Miller School Researchers Showcase Cancer Research at Annual Symposium
Four UM researchers offered a glimpse of the exciting cancer research taking place at the Miller School at the 2012 Gastrointestinal Cancers Symposium, the largest meeting in the world dedicated to research and breakthroughs in gastrointestinal malignancies. Held January 19-21 in San Francisco, the meeting gave UM researchers the opportunity to showcase promising results from several studies that could lead to randomized clinical trials at Sylvester Comprehensive Cancer Center/University of Miami Hospital and Clinics.
Peter Hosein, M.D., assistant professor of clinical medicine, presented “Initial experience using percutaneous irreversible electroporation (IRE) in the treatment of locally advanced pancreatic adenocarcinoma (LAPC) with vascular encasement.” Currently, surgery is the only curative option for patients suffering from pancreatic cancer, and most are not candidates for surgery due to local invasion of blood vessels, despite significant response to chemotherapy and/or radiation.
Irreversible electroporation, or NanoKnife, a local therapy to treat tumors prior to surgery, has led to significant and encouraging results. It is only available in a few centers in the world, and recently at the University of Miami thanks to the leadership efforts of Govindarajan Narayanan, M.D., associate professor of clinical radiology and chief of the Section of Vascular/Interventional Radiology. In the study, one quarter of patients with unresectable locally advanced pancreatic adenocarcinoma due to persistent vascular encasement after neoadjuvant therapy achieved a margin-negative resection after irreversible electroporation, including one patient who had a pathologically complete response. The novel findings and approach offer surgical treatment options for otherwise inoperable patients. Based on these successful results, Hosein and his team are planning a future neoadjuvant trial.
Arturo Loaiza-Bonilla, M.D., hematology and oncology fellow, presented “Percutaneous irreversible electroporation (IRE) in the treatment of hepatocellular carcinoma (HCC) and metastatic colorectal cancer (mCRC) to the liver: A retrospective analysis of the University of Miami experience.” The study found that IRE of liver tumors is safe and resulted in increased, progression-free survival when a complete response was attained. Many patients suffering from multifocal liver cancer or metastatic spread from colon cancer to the liver are not suitable candidates for surgery, transplantation or other local techniques. Using this technology, a powerful electrical field using high-voltage direct current is used to create holes in the tumor’s cell membranes and irreversibly damage the cell’s homeostasis mechanism, leading to instant cell death.
The results, which included the largest number of patients ever reported treated with IRE, offer an additional treatment alternative for patients. They also revealed that imaging studies showing a lack of enhancement after IRE correlated with a longer lifespan free of tumor progression or recurrence.
Yehuda Deutsch, M.D., internal medicine resident, presented “Cholangiocarcinoma: A joint cancer database analysis.” The study, which is one of the largest analyses of this rare malignancy, found that chemotherapy and chemo-radiation had a positive impact on survival in patients with late stage cholangiocarcinoma and that surgery improved survival in both early and advanced stages.
Vinicius Ernani, M.D., internal medicine resident, presented “Gemcitabine (G) and nab-paclitaxel (nab-P) in patients with refractory advanced pancreatic cancer (PC).” In the study, Ernani found that a combination of the chemotherapy drug gemcitabine with nab-paclitaxel, a novel albumin-bound paclitaxel, an established chemotherapy agent, and albumin, a very small naturally-occurring protein, benefitted half of the patients with advanced pancreatic cancer. The results offered encouraging data for the use of this agent in patients who have already been treated with several lines of chemotherapy, and the regimen is under further investigation in currently enrolling clinical trials.