Rush Cancer Annual Report 2012 by rushmedicalcenter

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									Discovery
2012 Rush University Cancer Center
Annual Report
 1 Chair’s Report                                                             13 Lung and Thoracic Cancers

 2 Rush University Cancer Center in Brief                                     14 Give and Take: Physician-Scientist
                                                                                 Collaborations Open Doors to Discovery
 4 Breast Cancer
                                                                              16 Melanoma and Cutaneous Cancers
 5 Endocrine Cancers
                                                                              17 Neurological Cancers
 6 Gastrointestinal Cancers
                                                                              18 Pediatric Cancers
 7 Genitourinary Cancers
                                                                              19 Sarcomas and Soft Tissue Tumors
 8 Exploring Strategies to Combat Breast Cancer
                                                                              20 Representative Publications
10 Gynecologic Cancers
                                                                              23 2011 Cancer Registry Report
11 Head and Neck Cancers
                                                                              25 Cancer Mortality at Rush
12 Hematalogic Cancers




              On the cover: Thoracic surgery nurse Nikita Patel, RN, MSN, and thoracic surgeon William Warren, MD.
DISCOVERy



chair’s report



As health care providers and researchers, we long for that “aha” moment —
and relish the pursuit of it. While that one puzzle piece may not offer a cure,
it may spare patients the burden of unnecessary treatments; it may inspire
colleagues to ask — and answer — more revealing questions; it may play a
vital role in unraveling mysteries behind cancer development and treatment.


In the 2012 Rush University Cancer Center Annual Report, we take a               Commission on Cancer accreditation. In 2012, Rush received its third
closer look at some of Rush’s research endeavors and the people behind           consecutive Outstanding Achievement Award from the Commission on
them. As practitioners of translational research, clinicians and scientists at   Cancer of the American College of Surgeons. Rush is one of only 13
Rush often enjoy dynamic and productive relationships, as you will see in        recipients to receive this nationwide award for the third time. The
our feature articles about research in breast, lung and colon cancers.           Outstanding Achievement Award recognizes cancer programs that strive
                                                                                 for excellence in providing quality care to cancer patients and is given to
In our cancer registry report (see p. 23), you’ll find that 3,138 cases          community-based teaching hospitals that demonstrate a commendation
were abstracted at Rush in 2011 (an increase from the previous year),            level of compliance with seven standards related to cancer committee
2,599 of which were analytic. These numbers reflect the breadth of               leadership, cancer data management, clinical management, research,
the diseases we treat. We are indebted to the patients behind these              community outreach and quality improvement.
numbers — many of whom participated in clinical trials — and the
many others affected by cancer.                                                  Quality initiative. As part of Rush’s ongoing efforts to prevent central
                                                                                 line-associated bloodstream infections (CLABSI), Rush formed a multidis-
While there are many exciting accomplishments cited in this report,              ciplinary team to recommend and implement changes in Rush’s inpatient
which includes snapshots of our cancer center and its programs, several          areas. On the floors in the Tower (which celebrated its first anniversary
more are worthy of mention:                                                      this year [see p. 2]) that care for patients with cancer, two pilot studies
                                                                                 were initiated: one in which nursing staff document line changes directly
Rush offering cancer treatment services in the western suburbs.                  on the tegaderm dressings to promote better visualization of when lines
In addition to serving residents in Oak Park, Rush now offers cancer treat-      need to be changed, and one in which Curos port protectors (disinfectant
ment services at a new medical office building in Lisle, Ill. Physicians from    caps) are used on IV access ports and needleless connectors to keep ports
Rush specializing in hematology, breast cancer, lung cancer, melanoma, tho-      clean and protected. These steps along with other initiatives, including
racic surgery, head and neck cancers, gynecologic oncology and brain tumors      staff education regarding line maintenance, are designed to significantly
will now be available to see patients in Lisle. This location also has a new     decrease CLABSI rates in the coming year.
chemotherapy infusion center, expanding services provided at Rush’s other
centers on the main campus in Chicago and at Rush Oak Park Hospital.             I would like to thank the many organizations with whom Rush collabo-
                                                                                 rates as well as the health care providers with whom we partner to pro-
Rush collaborates with Swedish Covenant Hospital and Rush-                       vide quality care to patients both in and outside of Chicago. I’d also like
Copley Medical Center. Rush and Swedish Covenant will develop and                to extend my gratitude to my colleagues here at Rush — our physicians,
share cancer treatment protocols and various benchmarks for patient              nurses and cancer registry staff — for their dedication and commitment
outcomes to improve quality, coordination and cost effectiveness of care         to our patients and their families. This is my last year serving as chair of
provided to cancer patients at both institutions. In addition, patients at       the cancer committee at Rush, and it has been a truly rewarding experi-
Swedish Covenant will have access to the cancer subspecialists at Rush.          ence. I have learned so much from so many during the past three years
The collaborative effort will include a tumor board, where physicians from       and have made discoveries of my own that have helped shape my own
Rush and Swedish Covenant regularly meet to review specific patient cases        approach to cancer care.
to arrive at personalized courses of treatment. Rush and Rush-Copley will
collaborate on cancer patient conferences, which are designed to improve
care by allowing physicians from both organizations to consult one an-
other on cases via real-time, state-of-the-art teleconferencing that includes
patient pathology and imaging.

                                                                                 Michael Liptay, MD
                                                                                 The Mary Denny Weaver Professor of Cancer Research
                                                                                 Chairperson, Department of Cardiovascular-Thoracic Surgery
                                                                                 Chair, Cancer Committee at Rush


                                                                                                          2012 Rush University Cancer Center Annual Report   1
DISCOVERy



rUsh UNiversity caNcer ceNter iN BrieF

The Rush University Cancer Center comprises all cancer-related clinical,
research and educational efforts at Rush, crossing 20 departments, divisions
and sections; inpatient and outpatient areas; professional clinical activities;
and the colleges of Rush University.




                                                        Support Services                                     Residency and Fellowship Programs
                                                        In addition to treating cancer, Rush is commit-      Rush offers a full range of selective residen-
                                                        ted to helping patients and their families cope      cies and fellowships, including the following
                                                        with its psychological, emotional and spiritual      programs for physicians interested in caring for
                                                        effects. Support services available at Rush          patients with cancer:
                                                        include the following:                               •	 Residency	in	radiation	oncology	
                                                        •	 An	American	Cancer	Society	patient	navigator		    •	 Residency	in	nuclear	medicine
                                                           who meets with patients and families to pro-      •	 Fellowship	in	hematology/medical	oncology	
Radiation oncologist Aidnag Diaz, MD, MPH
(left), and neurosurgeon Lorenzo Muñoz, MD,                vide vital support, including information about   •	 Fellowship	in	orthopedic	oncology	
work collaboratively in the brain tumor clinic.            available treatments, programs and commu-         •	 Fellowship	in	hospice	and	palliative	medicine	
Together, they created an access initiative for
                                                           nity services.
patients with metastatic brain cancer (see p. 17).
                                                        •	 The	Cancer	Integrative	Medicine	Program,		
                                                           through which patients have access to
Comprehensive Clinics                                      complementary therapies — such as
                                                           psychotherapy and nutritional counseling,
Rush, which serves both adults and children with
                                                           massage therapy, yoga and acupuncture —
cancer, is home to The Coleman Foundation
                                                           that promote their well-being and help
comprehensive clinics. In these multidisciplinary
                                                           maintain their quality of life.
clinics, a team approach is applied to patient
care, with the care team at Rush gathering to           •	 A	recently	expanded	palliative	and	supportive		
discuss the patient’s condition, review diagnos-           care program that offers distress screening,
tic tests and develop a treatment plan, often              pain management and many other services.
                                                                                                             Researcher Abde Abukhdeir, PhD, studies
in collaboration with the patient’s diagnosing          •	 Survivorship	services	for	lymphoma	and	breast		   molecular pathways related to breast cancer.
physician.                                                 cancer survivors.

The comprehensive clinics are dedicated to the
following:                                                                                                   Advancing Medicine Through Research
•	 Blood	and	bone	marrow	transplants                    Strategic Alliances and Outreach Efforts             The Rush University Cancer Center fosters
•	 Brain	cancer	                                        To provide the best possible care for patients       research across four broad programs that aim
•	 Breast	cancer	                                       across the region, Rush has formed key relation-     to deepen our understanding of cancer in order
•	 Chest	and	lung	tumors	                               ships with other organizations in Chicago and        to better prevent, detect and treat it. These pro-
•	 Gastrointestinal	cancers                             beyond, including the following:                     grams include cancer biology; clinical, behavioral
•	 Gynecologic	cancers                                  •	 Argonne	National	Laboratory	                      and translational research; molecular signatures
•	 Head	and	neck	cancers	                               •	 DuPage	Medical	Group                              and cancer outcomes; and tumor immunology.
•	 Inherited	susceptibility	to	cancer	                  •	 Illinois	Institute	of	Technology	                 For a list of cancer clinical trial opportunities, visit
•	 Leukemia	                                            •	 John	H.	Stroger,	Jr.	Hospital	of	Cook	County	     www.rush.edu/cancerclinicaltrials.	
•	 Lymphoma	                                            •	 Rush	Oak	Park	Hospital	
•	 Melanoma	and	soft	tissue	tumors		      	             •	 Rush-Copley	Medical	Center	
   (includes the former Pigmented Lesion Clinic)        •	 Swim	Across	America
•	 Multiple	myeloma	                                    •	 Swedish	Covenant	Hospital	
•	 Myelodysplastic/myeloproliferative	neoplasms	
•	 Prostate	cancer	
•	 Sarcomas
•	 Spine	tumors	



2    2012 Rush University Cancer Center Annual Report
                                                      “ In the Tower’s perioperative and interventional platform,
                                                        I often collaborate with the pathologist during my frozen
                                                        sections and am able to see the slides in real time on a large
                                                        flat screen in the operating room. This capability allows me to
                                                        better visualize what the pathologist sees.”
                                                                                              — Summer Dewdney, MD, gynecologic oncologist




Recognition and Accreditations                         The ToWeR: RUsh’s NeW hospiTAL
                                                  ¡    CeLebRATes iTs FiRsT ANNiveRsARy
•	 Rush	has	received	three	consecutive		 	
   outstanding achievement awards from
                                                       In	January,	Rush’s	new	hospital,	the	Tower,	
   the Commission on Cancer of the American
                                                       celebrated its first anniversary. Since its opening,
   College of Surgeons.
                                                       the Tower has received numerous distinctions
                                                       for design and was awarded Leadership in
•	 The	Coleman	Foundation	Blood	and	Bone		
                                                       Energy and Environmental Design (LEED) Gold
   Marrow Transplantation Clinic is accredited         Certification by the U.S. Green Building Council,
   by the Foundation for the Accreditation of          making the hospital the largest new-construction
   Cellular Therapy.                                   health care project in the world to be LEED gold
                                                       certified. Rush’s patient satisfaction scores from
•	 Rush’s	pathology	and	clinical	laboratories		        the Hospital Consumer Assessment of Healthcare
	 are	accredited	by	the	Joint	Commission.	             Providers and Systems reached an all-time high
                                                       for Rush following the Tower opening. And the
•	 Three	times	in	a	row,	Rush	has	received		           new operating room facilities in the Tower’s
   Magnet status — the highest recognition             perioperative and interventional platform have
   for nursing excellence — from the American          all been well-received, with oncologic surgeons
   Nurses Credentialing Center.                        collaborating with pathologists to visually
                                                       evaluate biopsies during procedures thanks to
•	 The	Regenstein	Breast	Imaging	Center		              large flat screens in the operating rooms.
   at Rush is an American College of
   Radiology-accredited Center of Excellence.
   This designation is awarded to centers that
   have received full accreditation in mam-
   mography, breast ultrasound, and
   stereotactic and ultrasound-guided
   needle biopsies.

•	 The	Association	for	the	Accreditation		
   of Human Research Protection Programs
   has awarded Rush full accreditation with
   distinction in Community Programs, giving
   special recognition to Rush’s community-
   based participatory research.

•	 Rush	has	been	named	among	the	top		
   hospitals in the country for quality, safety
   and efficiency four consecutive times by
   the Leapfrog Group, a national organization
   that promotes health care safety and quality
   improvement.
DISEASE-SITE PROGRAMS



Breast caNcer

Many breast cancer patients at Rush are seen at The Coleman Foundation                                            CLiNiCAL speCiALisTs
Comprehensive breast Cancer Clinic, the first clinic of its kind in the                                           Diagnostic radiologists:
Midwest. in the clinic, diagnostic data are correlated with a physical exam                                       Anne Cardwell, MD; Carol Corbridge, MD;
                                                                                                                  Janice	Dieschbourg,	MD;	Mireya	Dondalski,	
to determine disease staging and a treatment approach. A multidisciplinary                                        MD;	Peter	Jokich,	MD;	Gene	Solmos,	MD;	
team then meets with patients and families to discuss the best course of                                          Lisa Stempel, MD
treatment. Rush also has a robust breast cancer basic and clinical research                                       Medical oncologists:
program (for more see p. 8).                                                                                      Melody Cobleigh, MD; Katherine Kabaker,
                                                                                                                  MD; Ruta Rao, MD; Lydia Usha, MD
                                                                                                                  pathologists:
HigHligHTS                                                                                                        Paolo Gattuso, MD; Ritu Ghai, MD
                                                                                                                  plastic and reconstructive specialists:
PARP inhibitors: As part of a national trial for       enable his team of specialty trained radiologists
                                                                                                                  John	Cook,	MD;	Gordon	Derman,	MD;	
women with BRCA mutation-related meta-                 to better serve the different needs of each pa-            George Kouris, MD; Norman Weinzweig, MD
static cancer, Lydia Usha, MD, is investigating        tient population, while providing faster image
                                                                                                                  Radiation oncologists:
the poly (ADP-ribose) polymerase, or PARP,             sharing with other clinicians.
                                                                                                                  Katherine Griem, MD; Krystyna Kiel, MD
inhibitor veliparib. Researchers hope that this
promising new class of drugs will stop the re-         innovative radiotherapy: The Department                    surgical oncologists:
pair of cancer cells treated with chemotherapy         of Radiation Oncology offers specialized breast            Steven Bines, MD; Kambiz Dowlatshahi,
in patients with BRCA mutations.                       cancer irradiation using the prone technique.              MD; Darius Francescatti, MD; Alicia
                                                       This technique, developed by Katherine Griem,              Growney, MD; Andrea Madrigrano, MD;
international study testing site: For an               MD, and colleagues at Rush, reduces the                    Thomas Witt, MD; Norman Wool, MD
international study on ductal carcinoma in situ,       amount of radiation delivered to the lung in all
Rush is testing tumor samples from around the          patients and reduces the amount to the heart in            bReAsT TUMoR CoNFeReNCe
world to identify qualified participants. The          most patients with left breast cancer.
                                                                                                                  Mondays, 4 to 5 p.m.
study investigates the addition of Herceptin to                                                                   Janet	Wolter,	MD,	Clinical	and	Educational	
standard therapy to gauge its radiosensitizing         Radiotherapy expertise: As a board mem-                    Conference Room
ability. Because there are indications that just       ber of the American Society of Breast Disease,             1010 Professional Building
a single dose of Herceptin activates immunity          Krystyna Kiel, MD, radiation oncologist, has
against HER2, researchers such as Melody               presented at three international and national
                                                                                                                  CLiNiCAL ReseARCh
Cobleigh, MD, international chair of the               symposia on topics such as new approaches to
study, are also evaluating whether small doses         radiation therapy, treatment of brain metastasis           Rush is currently participating in the
of Herceptin can reduce the risk of cancer in          and postmastectomy radiation therapy.                      adjuvant therapy trial AFFINITy in which
the opposite breast.                                                                                              the antibody pertuzumab is combined with
                                                                                                                  Herceptin plus chemotherapy. For more
Early T-DM1 studies: For patients with highly                                                                     information about open clinical trials, visit
refractory metastatic breast cancer that has                                                                      www.rush.edu/cancerclinicaltrials.	To	enroll	a	
progressed on all standard therapy, a new option                                                                  patient in a clinical trial, call (312) 942-3608.
recently received FDA approval: T-DM1, a mol-
ecule that combines Herceptin and a chemother-
apeutic drug. Herceptin acts as a “smart drug,”
according to Melody Cobleigh, MD, one of
the leaders of early T-DM1 international trials.
The Herceptin attaches itself to tumor cells only;
the chemotherapeutic drug is then internalized
by the cancer cell, destroying itself from within
while leaving normal cells alone.

New breast imaging facilities: Two new
centers at Rush will provide digital mammog-
raphy in two locations: a screening center for
convenient access for routine mammograms,
                                                       Radiation oncologist Katherine Griem, MD (left), and
and a diagnostic and biopsy center. According          medical oncologist Melody Cobleigh, MD, are both
to director Peter Jokich, MD, these changes            actively involved in clinical research.



                                                                                                              ¡   For more information about the breast
                                                                                                                  cancer program or to refer a patient for
                                                                                                                  an initial visit or a second opinion, please
4   2012 Rush University Cancer Center Annual Report
                                                                                                                  call (312) CANCeR-1 (226-2371).
DISEASE-SITE PROGRAMS



eNDocriNe caNcers

                                                                                                                    CLiNiCAL speCiALisTs
                                                                                                                    endocrine surgeon:
                                                                                                                    Katy Heiden, MD
                                                                                                                    endocrinologists:
                                                                                                                    David Baldwin, MD; Tiffany Hor, MD;
                                                                                                                    Chung Kay Koh, MD; Sirimon Reutrakul,
                                                                                                                    MD; Kristina Todorova-Koteva, MD


                                                                                                                    eNDoCRiNe TUMoR CoNFeReNCe
                                                                                                                    Wednesdays (varies each month), 8 to 9 a.m.
                                                                                                                    250 Professional Building


                                                                                                                    CLiNiCAL TRiALs
                                                                                                                    For information about open clinical trials,
Endocrine surgeon Katy Heiden, MD, and endocrinologist David Baldwin, MD, meet regularly to review cases.
                                                                                                                    visit	www.rush.edu/cancerclinicaltrials.	
                                                                                                                    To enroll a patient in a clinical trial, call
                                                                                                                    (312) 942-3608.
Rush offers comprehensive care for cancerous and noncancerous
tumors of the endocrine system, including adrenal tumors, pancreatic
neuroendocrine tumors, parathyroid tumors and thyroid tumors. The
endocrine cancer team uses state-of-the-art procedures and imaging
techniques to diagnose patients as quickly and accurately as possible. After
diagnosis, an individualized treatment plan is developed for each patient.
An endocrinologist provides patients with long-term care, including
medication dose adjustment and follow-up scans. in cases that require
surgery, the endocrine surgeon — who now performs robotic surgeries as
well as traditional procedures — collaborates with the endocrinologist to
provide this follow-up care.


HigHligHTS

Seeing patients in Oak Park: Surgeon Katy                  State-of-the-art facilities: Surgeries for
heiden, MD, began seeing patients at Rush                  endocrine cancers are performed in Rush’s
Oak Park Hospital this past year. This is part             perioperative and interventional platform,
of Rush’s larger effort to provide high-quality,           located in the Tower, which opened in 2012.
geographically convenient cancer care to                   The majority of patients undergoing these
people living in Chicago’s western suburbs.                surgeries also go to extended recovery in
                                                           the new building, which offers single rooms
BRAF testing for thyroid cancer: Doctors at                and city views. The operating rooms house
Rush can now test for BRAF genetic mutations               state-of-the-art communication technologies,
in patients with thyroid cancer that is resistant          including an audiovisual system that connects
to radioactive iodine therapy. Many cells in               all operating rooms to each other and
papillary thyroid cancers have been found to               other departments at Rush. This enables
have changes in the BRAF gene, causing these               consultations to occur in real time during
cancers to grow. If patients test positive for             procedures.
the BRAF genetic mutation, tyrosine kinase
inhibitors — drugs that target BRAF gene
mutations — may be considered as treatment.



                                                                                                                ¡   For more information about the endocrine
                                                                                                                    cancers program or to refer a patient for
                                                                                                                    an initial visit or a second opinion, please
                                                        2012 Rush University Cancer Center Annual Report    5
                                                                                                                    call (312) CANCeR-1 (226-2371).
DISEASE-SITE PROGRAMS



GastroiNtestiNaL caNcers
The Coleman Foundation Comprehensive Gastrointestinal Cancers Clinic is                                         CLiNiCAL speCiALisTs
an integral part of the gastrointestinal cancers program at Rush, offering                                      Gastroenterologists:
the latest diagnostic capabilities as well as leading-edge treatment options.                                   John	Losurdo,	MD;	Joshua	Melson,	MD;	
                                                                                                                Sohrab Mobarhan, MD; David Shapiro, MD
As one of the few places in the Chicago area to provide a full spectrum of
care for patients with gastrointestinal cancers, the clinic brings together a                                   Colorectal surgeons:
                                                                                                                Marc	Brand,	MD;	Joanne	Favuzza,	DO;	
team of experts in gastroenterology, hepatology, medical oncology, radiation
                                                                                                                Bruce Orkin, MD
oncology, pathology, diagnostic and interventional radiology, and surgery.
                                                                                                                General surgeons:
Many new patients meet with this multidisciplinary team. in a single visit,
                                                                                                                Daniel Deziel, MD; Minh Luu, MD; Keith
patients leave knowing that there is a well-defined treatment plan designed                                     Millikan,	MD;	Jonathan	Myers,	MD	
to meet their specific needs. one of the program’s primary goals is to ensure
                                                                                                                interventional radiologists:
that patients have active roles in deciding their treatment plans.                                              Bulent Arslan, MD; Allen T. Chen, MD;
                                                                                                                Jayesh	Soni,	MD;	Ulku	Cenk	Turba,	MD

                                                                                                                Medical oncologists:
HigHligHTS                                                                                                      Mary	Jo	Fidler,	MD;	Marisa	Hill,	MD;	
                                                                                                                William Leslie, MD
Symposium: The Coleman Foundation                                                                               pathologist:
Gastrointestinal Cancers Clinic held its annual                                                                 Shriram	Jakate,	MD
daylong gastrointestinal cancer symposium
Feb. 23, 2013. Some of the topics covered                                                                       Radiation oncologists:
                                                                                                                Ross Abrams, MD; Krystyna Kiel, MD
included advances in the treatment of
gastrointestinal cancers, palliative care and                                                                   Radiologists:
management of liver metastases. Seven                                                                           John	Hibbeln,	MD;	Claire	Smith,	MD
scientific reports were published within the
                                                                                                                Thoracic surgeons:
year prior to the symposium.
                                                                                                                Gary Chmielewski, MD; Michael Liptay,
                                                                                                                MD; William Warren, MD
Alternative regimens: In the Journal of
Gastrointestinal Cancer Research, radiation                                                                     Transplant hepatologists:
oncologists Ross Abrams, MD, and shalini                                                                        Sheila Eswaran, MD; Nikunj N. Shah, MD
Garg, MD, as well as medical oncologist
William Leslie, MD, published a case report
of a patient with anal carcinoma. The patient                                                                   GAsTRoiNTesTiNAL TUMoR
                                                       Colorectal surgeon Bruce Orkin, MD, specializes in       CoNFeReNCe
developed a 5-fluorouracil (FU)-induced coronary       transanal endoscopic microsurgery.
syndrome early in her radiation treatment,                                                                      Tuesdays, 12:30 to 1:30 p.m.
leading doctors to change her chemotherapy                                                                      Janet	Wolter,	MD,	Clinical	
treatment to paclitaxel and cisplatin, which                                                                    and Educational Conference Room
was tolerated well. The patient continued to be                                                                 1010 Professional Building
disease-free five years after treatment, indicating    cancer team at Rush. Favuzza specializes in
that this approach can be used with radiation          minimally invasive surgeries, including laparo-          CLiNiCAL TRiALs
therapy in patients who cannot tolerate 5-FU.          scopic procedures.
                                                                                                                Rush is currently participating in a
                                                                                                                randomized, double-blind, phase III study
New surgeons: Rush named surgeon bruce                 grants for colorectal cancer screening:
                                                                                                                of the efficacy and safety of gemcitabine in
orkin, MD, from Tufts Medical Center, as               Gastroenterologist Joshua Melson, MD,                    combination with TH-302 compared with
chief of the Section of Colon and Rectal Sur-          received two grants from the American Cancer             gemcitabine in combination with placebo
gery. Orkin specializes in transanal endoscopic        Society during the past year. One is a grant to          in previously untreated patients with
microsurgery, robotic colorectal surgery and           develop blood biomarkers to identify patients            metastatic or locally advanced unresectable
pediatric colorectal surgery, and he pioneered         who have colorectal cancers. The other grant             pancreatic adenocarcinoma. To enroll a
single-port laparoscopic colorectal surgery.           will help fund a study testing the efficacy of           patient in a clinical trial, call (312) 942-3608.
Joanne Favuzza, Do, a colorectal surgeon,              a patient navigation program to promote
also recently joined the gastrointestinal              colorectal cancer screenings.




                                                                                                            ¡   For more information about the gastro-
                                                                                                                intestinal cancers program or to refer a
                                                                                                                patient for an initial visit or a second opin-
6   2012 Rush University Cancer Center Annual Report
                                                                                                                ion, please call (312) CANCeR-1 (226-2371).
DISEASE-SITE PROGRAMS



GeNitoUriNary caNcers
specialists at Rush diagnose and treat people with cancers of the                                                CLiNiCAL speCiALisTs
urinary tract and male genital tract, including bladder cancer, kidney                                           Medical oncologist:
cancer, prostate cancer and testicular cancer. Urologists offer advanced                                         John	Showel,	MD
treatment options — such as da vinci prostatectomy and minimally                                                 Radiation oncologist:
invasive cryosurgical procedures for prostate and kidney cancer. Leading-                                        David Sher, MD, MPH
edge radiation treatments are also available, including TomoTherapy,                                             Urologists:
intensity-modulated radiation therapy and both high-dose and traditional                                         Christopher Coogan, MD; Shahid
                                                                                                                 Ekbal,	MD;	Lev	Elterman,	MD;	Jerome	
brachytherapy. Rush also has an active surveillance program for men with                                         Hoeksema, MD; Kalyan Latchamsetty,
prostate cancer who are not undergoing treatment.                                                                MD; Laurence Levine, MD; Charles
                                                                                                                 McKiel	Jr.,	MD;	Dennis	Pessis,	MD

HigHligHTS
                                                                                                                 GeNiToURiNARy TUMoR CoNFeReNCe
Comparing treatment regimens:                           Testis cancer and marriage: Urologist                    Tuesdays, 7 to 8 a.m.
In a decision analysis published in Cancer,             Christopher Coogan, MD, and colleagues                   Neurosurgery Conference Room
David sher, MD, Mph, a radiation oncologist,            evaluated more than 30,000 cases of                      1115 Professional Building
and a colleague compared the two evidence-              testis cancer reported to the Surveillance,
based therapies for the treatment of high-risk          Epidemiology and End Results database between
                                                                                                                 CLiNiCAL TRiALs
prostate cancer: external-beam radiotherapy             1973 and 2005 and found that married status
with hormone therapy and radical prosta-                is an independent predictor of improved overall          Rush is currently participating in a
tectomy with adjuvant radiotherapy. Based               and cancer-specific survival in men with testis          clinical trial in which one objective is
                                                        cancer. Retroperitoneal lymph node dissection            to determine whether the addition of
on their model, the authors concluded that
                                                        was found to be an additional predictor of               neoadjuvent and concurrent short-
external-beam radiotherapy with hormone
                                                        improved survival in men with stages I and II            term androgen deprivation to prostate
therapy was superior and noted that trimodal-
                                                                                                                 bed radiation therapy (PBRT) improves
ity therapy may have local and distant control          nonseminomatous germ cell tumors. These
                                                                                                                 freedom from progression for five
benefits leading to optimal outcomes in men             findings were published in Urological Oncology.
                                                                                                                 years over that of PBRT alone in men
with prostate cancer.
                                                                                                                 treated with salvage radiation therapy
                                                        Additional technology: Rush, which was the
                                                                                                                 after radical prostatectomy. For more
Appointments: Urologist Dennis pessis, MD,              first Chicago hospital to offer robotic surgery
                                                                                                                 information about open clinical trials,
assumed the role of president of the American           with 3-D in high definition and has now                  visit	www.rush.edu/cancerclinicaltrials.	
Urological Association in 2012. Urologist               performed more than 1,000 procedures using               To enroll a patient in a clinical trial, call
Christopher Coogan, MD, was elected in                  this approach, has recently acquired additional          (312) 942-3608.
August	as	secretary/treasurer	of	the	Chicago	           da Vinci Surgical System technology. The new
Urological Society for a one-year term.                 equipment has dual control capabilities, a key
                                                        feature in training physicians, and is being
                                                        used to perform prostatectomies as well as
                                                        cystectomies to treat bladder cancer.




 Urologist Dennis Pessis, MD — shown here with a patient — was named president
 of the American Urological Association in 2012.
                                                                                                             ¡   For more information about the genitouri-
                                                                                                                 nary cancers program or to refer a patient
                                                                                                                 for an initial visit or a second opinion,
                                                      2012 Rush University Cancer Center Annual Report   7
                                                                                                                 please call (312) CANCeR-1 (226-2371).
DISCOVERy



expLoriNG strateGies to comBat
Breast caNcer




As any oncologist can tell you: Cancer is not a monolithic disease. each
person’s cancer is individual to his or her genetic signature. instead of a
search for “a cure to cancer,” there are now myriad questions specific to
each cancer and each person: Which drug combination will work best with
the tumor’s signature? Which mutated genes create drug resistance?


                                                       profiling and bioinformatics, and even fewer         Abukhdeir can test this model against samples
                                                       for breast cancer specifically.”                     from patients given only Herceptin, without
                                                                                                            chemotherapy. As one of the investigators
                                                       Using a combination of around 16 lipids, Deng        leading the initial Herceptin trials, Melody
                                                       and his colleagues developed a lipid signature       Cobleigh, MD, a medical oncologist at Rush,
                                                       they believe could be used to predict breast         collected patient samples throughout the trials,
                                                       cancer. In an initial study looking at 53 cancer     including samples from patients treated with
                                                       patients and 20 benign patients, they were able      Herceptin alone. “Dr. Cobleigh has samples
                                                       to detect breast cancer with a sensitivity of 92     that no one else in the world has, or can ever
Researchers Abde Abukhdeir, PhD (left), and
Youping Deng, PhD, are both investigating              percent, and an accuracy of around 94 percent,       have,” says Abukhdeir. “This is gold. So once
the molecular mechanisms behind the devel-             using this lipid signature. Their next step is to    we identify the genes that are the most likely
opment of breast cancer.
                                                       seek additional validation with more samples         culprits for resistance, we can use Dr. Cobleigh’s
                                                       and to combine the signature with microRNA to        samples to look at how frequently this occurs in
                                                       improve accuracy.                                    actual patient samples.”
Breast cancer clinicians and basic researchers
at Rush University Medical Center tackle the           Deng and colleagues also apply this method-          Targeting pathways
disease from all these angles — from trying            ology to investigate signatures for lung and         As a pilot study, Abukhdeir is also taking all the
to develop a biomarker for early detection to          prostate cancers.                                    drugs commercially available that target PIK3CA,
identifying mutations that lead to acquired                                                                 the most frequently mutated oncogene in breast
drug resistance.                                       Finding the mutations and the mechanisms             cancer, and testing them on breast cancers that
                                                       behind them                                          harbor mutations on other genes within the
Catching the disease in its earliest stages            As groundbreaking as Herceptin was, only             same pathway. The goal: to see whether drugs
youping Deng, phD, a bioinformatics                    20 percent of patients are especially sensitive      that address specific mutations will also affect
researcher at Rush, has a vision: Along with           to Herceptin as a single agent. For basic            the entire pathway.
checking a woman’s cholesterol and glucose             researchers like Abde Abukhdeir, phD,
levels, a primary care physician could also deter-     this relatively low response rate is a call to       If drugs that work on specific gene mutations
mine her breast cancer risk — all through the          action. Working with a research model that           can be shown to work on a pathway, patients
evaluation of lipids in her routine blood work.        recapitulates in the lab genetic alterations that    with rare mutations that currently have no
                                                       occur in the patient, Abukhdeir’s goal is to first   targeted therapies available may one day have
“Lipids have already been used as a biomarker          identify the genetic alterations that may be the     more individualized options. “If you add up all
to indicate other kinds of disease — diabetes,         cause of this resistance. These alterations can      the gene mutations within a pathway, it adds up
heart disease — and we know lipids are very            serve as markers that predict which patients         to a significant number,” he says. “That’s what
important to cancer,” Deng says. “But while            should receive therapy. More important,              I’m most excited about: trying to identify the
many lipids have been studied as a class,              these genetic alterations can serve as novel         best patient population for targeted therapies,
few studies have investigated individual lipid         targets for new therapies that may be able to        and at the same time expanding the repertoire
species as biomarkers using metabolic lipid            overcome Herceptin resistance.                       of drugs available.”




8   2012 Rush University Cancer Center Annual Report
                         “ While many lipids have been studied as a class, few studies have
                           investigated individual lipid species as biomarkers using metabolic lipid
                           profiling and bioinformatics, and even fewer for breast cancer specifically.”

                                                                                                   — Youping Deng, PhD, researcher




The missing link in cyclin D1                         cancer in relatives of BRCA mutation carriers.
overexpression?                                       She suggests that patients who have a known
                                                                                                               A Woman With BRCA-Mutant Chimeric Cells
Clinicians know that the protein cyclin D1,           BRCA 1 or 2 mutation in their families but test
a critical component of cell proliferation,           negative for it by blood testing, and later develop
overexpresses in several cancers: pancreatic,         a tumor consistent with hereditary breast and
prostate, lung and breast cancers and leukemia.       ovarian cancer syndrome, may in fact have
In fact, more than 50 percent of breast cancer        the familial BRCA mutation present in their
cells have cyclin D1 overexpression.                  tumor. Usha hypothesizes these patients had
                                                      BRCA-positive chimeric cells in their body since
The missing link, however, is what causes this        birth because their mother or gestational twin
overexpression. Di Chen, MD, phD, a biochemist        transferred these cells to them during pregnancy.
at Rush, and his colleagues hypothesize that          “If we confirm this hypothesis, the implications
overexpression occurs because of a defect in          can be far-reaching,” says Usha. “There is
sumoylation, a posttranslational modification         no explanation for these BRCA phenocopies.
involved in various cellular processes, including     Patients are counseled that they do not have
apoptosis. In initial studies, Chen’s group has       an increased risk for cancer, and that is not
found repeatedly that sumoylation leads to            necessarily true.”
ubiquitination, a process in which the regulatory
protein ubiquitin is attached to proteins and         The implications could apply to treatment as
labels them for destruction, and then protein         well as prevention. Some new therapeutic
degradation — thereby allowing for normal             approaches currently being studied for cancer
regulation of cyclin D1.                              that specifically target BRCA mutations, such
                                                      as PARP inhibitors (see p. 4), are not offered to
Taking this hypothesis to the next level, Chen        patients who test negative for the mutations;
and his colleagues hope to find agents that will      however, if this hypothesis is correct and they
stimulate ubiquitination. One potential agent:        have hidden BRCA mutations in their tumor,
arsenic trioxide, a highly toxic anticancer agent     these patients might benefit from these new
                                                      anticancer treatments as well.                                                            Key
currently used to treat leukemia. Chen is work-
                                                                                                                     susceptible to cancer breast tissue    BRCA-mutant cells
ing with a colleague from another institution
who is developing material to enable safer,           And the potential of chimeric cells might not be               susceptible to cancer ovarian tissue   BRCA-normal cells

local delivery of arsenic trioxide for the treat-     limited to cancer: “There are no known diseases
ment of breast cancer.                                associated with chimerism, and if it comes across          Lydia Usha, MD, a medical oncologist who
                                                      as a potential mechanism for predisposition to             specializes in cancer genetics, is currently testing
                                                                                                                 this hypothesis: Patients with known BRCA 1 or
inheriting a hidden mutation                          disease, that would be very new and could have             2 mutations in their family but who test negative
                                                      potential for other diseases.”                             for it and later develop tumors consistent with
As a medical oncologist who specializes in                                                                       hereditary breast and ovarian cancer may have
inherited susceptibility to cancer, Lydia Usha, MD,                                                              BRCA-positive chimeric cells that were transferred
                                                      To learn about clinical research on breast cancer,
is testing a novel hypothesis about the origin of                                                                to them during gestation.
                                                      see p. 4.




                                                                                                            2012 Rush University Cancer Center Annual Report                    9
DISEASE-SITE PROGRAMS



GyNecoLoGic caNcers
As a member of the National Cancer institute’s Gynecology oncology                                                       CLiNiCAL speCiALisTs
Group, the multidisciplinary gynecologic oncology team at Rush — which                                                   Gynecologic oncologists:
includes gynecologic oncologists and radiation oncologists — participates                                                Summer Dewdney, MD; Alfred Guirguis,
                                                                                                                         DO;	Jacob	Rotmensch,	MD;	Edgardo	Yor-
in numerous clinical trials as well as basic research aimed at improving
                                                                                                                         dan, MD
detection and treatment for gynecologic cancers. specialists evaluate
                                                                                                                         Medical oncologist:
patients via multidisciplinary consultation and offer a full spectrum of care,                                           Lydia Usha, MD
from treatment for gynecologic malignancies and complex surgical problems                                                pathologists:
to providing genetic evaluations.                                                                                        Pincas Bitterman, MD; Ritu Ghai, MD
                                                                                                                         Radiation oncologist:
                                                                                                                         Krystyna Kiel, MD

HigHligHTS
                                                                                                                         GyNeCoLoGiC TUMoR CoNFeReNCe
Etiology of ovarian cancer: Jacob Rot-                                                                                   Fridays, 7 to 8 a.m.
mensch, MD, a gynecologic oncologist, and                                                                                Pathology Conference Room
pincas bitterman, MD, a pathologist, are                                                                                 562	Jelke	Building
investigating the etiology of ovarian cancer
in collaboration with numerous academic
institutions. Currently, they are working with                                                                           CLiNiCAL TRiALs
the Illinois Institue of Technology and Utah                                                                             Rush is currently participating in many
State University to evaluate the interaction of                                                                          clinical trials related to gynecologic
stroma and epithelium to determine the cause                                                                             malignancies, including a phase II
of ovarian cancer. In a cooperative effort with                                                                          evaluation of temsirolimus in combination
University of Missouri and Utah State Univer-                                                                            with carboplatin and paclitaxel followed
sity, Rotmensch is also studying viral phage                                                                             by temsirolimus consolidation as first-
technology in an effort to develop diagnostic                                                                            line therapy in the treatment of clear
tools and treatments for ovarian cancer.                                                                                 cell carcinoma of the ovary. For more
                                                                                                                         information about open clinical trials, visit
Examining molecular differences: Alfred                                                                                  www.rush.edu/cancerclinicaltrials.	To	enroll	a	
                                                        Gynecologic oncologists at Rush — including Alfred               patient in a clinical trial, call (312) 942-3608.
Guirguis, Do, a gynecologic oncologist, is              Guirguis, DO, who is shown here using the da Vinci sur-
looking at ovarian and endometrial tumor tis-           gical system — are actively involved in clinical and basic
                                                        research at Rush.
sue at the molecular level, using gene profiling
and expression microarrays, to identify biomark-
ers. Along with researchers Animesh barua,
phD; and sanjib basu, phD, pathologist                  and outcomes. She is currently leading a pilot
pincas bitterman, MD, and fetal and neonatal            program at Rush to evaluate quality outcomes
ultrasound specialist Jacques Abramowicz,               in gynecologic malignancies.
MD, Guirguis has evaluated the expression of
glucose-regulated protein 78 (GRP78) and its            genetic counseling: Medical oncologist
regulator microrna-181 during the develop-              Lydia Usha, MD, leads the Rush Inherited
ment and progression of ovarian cancer.                 Susceptibility to Cancer (RISC) clinic, where
                                                        she counsels people on their personal and
improving outcomes: Gynecologic oncolo-                 family risks for developing cancer, and pro-
gist summer Dewdney, MD — who has                       vides information on prevention and early
a special interest in health disparities with           detection. Studies have shown that women
respect to endometrial cancer and has recently          who test positive for BRCA 1 and BRCA 2
investigated familial relationships between             gene mutations have a high risk of developing
uterine serous cancer and endometrial, ovarian          breast or ovarian cancer by the time they turn
and pancreatic cancers — is helping establish           70. In the RISC clinic, patients are checked
a collaboration between national cancer                 with a blood test for mutations in these and
organizations to improve quality measures               other genes known to cause cancer.




                                                                                                                     ¡   For more information about the gynecologic
                                                                                                                         cancers program or to refer a patient for an
                                                                                                                         initial visit or a second opinion, please call
10   2012 Rush University Cancer Center Annual Report
                                                                                                                         (312) CANCeR-1 (226-2371).
DISEASE-SITE PROGRAMS



heaD aND NecK caNcers

The head and neck cancers program at Rush offers patients the highly                                              CLiNiCAL speCiALisTs
specialized expertise and therapies necessary to treat these rare tumors —                                        Medical oncologists:
including those found on the underside of the brain, or skull base, which                                         Mary	Jo	Fidler,	MD;	John	Showel,	MD
represent only about 3 percent of cancers in patients in the United states.                                       Neurosurgeons:
To detect and treat cancer as well as check for recurrence, doctors use the                                       Richard Byrne, MD; Roham Moftakhar,
                                                                                                                  MD; Lorenzo Muñoz, MD
most advanced technology available. in fact, Rush was the first hospital in
                                                                                                                  Neuroradiologist:
Chicago to use a peT scan, the most accurate way to diagnose head and
                                                                                                                  Miral	Jhaveri,	MD
neck cancer and monitor the effectiveness of therapy.
                                                                                                                  Neurotologist:
                                                                                                                  R. Mark Wiet, MD
                                                                                                                  otolaryngologists/head
HigHligHTS                                                                                                        and neck surgeons:
                                                                                                                  Joseph	Allegretti,	MD;	David	Caldarelli,	
Multidisciplinary approach: The Coleman              tumor — and TrueBeam STx, a radiosurgical                    MD;	Paul	J.	Jones,	MD;	Andrew	Lerrick,	
Foundation Comprehensive Head and Neck               technology that delivers larger doses of                     MD; Thomas Nielsen, MD
Tumor Clinic meets regularly with patients           radiation to well-defined tumors while sparing
                                                                                                                  Radiation oncologists:
to tailor care to each individual. The team          surrounding tissues.
                                                                                                                  Aidnag Diaz, MD, MPH; David Sher, MD, MPH
includes neurosurgeons, otolaryngologists,
medical oncologists and radiation oncologists.       Support group: In collaboration with Gilda’s
Patients also benefit from the expertise of          Club Chicago, a throat cancer networking                     heAD AND NeCK TUMoR CoNFeReNCe
dedicated specialists in radiology, plastic and      group meets at Rush monthly. The meetings,                   First and third Wednesdays, 7 to 8 a.m.
reconstructive surgery, and oral oncology.           which consist of discussions, question and                   Janet	Wolter,	MD,	Clinical	and	
                                                     answer periods, and education, are open to                   Educational Conference Room
Evaluating treatment for salivary gland              those who themselves have cancer or are                      1010 Professional Building
tumors: Radiation oncologist David sher,             supporting a loved one with cancer.
MD, Mph, and colleagues from other institu-                                                                       CLiNiCAL TRiALs
tions evaluated a single-institution experience      Otolaryngology department names acting
                                                                                                                  Researchers at Rush often investigate
of patients with salivary gland tumors who           chairperson: Rush University has appointed
                                                                                                                  new therapies for head and neck
had undergone adjuvant intensity-modulated           paul J. Jones, MD, as acting chairperson of
                                                                                                                  cancers. For more information about
radiotherapy (IMRT), with or without concur-         the	Department	of	Otolaryngology/Head	and	
                                                                                                                  open	clinical	trials,	visit	www.rush.edu/
rent chemotherapy. They found that postop-           Neck	Surgery.	Jones	is	currently	director	of	
                                                                                                                  cancerclinicaltrials. To enroll a patient in a
erative IMRT was well-tolerated in patients          pediatric otolaryngology at Rush.
                                                                                                                  clinical trial, call (312) 942-3608.
and that there was a high rate of local control.
In addition, they noted excellent local control
with chemoradiotherapy in a subgroup of
patients who had adverse prognostic factors,
such	as	stage	T3/T4	disease,	nodal	positivity	
and positive margins. Findings were reported
in the International Journal of Radiation On-
cology, Biology, Physics.

Radiation oncology expertise: Rush has
two radiation oncologists, Aidnag Diaz,
MD, Mph, and David sher, MD, Mph, who
specialize in treating head and neck cancers.
This expertise is especially important with
these cancers because of their proximity to the
brain and spine. At Rush, radiation oncologists
have access to multiple tools, including 3-D
conformal radiotherapy — which allows
                                                     Medical oncologist Mary Jo Fidler, MD, treats patients
radiation oncologists to use multiple beams
                                                     with head and neck cancers as well as patients with
of radiation to fit the size and shape of the        lung cancer.




                                                                                                              ¡   For more information about the head and
                                                                                                                  neck cancers program or to refer a patient
                                                                                                                  for an initial visit or a second opinion,
                                                   2012 Rush University Cancer Center Annual Report     11
                                                                                                                  please call (312) CANCeR-1 (226-2371).
DISEASE-SITE PROGRAMS



hematoLoGic caNcers

hematologists, hematologist/oncologists, bone marrow transplant                                                     CLiNiCAL speCiALisTs
                                                                                                                    Dermatologist:
specialists and other blood cancer experts at Rush all share a commitment
                                                                                                                    Warren Piette, MD
to exploring every available path toward the best possible outcomes.
                                                                                                                    Geneticist:
This commitment propels research on new treatments — such as targeted
                                                                                                                    Wei-Tong Hsu, MD
therapies, immunoconjugates (e.g., radioimmunotherapy and other novel
                                                                                                                    hematologist/oncologists:
compounds), chemoimmunotherapy and stem cell transplantation. it also
                                                                                                                    Sefer Gezer, MD; Stephanie Gregory, MD; Reem
inspired the launch of patient-centered clinics to promote the most effective                                       Karmali, MD; Melissa Larson, MD; Agne Paner,
delivery of these treatments.                                                                                       MD;	Jamile	Shammo,	MD;	Parameswaran	
                                                                                                                    Venugopal, MD

                                                                                                                    hematopathologists:
                                                                                                                    Jerome	Loew,	MD;	Brett	Mahon,	MD;	
                                                                                                                    Ira Miller, MD
HigHligHTS
                                                                                                                    Radiation oncologist:
                                                                                                                    Ross Abrams, MD
Board appointment: The Lymphoma Research
Foundation elected hematologist stephanie                                                                           Radiologists:
Gregory, MD, to its scientific advisory board.                                                                      Amjad Ali, MD; David Turner, MD
The 45-member board reviews grant proposals
                                                                                                                    stem cell transplantation specialists:
and makes recommendations regarding re-                                                                             Henry	Fung,	MD;	John	Maciejewski,	MD,	PhD;	
search priorities and funding to the foundation.                                                                    Sunita Nathan, MD; Elizabeth Shima Rich, MD, PhD

improving hematopoietic stem cell                                                                                   For a listing of pediatric hematologist/
transplantation efficiency: This past year,                                                                         oncologists, go to p. 18.
stephanie Gregory, MD, hematologist; henry
Fung, MD, stem cell transplantation special-                                                                        heMAToLoGiC CANCeR CoNFeReNCes
ist; and other researchers published a study in
                                                                                                                    Lymphoma
Experimental Hematology regarding a strategy
                                                                                                                    Thursdays, 8 to 9 a.m.
designed to improve hematopoietic stem
                                                                                                                    1010 Professional Building
cell transplantation efficiency. Their findings
suggest that there may be clinical therapeutic                                                                      Leukemia
                                                        Hematologist/oncologist Melissa Larson, MD, cares for
                                                                                                                    Mondays, 1 to 2 p.m.
benefit to using CD26 inhibitors to improve             patients in Rush’s new hospital, the Tower.
                                                                                                                    1010 Professional Building
engraftment of unfractionated mobilized pe-
ripheral blood cells as well as cord blood cells.                                                                   Myelodysplasia/Myeloproliferative Disorders
                                                        that the treatment was well-tolerated, improv-              Alternate Fridays, 9 to 10 a.m.
Transplantation conditioning study: Stem                ing complete response rates and maintaining                 1010 Professional Building
cell transplantation specialist elizabeth shima         durable responses. The study’s co-authors in-               Multiple Myeloma
Rich, MD, phD, participated	in	a	phase	I/II	            cluded	hematolgist/oncologists	parameswaran                 Alternate Fridays, 8 to 9 a.m.
study of transplantation conditioning with              venugopal, MD; Jamile shammo, MD; and                       1010 Professional Building
clofarabine-melphalan-alemtuzumab for                   stephanie Gregory, MD; as well as stem cell
                                                                                                                    All conferences are held in the Janet Wolter,
patients with advanced hematologic malignan-            transplantation specialist henry Fung, MD.                  MD, Clinical and Educational Conference Room.
cies. While the conditioning promoted promis-
ing responses and duration of responses, the            Center of Excellence: Rush has been desig-
investigators found that renal toxicity poses a         nated a Center of Excellence by the Myelodys-               CLiNiCAL TRiALs
considerable risk particularly in older patients.       plastic Syndrome (MDS) Foundation. To be rec-               Investigators at Rush are participating in a
The study was published in Biology of Blood             ognized, institutions must meet specific criteria,          randomized, phase III study of PCI-32765 in
Marrow Transplantation.                                 including having morphologic expertise in MDS,              combination with bendamustine and rituximab
                                                        ongoing research and available cyotogenet-                  to treat patients with relapsed or refractory
Unique approach to indolent lymphomas:                  ics	and/or	molecular	genetics.	Hematologist/                b-cell chronic lymphocytic leukemia and small
In a study published in Clinical Lymphoma, My-          oncologist Jamile shammo, MD, is director of                lymphocytic lymphoma. For more information
eloma and Leukemia,	hematologist/oncologist	            the MDS program at Rush.                                    about	open	clinical	trials,	visit	www.rush.edu/
Reem Karmali, MD, evaluated the safety and                                                                          cancerclinicaltrials. To enroll a patient in a clini-
efficacy of combination chemoimmunotherapy              New staff: The hematologic cancer team wel-                 cal trial, call (312) 942-3608.
followed by radioimmunotherapy consolidation            comed two new members over the past year:
and rituximab maintenance as front-line treat-          hematologist/oncologists	Reem Karmali, MD,
ment in indolent lymphomas. It was found                and Agne paner, MD.                                     ¡   For more information about the hemato-
                                                                                                                    logic cancers program or to refer a patient
                                                                                                                    for an initial visit or a second opinion,
12   2012 Rush University Cancer Center Annual Report
                                                                                                                    please call (312) CANCeR-1 (226-2371).
DISEASE-SITE PROGRAMS



LUNG aND thoracic caNcers

physicians in Rush’s lung and thoracic oncology program apply the                                                              CLiNiCAL speCiALisTs
most advanced technologies and techniques — including video-assisted                                                           Medical oncologists:
thoracoscopic surgery, intensity-modulated and stereotactic radiation                                                          Marta Batus, MD; Philip Bonomi, MD;
therapy and novel biologic therapies — to treat a full spectrum of thoracic                                                    Mary	Jo	Fidler,	MD

cancers. At The Coleman Foundation Comprehensive Lung Cancer Clinic, a                                                         pathologists:
                                                                                                                               Mark Pool, MD; Paola Gattuso, MD
multidisciplinary team meets with patients to address conditions such as lung
                                                                                                                               pulmonary and critical care
cancer, mesothelioma, chest sarcomas, thymomas and lung metastases.
                                                                                                                               medicine specialists:
                                                                                                                               Robert Balk, MD; Michael Silver, MD;
HigHligHTS                                                                                                                     Betty Tran, MD, MS; Mark yoder, MD
                                                                                                                               Radiation oncologist:
Evaluating BKM120: Medical oncologist Mary                    Detecting early stage lung cancer: Rush’s                        David Sher, MD, MPH
Jo Fidler, MD, who was recently appointed to                  lung cancer screening program continues to
                                                                                                                               Thoracic radiologist:
the Chicago Medical Society’s board of trustees,              be a study site for the International Early Lung                 Palmi Shah, MD
is the principal investigator at Rush of a two-               Cancer Action Program, which aims to recruit
                                                              subjects at increased risk of developing lung                    Thoracic surgeons:
stage phase II study assessing the efficacy of
                                                                                                                               Gary Chmielewski, MD; Michael Liptay,
the PI3K-inhibitor — BKM120 — in patients                     cancer into a study of lung cancer screening
                                                                                                                               MD; William Warren, MD
with pretreated metastatic non-small cell lung                using low-dose chest CT.
cancer that exhibits PI3K pathway activation.
                                                              lung nodule clinic: The lung nodule clinic at                    LUNG AND ThoRACiC TUMoR
Age-related regulation of p16: Patholo-                       Rush is led by pulmonary and critical care special-              CoNFeReNCe
gists paolo Gattuso, MD, and Mark pool,                       ist betty Tran, MD, Ms. The clinic provides pa-                  Thursdays, 10 to 11 a.m.
MD; thoracic surgeon Michael Liptay, MD;                      tients with lung nodules or concerns about lung                  Janet	Wolter,	MD,	Clinical	and	
medical oncologist philip bonomi, MD;                         cancer a complete evaluation and plan with input                 Educational Conference Room
and researchers sanjib basu, phD, and Lela                    from specialists in pulmonary medicine and critical              1010 Professional Building
buckingham, phD, evaluated the epigen-                        care, thoracic surgery and radiology. Cases are
etic influences and promoter methylation                      discussed at a weekly board meeting, comprising
                                                                                                                               CLiNiCAL TRiALs
of selected tumor suppressor genes in early                   Tran and thoracic radiologist palmi shah, MD.
stage non-small cell lung cancer in patients                                                                                   Rush is currently participating in a clinical
                                                              Front-line therapy: Rush was one of two sites                    trial to assess the impact of prophylactic
30 to 87 years of age. They found that p16
                                                              in Illinois to participate in a small cell lung cancer           treatment on the incidence of adverse
promoter hypermethylation was associated
                                                              phase III study comparing progression-free                       events (after chemotherapy) in patients
with a worse outcome in patients 60 years of
                                                                                                                               with advanced non-small cell lung cancer
age or younger at the time of diagnosis, but                  survival	in	patients	treated	with	carboplatin/eto-
                                                                                                                               when treated daily with dacomitinib as a
it was not associated with the same outcome                   poside	and	patients	given	carboplatin/etoposide	
                                                                                                                               single agent. For more information about
in the 60 and older age group. Findings were                  with palifosfamide, a novel and very well toler-
                                                                                                                               open	clinical	trials,	visit	www.rush.edu/
published in Diagnostic Molecular Pathology.                  ated agent. Medical oncologist Marta batus,
                                                                                                                               cancerclinicaltrials. To enroll a patient in a
                                                              MD, was the lead Rush investigator.
                                                                                                                               clinical trial, call (312) 942-3608.




Left to right: Radiation oncologist David Sher, MD, MPH; medical oncologist Philip Bonomi, MD; clinical nurse specialist
Irene Haapoja, RN, MS; and clinical nurse coordinator Mary Ellen Hand, BSN, RN, participate in The Coleman Founda-
tion Comprehensive Lung Cancer Clinic.                                                                                     ¡   For more information about the lung and
                                                                                                                               thoracic cancers program or to refer a
                                                                                                                               patient for an initial visit or a second opin-
                                                           2012 Rush University Cancer Center Annual Report          13
                                                                                                                               ion, please call (312) CANCeR-1 (226-2371).
 DISCOVERy



Give aND taKe: physician-scientist collaborations
open doors to discovery




Jeff borgia, phD, and Jun sun, phD, chose to go into cancer research for
the same reason: They wanted to help people. And they both realized
that doing so meant finding ways to translate their scientific discoveries
into tools that clinicians can use to improve outcomes for patients. “As
a scientist, you have to think beyond the confines of your lab,” says
sun. “you have to ask, how can i contribute and make a difference in
the real world?”


                                                          VDR function. “We showed in the animal model         A team approach to lung cancer research
                                                          that VDR has a protective role,” she says. “Our      Just	as	Sun	partnered	with	a	clinician,	when	
                                                          hypothesis is that the same is true in people:       researcher Jeff borgia, phD, set out to address
                                                          We believe lack of intestinal VDR or suboptimal      some of the clinical challenges associated with
                                                          VDR signaling promotes inflammation and colon        lung cancer, he sought input from the physi-
                                                          cancer in susceptible individuals. Our preliminary   cians at Rush who care for lung cancer patients.
                                                          data are very promising, but now we need to
                                                          translate these findings to the clinic.”             “It’s important for scientists to understand
Gastroenterologist Ali Keshavarsian, MD,                                                                       what clinicians need to combat this disease
shares his clinical perspective with researcher           Connecting the dots                                  because we don’t want to develop tests that
Jun Sun, PhD.
                                                          To make that happen, Sun reached out to              aren’t clinically relevant,” says Borgia, who is
                                                          gastroenterologist Ali Keshavarzian, MD,             director of the Rush Proteomics and Biomark-
                                                          who specializes in inflammatory diseases and         ers Core Facility. “And it’s just as vital for
                                                          has been involved in numerous translational          physicians to understand what we’re capable
Putting colon cancer under the microscope
                                                          studies of colon cancer.                             of producing in the lab so they don’t set
Jun sun, phD, a biochemist, hopes to contrib-                                                                  unrealistic expectations.”
ute to the understanding of how the vitamin               Keshavarzian helped to ensure that Sun’s
D receptor (VDR) is involved in the pathogen-             hypothesis was testable in a human clinical          That’s the spirit behind Rush’s Thoracic Oncol-
esis of colon cancer — a discovery that could             context, and they collaborated on the design         ogy Research Group, which brings together
ultimately lead to better prevention and treat-           of an ex-vivo study that will utilize Keshavar-      medical oncologists, thoracic surgeons, radia-
ment for the disease.                                     zian’s vast repository of tissue samples to test     tion oncologists, pathologists and research-
                                                          whether the phenomena Sun observed in her            ers from multiple labs. The multidisciplinary
Vitamin D exerts its role via VDR, a chemical             mouse model are also present in humans.              group convenes weekly for the sole purpose
sensor; without proper VDR function, vitamin D            Discovering the mechanisms that regulate             of advancing lung cancer research: “We put
can’t be metabolized, causing a deficiency. Sun           intestinal VDR may, Sun and Keshavarzian             everything on the table, ask questions and
has noted a consistent link between low vitamin           believe, enable the development of therapies         share knowledge,” Borgia says.
D/VDR	and	high	intestinal	inflammation;	and	low	          that can modulate VDR signaling, which
VDR	expression	and	diminished	vitamin	D/VDR	              would reduce inflammation and possibly               Using biomarkers to enhance diagnosis
signaling in the intestine have been observed in          prevent colon cancer.                                This give-and-take is facilitating several proj-
many patients with both inflammatory bowel
                                                                                                               ects with game-changing potential — includ-
disease and colon cancer.                                 “Right now our current understanding of VDR          ing the potential to improve early diagnosis
                                                          signaling is insufficient to identify therapeutic    and boost survival rates.
In preliminary research, Sun and her colleagues           targets for colon cancer,” Sun says. “Within a
discovered that mice lacking VDR had hyperpro-            few years, I’m confident we’ll know more, and        Most notably, Borgia’s lab is working on a
liferation, intestinal inflammation and a higher          that we’ll be able to help a lot of patients.”       simple and cost-effective blood test that will
incidence of colon cancer than mice with normal
                                                                                                               allow clinicians to readily screen for non-small



14     2012 Rush University Cancer Center Annual Report
                                              “ It’s important for scientists to understand what clinicians need to combat this
                                                disease because we don’t want to develop tests that aren’t clinically relevant,
                                                and it’s just as vital for physicians to understand what we’re capable of
                                                producing in the lab so they don’t set unrealistic expectations.”
                                                                                                                                 — Jeff Borgia, PhD, researcher




cell lung cancer. The blood test is capable of
differentiating early stage non-small cell lung
cancer from benign lung nodules by measuring
a panel of serum biomarkers. As Borgia’s team
discovered, these serum proteins induce the pro-
duction of circulating antibodies in response to
specific molecules shed by lung cancer tumors.

“The most immediate application of this blood
test would be as a companion for low-dose spi-
ral CT; it could also be used initially to indicate
who should undergo a CT scan,” Borgia says.
“We have found that the combination of CT-
based preoperative staging with our biomarker
panel was superior at identifying patients with                  Vitamin D Receptor in intestine
locally advanced disease than either method
alone.”

On the horizon
With further improvement and refinement, the
serum panel could ultimately be used in con-
junction with CT scans or on its own. The team
will begin validation studies later this year. In the
meantime, they are developing additional blood
tests that can assess the nature of lesions detect-
ed by CT scanning and can help predict whether
a patient will have a positive response to a par-
ticular treatment. “With lung cancer, you don’t
have time to keep trying different treatments,”
Borgia says. “Getting it right the first time gives
patients the best chance at survival.”

Fortunately, for scientists like Borgia and Sun,
finding the right solutions is all in a day’s — and
a life’s — work.                                                 Brown stain indicates the location of human vitamin D receptor in the intestine.




                                                                                                        2012 Rush University Cancer Center Annual Report      15
DISEASE-SITE PROGRAMS



meLaNoma aND cUtaNeoUs caNcers
The melanoma and cutaneous cancers program, which includes the multi-                                          CLiNiCAL speCiALisTs
disciplinary Coleman Foundation Comprehensive Melanoma and soft Tissue                                         Dermatologists:
Clinic, provides specialized care for patients with cutaneous malignancies,                                    Jeffrey	Altman,	MD;	Sheetal	Mehta,	MD;	
                                                                                                               Marianne O’Donoghue, MD; Warren
such as melanoma, skin cancer, cutaneous t-cell lymphoma (CTCL) and other
                                                                                                               Piette, MD; Arthur Rhodes, MD, MPH;
soft tissue carcinomas. The team provides a full spectrum of care, including                                   Michael Tharp, MD
advocating prevention strategies, evaluating patients for skin cancer risk,                                    Dermatopathologists:
detecting early signs of malignancy and providing treatment (such as Mohs                                      Lady Dy, MD; Vijaya Reddy, MD
micrographic surgery for basal and squamous cell cancers and extracorpo-                                       Diagnostic radiologist:
real photopheresis to treat CTCL), for all stages of disease. investigators are                                Joy	Sclamberg,	MD
actively involved in basic and clinical research studying innovative approaches,                               immunologists:
such as vaccines and targeted therapies, to improve outcomes.                                                  Amanda Marzo, PhD; Carl Ruby, PhD;
                                                                                                               Andrew Zloza, MD, PhD
                                                                                                               Medical oncologist:
HigHligHTS
                                                                                                               Marta Batus, MD

Phase i melanoma research: Led by surgical               Melanoma Surveillance Clinic: Led by                  Neurosurgeon:
oncologist howard Kaufman, MD, Rush is                   dermatologist Arthur Rhodes, MD, Mph,                 Lorenzo Muñoz, MD
currently participating in a phase I study to            the Melanoma Surveillance Clinic at Rush              plastic and reconstructive surgeon:
evaluate the safety and immune effects of a new          monitors high-risk patients for early and             Gordon Derman, MD
oncolytic vaccine called Cavatak in subjects with        curable melanoma. For patients deemed to be
                                                                                                               Radiation oncologists:
advanced melanoma.                                       very high-risk based on prior evaluation and          Ross Abrams, MD; Krystyna Kiel, MD
                                                         risk assessment, Rhodes conducts a specialized
                                                         procedure called “melanoma surveillance               stem cell transplantation specialists:
Future implications: Rush and Loyola
                                                                                                               Henry	Fung,	MD;	John	Maciejewski,	MD,	
University have collaborated to develop a                using comparison to baseline total cutaneous
                                                                                                               PhD; Sunita Nathan, MD; Elizabeth Shima
treatment vaccine that could prevent and reverse         photographs,” or MSCP. This approach
                                                                                                               Rich, MD, PhD
the depigmentation that occurs in autoimmune             allows physicians to compare in real time all
vitiligo. Rush researcher (and the study’s lead          visible moles and all anatomic sites to digital       surgical oncologists:
co-author) Andrew Zloza, MD, phD, hopes                  photographic baseline using a high-resolution         Steven Bines, MD; Howard Kaufman, MD;
the findings — which were published in Science           monitor. The physician and patient may then           Keith Monson, MD
Translational Medicine — can be applied to the           focus on new or changing lesions, avoiding
treatment of melanoma. The study’s findings              surgery for photographically stable and               MeLANoMA AND soFT TissUe
suggest that delivering a modified form of               benign-appearing nevi.                                TUMoR CoNFeReNCe
the HSP70 gene (HSP70i) and forcing cells to
                                                                                                               Wednesdays, 11 a.m. to noon
produce the resulting HSP70i protein could be a          Comparing approaches: Rush is participating
                                                                                                               Janet	Wolter,	MD,	Clinical	and	Educational	
potential treatment for vitiligo.                        in a phase III multicenter study to compare
                                                                                                               Conference Room
                                                         sentinel lymphadenectomy and complete
                                                                                                               1010 Professional Building
                                                         lymph node dissection with sentinel lympha-
                                                         denectomy alone in cutaneous melanoma
                                                         patients with molecular or histopathological          CLiNiCAL TRiALs
                                                         evidence of metastases in the sentinel node.          Rush is currently participating in numerous
                                                         The	study	is	sponsored	by	the	John	Wayne	             clinical trials for cutaneous malignancies,
                                                         Cancer Institute and the National Institutes          including a study to compare the drugs
                                                         of Health.                                            ipilimumab and high-dose interferon-2b in
                                                                                                               patients with high-risk resected melanoma.
                                                         Caring for cutaneous t-cell lymphoma: The             For more information about open clinical
                                                         multidisciplinary cutaneous t-cell lymphoma           trials,	visit	www.rush.edu/cancerclinicaltri-
                                                         (CTCL) clinic at Rush, which is headed by             als. To enroll a patient in a clinical trial, call
                                                         dermatologist Warren piette, MD, provides             (312) 942-3608.
                                                         inpatient and outpatient consultation,
                                                         assessment and treatment of patients with
                                                         CTCL, Sézary syndrome and graft-versus-
                                                         host disease. Treatments include topical and
                                                         systemic approaches as well as extracorporeal
Plastic and reconstructive surgeon Gordon Derman, MD
(left); radiation oncologist Ross Abrams, MD (center);   photopheresis, one of the most effective
and surgical oncologist Howard Kaufman, MD (right),      treatments for CTCL. Rush is one of the few
are members of the multidisciplinary team.               centers in the Midwest offering this treatment.
                                                                                                           ¡   For more information about the melanoma
                                                                                                               and cutaneous cancers program or to refer
                                                                                                               a patient for an initial visit or a second opin-
16    2012 Rush University Cancer Center Annual Report
                                                                                                               ion, please call (312) CANCeR-1 (226-2371).
DISEASE-SITE PROGRAMS



NeUroLoGicaL caNcers
The neurological cancers program at Rush benefits from the expertise                                                 CLiNiCAL speCiALisTs
of neurologists, neurosurgeons, neuroradiologists and many other                                                     Neuro-oncologists:
specialists. in addition to pooling their knowledge each week at The                                                 Robert Aiken, MD; Nina Paleologos, MD
Coleman Foundation comprehensive brain tumor and spine tumor clinics,                                                Neuropathologist:
these experts continually investigate new therapies and search out the                                               Sukriti Nag, MD, PhD
latest technology in an effort to match patients with the best possible                                              Neuroradiologists:
treatments for their complex, challenging conditions.                                                                Sharon	Byrd,	MD;	Miral	Jhaveri,	MD;	
                                                                                                                     Mehmet Kocak, MD
                                                                                                                     Neurosurgeons:
                                                                                                                     Richard Byrne, MD; Roham Moftakhar, MD;
HigHligHTS                                                                                                           Lorenzo	Muñoz,	MD;	John	O’Toole,	MD
                                                                                                                     Neurotologist:
igF-1 receptor study: Neuro-oncologist                                                                               R. Mark Wiet, MD
Robert Aiken, MD, at Rush is the principal
                                                                                                                     pediatric hematologist/oncologist:
investigator for a phase I treatment study for                                                                       Paul Kent, MD
people who have recurrent, malignant astro-
                                                                                                                     Radiation oncologist:
cytomas. Aiken is investigating the oral drug
picropodophyllin (AXL 1717) for its ability to                                                                       Aidnag Diaz, MD, MPH
inhibit the IGF-1 receptor; Aiken reports that so
far the treatment has been well-tolerated with                                                                       bRAiN TUMoR CoNFeReNCe
few side effects.                                                                                                    Tuesdays, 11:30 a.m. to 12:30 p.m.
                                                                                                                     Janet	Wolter,	MD,	Clinical	and	
New spine tumor clinic: Led by neurosurgeon                                                                          Educational Conference Room
John o’Toole, MD, and radiation oncolo-                                                                              1010 Professional Building
gist Aidnag Diaz, MD, Mph, The Coleman
Foundation Comprehensive Spine Tumor Clinic
                                                                                                                     spiNe TUMoR CoNFeReNCe
provides individualized, comprehensive care for
malignant and benign spinal tumors, including                                                                        Thursdays, 9 a.m. to noon
                                                        Neuro-oncologist Nina Paleologos, MD, is investigating
stereotactic radiosurgery and minimally invasive        new treatments for malignant brain tumors.                   Woman’s Board Cancer Treatment Center
surgical procedures.                                                                                                 500 S. Paulina St.


New neuro-oncologist: Neuro-oncologist                                                                               CLiNiCAL TRiALs
Nina paleologos, MD, recently joined                    National leadership: Neurosurgeon Richard
                                                        byrne, MD, holds numerous leadership                         Researchers at Rush are investigating
Rush. In addition to extensive experience,
                                                        positions: president-elect of the Illinois State             a variety of new therapies for patients
Paleologos brings to Rush membership in the
                                                        Neurosurgical Society, and treasurer of the                  with brain and spine tumors, including
Brain Tumor Trials Collaborative, a network of
                                                                                                                     a dendritic cell vaccine trial for patients
medical centers that participate in clinical trials     Neurosurgical Society of America, and he
                                                                                                                     with newly diagnosed glioblastomas.
investigating new treatments for malignant              serves on the Congress of Neurological
                                                                                                                     For more information about open
brain tumors. She is also chair of the neuro-           Surgeons Executive Committee.
                                                                                                                     clinical	trials,	visit	www.rush.edu/
oncology accreditation exam committee for the                                                                        cancerclinicaltrials. To enroll a patient in a
United Council of Neurologic Subspecialties.            Skull base expertise: Neurosurgeon Roham
                                                                                                                     clinical trial, call (312) 942-3608.
                                                        Moftakhar, MD, joined the skull base surgery
Metastatic disease access initiative: For               team at Rush, collaborating with neurotologist
cancers metastisized to the brain, neurosurgeon         R. Mark Wiet, MD, and radiation oncologist
Lorenzo Muñoz, MD, and radiation oncologist             Aidnag Diaz, MD, Mph. Fellowship trained
Aidnag Diaz, MD, Mph, created an access                 in skull base and complex brain tumors,
initiative that allows patients to be seen by both      Moftakhar has extensive experience with
specialists back-to-back within one business day        acoustic neuromas, meningiomas, brain
of a referral. Muñoz and Diaz can be reached            stem tumors, vascular legions and pituitary
through a dedicated phone line answered                 tumors, among other brain and skull base
directly by the physicians.                             abnormalities.




                                                                                                                 ¡   For more information about the neurolog-
                                                                                                                     ical cancers program or to refer a patient
                                                                                                                     for an initial visit or a second opinion,
                                                      2012 Rush University Cancer Center Annual Report      17
                                                                                                                     please call (312) CANCeR-1 (226-2371).
 DISEASE-SITE PROGRAMS



peDiatric caNcers
                                                                                                                         CLiNiCAL speCiALisTs
                                                                                                                         orthopedic oncologist:
                                                                                                                         Steven Gitelis, MD
                                                                                                                         pediatric hematologist/oncologists:
                                                                                                                         Lisa Boggio, MD, MS; Paul Kent, MD; Allen
                                                                                                                         Korenblit, MD; Mindy Simpson, MD; Leonard
                                                                                                                         Valentino, MD
                                                                                                                         pediatric neuroradiologists:
                                                                                                                         Sharon Byrd, MD; Mehmet Kocak, MD
                                                                                                                         pediatric neurosurgeon:
                                                                                                                         Lorenzo Muñoz, MD
                                                                                                                         Radiation oncologists:
                                                                                                                         Ross Abrams, MD; Aidnag Diaz, MD, MPH


                                                                                                                         CLiNiCAL TRiALs
                                                                                                                         At Rush, the National Cancer Institute (NCI)
                                                                                                                         and the Children’s Oncology Group have open
Pediatric hematologist/oncologist Paul Kent, MD (shown here with a patient and her mother), participates in the          protocols that enroll patients up to age 50 as
National Institutes of Health’s Pharmaceuticals for Children Act.                                                        part of a Rush and NCI initiative to enroll, study
                                                                                                                         and improve outcomes for adolescents and
                                                                                                                         young adults with cancer, a group recognized
                                                                                                                         as having inferior outcomes. For more
home to one of the largest pediatric sarcoma programs in the Midwest and an
                                                                                                                         information about open clinical trials, visit
active research program in children’s oncology, the pediatric oncology program                                           www.rush.edu/cancerclinicaltrials.	To	enroll	a	
at Rush is staffed by clinicians and clinical researchers dedicated to the care of                                       patient in a clinical trial, call (312) 942-3608.
all young people — from infancy through young adulthood — with pediatric
hematologic malignancies, including leukemias and lymphomas, solid tumors
and sarcomas, and many rare cancers.


HigHligHTS

Raising money for research: Pediatric                        Pet therapy: At Rush, clinicians recognize pets
hematologist/oncologist	paul Kent, MD, joined                as important members of the family. To further
individuals and other organizations that support             promote family-centered care and help alleviate
pediatric cancer research to advocate a change               the emotional burden of life-threatening and
to schedule G of the 2012 Illinois state tax                 long-term illnesses, Rush encourages families to
forms. Thanks to their efforts, the Childhood                bring pets to visit seriously ill children as well as
Cancer Research Fund was among the options                   other patients at Rush.
listed for voluntary charitable donations, giving
taxpayers the opportunity to donate $1 to this               Collaboration: Rush,	the	John	H.	Stroger,	Jr.	
pediatric cancer research fund by checking a box             Hospital of Cook County and the University
on their tax form.                                           of Illinois Medical Center are a part of the
                                                             largest pediatric oncology network in Chicago.
Bear visit: The Chicago Bears’ Charles Tillman               These institutions bring their clinical research
visited Rush Children’s Hospital this past year.             programs together to promote access to clini-
Tillman’s Cornerstone Foundation, sponsored                  cal trials and streamline patient recruitment.
by Fifth Third Bank, set out to brighten the lives           Since the network’s inception in 2008, the
of chronically and critically ill children and their         combined clinical trial enrollment for the three
families through “Charles’ Locker.” Tillman                  institutions has climbed from fewer than 20
distributed Build-a-Bears and signed footballs to            patients to nearly 100.
entertain patients while they are undergoing or
recovering from treatment.

                                                                                                                     ¡   For more information about the pediatric
                                                                                                                         cancers program or to refer a patient for
                                                                                                                         an initial visit or a second opinion, please
18    2012 Rush University Cancer Center Annual Report
                                                                                                                         call (312) CANCeR-1 (226-2371).
DISEASE-SITE PROGRAMS



sarcomas aND soFt tissUe tUmors

Rush has one of illinois’ largest volumes for bone and soft tissue sarcomas,                                              CLiNiCAL speCiALisTs
offering comprehensive evaluation and treatment for adult and pediatric                                                   Diagnostic radiologists:
patients. The multidisciplinary team, which features orthopedic surgeons,                                                 John	Meyer,	DO;	Anthony	Zelazny,	MD
medical oncologists, pediatric and adult hematologist/oncologists, radiation                                              Medical oncologist:
oncologists, radiologists and pathologists, collaborates to create the optimal                                            Marta Batus, MD

treatment protocol for each patient. The team’s expertise includes manag-                                                 orthopedic oncologist:
                                                                                                                          Steven Gitelis, MD
ing metastatic bone disease to maintain function, minimize bone loss and
decrease pain. A key component of the program is the Limb preservation                                                    pathologists:
                                                                                                                          Jerome	Loew,	MD;	Brett	Mahon,	MD;	Ira	
Center at Rush, the only center of its kind in the region. physicians at the                                              Miller, MD; Vijaya Reddy, MD
center are leaders in the use of allografts for limb reconstruction as well as
                                                                                                                          pediatric hematologist/oncologists:
the development of state-of-the-art bone substitutes.                                                                     Paul Kent, MD; Allen Korenblit, MD
                                                                                                                          pediatric physiatrist:
                                                                                                                          Laura Deon, MD
HigHligHTS                                                                                                                Radiation oncologists:
                                                                                                                          Ross Abrams, MD; Krystyna Kiel, MD
Studying drug combinations: As part of a                      lower dose of radiation directly to the tumor               surgical oncologists:
multicenter, phase III study, Marta batus, MD,                may kill more tumor cells and cause less dam-               Steven Bines, MD; Howard Kaufman, MD
a medical oncologist, is comparing the effec-                 age to normal tissue.
tiveness and safety of eribulin with dacarba-
                                                              SARC trial: Medical oncologist Marta batus,                 sARCoMA CoNFeReNCe
zine in patients with soft tissue sarcoma.
                                                              MD, is an investigator in a phase III, interna-             Wednesdays, 9 to 10 a.m.
image-guided radiotherapy: Radiation on-                      tional, randomized clinical trial comparing the             Janet	Wolter,	MD,	Clinical	and	
cologist Ross Abrams, MD, is an investigator                  efficacy and safety of TH-302 in combination                Educational Conference Room
in a phase II trial of image-guided preopera-                 with doxorubicin to doxorubicin in patients                 1010 Professional Building
tive radiotherapy for the treatment of primary                with advanced soft tissue sarcoma. Batus is
soft tissue sarcomas of the extremities. Spe-                 working on the trial with the Sarcoma Alliance              CLiNiCAL TRiALs
cialized radiation therapy that delivers a                    for Research Through Collaboration.
                                                                                                                          Rush is participating in a phase III random-
                                                                                                                          ized controlled study of yondelis (trabect-
                                                                                                                          edin) or dacarbazine for the treatment of
                                                                                                                          advanced liposarcoma or leiomyosarcoma
                                                                                                                          previously treated with anthracycline and
                                                                                                                          ifosfamide. For more information about
                                                                                                                          open	clinical	trials,	visit	www.rush.edu/
                                                                                                                          cancerclinicaltrials. To enroll a patient in a
                                                                                                                          clinical trial, call (312) 942-3608.




Medical oncologist Marta Batus, MD, is investigating treatment options for patients with soft tissue sarcomas.

                                                                                                                      ¡   For more information about the sarcoma
                                                                                                                          and soft tissue tumors program or to refer a
                                                                                                                          patient for an initial visit or a second opin-
                                                           2012 Rush University Cancer Center Annual Report      19
                                                                                                                          ion, please call (312) CANCeR-1 (226-2371).
DISCOVERy



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p. Expression of death receptor 6         ences the outcome in young lung           Meekin	DS,	Darcy	K,	Ali	S,	Judson	       Mulshine JL; IASLC CT Screen-
by ovarian tumors in laying hens,         cancer patients. Diagn Mol Pathol.        PL, Mannel RS, Lele SB, O’Malley         ing Workshop 2011 Participants.
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2012;5(4):260-268.                                                                  lynch-associated malignancies.           Tomography Screening Workshop


20   2012 Rush University Cancer Center Annual Report
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                                                                                                          2012 Rush University Cancer Center Annual Report   21
DISCOVERy



represeNtative pUBLicatioNs

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leading to vitiligo. Pigment Cell         banov R. Cross-immunoreactivity         Norris CM, Haddad RI, Posner MR,       pathway in thyroid neoplasms
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of very elderly (≥80 years) non-          Chmielewski G, Liptay MJ, borgia        2012;23(9):2391-2398.                  ERK1/2	axis	that	coordinates	with	
Hodgkin lymphoma: impact of               JA. Development of a serum bio-         Shersher	DD,	Hong	E,	Breard	J,	        the PKC pathway in human articu-
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tatectomy for high-risk prostate          Ribeiro de Oliveira M, bonomi pD,       D. Phytoestrogen genistein up-         livering total body irradiation (TBI)
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22   2012 Rush University Cancer Center Annual Report
2011 caNcer reGistry report
Primary Site                                              Total   Analytic   Nonanalytic   Male        Female
oral Cavity & pharynx                                      136      121          15          97           39
Lip                                                         2         2           0           1            1
Tongue                                                     53        47           6          37           16
Salivary Glands                                             8         8           0           4            4
Floor of Mouth                                              4         4           0           2            2
Gum & Other Mouth                                          26        24           2          15           11
Nasopharynx                                                 3         1           2           3            0
Tonsil                                                     20        15           5          17            3
Oropharynx                                                 17        17           0          15            2
Hypopharynx                                                 3         3           0           3            0
Digestive system                                           505      409          96         253          252
Esophagus                                                  28        21           7          15           13
Stomach                                                    53        40          13          31           22
Small Intestine                                            17        12           5           6           11
Colon (excludes rectum)                                    140      112          28          59           81
Rectosigmoid	Junction																													         14        12           2           9            5
Rectum                                                     88        73          15          48           40
Anus, Anal Canal & Anorectum                               11        10           1           6            5
Liver & Intrahepatic Bile Duct                             55        45          10          40           15
Gallbladder & Other Biliary Tract                          22        18           4          10           12
Pancreas                                                   65        54          11          25           40
Retroperitoneum                                             5         5           0           4            1
Peritoneum, Omentum, Mesentery & Other Digestive Organs     7         7           0           0            7
Respiratory system                                         461      398          63         225          236
Nose, Nasal Cavity & Middle Ear                             7         7           0           5            2
Larynx                                                     40        30          10          30           10
Lung & Bronchus                                            412      359          53         189          223
Trachea, Mediastinum & Other Respiratory Organs             2         2           0           1            1
bones & Joints                                             18        16           2           8           10
soft Tissue                                                48        43           5          20           28
skin (excludes basal & squamous cell carcinomas)           119       91          28          69           50
breast                                                     466      402          64           7          459
Female Genital system                                      345      294          51           0          345
Cervix Uteri (excludes carcinoma in situ)                  67        49          18           0           67
Corpus & Uterus, NOS                                       185      168          17           0          185
Ovary                                                      57        47          10           0           57
Vagina                                                      4         2           2           0            4
Vulva                                                      24        21           3           0           24
Other Female Genital Organs                                 8         7           1           0            8
Male Genital system                                        145      112          33         145            0
Prostate                                                   137      105          32         137            0
Testis                                                      6         5           1           6            0
Penis                                                       2         2           0           2            0
Urinary system                                             122      109          13          94           28
Urinary Bladder                                            43        39           4          33           10
Kidney & Renal Pelvis                                      74        65           9          57           17
Ureter & Other Urinary Organs                               5         5           0           4            1
eye & orbit                                                 7         7           0           5            2
brain & other Nervous system                               203      186          17          85          118
endocrine system                                           102       93           9          42           60
Thyroid                                                    70        65           5          23           47
Other Endocrine (includes thymus)                          32        28           4          19           13
Lymphomas                                                  211      134          77         117           94
Hodgkin Lymphoma                                           23        15           8          11           12
Non-Hodgkin Lymphoma                                       188      119          69         106           82
Multiple Myeloma                                           61        45          16          33           28
Leukemias                                                  153      109          44          77           76         Analytic:	Cases	diagnosed	and/or	
Mesothelioma                                                9         8           1           8            1         received all or part of first course of
Unknown primary                                            16        12           4           8            8         care at Rush University Medical Center.
ill-Defined & Unspecified                                  10        10           0           8            2         Nonanalytic: Cases diagnosed and
other and Unspecified (Kaposi sarcoma)                      1         0           1           1            0         all first course treatment complete
Total                                                     3,138    2,599        539        1,302        1,836        elsewhere.


                                                                                                   2012 Rush University Cancer Center Annual Report        23
     DISCOVERy



2011 caNcer reGistry report                                                                                                                                                 Top 5 RUsh ANALyTiC siTes, 2011



                                                                                                                                                                         Colon
NeW CANCeR iNCiDeNCe by FiRsT CoNTACT yeAR, 2007 - 2011
                                                                                                                                                                                                     30
                                                                                                                                                                                                                                 stage 0               19




                                                                                                                                                                         Number of Analytic Cases
                             3000                                                                                                                                                                    25
                                                                                                                                                                                                                                 stage 1               26
                                                                                                                                                                                                     20                          stage 2               20
                             2500                                          2679         2670
                                                              2570                                 2599
                                                                                                                                                                                                     15                          stage 3               19
Number of Analytic Cases




                                          2296                                                                                                                                                                                   stage 4               30
                             2000
                                                                                                                                                                                                     10
                                                                                                                                                                                                                                 Unknown               0
                             1500                                                                                                                                                                     5                          Not Applicable        0

                                                                                                                                                                                                      0
                             1000                                                                                                                                                                         stages


                              500
                                                                                                                                                                         Lung

                                0                                                                                                                                                                   150
                                          2007                2008         2009         2010       2011                                                                                                                          stage 0               0




                                                                                                                                                                         Number of Analytic Cases
                                                                           year                                                                                                                     120                          stage 1               122

                                                                                                                                                                                                                                 stage 2               37
                                                                                                                                                                                                     90
 ANALyTiC CAse DisTRibUTioN by GeNDeR AND AGe AT DiAGNosis, 2011
                                                                                                                                                                                                                                 stage 3               75
                                                                                                                                                                                                     60                          stage 4               127
                             450
                                                                                                                                                                                                                                 Unknown               0
                                                                                                                                                                                                     30
                             400
                                                                                                     2683                                                                                                                        Not Applicable        1
                                                                                         409
                                                                                                                   Female                                                                            0
                             350                                              373                                  Male                                                                                   stages
  Number of Analytic Cases




                             300                                                            323
                                                                                                                                                                         breast
                                                                                                   288                                                                                              150
                             250                                                                                                                                                                                                 stage 0               82




                                                                                                                                                                         Number of Analytic Cases
                                                                                  246                                                                                                               120
                                                                                                     230                                                                                                                         stage 1               148
                             200
                                                                                                                                                                                                                                 stage 2               121
                                                                 190                                                                                                                                 90
                                                                                                                                                                                                                                 stage 3               32
                             150
                                                                                                                                                                                                     60                          stage 4               20
                                                                                                            130
                             100                                                                                                                                                                                                 Unknown               0
                                                    98                91                                                                                                                             30
                                                                                                                                                                                                                                 Not Applicable        0
                                                                                                                  76
                              50                                                                                                                                                                      0
                                     46 37               42
                                                                                                                                                                                                          stages
                                                                                                                         16     4
                               0
                                       0-29      30-39           40-49        50-59      60-69     70-79    80-89         90+
                                                                             Age in years
                                                                                                                                                                         Corpus Uteri
                                                                                                                                                                                                    120
 Top 10 NATioNAL ANALyTiC siTes, 2011                                                                                                                                                                                            stage 0               2
                                                                                                                                                                         Number of Analytic Cases




                                                                                                                                                                                                    100
                                                                                                                                                                                                                                 stage 1               106
                                     breast                                                                       14.85%
                                                                                                                                                                                                     80                          stage 2               8
                                                                                                                 14.57%
                                                                                                           13.13%                                                                                    60                          stage 3               23
                                       Lung
                                                                                                            13.85%                                                                                                               stage 4               24
                                                                                                                                                                                                     40
                                                                              6.72%                                                                                                                                              Unknown               0
                               Lymphomas
                                                                     4.71%                                                                                                                           20                          Not Applicable        1
                                  brain &                                     6.47%
                                other CNs 1.40%                                                                                                                                                       0
                                                                                                                                         UsA                                                              stages
site




                                                                           5.90%                                                         Rush
                             Corpus Uterus
                                                         2.91%
                                                                                                                                      Note: The graph compares USA
                                                                     4.88%                                                            data with that from Rush for the
                                Leukemias                                                                                             top 10 national analytic sites.    prostate
                                                     2.79%
                                                                 4.46%                                                                                                                               60
                                      Colon                                                                                                                                                                                      stage 0               0
                                                                             6.35%
                                                                                                                                                                         Number of Analytic Cases




                                                                                                                                                                                                     50
                                                                 4.37%                                                                                                                                                           stage 1               28
                                    prostate
                                                                                                                       15.09%                                                                        40                          stage 2               57
                                                     2.80%                                                                                                                                                                       stage 3               10
                                    Rectum                                                                                                                                                           30
                                                     2.50%
                                                                                                                                                                                                                                 stage 4               10
                                 Kidney &           2.36%                                                                                                                                            20
                               Renal pelvis                                                                                                                                                                                      Unknown               0
                                                               3.82%
                                                                                                                                                                                                     10                          Not Applicable        0
                                               0%         2%           4%          6%       8%     10%     12%         14%      16%
                                                                                      percentage                                                                                                      0
                                                                                                                                                                                                          stages
24                             2012 Rush University Cancer Center Annual Report
                                                                                                                                                                         Note: Data based on stage as defined by the American Joint Committee on Cancer (AJCC).
     obseRveD sURvivAL FoR bReAsT CANCeR CAses DiAGNoseD, 2003 - 2005




   Stage 1                                                  rush n=324         nat’l n=156118                                               Stage 2                                                        rush n=253       nat’l n=113508

                           100                                                                                                                                         100
                                 100 100     98.8 99.1       98.5 97.7                                                                                                       100   100
                                                                            96.5 96.0                                                                                                       98.0 98.0       96.0 94.9
                                                                                           95.6 94.2       94.2 92.1                                                                                                     94.0 91.5        91.5
Cumulative survival Rate




                                                                                                                                            Cumulative survival Rate
                                                                                                                                                                                                                                                    88.3   88.7 85.3
                            75                                                                                                                                          75



                            50                                                                                                                                          50



                            25                                                                                                                                          25



                             0                                                                                                                                           0
                                   Dx          1 year           2 years      3 years        4 years         5 years                                                            Dx               1 year       2 years      3 years         4 years           5 years




                                                            rush n=77          nat’l n=43066                                                                                                               rush n=47        nat’l n=15362
        Stage 3                                                                                                                                  Stage 4
                           100                                                                                                                                         100
                                 100 100                                                                                                                                     100   100
                                                     94.2
                                             90.9
Cumulative survival Rate




                                                                                                                                            Cumulative survival Rate




                                                             84.4 85.4
                            75                                                                                                                                         75
                                                                                    77.7                                                                                                    76.6
                                                                             71.4                  71.3
                                                                                                                  66.1
                                                                                            62.2                                                                                                    64.5
                            50                                                                             57.8                                                        50                                  57.4

                                                                                                                                                                                                                  47.3
                                                                                                                                                                                                                         40.4
                                                                                                                                                                                                                                35.3
                            25                                                                                                                                         25                                                               31.8               31.8
                                                                                                                                                                                                                                                 26.8
                                                                                                                                                                                                                                                                  20.9

                             0                                                                                                                                          0
                                   Dx          1 year           2 years      3 years        4 years         5 years                                                            Dx               1 year       2 years      3 years         4 years           5 years




     CANCeR MoRTALiTy (iNpATieNT) AT RUsh, Fy12*

                                                                                                                                                                                         risk-adjusted mortality index              compared with top cancer
                                                                                        actual mortality rate               predicated mortality rate                                    as published by Uhc                        hospitals (U.S. News)**
                                            surgical oncology                           2.09                                2.67                                                         0.78                                       8th out of 19
                                            Medical oncology                            2.13                                3.03                                                         0.70                                       3rd out of 19
                                            bone marrow transplant                      0.91                                3.06                                                         0.30                                       2nd out of 19




                                           * actual mortality = number of deaths per 100 discharges; predicted mortality = deaths expected based on how sick the patients are,
                                             per 100 discharges; mortality index = actual rate/predicted rate (index <1 means fewer patients died than predicted).


                                        ** comparison is with hospitals ranked in the top 20 by U.s. news & World report, which ranks hospitals based on a number of
                                           different measures including in-hospital mortality (rush is not ranked in this list; of the top 20, one hospital does not
                                           submit data to the University healthsystem consortium [Uhc]).


                                            source: University healthsystem consortium clinical database, Fy 2012 data.




                                                                                                                                                                                                   2012 Rush University Cancer Center Annual Report                      25
The Rush University Cancer Center comprises
all of the cancer-related clinical, research
and educational efforts at Rush, crossing 20
departments, divisions and sections; inpatient
and outpatient areas; professional clinical
activities; and the colleges of Rush University.




Rush is a not-for-profit health care, education and research enterprise
comprising Rush University Medical Center, Rush University, Rush Oak
Park Hospital and Rush Health.

PLEASE NOTE: All physicians featured in this publication are on the medical faculty of Rush University Medical
Center. Some of the physicians featured are in private practice and, as independent practitioners, are not
agents or employees of Rush University Medical Center.



Photography by the Rush Photo Group and Scott Strazzante.                                                        M-3064		7/13

								
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