Within Walking Distance New Pancreatic Cancer

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					                                                        Pathways
                                                                                                                                       SUMMER 2008




                                        University of California, San Diego | Rebecca and John Moores UCSD Cancer Center


                                                Within Walking Distance: New Pancreatic Cancer
                                                Treatments at the Moores UCSD Cancer Center
                                                “As the fourth leading cause of death in the U.S., pancreatic cancer is overlooked, underfunded,
                                                and misunderstood,” says Andrew Lowy, M.D., Chief of Surgical Oncology at the Moores UCSD
                                                Cancer Center. “This year, there will be 37,000 new patients diagnosed with pancreatic cancer,
                                                but of these, nearly 36,000 will die of their disease.”

In This Issue                                   While a diagnosis of pancreatic cancer can        Cancer Task Force, which is charged with
                                                be devastating, patients and families can         setting the direction of clinical research in
Message from the Director                       find hope at the Moores UCSD Cancer               pancreatic cancer in the U.S.
Dennis A. Carson, M.D.                          Center, where each day researchers are            David Cheresh, Ph.D., Associate Director
page 2                                          making daily progress in discovering and          for Translational Research at the Cancer
                                                developing cutting-edge treatments and a          Center, is searching for the “Achilles’ heel”
Biorepository: Collecting
Cancer Samples
                                                possible cure for pancreatic cancer.              of cancer with a cross-disciplinary team of
page 3                                          Unlike other cancer centers, the Moores           scientists including biologists, chemists,
                                                Cancer Center’s researchers are utilizing         and engineers. Their recent findings
News Briefs
                                                basic science to understand cancer at a           include a new aggressive nanoparticle/drug
page4
                                                biological and molecular level. Combined          combination that halts pancreatic and kidney
Donors Make the Difference                      with advanced options for surgery, radiation      cancers in mice. This new treatment
Rena Kerwin Memorial Scholarship                therapy, chemotherapy, targeted drug              strategy uses molecular “smart bombs” to
page 5                                          therapy, and clinical trials, patients are at     target metastasis with anticancer drugs.
                                                the nexus of emerging therapies, many of          “We achieved the desired anti-cancer effect
News of Note                                    which are only available at the Cancer Center.    while delivering the drug at 15 times below
Sadler Heads State ACS
Radiation Oncology Expanded
                                                “With a diverse research staff, we are            previous levels,” says Cheresh, who is also
page 5
                                                systematically cornering cancer from both         Professor and Vice-Chair of Pathology.
                                                the research bench and the patient’s              “We’re seeing a novel approach that has
Upcoming Events                                 bedside,” says Lowy, Co-Chair of the              an impact on metastatic growth without
page6                                           National Cancer Institute’s (NCI) Pancreatic      c o n t i n u e d o n pa g e   2



Pathways is a publication of the
                                                                           Leading-Edge Research Projects
Moores UCSD Cancer Center.
Executive Editor: Pam Werner                                               Presented at National Conference
Contributors: Jade Berggren, Jackie Carr,                                  Meaningful advances in cancer detection, prevention, and
Rachel de la Vega, Sarah Locher, Regan
                                                                           treatment are possible only through cutting-edge research.
Olsson, Gretchen Pelletier, Nancy Stringer,
Tammy Traudt
                                                                           Highlighted are a few Moores UCSD Cancer Center research
                                                                           projects that were recently presented at the American
Please contact us if you wish to have
                                                                           Association for Cancer Research conference:
your name removed from our mailing list.
Comments are also welcome.                                                 Chronic Lymphocytic Leukemia (CLL)
3855 Health Sciences Drive # 0658                                          Moores Cancer Center researchers have found an important
La Jolla, CA 92093-0658                                                    difference between two forms of CLL—aggressive and
(858) 822-0175                                                             mild. Leukemic cells from patients with the aggressive form
                                                                                                                                     c o n t i n u e d o n pa g e   3
Message from the Director                                              Pa n c r e a t i c C a n c e r Tr e a t m e n t s
                                                                       continued from front cover




                          T   his year we are celebrating the          negative side effects, such as weight loss and toxicity.”
                              Moores UCSD Cancer Center’s              A few doors down, Tony Reid, M.D., Ph.D.,
                          30th anniversary as a federally              Director of Clinical Research at the Cancer Center,
                          designated cancer center. Such an            is advancing new therapeutic approaches for patients
                          honor, bestowed by the National              and pioneering the use of gene therapy, viral vectors,
                          Cancer Institute, is not easily earned       and targeted therapies in clinical trials.
                          or maintained. Of the approximately
                                                                       “A patient entering our Cancer Center may embark
                          2,500 entities in the U.S. providing
                                                                       on one of many treatment paths depending on whether
                          cancer care, only 41 are NCI-designated
                                                                       or not their cancer is operable,” says Reid, a medical
                          Comprehensive Cancer Centers.
                                                                       oncologist. “Even when all signs of a tumor are
This year also marks the third anniversary of the opening of our       surgically removed, a few cancer cells may remain.
beautiful facility in La Jolla. Since this time, we have experienced   It’s our mission to seek and destroy those cells.”
tremendous growth, including a 20 percent increase in the
                                                                       By analyzing the DNA of a tumor, Reid’s team can
number of patients who receive care from us. And in just the last
                                                                       tailor a customized vaccine to pursue the rogue cells.
year, we have recruited eight new physicians.
                                                                       This clinical trial vaccine, administered by injection,
This year also marks our expansion of services to North County         enhances the immune system to detect and attack
to provide better access of care to our patients. Some of the          a mutant protein called K-ras that is secreted by
Moores Cancer Center radiation oncologists and surgeons now            pancreatic cancer cells.
see patients in clinical offices leased from the San Diego Cancer
                                                                       Since surgery is only appropriate for 20 percent of
Center in Encinitas, and this fall a radiation oncology center
                                                                       pancreatic cancer cases, it may be necessary to treat
will be added with some of the same advanced technology we
                                                                       the tumor itself by shrinking the growth away from
provide here in La Jolla.
                                                                       the blood supply. This second clinical trial approach
Since we moved into our new facility, there has been exciting          is accomplished by injecting the tumor with a cancer
progress in our research and development activities. We have           killer called “tumor necrosis factor,” or TNF, a gene
established collaborative research programs with local biotech         produced naturally by the human body.
and pharmaceutical companies that exceed $5 million. An
                                                                       Using a tiny ultrasound imaging device on the
internal collaboration with UCSD’s Scripps Institution of
                                                                       end of a probe, a scope is guided down the throat
Oceanography has led to the discovery of an ultra-potent
                                                                                                          and into the
new anti-cancer drug that is rapidly moving toward clinical
                                                                                                          stomach where
trials. Results from clinical trials of a gene immune therapy
                                                                                                          the pancreas
for leukemia developed at the Moores Cancer Center were
                                                                                                          can be viewed.
so successful that this therapy will be extended for testing in
                                                                                                          Then a high
patients with solid tumors. And a clinical trial involving cancer
                                                                                                          concentration of
stem cells has shown positive results against myeloproliferative
                                                                                                          TNF is injected
diseases, which can evolve into leukemia.
                                                                                                          directly into the
These are just a few examples of the growth and progress that is                                          tumor. Done
taking place every day at the Moores UCSD Cancer Center—                                                  in combination
where our only focus is defeating cancer.                              with chemotherapy and radiation, this therapy holds
                                                                       promise for becoming a new standard of care.
Sincerely,                                                             “When a cancer has spread, the gold standard of
                                                                       chemotherapy is administered in combination with an
                                                                       angiogenesis inhibitor which helps stop the cancer
                                                                       from using new blood vessels,” says Reid. “This
                                                                       clinical trial offers a combination of drug therapy
                                                                       that can help stop or slow the cancer’s progression.”
Dennis A. Carson, M.D.
Director, Moores UCSD Cancer Center                                    For more information about new pancreatic cancer treatments at
Chugai Pharmaceutical Chair in Cancer                                  the Moores UCSD Cancer Center, visit http://cancer.ucsd.edu/.
Associate Dean, UCSD Health Sciences




                                                                 2
Leading-Edge Research
continued from front cover
                                                     Biorepository Now Collecting Samples
                                                     to Test Early Cancer Detection

                                                     A    new biorepository, or speciman
                                                          bank, research study at the Moores
                                                     UCSD Cancer Center could lead to
                                                                                                                           way inside an
                                                                                                                           ultra low, minus
                                                                                                                           80 degree Celsius
                                                     early detection of some cancers and                                   freezer to maximize
                                                     ultimately identify new medical cures and                             its potential for
                                                     treatments. Richard B. Schwab, M.D.,                                  future use.
                                                     Assistant Clinical Professor of Medicine                               Currently, the
                                                     at the Moores Cancer Center, is leading                                largest use of the
have higher levels of activated survival             the longitudinal study to collect samples                              biorepository is
molecules than patients with mild disease.           and analyze corresponding data from            Richard B. Schwab, M.D.
                                                                                                                            analyzing blood
This suggests that aggressive cells may              participating cancer patients.                 samples from cancer patients in the hopes
respond more strongly to survival signals
                                                     “The fundamental significance of this          of developing a screening test for early
from surrounding cells and that interfering
                                                     biorepository is that these results can        diagnosis and possibly individualized
with these signals could make the cells
                                                     be used to develop diagnostic tests for        treatment. Studies of cancer-associated
more susceptible to chemotherapy.
                                                     early detection,” says Schwab. “We have        fatigue and weight loss are also planned.
Improving Detection Accuracy                         learned that when caught in its earliest       Until now, because of the challenges of
Moores Cancer Center researchers are                 stages, many cancers are curable.”             setting up a biorepository, only some
developing an automated system designed
                                                     As a translational researcher, Schwab not      tests have been studied on samples from
to improve accuracy in the detection of
                                                     only treats patients in the Cancer Center      a few healthy volunteers or very limited
malignant cells during surgery, ensuring
                                                     but also works in a laboratory to move         specimens from other centers. However,
complete removal of cancerous tissue.
                                                     research discoveries into clinical practice.   Schwab says the benefit of collecting
Currently, margins of the removed tumor
                                                     Based on the vision of Dennis Carson,          the samples and data greatly outweighs
are tested after surgery, so some patients may
                                                     M.D., Director of the Moores UCSD              the challenges and notes the program
need to return for repeat surgery if the
                                                     Cancer Center, this biorepository collects,    is very cost-effective. “There are many
tests indicate there is still cancerous tissue.
                                                     processes, and stores blood, urine, and        different types of cancer that have a huge
Prostate Screening                                   tumor samples, as well as corresponding        burden of disease, and these samples can
Current screening methods for prostate               data that goes along with each sample, for     accelerate countless research projects.”
cancer, specifically prostate-specific antigen       research studies. These studies take place     The Moores UCSD Cancer Center
(PSA) tests and digital rectal examinations,         each day in the Cancer Center’s research       biorepository was first seeded by Carson
are not perfect. Cancer Center researchers           towers with the hope of learning more          but now receives partial funding from
have developed a molecular test to                   about cancer.                                  the National Cancer Institute (NCI)
detect a recently discovered “fusion”
                                                     “The biorepository is critical to              through the Cancer Center grant and
gene that is only present in cancerous
                                                     understanding, preventing, and treating        in collaboration with Ajit Varki, M.D.,
and pre-cancerous prostate cells. Fusion
                                                     cancer,” says Carson. “However,                UCSD’s world-renowned glycobiology
genes may have the ability to predict
                                                     government grants are inadequate to            expert. Schwab hopes the biorepository
cancer development and indicate the
                                                     support sample collection, so Schwab’s         will accelerate collaborations of UCSD
aggressiveness of the cancer.
                                                     program depends upon community                 faculty, other academic collaborators,
For more information about the innovative research   support.”                                      and the innovative San Diego biotech
programs at the Moores UCSD Cancer Center, visit                                                    industry, ultimately leading to new cures
http://cancer.ucsd.edu/Research.                     Each newly admitted patient to the
                                                     Cancer Center is invited to participate        for cancer. “It’s critical to the future of
                                                     in the study. Nearly every patient is a        cancer care,” says Schwab.
                                                     possible applicant for the program and a
                                                     large number of patients are participating.
                                                     To date, the Cancer Center has collected
                                                     more than 750 blood and urine samples.
                                                     Each sample is stored in a very specific




                                                                      3
News Briefs                                                                                                           Celebrity Chefs Cook Gala
                                                                                                                      Raises More Than $725,000
Bench to Bedside: Potential New Therapy for Rare Blood Disorder
                                 Collaboration between industry and academia has led to
                                 human clinical trials of a new drug for a rare class of blood
                                 diseases called myeloproliferative disorders, a slow-growing
                                 blood cancer that spreads in the bone marrow and the
                                 peripheral blood. In just one year, this unique partnership
                                 of stem cell researchers from UC San Diego, Dana-Farber
                                 Cancer Institute, the Mayo Clinic, and TargeGen, a San
                                 Diego-based pharmaceutical company, moved from
                                 identifying the most promising drug candidate to clinical                            Carol Vassiliadis matches $100,000 at the Gala
                                 trials for a new drug to fight this degenerative disorder,                           “Fund-a-Need” auction.
Catriona Jamieson, M.D., Ph.D.,
with research associate Dennis   which affects more than 100,000 Americans. Led by
Young and lab technician Annelie Catriona H.M. Jamieson, M.D., Ph.D., Assistant Professor                             More than 400 guests gathered recently
Abrahamsson                      of Medicine at UCSD and Director of Stem Cell Research                               at the 27th annual Celebrity Chefs Cook
at the Moores UCSD Cancer Center, the research group found an inhibitor that can                                      Gala, raising more than $725,000 in
stop the overproliferation of blood cells that results in problems with blood clotting, heart                         support of the Moores UCSD Cancer
attacks, and, in some cases, leukemia. The drug is currently being tested in human                                    Center. The gala’s Italian theme “Bella
clinical trials at the UCSD School of Medicine and other major medical research universities.                         Notte,” or “beautiful night,” set the tone
                                                                                                                      for the evening.
Non-Invasive MRI Provides Window into Genetic Properties of Brain Tumors
                                                                                                                      Carol Vassiliadis, a member of the
                              Researchers at the UCSD School of Medicine, for the first                               Moores Cancer Center board, set the bar
                              time, have shown that magnetic resonance imaging (MRI)                                  for the benefit by establishing a generous
                              technology has the potential to non-invasively identify                                 match gift of $100,000 for the event’s
                              tumors and determine which of them, based on their                                      “Fund-a-Need” auction. Monies raised
                              molecular properties, may be responsive to specific forms                               from the auction will go to help recruit
                              of treatment. Prior to this study, diagnosis and treatment of                           more stellar researchers and physicians
                              brain tumors involved invasive biopsies or surgeries to                                 to the Cancer Center. Guests rallied to
                              obtain tissue and cell samples. UCSD colleagues analyzed                                support the important cause, pledging an
                              more than 2,000 genes that had previously been shown to                                 additional $230,000, which brought the
have altered expression in glioblastoma multiforme tumors, the most common and most                                   auction’s grand total to $330,000 in gifts.
aggressive type of brain tumor. Understanding this genetic activity could prove to be a
                                                                                                                      “Private support allows us to bring more
very strong predictor of survival in patients and explain why some patients have better
                                                                                                                      of the best and brightest physicians and
outcomes than others.
                                                                                                                      scientists to the Center, which is the key
                                                                                                                      to our continued success,” says Dennis
Aloha! Join us August 24 to Surf for a Cure                                                                           Carson, M.D., Director of the Moores
                                                                                                                      UCSD Cancer Center. “The gifts from
                             Now in its 15th year, the annual Luau and Longboard
                                                                                                                      the gala will benefit patients everywhere
                             Invitational has become the premiere surfing benefit in
                                                                                                                      as we recruit more physician-scientists
                             Southern California and is one of the most successful
                                                                                                                      to help translate discoveries today into
                             surfing-related fundraisers in the world. By combining the
                                                                                                                      better treatments tomorrow.”
                             “aloha spirit” of surfing with the business and scientific
                             communities, this event has raised more than $2.6 million                                Sue Kalish, San Diego Magazine’s
                             to benefit research, education, and outreach programs at                                 Volunteer of the Year and 2007 Celebrity
                             the Moores UCSD Cancer Center. This year’s title sponsor                                 Chefs Cook Gala chair, organized the
                             is Pfizer. Surf ’s up at 7:00 a.m. as teams of business                                  April 12 event. Fred Frye, M.D., and his
                             professionals and surfing legends paddle alongside each                                  wife Joy oversaw donations of fine wines,
                             other in friendly competition. Luau festivities commence                                 which were paired with guest chefs’
just before noon and feature a Hawaii-inspired buffet, entertainment by Polynesian                                    signature appetizers during the reception.
dancers, and an auction featuring surfing-related items.                                                              For more information on supporting the Moores
For more information on tickets, tables, and sponsorships, please contact Jennilyn Tan, Special Events Coordinator,   UCSD Cancer Center, call (858) 822-0175.
at (858) 822-0023 or jhtan@ucsd.edu. Also, visit www.longboardluau.org for more event details.

                                                                                       4
Donors Make the Difference                                                                             News of Note
Rena Kerwin Memorial Scholarship                                                                       Sadler Heads State Division of
                                                                                                       American Cancer Society
Heather Herman smiled when she saw the
large bouquet of carnations presented to                                                                                     Georgia Sadler,
her—a tradition for Rena Kerwin Memorial                                                                                     B.S.N., M.B.A.,
Scholarship recipients upon completion of
                                                                                                                             Ph.D., Director of
their coursework.
                                                                                                                             Community Outreach
Heather, a nurse practitioner with the                                                                                       at the Moores UCSD
Doris A. Howell Service, a palliative                                                                                        Cancer Center and
care consultation program at the                                                                                             Clinical Professor of
Moores UCSD Cancer Center, had                     Alan Klier with Heather Herman and JoAnn                                  Surgery at the School
                                                   Kozakowski-Koch of UCSD Home Infusion
been awarded the scholarship to pursue                                                                                       of Medicine, recently
                                                   oncology, and pain management and to
an end-of-life nursing certification.                                                                  added President of the California Division
                                                   nurture the spirit of compassion within
This “train the trainer” program was                                                                   of the American Cancer Society (ACS)
                                                   the nursing staff of the Cancer Center
designed so that upon completion                                                                       to her list of things to do. In this year-
                                                   and the UCSD Home Infusion
Heather could then train her colleagues.                                                               long appointment, Sadler will oversee the
                                                   Pharmacy. By enriching the
“Compassionate care makes a real                   professional caregiver, the Rena Kerwin             advancement of the society’s initiatives,
difference, and I wanted to foster it in           Scholarship serves to improve the                   customized to California’s population.
caregivers, especially nurses, who                 quality of life of the patients served by           Some initiatives include cancer control,
become so important to patients,” says             those nurses. Promoting educational                 community awareness of clinical trials,
Alan Klier. In 1999, Alan, along with              growth is the vehicle for sharing the               and the reduction of health disparities.
Rena’s friends and family, created the             beauty of Rena’s spirit with others                 “Tobacco is a leading cause of cancer, and
Rena Kerwin Memorial Scholarship in                challenged by their health.                         language barriers inhibit many Californians
memory of his life-long partner, who
                                                   In addition, some of the scholarship                from understanding the importance of
lost her three-year battle with breast             funds will support a professional                   smoking cessation,” says Sadler. “ACS
cancer. Rena chose to remain at home               seminar this fall on pain management,               is committed to delivering the smoking
during her illness and ulitilized the              open to all nurses, at the Moores                   cessation message in multiple languages
professional nursing services provided             UCSD Cancer Center. The seminar                     and in culturally appropriate ways.”
by the UCSD Home Care.                             will feature Betty Ferrell, Ph.D.,
The scholarship is designed to promote             F.A.A.N., from the City of Hope                     UCSD Radiation Oncology
continuing education in home care,                 Comprehensive Cancer Center.                        Services Expand to North County
                                                                                                       San Diego North County cancer patients
A Vision for the Future of the Moores UCSD Cancer Center                                               will soon receive better access to the most
                                                                                                       sophisticated radiation therapy. The
Give Today                                        To become a member of the UC San
                                                  Diego Legacy Society, simply notify the
                                                                                                       UC San Diego Department of Radiation
                                                                                                       Oncology, in conjunction with the UCSD
The UC San Diego Legacy Society                   UCSD Office of Planned Giving with
                                                                                                       Medical Center, the UCSD School
recognizes individuals who provide                your intentions. We can provide sample
                                                                                                       of Medicine, and the Moores UCSD
support for the University through                bequest language for inclusion in your
                                                                                                       Cancer Center, has broken ground for
planned gifts. Memberships belong to              will or trust, or otherwise assist you with
those who have made a deferred gift               a plan that meets your philanthropic and             construction of a radiation oncology
to UCSD through one or more of the                financial goals. With careful planning,              center at the San Diego Cancer Center
following methods:                                it is possible to reduce or eliminate                in Encinitas.
• Provision in their will or revocable trust      income and transfer taxes, while turning             The new center will feature the Trilogy
• Life income gift (charitable gift annuity,      appreciated assets into income for                   linear accelerator, the same sophisticated
  pooled income fund, charitable remainder        yourself or others.                                  technology used at the Moores UCSD
  trust, or charitable lead trust)                                                                     Cancer Center in La Jolla. The Trilogy by
                                                  For more information and to request a free copy of
• Retirement plan beneficiary designation
                                                  Your UC San Diego Guide to Giving, please            Varian, Inc., offers unmatched precision,
• Life insurance policy beneficiary designation
                                                  contact Geoff Graham at (858) 534-2249, and          power, and speed in pinpointing and
• Life estate gift (remainder interest in
                                                  visit our Web site at www.plannedgiving.ucsd.edu.
  real property)                                                                                       destroying tumors deep inside the body.

                                                                           5
Moores Cancer Center Events                                                                                     Helping You
Sunday, August 10                                             Community Event Partners
                                                                                                                Get Connected!
Survivor Beach - Pre Luau Event                               The Moores UCSD Cancer Center is
Sponsored by Genentech                                        grateful to our community event partners:          The following phone numbers
Scripps Pier, La Jolla                                        individuals and organizations who host             and Web site address are
8:00 – 10:00 AM                                               fundraising events to benefit cancer               provided here to help you
Sunday, August 24                                             research. Community events promote both            quickly and easily access the
15th Annual Luau & Longboard Invitational                     cancer awareness and the important work
                                                                                                                 information you need:
Scripps Institution of Oceanography, The Pawka Green          of the Moores Cancer Center as the only
7:00 AM – 1:00 PM Longboard Invitational                      NCI-designated Comprehensive Cancer                General information
9:00 AM Registration begins                                   Center in the region. Recent events have           (858) 534-7600
11:30 AM Luau opens                                           included golf tournaments, wine tasting
                                                              dinners, art shows, and a variety of other         New patients
Wednesday, September 10                                                                                          (858) 822-6100 or
                                                              special events.
Faculty Ambassador Event
                                                              Interested in Planning an Event?                   toll-free (866) 773-2703
“The Latest Information on Melanoma”
                                                              If you are interested in supporting
Greg Daniels, M.D., Ph.D.                                                                                        Clinical trials
Moores UCSD Cancer Center, Goldberg Auditorium                the Moores Cancer Center as the
                                                              beneficiary of your fundraising event,
                                                                                                                 (858) 822-5354
6:00 – 8:00 PM
                                                              please contact Tammy Traudt at (858)               If you are a physician
Saturday, October 11
                                                              822-1390 or ttraudt@ucsd.edu.                      (888) 822-8741
15th Annual Bruce Gorder UCSD 5K Walk for Melanoma
Moores UCSD Cancer Center                                                                                        Charitable donations
                                                              For reservations and information, please
8:30 AM – 12:30 PM                                                                                               (858) 822-0175
                                                              call (858) 822-0175. For a complete event
Saturday, May 16, 2009                                        schedule, please visit our Web site at
28th Annual Celebritry Chefs Cook Gala                                                                           Web site
                                                              www.cancer.ucsd.edu.
Sheraton San Diego Hotel and Marina                                                                              www.cancer.ucsd.edu
6:00 - 11:00 PM



Moores UCSD Cancer Center


President of the Board         ex officio members
Rudolph Rehm                   Marye Anne Fox, Ph.D.
                               David A. Brenner, M.D.
cancer center
                               Debra Neuman
board of directors
Suzanne Agarwal
J. Samuel Armstrong, IV
Gordon P. Boerner
                               Wayne Bardwell, Ph.D.
                               directors emeritus
                               Joany Mosher
                                                                  Pathways                                                        SUMMER 2008


Marilynn Boesky                Anne Otterson
                                                                  University of California, San Diego | Rebecca and John Moores UCSD Cancer Center
Carol Littlejohn Chang
Howard I. Cohen                Director, Moores UCSD
William T. Comer, Ph.D.                                                                                                            Non-Profit Org.
                               Cancer Center
Daniel J. Gatto                                                                                                                    U.S. Postage
                               Dennis A. Carson, M.D.
Frank M. Goldberg                                                                                                                  P   A    I     D
Charles F. Gorder, Sr., Esq.   Deputy Director                    3855 Health Sciences Drive #0658
                                                                                                                                   San Diego, CA
Donald W. Grimm                Research Operations                La Jolla, CA 92093-0658
                                                                                                                                   Permit No. 1909
Jerome S. Katzin, Esq.         Thomas J. Kipps, M.D., Ph.D.
Jeffrey Lipinsky               Medical Director
Cinda K. Lucas                 Oncology Services
Henry L. Nordhoff              Barbara A. Parker, M.D.
John W. Otterson, II           Associate Director
Tori Pitruzzello               Administration
Ian Pyka                       Ira S. Goodman
Justin Renaudin, M.D.
                               Director of Development
Mary Rand Taylor
                               Pamela M. Werner, CFRE
Carol Vassiliadis

				
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