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One Year National Review Of Clinical Trials During Covid: 
A Message From The Co-Directors: 
Dear Friends and Colleagues,
Two hallmarks of our new UC Cancer Center include resiliency and teamwork.  Nowhere is this more evident than our conduct of clinical research during Covid.   As our country and health systems struggle with the current resurgence of the Delta variant (B.1.617.2), we mark the one year anniversary of cancer research during the pandemic.  We have previously published how our UC Cancer Center adopted and continued to prioritize therapeutic clinical studies for the benefit of our patients https://pubmed.ncbi.nlm.nih.gov/32648667/.  In this month’s JAMA Network Open, our colleagues from the Southwest Oncology Group (SWOG) have published results describing the impact of covid on the conduct of cancer clinical trials.  The authors reviewed enrollments to both treatment trials, as well as, cancer control and prevention trials (CCP) conducted by the SWOG Cancer Research Network between 2016 (pre-Covid) to February, 2021 (during Covid). Overall, 29,398 patients were evaluated during this time period.  During the initial COVID-19 wave there was a 9% reduction in enrollment.  Enrollment recovered thereafter, but decreased again during the winter months, although only by 2% each week.  Overall, during the pandemic, actual enrollments were 77% of expected enrollments.  CCP studies had a more robust decline.  This decline was a reflection of re-allocation of scarce resources.  Remarkably, there was not a strong decline to enrollment reductions to treatment trials.  These results reflect the hard work and commitment to cancer research, for the benefit of patients, that was demonstrated by doctors, nurses, research associates, and health systems across the nation.  These results also reflect our own experience at the UC Cancer Center. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7265094/
 
In another remarkable piece published in Cancer Discovery, the lessons we learned during the current pandemic will change how cancer clinical trials are conducted in the future to one that is more patient centered rather than hospital centered.  What we will see in the future will include remote consenting, use of outside laboratories, increased use of community based network sites, remote infusions, decentralization of clinical trials to make it more accessible to rural and underserved populations, and a more streamlined alignment with the biopharmaceutical industry. https://cancerdiscovery.aacrjournals.org/content/candisc/early/2021/07/21/2159-8290.CD-21-0850.full.pdf 
 
Bob Marley once said, “You never know how strong you are until being strong is the only choice you have.”  Sometimes, obstacles make you stronger and the current COVID-19 pandemic has taught us lessons that will improve how clinical trials are conducted in the future.
Syed A. Ahmad, MD, FACS
Professor of Surgery
The Hayden Family Endowed Chair for Cancer Research
Co-Director, UC Cancer Center
William L. Barrett, MD
Professor & Chairman of Radiation Oncology
Co-Director, UC Cancer Center
UC Cancer Center Research Membership Program
We are pleased to announce the official launch of the UC Cancer Center Research Membership Program.  We invite faculty members from UC and CCHMC (all colleges, schools, institutes, departments, and divisions) that are currently engaged in active cancer-relevant research or aspire to pursue such research to formally apply for membership. Please visit the UCCC website for detailed information regarding membership criteria, application process, review procedures, member roles and responsibilities, and member benefits.
Click Here to Apply for UCCC Membership
Cincinnati Children's Survivorsip Clinic

Cincinnati Children's Cancer Survivorship Center, which is supported by the ATP Tennis Tournament, was established in 1988.  The Cancer Survivorship Center provides specialized longitudinal medical care and psychosocial support to childhood cancer survivors through adulthood. Greatly expanded in the past five years, the Cancer Survivorship Center today cares for more than 1,800 children and adult survivors of childhood cancer.  The Cancer Survivorship Center is designed for people who were diagnosed with a pediatric or young adult cancer at least five years ago and completed treatment for their cancer at least two years ago. Recently, Children’s collaborated with the Barrett Cancer Center at UC Health to provide specialized cancer survivor care to former childhood cancer survivors who have now reached adulthood.

Patients remain under the care of their primary care physician, returning to the Survivorship Center at least annually for a thorough evaluation to assess for potential late effects related to prior cancer treatment. The clinic’s multi-disciplinary team is dedicated to helping childhood cancer survivors thrive by:

  • Taking a comprehensive look at their medical history and current health concerns
  • Conducting annual health screenings and risk-based assessments
  • Coordinating medical care to address any late effects of cancer treatment, functional impairments and quality-of-life issues
  • Educating patients in details of prior therapy and prevention strategies to maintain healthy lifestyles
  • Helping patients transition from pediatric primary to adult care providers
  • Serving as an educational resource for community physicians, patients and families

With over two thirds of cancer survivors experiencing at least one chronic health condition because of their cancer or treatment, the Childhood Cancer Survivor Program focuses on research to improve outcomes for survivors. Some of this research includes human papillomavirus vaccination, cardiovascular health and wellness, fertility preservation, exercise programs, and research about kidney and liver health.  Attention to wellness, including physical and mental health, are crucial for healthy survivor outcomes.

We now have established programs in Cardio-Oncology and Onco-fertility.   The Cardio-Oncology Program was established through a joint collaboration between the Heart Institute and the Cancer and Blood Diseases Institute. The Cardio-Oncology Program offers a unique team approach to pediatric, adolescent, and young adult patients with cardiovascular disease as a result of treatment for cancer and blood disorders.  The goal of the Comprehensive Fertility Care & Preservation Program is to meet with patients whose medical condition or treatment regimens place them at risk for fertility complications in the future. It is one of the first and largest multidisciplinary oncofertility programs in the country.  By educating patients and families early on about the fertility risks of their diagnosis and treatments, they can determine if fertility preservation is available and right for them. We help the patient and family to understand the strengths, limitations, successes, and science behind each option. 

Please check out the Childhood Cancer Survivor Program website at https://www.cincinnatichildrens.org/service/c/cancer-blood/cancer/cancer-survivor , or call  513-636-CBDI to make a referral.

Heart-Healthy Lifestyle Is Associated with Reduced Cancer Risk
Mladen Golubic, MD
Professor, Family Medicine Integrative Medicine
The idea that diverse chronic conditions, the major source of suffering and death in modern societies, might be the manifestations of just one “disease” - poor lifestyle, is likely to raise eyebrows of many. Clearly, cardiovascular disease, such as heart attack, is distinct disease from cancer, just like hypertension is different from diabetes, or chronic kidney disease from asthma. Yet, the growing body of evidence suggests that these different diseases share modifiable, lifestyle-related risk factors. Some of those conditions also share molecular languages of inflammation, oxidative stress or regulation of gene expression that are involved in their development and progression. Those common molecular pathways are well known to be modulated by lifestyle factors, that is, our food choices, physical activity, sleep, relaxation and toxic substances such as tobacco.

A recent study reported in the Journal of the American College of Cardiology: Cardio-Oncology showed that in two large cohorts of patients (about 20,000 patients followed over 15 years who were free of cancer at the start), those who had high risk of developing cardiovascular disease also had almost 4-fold increased risk of future cancer when compared with patients with low cardiovascular risk (https://pubmed.ncbi.nlm.nih.gov/33870217/). On a molecular level, patients who had increased blood concentrations of molecule indicating elevated stress level on the heart, had higher cancer risk.

On the flip side, study participants who had optimal cardiovascular risk factors, that is, scored “As” on the so called “Life’s Simple 7” as per American Heart Association (AHA), had significantly decreased risk of subsequent cancer. The clear implication of this research is that adhering with a heart-healthy lifestyle may be important for preventing not only heart disease, but also cancer.

Here are the AHA’s “Life’s Simple 7” elements, the first three being positively and profoundly impacted by healthy lifestyle (the last four): 1) Manage blood pressure; 2) Control cholesterol; 3) Reduce blood sugar; 4) Get active; 5) Eat better; 6) Lose weight; and 7) Stop smoking. (https://www.heart.org/en/healthy-living/healthy-lifestyle/my-life-check--lifes-simple-7).

In the editorial comment on this study, Drs. Hibler and Lloyd-Jones state “The common soil of the 2 diseases (and other chronic diseases of aging, such as lung diseases, degenerative joint diseases, among others) necessitates holistic and comprehensive approaches to communication and implementation of health promotion and disease prevention strategies” (https://www.jacc.org/doi/full/10.1016/j.jaccao.2021.02.003). Advice to adhere with healthy lifestyle is universally embraced by organizations focused on heart health (American Heart Association, American College of Cardiology and other heart-centered professional organizations) and those dedicated to cancer care (American Cancer Society, American Society of Clinical Oncology, American Institute for Cancer Research and others). And it is conspicuously similar and universal: sit less and move more, eat predominantly plant-based diets of whole, unrefined, minimally processed foods (translation – cook more, eat less out). In addition, it is increasingly clear that implementation of self-care practices to relieve chronic stress by age-tested, safe and health-promoting meditation, prayer, Yoga or Tai Chi rather than by health-damaging substances (tobacco, sugar, etc) and ensuring that we obtain sufficient sleep and nurture harmonious relationships is the foundation for health promotion and prevention of ALL lifestyle-related chronic diseases.  

A large national survey shows that less than 3% of the US population exercises daily, has normal body fat, does not smoke and eats a healthy diet as suggested by the government guidelines (https://pubmed.ncbi.nlm.nih.gov/26906650/). You read this right. This is not an error. It is 3%! Clearly, we have a lot of room for improvements. How are YOU doing regarding the AHA’s “Life’s Simple 7”?  How can we help you be your best self? Medical professionals of diverse expertise at the Cancer Wellness Clinic are available and eager to work with you, help you sustain your commitment to small, steady steps in your self-care practices, especially the lifestyle domains that need most of your attention.  Call us (513-475-9567) to make an appointment – no referral is needed.

References:
  1. Lau ES, et al., Cardiovascular Risk Factors are Associated with Future Cancer.JACC CardioOncol. 2021 Mar;3(1):48-58. PMID: 33870217
  2. Hibler EA and Lloyd-Jones DM. Addressing the “Common Soil” of Risk Factors for Cardiovascular Disease and Cancer. JACC CardioOncol. 2021 Mar;3(1):59-61.
  3. Loprinzi PD et al., Healthy Lifestyle Characteristics and Their Joint Association With Cardiovascular Disease Biomarkers in US Adults. Mayo Clin Proc. 2016 Apr;91(4):432-42. doi: 10.1016/j.mayocp.2016.01.009. Epub 2016 Feb 20.PMID: 26906650
 
WELCOME NEW FACULTY
John Byrd, MD, begins his leadership of Internal Medicine

John Byrd, MD, began his term as chair of the Department of Internal Medicine on Thursday, July 1. He holds the Gordon and Helen Taylor Professor of Medicine endowed chair. Dr. Byrd comes to UC from the Ohio State University College of Medicine, where he served as the D. Warren Brown Chair of Leukemia Research.
 
Byrd, his wife, Laura, and their dog, Spot, moved into an historic home in the Hyde Park area prior to his start as chair.
 
At Ohio State, Byrd was named a Distinguished University Professor, a permanent title that is the highest faculty honor bestowed by university. It is given by the Board of Trustees to no more than three faculty members per year who demonstrate exceptional teaching, research, scholarly or creative work and service. Dr. Byrd’s other leadership roles included director of the Clara Bloomfield Center for Prognosis in Myeloid Leukemia, senior advisor for cancer experimental therapeutics and co-leader of the Leukemia Research Program. From 2010 until 2017, he served as director of the Division of Hematology.
 
A board-certified hematologist, Byrd specializes in caring for patients with chronic lymphocytic leukemia and acute myeloid leukemia. He has received more than $28 million in basic and clinical research grant support during his career. He serves as the national chief medical officer for Beat AML, a multi-site precision medicine study that provides access to novel treatments for Acute Myeloid Leukemia (AML). This study is only available at a handful of cancer centers across the country and is in the approval process for opening at UC in the coming months.

FACULTY ACCOMPLISHMENTS
Atsuo Sasaki, PhD, NCI R01 Grant Recipient

A new NCI R01 grant has been awarded to Atsuo Sasaki, PhD.  The title of the grant is "Therapeutic resistance and aggressive malignancy in glioblastomas: the contribution of GTP metabolism through regulation by IMPDH2."  The start date is 07/07/2021 and direct costs are $255,235.

Glioblastoma multiforme (GBM) is the most prominent and malignant primary brain tumor confers a dismal median survival of about one year. In this proposal Dr. Sasaki and his team will test the hypothesis that inhibition of GTP-energy metabolism will serve as a new therapeutic strategy against GBM. They will use pharmacological and molecular approaches that target GTP-energy metabolism in GBM cell culture and in GBM animal tumor models.

More information can be found on the NIH RePORTER.

Radiation Oncology Leader John Breneman, MD Awarded ASTRO Fellow Designation
 

John Breneman, MD, emeritus professor in the Department of Radiation Oncology, has been selected as a fellow of the American Society for Radiation Oncology (ASTRO). He is among 28 distinguished members of the organization to receive the ASTRO Fellow (FASTRO) designation this year, and is the first from the College of Medicine.

Breneman has served on the College of Medicine faculty since 1985 and is widely recognized for his contributions to the Children’s Oncology Group and the American Board of Radiology. He also is the medical director of the Cincinnati Children’s/UC Health Proton Therapy Center and associate director of the Brain Tumor Center.

The ASTRO fellows program recognizes individuals who have made significant contributions to the society and to the field of radiation oncology through research, education, patient care and service to the field. Since its inception in 2006, the FASTRO designation has been awarded to just 394 of ASTRO’s 10,000 members worldwide.
 
The 2021 class of fellows will be recognized at an awards ceremony in Chicago on Oct. 26 during ASTRO’s 63rd Annual Meeting.

Update on Breast Cancer Research

Su-Ju Lee MD, FACR, Rifat A. Wahab, DO, Lawrence D. Sobel, MD; Bin Zhang, PhD, Ann L. Brown, MD, Kyle Lewis, MD, Charmi Vijapura, MD and Mary C. Mahoney, MD had a major paper accepted by the American Journal of Roentgenology.

Their article, an "Analysis of 612 Benign Papillomas Diagnosed At Core Biopsy: Rate of Upgrade to Malignancy, Factors Associated with Upgrade, and A Proposal For Selective Surgical Excision," identifies several objectives such as "determining the malignancy upgrade rate of benign papillomas, identifying risk factors for upgrade, and formulating criteria for selective surgery."

The complete article is available for download. 

UC CANCER CENTER IN THE COMMUNITY
 
8th Annual UC Cancer Center, Charge Against Cancer

The UC Cancer Center, Charge Against Cancer will take place on Friday, August 27th. A highly educational, inspirational and collaborative day will feature a variety of speakers.

This will be the first step in the planning process for opening a comprehensive, state of the art and futuristic, world class cancer detection clinic in approximately September, 2022.

The event is in person (not virtual) and will take place at the Sample Space Event Center located at 140 Marian Spencer Way, Cincinnati, OH 45202. Complimentary parking is in the Mid Central Riverfront Garage (entrance on East Mehring Way).

The complete agenda and featured speakers is available for preview.

RSVP is required.  To confirm your particpation, please contact Kelly Hummel at kelly.hummel@uc.edu

ATP History & Charity

The Western & Southern Open is the nation's oldest professional tennis tournament played in its city of origin.  First played in 1899 on the site of current day Xavier University, the Open has been a fixture in the Queen City for more than a century.
 

While delivering great tennis to the world is the main product, the Western & Southern Open's primary mission for decades has been to use the event as a force for good.  Over the past decades, the tournament has given more than $11 million directly to key community beneficiaries such as Cincinnati Children's Hospital Medical Center (2020 Contribution:  $50,000) and The Barrett Cancer Center (2020 Contribution: $100,000).

Ride Cincinnati Impacts Cancer Research and Care
Celebrate with fellow riders and their guests at the exclusive Ride Cincinnati Kickoff Party on Friday, September 17, from 4 – 7 p.m. at the Top of the Park at The Phelps. Enjoy music, food and beverages and pick up your Rider credentials.  On Saturday, September 18, Riders will depart from downtown Cincinnati, completing routes ranging from 15 miles to 100 miles. Riders are then invited back to Yeatman’s Cove to a special rider celebration until 2:00 p.m.  Click here for registration information

William Barrett, MD, co-director of the University of Cincinnati Cancer Center, has participated in @RideCincinnati for the past 15 years. Hear how this grassroots bike tour impacts cancer research and care in Cincinnati.
 

UC CANCER CENTER MEMBER RESOURCES
Click Here for UCCC Funding Opportunities
The UC Cancer Center is a Cancer Program Member of the Association of Community Cancer Centers, which entitles everyone who is affiliated with the cancer program to receive ACCC member benefits. The Association of Community Cancer Centers (ACCC), the leading education and advocacy organization for the multidisciplinary cancer team. We are pleased to provide the following tools and resources, at absolutely no cost to you, as a member of our multidisciplinary team:
  • Subscription to the bimonthly journal Oncology Issues
  • Access to the most up-to-date public policy changes and advocacy issues affecting the oncology team through our Legislative Action Center and a biweekly email newsletter, ACCConnect.
The UC Cancer Center is also a member of the Advisory Board Oncology Roundtable and a subscriber to The Cancer Letter. To access these resources, please contact the UC Cancer Center.
UCCC TOWN HALL UPDATE
The May 21st UC Cancer Center Town Hall Meeting recording is available for review.  In this recording, Drs. Filak, Ahmad and Barrett offer updates about the latest advances of the Cancer Center.  In particular, our commitment to obtaining NCI designation and recent accomplishments are highlighted.
Click Here to Submit Information for the Newsletter
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