The Nexus of Personalized Medicine, Population Health and Research 2017 ANNUAL REPORT SWEDISH CANCER INSTITUTE EXECUTIVE COUNCIL

SWEDISH CANCER INSTITUTE The Nexus of Personalized Medicine, Population Health and Research 2017 ANNUAL REPORT SWEDISH CANCER INSTITUTE EXECUTIVE COUNCIL

Thomas Brown, M.D., MBA Executive Director, SCI

Todd A. Barnett, M.D. Radiation Oncology Services

Patricia L. Dawson, M.D., Ph.D. Patient Experience Improvement

Charles Drescher, M.D., Ph.D. Translational Research & Gynecologic Oncology

Philip J. Gold, M.D. Clinical Research

Eileen M. Johnston, M.D. North SCI Network

Henry G. (Hank) Kaplan, M.D. Hematology/Oncology Services

Christine A. Lee, M.D. East SCI Network (SMG)

Martin C. Palmer, M.D. SCI Outreach

John M. Pagel, M.D., Ph.D. Hematologic Malignancies

Eric Vallières, M.D. Surgery

Jim Yates, MSPH, MBA Vice President for Operations, SCI

Selin Demir Manager, SCI Administration & Program Services (not pictured) The Swedish Cancer Institute The Nexus of Personalized Medicine, Population Health and Research

The year was 1932 and Swedish Medical Center in Seattle, Wash., was thinking of its patients and the communities it served, and considering how it could influence the future of medicine. It was in that year, in the midst of The Great Depression, that Swedish opened the first cancer-care center west of the Mississippi. Given this history, the Swedish Cancer Insti- tute (SCI) has treated more people, for more types of cancer, than any other provider in the Pacific Northwest. It is through the optics of that decades-long history that the men and women of SCI approach each day, and how they have made SCI the nexus for highly personalized cancer care, evidence-based population health and research into innovative new therapies and technology.

Harnessing the Potential of Personalized Medicine During its 2013 strategic planning cycle, SCI committed to creating an integrated platform for genomic and biologic profiling that would produce actionable data. During the subsequent three years, the institute: • Launched its first genomic sequencing panel with 68 highly actionable gene alterations, with plans to increase the panel to approximately 300 gene alterations • Identified a cloud-based information technology platform that bolts onto its electronic medical record (Epic) to collect, organize and analyze pertinent clinical information and outcomes data

(Continued) Thomas D. Brown, M.D., MBA

www.swedish.org/cancer 1 • Established a molecular tumor board to assist physicians in applying genomic information to the care of their patients • Initiated an IRB-approved registration protocol to track how physicians used the collected data to improve patient outcomes • Opened The Robert and Jean Reid Family Innovative Therapeutics and Research Unit (Reid Family ITU) a state-of-the-art facility for early-phase clinical trials unit (For more information, see page 33.) Integrating the Institute for Systems Biology into the Swedish-Providence Health Alliance in 2016 has also affected personalized medicine at SCI. A multidisciplinary approach to acknowledging the convergence of biology, behavior and environment is helping us better understand how tumor biology can be applied in a clinical setting. Anna B. Berry, M.D., and Mariko Tameishi, MHA At SCI, though, our commitment to personalized medicine goes beyond gene sequencing and targeted therapies. It drives our holistic approach to cancer care. With 18 well-defined Supportive Care programs, a robust social work/social services team, and a host of classes, therapies and support groups, we are able to complement our patients’ medical and scientific care, and help them cope with the social, psychological and economic challenges of a cancer diagnosis. (For more information, see page 26.) It is evident that because of the progress we have made in the last three years, personalized medicine at SCI is positioned to influence cancer care for many more patients throughout Swedish and its partner healthcare organizations. In fact, we see personalized medicine as our portal to population health and improving the well-being of individuals and communities throughout the Pacific Northwest — and beyond.

Patricia L. Dawson, M.D., Ph.D., and Somasundaram Subramaniam, M.D., M.S.

2 2017 ANNUAL REPORT Influencing the Future of Cancer Care When Swedish first opened its cancer care facility in 1932, I am certain they did not realize that their efforts would launch what is now a premier clinical research center. The Swedish Cancer Institute’s research division works closely with other medical and research organizations, as well as pharmaceutical and biotechnology companies. It offers clinical trials through a wide variety of organizations, such as the National Cancer Institute Community Oncology Research Program (NCORP), the Southwest Oncology Group (SWOG), NCI’s Cancer Trials Support Unit (CTSU), the American College of Surgeons Oncology Group (ACOSOG), the Radiation Therapy Oncology Group (RTOG) and SCI’s own investigator-initiated research. The last decade has seen exponential Elissa Westmoreland, R.N., OCN growth in the prevention, diagnosis and treatment of cancer, as well as — and arguably most importantly — in survivorship. SCI has a long-standing tradition Separate from our efforts to advance Contributing to of forward projection when it comes to the science and benefits of personalized integrating new technologies, improving Population Health medicine, SCI also directs its resources on patient outcomes and translating research At SCI, we believe we have a responsibility programs that focus on high-risk popula- advances into evidence-based standards and an obligation to export expertise and tions, enhancing survivorship and distrib- of cancer care. Through this annual to marshal resources that improve access uting knowledge and expertise throughout report, you will see that this tradition has and contribute to the health of individuals the SCI Network. We have created a become the foundation upon which we and populations alike. nationally recognized model for early- have created a vital nexus of personalized detection screening for individuals at high As a respected thought leader within the medicine, population health and research risk for developing lung cancer, developed Providence-Swedish Health Alliance, and to benefit patients and their families far a multi-location survivorship program that an early adopter of an integrated personal- into the future. supports long-term success and quality ized medicine IT infrastructure, SCI helped of life for patients who have completed Welcome to the Swedish Cancer Institute create the Oncology Precision Network treatment, and implemented a broader and its 2017 Annual Report. (OPeN). This consortium (comprising SCI, Cancer Control Program to assess and Providence Cancer Institute in Oregon, Thomas D. Brown, M.D., MBA better meet the needs of the communities Stanford Medicine’s Cancer Institute in Executive Director we serve. California and Intermountain Healthcare in Swedish Cancer Institute Utah) is the manifestation of a collective vision to share de-identified genomic and clinical data, promoting data mining research and stimulating clinical application.

www.swedish.org/cancer 3 BREAST CANCER

Patricia L. Dawson, M.D., Ph.D. Keith T. Paige, M.D.

Breast cancer care is not episodic at recommend that women ages 40 and and radiation. They also had fewer mas- the Swedish Cancer Institute (SCI); older consider having annual screening tectomies and less chemotherapy than rather, it is a care continuum that mammograms (in contrast to the USPSTF women whose cancer was self-detected begins with diagnosis and continues guideline of ages 50 and older), as well as or detected during a clinical breast exam. through survivorship. The breast care annual clinical breast exams. As part of Another critical finding showed that with team at SCI continually reassesses early detection, they encourage women older women who had cancer detected the management of patients with to maintain familiarity with their breasts breast cancer to ensure their treatment by performing their own breast exams. Enterprise-wide Collaboration is the most appropriate and effective. Additionally, the SCI Breast Program recommends women with a 20 percent or As part of the Swedish affiliation with greater lifetime risk for breast cancer also Prevention and Providence St. Joseph Health, the obtain an annual breast MRI. SCI Breast Program has engaged in Early Detection The value of screening mammograms for clinical performance groups (CPGs) to Breast cancer care begins with prevention older women (those age 75 and older) is better understand what is occurring and early detection, and a firm belief in also a topic of debate. In 2015, SCI’s Henry throughout the system and to develop the value and benefit of mammographic Kaplan, M.D., and Judith Malmgren, evidence-based standards of care. As screening. The SCI Breast Program carefully Ph.D., completed a study that clearly co-chairperson of the Breast Clinical reviewed the materials, commentaries, shows the benefit. They looked at records CPG, SCI’s Breast Program Leader critiques and reviews of the guidelines of 14,000 breast cancer patients, with Patricia L. Dawson, M.D., Ph.D., issued by the United States Preventive 1,600 older than age 75. Results showed has shared SCI’s long history of its Services Task Force (USPSTF) and that the majority of older women whose progressive approach to identifying, decided to join the American College of cancers were detected by mammogram diagnosing and treating breast cancer, Radiology, the Society of Breast Imaging, had early-stage breast cancer, which and has worked toward implementation and other organizations in continuing to was frequently treated with lumpectomy of best practices across the enterprise.

4 2017 ANNUAL REPORT “Hidden Scar” certification, which documents the commitment and skill to minimize the cosmetic impact of breast surgery using specialized techniques. There have also been considerable advances in chemotherapy and how it is delivered. While chemotherapy has traditionally followed breast cancer surgery, today it is becoming more common to use neoadjuvant (i.e., preoperative) chemotherapy to reduce the size of the tumor and eradicate tumor from armpit lymph nodes. With a smaller tumor, surgeons may be able to perform a less-invasive surgery, avoid mastectomy and remove fewer armpit lymph nodes.

Research and Innovation SCI remains the only site in the Pacific Northwest that is involved with the innovative I-SPY breast cancer trial. The purpose of this study is to learn which new agents are most effective with specific Paula S. Hallam, M.D., and Claaire L. Buchanan, M.D. types of breast cancer and what early indicators of response are predictors of treatment success. The METRIC study is an important trial by screening mammogram, there was a plications. In 2016, Swedish became the designed for patients with triple-negative 97 percent five-year survival rate — 10 first and only cancer center in the country breast cancer, a group comprising about percent greater than the others. to offer women with early-stage breast 15 percent of breast cancer diagnoses. cancer permanent breast seed implants For many of these women, available treat- Advancing the Treatment as a safe and effective radiation therapy. ment options are not effective. This study Breast Microseed Treatment™, which uses provides an additional treatment option of Breast Cancer technology similar to that which has been with an investigational drug that targets Breast cancer can be extremely confusing used to treat prostate cancer for years, the gpNMB protein that is over-expressed for patients because of the number of involves placement of radioactive seeds in many cancers, including breast cancer. in the surgical cavity several weeks after different treatment options. It takes clinical The SCI is also developing important surgery. The radioactive seeds treat the expertise and experience to help patients research collaborations with Lee Hood, area over time, and lose all potency by determine how they want to proceed and M.D., and his colleagues at the Institute the time treatment is over. Breast Mi- what treatment would give them the best for Systems Biology (ISB), which will lead croseed Treatment (commonly known possible outcome. It also takes a com- to a new clinical trial. The Evaluation of as brachytherapy) joined other forms of mitment to individualized treatment plans Scientific Wellness Approach in Breast accelerated partial breast irradiation (APBI) and supportive care, and a responsible Cancer Survivors study aims to identify and shorter whole breast radiation therapy pioneering spirit in pursuit of advanced biomarkers for common side effects that protocols as elements of SCI’s focus on therapies. women experience when they receive shorter-course, individualized breast For example, determining which treatment systemic chemotherapy, such as fatigue, radiation therapy. is appropriate for women with ductal car- peripheral neuropathy and neurocognitive cinoma in situ (DCIS), which is considered In addition to identifying the appropriate changes. Evaluating and bringing clarity to the earliest form of breast cancer, requires treatment plan for patients, SCI breast the underlying mechanisms of these side context and consideration of various factors, surgeons have expertise in “oncoplastic” effects, will hopefully lead to the develop- including age, physiology and social im- surgical techniques. They have received ment of ways to prevent or ameliorate them.

www.swedish.org/cancer 5 GASTROINTESTINAL CANCER

Amir Bastawrous. M.D., MBA

The multidisciplinary subspecialty of According to statistics from the Centers Surgical Advancements gastrointestinal oncology accounts for Disease Control and Prevention and for the third largest patient population the National Cancer Institute, the incidence SCI is a regional resource for some of the at the Swedish Cancer Institute (SCI), and death rates for colorectal cancer for most highly advanced procedures, such as Hyperthermic Intraperitonial Chemotherapy with patients with colon cancer the Washington place the state among those (HIPEC) and Irreversible Electroporation largest group within the subspecialty. with the lowest rates in the country. This (IRE) using NanoKnife™. HIPEC is particu- Many initiatives over the years have suggests that efforts at SCI to streamline larly successful in treating intraperitoneal focused on improving outcomes and colon cancer care with a “rush-to-schedule” cancer that has metastasized from primary the patient experience through early approach to accommodate colonoscopy colorectal, ovarian, gastric or appendiceal referrals, as well as partnering with King detection, advanced technology, and cancer, or from mesothelioma and pseu- redesigned processes and evidence- County to send out more than 1,300 fecal domyxoma peritonei. After debulking the based practices. immunochemical testing kits to residents tumor, the surgeon “washes” the abdominal who have not yet had a colon cancer cavity with a heated sterile solution that screening, may be paying off. contains a chemotherapeutic agent. The treatment allows the chemotherapy to be absorbed locally, thus killing the cancer cells at the microscopic level and reducing the side effects associated with standard chemotherapy.

6 2017 ANNUAL REPORT GASTROINTESTINAL CANCER

Streamlining colon cancer care with a “rush-to- schedule” approach to accommodate colonoscopy referrals, and partnering with King County to distribute fecal immunochemical testing kits helps position Washington among states with the lowest incidence and death rates for colorectal cancer.

Evan S.K. Ong, M.D., M.S.

NanoKnife is a minimally invasive procedure cancer who have a successful Whipple The colorectal team has also focused on used to treat small, soft-tissue tumors that procedure have, as a group, five-year implementing a “Surgical Home” concept cannot be removed surgically due to loca- survival rates of up to 20-30 percent. This for colorectal surgery, to optimize every tion or the patient’s condition, or treated procedure may be an optimal treatment aspect of comprehensive care before, with standard chemotherapy or radiation. option for patients whose tumors are during and after surgery — from scheduling Precisely destroying the tumor’s membrane confined to the head of the pancreas and through preoperative preparations, surgery with high-voltage electrical bursts helps haven’t spread to the nearby major blood and recovery. Using a communication plat- avoid damage to the surrounding tissue vessels, liver, lungs or abdominal cavity. form developed by Twistle, the colorectal and structures. NanoKnife is effective for SCI surgeons were pioneers in the use of team has implemented two-way, interactive pancreatic ablations, with patients coming robotic-assisted surgery and the first in communication with its patients via smart to SCI for the procedure from throughout Washington to use the robotic technology phone, email and phone. This form of com- Washington, Alaska, Montana, Idaho, for colon surgery. SCI now has one of the munication has been shown to decrease Oregon and Northern California. largest groups of colorectal robotic surgeons readmissions, surgical site infections and lengths of stay, while increasing patient The Whipple procedure, also known as in the country. This group serves as a satisfaction. Although the surgical home pancreaticoduodenectomy, represents the national resource for training fellows in concept was first implemented at Swedish definitive surgical treatment for early stage robotic techniques. Swedish was among First Hill and Swedish Issaquah, the intent pancreatic head cancers. The number the first to install the next generation of is to extend this approach to other Swedish of Whipple procedures at SCI has nearly robotic technology, the da Vinci Xi® surgical campuses, and to all hospitals throughout tripled since bringing it on line in 2014. system, which offers high-definition 3D the Providence St. Joseph Health enterprise. Although complex, patients with pancreatic visualization and multi-quadrant operability, with shortened operating times. (Continued)

www.swedish.org/cancer 7 Endoscopic Enhancements As an integral component of gastrointestinal cancer care, the Gastroenterology Department has implemented multiple enhancements to diagnose, stage, treat and palliate patients with colon, esophageal, bile, pancreas and neuroendocrine tumors. Among these initiatives are: • Expanded access to endoscopic submucosal dissection for early gastric and esophageal cancers • Reduced surgeries for large, advanced colon polyps by offering complex endoscopic polypectomies • Using optical coherence tomography (NinePoint) to assess early recurrence of Barrett’s esophagus and dysplasia follow ablation • Identifying and treating bile duct cancers using SpyGlass® digital cholangioscopy • Offering radiofrequency ablation (RFA) for bile duct and neuroendocrine tumors Additionally, gastroenterologists have refined their surveillance protocols for Joel D. Lilly, M.D. identifying and following potentially precancerous pancreatic cysts.

Research • A trial using the investigational drug • A recently published study of data from PEGPH20 to increase the number high-volume laparoscopic and robotic As with other types of cancer, the effect of cancer-fighting white blood cells sites throughout Providence and Swedish of research on advancing the diagnosis accumulating in the tumor in patients that showed cost parity between the and treatment of gastrointestinal cancers with pancreatic cancer procedures and shorter lengths of stay is growing exponentially. SCI’s physician with robotic surgery. researchers are actively involved in a • A maintenance clinical trial for patients number of clinical trials for patients with ad- with pancreatic cancer who have BRCA As surgical and endoscopic technologies vanced gastrointestinal cancers, including: mutations and techniques continue to evolve, and drug therapies are introduced and made • A front-line trial for patients with high • An increased emphasis on early diagnosis available through clinical trials, SCI will microsatellite instability (MSI-H) colorectal of patients with hereditary cancers, continue to influence the prevention, cancer using immunotherapy such as Lynch syndrome, in order to diagnosis, treatment and survivability of personalize cancer treatment and to • Immunotherapy protocols for patients with gastrointestinal cancers. also screen relatives gastric cancer

8 2017 ANNUAL REPORT GENITOURINARY

James R. Porter, M.D.

Volume, experience and expertise robot-assisted surgery and its surgeons in the use of robot-assisted surgery in are the building blocks of quality were some of the first to apply these surgical higher-risk patients with later-stage disease. outcomes in the treatment of genito- techniques to genitourinary applications. Dr. Porter now leads a clinical practice group in developing system-wide best-practice urinary cancers. Whether selecting Results of several national surveys show guidelines for the use of robot-assisted the appropriate medical or surgical that experience is a determining factor in surgery in genitourinary cancer. management, or radiation therapy, the success of robot-assisted surgery. SCI the genitourinary team at the Swedish implemented its robot-assisted surgery Stereotactic Radiotherapy: The advent Cancer Institute (SCI) has achieved program for prostate cancer in 2005 when of stereotactic radiotherapy has also had documented long-term excellence. James R. Porter, M.D., already with four a dramatic impact on the treatment of years of robot-assisted prostate surgery prostate cancer. Although prostate tumors Prostate Cancer experience during those early years, joined respond well to radiation therapy, it is the medical staff at Swedish. Dr. Porter difficult to protect surrounding healthy Treating prostate cancer is a complex has used robot-assisted surgery for tissue, and conventional radiotherapy decision matrix. Options may include approximately 85 percent of the more than can lead to long-term bowl or urinary medical management, radiation, alone or 2,200 patients with prostate cancer he problems, as well as erectile dysfunction. in combination with surgery, or traditional, has treated at SCI during the last decade. In 2016, SCI radiation oncologist and laparoscopic or robot-assisted surgery. One of the documented benefits of this principle investigator Robert M. Meier, Robot-Assisted Surgery: Since its type of precise surgery is that 90 percent M.D., presented long-term results of the approval by the U.S. Food and Drug of these patients regain urinary control. first large, multicenter study to determine the safety and efficacy of stereotactic Administration in 2000, robot-assisted Although originally used for patients with radiotherapy in prostate cancer. This study surgery has had a dramatic impact on early-to-mid-stage disease, over the last confirmed that stereotactic radiotherapy multiple specialties. As an early adopter, five years there has been a gradual increase SCI has many years of experience with is an ideal treatment for men with newly (Continued)

www.swedish.org/cancer 9 A Retrospective Study: Minimally Invasive vs. Open Nephrectomy

One of the benefits of the affiliation between Swedish and Providence St. Joseph Health (PSJH) is the opportunity to evaluate outcomes across a broad spectrum of hospitals. James Porter, M.D., director of robotics at Swedish, recently worked with Chris Neighorn of Clinical Program Services for PSJH to conduct a retrospective study of minimally invasive (laparoscopic and robotic) versus open nephrectomy, and partial versus radical nephrectomy. The review looked at 21 hospitals in Alaska, California, Montana, Oregon and Washington, and included 141 surgeons, 28 robots and 1,693 total procedures between January 2013 and May 2015. Key study results showed that: 1. Partial nephrectomy is underutilized, with radical nephrectomy more Song Zhao, M.D., Ph.D. common even for small renal masses, despite partial nephrectomy better stereotactic radiosurgery as a front-line than 20 percent of metastatic prostate preserving renal function therapy for men with prostate cancer. cancers. A phase II clinical trial showed 2. Laparoscopic and robotic procedures Medical Management of Locally promising results of olaparib, a PARP had reduced mortality, shorter lengths Advanced or Metastatic Prostate Cancer: inhibitor, in patients with heavily treated of stay and fewest complications The standard of care for this category of metastatic hormone refractory prostate Song Zhao, M.D., Ph.D. 3. Surgeons with high volumes of mini- patients used to be androgen deprivation cancer. At SCI, , mally invasive procedures had fewer (hormonal) therapy. Today there are more is leading a clinical trial that investigates transfusions, lower complication rates therapeutic options that prolong survival the efficacy of talazoparib, a PARP inhibitor and shorter lengths of stay due to decades of vigorous research. that is more potent than olaparib, in metastatic hormone refractory prostate cancer In the last two years, results of multiple harboring DNA repair gene mutations. phase III clinical trials have provided diagnosed prostate cancer because the compelling evidence that the use of either precise delivery of radiation: abiraterone or docetaxel in addition to Renal Cell Cancer • More effectively avoids radiation to hormonal therapy significantly prolongs Renal cell cancer can be a silent disease, healthy tissue (bladder, rectum, testes survival and lowers the risk of cancer often discovered only after it is large or and urethra) progression and death, compared to has metastasized. During the last 10 to hormonal therapy alone. 15 years, advanced imaging has made it • Offers patients the convenience of possible to detect smaller masses in the treatment in just five visits Compounds that specifically inhibit poly (ADP-ribose) polymerase enzymes (PARP kidneys. Identifying renal cell cancer at an • Provides cancer control rates that inhibitors) have demonstrated potent anti- earlier stage increases treatment options are superior to historic data for other cancer activities in cancer cells harboring and potentially improves outcomes. radiation modalities mutations in DNA-repair genes, such SCI is able to offer patients with renal cell The study showed that at five years as BRCA1, BRCA2 and ATM. In recent cancer a full scope of surgical options, following treatment, 97 percent of low- studies, germ line mutations in DNA repair including traditional, laparoscopic and robot- and intermediate-risk patients were free genes were identified in about 12 percent assisted partial and radical nephrectomies. from prostate cancer progression and of metastatic hormone refractory prostate Because of the decades-long experience fewer than 2 percent experienced serious cancers, and somatic mutations in DNA with robotic surgery, SCI’s surgeons side effects, supporting the use of repair genes have been identified in more now routinely offer patients with small,

10 2017 ANNUAL REPORT early-stage renal cancer robot-assisted, kidney-sparing partial nephrectomy, rather than surgically removing the entire kidney. This precise surgical procedure has become the standard of care at SCI because it is better for the patient by improving long- term survival rates and avoiding the risk of renal insufficiency. As a reflection of the considerable expertise of SCI genitourinary surgeons and radiation oncologists, Joel D. Lilly, M.D., medical director of genitourinary oncology at SCI, has been tasked to lead a clinical practice group with the goal of identifying best practices and establishing enterprise- wide guidelines for Swedish and all of Prov- idence St. Joseph Health for the safe and effective treatment of genitourinary cancers.

Bladder Cancer Systemic chemotherapy with platinum- based regimens has been the standard of care for advanced/metastatic bladder can- Steven M. Eulau, M.D. cer. The five-year survival rate of 15 percent in patients with advanced bladder cancer has not changed in the past three decades. In the past two years, immunotherapy has become the most notable breakthrough in treating advanced bladder cancer. In immunotherapy, immune checkpoint inhibitors, including PD-1 and PD-L1 antibodies, unleash the immune system to attack cancer cells. Since May 2016, five immune checkpoint inhibitors (atezolizumab, avelumab, durvalumab, nivolumab and pembrolizumab) have been approved for treatment of patients with bladder cancer who have progressed on a platinum- based regimen or are considered ineligible for platinum-based regimens due to comorbidities. SCI participated in clinical trials of durvalumab in treating advanced bladder cancer, which led to FDA-approval in May 2017. The role of immunotherapy following surgery for patients with localized bladder cancer is yet to be determined. According to Dr. Zhao, preliminary efforts are under way to initiate a clinical trial at SCI to study the Robert M. Meier, M.D. potential benefit of immunotherapy with pembrolizumab following radical cystectomy.

www.swedish.org/cancer 11 GYNECOLOGIC CANCER

Charles W. Drescher, M.D.

Gynecologic oncologists associated At SCI, a majority of women with gyne- Ovarian cancer is a “hidden” with the Swedish Cancer Institute cologic cancers are treated with minimally (SCI) provide care for nearly one third invasive surgical procedures, including disease that frequently is of patients with gynecologic cancers those with endometrial, ovarian, cervical not discovered until it has in the state of Washington. In the last and vulvar cancers. Surgeons at SCI are quarter of 2016, SCI Division of some of the country’s most experienced in progressed into late-stage Gynecologic Oncology and Pacific the use of minimally invasive surgeries, in- cancer. SCI supports efforts Gynecology Specialists formalized cluding robotic hysterectomies of all types, and strengthened their alliance, bring- cancer resection and staging procedures, to develop systematic ing together two practice groups with sentinel lymph node mapping and biopsy, approaches, so women an overall goal of providing women and, where appropriate, fertility sparing at high risk can be offered greater — and more convenient — treatments. These surgeons have a com- access to gynecologic cancer care, bined total of more than 10,000 minimally the latest options for ancillary and supportive services, invasive surgical procedures, primarily using cancer prevention and palliative care and research studies. the robot-assisted laparoscopic platform. early detection.

12 2017 ANNUAL REPORT Research to observational study intended to document Gynecologic Cancer the extent of patient risk education, Enhance Care By the Numbers referrals for genetic counseling and testing, SCI has been a leader in gynecologic and participation in evidence-based guide- cancer treatment and early-detection More than 110,000 women in the line screening and/or medical and surgical clinical trials. Through the Pacific Cancer United States will be diagnosed with risk reduction interventions. This registry Research Consortium (PCRC), an SCI- gynecologic malignancies in 2018, trial is key during an era of some con- based NCI Community Oncology Research and more than 32,000 women will die troversy regarding cancer screening and Program (NCORP), physician researchers from some form of gynecologic cancer. management, even in women at high risk at SCI participate in gynecologic cancer Uterine cancer is the most common for these cancers. clinical trials relevant to cancer prevention, gynecologic malignancy with an screening and early detection, treatment, estimated 63,230 cases in the United Personalizing Care quality of life and post-treatment sur- States in 2018. veillance. Members of the Gynecologic In concert with SCI’s Personalized Medi- Oncology Division work directly with phar- Although the incidence of gynecologic cine initiatives, tumor sequencing is more maceutical and biotechnology companies cancer is 41 percent that of breast frequently being used to identify relevant to bring investigator-initiated trials, including cancer, the annual death rate from tumor gene alterations that can inform immunotherapy, directly to patients. gynecologic cancer is only 22 percent selection of the most appropriate and lower. Improvements in the early beneficial treatments. As molecular Over the years, a robust relationship has detection and treatment of gynecologic diagnostics and genetic analyses continue developed with other cancer research to advance, gynecologic oncologists are centers in Washington. In 1996, famed cancer are an urgent need. Less than 50 percent of women diagnosed with better able to identify and stratify patients SCI oncologist Saul Rivkin, M.D., to consider: established the Rivkin Center for Ovarian ovarian cancer survive five years. Cancer Research in memory of his wife Among all of the gynecologic cancers, • Who needs adjuvant therapy and Marsha. The center’s mission is to save only cervical cancer currently has an what type of therapy is most likely to women’s lives and reduce their suffering effective screening test. be beneficial through improved treatment, early detection Data Source: American Cancer Society. Cancer Facts & • Ways to avoid unnecessary treatment and prevention of ovarian cancer. The Figures 2018. Atlanta: American Cancer Society; 2018. • Methods to reduce treatment-related connection between SCI and the Rivkin side effects Center is as strong today as it was nearly dent research, and during the last three • Opportunities to improve outcomes two decades ago. That connection, decades have authored more than 160 along with close collaboration with Fred articles for peer-reviewed journals. Because ovarian cancer is a “hidden” Hutchinson Cancer Research Center, has disease that frequently is not discovered In collaboration with the Rivkin Center, SCI spurred the growth of the gynecologic until it has progressed into late-stage is activating a new registry protocol for cancer research program. Gynecologic cancer, there have been significant efforts women at high risk for ovarian and/or Oncology Division investigators have to develop systematic approaches for breast cancer. The Breast and Ovarian received funding from the NCI, Department identifying women at high risk, so they can Cancer Risk Education, Assessment and of Defense and the Ovarian Cancer be offered the latest options for cancer Management (BEAM) protocol is a unique Research Foundation to conduct indepen- prevention and early detection.

www.swedish.org/cancer 13 HEAD & NECK

Namou Kim, M.D., and Joseph B. Golden, M.D.

The Head & Neck Surgery multidisci- Cancers in the head and neck region plinary team at the Swedish Cancer require close coordination to ensure a Head & Neck Cancer Institute (SCI) — a regional quaternary comprehensive continuum of care. Among By the Numbers referral center — has seen consider- a broad range of subspecialties, a patient’s 2016 2017 able growth in the number of patients team may include medical oncology, head presenting with head and neck & neck surgery, radiation oncology, oral Index tumors cancers, thyroid cancers and para- surgery, pathology, endocrinology, imaging, presented at Head & 334 360 thyroid disorders. During the last nursing and cancer rehabilitation medicine, Neck tumor boards as well as swallowing and wound care several years, the service has fine- Thyroid and specialists, speech pathologists and social 396 571 tuned its processes to effectively parathyroid cases workers. SCI ensures patients have tailor each patient’s treatment plan a personalized clinical care team that Free tissue to his or her unique needs. 82 71 includes the most appropriate health-care microvascular flaps professionals, right from the beginning. Trans-oral 33 33 This is particularly important for patients robotic surgeries with malignancies of the upper aero- digestive tract or with thyroid cancers.

14 2017 ANNUAL REPORT HEAD & NECK

two surgical sites. SCI’s head and neck surgeons, along with an exceptional nursing and post-operative team, have the requisite experience and expertise to reduce the risk of infections and produce a 96-98 percent success rate for free flap reconstruction. Surgeons now employ 3-D virtual surgical planning for mandibular or maxillofacial reconstruction. The use of virtual surgical planning has greatly enhanced the positive outcomes of such free flap reconstructions, and has reduced intra-operative time, which improves patient safety.

Thyroid and Parathyroid Since opening in 2014, SCI’s Neck Mass and Thyroid Nodule Biopsy Clinic has seen a tremendous increase in its volumes, with 500 patients and 183 fine needle aspirations in 2017 alone. The clinic offers one-stop, one-day diagnostics — the ultimate convenience and anxiety Jeff M. Robin, MSHS, PA-C, and Joseph C. Sniezek, M.D. reduction for patients with a palpable neck mass or thyroid nodule. The one-stop visit in a single location provides a surgical consultation, ultrasound examination, Head & Neck secondary to radiation or trauma. Since ultrasound-guided fine needle/core biopsy 2010, the SCI’s Head & Neck team has and cytopathology review. Reconstructive Surgery performed 436 free flap reconstructive This service delivery concept, along with The 360 index tumors presented at SCI’s procedures. SCI’s multidisciplinary Thyroid/Parathyroid Head & Neck Tumor Board in 2017 A comprehensive candidate evaluation Tumor Board, is the first of its kind in the represent a 65 percent increase since 2014. process for free flap reconstruction helps Pacific Northwest. The fast-track process The approach with every patient presenting ensure success of this highly sophisticated and collaboration among multiple disciplines with cancer of the head or neck region is to procedure. Patients who are not good can- facilitates the diagnosis and early treatment balance the effectiveness of the treatment didates for free flap reconstruction include for patients with complex and advanced with an outcome that supports functional those who are very sick or elderly, as well malignancies, such as anaplastic thyroid and cosmetic recovery, and avoids what as those with compromised blood vessels. cancer, as well as undifferentiated and could be life-altering side effects. medullary carcinomas. Using the patient’s own tissue with its Microvascular free tissue transfer (free own blood supply is a versatile modality As demand continues to grow, this service flap reconstruction) has become the gold that eliminates the need for anti-rejection has added two additional ultrasound units standard for head and neck reconstruction medications and reduces the risk of graft and additional dedicated personnel, and for cancer patients. It is used primarily for failure. Connecting the graft, along with has developed an outreach program to functional and cosmetic restoration after its arteries and veins, is a delicate and both Swedish and non-Swedish medical ablative surgery for cancer. It is also used time-consuming procedure that produces practices. for restoration of compromised anatomy,

www.swedish.org/cancer 15 HEMATOLOGIC MALIGNANCIES

William I. Bensinger, M.D., and John M. Pagel, M.D., Ph.D., D.Sc.

Innovation is the driving force behind Since joining SCI in 2014, John M. Pagel, This highly sophisticated process, which the growth of the hematologic M.D., Ph.D., chief of hematologic malig- takes about two weeks, tricks the patient’s malignancies program and the nancies and medical director of the center, T-cells, so they attack only the cancer formation of the Center for Blood has led the pursuit of novel approaches cells. CAR T-cell therapy is a viable option Disorders and Stem Cell Transplanta- and drug therapies that could prove for patients whose cancer may have tion at the Swedish Cancer Institute instrumental in improving survivability and recurred despite lengthy chemotherapy (SCI). The program cares for patients disease control. For example, the center is and/or stem-cell transplantation. Early with benign and malignant diseases, the first outside a university-based medical results of the trials are optimistic, but more including acute and chronic leukemias, center to use chimeric antigen receptor studies are needed. T-cell (CAR T-cell) therapy to manipulate multiple myeloma, systemic amy- the patient’s own T-cells to treat his or her loidosis, Hodgkin and non-Hodgkin Stem Cell lymphoid malignancy. Through a clinical lymphomas, myelodysplastic syn- Transplant Program trial, SCI’s physician-researchers: dromes and other myeloproliferative In 2015, SCI hired William I. Bensinger, • Collect the patient’s T-cells disorders. M.D., to lead SCI’s Stem Cell Transplant • Engineer the chimeric gene into the T-cells Program. Dr. Bensinger’s goal is to ensure • Grow the engineered cells to increase a “patient friendly” approach to stem cell the number of cells into the millions transplantation for patients with blood cancers that will lead to positive outcomes • Reintroduce the engineered cells into the patient’s blood

16 2017 ANNUAL REPORT HEMATOLOGIC MALIGNANCIES

and returns patients to their personal on- 2. Immune checkpoint blockade through cologists as quickly as possible. Currently, programmed cell death for PD-L1 Center for Blood the center offers autologous stem cell receptors that allow cancer cells to hide Disorders and Stem Cell transplants, in which the patient’s own cells from the immune system’s T-cells, a Transplantation are collected and frozen while the patient novel therapy that has FDA approval for By the Numbers receives high doses of radiation and/or use with melanoma and lung cancer, chemotherapy therapy to kill the cancer and is under consideration for myeloma 2017 cells in their system. Following treatment, and other blood cancers Total office visits 6537 the patients frozen stem cells are thawed 3. CAR T-cell reengineering, which is and reintroduced to repopulate the blood now being expanded beyond lymphoid Stem cell transplantations 63 with healthy cells. Dr. Bensinger’s team is malignancies to include myeloma Open hematology research trials 69 also beginning to explore developing an allogenic stem-cell transplant program at 4. Immunoconjugates linking cancer-cell- Patients enrolled in a clinical trial 75 SCI, which would use stem cells from a directed antibodies with highly potent matching donor to suppress disease and chemotherapies to directly target the repopulate the patient’s blood. cancer cell for elimination New Patients to SCI First Hill Dr. Bensinger, an internationally renowned Advancing Cancer Care expert in myeloma, is also responsible for by Disease Group* investigating and initiating state-of-the-art through Clinical Trials treatments for myeloma that are not The Center for Blood Disorders and Stem routinely available outside large research Cell Transplantation sees clinical trials as organizations prior to final approval from the important potential components of its U.S. Food and Drug Administration (FDA). patients’ treatment plans. The SCI has He characterizes myeloma as the “poster developed a thorough and effective can- child” for innovative therapies research didate-selection process for most patients because they are treatable, but difficult to in every stage of blood cancer who have cure. With treatments improving dramatically been recently diagnosed, as well as for over the last 15 years, survival rates have those who have not achieved positive more than doubled for patients with multiple outcomes through other treatments. myeloma. But more can be done. With its existing state-of-the-art treatments SCI is involved in about a dozen new drug and a commitment to finding new therapies trials using immunotherapy to reinvigorate, to improve treatment outcomes and cur- Other hematology disorder (533) educate and reset the patient’s own ability, the Center for Blood Disorders and Multiple Myeloma (122) immune system to fight cancer, and to Stem Cell Transplantation has staked its Chronic Lymphocytic Leukemia (68) counter the immune system’s initial failure position as a pioneer in cancer care. to identify and eliminate cancer at its Diffuse Large B Cell Lymphoma (56) earliest stage. These therapies generally Follicular Lymphoma (45) fall into four strategies: Acute Myeloid Leukemia (24) Mantle Cell Lymphoma (17) 1. Monoclonal antibodies (mAb) to directly Myelodysplastic Syndrome (14) target cancer cells and stimulate the patient’s immune system. *Does not include patients who were hospitalized prior to their first clinic visit.

www.swedish.org/cancer 17 NEURO-ONCOLOGY

Charles S. Cobbs, M.D., and Tara L. Benkers, M.D.

The Swedish Cancer Institute (SCI) Neurosurgeons have state-of-the-art sensation and even paralysis. DTI can has a close collaborative relationship operating suites with interoperative MRI significantly improve surgical accuracy with the Swedish Neuroscience and computer-guided navigation equip- during a brain tumor resection and enables Institute (SNI) when it comes to ment to provide the safest and highest providers to customize their surgical diagnosing and treating patients with quality surgical procedures. Additionally, approach to minimize damage to healthy benign or malignant brain tumors. a neurophysiologist is available during any brain tissue. Neurosurgery, with or without systemic requested brain or skull-base surgery to therapy and radiation, remains the provide intraoperative neuromonitoring, The Ben & Catherine Ivy gold standard for treating accessible which helps ensure surgeons are able Center for Advanced to avoid neural elements that control key brain tumors. Many surgical pro- functions. Brain Tumor Treatment cedures are done endoscopically with a much smaller incision than a Most recently, SNI added diffusion tensor Since its opening in 2009, The Ben & Catherine Ivy Center for Advanced Brain traditional craniotomy, promoting a imaging (DTI) to its operating room technol- Tumor Treatment has taken its place faster recovery. For tumors that are ogy. DTI is an advanced MRI-based among the premier brain tumor centers not easily accessible, SCI is fortunate neuroimaging technique to visualize the in the country. Having a multidisciplinary to have available two stereotactic brain’s white matter tracts. The resulting team, which includes neurosurgeons, radiosurgery platforms, CyberKnife® 3D model is called a “diffusion tensor” and neuro-oncologists, radiation oncologists, and GammaKnife®, which allows provides a color-coded map that displays how the brain’s neurons are wired. Neuro- neuropathologists, neuroradiologists, radiation oncologists to select the surgeons use this intraoperative tool as neuro-oncology nurses and a social worker, best possible radiosurgery treatment a direct roadmap when removing brain is of immeasurable value to patients. for each individual patient. tumors and navigating around crucial nerve Of equal importance is the on-site com- fibers. Damage to these fibers can lead to prehensive brain-tumor research laboratory neurologic deficits, including pain, loss of that allows neuropathologists to rapidly

18 2017 ANNUAL REPORT own cancer stem cells to drive therapy decisions. The project’s theory is based on the knowledge that cancer stem cells are a subset of tumor cells and that GBM recurs if the cancer stem cells are not killed by chemotherapy or radiation. Removing these cells, growing them in the lab and using robotics to subject them to thousands of existing compounds can help determine which drugs or combination of drugs are most effective without subjecting the patient to multiple courses of chemotherapy. The Ivy Glioblastoma Atlas Project (Ivy GAP), which was conceived in 2006 and launched in 2009 as a partnership between The Ivy Center, Seattle’s Allen Institute for Brain Science and The Ben & Catherine Ivy Foundation, is a major research initiative focusing on mapping the gene activity in brain tumors. The Ivy GAP is a foundational resource for exploring the anatomic and genetic basis of glioblastoma at the cellular and molecular levels. The intent of this Research associates Hwahyung Lee and Liping Chen, and Charles S. Cobbs, M.D. collaborative effort is to give researchers universal access to a massive amount of tumor genomic information and ano- nymized patient clinical information as a perform genetic analysis of brain tumors immunotherapies, vaccine therapies, catalyst for innovative research that will and provide critical information that helps targeted therapies, gene-based biologics lead not only to a better understanding of The Ivy Center’s medical staff develop and novel modified chemotherapeutics, is GBM, but also to novel new therapies that personalized treatment plans that will one of the benefits of receiving care at a improve clinical outcomes and survival. produce the best possible outcomes. nationally recognized research institute. Another exciting research project is The Ivy Center’s medical staff includes The Susan J. McGregor Viral Glioblastoma evaluating the safety of the ExAblate Charles Cobbs, M.D., the Gregory Foltz, Immunotherapy Program is one of many Transcranial system for brain tumors. M.D., endowed director of The Ben & examples at Swedish of philanthropy The system uses magnetic resonance Catherine Ivy Center for Advanced Brain advancing research. The program is based guided focused ultrasound (MRgFUS) Tumor Treatment, and Tara Benkers, M.D., on research Dr. Cobbs began more than technology that combines MRI to visualize medical director of neuro-oncology. 15 years ago. Working with Institute for body anatomy and monitor treatment in Systems Biology (ISB) in Seattle and Fred real time with high-intensity focused ultra- There are many innovative research projects Hutchinson Cancer Research Center, sound to thermally ablate tissue inside the under way at The Ivy Center, including sev- researchers are leveraging new technologies skull. This noninvasive procedure is per- eral for patients with newly diagnosed and to extract proteins from tumors and to build formed through the patient’s intact skull. recurrent glioblastoma multiforme (GBM), a tumor profile that would help identify pro- one of the most aggressive and deadliest The Neuro-Oncology program at Swedish teins that all of the tumors share. The goal is forms of brain cancer. Since 2013, Dr. is a prime example of two institutes — the to produce a potent immunotherapy vaccine Benkers has brought on nearly a dozen Swedish Cancer Institute and the Swedish that would target those specific proteins, clinical trial therapies to expand access Neuroscience Institute — pooling their thus killing the proteins and the tumor. to experimental therapies for patients in considerable clinical and research expertise the Pacific Northwest who have been In 2015, The Ivy Center began a high-thru- and experience to advance the diagnosis diagnosed with GBM. Access to therapies put cancer stem cell project — the first and treatment of patients with brain cancer that are not yet publicly available, including of its kind in the world to use a patient’s and to improve outcomes and survivability.

www.swedish.org/cancer 19 SARCOMA

Christopher P. Cannon, M.D., and Min S. Park, M.D.

A multidisciplinary team of cancer spe- SCI is stepping up to address these • Tribectedin: For patients with advanced cialists is intent on making the Swedish challenging statistics by developing a liposarcoma and leiomyosarcoma, Cancer Institute (SCI) a regional referral comprehensive service for adults and whose cancer cannot be removed surgi- center for patients with soft-tissue and children in the Greater Puget Sound Area cally and have already been treated with bone sarcomas, which comprise three and the Olympic Peninsula. anthracycline-based chemotherapy percent of all adult cancers and seven The core sarcoma team includes medical • Eribulin: For patients with advanced percent of cancers in children. and surgical oncologists, orthopedic sur- liposarcoma whose cancer cannot be geons, radiation oncologists, pathologists, removed surgically and who have already The family of sarcoma cancers, including and diagnostic imaging and rehabilitation been treated with anthracycline-based cancers such as osteosarcoma, rhab- specialists. The team also includes plastic/ chemotherapy domyosarcoma and Ewing’s sarcoma, is reconstructive surgeons for free-flap and • Olaratumab: A novel platelet-derived often considered an orphan disease (those microvascular reconstruction. New patients affecting fewer than 200,000 individuals growth factor (PDGF) receptor-α–blocking receive a comprehensive, multidisciplinary, antibody that received accelerated nationally). This impression makes it difficult team-based evaluation and are triaged to to secure research funding through govern- approval by the U.S. Food and Drug a medical or surgical oncology pathway. Administration and can be used in ment sources or philanthropy. However, The goal is to create personal teams and based on 2007-2009 data from National combination with doxorubicin as an customized treatment plans that are appro- initial treatment for soft tissue tumors Cancer Institute Surveillance Epidemiology priate for the individual patient. End Result (SEER), one in 304 men and Through SCI’s partnership with the National women will be diagnosed with soft tissue Treatments for sarcomas are becoming Cancer Institute Community Oncology cancer and one in 1,270 with bone and joint much more sophisticated as gene se- Research Program (NCORP) and its partic- cancers during their lifetime. Extrapolating quencing helps further categorize the soft ipation in industry-sponsored clinical trials, those statistics to the U.S. population of tissue and bone tumors and the most physician-researchers at SCI have access 300 million, the Sarcoma Alliance suggests effective measures to treat them. Treating to investigational therapies that might be that about one million people have been or sarcomas at SCI may include newly incorporated into the treatment plan of a will be affected by sarcoma. approved therapies, such as: patient with a diagnosed sarcoma.

20 2017 ANNUAL REPORT THORACIC CANCER

Eric Vallières, MD, FRCSC

The American Cancer Society (ACS) The Swedish Cancer Institute (SCI) has than cancer. That is why SCI developed its estimates than in Washington State long focused its research and expertise on comprehensive, integrated Lung Cancer in 2018 there will be 4,810 new addressing lung and esophageal cancers, Screening and Tobacco Related Diseases cases of lung and bronchus cancer with the goal of improving outcomes Program for high-risk individuals. diagnosed — slightly higher that the through early diagnosis, and new and In addition to research and screening for 4,390 estimated new cases in 2017 innovative personalized therapies, includ- high-risk individuals, SCI also participates — and 390 new cases of esophageal ing expanded expertise in traditional and in research for individuals who don’t meet cancer. The ACS also estimates that minimally invasive surgical procedures. the approved, strict criteria for lung cancer 3,080 Washingtonians will die from screening. One of those protocols, funded lung or bronchus cancer in 2018 — Lung Cancer by a grant from the Flight Attendant Medical slightly lower than 2017 — and 380 SCI is a leader in the treatment and Research Institute (FAMRI), studies the role will die of esophageal cancer. research for all stages of lung cancer, of screening in non-smokers who have treating more patients with this type of been subjected to secondhand smoke. cancer than any other program in the Participation in studies for patients with state. Unfortunately, most patients who early stage lung cancer is integral to SCI’s are found to have lung cancer are diag- thoracic research program. The phase III nosed at a late stage. Often, there are no Stablemate’s Trial is evaluating the efficacy definitive symptoms until the cancer has of stereotactic radiosurgery (three to spread, and patients frequently attribute five treatments over eight or fewer days) one of the early warning signs, such as (Continued) a long-lasting cough, to something other

www.swedish.org/cancer 21 A Cake becomes a Benchmark

Marking five years of survival with a patient over a piece of cake has become a long-standing tradition at the Swedish Thoracic Surgery and Interventional Pulmonology Clinic. As thoracic surgeon Eric Vallières, M.D., FRCSC, referenced in a Swedish blog post, the thank-you cakes the survivors bring to the clinic not only recognize a significant milestone in their personal battles with cancer, they also represent the relationships patients develop with their care teams at Swedish. These cakes may be one of the best benchmarks for SCI’s thoracic team.

and comparing its outcomes in selected patients undergoing sublobar resection. Continuing a long tradition of investigating the role of combined therapies in early Brian E. Louie, M.D. stage disease, physician-researchers at SCI are also participating in trials that study the potential roles of targeted therapies or immunotherapies after the complete resection of stage II and III tumors. Patients with stage IV lung cancer also benefit from the personalized care available at SCI. Recent advances include increasing the availability of detailed genetic testing of the specific mutations driving the cancer, which can now be done from blood samples or tumor tissue. There is a growing array of systemic therapies based on the specific biology of a patient’s cancer, which may include targeted therapies that are highly effective against specific driver mutations, immunotherapy to stimulate the immune system to recognize and attack cancer, chemotherapy, or a combination of approaches. Systemic treatments may also be combined with local therapies, such as surgery or focused radiation, to eradicate specific cancer sites. Additionally, SCI has successfully integrated palliative medicine into the care pathway for patients with Howard L. West, M.D. stage IV lung cancer.

22 2017 ANNUAL REPORT Radiation oncologists may use external beam or brachytherapy radiation to treat a single area where lung cancer has metastasized, such as a tumor in the brain or in an adrenal gland, and also to palliate symptoms of advanced NSCLC, such as reducing pain, bleeding, trouble swallowing or cough. Esophageal Cancer SCI’s Esophageal Cancer Program is a dynamic, multidisciplinary program involving gastroenterologists, oncologists, surgeons and radiation oncologists. Thoracic surgeons and gastroenterologists have expanded their treatment options for Barrett’s esophagus, and early esophageal and gastric cancers. Focusing on the natural anatomical pathway, they offer two procedures that studies have shown effective in treating early esophageal cancers: endoscopic mucosal resection (EMR) and endoscopic submucosal dissection (ESD). When combined, endoscopic ablation of Jessica L. Brower, MSN, ARNP Barrett’s tissue and antireflux surgery can cure early-stage esophageal cancer and preserve the esophagus, while reducing the symptoms of GERD, which have been im- SCI currently has trials, or other targeted response to agents that stimulate the plicated as a cause of esophageal cancer. therapies, directed against driver mutations, immune system. The most common- including EGFR, ALK, ROS1, MET, RET, ly used agents, known as checkpoint There is also continued research by SCI’s BRAF and HER2, with additional trials inhibitors of either PD-1 or PD-L1, remove thoracic surgeons in preventing esophageal being added regularly. These trials and an inhibitory effect on the immune system cancer by treating acid reflux, the underlying therapies may be available not only for and can lead to dramatic and sustained cause of many cancers, with surgical patients with advanced/stage IV non-small responses that often last many years. control of the patient’s symptoms. They are cell lung cancer (NSCLC), but also for Clinical trials at SCI are evaluating how also participating in a multicenter study on some patients with earlier stage disease, to combine these agents with targeted the use of cryotherapy as an alternative to with targeted therapies administered as a therapy, chemotherapy or potentially other radiofrequency ablation (RFA) for treating post-operative therapy to reduce the risk agents that modulate the immune system. Barrett’s esophagus and early esophageal of cancer recurrence. As with targeted agents in patients with cancer. When surgery is required to remove an esophageal cancer, the thoracic surgery Immunotherapy agents are regularly specific driver mutations, some trials are testing the potential benefits of giving im- team seeks to minimize the impact through administered to patients with advanced minimally invasive approaches and novel NSCLC whose tumors have high levels munotherapy as a post-operative therapy to patients with earlier stage NSCLC to methods of pain control, which allows the of a biomarker called PD-L1, which is patient to mobilize and recover sooner. associated with a high probability of improve long-term outcomes.

www.swedish.org/cancer 23 RADIATION ONCOLOGY

Vivek K. Mehta, M.D., and Dailiang Cao, Ph.D.

Something as simple and common ment and shut down the system if radiation therapy (SABR) are emerging as as breathing can dramatically impact movements are outside of tolerance alternatives to surgery for patients with the delivery of radiation therapy. • Gating to appropriately turn the beam lung cancer. In fact, early results suggest Traditionally, radiation oncologists on and off during the respiratory cycle, that in certain patients these types of use lasers and tattoos to ensure which allows the radiation oncologist radiation therapy might have a greater patients who are scheduled for to target smaller areas and reduce curative value than surgery. Working multiple radiation therapy sessions exposure to normal tissue with SBRT and SABR radiation therapy are properly aligned each day. That technology, surface mapping increases As part of the consortium, SCI radiation system, however, treats the patient confidence that the beam is accounting oncologists have found surface mapping for changing breathing patterns and is as a one-dimensional entity, rather particularly beneficial when used with precisely delivering radiation to the target. than a three dimensional body. certain tumor types and clinical scenarios, Sarcoma: including patients with breast or lung cancer, Surface mapping provides The Swedish Cancer Institute (SCI) is one and also those with sarcomas. images that include rounded surfaces, of five sites that are part of a research which is particularly important with sarco- consortium with C-RAD, a manufacturer in Breast Cancer: When treating left-sided mas. This is a significant breakthrough in Sweden, to optimize the implementation breast cancer, it is important to minimize treating sarcomas. of surface mapping, a new technology to the radiation dose to the heart. Surface The Swedish Centers for Advanced Tar- precisely track even the slightest movement mapping is effective for patients who geted Radiation Therapy features the most of the patient or tumor. This new U.S. Food cannot tolerate Active Breathing Coordina- extensive selection of radiation technology and Drug Administration-approved system tor™ (ABC), which requires the patient take available on the West Coast. The addition offers three primary benefits: a deep breath to increase the distance of surface mapping and SCI’s participation between the target and the heart before • Improved positioning accuracy, speed in the five-site research consortium further the beam of radiation is delivered. and efficiency prior to treatment cements SCI’s reputation as a long-standing Lung Cancer: Stereotactic body radiation • Real-time monitoring to detect move- pioneer in the acquisition and use of lead- therapy (SBRT) and stereotactic ablative ing-edge and novel radiation therapies.

24 2017 ANNUAL REPORT A QUALITY ACTION PLAN

Nancy Thompson, MSN, R.N., AOCNS, and Ralph W. Aye, M.D.

Quality is intrinsic to the delivery of During the last two years, the Quality • Timing of referrals to hospice and cancer care at the Swedish Cancer and Safety Committee has collated and palliative care, with implementation Institute (SCI) every day and in every evaluated many national, regional and local of palliative care consult “triggers” for clinic and hospital throughout the sources, including the National Caner Data- defined patient groups SCI Network. It is a fundamental base (NCDB), the National Comprehensive • Documentation of the goals of care belief that regardless of where a Cancer Network (NCCN), the National discussion patient with cancer enters the Quality Forum (NQF), the Quality Oncology The committee also wants to see Swedish system, he or she can Practice Initiative (QOPI) and Hutchinson improvement throughout Swedish in expect the highest quality and safest Institute for Cancer Outcomes Research (HICOR). Based on that evaluation, the more effectively using hospice services, care. The membership of the Quality committee formalized its Blueprint for encouraging decision making and and Safety Committee supports that Quality Improvement and set priorities. palliative care goal setting by patients focus by including representatives and their family members, fostering from multiple campuses, disciplines The committee determined that end- supportive patient/physician end-of-life and specialties who have a passion of-life care would be SCI’s highest quality conversations, soliciting physician feedback for quality. improvement (QI) priority. The QI focus and the use of technology to measure includes: and track improvements. • The use and value of chemotherapy Because end-of-life care is part of the and radiation therapy within 14-30 days reality of cancer care, SCI’s Quality and of the end of a patient’s life Safety Committee is intent on improving • Admission to an intensive care unit the patient and family experience, and to within 14-30 days of the end of a supporting SCI’s care-delivery team as patient’s life part of the institute’s culture of quality. • Death in the hospital

www.swedish.org/cancer 25 SUPPORTIVE CARE

Left to right: Sharla Semana, LICSW; Danielle McLaughlin, LICSW; Anastasia Zankowsky, MSW; and Sandra Johnson, LICSW

Supportive Care Services at the Patient Distress Screening Supportive Care Services Swedish Cancer Institute (SCI) is 2016 and 2017 a multi-dimensional program that National Comprehensive Cancer Network integrates seamlessly into cancer (NCCN) guidelines state that distress in cancer patients should be recognized, care. Supportive care focuses on monitored, documented and treated. meeting the patient’s physical, * The Commission on Cancer stipulates 74 1,711 19,197 emotional, social and spiritual Acupuncture ACS Patient Cancer Education that cancer programs must incorporate Encounters Navigator Encounters, needs, regardless of how complex Encounters Network Wide screening of distress into the standard of or multi-faceted those needs might care, focusing on identifying psychological, be. These services, which are social, financial and behavioral issues that typically not covered by insurance, 967 78,113 2,309 1,493 may interfere with the patient’s treatment Psychiatry Social Work Genetic Cancer are funded through a financial com- Encounters Team Hours Counseling Rehabilitation and affect outcomes, and they must also Encounters Encounters mitment by Swedish and philanthropy. provide patients appropriate resources. SCI’s efforts to meet these guidelines

began in 2009 as a pilot program in its 554 3,396 1,297 2,294 Patient Education Massage Naturopathic Nutrition breast clinics. Since then the program Classes Offered Therapy Hours Medicine Counseling has grown to encompass all medical, Encounters Encounters surgical and radiation oncology clinics at all locations. A new technology (Tonic

for Health) was implemented in the fall 3,820 93,711 1,023 1,931 Knit for Life Video Podcast Art Therapy Music Therapy Encounters Views Encounters Encounters

*Acupuncture encounters data is only for 2017.

26 2017 ANNUAL REPORT Philanthropic support from the community and SCI’s strong commitment to providing supportive care services benefits patients and families who are living with cancer.

of 2015, making it possible for medical oncology patients to complete a distress screening using an iPad. With information imported to the electronic medical record, the patient’s healthcare team can make real-time assessments and intervene during the appointment if necessary. With a significant investment from SCI and donations from the community, SCI has increased the number of social workers in the last five years from five to 17, so Carrie Johnson, R.N., and Meridithe Mendelsohn, MPA, Ph.D. patients are better able to connect with a staff member who is trained to provide the support they need. Personalized Medicine’s Holistic Approach Supportive Care Services is an integral component of SCI’s Personalized Medicine program, which creates a truly holistic approach to cancer care. The commitment SCI has made to provide comprehensive support for cancer patients is demonstrated not only through the wide array of services, but also through program enhancements. For example, SCI hired psychiatrist Shamim H. Nejad, M.D., as medical director of the Division of Psychosocial Oncology, and increased the number of genetic counselors, so more patients and their families could have an opportunity to better understand the potential genetic consequences of their cancers, including psychosocial ramifications.

(Continued)

Music therapist Betsy Hartman, MT-BC (right)

www.swedish.org/cancer 27 Many studies have shown the value of expressive therapies when they are combined with counseling. Philanthropic support from individuals in the community has allowed SCI to expand these therapies and to fund programs like art and music therapies; the SCI Children’s Fund, which supports the children of adults with cancer; and CLIMB, an educational/play therapy program for children and their parents. Survivorship Through medical advancements, more patients are living with cancer as they would with a chronic disease, rather than an acute or episodic medical condition. Patients often fear the last day of treatment because it begins a new phase — survivorship — in which they no longer have the intimate guidance and structure they had during therapy. At SCI, patients are encouraged to meet with the survivorship team to establish a relationship and care plan that is future- focused and supportive of the personal relationships patients have with their oncologists and nurses. Established in Robert Resta, M.S., CGC 2016, SCI’s Survivorship Program continues to grow through outreach to medical oncologists and nurses, re-enforcing this additional service of enhanced support for patients as they transition from direct treatment to their new normal.

Shamim H. Nejad, M.D. (right), with Krish Patel, M.D.

28 2017 ANNUAL REPORT THE SWEDISH CANCER INSTITUTE NETWORK

Martin C. Palmer, M.D., Swedish Cancer Institute – Edmonds

The Swedish Cancer Institute (SCI) has had a long-standing tradition of Swedish Mill Creek providing care close to where patients (Breast Imaging) live and work. Over the years, that SCI at Swedish Edmonds commitment has seen perpetual growth in the number of locations SCI at Swedish Ballard where patients can receive screening, SCI at Swedish First Hill diagnostic testing and treatment. Swedish Cherry Hill In addition to Swedish First Hill, where SCI Radiosurgery Center most quaternary care is provided, patients are fortunate to have access to SCI’s Ben and Catherine Ivy Center for Advanced Brain Tumor Treatment robust cancer-care programs at Swedish’s Edmonds, Issaquah and Ballard campuses, Swedish Redmond and to neuro-oncology services at SEATTLE (Breast Imaging, Colorectal Cancer Care) Swedish Cherry Hill, for which SCI and BELLEVUE the Swedish Neurosciences Institute (SNI) Bellevue Commons share responsibility. (Breast Imaging) BURIEN (Continued) SCI at Swedish Issaquah

Swedish Renton Landing (Colorectal Cancer Care)

www.swedish.org/cancer 29 SCI Edmonds As the campus that serves the northern part of the Greater Puget Sound Area, SCI Edmonds has a robust medical oncology and hematology program that was reaccredited by the Commission on Cancer in 2016 with four commendations. Key to cancer care at SCI Edmonds, is the goal of providing services that allow many patients to avoid traveling great distances for ongoing care. Each month, the Hematology/Oncology clinic averages 80 new patients more than 1,100 patients for one or more visits. Due to increasing demand for patient services, this practice has recently expanded to seven physicians and one advanced practice clinician. The radiation oncology program at SCI Edmonds averages 40 patients per week for daily treatments. SCI Edmonds is a destination for patients in northwest Washington who need cancer care. It offers screening programs; surgical oncology services for colorectal, breast and urological cancers; a full inpatient service with diagnostic and interventional radiology, pathology, and other supporting disciplines; and provides access to clinical trials. Additionally, patients have full access to a wide range of supportive care services, including hospice/palliative care, genetic counseling, music therapy, nutrition counseling, social work services and financial counseling, local support groups and the services of a Survivorship Clinic. SCI Issaquah

When Swedish developed its campus at Christine A. Lee, M.D., and Amy Christian, MSN, R.N., OCN, Swedish Cancer Institute – Issaquah Issaquah, SCI knew that it was an opportunity to create a cancer care program from the bottom up, one that was independent, yet fully integrated with SCI First Hill. The “The Swedish Cancer Institute has developed a network of goal was to provide services locally as a means of overcoming the mental barrier distributed expertise throughout the Greater Puget Sound many patients have about crossing Lake Area as a way of bringing vital services to our communities. Washington for medical care. Since opening, SCI at Issaquah has seen The benefit to our patients and their families of offering growth in all general cancer areas, but quality cancer care closest to where they live and work especially in breast cancer, with new diagnoses up 65 percent from 2014 to is immeasurable.” Thomas D. Brown, M.D., MBA, Executive Director (Continued)

30 2017 ANNUAL REPORT Center on SCI First Hill. Social work and nutrition services, along with classes and seminars provide counseling, education and support. Neuro-Oncology at Swedish Cherry Hill The Swedish Cherry Hill campus is home to the shared neuro-oncology program, which is a collaboration between SNI and SCI. This program is centered at The Ben & Catherine Ivy Center for Advanced Brain Tumor Treatment, which is among the premiere brain tumor centers in the country and the largest in the Pacific Northwest. The multidisciplinary team of neurosurgeons, neuro-oncologists, radiation oncologists, neuropathologists, neuro-radiologists, neuro-oncology nurses and a social worker is of immeasurable value to patients. (For more information about this program, please see page 18.) Outreach SCI is committed to providing greater access to tertiary and quaternary cancer Back row (left to right): Matt Brown, R.N., OCN; Julie Gloede, BSN, R.N., OCN; Mitra Freer, care for communities in western Washing- BSN, R.N., OCN; and Julie Busby, MA-C/PSC-II. Front row (left to right): Stacy Trainor, BSN, ton. Many communities outside the Seattle R.N.; Julie Vannoy, BSN, R.N.; and Karen Buttram, BSN, R.N. urban area are unable to offer many of the services available at SCI, such as personalized medicine studies/gene sequencing, clinical research trials, stereotactic radio- 2016. In support of that growing patient Swedish Ballard therapy, multidisciplinary breast cancer population, Issaquah was the first location therapeutics and plastic reconstruction, SCI Ballard offers full medical oncology in the system to use 3D mammography head and neck surgery, sarcoma services, and infusion therapy services (chemo- for all of its screening and diagnostic thoracic surgery and interventional gas- therapy and biologics), as well as the mammograms. troenterology. The goal of SCI’s outreach supportive care services patients need as SCI Issaquah has a full panel of medical program is to provide those highly special- they progress from treatment to survivor- and surgical oncology subspecialists, and ized services at their clinics and hospitals, ship. The hematologist-oncologists at SCI has added a third hematologist-oncologist. and then return patients to their commu- Ballard have special expertise, including In addition to onsite radiation, chemotherapy nities and their personal cancer-care team focus on hematology, lung cancer and and infusion therapy, patients have access for long-term follow-up care. The outreach geriatric oncology. They also have access to a broad scope of supportive care program has developed an understanding to clinical research trials, including inno- services, including: psycho-oncology, of the ongoing subspecialty needs in com- vative molecularly targeted therapies. An social work, naturopathy, support groups, munities throughout western Washington, expanding breast imaging service, with educational seminars and classes, and a including the Olympic Peninsula, and has digital mammography, high-risk breast survivorship program. As SCI Issaquah built relationships with local oncologists to cancer screening and an onsite breast looks to the future, it envisions developing support their needs — and the needs of health clinic, is provided in close collabora- a coordinated melanoma program to fill an their patients. tion with the True Family Women’s Cancer identified need in the area.

www.swedish.org/cancer 31 ADVANCING CANCER CARE THROUGH RESEARCH

Philip J. Gold, M.D., and Evonne Lackey, CCRP

Over the years, the Swedish Cancer In 2017, more than 55 clinicians were • A molecular tumor board Institute (SCI) has fortified its role involved in more than 400 studies, and • The Robert and Jean Reid Family as a premier research institute, about 1,015 patients were either newly Innovative Therapeutics Unit, a state- through physician-initiated research enrolled in a study or engaged in follow-up of-the-art early phase clinical trials unit protocols, participation in large, protocols. SCI’s Commercial Trials Program focused on investigation of agents that multi-center studies, and phase I and currently has 58 sponsors and 88 research are informed by genomic and broader II protocols using investigational agreements. biologic profiling (see next page) agents. The SCI Personalized Medicine Research The SCI PMRP registry trial has now Program (PRMP) is a nationally and inter- accrued more than 1,000 patients, with In addition to evaluating new medications nationally recognized initiative comprising: and devices, SCI’s physician-researchers impactful findings beginning to emerge also investigate new approaches to • Inhouse next-generation sequencing from data mining of the emerging big-data combining therapies in the pursuit of the (NGS) of tumor DNA set. The SCI PMRP platform has also led to SCI participation in ASCO’s Targeted best possible outcomes, strategies for • An Institutional Review Board-approved Agency and Profiling Utilization Registry cancer prevention and screening, and registry trial advancements in integrated care, genetic Study (TAPUR). This study gives access • A cloud-based integrated informatics counseling, palliative care, rehabilitation to “off-label” use of molecularly targeted platform to facilitate evidence-based agents based on specific gene alterations services and survivorship. analysis and clinical trials matching found within a patient’s tumor.

(Continued)

32 2017 ANNUAL REPORT Advancing Cancer Care Through Research Continued

The American Association of Cancer Reid family and more than 1,200 other monitoring. It offers dedicated space for Research (AACR) has invited SCI, along donors, as well as a significant financial early-phase clinical trials, a translational with leading academic cancer centers, commitment from Swedish, SCI opened laboratory, a specialty pharmacy, a to participate in its GENIE project along The Robert and Jean Reid Family Innovative dedicated family lounge and specially with leading academic cancer centers. Therapeutics and Research Unit. The Reid trained nurses to administer infusions This international project will provide the Family ITU is an early-phase clinical trials according to study specifications. The critical mass of genomic and clinical data unit focused on investigational therapies Reid Family ITU currently has open 29 necessary to improve clinical decision that are driven by SCI’s Personalized early-phase trials. In its first year, more making, and to catalyze new clinical and Medicine Program, specifically biologically than 150 patients were treated on inves- translational research. Through its PMRP, targeted therapies directed by genomics, tigational therapies, accounting for more the SCI, in partnership with other Providence transcriptomics, proteomics, metabolomics, than 1,266 visits. cancer centers and institutes, is contributing micro-biomics and immunological profiling. Through research and innovation, SCI to the development of a Providence St. The Reid Family ITU was designed to be strives to provide cancer patients the best Joseph Health enterprise-wide personalized exceptionally patient and family centered, chance of survival and the highest quality medicine program. and to provide the space and technology of life, and to support initiatives to prevent In March 2016, thanks to a multi-million- to support the administration of novel and ultimately eliminate cancer. dollar lead gift by the Robert and Jean therapies and the associated high-level

SWEDISH CANCER INSTITUTE OPEN RESEARCH STUDIES

Breast 470018 TOLS CGSK 13046 ALTTO (Adjuvant 492190 KAPH CMER 10096 A Randomized Lapatinib and/or Trastuzumab Treatment Opti- Trial of MK8669 in Combination with MK-0646 400000 BEAD XNON 17115 IIT: The utility of misation) study. A Randomised, Multi-Centre, Compared to Exemestane in Estrogen Receptive intraoperative evaluation and microstaging of Open-Label, Phase III Study of Adjuvant Positive Breast Cancer Patients sentinel lymph nodes in breast cancer Lapatinib, Trastuzumab, Their Sequence and 492195 KAPH CNOV 11014 A randomized 470001 JOHE CGEN 13029 A Phase II, Their Combination in Patients with HER2/ErbB2 Phase III, double-blind, placebo-controlled mul- randomized study of Paclitaxel with GDC-0941 Positive Primary Breast Cancer ticenter trial of daily everolimus in combination versus Paclitaxel with Placebo in patients with 470020 TOLS FABP 13060 A Phase III Clinical with trastuzumab and vinorelbine, in pretreated Locally Recurrent or Metastatic Breast Cancer Trial Comparing the Combination of TC Plus women with HER2/neu over-expressing locally 470008 TOLS CGSK 13036 A randomized, Bevacizumab to TC Alone and to TAC for Women advanced or metastatic breast cancer Phase III, open-label study of Lapatinib plus with Node-Positive or High-Risk Node-Negative, 492204 KAPH CGAL 11105 PRESENT: Preven- Trastuzumab versus Trastuzumab as continued HER2-Negative Breast Cancer tion of Recurrence in Early-Stage, Node-Positive HER2 suppression therapy after completion 470021 TOLS FABP 13061 A Phase III clinical Breast Cancer with Low to Intermediate HER2 of first- or second-line Trastuzumab plus trial comparing the combination of Docetaxel Expression with NeuVax Treatment chemotherapy in subjects with HER2-positive plus Cyclophosphamide to Anthracycline-based Metastatic Breast Cancer 492220 BEAD CAGN 12113 Prospective neo- chemotherapy regimens for women with adjuvant REGISTRY trial linking MammaPrint, 470009 TOLS CJOH 13037 Randomized, node-positive or high-risk node-negative, Subtyping and treatment response: Neoadjuvant open-label study of Abiraterone Acetate (JNJ HER2-Negative Breast Cancer Breast Registry-Symphony Trial (NBRST) 212082) plus Prednisone with or without 470023 MCGR CSAN 13073 Multicenter Phase 492221 BEAD CAGN 12114 Prospective Registry Exemestane in postmenopausal women with III Randomized Trial Comparing Doxorubicin ER+ Metastatic Breast Cancer progressing after Of MammaPrint in breast cancer patient with an and Cyclophosphamide Followed By Docetaxel Intermediate recurrence Score (PROMIS) Letrozole or Anastrozole therapy (AC-T) with Doxorubicin and Cyclophosphamide 470011 TOLS CMCK 13039 A randomized, Followed By Docetaxel and Trastuzumab 492224 WAHL CGEN 12131 A Phase II, Ran- Phase 2 trial of preoperative MM-121 with (AC-TH) and With Docetaxel, Carboplatin and domized, Study of Paclitaxel with GCD-0941 Paclitaxel in HER2-negative Breast Cancer Trastuzumab (TCH) in the Adjuvant Treatment Versus Paclitaxel with Placebo in Patients with Locally Recurrent or Metastatic Breast Cancer 470013 TOLS CAMG 13041 A Randomized, of Node Positive and High Risk Node Negative Double-Blind, Placebo-Controlled, Multi-Center Patients with Operable Breast Cancer Containing 492235 ELLE CABV 13105 A Randomized, Phase 3 Study of Denosumab as Adjuvant the HER2 Alteration Phase 2 Study of the Efficacy and Tolerability of Treatment for Women With Early-Stage Breast 470025 TOLS CSAN 13115 A Phase III Trial of Veliparib in Combination with Temozolomide or Cancer at High Risk of Recurrence (D-CARE) Adjuvant TC versus TAC in Early Stage HER2- Veliparib in Combination with Carboplatin and Negative Breast Cancer Paclitaxel Versus Placebo Plus Carboplatin and 470014 DODA CGSK 13042 A Randomized, Paclitaxel in Subjects with BRCA1 or BRCA2 Double-Blind, Placebo-Controlled, Multicenter, 492180 ELLE CGSK 09139 A Randomized, Mutation and Metastatic Breast Cancer Phase III Study Comparing GW572016 and Phase III, Open-label Study of Lapatinib plus Letrozole versus Letrozole in Subjects with Trastuzumab versus Trastuzumab as Continued 492238 ELLE CPFI 13159 Multicenter, Random- Estrogen/Progesterone Receptor- Positive HER2 Suppression Therapy after Completion ized, Double-Blind, Placebo-Controlled, Phase Advanced or Metastatic Breast Cancer of First or Second-line Trastuzumab plus 3 Trial of Fulvestrant (Faslodex) with or without PD-0332991 (Palbociclib) Goserelin in Women 470015 DODA CGSK 13043 Phase II Random- Chemotherapy in Subjects with HER2 positive Metastatic Breast Cancer with Hormone Receptor-Positive, HER2-Neg- ized Trial of Neoadjuvant Trastuzumab and/or ative Metastatic Breast Cancer whose Disease Lapatinib plus Chemotherapy (Sequential FEC75 492188 KAPH FBIC 10016 I-SPY 2 Trial Progressed after Prior Endocrine Therapy and Paclitaxel) in Women with ErbB2- (HER2/ (Investigation of Serial studies to Predict Your neu-) Overexpressing Invasive Breast Cancer Therapeutic Responses with Imaging And MoLecular Analysis) www.swedish.org/cancer 33 492243 ELLE CICT 14034 A Randomized, 492339 KAPH NSWE 16012 Feasibility Study 470022 TOLS CBTH 13072 Phase 3 Open-Label, Double-Blind, Phase 2 Study of Ruxolitinib or for Drug Sensitivity Profiling of Breast Cancer Randomized, Multicenter Study of Imprime Placebo in Combination with Capecitabine Stem Cells PGG in Combination with Cetuximab (Erbitux) in Subjects with Advanced or Metastatic 492345 WAHL CMDV 16142 A Phase 3, in Subjects with Recurrent or Progressive KRAS HER2-Negative Breast Cancer Randomized, International Study Comparing Wild Type Colorectal Cancer 492245 ELLE CNOV 14049 A Phase II, single the Efficacy and Safety of Enzalutamide in 470024 JOHE CROC 13076 A Double-Blind, arm study of the use of steroid-based mouth- Combination With Paclitaxel Chemotherapy or Placebo-Controlled, Randomized, Multicenter wash to prevent stomatitis in postmenopausal as Monotherapy Versus Placebo With Paclitaxel Phase III Study Evaluating the Efficacy and women with advanced or metastatic hormone in Patients With Advanced, Diagnostic-Positive, Safety of Pertuzumab in Combination with receptor positive breast cancer being treated Triple-Negative Breast Cancer Trastuzumab and Chemotherapy in Patients with everolimus plus exemestane 492353 ELLE CMLN 16177 An Open-Label with HER2-Positive Advanced Gastric Cancer 492251 KAPH CABV 14055 A Phase 3, Placebo- Phase 2 Study of MLN0128 (A TORC1/2 Inhib- 492152 GOLP CNOV 08023 Phase II Trial of Controlled Trial of Carboplatin and Paclitaxel with itor) in Combination With Fulvestrant in Women LBH589 in Refractory Colorectal Cancer or without the PARP Inhibitor Velaparib (ABT-888) With ER-Positive/HER2-Negative Advanced or 492158 GOLP CCHU 08058 A Phase I, Open- in HER2-Negative Metastatic or Locally Advanced Metastatic Breast Cancer That Has Progressed Label, Multi-center, Dose-escalation Study of the Unresectable BRCA-Associated Breast Cancer During or After Aromatase Inhibitor Therapy Safety, Tolerability, and Pharmacokinetics of GC33 492258 ELLE CCED 14117 A Randomized Mul- 492363 ELLE CABP 16229 A Phase II Random- Administered Weekly in Patients With Advanced ticenter Pivotal Study of CDX-011 (CR011-vc- ized Study Evaluating the Biological and Clinical or Metastatic Hepatocellular Carcinoma (HCC) MMAE) in Patients with Metastatic, GPNMB Effects of the Combination of Palbociclib With 492167 LOUB CBRX 09021 HALO - Patient Over-Expressing, Triple-Negative Breast Cancer Letrozole as Neoadjuvant Therapy in Post-Meno- Registry: Ablation of Barrett’s Esophagus 492260 ELLE CPFI 14154 An expanded access pausal Women With Estrogen-Receptor Positive Primary Breast Cancer 492178 GOLP CAGI 10018 A Dose Finding study of Palbociclib in combination with Letrozole & Phase II Study of AZD 6244 (Hyd-Sulfate) as treatment of post-menopausal women with 492381 WAHL CFHC 13128 A Randomized, in Combination with Irinotecan in 2nd Line hormone receptor positive, HER2 negative Multicenter, Open-Label Phase III Study to Patients with K-ras or B-raf Mutation of Positive advanced breast cancer for whom Letrozole Evaluate the Efficacy and Safety of Trastuzumab Advanced Metastatic Colorectal Cancer therapy is deemed appropriate Emtansine Versus Trastuzumab as Adjuvant 492181 GOLP CAOI 10032 A Phase III Ran- 492268 KAPH CCAN 14177 Combination Therapy for Patients With HER2-Positive Primary Breast Cancer Who Have Residual Tumor Present domized Double-Blind Study to Assess the Effi- immunotherapy with Herceptin and the HER2 cacy and Safety of Perifosine Plus Capecitabine vaccine E75 in low and intermediate HER2 Pathologically in the Breast or Axillary Lymph Nodes Following Preoperative Therapy Versus Placebo Plus Capecitabine in Patients negative expressing breast cancer patients to with Refractory Advanced Colorectal Cancer prevent recurrence 492384 ELLE CCTX 17117 A Phase 1-2, Open- 492186 GOLP CNOV 10097 IIT Phase I/II Study 492275 WAHL CMCK 15087 A Randomized, Label, Dose-Finding, Proof of Concept, First-in- Human Study to Evaluate the Safety, Tolerability, of AUY922 and Cetuximab in Patients with Multicenter, Open Label Study of MM-302 Plus KRAS Wild-Type Metastatic Colorectal Cancer Trastuzumab vs. Chemotherapy of Physician’s Pharmacokinetics, and Pharmacodynamics of Choice Plus Trastuzumab in Anthracycline Naive CX-2009 in Adults With Metastatic or Locally 492192 GOLP CDAI 11028 A Randomized, Locally Advanced/Metastatic HER2-Positive Advanced Unresectable Solid Tumors (PRO- Placebo-Controlled, Phase I/II Study of ARQ197 Breast Cancer CLAIM-CX-2009) in combination with Irinotecan and Cetuximab in Subjects with metastatic colorectal cancer with 492291 KAPH CABP 15017 Phase III Study 4XXXXX KAPH CEIA 16183 A Randomized, Open-label, Multicenter, Phase 1b/2 Study of Wild-Type KRAS who have received Front-Line Evaluating Palbociclib (PD-0332991), a Cyclin- Therapy Dependent Kinase (CDK) 4/6 Inhibitor in Patients Eribulin Mesylate in Combination With PEGylated With Hormone-receptor-positive, HER2-normal Recombinant Human Hyaluronidase (PEGPH20) 492193 RIVS CCHO 11006 Phase I Trial of Primary Breast Cancer With High Relapse Risk Versus Eribulin Mesylate Alone in Subjects With Intraperitoneal nab-Paclitaxel (Abraxane) in the after Neoadjuvant Chemotherapy: PENELOPEB Human Epidermal Growth Factor Receptor 2 Treatment of Advanced Malignancies Primarily (HER2)-Negative, High-Hyaluronan (HA) Meta- Confined to the Peritoneal Cavity 492295 ELLE CMAC 15083 A Phase 3, Random- static Breast Cancer (MBC) ized Study of Margetuximab Plus Chemotherapy 492206 GOLP CBAY 12049 An Open-label vs Trastuzumab Plus Chemotherapy in the Treat- Cutaneous Phase IIIb Study of Regorafenib in Patients with ment of Patients With HER2+ Metastatic Breast Metastatic Colorectal Cancer (mCRC) Who 492147 RIVS CBRI 07162 A Multicenter Have Progressed After Standard Therapy Cancer Who Have Received Prior Anti-HER2 Treatment Protocol for Compassionate Use Therapies and Require Systemic Treatment of Ipilimumab (BMS 734016) Monotherapy in 492217 LOUB CTOR 12122 A Post-approval 492307 ELLE CELI 15247 monarcHER: A Phase Subjects with Unresectable Stage III or Stage IV Study of the LINX Reflux Management System 2, Randomized, Multicenter, 3-Arm, Open-Label Melanoma 492218 GOLP CATX 12140 A Phase 2 Study of Study to Compare the Efficacy of Abemaciclib 492242 KAPH CMER 14069 Expanded Access SGI-110 in the Treatment of Advanced Hepato- Plus Trastuzumab With or Without Fulvestrant to of MK-3475 in Metastatic Melanoma Patients cellular Carcinoma (HCC) Subjects Who Failed Standard-of-Care Chemotherapy of Physician’s with Limited to No Treatment Options Prior Treatment with Sorafenib Choice Plus Trastuzumab in Women With HR+, 492227 GOLP CEXE 13091 A Phase 3, HER2+ Locally Advanced or Metastatic Breast Gastroenterology Randomized, Double-blind, controlled Study Cancer 400000 FARA XNON 17084 IIT: Reducing the Use of Cabozantinib (XL184) versus Placebo in 492319 WAHL CONT 15263 Phase 2 Ran- of Catheters and Tubes after Hiatal Hernia Sur- Subjects with Hepatocellular Carcinoma who domized, Double-Blinded, Controlled Study gery: Evaluation of a Quality Improvement Project have Received Prior Sorafenib of ONT-380 vs Placebo in Combination With 400000 GRIJ XNON 17069 IIT: Anemia correction 492253 GOLP CAGI 14087 Phase 1/2 Study of Capecitabine and Trastuzumab in Patients With before colorectal cancer surgery: a retrospective PF-03084014 in Combination with Gemcitabine Pretreated Unresectable Locally Advanced or review of a single institutional experience and Nab-Paclitaxel in Patients with Previously Metastatic HER2+ Breast Carcinoma 400000 GRIJ XNON 17074 IIT: Efficacy vs. Cost Untreated Metastatic Pancreatic Ductal Adeno- 492320 KAPH CMDV 16064 A Phase 3, Open- in Colorectal Surgical Staplers carcinoma Label, Randomized, Parallel, 2-Arm, Multi-Center 492283 LOUB CTOR 15142 The CALIBER Study of BMN 673 Versus Physician’s Choice in 470006 JOHE CTES 13034 A Phase 3, multi- Study: A Randomized Controlled Trial of LINX Germline BRCA Mutation Subjects With Locally center, randomized, double-blind, active-con- versus Double-Dose Proton Pump Inhibitor Advanced and/or Metastatic Breast Cancer, Who trolled study of the safety and efficacy of Rolapi- Therapy for Reflux Disease Have Received No More Than 2 Prior Chemo- tant for the prevention of Chemotherapy-Induced therapy Regimens for Metastatic Disease Nausea and Vomiting (CINV) in subjects receiving Moderately Emetogenic Chemotherapy (MEC)

34 2017 ANNUAL REPORT 492284 SUBS CASZ 15146 A Phase III, Ran- 492273 ZHAS CELI 15052 A Double-Blinded, Hematologic domized, Double-Blind, Placebo Controlled, Placebo-Controlled, Randomized Phase II Multicentre Study of Maintenance Olaparib Study of Enzalutamide With or Without the PI3 400000 PAGJ XNON 17127 IIT: Clinical out- Monotherapy in Patients with gBRCA Mutated Kinase/mTOR Inhibitor LY3023414 in Men with comes following ibrutinib and venetoclax based Metastatic Pancreatic Cancer whose Disease Metastatic Castration Resistant Prostate Cancer therapy in chronic lymphocytic leukemia: A multi-center retrospective analysis. Has Not Progressed on First Line Platinum 492300 SONZ CASZ 15198 A Phase III, Ran- Based Chemotherapy domized, Open-label, Controlled, Multi-Center, 470003 JOHE CMLN 13031 An open-label, 492292 SUBS CUNC 15085 Phase Ib/II Study Global Study of First-Line MEDI4736 Monother- randomized, Phase 2 study to assess the effec- of Neoadjuvant Chemoradiotherapy With CRLX- apy and MEDI4736 in Combination With Tremeli- tiveness of R-CHOP with or without VELCADE 101 and Capecitabine for Locally Advanced mumab Versus Standard of Care Chemotherapy in previously untreated patients with Non-Ger- Rectal Cancer in Patients With Unresectable Stage IV Urothelial minal Center B-Cell-like Diffuse Large B-Cell Lymphoma. 492293 GOLP CMAC 15213 A Phase 1b/2, Bladder Cancer Open Label, Dose Escalation Study of Margetux- 492356 ZHAS CPEL 16192 A Phase 1, Multiple- 470005 JOHE CSEG 13033 A Phase 2, open- imab in Combination with Pembrolizumab in Pa- Dose, Dose-Escalation Trial of PT2385 Tablets, a label, study of Brentuximab Vedotin in patients with tients with Relapsed/Refractory Advanced HER2+ HIF-2α Inhibitor, in Patients With Advanced Clear CD30-positive nonlymphomatous malignancies Gastroesophageal Junction or Gastric Cancer Cell Renal Cell Carcinoma 470007 MCGR CSEG 13035 A Phase 2 study 492301 GOLP CBBI 15200 A Phase III Ran- 492367 ZHAS CMDV 16226 A Phase 2, of Brentuximab Vedotin in relapsed or refractory domized, Double-Blind, Placebo-Controlled Open-Label, 2-Arm, Response Rate Study of CD30-positive non-Hodgkin lymphoma (NHL) Clinical Trial of BBI608 plus Weekly Paclitaxel vs Talazoparib in Men With DNA Repair Defects 470012 TOLS CCLG 13040 The Chronic Placebo plus Weeky Paclitaxel in Adult Patients and Metastatic Castration-Resistant Prostate Lymphocytic Leukemia Disease Registry, with Advanced, Previously Treated Gastric and Cancer Who Previously Received Taxane-Based CONNECT CLL Gastro-Esophageal Junction Adenocarcinoma Chemotherapy and Progressed on at Least 1 470016 TOLS CNOV 13044 A Prospective, 492302 GOLP CHAL 15214 A Phase 1b Open- Novel Hormonal Agent (Enzalutamide and/or Non-Interventional Multicenter Registry in Iron Label Study of PEGylated Recombinant Human Abiraterone Acetate/Prednisone) Overloaded Lower-Risk Myelodysplastic Patients Hyaluronidase (PEGPH20) Combined With 4XXXXX ZHAS CAFT 17176 A Phase 3 Study of 470017 TOLS CNOV 13045 A multi-center, Pembrolizumab in Subjects With Selected Androgen Annihilation in High-Risk Biochemically randomized, double-blind, placebo-controlled Hyaluronan High Solid Tumors Relapsed Prostate Cancer clinical trial of deferasirox in patients with 492309 LOUB CC2T 15255 Multi-center Clinical Gynecologic myelodysplastic syndromes (low/int-1 risk) and Study to Evaluate the Coldplay Focal Ablation transfusional iron overload (TELESTO) 492359 PARM CASZ 16169 (CONCERTO) A System for the Treatment of Patients With Previ- 470019 TOLS CGSK 13047 A phase III, open ously Untreated Dysplastic Barrett’s Epithelium Single Arm, Open-label, Phase IIb Study to As- sess the Efficacy and Safety of the Combination label, randomized, multicenter trial of Ofatu- 492310 GOLP CHAL 15260 A Phase 3, Ran- of Cediranib and Olaparib Tablets in Women mumab added to Chlorambucil vs. Chlorambucil domized, Double-Blind, Placebo-Controlled, With Recurrent Platinum Resistant Epithelial Monotherapy in previously untreated patients Multicenter Study of PEGylated Recombinant Ovarian Cancer, Including Fallopian Tube and/or with Chronic Lymphocytic Leukemia Human Hyaluronidase (PEGPH20) in Combi- Primary Peritoneal Cancer Who do Not Carry a 470027 TOLS CAXN 13125 Paroxysmal nation With Nab-Paclitaxel Plus Gemcitabine Deleterious or Suspected Deleterious Germline Nocturnal Hemoglobinuria (PNH) Registry Compared With Placebo Plus Nab-Paclitaxel and BRCA Mutation Gemcitabine in Participants With Hyaluronan-High 492085 MILM CGEN 0444 The National Stage IV Previously Untreated Pancreatic Ductal 492369 Tapur Targeted Agent and Profiling Lymphocare Study: An Observational Study of Adenocarcinoma Utilization Registry (TAPUR) Study Treatment, Outcomes and Prognosis in Patients with Follicular Non-Hodgkin’s Lymphoma 492326 GOLP CMER 15288 A Phase III Study of 492384 Cytomx 2009 A Phase 1-2, Open-Label, Pembrolizumab (MK-3475) vs. Chemotherapy Dose-Finding, Proof of Concept, First-in-Human 492111 MILM CNOV 0598 A Phase IA/II Multi- in Microsatellite Instability-High (MSI-H) or Study to Evaluate the Safety, Tolerability, center, Dose-Escalation Study Of Oral AMN107 Mismatch Repair Deficient (dMMR) Stage IV Pharmacokinetics, and Pharmacodynamics of On A Continuous Daily Dosing Schedule In Colorectal Carcinoma (KEYNOTE-177) CX-2009 in Adults With Metastatic or Locally Adult Patients With Gleevec-Resistant CML In Advanced Unresectable Solid Tumors (PRO- Accelerated Phase Or Blast Crisis, Relapsed/ 492335 GOLP CAGI 16099 A Phase II, Multi- CLAIM-CX-2009) Refractory Ph+ ALL, Systemic Mastocytosis, Or center, Single-Arm Study of Oral Ceritinib in Adult Hypereosinophilic Syndrome Patients With ALK-Activated Gastrointestinal 492385 DREC CAPA 17124 PiSARRO APR407 Malignancies p53 Suppressor Activation in Recurrent High 492150 MILM CNOV 07146 Bone Marker Grade Serous Ovarian Cancer, a Phase Ib/ Directed Dosing of ZOMETA (zoledronic acid) 492343 BASA CITV 16181 A Multi-Center II Study of Systemic Carboplatin Combination for the Prevention of Skeletal Complications in Retrospective Comparison of Intracorporeal Chemotherapy With or Without APR-246 Patients with Advanced Multiple Myeloma and Extracorporeal Anastomoses for Minimally Invasive Right Colectomy 492386 PREJ CTES 17125 (GARNET) A Phase 492159 KAPH CCLG 07163 A Phase III, Ran- 1 Dose Escalation and Cohort Expansion Study domized, Open-Label, 3-Arm Study To Determine 492357 LOUB CSUR 16082 Registry of Out- of TSR-042, an Anti-PD-1 Monoclonal Antibody, The Efficacy And Safety Of Lenalidomide Plus comes From AntiReflux Surgery (ROARS) in Patients With Advanced Solid Tumors Low-Dose Dexamethasone When Given Until 492366 GOLP CAGI 16232 A Phase 2, Open- 492389 PREJ CTES 17106 (PRIMA) A Phase Progressive Disease Or For 18 Four-Week Cycles Label, Single-Arm, Multicenter Study to Evaluate 3, Randomized, Double-Blind, Placebo-Con- Versus The Combination Of Melphalan, Predni- the Efficacy and Safety of INCB054828 in Sub- trolled, Multicenter Study of Niraparib Mainte- sone, And Thalidomide Given For 12 Six-Week jects With Advanced/Metastatic or Surgically Un- nance Treatment in Patients With Advanced Cycles In Patients With Previously Untreated resectable Cholangiocarcinoma Including FGFR2 Ovarian Cancer Following Response on Front- Multiple Myeloma Who Are Either 65 Years Of Translocations Who Failed Previous Therapy Line Platinum-Based Chemotherapy Age Or Older Or Not Candidates For Stem Cell Transplantation (Protocol Ifm 07-01) Genitourinary 492400 PREJ CNBM 17108 NuCana PRO A Phase II Open- Label Study of NUC-1031 492166 MILM CCEP 08114 An Open Label, 492207 WESH CEXE 12061 A Phase 3, Randomized Multicenter Study of Benda- randomized, double-blind, controlled trial of in Patients With Platinum-Resistant Ovarian Cancer mustine Hydrocholride and Rituximab (BR) cabozantinib (XL184) vs. mitoxantrone plus pred- Compared with Rituximab, Cyclophospha- nisone in men with previously treated symptom- 905244 PMRP Personalized Medicine Research mide, Vincristine, and Prednisone (R-CVP) or atic castration-resistant prostate cancer Program – A Registry Protocol Rituximab, Cyclophosphamide, Doxorubicin, RESTART (Fred Hutch) Learning to Reduce Vincristine and Prednisone (R-CHOP) in the Stress and Anxiety after Cancer Treatment First Line Treatment of Patients with Advanced

www.swedish.org/cancer 35 Indolent Non-Hodgkin’s Lymphoma (NHL) and Monotherapy Versus Salvage Chemotherapy in 492287 KAPH CARI 15177 A Postmarketing Mantle Cell Lymphoma (MCL) Subjects with FLT3-ITD Positive Acute Myeloid Observational Cohort Study to Evaluate the 492170 MILM CNOV 09058 A Phase Ib Multi- Leukemia (AML) Refractory to or Relapsed after Incidence of and Risk Factors for Vascular Center, Open-Label, Dose-Escalation Study First-Line Treatment with or without Hematopoiet- Occlusive Events Associated with lclusig of Oral LBH589 and IV Bortezomib in Adult ic Stem Cell Transplantation (HSCT) Consolidation (Ponatinib) in routine Clinical Practice in the US Patients with Multiple Myeloma 492256 PAGJ CCLG 14066 Connect MDS and Protocol#: AP24534-13-401 492175 KAPH CCLG 09069 A Phase 3, Multi- AML: Myelodysplastic Syndromes (MDS) and 492288 PAGJ CINA 15183 Open Label 1b/2a center, Randomized, Open Label, Parallel-Group Acute Myeloid Leukemia (AML)Disease Registry Trial of a Combination of IPH2201 and Ibrutinib Study Of The Efficacy And Safety Of Lenalido- 492259 MILM CARY 14097 ARRAY-520-311: in Patients With Relapsed or Refractory Chronic mide (Revlimid) Versus Chlorambucil As First line A Multinational, Randomized, Open-label Phase Lymphocytic Leukemia Therapy For Previously Untreated Elderly Patients 3 Study of Filanesib (ARRY-520) + Carfilzomib 492290 PAGJ CCLG 15199 Phase 3 Ran- With B-Cell Chronic Lymphocytic Leukemia Versus Single-agent Carfilzomib in Patients With domized, Double-Blind, Placebo Controlled, 492177 MILM CNOV 09140 A Multicenter, Ran- Advanced Multiple Myeloma Multicenter Study to Compare the Efficacy and domized, Double-Blind, Placebo Controlled Phase 492265 PAGJ CABV 14200 A Phase 1 Study Safety of Lenalidomide (CC-5013) Plus R-CHOP Ill Study Of Panobinostat (PAN) In Combination Evaluating the Safety and Pharmacokinetics Chemotherapy (R2-CHOP) Versus Placebo Plus With Bortezomib (BTZ) And Dexamethasone (Dex) of ABT-199 in Subjects With Relapsed or R-CHOP Chemotherapy in Subjects with Pre- Inpatients With Relapsed Multiple Myeloma Refractory Chronic Lymphocytic Leukemia and viously Untreated Activated B-Cell Type Diffuse Large B-Cell Lymphoma 492197 KRAK CBRI 11060 Studying Inter- Non-Hodgkin Lymphoma ventions for Managing Patients with Chronic 492267 PAGJ CGEN 15005 A Phase 1b/2 Study 492294 PAGJ CPCY 15182 informCLL: A Myeloid Leukemia In Chronic Phase: The 5-Year Evaluating the safety, tolerability and anti-tumor Disease Registry for Patients With Chronic Prospective Cohort Study (SIMPLICITY) activity of polatuzumab vedotin (DCDS4501A) in Lymphocytic Leukemia 492201 KAPH CPFI 11036 An Open-Label, Combination with Rituximab (R) or obinutuzumab 492299 BENW CSAN 15195 A Phase 1b Study Randomized, Phase 3 Study of Inotuzumab (G) plus bendamustine (B) in relapsed or refracto- of SAR650984 (Isatuximab) in Combination With Ozogamicin Administered in Combination with ry follicular or diffuse large B-cell lymphoma Pomalidomide and Dexamethasone for the Treat- Rituximab Compared to Defined Investigator’s 492269 PAGJ CTGT 15050 A Phase 3, ment of Relapsed/Refractory Multiple Myeloma Choice Therapy in Subjects with Relapsed or Randomized, Study to Assess the Efficacy 492303 PAGJ CTGT 15251 A Phase 3, Refractory CD22-Positive Aggressive Non-Hod- and Safety of Ublituximab in Combination with Randomized Study to Assess the Efficacy and gkin Lymphoma Who Are Not Candidates for Ibrutinib Compared to Ibrutinib Alone, in Safety of Ublituximab in Combination With Intensive High-Dose Chemotherapy Patients with Previously Treated High-Risk TGR-1202 Compared to Obinutuzumab in 492211 MILM CELI 11122 A Phase 2 Study of Chronic Lymphocytic Leukemia (CLL) Combination With Chlorambucil in Patients With LY2784544 in Patients with Myeloproliferative 492270 PAGJ CEME 15016 A Phase 1b, Open Chronic Lymphocytic Leukemia (CLL) Neoplasms Label Study to Evaluate the Safety and Efficacy 492304 BENW CBRI 15196 A Phase 2 Single 492219 MILM CCLG 12115 A Multicenter, Single- of TRU-016 in Combination with Rituximab, in Arm Study of Elotuzumab in Combination With Arm, Open-Label Treatment Use Program for Combination with Obinutuzumab, or in Combi- Pomalidomide and Low Dose Dexametha- Pomalidomide (POM) in Combination with Low nation with Rituximab and Idelalisib in Patients sone (EPd) in Patients With Multiple Myeloma Dose Dexamethasone (LD_DEX) in Subjects with with Chronic Lymphocytic Leukemia Relapsed or Refractory to Prior Treatment With Relapsed or Refractory Multiple Myeloma 492271 PAGJ CPCY 15049 A Multi-Center Lenalidomide 492222 MILM CCLG 13051 A Phase 3, Open-Label Study of the Brutons Tyrosine 492305 BENW CKPT 15161 A Phase 2b, Multicenter, Randomized, Open Label Study to Kinase (BTK) Inhibitor, Ibrutinib, in Combination Open-Label, Single-Arm Study of Selinexor Compare the Efficacy and Safety of Poma- with MEDI4736, in Subjects with Relapsed or (KPT-330) Plus Dexamethasone in Patients With lidomide, Bortezomib and Low-Dose Dexa- Refractory Lymphomas Multiple Myeloma Exposed to Bortezomib, Car- methasone versus Bortezomib and Low-Dose 492272 PAGJ CACT 15015 A Phase 1/2, filzomib, Lenalidomide and Pomalidomide and Dexamethasone in Subjects with Relapsed or Multicenter, Open-label, and Dose-escalation Refractory to an IMiD and a Proteasome Inhibitor Refractory Multiple Myeloma Study of ACP-196 in Subjects with Chronic 492308 PAGJ CGEN 15248 A Phase Ib/II Study 492223 MILM CGIL 13050 A Phase 3, Random- Lymphocytic Leukemia, Richter’s Syndrome or Evaluating the Safety and Efficacy of Obinu- ized, Double-Blind, Placebo-Controlled Study Prolymphocytic Leukemia tuzumab in Combination With Idasanutlin in Evaluating the Efficacy and Safety of Idelalisib 492276 PAGJ CPRT 15078 A Phase II Study of Patients With Relapsed or Refractory Follicular (GS-1101) in Combination with Bendamustine PNT2258 in Patients With Richter’s Transforma- Lymphoma or Diffuse Large B-Cell Lymphoma and Rituximab for Previously Treated Indolent tion (RT) 492311 PAGJ CADC 15261 A Phase 1, Non-Hodgkin Lymphomas 492277 PAGJ CONY 15059 Phase 1b Study of Open-label, Dose-escalation, Multicenter Study 492228 MILM CCLG 13084 A Phase 3, Ran- Carfilzomib Administered Once Weekly in Com- to Evaluate the Tolerability, Safety, Pharmaco- domized, Double-blind, Placebo-Controlled bination with Lenalidomide and Dexamethasone kinetics, and Activity of ADCT-301 in Patients Study to Compare the Efficacy and Safety of in Subjects with Multiple Myeloma With Relapsed or Refractory CD25-positive Oral Azacitidine plus Best supportive Care Acute Myeloid Leukemia (AML) or CD25-posi- 492280 PAGJ CACT 15144 A Randomized, tive Acute Lymphoblastic Leukemia Versus Best Supportive Care as Maintenance Multicenter, Open-Label, Non-Inferiority, Phase Therapy in Subjects with Acute Myeloid Leukemia 3 Study of ACP-196 Versus Ibrutinib in Previ- 492312 PAGJ CACT 15262 A Phase II Study in Complete Remission ously Treated Subjects with High Risk Chronic Using ACP-196 in Patients With Relapsed/Refrac- 492230 KAPH CMLN 13092 A Phase 3, Lymphocytic Leukemia tory and Treatment Naive Deletion 17p CLL/SLL Randomized, Double-blind, Multicenter Study 492281 PAGJ CACT 15143 A Randomized, 492313 MAWR CSEG 15270 A Phase 1/2 Comparing Oral MLN9708 Plus Lenalidomide and Multicenter, Open-Label, 3 Arm Phase 3 Study of Vadastuximab Talirine (SGN-CD33A) in Dexamethasone versus Placebo Plus Lenalido- Study of Obinutuzumab in Combination With Combination With Azacitidine in Patients With mide and Dexamethasone in Adult Patients with Chlorambucil, ACP-196 in Combination With Previously Untreated International Prognostic Newly Diagnosed Multiple Myeloma (NDMM) Obinutuzumab, and ACP-196 Monotherapy in Scoring System (IPSS) Intermediate-2 or High 492234 MILM CMEI 13093 A Phase II Random- Subjects With Previously Untreated CLL Risk Myelodysplastic Syndrome (MDS) ized, Double-Blinded, Placebo-Controlled Study 492282 PAGJ CACY 15139 A Dose-Escalation 492314 PAGJ CTGT 16028 A Phase 2 Study to of Pracinostat in Combination with Azacitidine in Study to Determine the Maximum Tolerated Assess the Safety and Efficacy of TGR-1202 in Patients with Previously Untreated International Dose, Safety, and Preliminary Antitumor Activity Patients with Chronic Lymphocytic Leukemia Prognostic Scoring System (IPSS) Intermediate of Oral ACY-241 Alone and in Combination With (CLL) who are Intolerant to Prior BTK or Risk 2 or High-Risk Myelodysplastic Syndrome Pomalidomide and Low Dose Dexamethasone PI3K-Delta Inhibitor Therapy 492241 MAWR CAMB 14011 A Phase 3 Open- in Relapsed or Relapsed and Refractory Multiple Label Randomized Study of Quizartinib (AC220) Myeloma

36 2017 ANNUAL REPORT 492315 BENW CKPT 15267 A Phase 1b/2 492333 BENW CCLG 16096 A Phase 2, asone (Dara-CyBorD) in Previously Untreated and Study of Selinexor (KPT-330) in Combination Multicenter, Open-label, Study to Determine Relapsed Subjects With Multiple Myeloma With Backbone Treatments for Relapsed/Re- the Safety and Efficacy for the Combination 492362 PAGJ CMER 16187 A Phase II Study fractory Multiple Myeloma of Durvalumab (DURVA) and Daratumumab of Pembrolizumab (MK-3475) in Subjects With 492316 PAGJ CTGT 16025 A Multi-Center, (DARA) (D2) in Subjects With Relapsed and Relapsed or Refractory Primary Mediastinal Open-Label, Study to Evaluate the Safety and Refractory Multiple Myeloma (RRMM) Large B-cell Lymphoma (rrPMBCL) or Relapsed Efficacy of Ublituximab (TG-1101) in Combination 492336 PAGJ CIMG 15253 A Phase 2 Study or Refractory Richter Syndrome (rrRS) With TGR-1202 for Patients Previously Enrolled to Evaluate the Efficacy and Tolerability of 492364 PAGJ CSEG 16237 A Phase 2 in Protocol UTX-TGR-304 IMGN529 in Combination With Rituximab in Open-label Study of Brentuximab Vedotin in 492317 PAGJ CACT 16065 A Phase 1b, Mul- Patients With Relapsed and/or Refractory Front-line Therapy of Hodgkin Lymphoma (HL) ticenter, Open-label Study of ACP-196 in Com- Diffuse Large B-Cell Lymphoma and Other in Adults Age 60 and Above Forms of Non-Hodgkin’s Lymphoma bination With Bendamustine and Rituximab 492365 MAWR CFRM 16234 A Phase 1/1b, (BR) in Subjects With Mantle Cell Lymphoma 492337 PAGJ CKIT 16051 A Phase 1-2 Multi- Multicenter, Open-label, Dose-Escalation 492321 BENW CCLG 16018 A Phase 1a/1b, Center Study Evaluating the Safety and Study of FT-2102 as a Single Agent and in Multi-center, Open-label, Dose Finding Study Efficacy of KTE-C19 in Adult Subjects With Combination With Azacitidine in Patients With to Assess the Safety, Tolerability, Pharmacoki- Relapsed/Refractory B-precursor Acute Lym- Acute Myeloid Leukemia or Myelodysplastic netics and Preliminary Efficacy of the Pleiotropic phoblastic Leukemia (r/r ALL) (ZUMA-3) Syndrome With an IDH1 Mutation Pathway Modifier (PPM) CC-122 Administered 492338 MAWR CNOV 16100 An Open-label, 492368 PAGJ CGEN 16186 A Phase Ib/II Study Orally to Subjects With Advanced Solid Tumors, Multi-center, Expanded Treatment Protocol of Evaluating the Safety and Efficacy of Obinu- Non-Hodgkin’s Lymphoma, or Multiple Myeloma Midostaurin (PKC412) in Adult Patients With tuzumab in Combination With Idasanutlin and 492322 MAWR CKPT 15084 A Randomized, Newly Diagnosed Fms-like Tyrosine Kinase Re- Venetoclax in Patients With Relapsed or Refrac- Open Label, Phase 2 Study of the Selective ceptor (FLT3) Mutated Acute Myeloid Leukemia tory Follicular Lymphoma and Obinutuzumab or Inhibitor of Nuclear Export (Sine) Selinexor (AML) Who Are Eligible for Standard Induction Rituximab in Combination With Idasanutlin and (KPT-330) Versus Specified Physician’s Choice and Consolidation Chemotherapy Venetoclax in Patients With Relapsed or Refrac- in Patients ≥ 60 Years Old With Relapsed/ 492341 MAWR CCNT 16105 A Randomized, tory Diffuse Large B-Cell Lymphoma Refractory Acute Myeloid Leukemia (AML) Who Phase II Study of CX-01 Combined With Stan- 492370 MAWR CSEG 17022 A randomized, Are Ineligible for Intensive Chemotherapy and/ dard Induction Therapy for Newly Diagnosed double-blind, placebo-controlled phase 2 or Transplantation Acute Myeloid Leukemia study of vadastuximab talirine (SGN-CD33A) in 492324 PAGJ CKPT 15254 A Phase 2b Open- 492344 PAGJ CATN 15249 A Phase I/II combination with cytarabine and daunorubicin label, Randomized Two-arm Study Comparing Study of Low Dose Cytarabine and Lintuzum- (7+3) induction chemotherapy in newly-diag- High and Low Doses of Selinexor (KPT-330) ab-Ac225 in Older Patients With Untreated nosed acute myeloid leukemia patients in Patients With Relapsed/Refractory Diffuse Acute Myeloid Leukemia 492371 PAGJ CACT 16225 A Phase 3, Large B-Cell Lymphoma (DLBCL) 492346 PAGJ CMEI 16154 A Phase 1b, Open- Randomized, Double-blind, Placebo-con- 492325 PAGJ CPFI 15268 A Phase 1 Phar- Label, Dose Escalation Study of ME-401 in Sub- trolled, Multicenter Study of Bendamustine and macokinetic-Pharmacodynamic Study Of jects With Relapsed/Refractory Chronic Lympho- Rituximab (BR) Alone Versus in Combination Avelumab (MSB0010718C) In Patients With cytic Leukemia/Small Lymphocytic Lymphoma With Acalabrutinib (ACP-196) in Subjects With Previously Treated Advanced Stage Classical (CLL/SLL) or Follicular Lymphoma (FL) Previously Untreated Mantle Cell Lymphoma Hodgkin’s Lymphoma 492348 PATK CXNC 16182 A Phase 1 492372 PAGJ CTGT 17030 A Phase 2b Ran- 492327 PAGJ CMER 16040 Phase Ib Trial of Multidose Study to Evaluate the Safety and domized Study to Assess the Efficacy and Safety Pembrolizumab (MK-3475) in Combination Tolerability of XmAb13676 in Patients With of the Combination of Ublituximab + TGR-1202 With Dinaciclib (MK-7965) in Subjects With CD20-Expressing Hematologic Malignancies and TGR-1202 Alone in Patients With Previously Hematologic Malignancies (KEYNOTE-155) 492351 BENW CCLG 16153 A Phase 1b Treated Diffuse Large B-Cell Lymphoma 492328 PAGJ CCRS 16050 Open-Label, Multicenter, Open-label Study to Determine the 492374 PAGJ CCLG 16212 A Phase 2, Open- Phase 2 Study to Evaluate the Efficacy and Recommended Dose and Regimen of Durvalum- label, Multicenter Study to Evaluate the Safety Safety of CUDC-907 With and Without Rit- ab (MEDI4736) (DUR) in Combination With and Clinical Activity of Durvalumab in Combi- uximab in Patients With Relapsed/Refractory Lenalidomide (LEN) With and Without Low-dose nation With Rituximab, Cyclophosphamide, MYC-Altered Diffuse Large B-Cell Lymphoma Dexamethasone (Dex) in Subjects With Newly Doxorubicin, Vincristine, Prednisone (R-CHOP) 492329 BENW CMER 16052 A Phase III Diagnosed Multiple Myeloma (NDMM) or With Lenalidomide Plus R-CHOP (R2-CHOP) Study of Lenalidomide and Low-dose Dexa- 492352 BENW CBAY 16145 A Phase 1b/2 in Subjects With Previously Untreated, High-Risk methasone With or Without Pembrolizumab Trial to Evaluate the Safety and Efficacy of Diffuse Large B-Cell Lymphoma (MK3475) in Newly Diagnosed and Treatment Radium-223 Dichloride (BAY88-8223) in Com- 492375 PAGJ CPCY 17024 A Multicenter, Naive Multiple Myeloma (KEYNOTE-185) bination With Bortezomib and Dexamethasone Randomized, Double-blind, Placebo-controlled 492330 MAWR CSEG 16032 A Randomized, in Early Relapsed Multiple Myeloma Phase 3 Study of the Bruton’s Tyrosine Kinase Double-blind Phase 3 Study of Vadastuximab 492354 BENW CSEG 16172 Phase 1 Study of (BTK) Inhibitor, Ibrutinib, in Combination With Talirine (SGN-CD33A) Versus Placebo in SGN-CD352A in Patients With Relapsed or Rituximab Versus Placebo in Combination With Combination With Azacitidine or Decitabine Refractory Multiple Myeloma Rituximab in Treatment Naïve Subjects With Follicular Lymphoma in the Treatment of Older Patients With Newly 492358 MAWR CAPG 16194 A Phase 3 Diagnosed Acute Myeloid Leukemia (AML) Multicenter, Randomized, Double-Blind, Place- 492377 PAGJ CPCY 16238 Phase 2 Study of 492331 PAGJ CTGT 16093 Screening bo-Controlled Trial of the FLT3 Inhibitor Gilteri- the Combination of Ibrutinib Plus Venetoclax Protocol to Determine High-Risk Cytogenetic tinib (ASP2215) Administered as Maintenance in Subjects With Treatment-naïve Chronic Features in Patients With Previously-Treated Therapy Following Induction/Consolidation Lymphocytic Leukemia/Small Lymphocytic CLL That May be Eligible for TG Therapeutics Therapy for Subjects With FLT3/ITD AML in Lymphoma Trial UTX-IB-301 (TGTX-LAB-001) First Complete Remission 492378 PAGJ CEPZ 17068 An Open-Label, 492332 MAWR CAPG 16067 A Phase 2/3 492360 BENW CMLN 16118 A Phase 3, Ran- Multicenter, Phase 1/2 Study of Tazeme- Multicenter, Open-label, 3-arm, 2-Stage domized, Placebo-Controlled, Double-Blind tostat (EZH2 Histone Methyl Transferase Randomized Study of ASP2215 (Gilteritinib), Study of Oral Ixazomib Maintenance Therapy [HMT] Inhibitor) as a Single Agent in Subjects Combination of ASP2215 Plus Azacitidine and After Initial Therapy in Patients With Newly With Advanced Solid Tumors or With B-cell Azacitidine Alone in the Treatment of Newly Diagnosed Multiple Myeloma Not Treated With Lymphomas and Tazemetostat in Combination Diagnosed Acute Myeloid Leukemia With FLT3 Stem Cell Transplantation With Prednisolone in Subjects With Diffuse Large B Cell Lymphoma Mutation in Patients Not Eligible for Intensive 492361 BENW CJSA 16213 Daratumumab Plus Induction Chemotherapy Cyclophosphamide, Bortezomib and Dexameth-

www.swedish.org/cancer 37 492379 PAGJ CKIT 16230 A Phase 2 Lung/Pulmonary 492182 WESH CBIP 10060 Randomized Phase Multicenter Study Evaluating the Efficacy of 3 Trial of Gemcitabine/Carboplatin With or Without KTE-C19 in Subjects With Relapsed/Refractory 400000 AYER XNON 17162 IIT: Surgical Man- BSI-201 (SAR240550) (a PARP1 inhibitor) in Mantle Cell Lymphoma (r/r MCL) (ZUMA-2) agement of Patients with Esophageal Outflow Patients with Previously Untreated Stage IV Squa- Obstruction and Reflux 492380 MAWR CMEI 17040 A Two-Stage, mous Non-Small-Cell Lung Cancer (NSCLC) Open-Label Followed by Placebo-Controlled 400000 FARA XNON 17123 IIT: Retrospective 492183 AYER CVIS 09023 Collaborative Study Phase 2 Study of Pracinostat and Azacitidine in Comparison of Surgical Therapy for Primary on Sputum Cytology of Lung Cancer Patients by Patients With IPSS-R High and Very High Risk Spontaneous Pneumothorax the Swedish Cancer Institute and VisionGate, Inc. Myelodysplastic Syndromes Previously Untreated 400000 FARA XNON 17157 IIT: Use of Intra- 492184 GOOG CELIus 0492.01 Randomized With Hypomethylating Agents Operative Steroids During Pneumonectomy Phase III Study of Docetaxel or Pemetrexed 492382 MAWR CXNC 17023 A Phase 1 400000 GORJ XNON 17082 IIT: Pre-hospital with or without Cetuximab in Patients with Multiple Dose Study to Evaluate the Safety and planning, Intensive Care Unit and Palliative Care Recurrent or Progressive Non-Small Cell Lung Tolerability of XmAb®14045 in Patients With Resource Utilization in Cancer Patients Cancer after Platinum-Based Therapy CD123-Expressing Hematologic Malignancies. 400000 GORJ XNON 17083 IIT: Evaluation of in- 492185 VALE CGSK 10028 Study of GS- 492383 MAWR CATX 17099 A Phase 3, dividuals referred to/participating in Lung Cancer K2302032A Antigen-Specific Cancer Immu- Multicenter, Randomized, Open-Label Study Screening Programs: the network experience notherapeutic in Patients With Resectable of Guadecitabine (SGI-110) Versus Treatment 400000 GORJ XNON 17154 IIT: Management Non-Small Cell Lung Cancer Choice in Adults With Previously Treated Acute of Pleural Space Infections 492189 WESH CDAI 10107 A Phase 3, Ran- Myeloid Leukemia 400000 LOUB XNON 17155 IIT: Validation of domized, Double-blind, Placebo-Controlled 492388 PATK CBRI 17116 Randomized, Carcinoid Staging System: Outcomes in Pa- Study of ARQ 197 Plus Erlotinib versus Placebo Open-label, Phase 3 Trial of Nivolumab Plus tients with Neuroendocrine Tumors of the Lung Plus Erlotinib in Previously Treated Subjects with Brentuximab Vedotin Versus Brentuximab and Bronchi Undergoing Resection Locally Advanced or Metastatic, Non-Squamous, Vedotin Alone in Participants With Relapsed Non-Small Cell Lung Cancer Refractory or Ineligible for Autologous Stem Cell 400000 LOUB XNON 17156 IIT: Clinical Out- comes After Magnetic Sphincter Augmentation 492191 WESH CAPG 11012 A Randomized, Transplant (ASCT) Advanced Stage Classical Double-Blind, Phase 2 Study of erlotinib (Tarceva) Hodgkin Lymphoma (CheckMate 812: CHECK- in Patients with Atypical Reflux Symptoms and Dysmotility. in combination with OSI 906 or placebo in point Pathway and nivoluMAb Clinical Trial Chemonaive Patients with Advanced NSCLC with Evaluation 812) 400000 LOUB XNON 17169 IIT: The long term Activating Mutations of the Epidermal Growth 492390 PATK CACT 17145 A Phase 1/2 safety and efficacy of peroral endoscopic my- Factor Receptor (EGFR) Gene Proof-of-Concept Study of the Combination of otomy (POEM) for the treatment of achalasia: A single institution experience 492209 WESH CZIO 12046 MATISSE: A Acalabrutinib and Vistusertib in Subjects With Multi-center, Open-Label, Adaptive, Randomized Relapsed/Refractory B-cell Malignancies 470010 TOLS CELI 13038 An open-label, Study of Palifosfamide-tris, a Novel DNA 492391 MAWR CHEL 17107 A Phase III, Double- multicenter, randomized, Phase 2 study of a Crosslinker, in Combination with Carboplatin and Blind, Placebo-Controlled, Multicenter, Ran- Recombinant Human Anti-VEGFR-2 Mono- Etoposide (PaCE) Chemotherapy versus Carbo- domized Study Of Pracinostat In Combination clonal Antibody, IMC-1121B in combination platin and Etoposide (CE) Alone in Chemotherapy With Azacitidine In Patients ≥18 Years With with Platinum-based chemotherapy versus Naive Patients with Extensive-Stage Small Cell Newly Diagnosed Acute Myeloid Leukemia Unfit Platinum-based chemotherapy alone as first- Lung Cancer For Standard Induction Chemotherapy line treatment of patients with recurrent or advanced Non-small Cell Lung Cancer (NSCLC) 492212 WESH CBRI 12071 An Open-Label 4XXXXX MAWR CABV 17098 A Randomized, Randomized Phase III Trial of BMS-936558 ver- Double-Blind, Placebo Controlled Study of Vene- 470026 TOLS CBOH 13123 LUX-Lung 8: A sus Docetaxel in Previously Treated Advanced toclax Co-Administered With Low Dose Cytara- Randomized, open-label phase III trial of afatinib or Metastatic Squamous Cell Non-Small Cell bine Versus Low Dose Cytarabine in Treatment versus erlotinib in patients with advanced squa- Lung Cancer mous cell carcinoma of the lung as second-line Naïve Patients With Acute Myeloid Leukemia 492213 WESH CBRI 12090b An Open-Label Who Are Ineligible for Intensive Chemotherapy therapy following first-line platinum-based chemotherapy Randomized Phase III Trial of BMS-936558 ver- 4XXXXX MAWR CATX 17131 A Phase 3, Multi- sus Docetaxel in Previously Treated Metastatic center, Randomized, Open-Label Study of Gua- 492139 VALE CGSK 06129 GSK1572932A Non-squamous Non-small cell Lung Cancer Antigen-Specific Cancer Immunotherapeutic as decitabine (SGI-110) Versus Treatment Choice in 492214 WESH CROC 12104 A Phase I/II Study Adults With Myelodysplastic Syndromes (MDS) Adjuvant Therapy in Patients With Resectable MAGE-A3 Positive Non-Small Cell Lung Cancer of the ALK Inhibitor CH5424802 in Patients with or Chronic Myelomonocytic Leukemia (CMML) ALK-Rearranged Non-Small Cell Lung Cancer Previously Treated With Hypomethylating Agents 492171 WESH CPFI 09078 Phase 3 Random- 492216 WESH CBOH 12127 LUX-Lung EAP 4XXXXX MAWR CNOH 17121 A Phase 2 Open- ized, Open-Label Study of the Efficacy and Safety of PF-02341066 Versus Standard Of US: An open label expanded access program Label, Multi-Center, Randomized, Controlled, of afatinib (BIBW 2992) for patients with locally Dose-Finding Study of DCC-UCB in Adults Care Chemotherapy (Pemetrexed or Docetaxel) in Patients with Advanced Non-Small Cell Lung advanced or metastatic non-small cell lung Receiving High Dose Chemotherapy for Acute cancer (NSCLC) harboring EGFR mutation(s) Myeloid Leukemia Cancer Harboring a Translocation or Inversion Event Involving the Anaplastic Lymphoma Kinase 492225 VALE CGSK 13048 GSK2302032A 4XXXXX PATK CAMG 16184 A Phase 2 Open- (ALK) Gene Locus Antigen-Specific Cancer Immunotherapeutic as label Study Investigating the Safety and Efficacy 492172 WESH CPFI 09080 Phase 2, Open-La- Adjuvant Therapy in Patients With Non-Small of Blinatumomab After Frontline R-Chemotherapy Cell Lung Cancer in Adult Subjects With Newly Diagnosed High- bel Single Arm Study of the Efficacy and Safety risk Diffuse Large B-Cell Lymphoma (DLBCL) of PF-02341066 in Patients with Advanced 492226 WESH CNOV 13049 A phase III, mul- Non-Small Cell Lung Cancer Harboring a Trans- ticenter, randomized, open-label study of oral 4XXXXX PATK CMLN 17105 Phase 2 Study of location or Inversion Involving the Anaplastic LDK378 versus standard chemotherapy in adult TAK-659 in Patients With Relapsed or Refractory Lymphoma Kinase (ALK) Gene Locus patients with ALK-rearranged (ALK-positive) Diffuse Large B-Cell Lymphoma After at Least 2 advanced non-small cell lung cancer who have Prior Lines of Chemotherapy. 492176 WESH CSYT 09106 A Non-Random- ized, Open-label, Multi-Center, Multi-Cohort been treated previously with chemotherapy 4XXXXX PATK CPCY 17146 Phase 3 Study Phase 2 Study Evaluating the Efficacy and (platinum doublet) and crizotinib of Ibrutinib in Combination With Venetoclax in Safety of STA-9090 in Subjects with Stage IIIB 492229 GORJ CPUL 12132 Lung function Im- Subjects With Mantle Cell Lymphoma or IV Non-Small Cell Lung Cancer provement after Bronchoscopic Lung Volume Re- 4XXXXX PATK CSNE 17144 A Phase 1b/2 492179 WESH CGER 10029 A Randomized duction with PulmonX Endobronchial Valves used Dose-Escalation and Cohort-Expansion Study Phase II Study of Imetelstat as Maintenance in Treatment of Emphysema (LIBERATE Study) of the Noncovalent, Reversible Bruton’s Tyrosine Therapy After Initial Induction Chemotherapy for Kinase Inhibitor, SNS-062, in Patients With Advanced Non-Small Cell Lung Cancer (NSCLC) B-Lymphoid Malignancies

38 2017 ANNUAL REPORT 492231 WESH CASZ 13107 A Phase III, Double- 492261 GORJ CSPI 14088 A Prospective 492347 WESH CTAI 16158 A Randomized, Blind, Randomized, Placebo-Controlled Study to Study with IBV Valve System for the Treatment Open-Label, Multi-Center, International Phase Assess the Efficacy and Safety of Selumetinib of Prolonged Air Leak 2 Study of TAS-114 in Combination With S-1 in (AZD6244; Arry-142886) (Hyd-Sulfate) in Com- 492262 WESH CBOH 14127 Multicentre, Ran- Patients With Advanced or Metastatic Non-Small bination with Docetaxel, in Patients receiving domised, Double-blind, Phase III Trial to Investi- Cell Lung Cancer second line treatment for KRAS Mutation-Positive gate the Efficacy and Safety of Oral Nintedanib 492349 LOUB CITV 16155 Temporal Trends Locally Advanced or Metastatic Non-Small Cell Plus Docetaxel Therapy Compared to Placebo and Outcomes Measures During Transition to Lung Cancer (Stage IIIb-IV) (SELECT-1) Plus Docetaxel Therapy in Patients With Stage Robotic Pulmonary Lobectomy 492233 WESH CATX 13106 A Study of HSP90 IIIB/IV or Recurrent, Adenocarcinoma Subtype 492350 WESH CINI 16210 A Prospective Study Inhibitor AT13387 Alone and in Combination Non-small Cell Lung Cancer After Failure of First to Evaluate the Performance of Inivata Liquid with Criztonib in the Treatment of Non-Small Line Chemotherapy Biopsy Compared With Standard Tissue Biopsy Cell Lung Cancer (NSCLC) 492263 WESH CONC 14169 A Phase 1b/2 for Detection of Genomic Alterations in Patients 492237 WESH CDAI 14015 Phase 3, Ran- Study of OMP-59R5 in Combination with Etopo- With Advanced Non Small Cell Lung Cancer domized, Placebo Controlled, Double-blind, side and Platinum Therapy in Subjects with Un- 4XXXXX LOUB FEMO 17044 Incorporating Multi-Center, Two-Part Study of Patritumab treated Extensive Stage Small Cell Lung Cancer Patient Reported Outcomes for Lung Cancer (U3-1287) in Combination with Erlotinib in EGFR 492264 WESH CUNC 14176 Multicenter Phase Resection into the Society of Thoracic Surgeons Wild-Type Subjects with Locally Advanced II Trial of Neoadjuvant Cisplatin and Nab-pacli- Database or Metastatic Non-Small Cell Lung Cancer taxel for (N2) Defined Stage IIIA Non-Small Cell 4XXXXX WESH CARI 17177 A Phase 1/2 Study (NSCLC) who have Progressed on at Least one Lung Cancer (NSCLC) Prior Systemic Therapy of the Safety, Pharmacokinetics, and Anti-Tumor 492266 WESH CMER 15036 A Phase I/II Study Activity of the Oral EGFR/HER2 Inhibitor AP32788 492239 WESH CICT 14016 A Randomized, Dou- of MK-3475 (SCH900475) in Combination with in Non-Small Cell Lung Cancer ble-Blind Phase 2 Study of Ruxolitinib or Placebo Chemotherapy or Immunotherapy in Patients in Combination with Pemetrexed/Cisplatin and 4XXXXX WESH CMER 17175 A Phase 3, Ran- with Locally Advanced or Metastatic Non-Small domized, Double-Blind Study of Pembrolizumab Pemetrexed Maintenance for Initial Treatment of Cell Lung Carcinoma Subjects with Nonsquamous Non-Small Cell Lung (MK-3475) plus Epacadostat (INCB024360) Cancer that is Stage IIIB with Pleural/Pericardial 492286 GORJ CSPI 15163 Safety and Effective- Versus Pembrolizumab plus Placebo as First- Effusion, Stage IV, or Recurrent ness of the Spiration Valve System in Air Leaks Line Treatment in Patients with Metastatic 492278 WESH CTHS 15086 A Phase 2 Study Non-Small Cell Lung Cancer Expressing High 492240 WESH CAPG 14035 An Open-label, Levels of PD-L1 Phase 1 Dose Escalation Study of Oral ASP8273 of TH-4000 in Patients With EGFR-Mutant, in Subjects with Non-Small-Cell Lung Cancer T790M-Negative, Advanced Non-Small Cell Multiple Tumor Types (NSCLC) Who Have Epidermal Growth Factor Lung Cancer Progressing on an EGFR Tyrosine 400000 GOOG XNON 17081 Single Patient IND Receptor (EGFR) Mutations Kinase Inhibitor for the Compassionate Use of Lorlatinib (PF- 492246 VALE CMGL 14050 LUNG CAncer- 492279 WESH CASZ 15140 A Multi-center, 06463922) for NSCLC with ROS-1 Mutation REgistry: An Open Registry to Measure the Im- AZD9291 Expanded Access Program for the 492198 WESH CTHA 11015 Study of Prognos- pact of Adding RNA Expression Testing (myPlan Treatment of Patients With Advanced/Metastatic tic Value of T Cell Receptor Diversity and CD4 Lung Cancer) on Referral Decisions in Newly EGFR T790M Mutation-positive Non-small Cell Lymphopenia in First Relapse Breast or Lung Diagnosed Early Stage Lung Adenocarcinoma Lung Cancer (NSCLC) Who Have Received Prior Cancer Patients Patients (LUNG CARE Registry) EGFR TKI Therapy 492200 KAPH CMER 11055 A Phase III Random- 492247 VALE CCRB 14052 AirTight: A Pro- 492285 WESH CPFI 15153 A Phase 1b Study ized, Placebo-Controlled, Clinical Trial to Study the spective Controlled Post-Approval Study of Of Crizotinib In Combination With Pembrolizumab Safety and Efficacy of V212 in Adult Patients with NeoMend ProGEL Pleural Air Leak Sealant in (Mk-3475) In Patients With Untreated Advanced Solid Tumor or Hematologic Malignancy the Treatment of Visible Pleural Air Leaks after Alk-translocated Non Small Cell Lung Cancer Standard Pleural Closure 492297 LOUB CUTS 15151 JoLT-Ca A Random- 492203 WESH CPFI 11090 A Phase 2, Multi-Co- hort Study to Evaluate the Impact of Prophylactic 492248 WESH CUNC 14056 A Phase II, ized Phase III Study of Sublobar Resection (SR) Intervention on dermatologic and Gastrointestinal multicenter, single arm study of the tolerability of Versus Stereotactic Ablative Radiotherapy (SAbR) Adverse Events and Patient Reported Outcomes weekly nab-paclitaxel as second line treatment in High Risk Patients With Stage I Non-Small Cell in Patients Treated with Dacomitinib for elderly patients with advanced lung cancer Lung Cancer (NSCLC), The STABLE-MATES Trial 492205 GOLP CMDI 11120 A Phase 1, Multi- 492249 WESH CCLG 14014 A phase III, 492318 WESH CGEN 15287 A Phase III, center, Open-label Study to Evaluate the Safety, randomized, open-label, crossover, multi-center, Open-Label, Randomized Study of Atezolizumab Tolerability, and Pharmacokinetics of MEDI0639 safety and efficacy study to evaluate nab-Pacli- (MPDL3280A, Anti-Pd-L1 Antibody) in Combina- in Adult Subjects with Advanced Solid Tumors taxel (Abraxane) as maintenance treatment after tion With Carboplatin or Cisplatin + Pemetrexed induction with nab-Paclitaxel plus carboplatin in Compared With Carboplatin or Cisplatin + Peme- 492208 WESH CDAI 12058 A Phase 1, Open-La- subjects with squamous cell non-small cell lung trexed in Patients Who Are Chemotherapy-Naive bel, Multiple-Ascending-Dose Study of DS-2248, cancer (NSCLC) and Have Stage IV Non-Squamous Non-Small an Orally Bioavailable Heat Shock Protein 90 Cell Lung Cancer Inhibitor, in Subjects with Advanced Solid Tumors 492250 WESH CCLO 14072 A Phase 1/2, Open-Label, Safety, Pharmacokinetic and 492323 WESH CGEN 15212 A Phase III, Open- 492215 WESH CPCT 12110 A Phase I/II, Preliminary Efficacy Study of Oral CO-1686 in label, Randomized Study to Investigate the Multi-Center, Open-Label, Dose Escalation Patients with Previously Treated Mutant EGFR Efficacy and Safety of MPDL3280A (Anti-PD-L1 Trial of the Safety and Pharmacokinetics of Non-Small Cell Lung Cancer (NSCLC) Antibody) Compared With Best Supportive Care Intravenous PR610 given Weekly in Subjects Following Adjuvant Cisplatin-based Chemother- with Solid Tumors 492255 WESH CARI 14125 A Randomized apy in PD-L1-Selected Patients With Completely 492232 MILM CNNH 13160 A Placebo-Con- Phase 2 Study of AP26113 in Patients with Resected Stage IB-IIIA Non-small Cell Lung trolled Study of Oral L-glutamine and Pyridox- ALK-positive, Non-small Cell Lung Cancer Cancer (NSCLC) Previously Treated with Crizotinib al-5-phosphate (Vitamin B6) for the mitigation 492340 WESH CEMS 16141 A Phase II Single- of Velcade-Induced Peripheral Neuropathy: A 492257 WESH CELI 14096 A Randomized Arm Trial to Investigate Tepotinib in Stage IIIB/ Pilot Study Phase 3 Study of LY2835219 plus Best Support- IV Adenocarcinoma of the Lung with MET Exon 492252 ELLE CNOV 14156 Modular phase II ive Care versus Erlotinib plus Best Supportive 14 (METex14) Skipping Alterations After Failure study to link targeted therapy to patients with Care in Patients with Stage IV NSCLC with a of at Least One Prior Active Therapy, Including a pathway activated tumors: Module 7 Ceritinib Detectable KRAS Mutation Who Have Progressed Platinum-Doublet-Containing Regimen After Platinum-Based Chemotherapy (LDK378) for patients whose tumors have 492342 WESH CGUA 16168 Noninvasive vs aberrations in ALK or ROS1 Invasive Lung Evaluation (NILE-Trial)

www.swedish.org/cancer 39 492274 GOLP CMDI 15047 A Phase 1/2 Study S1418 A Randomized, Phase III Trial to 907005 GY 006 A Randomized Phase II Trial to Evaluate the Safety, Tolerability, and Phar- Evaluate the Efficacy and Safety of MK-3475 of Radiation Therapy and Cisplatin Alone or macokinetics of MEDI4736 in Subjects With (Pembrolizumab) as Adjuvant Therapy for Triple in Combination with Intravenous Triapine in Advanced Solid Tumors Receptor-Negative Breast Cancer with >/= 1 Women with Newly Diagnosed Bulky Stage 492289 DREC CMDI 15193 A Phase I Study of CM Residual Invasive Cancer or Positive Lymph IB2, Stage II, IIIB, or IVA Cancer of the Uterine MEDI4736 (Anti-PD-L1 Antibody) in Combination Nodes (ypN+) after Neoadjuvant Chemotherapy Cervix or Stage II-IVA Vaginal Cancer With Tremelimumab (Anti-CTLA-4 Antibody) in A011106 ALTernate approaches for clinical 907005 S 1609 DART Dual Anti-CTLA-4 and Subjects With Advanced Solid Tumors stage II or III Estrogen Receptor positive breast Anti-PD-1 Blockade in Rare Tumors cancer NeoAdjuvant TrEatment (ALTERNATE) 492306 GOLP CBRI 15242 A Phase 1/2, Open- Lung label Study of Nivolumab Monotherapy or in postmenopausal women: A Phase III Study - Nivolumab Combined With Ipilimumab in Subjects Fulvestrant and/or Anastrozole in Treating Post- A151216 Adjuvant Lung Cancer Enrichment With Advanced or Metastatic Solid Tumors menopausal Patients With Stage II-III Breast Marker Identification and Sequencing Trial Cancer Undergoing Surgery (ALCHEMIST) (non-squamous NSCLC only) 492369 BRWT CASC 16133 Targeted Agent and Profiling Utilization Registry (TAPUR) Study S1207 Phase III Randomized, Placebo-Controlled A081105 Randomized Double Blind Placebo Clinical Trial Evaluating the Use of Adjuvant Controlled Study of Erlotinib or Placebo in 492373 ELLE CCTX 16214 An Open-Label, Endocrine Therapy +/- One Year of Everolimus in Patients with Completely Resected Epidermal Dose-Finding and Proof of Concept Study of Patients with High-Risk, Hormone Receptor- Growth Factor Receptor (EGFR) Mutant Non- the PD-L1 Probody Therapeutic , CX-072, as Positive and HER2/neu Negative Breast Cancer. small Cell Lung Cancer (NSCLC) Monotherapy and in Combination With Yervoy e3 Breast Cancer Study evaluating everolimus CALGB-30610 Phase III Comparison of Thoracic (Ipilimumab) or With Zelboraf (Vemurafenib) in with endocrine therapy (CCDR) Subjects With Advanced or Recurrent Solid Radiotherapy Regimens in Patients with Limited Tumors or Lymphomas A011202 A Randomized Phase III Trial Evaluating Small Cell Lung Cancer Also Receiving Cisplatin the Role of Axillary Lymph Node Dissection in or Carboplatin and Etoposide 492387 XIEB CBTH 17118 A Multicenter, Breast Cancer Patients (cT1-3 N1) Who Have E4512 A Phase III Double-Blind Trial for Surgically Open-label, Phase 2 Study of Imprime PGG Positive Sentinel Lymph Node Disease After Resected Early Stage Non-Small Cell Lung and Pembrolizumab in Subjects With Advanced Neoadjuvant Chemotherapy Melanoma Failing Front-line Treatment With Cancer: Crizotinib versus Placebo for Patients Checkpoint Inhibitors (CPI) or Triple Negative Gastroenterological with Tumors Harboring the Anaplastic Lymphoma Kinase (ALK) Fusion Protein Breast Cancer (TNBC) Failing Front-line Chemo- S1417CD Implementation of a Prospective therapy for Metastatic Disease Financial Impact Assessment Tool in Patients S1400 Biomarker-Driven Master Protocol for 4XXXXX BRWT CSTA 17135 Profiling Biospeci- with Metastatic Colorectal Cancer (CCDR) Previously Treated Squamous Cell Lung Cancer mens From Cancer Patients to Screen for Molec- (Pre-Screening Step) Lung-MAP Study (open S1505 A Randomized Phase II Study of substudy: S1400G and S1400I) ular Alterations Related to Treatment Selection Perioperative mFOLFIRINOX versus Gemcit- S1400G A Phase II Study of Talazoparib (BMN Oral, Head and Neck abine/nab-Paclitaxel as Therapy for Resectable Pancreatic Adenocarcinoma 673) in Patients with Homologous Recombination 492132 MEHV CELIus 0605 Prospective, Lon- Repair Deficiency Positive Stage IV Squamous gitudinal, Multi-Center, Descriptive Registry for Genitourinary Cell Lung Cancer (Lung-MAP Subprotocol) Patients Receiving Therapy Other Than Surgical S1602 A Phase III Randomized Trial to Evaluate S1400I A Phase III Randomized Study of Resection Alone for Newly Diagnosed Head and the Influence of BCG Strain Differences and Nivolumab Plus Ipilimumab Versus Nivolumab Neck Cancer T Cell Priming with Intradermal BCG Before for Previously Treated Patients with Stage IV Intravesical Therapy for BCG-Naive-Grade Squamous Cell Lung Cancer and No Matching NCORP Open Studies Non-Muscle Invasive Bladder Cancer Biomarker (Lung-Map Subprotocol) Brain S1500 A Randomized, Phase II Efficacy Melanoma Assessment of Multiple MET Kinase Inhibitors A071401 Phase II Trial of SMO/AKT/NF2 (Cabozantinib [NSC #761968], Crizotinib [NSC S1320 A Randomized Phase II Trial of Intermittent Inhibitors in Progressive Meningiomas With #749005], Savolitinib [NSC #785348], and Versus Continuous Dosing of Dabrafenib SMO/AKT/NF2 Mutations Sunitinib [NSC #736511]) in Metastatic Papillary (NSC-763760) and Trametinib (NSC-763093) in BRAFV600E/K Mutant Melanoma A221101 A Phase III Randomized, Double-Blind Renal Carcinoma (PAPMET) Placebo Controlled Study of Armodafinil Gynecologic Multiple Sites (Nuvigil®) To Reduce Cancer-Related Fatigue in Patients with Glioma 907005 RTOG-0724 Phase III Randomized DCP001 Use of a Clinical Screening Tool to Study of Concurrent Chemotherapy and Pelvic Address Cancer Health Disparities in the NCI U13059 A Geriatric Assessment Intervention for Radiation Therapy With or Without Adjuvant Community Oncology Research Program Patients Aged 70 and Over Receiving Chemo- Chemotherapy in High-Risk Patients With Early- (NCORP)(CC) therapy for Cancer: Reducing Chemotherapy Stage Cervical Carcinoma Following Radical Toxicity in Older Patients (CC) EAY131 Molecular Analysis of Therapy Choice Hysterectomy (MATCH) Breast 907005 AGCT1531 A Phase 3 Study of Active S1415CD A Pragmatic Trial to Evaluate a A011401 Randomized Phase III Trial Evaluating Surveillance for Low Risk and a Randomized Guideline-Based Colony Stimulating Factor the Role of Weight Loss in Adjuvant Treatment Trial of Carboplatin vs. Cisplatin for Standard Standing Order Intervention and to Determine of Overweight and Obese Women with Early Risk Pediatric and Adult Patients With Germ the Effectiveness of Colony Stimulating Factor Breast Cancer Cell Tumors Use as Prophylaxis for Patients Receiving Chemotherapy with Intermediate Risk for Febrile A211201 Change in Mammographic Density 907005 GOG 0279 A Phase II Trial Evaluating Neutropenia-Trial Assessing CSF Prescribing with Metformin Use: A Companion Study to Cisplatin (NSC #119875) and Gemcitabine Effectiveness and Risk (TRACER) (CCDR) NCIC Study MA.32 (NSC #613327) Concurrent With Intensity- Modulated Radiation Therapy (IMRT) in the A221102 Randomized Double-Blind Placebo Treatment of Locally Advanced Squamous Cell Controlled Study of Subcutaneous Testosterone in Carcinoma of the Vulva the Adjuvant Treatment of Postmenopausal Wom- en with Aromatase Inhibitor Induced Arthralgias 907005 GOG 263 Randomized Phase III Clinical Trial of Adjuvant Radiation versus Chemoradiation E1Z11 A Cohort Study to Evaluate Genetic Pre- in Intermediate Risk, State I/IIA Cervical Cancer dictors of Aromatase Inhibitor Musculoskeletal Treated with Initial Radical Hysterectomy and Symptoms (AIMSS) Pelvic Lymphadenectomy.

40 2017 ANNUAL REPORT SWEDISH CANCER INSTITUTE SITE LISTING – 2016

NON- NON- DISEASE SITE ANALYTIC TOTAL DISEASE SITE ANALYTIC TOTAL ANALYTIC ANALYTIC BONE, CONNECTIVE TISSUE, SKIN Vulva 36 3 39 Bone 17 3 20 Other Female Site 20 2 22 Connective and Soft Tissue 39 16 55 Total Gynecological 609 Retroperitoneum/Peritoneum 9 3 12 HEAD AND NECK Gum and Other Parts Skin and Melanoma 191 52 243 42 14 56 of the Mouth Total Bone, Connective Tissue, Skin 330 Larynx 46 8 54 BRAIN AND CENTRAL NERVOUS SYSTEM Lip and Tongue 95 15 110 Brain 168 84 252 Nasal Cavity and Middle Ear 13 5 18 Central Nervous System 102 50 152 Pharynx 20 8 28 Meninges 189 75 264 Salivary Gland 19 4 23 Total Brain and Central Nervous System 668 Sinus 8 1 9 BREAST Thyroid 239 27 266 Breast 1157 235 1392 Tonsil 27 19 46 Total Breast 1392 Other Endocrine Gland 132 89 221 Total Head & Neck 831 GASTROINTESTINAL Anus, Anal Canal, Anorectum 27 9 36 HEMATOLOGICAL MALIGNANCIES Hematopoietic and Bile Ducts 32 7 39 297 141 438 Reticuloendothelial Colon 278 75 353 Hodgkins 10 5 15 Gallbladder 18 1 19 Leukemia 11 0 11 Liver 139 69 208 Lymphoma NOS 0 2 2 Pancreas 169 41 210 Non-Hodgkins 149 57 206 Rectum and Rectosigmoid 163 41 204 Total Hematological Malignancies 672 Small Intestine 40 10 50 Stomach 90 20 110 THORACIC Other Digestive Organs 6 1 7 Bronchus and Lung 511 150 661 Total Gastrointestinal 1236 Esophagus 85 18 103 Heart, Mediatinum, Pleura 21 4 25 GENITOURINARY Thymus 10 4 14 Bladder 140 31 171 Trachea 1 0 1 Kidney and Pelvis 157 30 187 Total Thoracic 804 Penis 2 0 2 Prostate 587 241 828 OTHER AND ILL-DEFINED SITES Testis/Other Male Genital Organ 29 7 36 Other 6 10 16 Ureter 6 3 9 Total Other and Ill-Defined Sites 16

Other 2 0 2 UNKNOWN Total Genitourinary 1137 Unknown 65 15 80 GYNECOLOGICAL Total Unknown 80 Cervix 81 9 90 Ovary 112 37 149 TOTAL 2016 6082 1791 7873 Uterus 262 36 298

www.swedish.org/cancer 41 BIBLIOGRAPHY

This bibliography features selected recent publications by Swedish Cancer Institute members and affiliated physicians (noted in bold) from 2016-2017.

Breast Cancer Cologne K, Bastawrous A. How to achieve Genitourinary Cancer cecal intubation in patients with angulated Andersen MR, Thorpe J, Buist DS, Beatty and redundant colons? Semin Colon Rectal Allen NE, Travis RC, Appleby PN, Albanes JD, Watabayashi K, Hanson N, Resta R, Surg 2017;(28):4–7. D, Barnett MJ, Black A, Bueno-de-Mesquita et al. Cancer risk awareness and concern HB, Deschasaux M, Galan P, Goodman among women with a family history of Ehlers AP, Simianu VV, Bastawrous AL, et GE, et al. Selenium and Prostate Cancer: breast or ovarian cancer. Behav Med. al. Alvimopan Use, Outcomes, and Costs: Analysis of Individual Participant Data from 2016;42(1):18-28. doi:10.1080/08964289.2 A Report from the Surgical Care and Out- Fifteen Prospective Studies. J Natl Cancer 014.947234. [Epub 2014 Nov 3] comes Assessment Program Comparative Inst. 2016 Jul 6;108(11). pii: djw153. doi: Effectiveness Research Translation Network 10.1093/jnci/djw153. Jung S, Wang M, Anderson K, Baglietto L, Collaborative. J Am Coll Surg. 2016 Bergkvist L, Bernstein L, van den Brandt PA, May;222(5):870-7. doi: 10.1016/j.jamcoll- Petimar J, Wilson KM, Wu K, Wang M, Brinton L, Buring JE, Heather Eliassen A, surg.2016.01.051. [Epub 2016 Feb 5] Albanes D, van den Brandt PA, Cook MB, Falk R, Gapstur SM, Giles GG, Goodman Giles GG, Giovannucci EL, Goodman GE, G, et al. Alcohol consumption and breast Kinon MD, Scoco A, Farinhas JM, Kobets et al. A Pooled Analysis of 15 Prospective cancer risk for estrogen receptor status: in a A, Weidenheim KM, Yassari R, Lasala PA, Cohort Studies on the Association Between pooled analysis of 20 studies. Int J Epidemiol. Graber JJ. Glioblastoma multiforme presenting Fruit, Vegetable, and Mature Bean Consumption 2016;45(3):916-28. doi: 10.1093/ije/dyv156. with an open ring pattern of enhancement and Risk of Prostate Cancer. Cancer Epidemiol [Epub 2015 Aug 28] on MR imaging. Surg Neurol Int. 13 Jun Biomarkers Prev. 2017 Aug;26(8):1276-1287. 2017;8:106. doi: 10.1158/1055-9965.EPI-16-1006. Epub MacDonald LR, Hippe DS, Bender LC, 2017 Apr 26. Cotter EW, Voria PR, Hallam PS, Wang Rashidi L, Neighorn C and Bastaworus A. CL, Haseley DR, Kelly MM, Parikh JR, Outcome Comparisons Between High-Volume Price AJ, Travis RC, Appleby PN, Albanes D, Beatty JD, Rogers JV. Positron Emission Robotic and Laparoscopic Surgeons in a Barricarte Gurrea A, Bjørge T, Bueno-de- Mammography Image Interpretation for Large Healthcare System, Am J Surg. 2017 Mesquita HB, Chen C, Donovan J, Gislefoss Reduced Image Count Levels. J Nucl Med. May;213(5):901-905. doi: 10.1016/j.amjsurg. R, Goodman G, et al. Endogenous Hormones, 2016 Mar;57(3):348-54. doi: 10.2967/ 2017.03.034. Epub 2017 Apr 6. Nutritional Biomarkers, and Prostate Cancer jnumed.115.165787. [Epub 2015 Dec 3] Collaborative Group. Circulating Folate and Simianu VV, Fichera A, Bastawrous AL, Vitamin B12 and Risk of Prostate Cancer: A Potkul RK, Unger JM, Livingston RB, Crew Davidson GH, Florence MG, et al. Number of Collaborative Analysis of Individual Participant KD, Wilczynski SP, Salomon CG, Smith BL, Diverticulitis Episodes Before Resection and Data from Six Cohorts Including 6875 Wong L, Campbell DL, Einspahr DE, Anderson Factors Associated With Earlier Interventions. Cases and 8104 Controls. Eur Urol. 2016 GL, Hershman D, Goodman GE, et al. JAMA Surg. 2016 Feb 10; doi: 10.1001/ Dec;70(6):941-951. doi: 10.1016/j.eururo. Randomized trial of medroxyprogesterone jamasurg.2015.5478. 2016.03.029. acetate for the prevention of endometrial pathology from adjuvant tamoxifen for breast Thornblade LW, Varghese TK, Shi X, Wu K, Spiegelman D, Hou T, Albanes D, cancer: SWOG S9630. npj Breast Cancer. Bastawrous AL, et al. Preoperative Allen NE, Berndt SI, van den Brandt PA, 2016;2:16024. doi: 10.1039/npjbcancer. Immunonutrition and Elective Colorectal Giles GG, Giovannucci E, Goldbohm RA, 2016.24. [Epub 2016 Aug 10]. Resection Outcomes. Dis Colon Rectum. Goodman G, et al. Associations between 2017;60(1):68-75. unprocessed red and processed meat, Potkul RK, Unger JM, Livingston RB, Crew Umamaheswaran P, Bastawrous AL. poultry, seafood and egg intake and the risk KD, Wilczynski SP, Salomon CG, Smith BL, of prostate cancer: A pooled analysis of 15 Wong L, Campbell DL, Einspahr DE, Anderson Abdominal Surgical Approached to Rectal Prolapse: The evolution of evaluation and prospective cohort studies. Int J Cancer. GL, Hershman D, Goodman GE, Brown 2016 May 15;138(10):2368-82. PH, Meyskens FL, Albain KS. Randomized management of urinary or fecal incontinence trial of medroxyprogesterone acetate for the and pelvic organ prolapse. Curr Prob Surg. prevention of endometrial pathology from 2015 Mar;52(3):92-136. Gene Sequencing/ adjuvant tamoxifen for breast cancer: SWOG Zhang M, Wang Z, Obazee O, Jia J, Childs Personalized Medicine S9630. NPJ Breast Cancer. 2:16024; 10 Aug EJ, Hoskins J, Figlioli G, Mocci E, Collins I, 2017. doi:10. 1038/npjbcancer.2016.24. West H. Can we define and reach precise Chung CC, Hautman C, Arslan AA, Beane- goals for precision medicine in cancer care? Freeman L, Bracci PM, Buring J, Duell EJ, J Clin Oncol. 2016;34:3595-3597. Gastroenterological Cancer Gallinger S, Giles GG, Goodman GE, et al. Three new pancreatic cancer susceptibility West H. No solid evidence, only a hollow Baer C, Menon R, Bastawrous S, Bastawrous signals identified on chromosomes 1q32.1, argument for universal tumor sequencing; A. “Emergency Presentations of Colorectal 5p15.33 and 8q24.21. Oncotarget. 2016 Show me the data. JAMA Oncol. Emergencies” in Advances in Colorectal Neo- Oct 11;7(41):66328-66343. doi: 10.18632/ 2016;2:717-718. plasia. Surg Clin North Am. 2017:97(3). oncotarget.11041.

42 2017 ANNUAL REPORT Gynecologic Cancer BS, Kline J, Kochenderfer JN, Kwak LW, Levy Mawad R, Becker PS, Hendrie P, Scott B, R, de Lima M, Litzow MR, Mahindra A, Miller Wood BL, Dean C, Sandhu V, Deeg HJ, Bates G, Taub R, West H. Fertility and cancer J, Munshi NC, Orlowski RZ, Pagel JM, et al. Walter R, Wang L, Myint H, Singer JW, Estey treatment. JAMA Oncol. 2016;2:284. The Society for Immunotherapy of Cancer E, Pagel JM. Phase II Study of Tosedostat Buas MF, Gu H, Djukovic D, Zhu J, Drescher Consensus Statement on Immunotherapy for with Cytarabine or Decitabine in Newly CW, et al. Identification of novel candidate the Treatment of Hematologic Malignancies: Diagnosed Older Patients with Acute Myeloid plasma metabolite biomarkers for distinguish- Multiple Myeloma, Lymphoma, and Acute Leukaemia or High-Risk MDS. Br J Haematol. ing serous ovarian carcinoma and benign Leukemia. J Immunother Cancer. 2016;40:90. 2016;172(2):238-45. serous ovarian tumors. Gynecol Oncol. 2016 Brown JR, Hallek M, Pagel JM. Chemoim- Orozco JJ, Kenoyer A, Balkin ER, Gooley TA, Jan;140(1):138-44. doi: 10.1016/j.ygyno. munotherapy versus targeted treatment in Hamlin DK, Wilbur DS, Hylarides MD, Frost 2015.10.021. [Epub 2015 Oct 30] CLL: when, how long, how much, in which SH, Mawad R, O’Donnell P, Sandmaier BM, Celik S, Logsdon BA, Battle S, Drescher combination? Am Soc Clin Oncol Educ Fuchs EJ, Luznik L, Green DJ, Gopal AK, CW, et al. Extracting a low-dimensional Book. 2016;35:e387-98. Press OW, Pagel JM. Anti-CD45 Radioimmu- notherapy without TBI before BMT Facilitates description of multiple gene expression Brown JR, Hillmen P, O’Brien S, Barrientos datasets reveals a potential driver for Persistent Haploidentical Donor Engraftment JC, Reddy NM, Coutre SE, Tam CS, Mulligan in a Murine Model. Blood. 2016;127(3):352-9. tumor-associated stroma in ovarian cancer. SP, Jaeger U, Barr PM, Furman RR, Kipps Genome Med. 2016 Jun 10;8(1):66. doi: TJ, Cymbalista F, Thornton P, Caligaris-Cappio Pagel JM. A Richter transformation PD-1 10.1186/s13073-016-0319-7. F, Delgado J, Montillo M, DeVos S, Moreno block party. Blood. 2017;129(26):3397-3398. C, Pagel JM, et al. Extended follow-up and Drescher CW, Beatty JD, Resta R, et al. Pagel JM. Initiation of Treatment in Chronic The effect of referral for genetic counseling impact of high-risk prognostic factors from the phase 3 RESONATE study in patients Lymphocytic Leukemia. Clin Adv Hematol on genetic testing and surgical prevention in Oncol. 2016;14;suppl 8(5):3-5. women at high risk for ovarian cancer: Results with previously treated CLL/SLL. Leukemia. from a randomized controlled trial. Cancer. 2018 Jan;32(1):83-91. doi: 10.1038/ Pagel JM. Neighborhood Imbalances: 2016 Jul 22. doi: 10.1002/cncr.30190. [Epub leu.2017.175. Epub 2017 Jun 8. Overcoming MCL Drug Resistance. Blood. ahead of print] Byrd JC, Harrington B, O’Brien S, Jones JA, 2016;128(24):2752-2753. Gregory MT, Bertout JA, Ericson NG, Taylor Schuh A, Devereux S, Chaves J, Wierda WG, Pagel JM, West HJ. Chimeric Antigen SD, Mukherjee R, Robins HS, Drescher CW, Awan FT, Brown JR, Hillmen P, Stephens Receptor (CAR) T-Cell Therapy. JAMA Bielas JH. Targeted single molecule mutation DM, Ghia P, Barrientos JC, Pagel JM, et al. Oncol. 2017 Nov 1;3(11):1595. doi: detection with massively parallel sequencing. Acalabrutinib (ACP-196) in Relapsed Chronic 10.1001/jamaoncol.2017.2989. Nucleic Acids Res. 2016 Feb 18;44(3):e22. Lymphocytic Leukemia. N Engl J Med. doi:10.1093/nar/gkv915. [Epub 2015 Sep 17] 2016;374(4):323-32. Patel K, West HJ. Febrile Neutropenia. JAMA Oncol. JAMA Oncol. 2017 Dec 1;3(12):1751. McIntosh MW, Drescher C, Fitzgibbon MM. Coutre SE, Burger JA, Pagel JM. Discussion: doi: 10.1001/jamaoncol.2017.1114. Ovarian Cancer Early Detection Needs Better Managing Risk when using Idelalisib. Clin Adv Imaging, Not Better Algorithms or Biomarkers. Hematol Oncol. 2016;14(5 Suppl 8):13. Robak T, Hellman A, Kloczko J, Loscertales J, J Clin Oncol. 2016 Jan 10;34(2):199-200. Lech-Maranda E, Pagel JM, et al. Random- Cowan AJ, Stevenson PA, Gooley TA, ized Phase 2 Study of Otlertuzumab and doi: 10.1200/JCO.2015.63.7843. [Epub Frayo SL, Oliveira GR, Smith SD, Green DJ, 2015 Nov 16] Bendamustine versus Bendamustine in Roden JE, Pagel JM, Wood BL, Press OW, Patients with Relapsed Chronic Lymphocytic Saydaminova K, Strauss R, Xie M, Bartek J, Gopal AK. Results of a Phase I-II Study of Leukaemia. Br J Haematol. 2017 Richter M, van Rensburg R, Drescher C, Fenretinide and Rituximab for Patients with Feb;176(4):618-628. doi: 10.1111/bjh.14464. et al. Sensitizing ovarian cancer cells to Indolent B-Cell Lymphoma and Mantle Cell chemotherapy by interfering with pathways Lymphoma. Br J Haematol. January 2017. Roberts AW, Davids MS, Pagel JM, et al. 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www.swedish.org/cancer 43 Foster H, Ulasov IV, Cobbs CS. Human cy- Practice Management Boys JA, Worrell SG, Chandrasoma P, Dunst tomegalovirus-mediated immunomodulation: CM, Hofstetter WL, Louie BE, et al. Can the Effects on glioblastoma progression. Biochim Polite B, Ward JC, Cox JV, et al. A Pathway Risk of Lymph Node Metastases Be Gauged Biophys Acta. 2017 Aug;1868(1):273-276. Through the Bundle Jungle. J Oncol Pract, in Endoscopically Resected Submucosal doi: 10.1016/j.bbcan.2017.05.006. 2016 Jun;12(6):504-9. doi: 10.1200/ Esophageal Adenocarcinomas? A Multi-Center JOP.2015.008789. Study. J Gastrointest Surg. 2016;20(1):6-12. Ghosh D, Funk CC, Caballero J, Shah N, Rouleau K, Earls JC, Soroceanu L, Foltz G, Thomas CA, Ward JC. The Oncology Care Brown LM, Louie BE. How I Do It: Right Cobbs CS, Price ND, Hood L. A Cell-Surface Model: A Critique. Am Soc Clin Oncol Educ robotic thymectomy. Ann Thorac Surg. In Membrane Protein Signature for Glioblastoma. Book. 2016;35:e109-14. doi: 10.14694/ press. (2017) 103(2):369-72. Cell Syst. 2017 May 24;4(5):516-529.e7. doi: EDBK_156883. 10.1016/j.cels.2017.03.004. Brown LM, Louie BE, Jackson NK, Farivar Supportive Care AS, Aye RW, Vallières E. Recurrence And Ghosh D, Ulasov IV, Chen L, Harkins LE, Survival After Segmentectomy In Patients Wallenborg K, Hothi P, Rostad S, Hood Alfano CM, Zucker DZ, et al. A Precision With Prior Lung Resection For Early Stage L, Cobbs CS. TGFB-Responsive HMOX1 Medicine Approach to Improve Cancer Non-Small Cell Lung Cancer. Ann Thorac Expression Is Associated with Stemness Rehabilitation’s Impact and Integration with Surg. 2016;102(4):1110-1118. and Invasion in Gioblastoma Multiforme. Cancer Care and Optimize Patient Wellness. Stem Cells. 2016 Sep;34(9):2276-89. doi: Curr Phys Med Rehabil. 2017;1-10. [Epub Carreras-Torres R, Haycock PC, Relton 10.1002/stem.2411. 2017 February 16] CL, Martin RM, Smith GD, Kraft P, Gao C, Tworoger S, Le Marchand L, Wilkens LR, Park Joseph GP, McDermott R, Baryshnikova MA, Cheville AL, Mustian K, Winters-Stone K, SL, Haiman C, Field JK, Davies M, Marcus Cobbs CS, Ulasov IV. Cytomegalovirus as Zucker DS, et al. Cancer Rehabilitation: An M, Liu G, Caporaso NE, Christiani DC, Wei Y, an oncomodulatory agent in the progression Overview of Current Need, Delivery Models, Chen C, Doherty JA, Severi G, Goodman GE, of glioma. Cancer Lett. 2017 Jan 1;384:79-85. and Levels of Care. Phys Med Rehabil Clin et al. The causal relevance of body mass index doi: 10.1016/j.canlet.2016.10.022. N Am. 2017 Feb;28(1):1-17. doi: 10.1016/j. in different histological types of lung cancer: A pmr.2016.08.001. Mendalian randomization study. Sci Rep. 2016 Ngô HM, Zhou Y, Lorenzi H, Wang K, Kim TK, Aug 4;6:31121. doi: 10.1038/srep31121. Zhou Y, Bissati KE, Mui E, Fraczek L, Rajago- Decker VB, Howard GS, Holdread H, et al. pala SV, Roberts CW, Henriquez FL, Montpetit Piloting an Automated Distress Management Carreras-Torres R, Johansson M, Haycock PC, A, Blackwell JM, Jamieson SE, Wheeler K, Program in an Oncology Practice. Clin J Wade KH, Relton CL, Martin RM, Davey Smith Begeman IJ, Naranjo-Galvis C, Alliey-Rodri- Oncol Nurs. 2016 Feb;20(1):E9-E15. doi: G, Albanes D, Aldrich MC, Andrew A, Arnold guez N, Davis RG, Soroceanu L, Cobbs C, 10.1188/16.CJON.E9-E15. SM, Bickeböller H, Bojesen SE, Brunnström et al. Toxoplasma Modulates Signature Path- H, Manjer J, Brüske I, Caporaso NE, Chen ways of Human Epilepsy, Neurodegeneration Thoracic Cancer C, Christiani DC, Christian WJ, Doherty JA, & Cancer. Sci Rep. 2017 Sep 13;7(1):11496. Duell EJ, Field JK, Davies MPA, Marcus MW, doi: 10.1038/s41598-017-10675-6. Achim V, Aye RW, Farivar AS, Vallières E, Goodman GE, et al. Obesity, metabolic factors Louie BE. A Combined Thoracoscopic and and risk of different histological types of lung Schroeder B, Shah N, Rostad S, McCullough Laparoscopic Approach for High Epiphrenic cancer: A Mendelian randomization study. B, Aguedan B, Foltz G, Cobbs CS. Genetic Diverticula and the Importance of Complete PLoS One. 12(6):e0177875; 8 Jun 2017. investigation of multicentric glioblastoma Myotomy. Surg Endosc. 2016 Jul 12. [Epub multiforme: case report. J Neurosurg. 2016 ahead of print] Cattoni M, Vallières E, Brown LM, Sarkeshik May;124(5):1353-8. doi: 10.3171/2015. AA, Margaritora S, Siciliani A, Imperatori A, 4.JNS142231. [Epub 2015 Oct 16] Aye RW, Qureshi AP, Wilshire CL, Farivar Rotolo N, Farjah F, Wandell G, Costas K, Mann AS, Vallières E, Louie BE. Feasibility, Safety, C, Hubka M, Kaplan S, Farivar AS, Aye RW, Ulasov IV, Foster H, Butters M, Yoon JG, and Short-term Efficacy of the Laparoscopic Louie BE. Is there a role for traditional nuclear Ozawa T, Nicolaides T, Figueroa X, Hothi P, Nissen-Hill Hybrid Repair. Surg Endoscopy. medicine imaging in the management of Prados M, Butters J, Cobbs C. Precision 2016;30(2):551-558. pulmonary carcinoid tumors? Eur J Cardio- knockdown of EGFR gene expression using Bazhenova L, Hodgson JG, Langer CJ, thorac Surg. 2017 May 1;51(5):874-879. doi: radio frequency electromagnetic energy. J 10.1093/ejcts/ezw422. Neurooncol. 2017 Jun;133(2):257-264. doi: Simon GR, Gettinger SN, Ou S-HI, Reckamp 10.1007/s11060-017-2440-x. KL, West HJ, et al. Activity of brigatinib Cattoni M, Vallières E, Brown LM, Sarkeshik (BRG) in crizotinib (CRZ)-resistant ALK+ AA, Margaritora S, Siciliani A, Imperatori A, Ulasov IV, Kaverina NV, Ghosh D, Barysh- NSCLC patients (pts) according to ALK Rotolo N, Farjah F, Wandell G, Costas K, nikova MA, Kadagidze ZG, Karseladze AI, plasma mutation status. J Clin Oncol Mann C, Hubka M, Kaplan S, Farivar AS, Baryshnikov AY, Cobbs CS. CMV70-3P 2017:34 (suppl; abstr 9065). Aye RW, Louie BE. External validation of a miRNA contributes to the CMV mediated prognostic model of survival for 1 resected glioma Stemness and represents a target for Belanger A, Nguyen K, Osman U, Gilbert CR, Allen K, Al Rasis, A, Yarmus L, Akulian J. Pleu- typical bronchial carcinoid tumors. Ann Thor glioma experimental therapy. Oncotarget. Surg. 2017 August;104(4):1215-20. 2017 Apr 18;8(16):25989-25999. doi: ral Effusions in Non-Transplanted Cystic 10.18632/oncotarget.11175. Fibrosis Patients. J Cyst Fibros. 2017;16(4): Cattoni M, Vallières E, Brown LM, Sarkeshik 499-502. doi: 10.1016/j.jcf.2016.11.006. AA, Granone P, Siciliani A, Dominioni L, Ulasov IV, Kaverina NV, Ghosh D, Barysh- Bellevue OC, Louie BE, Jutric Z, Farivar Imperatori A, Farjah F, Wandell G, Costas K, nikova MA, Kadagidze ZG, Karseladze AI, Mann C, Hubka M, Kaplan S, Farivar AS, Baryshnikov AY, Cobbs CS. CMV70-3P AS, Aye RW. A Hill Gastropexy Combined With Nissen Fundoplication Appears to Aye RW, Brian E. Louie. Improvements in miRNA contributes to the CMV mediated TNM Staging of Pulmonary Neuroendocrine glioma stemness and represents a target for Mitigate the Shortcomings of Collis-Nissen in the Management of Short Esophagus. J Tumors. Requires Histology and Regrouping glioma experimental therapy. Oncotarget. of Tumor Size. J Thorac Cardiovasc Surg. 2017 Apr 18;8(16):25989-25999. doi: Gastrointest Surg. 2017 Oct 2. doi: 10.1007/ s11605-017-3598-4. 2018 Jan;155(1):405-413. doi: 10.1016/j. 10.18632/oncotarget.11175. jtcvs.2017.08.102. Epub 2017 Sep 9.

44 2017 ANNUAL REPORT Cerfolio RJ, Louie BE, Farivar AS, Onai- Goodman G, Chen C, Doherty JA, et al. Liu SV, Aggarwal C, Brzezniak C, Doebele tis M, Park BJ. Consensus Statement On Fine-mapping of chromosome 5p15.33 RC, Gerber DE, Gitlitz B, Horn L, Solomon Definitions and Nomenclature for Robotic based on a targeted deep sequencing and BJ, Stinchcombe T, Villaruz LC, West H, et al. Thoracic Surgery. J Thorac Cardiovasc Surg. high density genotyping identifies novel lung Phase 2 study or tarloxotinib bromide (TRLX) in 2017;154(3):1065-1069. cancer susceptibility loci. J Carcinog. 2016 patients (pts) with EGFR-mutant, T790M-neg- Jan;37(1):96-105. Epub 2015 Nov 20. ative NSCLC progression on an EGFR TKI. J Fang W, Yao X, Antonicelli A, Louie BE, Gu Clin Oncol. 2016;34 (suppl; abstr TPS9100). Z, Vallières E, Huang J, Korst R, Detterbeck Handy JR, Costas K, Nisco S, Schaerf R, F. Comparison of Surgical Approach and Vallières E, et al. Editorial: Regarding Amer- Louie BE. Is Tissue the Issue? J Thorac Extent of Resection for Masaoka-Koga Stage ican College of Surgeons Commission on Cardiovas Surg. 2017;153(6):1598-1599. I and II Thymic Tumors in Europe, North Cancer Non-Small Cell Lung Cancer Quality America and Asia: an ITMIG Retrospective of Care Measure 10RLN. Ann Thorac Surg. Louie BE. To resect or not to resect in T1 Database Analysis. Euro J Cardiothorac 2016 Oct;102:1040–1041. Esophageal Carcinoma. J Thorac Cardiovasc Surg. 2017:1-7. Surg. 2017;153:1208. Johnson CS, Louie BE, Wille A, Dunst CM, Feczko A, Mckeown E, Wilson JL, Louie BE, Worrell SG, DeMeester SR, Reynolds J, Dixon Louie BE, Schneider AM, Schembre DB, Aye RW, Gorden JA, Vallieres E, Farivar J, Lipham JC, Lada M, Peters JH, Watson TJ, Aye RW. Impact of Prior Interventions on AS. Assessing Survival and Grading the Farivar AS, Aye RW. The Durability Of En- outcomes during per oral endoscopic my- Severity of Complications in Octogenarians doscopic Therapy For Treatment Of Barrett’s otomy. Surg Endosc. 2017 Apr;31(4):1841- Undergoing Pulmonary Lobectomy. Metaplasia, Dysplasia And Mucosal Cancer 1848. doi: 10.1007/s00464-016-5182-5. Can Respir J. 2017;2017:6294895. doi: After Nissen Fundoplication. J Gastrointest Louie BE, Wilson JL, Kim S, Cerfolio RJ, 10.1155/2017/6294895. Epub 2017 Feb 8. Surg. 2015 May;19(5):799-805. doi: 10.1007/ Park BJ, Farivar AS, Vallières E, Aye RW, et s11605-015-2783-6. [Epub 2015 Mar 5] Gilbert CR, Abendroth C, Yarmus L. The al. Comparison of Video-Assisted Thoraco- Intranodal Presence of Coexisting Granulo- Kachuri L, Amos CI, McKay JD, Johansson M, scopic Surgery and Robotic Approaches for matous Inflammation and Carcinoma during Vineis P, Bueno-de-Mesquita HB, Boutron- Clinical Stage I and Stage II Non-Small Cell Transbronchial Needle Aspiration of Intratho- Ruault MC, Johansson M, Quirós JR, Sieri Lung Cancer Using The Society of Thorac- racic Lymphadenopathy. J Bronchology Interv S, Travis RC, Weiderpass E, Le Marchand L, ic Surgeons Database. Ann Thorac Surg. Pulmonol. 2017;24(1):80-83. doi: 10.1097/ Henderson BE, Wilkens L, Goodman G, et 2016;102(3):917-924. LBR.0000000000000128. al. Fine-mapping of chromosome 5p15.33 Merzlikin OV, Louie BE, Farivar AS, Shultz based on a targeted deep sequencing and D, Aye RW. Repair of Symptomatic Parae- Gilbert CR, Akullian JA, Gorden JA. The high density genotyping identifies novel lung Impact of the ASAP Trial: Maybe We sophageal Hernias in Elderly (>70 Years) Pa- cancer susceptibility loci. J Carcinog. 2016 tients Results in Sustained Quality of Life at 5 Shouldn’t Act So Quickly. Am J Respir Crit Jan; 37(1):96-105. [Epub 2015 Nov 20] Care Med. 2018 Jan 1;197(1):142-143. doi: or more years. Surg Endosc 2017;10.1007/ 10.1164/rccm.201705-0956LE. Kidane B, Peel JK, Seely A, Malthaner RA, s00464-017-5432-1. Finley C, Grondin S, Louie BE, Srinathan McClune JR, Wilshire CL, Gorden JA, Louie Gilbert CR, Fathi JT, Ely R, Wilshire CL, S, Darling GE. National Practice Variation in Louie BE, Aye RW, Farivar AS, Vallières E, BE, Farviar AS, Stefanski MJ, Vallieres E, Pneumonectomy Perioperative Care among Aye RW, Gilbert CR. Safety and Efficacy Gorden JA. The Economic Impact of a Nurse Canadian Thoracic Surgeons. Interact Practitioner Directed Lung Cancer Screening, of Intrapleural Tissue Plasminogen Acti- Cardiovas Thorac Surg. 2017 Dec vator and DNase during Extended Use Incidental Pulmonary Nodule, and Tobacco 1;25(6):872-876. doi: 10.1093/icvts/ivx252. Cessation Clinic. J Thorac Cardiovasc Surg. in Complicated Pleural Space Infections. 2018 Jan;155(1):416-424. doi: 10.1016/j. Kim D-W, Tiseo M, Ahn M-J, Reckamp RL, Can Respir J. 2016;2016:9796768. doi: jtcvs.2017.07.086. Epub 2017 Sep 13. Hansen KH, Kim S-W, Huber RM, West H, 10.1155/2016/9796768. et al. Brigatinib (BRG) in patients (pts) with Gilbert CR., Gorden JA. Use of intrapleural McKay JD, Hung RJ, Han Y, Zong X, Carreras- crizotinib (CRZ)-refractory ALK+ non-small Torres R, Christiani DC, Caporaso NE, tissue plasminogen activator and deoxyri- cell lung cancer (NSCLC): First report of effi- bonuclease in pleural space infections: an Johansson M, Xiao X, Li Y, Byun J, Dunning cacy and safety from a pivotal randomized A, Pooley KA, Qian DC, Ji X, Liu G, Timofeeva update on alternative regimens. Curr Opin phase (ph) 2 trial (ALTA). J Clin Oncol. Pulm Med. 2017;23(4):371-375. MN, Bojesen SE, Wu X, Le Marchand L, 2016;34 (suppl; abstr 9007). Albanes D, Bickeböller H, Aldrich MC, Bush Gilbert, CR, Casal RF; Feller-Kopman D; Levy G, Aye RW, Farivar AS, Louie BE. A WS, Tardon A, Rennert G, Teare MD, Field Lee HJ; Frimpong B, Dincer HE, Podgaetz E, Combined Nissen Plus Hill Repair Reduces JK, Kiemeney LA, Lazarus P, Haugen A, Lam Benzaquen S, Majid, A, Folch, E, Gorden JA, Recurrences for Paraesophageal Hernia S, Schabath MB, Andrew AS, Shen H, Hong et al. Use of One-Way Intrabronchial Valves in Compared to Laparoscopic Nissen Alone. J YC, Yuan JM, Bertazzi PA, Pesatori AC, Ye the Management of Air Leaks After Tube Tho- Gastrointest Surg. 2016;10.1007/s11605- Y, Diao N, Su L, Zhang R, Brhane Y, Leighl racostomy Drainage. Ann Thorac Surg. 2016 016-3225-9. N, Johansen JS, Mellemgaard A, Saliba W, May;101(5):1891-6. doi: 10.1016/j.athorac- Haiman CA, Wilkens LR, Fernandez-Somoano sur.2015.10.113. [Epub 2016 Feb 12] Levy G, Cordes MA, Farivar AS, Aye RW, A, Fernandez-Tardon G, van der Heijden Louie BE. Transversus Abdominis Plane HFM, Kim JH, Dai J, Hu Z, Davies MPA, Mar- Gilbert CR, Yarmus LB, Feller-KopmanDJ, Block Improves Perioperative Outcomes After cus MW, Brunnström H, Manjer J, Melander Lee HJ, Gorden JA. The Undefined Value Esophagectomy versus Thoracic Epidural. O, Muller DC, Overvad K, Trichopoulou A, of Pleural Interventions in Advanced Heart Ann Thorac Surg. 2017 Dec 1. pii: S0003- Tumino R, Doherty JA, Barnett MP, Chen C, Failure and Recurrent Pleural Effusions. Ann 4975(17)31192-X. doi: 10.1016/j.athorac- Goodman GE, et al. Large-scale association Am Thorac Soc. 2016 Mar;13(3):447-8. doi: sur.2017.08.046. [Epub ahead of print] analysis identifies new lung cancer susceptibility 10.1513/AnnalsATS.201512-825LE. loci and heterogeneity in genetic susceptibility across histological subtypes. Nat Genet. 2017;49(7):1126-32.

www.swedish.org/cancer 45 Modin HE, Fathi JT, Gilbert CR, Wilshire CL, Warren HF, Louie BE, Farivar AS, Wilshire Yu HA, Spira AI, Horn L, Weiss J, West H, Wilson AK, Aye RW, Farivar AS, Louie BE, C, Aye RW. Manometric Changes to the et al. Antitumor activity of ASP8273 300 Vallières E, Gorden JA. Pack-Year Cigarette Lower Esophageal Sphincter After Magnetic mg in subjects with EGFR mutation-positive Smoking History for Determination of Lung Sphincter Augmentation in Patients with non-small cell lung cancer. Interim results Cancer Screening Eligibility. Comparison Chronic Gastroesophageal Reflux Disease. from an ongoing phase 1 study. J Clin Oncol. of the Electronic Medical Record versus a Ann Surg. 2017 Jul;266(1):99-104. doi: 2016;34 (suppl; abstr 9050). Shared Decision-making Conversation. Ann 10.1097/SLA.0000000000001935. Am Thorac Soc. 2017;14(8):1320-25. 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Am Socinski MA. Impower132: a phase III clinical York, NY: Springer. 2016. J Respir Crit Care Med. 2016;193(1):68-77. trial of 1L atezolizumab plus platinum-based Crickman R. Systematic Review of Control doi: 10.1164/rccm. 201507-1332OC. chemotherapy in chemo-naïve advanced Measures to Reduce Hazardous Drug non-squamous NSCLC. J Clin Oncol Pujol JL, De Pas T, Rittmayer A, Vallières E, Exposure for Health Care Workers. J Nurs 2017;34 (suppl; abstr TPS9101). Kubisa B, Levchenko E, Wiesemann S, Mas- Care Qual. 2016 Apr-Jun;31(2):183-90. doi: ters GA, Shen R, Tjulandin SA, Hofmann HS, Wilshire CL, Louie BE, Horton MP, 10.1097/NCQ.0000000000000155. Vanhoutte N, Salaun B, Debois M, Jarnjak Castiglioni M, Aye RW, Farivar AS, West Crickman, R., Finnell, D. S. (2017). Chemo- S, De Souva Ales PM, Louahed J, Brichard HL, Gorden J, Vallières E. Comparison of therapy safe handling: Limiting nursing expo- VG, Lehmann FF. Safety and immunogenicity outcomes for patients with lepidic pulmonary sure with a hazardous drug control program. of the PRAME cancer immunotherapeutic adenocarcinoma defined by 2 staging sys- Clin J Oncol Nurs. 2017 Feb 1;21(1):73-78. in patients with resected non‐small cell lung tems: A North American experience. J Thorac doi: 10.1188/17.CJON.73-78. cancer: a phase I dose escalation study. J Cardiovasc Surg. 2016;151(6):1561-1568. Thor Oncol. 2016;11(12):2208-2217. Gupta A, West H. Mucositis (or stomatitis). Wilshire CL, Louie BE, Shultz D, Jutric Z, JAMA Oncol. 2016;2:1379. Ruhaak LR, Stroble C, Dai J, Barnett M, Farivar AS, Aye RW. Clinical Outcomes Of Taguchi A, Goodman GE, et.al. Serum Reoperation For Failed Antireflux Surgery. Subbiah V, West HL. Bone complications in Glycans as Risk Markers for Non-Small Cell Ann Thorac Surg. 2016;101(4):1290-1296. patients with cancer. JAMA Oncol. 2016;695. Lung Cancer. Cancer Prev Res (Phila). 2016, April;9(4):317-23. Wilshire CL, Vallières E, Shultz D, Aye RW, Subbiah V, West HL. Jaundice (hyperbilirubin- Farivar AS, Louie BE. Robotic resection of 3 emia) in cancer. JAMA Oncol. 2016;2:1236. Schneider AM, Louie BE, Warren HF, Farivar cm and larger thymomas is associated with AS, Schembre DB, Aye RW. Matched low perioperative morbidity and mortality. Inno- Thompson N, Christian A. Oral Chemo- Comparison of Per Oral Endoscopic Myotomy vations (Phila). 2016 Sep/Oct;11(5):321-326. therapy: Not just an ordinary pill. Am Nurse to Laparoscopic Heller Myotomy for the Today. 2016;11(9);16-22. Treatment of Achalasia. J Gastrointest Surg. Wilshire CL, Louie BE, Horton MP, Castiglioni 2016;20(11):1789-96. M, Aye RW, Farivar AS, West HL, Gorden West H. Balancing benefit, risk, and time JA, Vallières E. Comparison of outcomes for to new cancer therapies. JAMA Oncol. Shaw AT, Gandhi L, Gadgeel S, Riely GJ, patients with lepidic pulmonary adenocarci- 2016;2:122. Cetnar J, West H, et al. 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46 2017 ANNUAL REPORT SWEDISH CANCER INSTITUTE MEMBERS

Mohamed Alassas, M.D. Kimberly Ferguson, PA-C Edward Lee, M.D. James Porter, M.D. Kathi Adamson, M.D. Joanna Fesler, ARNP Ellyn Lee, M.D. Andrew F. Precht, M.D. Garrett D. Alcorn, M.D. Michael Florence, M.D. Thomas K. Lee, M.D. Joshua Press, M.D. Kirsten Alcorn, M.D. Daniel Flugstad, M.D. Vanessa Lewinger, ARNP Leslie Price, M.D. Sherry Mae Ancheta, M.S., CGC James Gasparich, M.D. Robert Lieppman, M.D. Nicholas Procaccini, M.D. Carolyn Anderson, ARNP Patricia Geraghty, M.D. Joel Lilly, M.D. Amarnath Ramakrishnan, M.D. Torrance Andrews, M.D. Christopher Gilbert, D.O. Skyler Lindsley, M.D. Rostislav Ranguelov, M.D. Monica Argawal, M.D. Timothy Gleason, M.D. Brandon Liu, M.D. Joseph Rank, M.D. Karlee Ausk, M.D. Philip Gold, M.D. Christopher Loiselle, M.D. Elizabeth Ranker, P.A. Ralph Aye, M.D. Sheldon Goldberg, M.D. Jacquelyn Lorie, P.A. Jon A. Reed, M.D. Melissa Hayes Balmadrid, M.D. Blake Golden, M.D. Brian Louie, M.D., MHA, MPH Beth Ann Reimel, M.D. Dae Hee Bang, M.D. Gary Goodman, M.D. Cecilia Lynn, ARNP Robert Resta, M.S., CGC Todd Barnett, M.D. Jed Gorden, M.D. Steven Macfarlane, M.D. Kristine Rinn, M.D. Darlene Barr, M.D. Margaret Gorham, ARNP John Maldazys, M.D. Saul Rivkin, M.D. Amir Bastawrous, M.D., MBA Rachel Gorham, WHNP-BC Katherine Mandell, M.D. Jeffrey Robin, P.A. Ami Batchelder, P.A. Maria E. Gorospe, M.D. Kristin Manning, M.D. Timothy Roddy, M.D. David Beatty, M.D. Rajen Goyal, M.D. Kristin Mantei, M.D. James Rogers, M.D. Tara Benkers, M.D. Thomas Green, M.D. Jessie Marrs, M.D. Steven Rostad, M.D. William Bensinger, M.D. Thomas Greene, MSN, ARNP Ryan Martinez, M.D. Lio Ryu, PA-C Anna Berry, M.D. Douglas Grier, M.D. Timonthy Mate, M.D. Marco Salazar, M.D. Kevin Beshlian, M.D. John Griffin, M.D. Raya Mawad, M.D Drew Schembre, M.D. George Birchfield, M.D. Kashina Groves, ARNP Vivek Mehta, M.D. Chirag Shah, M.D., MPH Cate Blanshan, ARNP Judson Hall, P.A. Robert Meier, M.D. Maryann Shango, M.D. Adam Bograd, M.D. Paula Hallam, M.D. Raman Menon, M.D. Hillary Shaw, M.D. Amy BonDurant, M.D. Steven Han, M.D. Wandra Miles, M.D. Jennifer Shook, M.D. James Borrow, M.D. James Hanson, M.D. Suzette Miranda, M.D. Forrest Simmons, PA-C Alan C. Boudousquie, M.D. Nancy Hanson, M.S., CGC Rajnish Mishra, M.D. Michelle Sinnett, M.D. Jack Brandabur, M.D. Kurt Harmon, M.D. Loulie Molloy, M.D. Joseph Sniezek, M.D., M.B.A Jessica Brower, ARNP Jason Harper, M.D. Susan Montgomery, M.D. James Spiegel, M.D. Thomas D Brown, M.D., MBA Lisa Harsted, P.A. Christy Moore, PA-C Somasundaram Subramaniam, Sally Browning, M.D. Marquis Hart, M.D. David Moore, M.D., MBA M.D., M.S. Claire Buchanan, M.D. Melinda Hawkins, M.D. Astrid Morris, M.D. Robert Takamiya, M.D. Christopher Cannon, M.D. Livia Hegerova, M.D. Nancy Fairlie Muggoch, ARNP Emma Thomas, ARNP Christopher Carlson, M.D. Eric Heinberg, M.D. John Mullen, M.D. Lisa Thomassen, M.D. Kara Carlson, M.D. Karen Hendershott, M.D. Frenanda Musa, M.D. Sean Thornton, M.D. Phillip Chapman, M.D. Heather Holdread, ARNP Christiane Mullins, M.D. Shannon Tierney, M.D. Trang Chau, ARNP Genee Holtzman, ARNP Laura Nason, M.D. Andrew Ting, M.D. Jey-Hsin Chen, M.D. Marc Horton, M.D. Diane Nathan, M.D. M. Christine Tiu, PA-C Martha Clay, ARNP Matthew Horton, M.D. Shamim Nejad, M.D. Erik Torgerson, M.D. Charles Cobbs, M.D., Ph.D. Charles Hunter, M.D. Brianna Nelson, M.S., CGC John Travaglini, M.D. Carol Cornejo, M.D. LuLu Iles-Shih, M.D. Erik Ness, M.D. John Tschirhart, M.D. David J. Corwin, M.D. Christina Isacson, M.D. Nancy Neubauer, M.D. Eric Vallières, M.D. Betsey Cotter, M.D. Eileen Johnston, M.D. Justin Olsen, M.D. Daniel Veljovich, M.D. Patricia Dawson, M.D., Ph.D. Matthew Johnston, M.D. David Omdal, M.D. Sandra Vermeulen, M.D. Thomas A. Dean, M.D. Carolyn Jordan, M.D. Evan Ong, M.D., M.S. Pooja Voria, M.D. MBA Stephanie Dishman, ARNP Thomas Jurich, M.D. Robert Osnis, M.D. Shilpa Vyas, M.D. Heidi Dishneau, ARNP Henry “Hank” Kaplan, M.D. John Pagel, M.D., Ph.D. Tanya Wahl, M.D. David Dong, M.D. Bart Keogh, M.D., Ph.D. Ellen Paget, ARNP Nan Ping Wang, M.D. Soumya Donohoe, ARNP Byung K. Kim, M.D. Keith Paige, M.D. Jeffery Ward, M.D. Brian Dontchos, M.D. Namou Kim, M.D. Martin Palmer, M.D. Sean Wells, M.D. Robert Douglas, M.D. Rodney Kratz, M.D. Melanie Panchal, ARNP Howard “Jack” West, M.D. Charles Drescher, M.D. Bruce G. Kulander, M.D. Min Park, M.D. Jennifer Wulff, ARNP Mariann Drucker, M.D. Jennifer Kum, M.D. Krish Patel, M.D. John Wynn, M.D. Michelle Eden, M.D. Patti Kwok, ARNP David Patterson, M.D. Danbin Xu, M.D., Ph.D. Paul Edmonson, M.D., Ph.D. Dan Labriola, N.D. Nuria Periz-Reyes, M.D. Bin Xie, M.D. Erin Ellis, M.D. Daniel Landis, M.D., Ph.D. Mary Lee Peters, M.D. Edwin Yau, M.D. Stephen Eulau, M.D. Brian Lee, M.D. William Peters III, M.D. Song Zhao, M.D., Ph.D. Alex Farivar, M.D. Christine Lee, M.D. Ellen Pizer, M.D. Gholamreza Zinati, M.D. Robert Feldman, M.D. Douglas Lee, M.D. Darren Pollock, M.D. David Zucker, M.D., Ph.D. Mehmet Fer, M.D. www.swedish.org/cancer 47 SWEDISH CANCER INSTITUTE OPERATIONS AND ADMINISTRATIVE TEAM

Jim Yates, MSPH, MBA Stacey Harestad Deborah Park Vice President for Operations Sr. Business Development Specialist Executive Assistant, SCI Administration SCI and Digestive Health Network Sandra Johnson, MSW, LICSW Carlotta Reynolds, R.N. Maya Abboud-Finch, BSN, R.N., OCN Manager, Oncology Social Work Nurse Manager, First Hill Inpatient Oncology Manager, SCI Radiation Oncology Services Barbara Kollar, MHA, CHES Laura Roberts Aliki Birkenbuel, MHSA Director, Supportive Care Network & Manager, Breast Imaging Services Operations Manager, SCI Edmonds Oncology Affiliate Services; and Thoracic, Colon Lineasia Sane, R.T. & Rectal, and Head & Neck Clinics Candy Bonham, CTR Supervisor Cancer Program Coordinator and Jeff Krumroy Radiation Oncology Technical Services Registry Supervisor Sr. Clinical Operations Coordinator Jill Sato SCI Edmonds Oncology Andy Case, MSN, R.N., OCN, NE-BC Marketing Director, Swedish Director, Medical Oncology Evonne Lackey David Shepard, Ph.D. Director (Interim), Cancer Research Amy Christian, MSN, R.N., OCN Director, Medical Physics and Dosimetry Manager, SCI Issaquah Oncology Jennifer Lamharzi, R.N., BSN, OCN Eddie Swafford Manager, First Hill/Ballard Treatment Center Susan Christian, BSN, R.N., OCN SHS Administrative Director Operations Supervisor, Nursing, SCI Edmonds Oncology I-Nong Lee, MHA Swedish Institutes Sr. Project Manager Linda Cole, MHA, BSN, R.N., OCN Mariko Tameishi, MHA Manager, First Hill Treatment Center and ITU Robert Loomis Associate Director, SCI Research Enterprise Supervisor Teresa Coluccio, M.N., R.N., CBCN Nancy Thompson, MSN, R.N. Clinic Operations, Radiation Oncology Manager, Multidisciplinary Breast Clinic Director, Quality and Clinical Practice Mary Beth Lowell Rachel Crickman, DNP, R.N., AOCNS Kaitlyn Torrence, MHA Director of Communications, Swedish Oncology Clinical Nurse Specialist – Inpatient Project Manager, Clinical Effectiveness Geoffrey Martin, MBA Jennifer Crow Thuy Trinh, M.S. Director of Finance, Institute Finance Supervisor, Breast Imaging Clinical Operations Manager, Cancer Informatics, Jana Mastandrea Quality and Registry Selin Demir Sr. Physician Recruiter Manager, SCI Administration & R.J. Tripicchio Swedish Provider Services Program Services Manager, Swedish Provider Services Karen McInerney, RTRM Will Erickson, CHFP Samantha Vanover Director, True Family Women’s Cancer SHS Director of Finance – Provider Sr. Director of Philanthropy Treatment Center and Breast Care Network Compensation Genevieve Vergara Khadija McNitt, R.N., BSN, OCN Darlene Fanus, RTRM Supervisor, Clinic Operations, SRC Clinical Nurse Manager, Medical Oncology Manager, Mobile Mammography Program Elizabeth Waite, BSN, R.N., OCN and Breast Care Community Outreach Meridithe Mendelsohn, Ph.D. Nurse Manager, First Hill Inpatient Oncology Program Manager, Cancer Survivorship Pamela Frazier-Jones Jeff Walker Manager, Cancer Research Lauren Moore, CFRE Sr. Director of Development Director of Philanthropy Amy Fox Swedish Medical Center Foundation Swedish Medical Center Foundation Manager (Interim), Cancer Research Natalie Wang Jolene Morgan Denise Gwinn Financial Analyst, Institute Finance Human Resources Client Manager Manager, Thoracic, Colon and Rectal, Todd Wilson and Head and Neck Clinics Tish Paolino Administrative Assistant III, SCI Administration Clinic Administrator Nancy Hanson Gynecologic Oncology and Lisa Wolfendale Supervisor, Hereditary Cancer Clinic Pelvic Surgery Clinic Manager, SCI Plastics Aesthetics

48 2017 ANNUAL REPORT SWEDISH CANCER INSTITUTE CANCER COMMITTEE

Ralph Aye, M.D. Philip Gold, M.D. Michael Myint, M.D. Chairman, Cancer Committee Medical Oncology/Medical Director, Medical Director, Clinical Research SHS Quality & Patient Safety John Griffin, M.D. Cancer Physician Paul Hallam, M.D. Damarise Navarro, MPH, CHES Liaison/Colorectal Surgery Diagnostic Radiology Health Education/Community Outreach

Maya Abboud-Finch, BSN, R.N., OCN Nancy Hanson, M.S., CGC Shamim Nejad, M.D. Manager, Supervisor, Hereditary Cancer Clinic Medial Director, SCI Radiation Oncology Services Psychosocial Oncology Program Livia Hegerova, M.D. Amir Bastawrous, M.D., MBA Medical Oncology Donielle O’Connor, M.Ed. ColoRectal Surgery SCI Research Julie Herbst, R.D. Anna Berry, M.D. Nutritional Services James Porter, M.D. Molecular Pathology Urological Surgery Christina Isacson, M.D. David Beatty, M.D. Pathology Danielle Posada Bioinformatics Medical Education Sandra Johnson, MSW, LISCW Blake Golden, M.D. Manager, Oncology Social Work Joseph Sniezek, M.D. Head & Neck Surgery Head & Neck Surgery Namou Kim, M.D. Thomas Brown, M.D., MBA Head & Neck Surgery Steven Stanos, M.D. SCI Executive Director Pain Management Services Barbara Kollar, MHA, CHES Candy Bonham, CTR Director, Supportive Care Network & Caryn Stewart, MSW, LICSW, OSW-C Cancer Program Coordinator Affiliate Services; and Thoracic, Colon Social Work & Registry Supervisor & Rectal, and Head & Neck Clinics Mariko Tameishi, MHA Christopher Cannon, M.D. Daniel Labriola, N.D. Associate Director, Musculoskeletal Surgery Naturopathic Services SCI Research Enterprise

Andy Case, MSN, R.N., OCN Evonne Lackey Nancy Thompson, R.N., MSN, AOCNS Director, Medical Oncology Director, Interim, Cancer Research Director, Quality & Clinical Practice

Rachel Crickman, DNP, R.N., AOCNS Ellyn Lee, M.D. Thuy Trinh, M.S. Oncology Nursing Palliative Care Services Manager, Cancer Informatics, Quality and Registry Patricia Dawson, M.D., Ph.D. Karen McInerney, R.T. Medical Director, SCI Breast Program Director, True Family Women’s Cancer Dan Veljovich, M.D. Treatment Center & Breast Care Network Gynecologic Oncology Surgery Selin Demir Manager, SCI Administration & Vivek Mehta, M.D. Jim Yates, MSPH, MBA Program Services Radiation Oncology Vice President of Operations, SCI and Digestive Health Network David Dong, M.D. Meridithe Mendelsohn, Ph.D. Medical Oncology – Issaquah Program Manager, Cancer Survivorship David Zucker, M.D., Ph.D. Cancer Rehabilitation Nici Feldhammer American Cancer Society Representative SWEDISH CANCER INSTITUTE LOCATIONS 855-XCANCER (855-922-6237)

Ballard Cherry Hill 5300 Tallman Ave. NW 550 17th Ave., Suite A10 Seattle, WA 98107 Seattle, WA 98122 Photo by Benjamin Benschneider Edmonds Issaquah 21632 Highway 99 751 NE Blakely Drive Edmonds, WA 98026 Issaquah, WA 98029

Swedish Bellevue Swedish Redmond Commons 18100 NE Union Hill Road 1200 112th Ave. NE, Suite B250 Redmond, WA 98052 First Hill Bellevue, WA 98004 Arnold Pavilion,1221 Madison St. Swedish Renton Seattle, WA 98104 Swedish Mill Creek Landing 13020 Meridian Ave. S. 910 N. 10th Place Everett, WA 98208 Renton, WA 98057