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Kevin Cullen, MD
The NCI designation, which is assigned to a limited number of cancer centers, is given on the basis of scientific excellence in basic and clinical research, and will further the Greenebaum Cancer Center’s work through additional NCI funding up to $3 million over three years. The U.S. News and World Report ranking is based on quality of care.
E. Albert Reece, MD, PhD, MBA, vice president of medical affairs, and dean of the School of Medicine, reports that, in the current funding environment, getting NCI accreditation has become difficult. “The quality of research needed to qualify has changed significantly in the last couple of years,” he says. “The process has become a great deal more competitive than it was in the past; so in effect that becomes an additional tribute to the researchers and clinicians who comprise the cancer center, and whose work is responsible for this distinction.”
Pointing to one of those researchers, Kevin Cullen, MD, professor of medicine, pharmacology and experimental therapeutics, and director of the cancer center, cites Angela H. Brodie, PhD, professor of pharmacology and experimental therapeutics, who is recognized worldwide for her discovery of a hormonal breast cancer treatment. “Angela Brodie is clearly an eminent scientist who has distinguished our program,” Cullen says. “Her contributions to breast cancer research make her one of the most important people in her field. ”
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In a word, she was successful. Brodie performed the basic science and developed a compound leading to a new class of drugs called aromatase inhibitors, which have been in use worldwide since the early 1990s, and are replacing tamoxifen. In addition to being prescribed for new patients as an alternate to painful chemotherapy, they are well tolerated, and are successfully used for those who have exhausted their five-year limits of tamoxifen. There is some evidence that aromatase inhibitors are effective in stopping tumor progression as well.
In the meantime, Brodie is collaborating with Vincent Njar, PhD, associate professor of pharmacology, in work with a different enzyme that may be effective in prostate cancer treatment. That project has been licensed, through the university, to a Boston company preparing it for clinical trials.
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Cullen reports the sum total of efforts by cancer center scientists suggests important milestones for the center in coming years. He refers to Alan Tomkinson, PhD, associate director for basic science, and Scott Strome, MD, professor and chair of otorhinolaryngology. “Alan’s laboratory is doing cutting edge work on DNA damage and DNA repair to determine how patients respond to either chemotherapy or radiation therapy,” Cullen says. “To some degree, cancer treatment revolves around altering the ability of cancer cells to divide. So how the DNA within the cell is damaged and how it responds to damage is a critical part of how people respond to treatment. This work, I believe, may turn out to provide important therapeutic targets in the next couple of years.”
He adds that Strome heads the tumor immunology and immunotherapy program. “His group has developed novel oral cancer vaccines which are undergoing clinical trials for the treatment of people with advanced oral cancer—a treatment that, ultimately, may be used for prevention as well,” he says.
Another key area of interest at the Greenebaum Cancer Center is its focus on the issue of health disparities. “Nearly 40 percent of our patients are underserved minorities,” Cullen says. “That’s an unusual percentage for any cancer center in the country, and it means we have a special responsibility to these patients.”
He explains that there are serious disparities in treatment and outcomes of treatment in different ethnic groups. Some of this is due to biology and some to access to care. “We’re aiming to reverse that trend,” he says. “Although studies show that minorities account for few of those likely to take advantage of clinical trials, 70 percent of the women in our clinical breast cancer trials last year were African Americans. To my mind, that points to two important conclusions—we’re working hard to break down the disparities that exist in health care, and we have established trust among the African-American community.”
Perhaps one of the most important activities at the center is its collaboration with the medical school’s institute of human virology (IHV) and joint efforts toward vaccine development. Robert Gallo, MD, IHV founder and director, one of the most eminent scientists in the world, co-discovered the HIV virus, and was the one to develop the blood test that identifies the virus. He says he looks forward to collaborative efforts between IHV and the Greenebaum Cancer Center, a partnership that will augment the viral oncology program, and develop cancer vaccines, along with IHV’s own AIDS vaccine candidate. The corresponding benefit of such work is that, as HIV patients now live longer lives, their risk of cancer and cardiovascular disease has increased significantly. “Currently, IHV and the cancer center are jointly recruiting a vaccinologist whose participation in our programs will have an enormous impact on our combined activities,” Gallo says.
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Cullen reports that the Roslyn and Leonard Stoler Pavilion centered on multidisciplinary outpatient care, encompasses the mission of the cancer center in providing care for newly diagnosed patients within a week through team involvement that includes oncologists, surgeons and radiation oncologists. In addition, Cullen points to the development of several training programs and an NCI grant to train clinical investigators in accordance with NCI emphasis on the education and mentoring of young investigators. Looking to the future, he says, “We are moving ahead with programs in viral oncology and tumor immunology. We have developed a division of epidemiology, and are in the process of recruiting a division chief now, who also will direct population studies at the cancer center.”
As to goals for the ambitious agenda the Greenebaum Cancer Center will tackle as an NCI designated center, Cullen has no doubts. “We want to be perceived as the best place in Maryland to receive cancer care,” he says. “We want to be recognized for what we are—a national leader in both cancer research and treatment.”
Photos on pages 15-17 by Stephen Spartana
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