Maryland Woman Benefits when Two Emerging Areas of Science Aimed at Beating Cancer Come Together

Precision Medicine and Immunotherapy: Tomorrow’s Cancer Treatments Today at MedStar Georgetown

(Washington, D.C.)  – A Maryland woman is benefitting from the intersection of two promising fields of science: precision medicine to genetically profile cancer and immunotherapy to unleash the immune system to fight it.

It’s a case her doctors are calling “remarkable.”

Diane Lucey, 49 of Leonardtown, Maryland was living in Georgia in 2014 when she noticed a small bump in her mouth.  The two centimeter tumor was determined to be a rare type of cancer called neuroendocrine carcinoma. She had it surgically removed, received six weeks of radiation and thought she was cancer free. But in the summer of 2016 a scan revealed cancer in her liver and her right lung.  

“It came from out of the blue,” Lucey says.  “I thought I was done with my cancer when it came back.”

Diane during treatmentBy then Lucey was working as a chemist for Calvert County and living in Leonardtown, Maryland. Her oncologist at nearby MedStar St. Mary’s Hospital sent her to MedStar Georgetown where she would have full access to the latest treatments as well as clinical trials through the Georgetown Lombardi Comprehensive Cancer Center.

“This was a rare disease in a young, healthy person,” says Amir Khan, MD, medical director of Cancer Care and Infusion Services at MedStar St. Mary’s and Lucey’s oncologist.  “I wanted to have her treatment plan formalized quickly and to see if there were other options for her beyond standard therapy, which is chemo therapy.”

Lucey next met with Louis M. Weiner, MD, director of MedStar Georgetown University Hospital’s Lombardi Comprehensive Cancer Center and Georgetown Lombardi, the research arm of MedStar Georgetown. “Here at Georgetown, we partner with Caris Life Sciences to perform detailed molecular profiling of patients’ tumors. In Ms. Lucey’s case we sent part of her liver tumor to Caris and found the cancer cells had the right target, PD-L1 expression, that clinical trials have shown make cancers sensitive to certain immunotherapy drugs.”

In October 2016 Lucey began receiving injections of the immunotherapy nivolumab, sold under the brand name Opdivo, one hour every two weeks for 12 weeks. Because Georgetown Lombardi is part of the Medstar system, Lucey was able to receive her treatments closer to home at MedStar St. Mary’s Hospital.

Her first scan in January 2017 showed her liver tumor had shrunk by half and the lesions in her lung were shrinking as well.

“My doctors were thrilled and of course I’m thrilled at the results,” says Lucey. “And the best part is that I’ve been able to work and live my daily normal life with no pain or fatigue, no hair loss, no nausea or loss of appetite. Compared to the radiation I had before, this immunotherapy was nothing.”

Born and raised on the Florida coast, Lucey is an avid boater, loves to fish and spend time on the nearby Chesapeake Bay. “I’m at the beach and on the water as much as I possibly can,” says Lucey. “With this treatment I’ve been able to continue to make plans to enjoy the things I’m passionate about including a big fishing trip to Florida with my family this year. I’m also pursuing my other hobbies like golf, restoring old furniture, painting and making jewelry.”Diane golfing

“Ms. Lucey’s case is a perfect example of what those of us who worked on former Vice President Joseph Biden’s Cancer Moonshot believe is the future of beating cancer,” says Dr. Weiner who served on the National Cancer Institute’s blue ribbon panel working group on immunotherapy as part of the National Cancer Moonshot Initiative.

“Of the 13 critical areas we recognized, this case satisfies three: delivering cutting edge cancer care to patients where they live, capturing the benefits of precision medicine to treat the right cancer with the right medication at the right time, and to harness the immune system to control and attack the cancer.”

Nivolumab is FDA approved for advanced melanoma, advanced non-small cell lung cancer, advanced renal cell carcinoma, classical Hodgkin lymphoma, advanced squamous cell carcinoma of the head and neck, and urothelial carcinoma or bladder cancer.

“The only side effect I had was a small rash on my belly, but that went away with a course of Prednisone,” says Lucey.

Side effects, sometimes serious ones, occur in fewer than 10 percent of patients taking immunotherapy. Immunotherapy does not work in all patients.

“Ms. Lucey’s situation is also a great example of how MedStar Georgetown Cancer Institute, a network of hospitals linked with clinical and research priorities uses the resources available at our NCI-designated Comprehensive Center to work collaboratively to provide patients in somewhat distant areas access to the latest advances in world class cancer care. She received tomorrow’s treatments today, without leaving her hometown,” says Dr. Weiner.

Diane with her sisters“Ms. Lucey is very lucky,” says Dr. Khan.  “Immunotherapy is another tool in the hands of physicians and it will impact some patients more than others. We don’t know how long it will work for her but more and more people are living better and longer with cancer these days.  I wish all my patients could benefit this way.”

Dr. Weiner says research shows that when immunotherapy works rapidly, as in Lucey’s case, the results tend to be more long lasting.

“My daily life is normal.  I don’t think about having cancer.  I just keep living my life being very grateful and hoping for continued good news,” says Lucey.

Marianne Worley
Director of Media Relations
Office: 703-558-1287
Pager: 202-405-2824
[email protected]

Healthy Heart Advice for Women

 

"Goldilocks" Exercise and SleepWoman Running

Exercise and good rest are healthy habits, right?  What is the right amount for optimal cardiovascular health? For exercise, brisk walking is good enough - 30 to 60 minutes on most days of the week does the trick!  Women who exercise moderately and regularly experience fewer than half as many heart attacks as those who don’t. And, research in healthy women shows that the optimal sleep duration is seven hours.  Less than seven hours is associated with increased heart risk.  Now here’s the interesting part:  you can get too much of a “good thing.”  Exercise and sleep research also suggests that long-duration intense exercise actually reduces some of the benefits seen with moderate exercise. And, excessive sleep duration is also associated with higher heart risk. So, good sleep, and daily exercise - not too little, not too much - shoot for “just right!”

Are you Inflammatory?

Everyone should “know your numbers.” Blood pressure (below 140/90 mm Hg) and cholesterol (lower is better) are among the most important to know. But do you know your inflammatory number?  Here’s the idea:  All of us have a certain level of an “inflammatory” response in our bodies at all times - it is there to be ready to fight infections, but also can be slightly stimulated by chronic inflammation in our bodies:  that chronic joint problem; a chronic illness (like rheumatoid arthritis); bad teeth and gums and so on. Doctors can measure your level of inflammation using a test known as C-reactive protein. It is a simple blood test that can be added to your cholesterol measurement test, and it indicates the level of inflammation in your body. Research in healthy women shows that optimal heart health is achieved when cholesterol and inflammation are BOTH at low levels. Interestingly, inflammation alone creates heart risk no matter how well your cholesterol is controlled. Thankfully, common cholesterol medications known as statins not only reduce cholesterol, but also reduce inflammation. So, the next time you have your cholesterol checked, ask your doctor if they can also check your CRP- you’ll learn more about your heart risk!

“Take an Aspirin and Call Me in the Morning?” - Not Quite

Do you take aspirin?  If you do, but don’t have a history of heart disease or stroke, you should think about re-evaluating your treatment with your doctor. Recent advice on the use of aspirin in healthy women suggests that MOST women without prior heart disease should probably not be taking a “preventive” dose of aspirin. The reason is that the benefits, while real, are generally small and offset by the risks of aspirin - mainly bleeding. The decision can be a complicated one, based upon your individual heart risk.  So, certainly ask your provider if preventive aspirin is for you. And, if you are on aspirin, it is worth a double check to make sure this treatment remains a good choice!

Should You Take a Cholesterol Pill?

To make this decision, it depends on your risk for heart disease and stroke. A detailed calculator is available to measure your heart risk. It depends on several factors such as your blood pressure, your cholesterol levels, inflammation, family history, age and smoking behavior. Recent guidelines say that if your risk is at least 7.5 percent, then there is a 7.5 percent chance of developing heart disease or stroke in the next 10 years, and a statin would be indicated. Statins are among our most effective and safest medications for heart disease prevention. And, here’s the good news: research across the last two decades show us that women who take a statin when indicated benefit at least as much, if not more, as men! 

So, live well first, but when medications to treat your cholesterol are indicated, medications can be very helpful! You can check out your heart risk at www.reynoldsriskscore.org.

By Dr. Allen Taylor
Chief, Cardiology Division
Medstar Georgetown University Hospital
Medstar Washington Hospital Center
Medstar Heart and Vascular Institute


Dr. Allen J. Taylor, Chief of Cardiology, MedStar Heart & Vascular Institute

Marianne Worley
Director of Media Relations
Office: 703-558-1287
Pager: 202-405-2824
[email protected]

Georgetown Clinical Trial Testing Nilotinib in Alzheimer’s Disease Begins

WASHINGTON (January 24, 2017) – A clinical trial to examine the effect of nilotinib on clinical outcomes and biomarkers in people with mild to moderate Alzheimer’s disease has opened at Georgetown University Medical Center (GUMC).

The clinical trial is a phase II, randomized, double blinded, placebo-controlled study to evaluate the impact of low doses of the cancer drug nilotinib (Tasigna®). GUMC is conducting the study with its clinical partner, MedStar Georgetown University Hospital.

The rationale for using nilotinib is based on laboratory and clinical research conducted by the Georgetown Translational Neurotherapeutics Program (TNP). Nilotinib appears to aid in the clearance of accumulated beta-amyloid (Abeta) plaques and Tau tangles in the brain. Both are hallmarks of Alzheimer’s disease. Nilotinib appears to penetrate the blood-brain barrier and turn on the “garbage disposal” machinery inside neurons (a process known as autophagy) to clear the Tau, Abeta and other toxic proteins.

“In a 2015 proof of concept study at Georgetown, patients with Parkinson’s disease or dementia with Lewy bodies were treated with nilotinib. As my colleagues reported, those who completed the study had a reversal in disease progression, observed both clinically and in key biomarkers—the same biomarkers seen in Alzheimer’s,” explains Scott Turner, MD, PhD, medical co-director of the TNP, who will serve as principal investigator for the study. “But even before the Parkinson’s study, research in the laboratory strongly supported studying this drug in people with Alzheimer’s. The promising results of the Parkinson’s study give an even stronger rationale.”

“When used in higher doses for chronic myelogenous leukemia (CML), nilotinib forces cancer cells into autophagy or cell death. The dose used in CML treatment is significantly higher than what we will use in our Alzheimer’s study,” says Charbel Moussa, MB, PhD, scientific and clinical research director for the Translational Neurotherapeutics Program. “When used in smaller doses once a day, as in this study, it appears nilotinib turns on autophagy for about four to eight hours—long enough to clean out the cells without causing cell death. Toxic proteins that build up again then appear to be cleared when the drug is given again the next day.”

Moussa conducted the preclinical research that led to the discovery of nilotinib for the potential treatment of neurodegenerative diseases.

Moussa is an inventor on a US patent owned by Georgetown University and on other pending US and foreign patent applications for use of nilotinib and other tyrosine kinase inhibitors for the treatment of neurodegenerative diseases.

The Alzheimer's Drug Discovery Foundation is supporting this clinical trial through a $2.1 million grant to Turner.  The study has also received private philanthropic support.

Turner conducts additional clinical research supported by funding to Georgetown University from Lilly, Biogen, Merck, Acadia, and Toyama as well as the National Institutes of Health and Department of Defense.

To learn more about this clinical trial, please click here.  To learn about other Alzheimer’s clinical studies, please visit the Georgetown Memory Disorders Program website.


Meet Dr. Turner

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Marianne Worley
Director of Media Relations
Office: 703-558-1287
Pager: 202-405-2824
[email protected]

Transplant Patient Starts off New Year with a Better Night’s Sleep and Gratitude for NPR Listeners after National Broadcast

Creasey being interviewedMedStar Georgetown kidney transplant recipient Constance Creasey learned about the kindness of strangers after a national radio broadcast featured her story, along with an interview with Dr. Matthew Cooper, MD, medical director of the Kidney Pancreas Transplant program at the MedStar Georgetown Transplant Institute.

NPR national medical correspondent Richard Harris compiled a story about Medicare coverage of anti-rejection drugs that expires after three years, but continues to pay for dialysis and even a new transplant. Dr. Cooper commented that this is a policy he believes needs to change.

To add patient perspective NPR interviewed Creasey, age 60 of Washington, D.C. who mentioned that sleeping on a bed is a luxury she can’t afford because she has to save money for her anti-rejection medications. When NPR’s Morning Edition  listeners heard the story on December 22, many wanted to donate and began to contact NPR and MGUH Media Relations to find out how.

A woman from Virginia bought Creasey a bed right after the holidays, while donated gift cards from all over the country provided her with sheets and blankets. Another woman from Illinois started a funding page for Creasey; some listeners donated to the MGTI's patient assistance fund that helps patients like Creasey in similar situations.  

“I was overwhelmed and in total disbelief,” said Creasey. “I didn’t feel like I deserved it.  I was just trying to bring awareness to this issue for other people like myself.” 

Creasey spent 11 years on dialysis after her kidney failed and received a transplant in 2015. Thankfully, the surgery was a success. However, to prevent rejection, Creasey will have to take medication for the rest of her life. She is becoming increasingly concerned about how she is going to pay for her medication after Medicare stops covering the costs in 2018. 

Creasey has been “truly grateful” for what people have given her since the story on NPR. She is enjoying her brand new bed, headboard and frame with sheets, a comforter and some curtains. She is happy to finally make her room a little more like home.  Creaseys says she can now turn her heat down because sleeping on the floor was cold.

“I’m starting off my new year with more faith in people. This experience has touched my heart and I can’t thank everyone enough, “Creasey said.

-Shannon McCarthy

Media Contact

Marianne Worley
Director of Media Relations
Office: 703-558-1287
Pager: 202-405-2824
[email protected]