tools as to limited-distribution oral oncology the robot. Over the last year greater agents through Wake Forest Baptist- than 80 percent of all chemotherapy operated pharmacies. Over 30,000 was made on the APOTECA platform. prescriptions were dispensed in the Eventually, all chemotherapy will Cancer Center community pharmacy be made and tracked on one in 2015, with over 1,600 prescriptions coordinated system, globally a first of for oral chemotherapy. The pharmacy its kind. team works with insurance companies to minimize the time from physician prescribing to delivery to the patient.

Fulfilling its educational mission, the Pharmacy Department offers a postgraduate Year 2 specialty pharmacy residency program to train pharmacists to care for cancer patients. It also trains medical students and residents through participation on the patient care team. Students from regional schools of pharmacy also are incorporated into the pharmacy care model.

As part of its research mission, the Pharmacy Department provides oversight of investigational studies through protocol review and research committee participation. Pharmacy operations ensure proper storage and preparation of investigational agents. Pharmacy residents,

18 2015 CANCER PROGRAM ACTIVITIES PUBLIC EDUCATION One of the Comprehensive Cancer Center’s goals is promoting public awareness of cancer. Prevention and early detection are stressed through educational programs and activities. The following were highlights of our ▶▶ BestHealth: Preventing Colon ▶▶ “What you need to know about public awareness program. Cancer breast disease”: A talk given to OB/Gyn grand rounds ▶▶ BestHealth: Breast Navigation ▶▶ Bowman Gray Stadium: Breast Navigation ▶▶ Lung Cancer Screening: A talk to ▶ St. Andrew’s Presbyterian Church ▶ community practices Health Fair: Breast Navigation ▶▶ RockTenn Employee Expo ▶▶ Get Your Rear in Gear ▶▶ Hispanic Latino Community ▶▶ Community Health Day at Education and Outreach Panel Lexington Medical Center ▶▶ “Colon and Rectal Cancer: Know Your History, Change Your Risks”: A Discussion: Discussion concerning ▶▶ Teaming Up Against Breast Cancer: end-of-life care and advance care African-American women of all talk given at Davie Medical Center planning ages hear from experts sharing ▶▶ 6th Annual Clemmons ▶▶ Stand Up To Cancer about screening and prevention Community Day and from breast cancer survivors. ▶▶ 9th Annual Breast Cancer ▶▶ Cancer Services’ Wrapped Up in Symposium ▶▶ Piedmont Triad Airport: Breast Ribbons Navigation ▶▶ Susan G. Komen Race for the Cure ▶▶ Komen Hispanic Community ▶▶ William Sims Center: Breast Outreach: Hispanic Clinical Trial ▶ Pink Ribbons Talk: Cancer Services ▶ Navigation Navigator ▶▶ Health Fair: UNCG: Employee ▶▶ BestHealth: Skin Cancer Prevention ▶▶ “Colon and Rectal Cancer”: A talk Wellness Expo given at Lexington Medical Center ▶▶ National General Wellness Fair ▶▶ BestHealth: Good Nutrition for ▶▶ Cancer Recovery Skills Group Class Your Shopping Basket ▶▶ Wake Forest School of Medicine: Share the Health Fair ▶▶ Inmar Health Fair ▶▶ “Benign and Malignant Breast Disease”: A talk given at the Arbor ▶▶ ACS – Road Rally: Volunteers ▶▶ ACS Relay for Life donate their time and use of their Acres Retirement Community ▶▶ “Skin Cancer: Diagnosis and vehicle to transport patients to ▶ BestHealth: Assess Your Cancer Prevention”: A talk given in Sticht ▶ their cancer treatments Risks Center Auditorium ▶▶ Pink Night Basketball Game ▶▶ Gospel Light Baptist Church: Breast ▶▶ Free Skin Cancer Screening ▶ Davie Medical Center: Breast Navigation ▶ ▶▶ 24th Annual Cancer Survivors Day Navigation ▶▶ Mt. Zion Baptist Church: Breast 2015 “: Celebration of Life” ▶▶ Winterlark fundraiser Navigation ▶▶ Lung Cancer Initiative of NC: A ▶▶ Oracle Employee Health Fair ▶▶ “Breast Disease 101”: A talk Network of Hope and Action given to Year 2 medical students’ ▶ BestHealth: Gluten-free Diets: ▶ women’s health block When Are They Appropriate? ▶▶ BestHealth: BMI Screening

2015 CANCER PROGRAM ACTIVITIES 19 more than $640,000 in grants

RADIATION ONCOLOGY Radiation Oncology continues to areas under active investigation in grow as it strives to become a “Top the Radiation Biology laboratories. 10” radiation oncology department Bio-anatomic radiation therapy nationally. There are currently 10 treatment planning and delivery, radiation oncologists, nine radiation integrating functional and physicists and two radiation bio-physiological imaging with biologists. The department enjoys MRI, MR spectroscopy and positron the Outpatient Comprehensive emission tomography are all areas of Cancer Center building with active investigation by the Radiation multidisciplinary cancer care from Physics section. medical and surgical oncology The Gamma Knife Stereotactic as well as diagnostic radiology. Radiosurgery (GKSRS) program With in-department CT/PET and was initiated in 1999 and continues MRI scanners as radiation therapy physicians joined our professional to be one of the seven busiest simulation devices, the department staff in February 2014, adding to the in the United States, treating is one of the most technologically physics services previously provided. approximately 35 patients per sophisticated in the world. In total, Radiation Oncology and its month. The Stereotactic Body affiliated practices treat more than The Radiation Oncology Radiotherapy (SBRT) program 160 patients per day with radiation Residency Training Program is one of the select few in the therapy, making this the largest attracts high-quality residents and nation, with nearly a decade of provider of radiation therapy services currently has six serving. The ratio experience treating more than 4,600 in the Piedmont Triad and north of applicants to positions is about patients in that time. Other new central North Carolina. 100 to one. Radiation physics and programs and technologies now both classical/molecular radiation in clinical use include high-dose In the past year, the main campus biology are taught to the residents, rate brachytherapy, brachytherapy and regional practices consulted who also spend six to 12 months simulation and treatment 3,400 patients, saw more than performing basic laboratory planning utilizing the Integrated 5,400 in follow-up and treated research. The department received Brachytherapy Unit, fractionated more than 2,750 with external an NIH/NCI T32 Training Grant in stereotactic radiotherapy, intensity beam radiation therapy and more 2005, which ended in 2015. Focused modulated radiation therapy, than 700 with special procedures on translational radiation oncology image-guided radiation therapy and including Gamma Knife/ for post-doctoral fellows in clinical Volumetric Arc Therapy (VMAT). Stereotactic radiosurgery, prostate radiation oncology, biology and and gynecologic brachytherapy, Radiation Oncology has three physics, four trainees completed the total body irradiation and image- affiliated practices in west central program. guided radiation. In summary, the North Carolina that are staffed Department of Radiation Oncology Clinical and basic research activities with physicians and physicists is well positioned locally, regionally, are supported with NIH/NCI grants, from Wake Forest Baptist: Hugh nationally and internationally as a foundation/society grants and Chatham Memorial Hospital leader in the treatment and research industry grants totaling $640,000. in Elkin, Lexington Medical of radiation therapy for malignant Novel radiation dose modifying Center – Radiation Oncology and select benign diseases. agents and the study of radiation and Iredell Memorial Hospital in injury to the normal tissues are two Statesville. Iredell Memorial Hospital

20 2015 CANCER PROGRAM ACTIVITIES SUPPORTIVE CARE AND SURVIVORSHIP SERVICES

The Comprehensive Cancer Center Volunteers are active in hospital medical students on medicine and has two programs designed to visitation and providing hospitality psychosocial issues in oncology, and address the emotional needs of and refreshments in the Hematology chemotherapy classes within the patients and family members. The and Oncology and Radiation hospital. The POP is funded through unique integration of psychosocial Oncology clinics. These core fee-for-service activity and grants. support and counseling services volunteers are supported by another The Cancer Patient Support and into the Hematology and Oncology group of about 80 community Psychosocial Oncology programs Clinic distinguishes the Cancer volunteers who are active in the have been designed to meet a wide Center from many others in the annual Winterlark fundraiser, the range of patient needs. Most cancer nation and strengthens the capability annual Survivor’s Day Celebration patients and their families do not to provide multidimensional care. and numerous celebration activities need intensive psychosocial care, but Such an integrative model allows throughout the year. rather supportive services provided for interdisciplinary collaboration The Psychosocial Oncology through volunteers and professional and the delivery of mental health Program (POP) counselors. CPSP and POP are services in conjunction with medical positioned to take care of intensely care. The CPSP/POP is woven into The Psychosocial Oncology Program disturbed patients as well as those the Supportive Care and Survivorship began as the Psychological Services proceeding through a “normal” crisis Services Network at Wake Forest arm of the Cancer Center in 1988, during diagnosis and treatment. Baptist, which makes available with the purpose of providing Studies conducted in our outpatient a variety of integrative medicine psychological assessment and clinic have shown that a new cancer services for patients and family counseling for patients and family diagnosis is extremely distressing, yet members. members suffering from more intense psychological disturbance. Patients can be modified by a simple orien- tation procedure. PSYCHOSOCIAL ONCOLOGY often need help with symptom SERVICES management, including anxiety and depression, family conflict and The Cancer Patient Support communication conflicts with the Program (CPSP) health care team. Additional services The mission of the Cancer Patient include general supportive counseling Support Program is to provide social and specific behavioral procedures, support for cancer survivors and including relaxation training and family members with the goal of stress management. This program enhancing quality of life during the provides psychological screening and diagnosis and treatment process. quality-of-life assessment for all bone Services from this program are marrow transplant patients prior to provided at no charge to the patient transplantation. and family members. The POP also maintains active There are six full-time equivalent staff research and teaching agendas. members and about 30 weekly core Current lines of research focus on volunteers who provide a variety of fear of cancer recurrence and the services in the clinic and hospital. long-term quality of life of patients Services delivered by professional undergoing extreme treatments staff include individual and family (such as stem cell transplantation) counseling, inpatient consultation/ as well as the variables affecting liaison work, music/harp therapy, new patients’ and caregivers’ attitudes patient survivorship orientation and toward the completion of advance educational groups, and education directives. Staff members publish and and training for staff at Wake Forest present findings at local and national Baptist. The CPSP also supports conferences, and look to research inpatient therapeutic massage on a findings to inform clinical practice. referral basis and assists with financial Teaching activities have included and temporary housing support for a psychosocial seminar for fellows, patients in need. lectures to first- and second-year continues on next page

2015 CANCER PROGRAM ACTIVITIES 21 The CPSP and POP programs ▶▶Mindfulness-based Stress assist in ensuring that these goals represent unique offerings within the Reduction: Learn practices to be honored during moments of administrative structure of the Cancer cultivate calmness and relaxation. serious illness. Through proactive Center and Section of Hematology conversations with loved ones, ▶▶Therapeutic Music is offered and Oncology. The CPSP/POP and through a trained harpist and a family members and friends can Supportive Care and Survivorship group of volunteer musicians. provide a gift of love through Services Network at WFBH make understanding the goals of care. available a variety of services SUPPORTIVE SERVICES ▶▶Patient Financial Resources including massage therapy, psychiatry, Services: Resource recovery ▶▶Genetic Counseling: Conducts risk social work, pastoral care and others. specialists provide financial relief to Because both the CPSP and POP are assessment for hereditary cancer syndromes. patients and families who do not located within Cancer Center clinics have the resources to pay for health (Hematology and Oncology, radiation ▶▶Nutrition Counseling and care services. These specialists therapy and surgery), they are highly Education: Available at the will assist patients and families visible and well received. The CPSP outpatient Cancer Center to in establishing payment plans, and POP continue to help patients help manage treatment-related pursuing financial assistance from and family members maintain quality nutrition side effects such as weight Medicaid and agency programs, of life during and after treatment. loss, nausea, sore or dry mouth, and applying for charity care and constipation or diarrhea, taste other discounts. SUPPORTIVE CARE AND changes and difficulty swallowing. ▶▶Patient Advocate: Cancer SURVIVORSHIP SERVICES Symptoms can often be minimized with some dietary changes. Services, Inc. assists patients and ▶▶Gentle Yoga: These classes are families in addressing the financial open to cancer patients and ▶▶Palliative Care: Enhances quality and social challenges that people survivors and their close family of life, prevents and relieves with cancer often encounter. members or friends. Mats and suffering of patients with serious ▶Physical Therapy (PT) and equipment are available. Classes and/or terminal illness. ▶ Occupational Therapy (OT): PT are held in the Meditation Room, ▶▶Pastoral Care: Chaplains are rehabilitates gross motor skills. OT second floor, Outpatient Cancer available for individual consul- improves specific movements and Center. Individual sessions may be tation, prayer and planning of tasks. Lymphedema management set up free of charge. advance directives. A chaplain helps reduce enlargement, fullness ▶▶Guided Imagery and Hypnosis: leads a brief meditation on the first and achiness after a lumpectomy. Suggestive guidance in a trance Wednesday of every month at 1:30 ▶Social Work Services: Located on state helps patients manage pain pm in the Meditation Room on the ▶ the third floor of the Outpatient and nausea and improve coping. second floor of the Cancer Center. Additionally, services are held in Comprehensive Cancer Center, ▶▶Massage Therapy: Eight types of Davis Chapel on Sunday at 10 am Social Work Services can assist massage are offered in the Cancer and Monday, Wednesday and with finding financial resources, Center, at the Sticht Center and at Friday at noon. coping with illness, caregiver stress, CompRehab. working with the medical team to ▶▶Conversations of Love (Advance ▶▶Meditation Room: Located on set up and coordinate home care, Directive Education): In an the second floor of the outpatient ordering medical equipment, and informal setting, one of Wake Cancer Center, this room is set general information and referral. Forest Baptist’s chaplains lead aside for quiet meditation or discussions about how individual prayer. values shape goals for medical care during times of illness, and how advance care planning can

22 2015 CANCER PROGRAM ACTIVITIES CANCER SURVIVORSHIP PROGRAM The Cancer Center is dedicated care to breast cancer patients in two clinic providers are nurse practitioners to the continued growth and clinics at Wake Forest Baptist Health with a specialty in the care of breast development of the Cancer Medical Plaza-Clemmons. These and lung cancer patients. The Blood Survivorship Program. In 2014, the clinics typically see 15 to 20 patients and Marrow Transplant Program also program became a department of per week for long-term survivorship began a survivorship program in the Cancer and Blood Disorders follow-up care. The lung cancer January 2016, serving an average of 4 Service Line and has been providing survivorship clinic began seeing lung patients per week. focused cancer survivorship follow-up cancer survivors in January 2015. The

SURGICAL ONCOLOGY Surgical Oncology is a key component of the Comprehensive Cancer Center. It is extensively involved in multimodality consultations for the care of patients with melanoma, sarcoma, endocrine tumors and diseases of the breast, as well as the full spectrum of gastrointestinal malignancy from esophagus to anus. The service is very busy, with approximately 1,500 major operative cases and more than 8,000 outpatient visits per year.

The clinical service includes seven fellowship-trained surgical oncologists,, two surgical oncology fellows, four surgical house officers, two to three medical students, five advanced practitioners and four nurses. Edward Levine, MD (Chief of the Service), Russell Howerton, MD, Perry Shen, MD, Marissa Howard- McNatt, MD, Kostas Votanopoulos, is staffed by surgical oncology, Esophageal cancer is evaluated by a MD, Jennifer Cannon, MD, and medical oncology, radiation oncology, multimodality team led by Dr. Levine. Clancy Clark, MD, serve as the advanced nursing practitioners, plastic The team was previously awarded clinical faculty. Specialized advanced surgeons, research nurses, clinic grants from the National Cancer nurses support the breast care clinic, navigators and genetic counselors. Institute to evaluate new imaging inpatient surgical oncology and The BCC was among the first to be technology, which could help define gastrointestinal tumor care. The recognized by and continues to be the patients who achieve a complete clinical research effort is supported by certified by the NAPBC, and accred- response to chemotherapy and two research nurses and two full-time itation was renewed for three years radiation. The results of these research data managers. in 2015. The BCC facilitates complex efforts have been published and are CLINICAL INITIATIVES multimodality care in a setting that widely cited, and our multimodality fosters participation in state-of-the-art team serves as a regional reference The multimodality Breast Care Clinic research trials. Dr. Howard-McNatt clinic for care of patients with (BCC) was founded in January 2000 is the lead breast surgeon for this cancer of the esophagus. Newer and is an integral part of Surgical clinic, and supervised an expansion approaches to therapy, including Oncology. The BCC evaluates about of the clinic to the Clemmons office. minimally invasive esophagectomy, 100 breast patients every week, with Additionally, we have broadened our are now part of the standard care for more than 350 new breast cancer long-term survivor clinics for breast these patients. The team includes cases evaluated in 2015. The BCC cancer. not only surgical oncology, but

continues on next page 2015 CANCER PROGRAM ACTIVITIES 23 radiation and medical oncology, Chemotherapy (HIPEC) is nationally melanoma, sarcoma, endocrine as well as gastroenterologists with and internationally recognized. tumors and diseases of the breast, specific experience and expertise This program is led by Dr. Levine, as well as the full spectrum of in esophageal cancer. These efforts with the support of Drs. Shen and gastrointestinal malignancies, from are supported by an advanced nurse Votanopoulos. We currently perform esophagus to anus. This includes coordinator. about 100 HIPEC cases annually, preoperative and postoperative care, with more than 1,250 cases followed in addition to operative management. HepatoPancreaticoBiliary (HPB) in our prospective data registry for The BCC also hosts house officers surgery relates to complex liver and HIPEC survivors. Ours is one of the from Gynecology, Internal Medicine pancreas surgery, led by Dr. Shen, largest experiences with this complex and Family Medicine. with Drs. Howerton and Clark. Dr. modality worldwide. Dr. Levine Shen heads a clinical team supported A weekly multidisciplinary/ and the HIPEC team published the by a weekly CME-accredited HPB multimodality surgical oncology largest single institutional experience multimodality conference. The conference, which serves as the with HIPEC with over 1,000 patients group is now working on minimally CME-accredited “tumor board’’ treated, in the Journal of the invasive approaches to hepatic for the institution, meets Fridays at American College of Surgeons 2014; resection, and has performed several noon in the Cancer Center. This is 518: 573-587.This HIPEC program successful “robotic” resections. supplemented by a CME-accredited continues to draw patients from Newer approaches to liver surgery HPB tumor conference meeting around the country and is linked to have afforded improved outcomes weekly on Tuesdays at noon. On a variety of research initiatives, such not only to patients with primary Sept. 25, 2015 Surgical Oncology as the largest quality-of-life study for hepatic tumors, but those with sponsored its 10th annual breast HIPEC patients worldwide. Dr. Levine cancers metastatic to the liver as well. cancer symposium, and on October was recently awarded a research grant Extensive experience with newer 23, 2015, ran a well-attended HPB from the National Organization for approaches to pancreatic tumors and conference. Rare Diseases (NORD) to continue the disease has led to streamlined care lead groundbreaking research into the A surgical oncology fellowship plans for patients as well as research genetics of cancer of the appendix, was initiated in 2010. The two-year initiatives for pancreatic patients. which commonly benefits from fellowship is for general surgeons Dr. Votanopoulos continues his efforts therapy with HIPEC. seeking additional qualifications and to bring surgical oncology expertise training in advanced techniques in beyond the main campus. He leads EDUCATION surgery and oncology training. All of the General Surgery effort at the VA – Faculty members of Surgical the fellows to complete the program Salisbury, while maintaining an active Oncology are dedicated to teaching have obtained faculty positions practice at the Cancer Center on the the next generation of physicians (at Georgetown, Johns Hopkins, main campus. He has a broad-based to care for those with oncologic Louisiana State University and Eastern surgical oncology practice and has diseases. Trainees on service are Virginia University). The American been increasingly active in research, part of a team bringing considerable Board of Surgery recently created a and recently completed his PhD, clinical expertise to serve patients new certification program in Surgical as well. who require cancer staging, treatment Oncology. Our application to the Board of Surgery for accreditation Dr. Jennifer Cannon brings additional and follow-up due to primary, was approved last year and our expertise in the care of endocrine recurrent or metastatic malignancy. fellowship is now fully accredited (one tumors to the Surgical Oncology A substantial portion of clinical effort of only 23 programs in North America team. She has already expanded the is also devoted to the resection of so honored). capabilities for treatment of the full metastatic disease, including that of spectrum of endocrine tumors of the the liver, lung, peritoneum and lymph thyroid and parathyroid. She has also nodes. Extensive clinical experience initiated minimally invasive adrenal in a tertiary referral setting provides gland (adrenalectomy) procedures. the surgical know-how for dealing with rare and unusual neoplasms. Our innovative treatment of With this rich background, fellows, malignant disease that has spread house staff and medical students on throughout the peritoneal cavity the service are extensively involved with cytoreductive surgery and in multimodality consultations for Hyperthermic Intraperitoneal the care of cancer patients with

24 2015 CANCER PROGRAM ACTIVITIES Surgical Oncology holds more than $500,000 in active extramural funding

RESEARCH and research faculty of Surgical evaluating innovative ways to Surgical Oncology actively supports Oncology holds more than $500,000 treat primary and metastatic liver research in basic science, translational in active extramural funding, as well tumors. Dr. Clark has also initiated science and clinical arenas. Clinical as receiving significant philanthropic innovative research evaluating “fit trials in association with the NRG assets for cancer research. bit” data for predicting outcomes for older patients undergoing are coordinated by Dr. Levine, who Translational research projects major cancer surgery. Dr. Howard- serves as their principal investigator. evaluating genetic and proteomic McNatt published research this year Surgical Oncology also collaborates changes associated with cancer of evaluating the impact of genetic with investigators in the Alliance the breast, GI and hepatobiliary testing for familial breast cancer on group, as well as other members of malignancy, as well as peritoneal surgical decision-making. the Cancer Center, including Public carcinomatosis, are ongoing. Dr. Health Sciences, Exercise Physiology, Levine initiated such studies of the These efforts led to the publication Gastroenterology, Cancer Biology, genetics of cancer of the appendix, of 12 peer-reviewed manuscripts in Radiology, Nuclear Medicine, and and published new data on genomic 2015, as well as major presentations Medical and Radiation Oncology. signatures predictive of outcomes at leading surgical and oncology In 2015, Surgical Oncology enrolled for this disease. Dr. Votanopoulos societies. These publications span nearly 300 patients on treatment continues to be prolific in publication the gamut from basic science to protocols and more than 1,750 on of manuscripts related to gastric and translational and clinical issues tissue-procurement studies. The appendiceal cancer as well as HIPEC relevant to several tumors. surgical oncology faculty had a procedures. Drs. Shen and Clark have total of 27 research protocols open a focused clinical effort in pancreatic during the year. Currently, the clinical and hepatobiliary malignancy,

2015 CANCER PROGRAM ACTIVITIES 25 UROLOGIC ONCOLOGY The Urologic Oncology program to patients. The genitourinary has more than tripled. In addition to within the Comprehensive Cancer clinical trial group established about the clinical activities noted above, the Center brings together clinicians from fours years ago consists of basic urologic group also supports, through multiple departments in the Medical scientists, urological, medical and additional collaborations, significant Center to facilitate the provision radiation oncologists. They oversee translational and basic research of multidisciplinary cancer care to the success of numerous in-house, efforts in Urologic Oncology. carry out innovative clinical trials to industry and cooperative oncology The Section of Urologic Oncology, improve the care of patients with group trials through Alliance, part of the Department of Urology, genitourinary malignancies. Through National Institute of Health and includes K.C. Balaji, MD, Ronald the activities of the genitourinary Radiation Therapy Oncology Group Davis, MD, MBA, Ashok Hemal, oncology group, special expertise (RTOG). Through these mechanisms, MD, and Dan Rukstalis, MD. The is directed toward the diagnosis, patients have access to clinical trials group works closely with the rest of staging, treatment and follow-up of for most genitourinary malignancies the genitourinary oncology team, patients with tumors of the prostate, that incorporate multiple modalities including Christopher Thomas, MD, bladder, kidney/ureter, testis and of treatment to produce the best Rhonda Biting, MD, and Michael other genitourinary sites. The latest possible treatment outcome. Goodman, MD, from medical techniques including laparoscopic Between 2010 and 2015, accrual to oncology, and Bart Frizzell, MD, from and robotic approaches are offered genitourinary oncology clinical trials radiation oncology.

26 2015 CANCER PROGRAM ACTIVITIES 2014 CANCER DATA 2014 CANCER REGISTRY DATABASE

TOTAL CASES* NUMBER PERCENT GENDER NUMBER PERCENT Lung 582 12.1 Male 2,497 51.7 Breast 457 9.5 Female 2,333 48.3 Colorectal 364 7.5 Oral cavity, pharynx 298 6.2 RACE NUMBER PERCENT Melanoma of skin 283 5.9 White 4,167 86.3 Prostate 282 5.8 Black 576 11.9 Leukemia 274 5.7 Other 87 1.8 Brain, CNS 245 5.1 NH Lymphoma 199 4.1 ETHNICITY — HISPANIC Kidney, renal pelvis 173 3.6 Male 36 0.7 Pancreas 160 3.3 Female 60 1.2 Thyroid 130 2.7 Bladder 123 2.5 CLASS OF CASE Uterus 96 2 Analytic/new dx 3,874 80.2 Connective tissue 87 1.8 Non-analytic/recurr 455 9.4 Multiple myeloma 86 1.8 Consults, dx workup 501 10.4 CMPD, MDS 83 1.7 Stomach 82 1.7 RESIDENCE Esophagus 79 1.6 North Carolina 4,025 83.3 Liver 74 1.5 Other states in USA 802 16.6 Larynx 71 1.5 Outside of USA 3 0.06 Other female 58 1.2 Other endocrine 55 1.1 PATIENT HISTORY Ovary 54 1.1 Family History 3,041 63 Unknown primary 52 1.1 Tobacco History 2,896 60 Small intestine 38 0.8 cigarette 888 Mets SCCa/BCCa 36 0.7 cigar/pipe 15 Cervix 35 0.7 snuff/chew/smokeless 117 Anus, anal canal 31 0.6 combination use 29 Bone 30 0.6 previous use 1,847 Other skin 29 0.6 Alcohol History (2 or more drinks/day) 556 11.5 Gallbladder, biliary 28 0.6 current use 372 Nasal, sinus 27 0.6 past history 184 Hodgkins disease 26 0.5

Eye 24 0.5 PRIMARY NEOPLASMS Retroperitoneum 22 0.5 Other urinary 18 0.4 One primary only 3,464 71.7 Other digestive 11 0.2 First of two primaries 181 3.7 Other male 7 0.1 Second primary 748 15.5 Testis 6 0.1 Third primary 148 3.1 Ill-defined 4 0.1 Fourth primary 20 0.4 Pleura, Med, Heart 4 0.1 Fifth primary 9 0.2 Peripheral nerves 4 0.1 Sixth primary 3 0.1 Thymus 3 0.1 Benign neoplasms 257 5.3 Total Cases 4,830 100

*Includes maligant, in-situ, selected benign cases; newly diagnosed, recurrent and consult cases

28 2014 CANCER DATA COMPARISON OF 2014 WFBMC, STATE AND NATIONAL DATA

WFBMC NORTH CAROLINA USA

PRIMARY SITE CASES PERCENT CASES PERCENT CASES PERCENT

Lung 487 14.4 8,624 15.1 224,210 13.5

Breast 331 9.8 7,898 13.8 235,030 14.1

Colorectal 246 7.3 4,746 8.3 136,830 8.2

Oral cavity, pharynx 209 6.2 1,419 2.5 42,440 2.5

Prostate 208 6.1 8,399 14.7 233,000 14

Leukemia 204 6 1,378 2.4 52,380 3.1

Melanoma of skin 187 5.5 2,482 4.3 76,100 4.6

Kidney, renal pelvis 147 4.3 1,942 3.4 63,920 3.8

Pancreas 138 4.1 1,354 2.4 46,420 2.8

NH Lymphoma 138 4.1 2,120 3.7 70,800 4.3

Thyroid 116 3.4 1,308 2.3 62,980 3.8

Uterus 89 2.6 1,509 2.6 52,630 3.2

Bladder 87 2.6 2,402 4.2 74,690 4.5

Brain, CNS 76 2.2 718 1.3 23,380 1.4

Soft Tissue 74 2.2 375 0.7 12,020 0.7

Stomach 63 1.9 720 1.3 22,220 1.3

Liver, bile ducts 62 1.8 767 1.3 33,190 2

Larynx 60 1.8 533 0.9 12,630 0.8

Multiple myeloma 53 1.6 805 1.4 24,050 1.4

Esophagus 46 1.4 548 1 18,170 1.1

Ovary 33 1 724 1.3 21,980 1.3

Small intestine 30 0.9 300 0.5 9,160 0.6

Cervix 25 0.7 380 0.7 12,360 0.7

All Others 313 9.2 5,847 10.2 104,950 6.3

Total Cases 3,392 100 57,298 100 1,665,540 100

Note: Includes newly diagnosed invasive cancer cases (includes bladder in-situ cases). Excludes basal and squamous cell skin cancers, in-situ (except for bladder), benign neoplasms, non-analytic cases, and consultations.

WFBMC – exact figures NC – estimated numbers from NC-Central Cancer Registry Facts and Figures 2014 USA – estimated numbers from American Cancer Society Cancer Facts and Figures 2014

2014 CANCER DATA 29 PRIMARY SITE DISTRIBUTION 2014

Site Total Class of Case* Gender and Race

A NA C white black other Hispanic male female male female male female male female Total cases 4,830 3,874 455 501 2,161 2,006 290 286 46 41 36 60 Oral cavity, pharynx 298 259 17 22 179 92 15 8 3 1 0 1 lip 12 10 2 0 7 5 0 0 0 0 0 0 tongue 74 61 9 4 51 17 4 0 2 0 0 0 gum 12 12 0 0 3 7 1 1 0 0 0 0 floor of mouth 20 19 0 1 14 4 1 0 1 0 0 0 palate 16 15 0 1 7 9 0 0 0 0 0 0 other mouth 23 22 1 0 10 11 1 1 0 0 0 0 salivary, malignant 23 18 1 4 13 7 1 2 0 0 0 0 salivary, benign 41 41 0 0 15 23 0 2 0 1 0 1 tonsil 42 33 3 6 33 5 3 1 0 0 0 0 oropharynx 13 8 0 5 13 0 0 0 0 0 0 0 nasopharynx 4 3 0 1 2 2 0 0 0 0 0 0 pyriform sinus 2 2 0 0 2 0 0 0 0 0 0 0 hypopharynx 12 11 1 0 7 1 4 0 0 0 0 0 other oral cavity 4 4 0 0 2 1 0 1 0 0 0 0 Digestive system 867 659 83 125 429 300 62 54 15 7 9 14 esophagus 79 56 4 19 65 7 2 3 2 0 1 0 stomach 82 63 3 16 40 27 6 7 0 2 0 5 s intestine 38 30 3 5 22 11 3 2 0 0 0 1 colon 241 150 50 41 102 98 19 17 3 2 2 2 rectosigmoid 13 13 0 0 7 4 1 0 1 0 1 0 rectum 110 85 6 19 50 43 5 7 4 1 1 1 anus/anal canal 31 27 2 2 12 9 8 2 0 0 1 0 liver 74 62 10 2 42 25 3 4 0 0 2 1 gallbladder 8 6 0 2 6 0 1 1 0 0 0 0 biliary 20 18 1 1 10 4 3 0 3 0 1 0 pancreas 160 139 4 17 70 64 11 11 2 2 0 2 other digestive 11 10 0 1 3 8 0 0 0 0 0 2 Respiratory sys 683 577 50 56 335 241 56 38 7 6 5 2 nasal cavity 17 14 1 2 9 6 0 2 0 0 0 0 sinuses 10 7 2 1 5 4 1 0 0 0 0 0 larynx 71 61 6 4 46 8 10 5 2 0 2 0 lung-non small 506 429 31 46 239 188 41 27 5 6 3 2 lung-small cell 76 64 9 3 35 34 3 4 0 0 0 0 thymus 3 2 1 0 1 1 1 0 0 0 0 0 Pleura/Med/Heart 4 4 0 0 3 0 1 0 0 0 1 0 Bone 30 28 0 2 8 17 4 1 0 0 0 0 Hematopoietic system 443 295 52 96 231 153 28 25 3 3 6 11 multiple myeloma 86 53 10 23 41 25 11 8 1 0 1 1 lymphoid leukemia 90 64 13 13 51 29 4 4 1 1 5 4 myeloid leukemia 172 141 13 18 88 69 7 8 0 0 0 6 other leukemia 12 4 3 5 7 4 1 0 0 0 0 0 CMPD, MDS 83 33 13 37 44 26 5 5 1 2 0 0

30 2014 CANCER DATA Site Total Class of Case* Gender and Race

A NA C white black other Hispanic male female male female male female male female

Skin 348 303 28 17 210 130 5 3 0 0 0 0 melanoma 283 253 15 15 165 116 1 1 0 0 0 0 other skin 29 27 1 1 17 6 4 2 0 0 0 0 mets SCCa/BCCa 36 23 12 1 28 8 0 0 0 0 0 0 Peripheral Nerves 4 3 0 1 2 1 0 1 0 0 0 0 Retroperitoneum 22 17 3 2 9 9 2 2 0 0 0 0 Connective tissue 87 74 5 8 49 30 3 3 1 1 2 4 Breast 457 388 29 40 7 364 1 74 0 11 0 14 Female genital sys 243 219 16 8 0 210 0 27 0 6 0 7 vulva 46 44 2 0 0 38 0 7 0 1 0 0 vagina 5 4 0 1 0 5 0 0 0 0 0 0 cervix 35 31 1 3 0 29 0 4 0 2 0 2 uterus 96 89 6 1 0 83 0 11 0 2 0 1 ovary, malignant 42 33 6 3 0 38 0 3 0 1 0 0 ovary, borderline 12 12 0 0 0 10 0 2 0 0 0 2 other female 7 6 1 0 0 7 0 0 0 0 0 2 Male genital sys 295 219 44 32 232 0 57 0 6 0 6 0 penis 5 5 0 0 5 0 0 0 0 0 0 0 prostate 282 208 43 31 219 0 57 0 6 0 6 0 testis 6 4 1 1 6 0 0 0 0 0 0 0 other male 2 2 0 0 2 0 0 0 0 0 0 0 Urinary system 314 251 51 12 191 78 23 16 6 0 4 0 kidney 160 140 17 3 83 54 9 12 2 0 2 0 renal pelvis 13 9 3 1 8 2 2 1 0 0 0 0 ureter 8 6 2 0 6 1 1 0 0 0 0 0 bladder 123 87 29 7 86 19 11 3 4 0 2 0 other urinary 10 9 0 1 8 2 0 0 0 0 0 0

Eye 24 19 1 4 9 15 0 0 0 0 0 0

Brain, CNS 245 206 19 20 89 138 8 6 2 2 1 1 brain, malignant 93 76 3 14 49 38 2 3 1 0 1 0 brain, benign 152 130 16 6 40 100 6 3 1 2 0 1 Thyroid/Endocrine 185 162 16 7 54 105 9 13 1 3 1 3 thyroid 130 116 10 4 28 84 4 12 0 2 0 3 adrenal 3 1 1 1 0 3 0 0 0 0 0 0 other malignant 0 0 0 0 0 0 0 0 0 0 0 0 other benign 52 45 5 2 26 18 5 1 1 1 1 0 Lymphoma 225 152 40 33 105 93 14 10 2 1 1 3 NHL 199 138 35 26 93 86 10 7 2 1 1 3 Hodgkins 26 14 5 7 12 7 4 3 0 0 0 0 Unknown Primary 52 37 1 14 17 28 2 5 0 0 0 0 Ill-defined 4 2 0 2 2 2 0 0 0 0 0 0

*Class of Case: A – analytic, newly diagnosed; NA – non-analytic, first seen with recurrent disease; C – consultations, diagnostic workup

2014 CANCER DATA 31 COMPARISON OF WFBMC MOST PREVALENT SITES BY YEAR newly diagnosed cases

500

2008 2009 2010 400 2011 2012 2013 2014 300

200

100

0 Lung Breast Melanoma Oral Colorectal Leukemia Prostate Kidney NHL Thyroid Pancreas Bladder of Skin

32 2014 CANCER DATA 2015 PUBLISHED ABSTRACTS Published Abstracts CANCER PREVENTION AND CONTROL (CPC) CANCER BIOLOGY AND BIOCHEMISTRY (CBB) CLINICAL RESEARCH PROGRAM (CRP) TUMOR PROGRESSION AND RECURRENCE PROGRAM (TPR)

Palmer NR, Kent EE, Forsythe LP, Arora NK, Rowland JH, Aziz NM, McEvoy JW, Nasir K, DeFilippis AP, Lima JA, Bluemke DA, Hundley Blanch-Hartigan D, Oakley-Girvan I, Hamilton AS, Weaver KE(CPC). WG(CPC), Barr RG, Budoff MJ, Szklo M, Navas-Acien A, Polak Racial and Ethnic Disparities in Patient-Provider Communication, JF, et al. Relationship of Cigarette Smoking With Inflammation Quality-of-Care Ratings, and Patient Activation Among Long-Term and Subclinical Vascular Disease: The Multi-Ethnic Study of Cancer Survivors. J Clin Oncol. 2014;32(36): 4087-94 PMC4265119. Atherosclerosis. Arterioscler Thromb Vasc Biol. 2015;35(4): 1002-10 PMC4484586. Arcury TA(CPC), Laurienti PJ, Talton JW, Chen H, Howard TD, Summers P, Quandt SA(CPC). Urinary Cotinine Levels Among Latino Neuhouser ML, Cheng TY, Beresford SA, Brown E, Song X, Miller Tobacco Farmworkers in North Carolina Compared to Latinos Not JW, Zheng Y, Thomson CA, Shikany JM, Vitolins MZ(CPC), Rohan Employed in Agriculture. Nicotine Tob Res. 2015. T, et al. Red blood cell folate and plasma folate are not associated with risk of incident colorectal cancer in the Women’s Health Avis NE(CPC), Levine BJ, Case LD(CRP), Naftalis EZ, Van Zee KJ. Initiative Observational Study. Int J Cancer. 2015;137(4): 930-9 Trajectories of Depressive Symptoms Following Breast Cancer PMC4478092. Diagnosis. Cancer Epidemiol Biomarkers Prev. 2015;24: 1789-95 PMC4634642. Palmer NR, Weaver KE(CPC), Hauser SP, Lawrence JA, Talton J, Case LD(CRP), Geiger AM. Disparities in barriers to follow-up care Beavers DP, Pettinger M, Espeland MA, Snively BM, Leng X, Hunt between African American and White breast cancer survivors. JR, Tindle HA, Shumaker SA(CPC). The Evolution of the WHI 80+ Support Care Cancer. 2015;23: 3201-9 PMC4586316. Cohort. J Gerontol A Biol Sci Med Sci. 2015. Rodrigues LU, Rider L, Nieto C, Romero L, Karimpour-Fard A, Loda Bell RA(CPC), McDermott H, Fancher TL, Green MJ, Day FC, M, Lucia MS, Wu M, Shi L, Liu W(CPC), Xu J, et al. Coordinate Wilkes MS. Impact of a Randomized Controlled Educational Trial loss of MAP3K7 and CHD1 promotes aggressive prostate cancer. to Improve Physician Practice Behaviors Around Screening for Cancer Res. 2015;75(6): 1021-34 PMC4531265. Inherited Breast Cancer. J Gen Intern Med. 2015;30(3): 334-41 PMC4351290. Salsman JM(CPC), Pustejovsky JE, Jim HS, Munoz AR, Merluzzi TV, George L, Park CL, Danhauer SC(CPC), Sherman AC, Snyder MA, Chotenimitkhun R, D’Agostino R, Jr.(CPC), Lawrence JA(CRP), Fitchett G. A meta-analytic approach to examining the correlation Hamilton CA, Jordan JH, Vasu S, Lash TL, Yeboah J, Herrington between religion/spirituality and mental health in cancer. Cancer. DM, Hundley WG(CPC). Chronic Statin Administration May 2015;121: 3769-78 PMC4618157. Attenuate Early Anthracycline-Associated Declines in Left Ventricular Ejection Function. Can J Cardiol. 2015;31(3): 302-7 Sherman AC, Merluzzi TV, Pustejovsky JE, Park CL, George L, PMC4410009. Fitchett G, Jim HS, Munoz AR, Danhauer SC(CPC), Snyder MA, Salsman JM(CPC). A meta-analytic review of religious or spiritual Danhauer SC(CPC), Russell G, Case LD(CRP), Sohl SJ, Tedeschi involvement and social health among cancer patients. Cancer. RG, Addington EL, Triplett K, Van Zee KJ, Naftalis EZ, Levine B, 2015;121: 3779-88 PMC4618183. Avis NE(CPC). Trajectories of Posttraumatic Growth and Associated Characteristics in Women with Breast Cancer. Ann Behav Med. Sparano JA, Gray RJ, Makower DF, Pritchard KI, Albain KS, Wagner 2015;49: 650-9 PMC4561191. LI(CPC), Geyer CE, Jr., Dees EC, Perez EA, Olson JA, Zujewski J, et al. Prospective Validation of a 21-Gene Expression Assay in Breast Jim HS, Pustejovsky JE, Park CL, Danhauer SC(CPC), Sherman AC, Cancer. N Engl J Med. 2015. Fitchett G, Merluzzi TV, Munoz AR, George L, Snyder MA, Salsman JM(CPC). Religion, spirituality, and physical health in cancer Sutfin EL(CPC), Reboussin BA, Debinski B, Wagoner KG, Spangler patients: A meta-analysis. Cancer. 2015;121: 3760-8 PMC4618080. J(CPC), Wolfson M(CPC). The Impact of Trying Electronic Cigarettes on Cigarette Smoking by College Students: A Prospective Analysis. Jones SM, LaCroix AZ, Li W, Zaslavsky O, Wassertheil-Smoller Am J Public Health. 2015;105: e83-9 PMC4504281. S, Weitlauf J, Brenes GA, Nassir R, Ockene JK, Caire-Juvera G, Danhauer SC(CPC). Depression and quality of life before and after Sutfin EL(CPC), Sparks A, Pockey JR, Suerken CK, Reboussin BA, breast cancer diagnosis in older women from the Women’s Health Wagoner KG, Spangler J(CPC), Wolfson M(CPC). First tobacco Initiative. J Cancer Surviv. 2015;9: 620-9 PMC4547920. product tried: Associations with smoking status and demographics among college students. Addict Behav. 2015;51: 152-157. Kelly MG, Winkler SS, Lentz SS(CRP), Berliner SH, Swain MF, Skinner HG, Schwartz GG(CPC). Serum Calcium and Serum Albumin Are Vera T, D’Agostino RB, Jr.(CPC), Jordan JH, Whitlock MC, Biomarkers that Can Discriminate Malignant from Benign Pelvic Melendez GC, Lamar ZS(CRP), Porosnicu M(CRP), Bonkovsky HL, Masses. Cancer Epidemiol Biomarkers Prev. 2015;24: 1593-8. Poole LB(CBB), Hundley WG(CPC). Relation of Pre-anthracycline Serum Bilirubin Levels to Left Ventricular Ejection Fraction After Lewis JA, Petty WJ(CRP), Tooze JA(CPC), Miller DP(CPC), Chiles Chemotherapy. Am J Cardiol. 2015. C(CRP), Miller AA(CRP), Bellinger C(CRP), Weaver KE(CPC). Low- dose CT Lung Cancer Screening Practices and Attitudes Among Wagner LI(CPC), Zhao F, Hong F, Williams ME, Gascoyne RD, Krauss Primary Care Providers at an Academic Medical Center. Cancer JC, Advani RH, Go RS, Habermann TM, Leach JW, O’Connor B, et Epidemiol Biomarkers Prev. 2015;24(4): 664-70 PMC4383689. al. Anxiety and Health-Related Quality of Life Among Patients With Low-Tumor Burden Non-Hodgkin Lymphoma Randomly Assigned to Lipkus IM, Reboussin BA, Wolfson M(CPC), Sutfin EL(CPC). Two Different Rituximab Dosing Regimens: Results From ECOG Trial Assessing and Predicting Susceptibility to Waterpipe Tobacco E4402 (RESORT). J Clin Oncol. 2015;33(7): 740-8 PMC4334777. use Among College Students. Nicotine Tob Res. 2015;: 1120-5 PMC4542741.

34 2015 PUBLISHED ABSTRACTS Wang W, Ma XP, Shi Z, Zhang P, Ding DL, Huang HX, Saiyin HG, Lears KA, Parry JJ, Andrews R, Nguyen K, Wadas TJ(CBB), Rogers Chen TY, Zheng SL(CPC), Sun J(CPC), Yu H, et al. Epidermal growth BE. Adenoviral-mediated imaging of gene transfer using a factor receptor pathway polymorphisms and the prognosis of somatostatin receptor-cytosine deaminase fusion protein. Cancer hepatocellular carcinoma. Am J Cancer Res. 2015;5(1): 396-410 Gene Ther. 2015;22(4): 215-21 PMC4409539. PMC4300692. Li R, Macnamara LM, Leuchter JD, Alexander RW(CBB), Cho SS. MD Winchester DA, Till C, Goodman PJ, Tangen CM, Santella RM, Simulations of tRNA and Aminoacyl-tRNA Synthetases: Dynamics, Johnson-Pais TL, Leach RJ, Xu J, Zheng SL(CPC), Thompson IM, Folding, Binding, and Allostery. Int J Mol Sci. 2015;16(7): 15872-902 Lucia MS, et al. Variation in genes involved in the immune response PMC4519929. and prostate cancer risk in the placebo arm of the Prostate Cancer Liu Y, Guthold M(CBB), Snyder MJ, Lu H. AFM of self-assembled Prevention Trial. Prostate. 2015;75(13): 1403-18 PMC4536102. lambda DNA-histone networks. Colloids Surf B Biointerfaces. Miao Z, Reisz JA, Mitroka SM, Pan J, Xian M, King SB(CBB). A 2015;134: 17-25 PMC4573237. selective phosphine-based fluorescent probe for nitroxyl in living Manils J, Gomez D, Salla-Martret M, Fischer H, Fye JM, Marzo cells. Bioorg Med Chem Lett. 2014;25(1): 16-19 PMC4355083. E, Marruecos L, Serrano I, Salgado R, Perrino FW(CBB), Garcia- Perkins A, Poole LB(CBB), Karplus PA. Tuning of Peroxiredoxin Pedrero. Multifaceted role of TREX2 in the skin defense against Catalysis for Various Physiological Roles. Biochemistry. 2014;53(49): UV-induced skin carcinogenesis. Oncotarget. 2015;6: 22375-96. 7693-705 PMC4270387. Mims J, Bansal N, Bharadwaj MS, Chen X, Molina AJ, Tsang Chen X, Liu L, Mims J, Punska EC, Williams KE, Zhao W, Arcaro KF, AW(TPR), Furdui CM(CBB). Energy Metabolism in a Matched Model Tsang AW(TPR), Zhou X(TPR), Furdui CM(CBB). Analysis of DNA of Radiation Resistance for Head and Neck Squamous Cell Cancer. Methylation and Gene Expression in Radiation-Resistant Head and Radiat Res. 2015;183(3): 291-304 PMC4465128. Neck Tumors. Epigenetics. 2015;10(6): 545-61. Opris I, Santos LM, Gerhardt GA, Song D, Berger TW, Hampson Cortese-Krott MM, Kuhnle GG, Dyson A, Fernandez BO, Grman RE, Deadwyler SA(CBB). Distributed encoding of spatial and object M, DuMond JF, Barrow MP, King SB(CBB), Nakagawa H, Ondrias categories in primate hippocampal microcircuits. Front Neurosci. K, Nagy P, et al. Key bioactive reaction products of the NO/H2S 2015;9: 317 PMC4594006. interaction are S/N-hybrid species, polysulfides, and nitroxyl. Proc Perkins A, Nelson KJ, Parsonage D, Poole LB(CBB), Karplus PA. Natl Acad Sci U S A. 2015;112: E4651-60 PMC4553758. Peroxiredoxins: guardians against oxidative stress and modulators Cunniff B, Newick K, Nelson KJ, Wozniak AN, Beuschel S, Leavitt of peroxide signaling. Trends Biochem Sci. 2015;40: 435-45 B, Bhave A, Butnor K, Koenig A, Lowther WT(CBB), James AM, et PMC4509974. al. Disabling Mitochondrial Peroxide Metabolism via Combinatorial Poole LB(CBB). The Basics of Thiols and Cysteines in Redox Biology Targeting of Peroxiredoxin 3 as an Effective Therapeutic Approach and Chemistry. Free Radic Biol Med. 2015;80: 148-57 PMC4355186. for Malignant Mesothelioma. PLoS One. 2015;10(5): e0127310 PMC4444329. Ridnour LA, Cheng RY, Weiss JM, Kaur S, Soto-Pantoja DR(CBB), Basudhar D, Heinecke JL, Stewart CA, DeGraff W, Sowers AL, Davis RR, Shaban NM, Perrino FW(CBB), Hollis T(CBB). Crystal Thetford A, et al. NOS Inhibition Modulates Immune Polarization structure of RNA-DNA duplex provides insight into conformational and Improves Radiation-Induced Tumor Growth Delay. Cancer Res. changes induced by RNase H binding. Cell Cycle. 2015;14(4): 668- 2015;75(14): 2788-99 PMC4506231. 73 PMC4615118. Swanner J, Mims J, Carroll DL(CRP), Akman SA, Furdui CM(CBB), Deadwyler SA(CBB), Berger TW, Opris I, Song D, Hampson RE. Torti SV, Singh RN(CBB). Differential cytotoxic and radiosensitizing Neurons and networks organizing and sequencing memories. Brain effects of silver nanoparticles on triple-negative breast cancer and Res. 2015;1621: 335-44 PMC4485978. non-triple-negative breast cells. Int J Nanomedicine. 2015;10: 3937- Ding S, Bierbach U(CBB). Target-selective delivery and activation 53 PMC4501353. of platinum-based anticancer agents. Future Med Chem. 2015;7(7): Xiong S, Patrushev N, Forouzandeh F, Hilenski L, Alexander 911-27. RW(CBB). PGC-1alpha Modulates Telomere Function and DNA Fahrenholtz CD, Hadimani M, King SB(CBB), Torti SV, Singh R(CBB). Damage in Protecting against Aging-Related Chronic Diseases. Cell Targeting breast cancer with sugar-coated carbon nanotubes. Rep. 2015;12: 1391-9 PMC4549794. Nanomedicine (Lond). 2015;10: 2481-97 PMC4610120. Chen Y, Xia Y, Smith GM, Carroll DL(CRP). Frequency-dependent, Gmeiner WH(CBB), Boyacioglu O, Stuart CH, Jennings-Gee J, Balaji alternating current-driven, field-induced polymer electroluminescent KC(CRP). The cytotoxic and pro-apoptotic activities of the novel devices with high power efficiency. Adv Mater. 2014;26(48): fluoropyrimidine F10 towards prostate cancer cells are enhanced 8133-40. by Zn -chelation and inhibiting the serine protease Omi/HtrA2. Garzon R, Volinia S, Papaioannou D, Nicolet D, Kohlschmidt J, Yan Prostate. 2015;75(4): 360-9 PMC4293244. PS, Mrozek K, Bucci D, Carroll AJ, Powell BL(CRP), Wetzler M, et Gmeiner WH(CBB), Jennings-Gee J, Stuart CH, Pardee TS(CRP). al. Expression and prognostic impact of lncRNAs in acute myeloid Thymineless death in F10-treated AML cells occurs via lipid raft leukemia. Proc Natl Acad Sci U S A. 2014;111(52): 18679-84 depletion and Fas/FasL co-localization in the plasma membrane PMC4284555. with activation of the extrinsic apoptotic pathway. Leuk Res. Klepin HD(CRP), Rao AV, Pardee TS(CRP). Acute myeloid leukemia 2015;39(2): 229-35 PMC4306618. and myelodysplastic syndromes in older adults. J Clin Oncol. Godwin R, Gmeiner W(CBB), Salsbury FR, Jr.(CBB). Importance of 2014;32(24): 2541-52. long-time simulations for rare event sampling in zinc finger proteins. Parikh F, Duluc D, Imai N, Clark A, Misiukiewicz K, Bonomi M(CRP), J Biomol Struct Dyn. 2015;: 1-10 PMC4600012. Gupta V, Patsias A, Parides M, Demicco EG, Zhang DY, et al. Grieves JL, Fye JM, Harvey S, Grayson JM(TPR), Hollis T(CBB), Chemoradiotherapy-induced upregulation of PD-1 antagonizes Perrino FW(CBB). Exonuclease TREX1 degrades double-stranded immunity to HPV-related oropharyngeal cancer. Cancer Res. DNA to prevent spontaneous lupus-like inflammatory disease. Proc 2014;74(24): 7205-16 PMC4498250. Natl Acad Sci USA. 2015;112(16): 5117-22 PMC4413332. Ahn H, Ju YM, Takahashi H, Williams DF, Yoo JJ, Lee SJ, Okano Harris RS, Perrino FW(CBB), Shaban NM. The multidimensional T, Atala A(CRP). Engineered small diameter vascular grafts by nature of antiviral innate immunity. Cell Host Microbe. 2015;17(4): combining cell sheet engineering and electrospinning technology. 423-5 PMC4616157. Acta Biomater. 2015;16: 14-22.

2015 PUBLISHED ABSTRACTS 35 Atala A(CRP), Murphy S. Regenerative medicine. JAMA. Robert SM, Buckingham SC, Campbell SL, Robel S, Holt KT, 2015;313(14): 1413-4. Ogunrinu-Babarinde T, Warren PP, Sontheimer H(CRP), Reid MA, Eschbacher JM, Berens ME, et al. SLC7A11 expression is associated Chiles C(CRP), Duan F, Gladish GW, Ravenel JG, Baginski SG, with seizures and predicts poor survival in patients with malignant Snyder BS, DeMello S, Desjardins SS, Munden RF. Association glioma. Sci Transl Med. 2015;7(289): 289ra86 PMC4503260. of Coronary Artery Calcification and Mortality in the National Lung Screening Trial: A Comparison of Three Scoring Methods. Sadri-Ardekani H, Atala A(CRP). Regenerative medicine for the Radiology. 2015;276(1): 82-90. treatment of reproductive system disorders: Current and potential options. Adv Drug Deliv Rev. 2015;82-83: 145-52. Hudson MM, Oeffinger KC, Jones K, Brinkman TM, Krull KR, Mulrooney DA, Mertens A, Castellino SM(CRP), Casillas J, Gurney Schwarz L, Votanopoulos K, Morris D, Yonemura Y, Deraco M, JG, Nathan PC, et al. Age-Dependent Changes in Health Status in Piso P, Moran B, Levine EA(CRP), Tuech JJ. Is the Combination the Childhood Cancer Survivor Cohort. J Clin Oncol. 2015;33(5): of Distal Pancreatectomy and Cytoreductive Surgery With HIPEC 479-91 PMC4314595. Reasonable? Results of an International Multicenter Study. Ann Surg. 2015. Johnson AG, Ruiz J(CRP), Hughes R, Page BR, Isom S, Lucas JT, McTyre ER, Watabe K(TPR), Ayala-Tatter SB, Bourland DJ, Chan Sontheimer H(CRP). Brain cancer: Tumour cells on neighbourhood MD(CRP), et al. Impact of systemic targeted agents on the clinical watch. Nature. 2015. outcomes of patients with brain metastases. Oncotarget. 2015;6: Spolverato G, Ejaz A, Kim Y, Squires MH, Poultsides G, Fields 18945-55. RC, Bloomston M, Levine EA(CRP), Votanopoulos K, Hawkins Ko IK, Peng L, Peloso A, Smith CJ, Dhal A, Deegan DB, WG, Pawlik TM, et al. Prognostic Performance of Different Lymph Zimmerman C, Clouse C, Zhao W, Soker S(TPR), Atala A(CRP), et al. Node Staging Systems After Curative Intent Resection for Gastric Bioengineered transplantable porcine livers with re-endothelialized Adenocarcinoma. Ann Surg. 2015. vasculature. Biomaterials. 2015;40: 72-9. Williams JK, Eckman D, Dean A, Moradi M, Allickson J, Cline Lindsley RC, Mar BG, Mazzola E, Grauman PV, Shareef S, Allen SL, JM(TPR), Yoo JJ, Atala A(CRP). The Dose-Effect Safety Profile of Pigneux A, Wetzler M, Powell BL(CRP), Erba HP, Damon LE, et al. Skeletal Muscle Precursor Cell Therapy in a Dog Model of Intrinsic Acute myeloid leukemia ontogeny is defined by distinct somatic Urinary Sphincter Deficiency. Stem Cells Transl Med. 2015;4(3): 286- mutations. Blood. 2015;125(9): 1367-76 PMC4342352. 94 PMC4339845. Makarev E, Fortney K, Litovchenko M, Braunewell KH, Zhavoronkov Young RP, Duan F, Chiles C(CRP), Hopkins RJ, Gamble GD, Greco A, Atala A(CRP). Quantifying signaling pathway activation to EM, Gatsonis C, Aberle D. Airflow Limitation and Histology-shift monitor the quality of induced pluripotent stem cells. Oncotarget. in the National Lung Screening Trial: the NLST-ACRIN Cohort 2015;6: 23204-12. Substudy (N=18, 714). Am J Respir Crit Care Med. 2015;192: 1060-7. Malik M, Chiles J, 3rd, Xi HS, Medway C, Simpson J, Potluri S, Howard D(CRP), Liang Y, Paumi CM, Mukherjee S, Crane P, et Ferluga S, Debinski W(TPR). Ephs and Ephrins in malignant gliomas. al. Genetics of CD33 in Alzheimer’s disease and acute myeloid Growth Factors. 2014;32(6): 190-201. leukemia. Hum Mol Genet. 2015;24(12): 3557-70 PMC4498153. Singh R, Pochampally R, Watabe K(TPR), Lu Z, Mo YY. Exosome- Norden AD, Ligon KL, Hammond SN, Muzikansky A, Reardon mediated transfer of miR-10b promotes cell invasion in breast DA, Kaley TJ, Batchelor TT, Plotkin SR, Raizer JJ, Lesser GJ(CRP), cancer. Mol Cancer. 2014;13: 256 PMC4258287. Drappatz J, et al. Phase II study of monthly pasireotide LAR Bedognetti D, Hendrickx W, Marincola FM, Miller LD(TPR). (SOM230C) for recurrent or progressive meningioma. Neurology. Prognostic and predictive immune gene signatures in breast cancer. 2015;84(3): 280-6 PMC4335993. Curr Opin Oncol. 2015;27: 433-44. Okada H, Butterfield LH, Hamilton RL, Hoji A, Sakaki M, Ahn BJ, Carpenter RL, Paw I, Dewhirst MW, Lo HW(TPR). Akt phosphorylates Shaw EG(CPC), Engh J, Chan MD(CRP), Lively MO(TPR), Lieberman and activates HSF-1 independent of heat shock, leading to Slug FS, et al. Induction of robust type-I CD8+ T-cell responses in overexpression and epithelial-mesenchymal transition (EMT) of WHO grade 2 low-grade glioma patients receiving peptide- HER2-overexpressing breast cancer cells. Oncogene. 2015;34(5): based vaccines in combination with poly-ICLC. Clin Cancer Res. 546-57 PMC4112182. 2015;21(2): 286-94 PMC4297523. Carpenter RL, Paw I, Zhu H, Sirkisoon S, Xing F, Watabe K(TPR), Rapp SR(CRP), Case LD(CRP), Peiffer A, Naughton MM, Chan Debinski W(TPR), Lo HW(TPR). The gain-of-function GLI1 MD(CRP), Stieber VW, Moore DF, Jr., Falchuk SC, Piephoff JV, transcription factor TGLI1 enhances expression of VEGF-C and Edenfield WJ, Shaw EG(CPC), et al. Donepezil for Irradiated Brain TEM7 to promote glioblastoma angiogenesis. Oncotarget. 2015;6: Tumor Survivors: A Phase III Randomized Placebo-Controlled 22653-65. Clinical Trial. J Clin Oncol. 2015;33(15): 1653-9 PMC4429174. Choi DS, Stark DJ, Raphael RM, Wen J, Su J, Zhou X(TPR), Chang Ravandi F, Ritchie EK, Sayar H, Lancet JE, Craig MD, Vey N, CC, Zu Y. SDF-1alpha stiffens myeloma bone marrow mesenchymal Strickland SA, Schiller GJ, Powell BL(CRP), Erba HP, Pigneux A, et al. stromal cells through the activation of RhoA-ROCK-Myosin II. Int J Vosaroxin plus cytarabine versus placebo plus cytarabine in patients Cancer. 2015;136(5): E219-29 PMC4452452. with first relapsed or refractory acute myeloid leukaemia (VALOR): a randomised, controlled, double-blind, multinational, phase 3 study. Choudhary M, Naczki C, Chen W, Barlow KD, Case LD(CRP), Lancet Oncol. 2015;16: 1025-36. Metheny-Barlow LJ(TPR). Tumor-induced loss of mural Connexin 43 gap junction activity promotes endothelial proliferation. BMC Ready NE, Pang HH, Gu L, Otterson GA, Thomas SP, Miller Cancer. 2015;15(1): 427 PMC4464240. AA(CRP), Baggstrom M, Masters GA, Graziano SL, Crawford J, Bogart J, et al. Chemotherapy With or Without Maintenance Chowdhury SM, Zhu X, Aloor JJ, Azzam KM, Gabor KA, Ge W, Sunitinib for Untreated Extensive-Stage Small-Cell Lung Cancer: Addo KA, Tomer KB, Parks JS(TPR), Fessler MB. Proteomic analysis A Randomized, Double-Blind, Placebo-Controlled Phase II of ABCA1-null macrophages reveals a role for stomatin like Study-CALGB 30504 (Alliance). J Clin Oncol. 2015;33(15): 1660-5 protein-2 in raft composition and Toll like Receptor signaling. Mol PMC4429175. Cell Proteomics. 2015;14: 1859-70 PMC4587328.

36 2015 PUBLISHED ABSTRACTS DelNero P, Lane M, Verbridge SS(TPR), Kwee B, Kermani P, Song Q, Wang H, Bao J, Pullikuth AK, Li KC(CRP), Miller LD(TPR), Hempstead B, Stroock A, Fischbach C. 3D culture broadly regulates Zhou X(TPR). Systems biology approach to studying proliferation- tumor cell hypoxia response and angiogenesis via pro-inflammatory dependent prognostic subnetworks in breast cancer. Sci Rep. pathways. Biomaterials. 2015;55: 110-8 PMC4417672. 2015;5: 12981 PMC4530341. Gabrusiewicz K, Hossain MB, Cortes-Santiago N, Fan X, Kaminska Suresh V, Liu L, Adjeroh D, Zhou X(TPR). RPI-Pred: predicting B, Marini FC(TPR), Fueyo J, Gomez-Manzano C. Macrophage ncRNA-protein interaction using sequence and structural Ablation Reduces M2-Like Populations and Jeopardizes Tumor information. Nucleic Acids Res. 2015;43(3): 1370-9 PMC4330382. Growth in a MAFIA-Based Glioma Model. Neoplasia. 2015;17(4): Tesfay L, Clausen KA, Kim JW, Hedge P, Wang X, Miller LD(TPR), 374-84 PMC4415120. Deng Z, Blanchette N, Arvedson T, Miranti CK, Torti SV, et al. Haas KM(TPR). B-1 lymphocytes in mice and nonhuman primates. Hepcidin regulation in prostate and its disruption in prostate cancer. Ann N Y Acad Sci. 2015;: PMC4627897. Cancer Res. 2015;75(11): 2254-63 PMC4454355. Hossain A, Gumin J, Gao F, Figueroa J, Shinojima N, Takezaki T, Turner RL, Groitl P, Dobner T, Ornelles DA(TPR). Adenovirus Priebe W, Villarreal D, Kang SG, Marini FC(TPR), Sulman E, et al. replaces mitotic checkpoint controls. J Virol. 2015;89(9): 5083-96 Mesenchymal Stem Cells Isolated from Human Gliomas Increase PMC4403466. Proliferation and Maintain Stemness of Glioma Stem Cells Through Wu K, Fukuda K, Xing F, Zhang Y, Sharma S, Liu Y, Chan MD(CRP), the IL-6/gp130/STAT3 pathway. Stem Cells. 2015;33: 2400-15 Zhou X(TPR), Qasem SA, Pochampally R, Watabe K(TPR), et al. Roles PMC4509942. of the cyclooxygenase 2 matrix metalloproteinase 1 pathway in Hosseini Y, Agah M, Verbridge SS(TPR). Endothelial cell sensing, brain metastasis of breast cancer. J Biol Chem. 2015;290(15): 9842- restructuring, and invasion in collagen hydrogel structures. Integr 54 PMC4392281. Biol (Camb). 2015;7: 1432-41 PMC4630156. Xing F, Sharma S, Liu Y, Mo YY, Wu K, Zhang YY, Pochampally R, Langston PK, Yang M, Bierbach U(CBB), Parsonage D, Poole Martinez LA, Lo HW(TPR), Watabe K(TPR). miR-509 suppresses brain LB(CBB), Price MJ, Grayson JM(TPR). Au-ACRAMTU-PEt3 Alters metastasis of breast cancer cells by modulating RhoC and TNF- Redox Balance To Inhibit T Cell Proliferation and Function. J alpha. Oncogene. 2015;34: 4890-900 PMC4530094. Immunol. 2015;195(5): 1984-94. Yacovone SK, Ornelles DA(TPR), Lyles DS(TPR). The border-to- Liu L, Jin G, Zhou X(TPR). Modeling the relationship of epigenetic border distribution method for analysis of cytoplasmic particles and modifications to transcription factor binding. Nucleic Acids Res. organelles. Cell Tissue Res. 2015. 2015;43(8): 3873-85 PMC4417166. Yu N, Puckett S, Antinozzi PA, Cramer SD, Lyles DS(TPR). Changes Paw I, Carpenter RC, Watabe K(TPR), Debinski W(TPR), Lo HW(TPR). in susceptibility to oncolytic vesicular stomatitis virus during Mechanisms regulating glioma invasion. Cancer Lett. 2015;362(1): progression of prostate cancer. J Virol. 2015;89(10): 5250-63 1-7 PMC4435977. PMC4442527. Skardal A, Devarasetty M, Rodman C, Atala A(CRP), Soker S(TPR). Liver-Tumor Hybrid Organoids for Modeling Tumor Growth and Drug Response In Vitro. Ann Biomed Eng. 2015;43: 2361-73 PMC4573342.

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