Betsy Hilfiger (Left) and Dana Delany Honored Along with the Stand up to Cancer Executive Leadership Council at the 2009 Evening with the Stars Gala (See Page 12.)
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OUTREACHVOL X ISSUE I FEBRUARY 2010 Betsy Hilfiger (left) and Dana Delany honored along with the Stand Up To Cancer Executive Leadership Council at the 2009 Evening With the Stars gala (See page 12.) February 2010 OUTREACH 1 BOARD OF DIRECTORS CHAIR’s MESSAGE Jason Kuhn, Chair, Tampa, Fla. Stephanie R. Davis, JD, MA, Secretary, LOOKING AHEAD WITH OPTIMISM Sherman Oaks, Calif. Tim Ennis, Boca Raton, Fla. Dear Pancreatic Cancer Action Network Friends: Julie Fleshman, JD, MBA, President & CEO, Los Angeles For me, a new year always brings a renewed sense of Stevan Holmberg, MBA, DBA, Potomac, Md. hope and opportunity. Currently, the momentum in the Peter Kovler, Washington, D.C. pancreatic cancer scientific community is growing and Laurie MacCaskill, Los Angeles researchers we speak to believe that we are at a tipping Jai Pausch, Hampton Roads, Va. point. This optimism always motivates us to work harder Cynthia Stroum, Founding Chair Emeritus, Seattle and smarter to help accelerate breakthroughs. Since 1999, the research landscape for pancreatic cancer has transformed SCIENTIFIC ADVISORY BOARD and continues to evolve. The Pancreatic Cancer Action Network has played a Dafna Bar-Sagi, PhD, Chair, New York University Teri Brentnall, MD, University of Washington significant role in helping to bring about this evolution. The number of investigators Michael Hollingsworth, PhD, studying the disease continues to grow, and the field of pancreatic cancer research University of Nebraska Medical Center is attracting more brilliant minds than ever before. Ralph Hruban, MD, Johns Hopkins University Elizabeth Jaffee, MD, Johns Hopkins University Ten years ago, the story was much different. Public and private funding for such Craig Logsdon, PhD, research was severely lacking and little collaboration took place in the field. Since MD Anderson Cancer Center that time, our efforts have led to significant increases in both federal and private Margaret Mandelson, PhD, research funding. Additional patient resources, more patient advocates and Fred Hutchinson Cancer Research Center increased access to new treatment options also have brightened the outlook for Gloria Petersen, PhD, Mayo Clinic the pancreatic cancer community. Margaret Tempero, MD, University of California, San Francisco Contributions from many individuals, corporations and foundations have made David Tuveson, MD, PhD, this advancement possible. Our Community Outreach events continue to grow Cambridge Research Institute/CRUK exponentially in communities from coast to coast. And our first national cause- Selwyn Vickers, MD, University of Minnesota marketing campaign with bedding industry leader Tempur-Pedic®, which began Geoffrey Wahl, PhD, Salk Institute late last year, was a tremendous success, generating $500,000. I am happy MEDICAL ADVISORY COUNCIL to report that the company will embark on a second fundraising campaign with Mark Talamonti, MD, Chair, us this fall. NorthShore University HealthSystem Jordan Berlin, MD, Despite this progress, much remains to be done, so I hope you will encourage Vanderbilt-Ingram Cancer Center your friends and family members to become involved with us. Opportunities are John Cameron, MD, Johns Hopkins University available throughout the year nationwide. Register to join us at the 2010 Pancreatic Marcia Canto, MD, Johns Hopkins University Cancer Advocacy Day in Washington, D.C., on June 21st and 22nd. Attend one Christopher Crane, MD, of our 2010 spring symposia: in Dallas on March 26th, Seattle on April 30th, or MD Anderson Cancer Center Pittsburgh on May 22nd. Or participate in one of our many Community Outreach Jason Fleming, MD, events around the country. (To learn more, go to www.pancan.org.) MD Anderson Cancer Center Julie Meddles, RD, LD, By bolstering our ranks even more, I know we can continue to advance progress Ohio State University Medical Center and bring hope to all of those touched by this leading cancer killer. Mary Mulcahy, MD, Northwestern University Maria Petzel, RD, CSO, LD, CNSD, With wishes for a joyous 2010, MD Anderson Cancer Center Vincent Picozzi, MD, Virginia Mason Medical Center Mark Pochapin, MD, Jay Monahan Center for Jason Kuhn Gastrointestinal Health Board Chair OUR MISSION The Pancreatic Cancer Action Network is a nationwide network of people dedicated to working together to advance research, support patients and create hope for those affected by pancreatic cancer. Cover image: Angela Johnson CONSENSUS REPort OFFERS RECOMMENDatIONS In 2007, the National Cancer FUTURE CLINICAL TRIALS: Patients with locally advanced Institute convened the Clinical unresectable (inoperable) disease should be studied Trials Planning Meeting on separately from those with metastatic disease, and patients Pancreas Cancer Treatment. At the with unfavorable performance status should be studied gathering, clinical, translational, separately from those with good performance status (a and basic science investigators measure of the patient’s ability to perform daily activities). studying pancreas cancer met Furthermore, uniform eligibility criteria across phase II trials with representatives from the will aid in future comparisons of studies. By closely studying patient advocacy community, these groups of patients separately, true differences in the pharmaceutical industry and response to treatment can be observed. various government agencies to discuss ways to integrate current scientific knowledge into For phase II and phase III clinical trials, overall survival should better clinical trial designs. remain the primary measurement used to assess treatments. Additionally, researchers should consider clinical trials de- In October 2009, lead author Philip Philip, MD, PhD, of signed with multitargeted approaches based on scientific Detroit's Barbara Ann Karmanos Cancer Institute and his col- rationale, as well as trials with non-gemcitabine-based treat- leagues published a follow-up consensus report online in the ment combinations. Journal of Clinical Oncology* outlining specific recommen- dations regarding the disease in the areas of drug targets, TUMOR BANKS (BIOREPOSITORIES): One of the biggest barriers preclinical (laboratory) models to study pancreatic cancer, to conducting translational research in pancreatic ductal ad- future clinical trials, biorepositories (tumor banks), and bio- enocarcinoma is a lack of appropriately collected, clinically markers. Following is a summary of this report. and molecularly annotated, and properly stored biological material. Therefore, all randomized and selected single-arm TARGETS: Mutations in the K-ras gene occur in more than 90 clinical trials should consider the inclusion of a biorepository, percent of pancreatic cancers, making it a popular target and infrastructure should be established to allow easy and for potential therapies. However, the K-ras gene controls shared use of this material. a complex series of cell signals and is difficult to effectively block. Despite these complexities, targeting K-ras remains BIOMARKERS: Currently, no biomarkers for early detection or a high priority. Furthermore, numerous other tumor cell sig- drug efficacy exist for pancreatic cancer. Biomarkers should naling targets were identified and suggested as priorities for be tested in preclinical animal models and further evaluation further research, including: Raf, MEK, PI3-K, EGFR, IGF-1R, should be part of future clinical trials. VEGF/VEGFR, HIF-1alpha, TGF-beta, and c-Met. Hedgehog, CXCR4, BMi-1, and Notch were also identified as targets for CONCLUSION: Research progress has been made in under- signaling-related cancer stem cells, which are thought to be standing the molecular and genetic basis of pancreatic responsible for the initiation and progression of tumors. cancer, identifying potential therapeutic targets, and devel- oping laboratory models of pancreatic cancer. Thorough The final category of targets cited relates to the tumor investigation of the identified targets and molecular path- microenvironment: the cells, molecules and blood vessels ways, as well as standardization of pre-clinical models, are that surround and feed a tumor cell. Though important, needed. As these steps are successfully undertaken, re- interactions between tumors and surrounding cells are not searchers will gain greater understanding of the disease and well understood, so more research is needed. the ability to design and test therapies with higher chances of benefitting patients. Future clinical trials should be based PRE-CLINICAL (LABORATORY) MODELS: The development and on this knowledge. standardization of preclinical models, including genetically engineered mouse models, primary tumor xenografts (im- The Pancreatic Cancer Action Network will utilize the recom- planting human tumors in mice), and cell-based studies are mendations of this consensus report to guide new initiatives also needed. These steps are required to create reliable pre- within the scientific and medical communities. clinical models that closely imitate human pancreatic cancer. The more strictly the pre-clinical models replicate human *Philip PA, Mooney M, Jaffe D, et al. Consensus Report of pancreatic cancer, the more likely studies using these mod- the National Cancer Institute Clinical Trials Planning Meet- els will accurately predict how effective treatments, imaging ing on Pancreas Cancer Treatment. J Clin Oncol. 2009; techniques, or early detection methods will be in humans. 27: 5660-5669. February 2010 OUTREACH 1 MEET A GRANTEE Kimberly A. Kelly, PhD: Working