Despite recent progress in the development of new drugs and treatment options for prostate cancer, metastatic disease mortality remains a major concern, highlighting a critical need for the discovery of biomarkers and the development of tests that can identify men who are at a highly elevated risk for developing metastatic disease before they are ever diagnosed.

Victoria Belancio, PhD, associate professor of structural and cellular biology and associate director for cancer education at Tulane Cancer Center, and her team are working on just such a test, and she was recently awarded a four-year, $1.032 million Department of Veterans Affairs Merit Award Grant to support her investigations.

"This idea is very similar to BRCA1, BRCA2 and other genetic tests that identify elements already present in the genome," said Belancio. "Such a test could be administered at any point during a man's life — even prenatally — to identify the presence of a particular biomarker and locations of genetic variations in the genome that might be associated with aggressive metastatic disease. Those at increased risk could then be more proactive about being screened."

The biomarker Belancio is targeting is a mobile element called polymorphic L1 — or pL1. Mobile elements are segments of DNA that can jump around within the genome, reshuffling genetic material as it copies and reinserts itself randomly.

"L1 contributes to genomic instability," said Belancio. "It's known to cause mutations that can either initiate tumorigenesis or contribute to the progression of cancer."

Belancio's preliminary analysis of Whole Genome Sequencing datasets and sample tissues from our Prostate Cancer Research Program biorepository — a collection of tissue specimens from Tulane's unique cohort of prostate cancer patients maintained by Dr. Oliver Sartor and Dr. Elisa Ledet — shows that specific pL1s are enriched in the genomes of patients with metastatic disease, meaning this genetic variable could be a potential new and powerful biomarker of aggressive prostate cancer.

In this project, Belancio's team is also aiming to identify novel genetic variations to determine whether the number and/or composition of pL1s in patient genomes — alone or in combination with identified variations — is positively associated with aggressive disease.

But whole genome sequencing is time-consuming, very expensive, and impractical for high throughput clinical use. "And so what we've done is develop a technique for which Tulane has filed a patent that would allow us to determine the presence of both pL1 and targeted genetic variations through a simple blood test," said Belancio.

Her team's short-term goal is to generate through this project proof-of-principle pre-clinical data that show applying this technique can potentially distinguish patients who will develop aggressive metastatic prostate cancer from those who will not. And the long-term outcome of the success of this proposal would be a reliable genetic blood test that is cheap, effective, accurate, fast and easy to administer in the clinic.

"Many men will develop prostate cancer as they age," said Belancio. "The lack of reliable genetic biomarkers to understand who will progress to aggressive metastatic disease has led to many cases of over treatment. And the ways in which these patients are treated can have very devastating physical and psychological effects. If our work can change this, it will have very important implications for disease management."

Tulane School of Medicine is pleased to announce Jessica Shank, MD, has been appointed as the Interim Medical Director of the Tulane Cancer Center and lead physician on the Tulane Cancer Center transition team for the LCMC affiliation.

Thanks to advances in cancer therapies, most forms of breast cancer are highly treatable, especially when caught early.

But the last frontier cases — those that can’t be treated with hormone or targeted therapies and don’t respond to chemotherapy — remain the deadliest and hardest to treat. Tulane University researchers have discovered for the first time how these cancers persist after chemo and why they don’t respond well to immunotherapies designed to clear out remaining tumor cells by revving up the immune system.

The process of surviving chemotherapy triggers a program of immune checkpoints that shield breast cancer cells from different lines of attack by the immune system. It creates a “whack-a-mole” problem for immunotherapy drugs called checkpoint inhibitors that may kill tumor cells expressing one checkpoint but not others that have multiple checkpoints, according to a new study published in the journal Nature Cancer.

“Breast cancers don't respond well to immune checkpoint inhibitors, but it has never really been understood why,” said corresponding author James Jackson, PhD, associate professor of biochemistry and molecular biology at Tulane University School of Medicine. “We found that they avoid immune clearance by expressing a complex, redundant program of checkpoint genes and immune modulatory genes. The tumor completely changes after chemotherapy treatment into this thing that is essentially built to block the immune system.”

Researchers studied the process in mouse and human breast tumors and identified 16 immune checkpoint genes that encode proteins designed to inactivate cancer-killing T-cells.

“We’re among the first to actually study the tumor that survives post-chemotherapy, which is called the residual disease, to see what kind of immunotherapy targets are expressed,” said the study’s first author Ashkan Shahbandi, an MD/PhD student in Jackson's lab.

The tumors that respond the worst to chemotherapy enter a state of dormancy – called cellular senescence – instead of dying after treatment. Researchers found two major populations of senescent tumor cells, each expressing different immune checkpoints activated by specific signaling pathways. They showed the expression of immune evasion programs in tumor cells required both chemotherapy to induce a senescent state and signals from non-tumor cells.

They tested a combination of drugs aimed at these different immune checkpoints. While response could be improved, these strategies failed to fully eradicate the majority of tumors.

“Our findings reveal the challenge of eliminating residual disease populated by senescent cells that activate complex immune inhibitory programs,” Jackson said. “Breast cancer patients will need rational, personalized strategies that target the specific checkpoints induced by the chemotherapy treatment.”

The full study is available online here.

The American Society of Hematology (ASH) named Chancellor Donald, MD, a winner of this year’s Exemplary Service Award. Donald is an assistant professor of medicine, hematology, and oncology at Tulane University School of Medicine and medical director of cancer management at University Medical Center New Orleans.

ASH is the largest organization devoted to equitable high-quality care to improve the lives of patients with blood and bone marrow disorders. The Exemplary Service Award was established in 1998 to recognize individuals whose outstanding service has significantly advanced the interests of ASH.

This award specifically recognizes Donald and his peers for their “extensive contributions to the COVID-19 content curation group to ensure that the hematology community had access to the most trustworthy and up-to-date resources in the rapidly evolving pandemic environment.” As chair of the ASH Committee on Practice, Donald brought his insights and expertise to help the group identify and address the most pressing needs for practitioners on the front lines of the pandemic. The accurate and updated information Donald and his fellow honorees gathered made Hematology.org a trusted source for patients, physicians and researchers across the globe.

The award was presented during ASH’s recent 64th Annual Meeting and Exposition in New Orleans.

Check out this new tool — developed by the American Cancer Society in collaboration with the Division of Anatomy at The Ohio State University College of Medicine — to help patients and caregivers understand terms they may see on test reports or during visits that relate to body systems or organs. Through this new educational resource, patients can explore 3D interactive tours of the human anatomy. Tour the gallery here.

The Cancer Crusaders 16th Annual Golf Tournament is scheduled for Monday, March 20, 2023, at Chateau Golf & Country Club, 3600 Chateau Blvd., Kenner.

Every hour of every day a person dies of cancer in Louisiana. That statistic is what fuels every member of this organization, along with their steadfast belief that "the answer to cancer is research." Please help them to continue making a difference by signing up for the tournament today. There are several sponsorship and team packages still available. If you're unable to participate but still want to support the cause, please consider making a tax-deductible donation. For more information on all of these options, please visit the tournament website.

Pink Games — a series of benefit volleyball games and other fundraising events held at the schools and often involving friendly competitions among grade levels — was started by David Mocklin, head athletic trainer at the Tulane Institute of Sports Medicine, eight years ago in an effort to help alleviate the stress of local cancer patients.

Tulane Cancer Center's PRF was established in 1998 to help patients meet unexpected expenses associated with their care. It's often the only source available to our social worker to solve urgent problems — things like lack of transportation, meals or temporary lodging — that could become insurmountable impediments to the ability of a patient to follow his or her cancer treatment plan. These funds are also an important source of emotional relief for needy patients facing a cancer diagnosis. 

"The Pink Games have generated an incredible $261,408 in support for our cancer patients over the years," said Prescott Deininger, PhD, Tulane Cancer Center director. "We are deeply grateful and couldn’t be prouder of the students — tomorrow’s community leaders — who are making such an impact in the lives of their neighbors in need. They are setting an example of empathy and concern for others that we all should follow. On behalf of our faculty, staff, and most importantly, the cancer patients who have been and will continue to be helped through these incredibly generous efforts, I thank them," said Deininger.  

If you would like to make a donation to Tulane Cancer Center's Patient Relief Fund, please visit our "Giving" page by clicking here.

Members of Krewe de Pink — a New Orleans-based 501c3 organization dedicated to raising funds for breast cancer research — recently presented Tulane Cancer Center with a check for $45,000, representing the results of their fundraising efforts in 2022.

"We are extremely fortunate to benefit from the deep convictions of community supporters who meaningfully help drive progress toward new treatment options and cures," said Prescott Deininger, PhD, Cancer Center director. "We are keenly aware of the time, dedication and commitment it takes to raise these funds, and we couldn't be more grateful."

For more information on Krewe de Pink or any of these events, please visit their website at www.krewedepink.org.