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MSK News Summer 2021 Download SUMMER 2021 SPECIAL ISSUE MSKNewsMEMORIAL SLOAN KETTERING CANCER CENTER Defeating Cancer’s Spread On the 50th anniversary of the War on Cancer, this SPECIAL ISSUE focuses on metastasis: What’s available now — and on the horizon — for patients like Ilene Thompson facing advanced disease. ALSO INSIDE: A Major Advance for Prostate Cancer Patients Seed and Soil: A Cancer Cell’s Journey How to Outsmart Tumor Evolution TABLE OF Dear MSK Community, These are the four most frightening words for a patient to hear: “Your cancer is back.” CONTENTS As we mark the 50th year of the War on Cancer and look to the future, our mission at Memorial Sloan Kettering is nothing less than conquering the most urgent challenge: preventing cancer’s spread. Also called metastasis, it causes 90 percent of cancer deaths. It’s why we are devoting this entire issue to reporting on how we offer hope and help to patients whose cancer has spread. 12 Metastasis: A Roadmap In the clinic, we are developing more targeted drugs, more precise radiation, and more sophisticated See the journey of a cancer cell as it transforms surgical techniques to treat our patients. In the lab, we are learning more every day about why and travels through the body. cancer cells metastasize and how to stop them. Our vision to save more lives requires a commitment to hire and train the brightest minds Multiplying the Army and a significant investment in four key areas of technology, which are already bringing about 17 astonishing advances: of Cancer-Fighting Immune Cells • Better models to study cancer: Conducting research in mice is time-consuming and doesn’t Learn about a new technology taking necessarily reflect cancer biology in humans. New technology makes it possible to grow samples immunotherapy to the next level. It multiplies of a patient’s own tumor in a dish in order to understand its evolution and test its response to an army of cells to seek out and destroy a cancer drug — getting results faster than ever before. 4 8 metastases anywhere in the body. • Visualizing cancer at every level from atoms to organs: State-of-the-art imaging equipment A Major Advance Seed and Soil can be used to visualize single cells moving and reacting in real time; observe how cancer cells MSK researchers are learning Radiation Reimagined behave and find them before they take root in new places; inspect fragile tissue samples; Finds Hidden 18 more about how cancer cells Meet the specialists at MSK who are pioneering and spot tumors in the body. Prostate can survive undetected for the use of potent, knifelike beams that can sear Cancer Cells years only to return in new cancer cells and spare healthy tissues to give • Analyzing cells one at a time: We’ve made great progress understanding how genetic mutations A transformation is coming places. These insights will our patients a second chance — with fewer can drive cancers. But they don’t account for all tumor behaviors, particularly metastasis. in how prostate cancer guide future therapies. side effects. Sophisticated equipment helps us understand how cancer cells adapt to new environments is identified and treated, as they break free from their original tumors. even after relapse. MSK researchers are leading • Using computers to decode cancer’s behavior: Through all of our new technologies, we are A New Frame of Mind the way. 20 MSK doctors are treating metastatic brain cancer gathering more data than ever before. We need to improve our computational methods to aggressively and getting good results. organize, describe, and find patterns in this data that can unlock the reasons cancer spreads. Our patients choose MSK because our compassionate care is powered by innovative research that we conduct through a major investment of resources. Our scientists and physicians have helped 22 Always by Your Side develop and test groundbreaking chemotherapy drugs, immunotherapies, surgical and radiation Deep relationships in our breast cancer support techniques, and countless other treatments that have saved lives. And we share our work with the world. groups are another form of treatment. We know that with enough resources, we will stay on a path of relentless discovery, leading the way and protecting our patients from hearing those four frightening words. BACK COVER Two Visionary Donors Are Changing the Way Metastasis Is Studied at MSK His Cancer Spread Much of the work described in this issue reflects 14 Three Times the pioneering efforts of the Alan and Sandra Gerry Metastasis and Tumor Ecosystems Center When cancer cells change, special testing enables new (GMTEC). Founded in 2017 with generous support therapies to keep the disease at bay. Garth Atchley was from Alan and Sandra Gerry, GMTEC fosters diagnosed with lung cancer that spread to his brain four pathbreaking research by investigators across CRAIG B. THOMPSON LISA DEANGELIS JOAN MASSAGUÉ years ago, and he’s still running marathons. MSK. Learn more about how the Gerrys have President and Physician-in-Chief and Director, accelerated metastasis research. Chief Executive Officer Chief Medical Officer Sloan Kettering Institute Read more stories online: mskcc.org/summer-2021 | 3 A Major Advance Tracking and Treating Hidden Prostate Cancer Cells A transformation is coming for patients with prostate cancer, says Memorial Sloan Kettering medical oncologist Michael Morris. Researchers at MSK have helped pioneer major advances that will enable doctors to pinpoint the location of prostate cancer cells more precisely than ever before so they can be targeted with personalized treatments. The researchers also have begun to solve an enduring mystery about how some metastatic prostate cancers escape powerful drugs. The most immediate breakthrough than we could with standard CT or involves a new form of imaging. PET scans,” he says. Dr. Morris played “This is the biggest diagnostic advance a leading role in clinical trials testing for prostate cancer since the 1980s, when a particular tracer that is easy to the PSA [prostate specific antigen] test manufacture and can be used at all was introduced,” Dr. Morris says. “Imaging institutions. MSK radiologist Hebert has been the Achilles heel of prostate Alberto Vargas and interventional cancer because the disease is hard to radiologist Jeremy Durack were key detect after it has spread, forcing many collaborators in the development and treatment choices to be based on estima- testing of the tracer. tion and probabilities. Now, we can be In May, the FDA approved this tracer much more confident that we are correctly — the first for national, widespread use. identifying the location of the disease to The PSMA advance is the result of years make an accurate treatment plan.” of work by MSK’s Molecular Imaging and “I had no side effects either on the day of the The new technology uses a radioactive Therapy Service, led by Heiko Schöder. procedures or afterward. My PSA went right substance that selectively seeks out and This technology has an even more attaches to a specific protein on the cancer exciting potential: zeroing in on prostate down, and my blood tests have been really good. cell surface. The protein, called prostate- cells to destroy them. A therapy called specific membrane antigen (PSMA), is not 177Lu-PSMA-617 selectively binds to From how I feel today, you would never think found on most normal cells. When the PSMA in prostate cancer cells and I had cancer a few years ago.” radioactive tracer binds to the prostate delivers DNA-damaging radiation, killing cancer cells, they show up as bright spots the cell. Patients receive this treatment —Michael Rosenblum, MSK Patient on a PET scan. by injection over six sessions, usually “With PSMA PET, we can now detect spaced six weeks apart, given by nuclear the cancer cells directly and much earlier medicine physicians. 4 | MSKNews Read more stories online: mskcc.org/summer-2021 | 5 “Effective treatments for metastatic June. Men who received the drug had a resistance, based on lessons he learned prostate cancer have been limited, so this median of 8.7 months of progression-free from pioneering the lifesaving treatment could be a game-changer,” Dr. Morris says. survival — the period when the disease imatinib (Gleevec®) to treat chronic Just ask Michael Rosenblum. In 2019, didn’t worsen — compared with 3.4 myeloid leukemia (CML). Imatinib targets his prostate cancer had become resistant months for those receiving only standard an abnormal protein and essentially cures to treatment and had spread to his bones. treatment. Side effects were not serious. CML — a landmark in targeted cancer therapy. His PSA levels — a marker that normally Among the most common was dry mouth. But Dr. Sawyers discovered cancer should be in the single-digit range — had “We hope this therapy will receive cells could become resistant to imatinib. soared to more than 100. FDA approval,” says Dr. Morris, whose This raised the question of whether a Dr. Morris enrolled Michael in a clinical research has been supported by the different mechanism had taken over to trial led by nuclear medicine physician philanthropy of the Magnier family. promote the cancer. Researchers wondered Lisa Bodei testing the benefits of 177Lu- For Dr. Morris, the recent inroads if they were still focused on the right target. PSMA-617 when used in combination against this stubborn disease — the Dr. Sawyers’ instincts told him to zero in with standard prostate cancer therapy. second leading cause of cancer death in even more closely on the abnormal protein, Since Michael’s last treatment in February men — are especially gratifying. believing it was the scene of the crime. 2020, the 75-year-old has been free of “I have been involved in the PSMA “When you play the game Clue and symptoms.
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