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    Science Report ADVANCES IN CANCER RESEARCH


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    Created by Huntsman Cancer Institute’s Office of Communications ©2016 www.huntsmancancer.org


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    OUR TIME BEGAN with an empty lot and a dream full of promise, determination, and audacity. A dream to do the impossible. Achieve the unachievable. Defeat the undefeatable. AS JON M. HUNTSMAN SAYS, Cancer moves fast. And we have to move faster.”


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    VICE PRESIDENT JOE BIDEN VISITED HCI FEBRUARY 26, 2016, AS A PART OF THE WHITE HOUSE'S CANCER MOONSHOT INITIATIVE. HE TOURED THE FACILITY AND PARTICIPATED IN A ROUNDTABLE DISCUSSION WITH HUNTSMAN CANCER FOUNDATION BOARD CHAIR GOVERNOR JON M. HUNTSMAN; HCI CEO AND DIRECTOR MARY BECKERLE, PhD; SENATOR ORRIN HATCH; UNIVERSITY OF UTAH HEALTH CARE CEO AND SENIOR VICE PRESIDENT FOR HEALTH SCIENCES, VIVIAN LEE, MD, PhD, MBA; AND LOCAL CANCER SURVIVORS AS WELL AS CANCER PHYSICIANS AND RESEARCHERS.


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    THE UNIVERSITY OF UTAH AND HCI HONORED THE HUNTSMAN FAMILY AND CELEBRATED NATIONAL CANCER INSTITUTE COMPREHENSIVE DESIGNATION AT AN EVENT HELD JULY 9, 2015. JUNE 2016 control,” Vice President Joe Biden, came to HCI to learn about how our unique resources can be applied Exceptional. on a national scale to accelerate cancer research and save lives. HCI has shown how exceptional assets At Huntsman Cancer Institute (HCI), it’s more than a like the Utah Population Database—the largest of its word. It’s the standard to which we hold every aspect kind in the world that combines family histories with of our organization. medical records—can be used to find some cancers at their earliest, most treatable stages, and sometimes Exceptional means a willingness to take a critical look stop cancer from ever occurring using precision at your work and honestly ask if your contributions prevention. The Vice President heard about how HCI make a difference in the lives of cancer patients and works to eradicate cancer disparities across the vast their families. Exceptional requires bold vision, a Mountain West, and how we work on innovative willingness to take risks, and nimble recalibration cancer care approaches to improve treatments for when things aren’t working as planned. It means people with cancer and their caregivers. patient satisfaction ratings in the 99th percentile nationwide. It means novel research published in Some say curing cancer is impossible. Being prestigious, peer-reviewed journals and supported exceptional means knowing that nothing is impossible. by the best funding agencies. It means the most I am inspired by the words of our founder, Jon innovative clinical trials for our patients. M. Huntsman: “I have always viewed hurdles and challenges as opportunities to move ahead.” Exceptional is the standard we set for ourselves. HCI’s world-class, state-of-the-art cancer research programs The bar could not be higher. The challenge could not were awarded status as a National Cancer Institute be greater. We all must be committed to exceptional Comprehensive Cancer Center in 2015. The highest if we are to launch this “cancer moonshot”—one of designation possible, our peers include distinguished the greatest challenges ever known. Nothing less than institutions such as MD Anderson Cancer Center, exceptional is acceptable as we move ahead. Memorial Sloan-Kettering Cancer Center, and Dana- Sincerely yours, Farber Cancer Institute of Harvard University. And 2016 may be the start of our most exceptional achievements yet. After President Obama announced his Cancer Moonshot Initiative during the 2016 State CEO AND DIRECTOR of the Union, the man he put in charge of “mission HUNTSMAN CANCER INSTITUTE


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    EACH YEAR, researchers at Huntsman Cancer Institute (HCI) make discoveries—large and small—that enhance our understanding of how and why cancer develops, as well as its long-term effects on health and well-being. N. JEWEL SAMADDER, MD, MSc CORNELIA ULRICH, PhD, MS HCI INVESTIGATOR HCI SENIOR DIRECTOR OF POPULATION SCIENCES; PROFESSOR OF ASSISTANT PROFESSOR OF MEDICINE, UNIVERSITY OF UTAH POPULATION HEALTH SCIENCES, UNIVERSITY OF UTAH; JON AND KAREN HUNTSMAN PRESIDENTIAL PROFESSOR IN CANCER RESEARCH When Cancers of Unknown Origin Strike, New Understanding of Aspirin's Role in Family Members Are at Increased Risk Cancer Prevention Cancer usually begins in one place and spreads, An HCI study adds to the evidence that aspirin can but in patients with cancers of unknown primary prevent some cancers and points to a new biological (CUP) origin, the starting point is unclear. pathway that deserves further investigation. Aspirin “This means we are not able to select a type of decreases the risk of colorectal, and possibly chemotherapy or radiotherapy that the cancer other, cancers. However, better understanding of would respond to best,” says HCI investigator how it works is essential before recommending it Jewel Samadder, MD, MSc. He led a study generally as a means to prevent cancer. In a study published in the Journal of the American Medical published in the journal Cancer Epidemiology, Association Oncology that found family members Biomarkers, and Prevention, Cornelia Ulrich, PhD, of patients with CUP origin have a higher risk of MS, Senior Director of Population Sciences at HCI, also developing unnamed cancers. Their risk for and her collaborators used a new technique called cancers of the lung, pancreas, colon, and some metabolite profiling. Their study shows aspirin blood cancers is also higher. “Knowing this opens substantially decreases the level of a chemical up a new way of looking at the biology of cancers considered a driver of cancer development. Ulrich of unknown primary,” Samadder says. “We need to says, “It is really exciting that aspirin, which can research whether chemotherapy should be tailored work in colorectal cancer prevention, is now linked to one of these sites.” to a new pathway that has shown to be relevant for cancer formation.”


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    These stories highlight only a handful of the promising research underway at HCI. ANNE KIRCHHOFF, PhD, MPH DON AYER, PhD HCI INVESTIGATOR HCI INVESTIGATOR ASSISTANT PROFESSOR OF PEDIATRICS, UNIVERSITY OF UTAH PROFESSOR OF ONCOLOGICAL SCIENCES, UNIVERSITY OF UTAH New Strategies to Support Survivors of Tracking Sugar to Determine a Childhood Cancers Woman’s Breast Cancer Risk Today, more than 80% of children with cancer Triple-negative breast cancers are often more survive to become adults. However, many face aggressive with fewer treatment options than other health-related challenges and medical issues that types of breast cancer. Many cancer cells, including keep them from working. A study led by Anne triple-negative cells, are addicted to the sugar glucose Kirchhoff, PhD, MPH, an HCI investigator, and the amino acid glutamine. “You could imagine shows childhood cancer survivors are more than that cells addicted to these nutrients could be starved five times as likely to enroll in federal disability and killed more easily than normal cells,” says assistance compared to people without a cancer senior author Don Ayer, PhD, an HCI investigator. history. “The long-term impact of cancer can Two proteins called Myc and TXNIP usually work affect other issues besides health outcomes,” says together to keep glucose use and cell growth in Kirchhoff. “There’s a growing strategy to support balance. In triple-negative breast cancer, Ayer and his survivors in the long term.” HCI’s Pediatric Cancer collaborators found an abnormal interaction between Late-Effects Clinic is one example. This clinic the two proteins significantly increases glucose use provides adult survivors of childhood cancers with and cell growth. These proteins also appear to play a health management resources, including access to role in the spread of cancer to other parts of the body. providers. The study was published in the Journal Ayer says if the result is validated in clinical trials, of the National Cancer Institute. then this Myc/TXNIP signature could identify women at high risk for cancer recurrence. The study appeared in Proceedings of the National Academy of Sciences.


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    JOSHUA SCHIFFMAN, MD NICOLA CAMP, PhD HCI INVESTIGATOR HCI INVESTIGATOR PROFESSOR OF PEDIATRICS, UNIVERSITY OF UTAH PROFESSOR OF MEDICINE, UNIVERSITY OF UTAH EDWARD B. CLARK, MD, ENDOWED CHAIR IN PEDIATRICS Looking for Grand-Scale Answers to Improving Outcomes for Myeloma Cancer Questions Patients Who Face Grim Odds Elephants have 100 times as many cells as people. It’s a sobering statistic: an average of 43% of It seems they would be 100 times more likely to multiple myeloma patients die within five years get cancer over their long life span of 50 to 70 of diagnosis. What’s more, a recent study found years. Yet, elephants rarely get cancer. A study multiple myeloma patients with a variation in the led by researchers at HCI and Arizona State gene FOPNL die one to three years sooner. The University may have discovered why. Elephants largest study of inherited genetics and myeloma have dozens more copies of a gene that blocks survival to date, the collaboration included tumors than humans do. Elephants may also researchers from HCI and 17 other institutions. have a better way to kill damaged cells that could “We were able to identify the FOPNL variant become cancerous. “Nature has already figured because it has quite a large effect on survival. With out how to prevent cancer. It’s up to us to learn even larger collaborative studies, we hope to add how different animals tackle the problem so we to this,” says HCI investigator Nicola Camp, PhD. can adapt those strategies to prevent cancer in Published in Nature Communications, the results people,” says Joshua Schiffman, MD, an HCI are a step toward applying precision medicine to investigator and pediatric oncologist. He is co- this aggressive cancer that affects bone marrow senior author of the paper published in Journal cells involved in coordinating the body’s immune of the American Medical Association. response. Future studies will focus on finding therapies to improve prospects for this newly identified group of FOPNL patients.


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    CLOCKWISE FROM LEFT: NEERAJ AGARWAL, MD, HCI INVESTIGATOR, ASSOCIATE PROFESSOR OF MEDICINE, UNIVERSITY OF UTAH; LISA CANNON- ALBRIGHT, PhD, HCI INVESTIGATOR, PROFESSOR OF MEDICINE, UNIVERSITY OF UTAH; FREDERICK ALBRIGHT, PhD, RESEARCH ASSISTANT PROFESSOR OF PHARMACOTHERAPY; ROBERT STEPHENSON, MD, HCI INVESTIGATOR, PROFESSOR OF SURGERY, UNIVERSITY OF UTAH, JON M. HUNTSMAN PRESIDENTIAL ENDOWED CHAIR IN UROLOGIC ONCOLOGY Giving Family Prostate Cancer History the Third Degree A study led by HCI investigator Lisa Cannon-Albright, PhD, shows that whether a man’s uncles and great- grandparents had prostate cancer could be as important as whether his father had prostate cancer. Taking a more complete family history that includes these second- and third-degree relatives would give a better picture of a patient’s prostate cancer risk. “Typically, a clinician will ask a patient whether there are any people in the family with prostate cancer, possibly identifying whether they are first-degree relatives. And that’s about as far as it goes,” says Cannon-Albright. Her team, including Neeraj Agarwal, MD; Frederick Albright, PhD; and Robert Stephenson, MD, used information from the Utah Population Database to create individualized risk estimates for men based on prostate cancer history in their first-, second-, and third- degree relatives. Published in the journal Prostate, the study also showed family history of prostate cancer in maternal relatives is just as important. “Family history data is an economically sustainable, viable, powerful, and effective way to accurately estimate prostate cancer risk,” says Cannon-Albright.


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    By The Numbers 4new,000 1,200 A GIVEN DAY AT HCI 15 surgeries 70 inpatients cancers GENETIC COUNSELING PATIENT CARE 83 infusion treatments DIAGNOSED consultations provided 110 radiation therapy treatments 125,000 245 radiology procedures outpatient 354 outpatient visits visits hosted PERSONNEL RESEARCH 1,600 employees 450 183 volunteers completed 16,875 hours 200 CLINICAL TRIALS open at any given time CANCER RESEARCH PROJECTS of service in 2015 Provided cancer training to 350 students supported by scientific funding agencies EDUCATION AND OUTREACH >$93 millioninvested in 460 accepted papers HCI Cancer Learning Center served nearly research across the cancer center 14,000 individuals in 2015 through visits, 162 faculty research teams calls, and emails. investigating all aspects of cancer for publication in peer-reviewed scientific journals More than 73,000 individuals reached through community health events. MAJOR EXPANSION TO OPEN IN 2017 HCI manages the UTAH POPULATION DATABASE The Primary Children’s and Families’ - the largest genetic database in the world Cancer Research Center WITH MORE THAN 16 MILLION RECORDS linked to genealogies, health records, 220,000 sq. ft. expansion will and vital statistics. double HCI’s research capacity


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    Nothing is too hard, nothing is too far, and nothing that is impossible can’t be done.


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    www.huntsmancancer.org


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