An eventful year at Fred Hutch: from defusing obesity’s role in cancer to breakthroughs in pancreas cancer research
Editor’s note: It was an eventful 2012 at Fred Hutch, with our researchers making major breakthrough announcements on several fronts. Our campus also was shaken by the death of one of our very own—Dr. Don Thomas, who has long been considered the father of bone marrow transplantation. Here’s a look back at a few of the key happenings at Fred Hutch during the last 12 months.
At one point in 2012, there were 999,999 people around the world who had received a bone marrow transplant. And somewhere on the planet, that 1 millionth person afflicted by a blood cancer—perhaps a 10-year-old girl suffering from leukemia or a grandfather who would not have been a candidate for the procedure just a few short years ago—received a life-saving transplant. It’s difficult to determine exactly when this happened, or where, but one thing is clear: that transplant happened because Fred Hutch and its team of researchers pioneered bone marrow transplantation.
That’s why 2012 was a special year for all of us who work at Fred Hutch. The 1 millionth transplant reinforced the importance of the work that goes on at Fred Hutch. The transplantation procedure, which has saved the lives of hundreds of thousands of patients, was at first available only in Seattle, Fred Hutch’s home. But over the years, our researchers have trained doctors from everywhere , helping save lives throughout the U.S. and throughout the world.
Today, Fred Hutch researchers continue to break barriers to transplantation, making it safer and available to a wider pool of patients—with the goal of offering the life-saving procedure to practically every one who needs it.
Transplantation also is being used to treat solid tumors such as breast cancer as well as nonmalignant diseases such as sickle cell anemia, multiple sclerosis and autoimmune diseases such as scleroderma. Recently, we started recruiting patients for a clinical trial to test the effectiveness of transplantation to treat Crohn’s disease, a chronic inflammation of the gastrointestinal system.
The passing of a legend
In October, colleagues mourned the death of Dr. Don Thomas, who earned a Nobel Prize for developing bone marrow transplantation at Fred Hutch.Thanks to Thomas and his team of researchers, nurses, clinicians and patients, bone marrow transplantation and its sister therapy, blood stem cell transplantation, are one of cancer treatment’s greatest success stories. A diagnosis of leukemia was once considered a death sentence. Now, some leukemias have cure rates of up to 90 percent.”To the world, Don Thomas will forever be known as the father of bone marrow transplantation, but to his colleagues at Fred Hutch he will be remembered as a friend, colleague, mentor and pioneer,” said Dr. Larry Corey, president and director of Fred Hutch.”The work Don Thomas did to establish marrow transplantation as a successful treatment for leukemia and other otherwise fatal diseases of the blood is responsible for saving the lives of tens of thousands of people around the globe. His legacy to Fred Hutch cannot be overstated. The success of his lifesaving cancer research built the platform for the breakthrough science that our faculty members in all disciplines continue to produce.”
Thomas’ discoveries have sparked whole new areas of research, including the promising field of immunotherapy, which harnesses the power of the immune system to kill cancer with few side effects. Immunotherapy has been used at Fred Hutch to put stage 4 melanoma patients into complete, long-term remission.
“One of our goals with our work in immunotherapy is to replace the stem cell transplant for many patients who are being treated for blood cancers, as transplantation is a very intensive process that carries a number of risks,” said Dr. Fred Appelbaum, director of the Hutchinson Center’s Clinical Research Division.
“If we achieve that, we will have brought our own research full circle, since we’re the center that developed marrow and stem cell transplantation as a cure for leukemias and other blood cancers. I find it poetically ironic that the offshoot of BMT—immunotherapy—could one day make transplants unnecessary for many patients.”
Fred Hutch breaks through the pancreas cancer treatment barrier
Just as leukemia was a certain death sentence until the advent and refinement of bone marrow transplantation, pancreas cancer is notoriously resistant to treatment, making it among the deadliest of malignancies. That is starting to change.
Earlier this year, Dr. Sunil Hingorani and colleagues in the Fred Hutch Clinical Research Division made a literal breakthrough against pancreas cancer by overcoming the mechanism by which such tumors resist treatment. By using a special enzyme to shatter the biological barrier the tumor builds around itself, they made the cancer vulnerable to standard chemotherapy, increasing survival time by 70 percent.
While these encouraging results were made in mice that were genetically engineered to develop pancreas cancer, early clinical trials in humans already are under way at a few sites in the U.S. and Europe, including Seattle Cancer Care Alliance, Fred Hutch’s patient-treatment arm.
This breakthrough is both professional and personal for Hingorani, whose first pancreas-cancer patient out of medical school was his own father.
Genetics discoveries leads to partnership to develop therapy for a form of muscular dystrophy
A series of groundbreaking discoveries begun in 2010 about the genetic causes of facioscapulohumeral muscular dystrophy (FSHD), the third most common form of inherited muscular dystrophy, resulted in additional breakthrough findings in 2012 by an international team of researchers co-led by Fred Hutch’s Dr. Stephen Tapscott. As a result, Fred Hutch and GlaxoSmithKline PLC (GSK) recently announced a partnership to develop therapeutics to treat FSHD. The goal is to develop a small-molecule-based medicine to potentially reverse the disease by inhibiting the activity of a protein that is incorrectly expressed by the DUX4 gene in people with the disease.The protein activity is what damages muscle cells and leads to progressive muscle weakness and atrophy in FSHD patients.
Tapscott and colleagues identified the genes and proteins that damage muscle cells, as well as the mechanisms that can cause the disease. These discoveries could lead to a biomarker-based test for diagnosing FSHD.
The findings also have implications for developing future treatments for FSHD as well as for cancer.
Making precision medicine a reality
This year, Dr. Pete Nelson and his colleagues discovered three types of aggressive prostate tumors that mutate at a much faster rate than others and become resistant to treatment.
Identifying these genetic mutations provides clues to why some prostate cancers are lethal, and potentially could lead to prevention methods, screening tests for early cancer detection or drug targets to slow or halt cancer growth.
This genetic knowledge could enable researchers to tailor treatments that target the genetic drivers of the cancers. It’s all part of Fred Hutch’s precision medicine initiative, which is aimed at getting the right medicine to the right patient at the right time.
Defusing obesity’s role in cancer
Hutchinson Center researchers made key strides toward understanding—and potentially defusing—the coming epidemic of obesity-related cancers.
Being overweight or inactive is known to increase a person’s risk of some of the most common cancers, including colorectal cancer and breast cancer. This year, Dr. Anne McTiernan published findings from several studies that explain how weight loss can reduce breast cancer risk and describe evidence-based factors that contribute to successful weight loss.
Meanwhile, Dr. Mario Kratz made significant progress with some of the world’s most innovative feeding studies, which he believes will redefine the guidelines of what we should and shouldn’t eat to reduce our cancer risk. His research focuses on inflammation, one of the big keys in the obesity-cancer equation.
New institute is dedicated to health economics and patient outcomes research
In July, the Hutchinson Center announced it would become the nation’s first comprehensive cancer center to launch a research institute dedicated to studying the economics of cancer care, prevention and research.
The institute, scheduled to open in 2013, will focus on core research areas that include outcomes research in cancer, cost-effectiveness of prevention, early detection and treatment, and health policy in cancer and other chronic diseases.
The institute will help identify cancer treatments that are both clinically and economically effective in order to advance the Center’s mission to eliminate cancer and other diseases as a cause of human suffering and death.
Fred Hutch’s work in Uganda gets media spotlight
Late in 2012, the Hutchinson Center’s work to research and improve the quality of cancer care in Uganda received a lot of attention when Public Radio International’s popular program The World explored the burden of cancer in the developing world.
“Cancer’s New Battleground—the Developing World,” examined the work of Fred Hutch’s Dr. Corey Casper, director of the UCI/Hutchinson Center Cancer Alliance, as well as the Center’s partner, the Uganda Cancer Institute. The coverage, which included radio segments, blog posts, videos, info graphics, social media including a Facebook online chat and more, put a highlight on the burden of cancer in developing nations and Fred Hutch’s work in trying to address this need.
Fetal cells persist in women long after they give birth
Two studies from the labs of Drs. J. Lee Nelson and V. K. Gadi revealed that women who give birth have fetal DNA that persists for decades in their circulating blood and in their brains. Both researchers are experts in the phenomenon known as fetal microchimerism.
Gadi’s study showed what could be a causative link between the concentration of circulating Y-chromosome fetal cells in women who gave birth to children of either sex and their risk of later developing breast cancer and colon cancer.
The presence of fetal cells is a double-edged sword: Women with the lowest concentration of fetal cells were 70 percent less likely to have breast cancer, while women with the highest concentration of fetal cells had a four-fold increased risk for colon cancer when compared with healthy controls. The how and why of this contradictory role of fetal microchimerism is not known and requires more study.
The study from Nelson’s lab showed that male DNA is commonly found in the brains of women, most likely derived from prior pregnancy with a male fetus. The medical implications of male DNA and male cells in the brain are unknown. However, the findings support the likelihood that fetal cells frequently cross the human blood-brain barrier and that fetal microchimerism in the brain is relatively common. Until this study, it was not known whether these cells could cross the barrier in humans.