From basic research, to patient care, to impact in the community, the OHSU Knight Cancer Institute has a mission to end cancer as we know it. Here’s a look back at a year of accomplishments.

Delivering discoveries

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  OHSU and the Portland VA enrolled more subjects than any other U.S. site in the clinical trial establishing the first FDA-approved drug for non-metastatic prostate cancers resistant to hormone therapy. Knight Cancer physician Julie Graff, M.D., co-authored a New England Journal of Medicine report on the clinical trial, which showed that the androgen receptor inhibitor apalutamide improved metastasis-free survival and time to symptomatic progression.

• To take on an aggressive blood cancer, Knight Cancer researchers led by Jeff Tyner, Ph.D., released a trove of data on drug sensitivity, gene alterations and other features of tumor cells from more than 500 people with acute myeloid leukemia. It is the largest cancer dataset of its kind and it is intended to accelerate the search for new AML treatments.
• SMMART, a new clinical trials platform built by Knight Cancer scientists, is making it possible to study each person’s tumor in exquisite detail, track how cancer cells evolve in response to treatment, and use the information to select combinations of drugs tailored for the individual. “We are using the findings from our analytics platform to obtain the best possible treatment in real time,” said Gordon Mills, M.D., Ph.D., director of precision oncology.
• The Beat AML clinical trial has matched 250 study participants to targeted treatments for acute myeloid leukemia – with promising early results. “That’s real progress. That’s helping patients in a way that we haven’t been able to before,” Knight Cancer Institute Director Brian Druker, M.D., told an audience at the ASH annual meeting.

  

• Knight Cancer researchers are working on a targeted therapy that blocks a pathway tumor cells use to mobilize in the deadly process of metastasis. Ray Bergen, M.D., and co-authors detailed their progress in Nature Communications.
• Researchers led by Lisa Coussens, Ph.D., revealed a novel mechanism underlying how cancer cells co-opt complement proteins of the immune system to promote tumor growth. Using a drug to block a key complement signaling pathway boosts effectiveness of chemotherapy in an animal model of squamous cell cancers, the team reported.

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  Tumor cells fuse with immune cells and become more aggressive, Melissa Wong, Ph.D., and co-authors reported in Science Advances. The hybrid cells, readily detected in cancer patients’ blood, gain new powers to mobilize and form new tumors. The relative abundance of hybrids circulating in blood suggests they could be harnessed for early detection and tracking treatment response.

• Outcomes for patients with osteosarcoma, many of them children and teenagers, have changed little in decades, but Knight Cancer physicians have identified a promising targeted therapy. Lara Davis, M.D., and Christopher Ryan, M.D., reported improved progression-free survival for patients receiving a tyrosine kinase inhibitor.

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  Breast cancers that emerge in young women within a few years after pregnancy are strikingly more dangerous. The common pain reliever ibuprofen might work as a preventive treatment to reduce the risk, according to pre-clinical findings by Pepper Schedin, Ph.D., Nathan Pennock, Ph.D., and colleagues. Their research also shows how non-steroidal anti-inflammatory drugs such as ibuprofen might boost response to immunotherapy agents.

• Knight Cancer researchers are using gut bacteria to fight tumors. Julie Graff, M.D., Amy Moran, Ph.D., and colleagues were awarded $1 million to test the idea that adjusting the diversity of bacteria inhabiting the intestines could make aggressive prostate cancers more responsive to treatment with immune therapy drugs called PD-1 inhibitors.
• Findings from the lab of Joshi Alumkal, M.D., set the stage for developing a new treatment approach to stop lethal, castration-resistant prostate tumors – the second leading cause of cancer death in the U.S. Alumkal, with Archana Sehrawat, Ph.D., and colleagues, uncovered a signaling pathway that prostate cancers use to evade hormonal therapies.

Serving Oregonians

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  OHSU was one of 12 clinical trial sites in the U.S. establishing the first CAR-T-cell therapy for an aggressive blood cancer called diffuse large B-cell lymphoma, the most common type of non-Hodgkin lymphoma. “The potential for this therapy is huge,” said Richard Maziarz, M.D., medical director of the adult blood and marrow stem cell transplant and cellular therapy program in the OHSU Knight Cancer Institute. The latest clinical trial results at OHSU and 26 other study sites around the world show high rates of durable responses to treatment with the CAR T-cell therapy.

• Total funding awarded by the Knight Cancer Institute Community Partnership Program passed the $2 million mark in January. Launched in 2014, the program has provided money, training and technical assistance for community-led projects serving all 36 Oregon counties. The latest round of funding, totaling $320,000, supports 13 new and 4 previously funded projects that target a diverse range of cancer types and demographics.
• Knight Cancer oncologist Vinay Prasad, M.D., M.P.H., took aim at the financial toxicity of cancer drugs in a Marquam Hill Lecture. Prasad examined the forces influencing cancer drug pricing, and he explored policy changes that could start solving the affordability problem for people with cancer.

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  The Knight Cancer Institute’s free cooking classes provide tasty recipes and expert nutrition information chosen with cancer survivors in mind by registered oncology dietitian Amanda Bryant, R.D., C.S.O., L.D., and colleagues. Anyone can watch the classes online via streaming video.

• The VA Portland Health Care System is one of 12 centers across the U.S. selected for a national initiative to give military veterans more opportunities to participate in cancer clinical trials. Affiliation with the Knight Cancer Institute was a key factor helping the Portland VA successfully compete for the award.
• Palliative care was associated with decreased risk of death from suicide among veterans with advanced lung cancer, according to research by Donald Sullivan, M.D. The rate of suicide in the study cohort was more than five times higher than the average among veterans of a comparable age and gender using VA health care. Patients with lung cancer who had at least one palliative care visit after their diagnosis were 81 percent less likely to die by suicide than those who received no palliative care.
• The Healthy Oregon Project, or HOP, aims to learn more about how genetics, environment and behaviors affect the risk of chronic disease, including cancer. It’s being led by the Knight Cancer Institute’s Paul Spellman, Ph.D., and Jackie Shannon, Ph.D., R.D., M.P.H.I.
• U.S. News & World Report rated OHSU among the top 30 for adult cancer care in its 2018 Best Hospital Rankings. The Knight Cancer Institute came in at No. 28 in the nation, and scored in the same tier as the No. 1 rated cancer center in the nation on all but one measure. OHSU Doernbecher Children’s Hospital advanced to No. 41 among children’s cancer centers in the U.S. News ratings – up from 47 last year.

Leading the way

• The world’s top scientists in the field of cancer early detection gathered in Portland in October for the third in an ongoing series of conferences organized by the Knight Cancer Institute and Cancer Research UK, joined this year by the Canary Center at Stanford University. The Early Detection of Cancer Conference is part of a long-term commitment to invest in early detection research, to understand the biology behind early stage cancers, find new detection and screening methods, and enhance the uptake and accuracy of screening.

  

• The American Association for Cancer Research honored Lisa Coussens, Ph.D., with the Princess Takamatsu Memorial Lectureship, which celebrates “novel and significant work with far-reaching impact on the detection, diagnosis, treatment, or prevention of cancer” and comes with a $10,000 cash prize. Coussens, Knight Cancer associate director for basic research, was also named a Fellow of the American Association for the Advancement of Science, which cited her pioneering discoveries about the roles of immune cells in promoting tumor progression.

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  Knight Cancer Institute Director Brian Druker, M.D., came in at No. 15. in a new list of the 100 “most accomplished and influential Oregonians of all time,” ahead of such luminaries as artist Mark Rothko, physician and civil rights leader DeNorval Unthank, children’s book author Beverly Cleary, and The Simpsons creator Matt Groening. Druker also was awarded the Tang Prize in Biopharmaceutical Science for his role in developing Gleevec, the targeted therapy drug that “fundamentally altered the field of oncology.” And he received the top prize bestowed by the American Association for Clinical Chemistry.

• A $2.5 million gift established the Wayne and Julie Drinkward Endowed Chair in Precision Oncology for Gordon Mills, M.D., Ph.D. The endowment will support the development of new ideas in cancer treatment and the mentorship of up-and-coming cancer scientists and physicians.
• Kerri Winters-Stone, Ph.D., is among the experts convened by the American College of Sports Medicine for a revision of the group’s exercise recommendations for cancer survivors. Winters-Stone, co-leader of the Knight Cancer Institute’s Cancer Prevention and Control Program, also received two major National Cancer Institute awards: one to study the benefits of a partnered exercise program for couples coping with cancer, and another to study strength training vs. tai chi as a means to prevent the frailty, falls and fractures associated with androgen deprivation therapy for prostate cancer.
• Knight Cancer physcian-Scientists Joshi Alumkal, M.D., Tom Beer, M.D., Julie Graff, M.D., and George Thomas, M.D., co-authored three of the 25 most important prostate cancer studies published this year, and one runner up, as judged by the Prostate Cancer Foundation.
• The Knight Cancer Institute completed its new research building on schedule and on budget. It is “the embodiment of what we can accomplish when we come together for a cause that’s bigger than any one of us,” Brian Druker, M.D., told the grand opening crowd. The Oregon Legislature provided $160 million of the total $190 million in building construction funding.“This building stands as a monument to those who we’ve lost [to cancer] and a testament to the urgency of our work,” he said. “Because of you, the end of cancer begins here.”