C olumbia and Weill Cornell researchers atNewYork-Presbyterian Hospital are settingthe pace for innovations in the treatment

of prostate cancer, focusing on targeted genetherapy and anti-angiogenesis therapy. “Today,treatment for prostate cancer is moving moretoward targeted therapy,” said David Nanus,MD. “Radioactive monoclonal antibodyJ591, for example, recognizes prostate- spe-cific membrane antigen (PSMA), a highlyrestricted protein expressed on prostate cancercells. PSMA expression increases in moreadvanced prostate cancer making it an ideal target for directed therapy.”

At NewYork-Presbyterian/Weill CornellMedical Center, patients are currently beingenrolled in clinical trials using J591.According to Dr. Nanus, promising results in Phase I and II studies have moved this agent forward. Current plans are to combineJ591 with chemotherapy to boost response. The study is being conducted under aDepartment of Defense Congressionally Directed Medical Research Program.

“Adenovirus-delivered gene therapy has also demonstrated substantial promise inpreclinical studies and could be a novel approach,” said Dr. Nanus. Preclinical resultspublished in Cancer Gene Therapy (2007;14:583-589) have shown its ability to “inhibitprostate cancer using gene transfer approaches in animal models,” he added. “There is

New Research inNon-HodgkinsLymphoma

A t NewYork-Presbyterian Hospital,the exceptional collaborationbetween researchers and clinicians

has moved the application of state-of-the-art therapies for non-Hodgkins lymphoma(NHL) from the bench to the bedside.

Investigators at the Herbert IrvingComprehensive Cancer Center (HICCC)of NewYork-Presbyterian Hospital/Columbia University Medical Center, forinstance, are involved in everything fromstudying the genetics of cancer to con-ducting multimodality trials. TheLymphoid Malignancy Program atHICCC, which also includes WeillCornell investigators at NewYork-Presbyterian Hospital, recently recruitedOwen O’Connor, MD, PhD, from theMemorial Sloan-Kettering Cancer Center,where he was Head of the Laboratory ofExperimental Therapeutics for Lympho-proliferative Malignancies.

Dr. O’Connor has a long history ofinnovations in the treatment of NHL,focusing on the biochemical and molecularactivities that mediate gene transcriptionand tumor growth and generating newtargets for treatment. Before coming toNewYork-Presbyterian/Columbia, Dr.O’Connor conducted studies of suberoy-lanilide hydroxamic acid (SAHA), whichis one of several histone deacetylaseinhibitors whose anticancer propertieshave attracted attention.

Since arriving at the Hospital, Dr.O’Connor has collaborated with RiccardoDalla Favera, MD, on work to match genetargets with available or developing thera-pies, focusing on identifying the genes

see NHL, page 7

ONCOLOGYN E W YO R K – P R E S B Y T E R I A N

Affiliated with COLUMBIA UNIVERSITY COLLEGE OF PHYSICIANS AND SURGEONS and WEILL CORNELL MEDICAL COLLEGE

Fall 2007

see Prostate, page 8

New Developments in Lymphoma Biology and TreatmentWeb CastOctober 17, 2007

Current Trends in GenitourinaryMalignancies: Third Annual ConferenceOctober 27, 2007

Advances in Colorectal Cancer TherapiesWebcast“Pure” laparoscopic versus “hand-assisted” laparoscopic surgery; new approaches to minimally invasive surgery.

For more information, visit: www.nypcancer.org

Lung Cancer

2 NewYork-Presbyterian Hospitalresearchers published a landmark

study showing that early detection of lungcancer can favorably change outcomes.

Colorectal Cancer

4 Exciting new treatments for colorectal cancer are improving patient outcomes.

Pediatric Wellness

5 The new wellness program at Morgan Stanley Children’s Hospital of

NewYork-Presbyterian/Columbia UniversityMedical Center.

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A histology of prostate cancer. Researchers atNewYork-Presbyterian Hospital are investigatingpromising new approaches to treatment, includinggene therapy and anti-angiogenesis therapy.

Prostate Studies Tout Gene, Anti-Angiogenesis Therapies

UPDATE

S

A landmark study in The NewEngland Journal of Medicine hasshown that early detection of

lung cancer can favorably change out-comes (2006;355:1763-1771). The study,a multinational collaboration publishedunder the auspices of the InternationalEarly Lung Cancer Action Program (I-ELCAP), was initiated by Weill Cornellinvestigators at NewYork-PresbyterianHospital under the direction of Claudia I.Henschke, MD, PhD, principal investiga-tor. Dr. Henschke also chaired the WritingCommittee of I-ELCAP; the other mem-bers were David Yankelevitz, MD,

Daniel Libby, MD, Mark Pasmantier,MD, James Smith, MD, and OlliMiettinen, MD, PhD. From the initiationof I-ELCAP, Columbia investigators ledby John Austin, MD, have been key collaborators.

“We had previously demonstrated thatscreening is effective for early detection oflung cancer. The importance of this studyis that it confirmed that early [lung can-cer] detection, which can lead to earlytreatment, markedly increases the likeli-hood of survival,” said Dr. Henschke.

The study, which employed low-dose,spiral computed tomography (CT) toidentify noncalcified nodules for biopsy,opens the door for further efforts toexpand lung cancer screening. In thestudy, 31,567 asymptomatic men andwomen were screened. Criteria includedage older than 40 years and having a riskfactor for lung cancer—most often a his-tory of cigarette smoking, but also occu-pational exposure to such carcinogenic

substances as asbestos and radon, orexposure to secondhand smoke. Althoughthese risk factors were the focus of I-ELCAP, they may not be the only onesused for screening now that there is evi-dence that screening can improve out-comes. New research protocols are beingdesigned to look at a variety of otherpopulations, such as a population offlight attendants who never smoked butwho had previous occupational exposureto cigarette smoke.

“One of the important questions toaddress in future studies is how frequent-ly to screen patients in the highest risk

groups in order to identify lung cancer atits earliest stages,” Dr. Henschke said.Although cost-efficacy will have to becalculated according to risk status, cur-rent screening protocols have already beenshown to be cost effective in high-risk

groups, she said.“This is clearly a critical avenue for

research,” said Dr. Austin. He noted thatNewYork-Presbyterian Hospital/Columbia University Medical Centerentered more than 500 patients into theI-ELCAP study, and results in this sub-population mirrored the overall results.He agreed that the new data very muchweaken the arguments of the skepticsabout the importance of early detectionfor improving outcomes. “We also havevery sophisticated treatment protocolsand are involved in trials of several differ-ent modalities in lung cancer, but thebest results are going to be achieved inthose who are diagnosed at the earliestpossible stage,” Dr. Austin said.

The evidence that screening can detectsmall lesions in the lung has opened up arange of research involving the collabora-tion of several innovators in radiology.Not least among these is Dr. Yankelevitz,who also served on the WritingCommittee of I-ELCAP and has led

or contributed to a number of studiesdesigned to identify prognostic factors at the time of detection, including early detection.

In current or former smokers aged 60years or older, the baseline detection rate

Lung Cancer: Do Early Screening,Treatment Yield Better Outcomes?

ONCOLOGYN E W Y O R K – P R E S B Y T E R I A N

“One of the important questions to address in future studies is how frequently to screen

patients in the highest risk groups in order to identify lung cancer at its earliest stages.”

—Claudia I. Henschke, MD, PhD

A CT scan of the lung. NewYork-Presbyterian Hospital researchers are investigating the efficacy of low-dose CT inlung cancer screening.

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2 www.nypcancer.org

NewYork-Presbyterian Oncology is a publication of the Cancer Centers of NewYork-Presbyterian Hospital. The Cancer Centers are at the forefront ofcancer screening and diagnosis, basic science, and clinical research. The Cancer Centers serve more than 6,500 newcancer patients each year, who receive state-of-the-art multidisciplinary care. The Cancer Centers include the NCI-designated Herbert Irving Comprehensive Cancer Center at NewYork-Presbyterian Hospital/Columbia UniversityMedical Center and the Weill Cornell Cancer Center at NewYork-Presbyterian Hospital/Weill Cornell Medical Center,which are respectively comprised of faculty from the Columbia University College of Physicians and Surgeons andthe Weill Cornell Medical College.

NewYork-Presbyterian Oncology Editorial BoardNasser Altorki, MD Division Chief, Thoracic Surgery

NewYork-Presbyterian/Weill CornellDavid B. Skinner Professor of Thoracic Surgery

Weill Cornell Medical College nkaltork@med.cornell.edu

Mitchell C. Benson, MD Urologist-in-Chief

NewYork-Presbyterian/Columbia Member

Herbert Irving Comprehensive Cancer CenterGeorge F. Cahill Professor and Chairman of Urology

Columbia University College of Physicians and Surgeonsmcb2@columbia.edu

Andrew J. Dannenberg, MD Co-Director, Cancer Prevention Program

NewYork-Presbyterian/Weill CornellHenry R. Erle, MD-Roberts Family Professor of Medicine

Weill Cornell Medical Collegeajdannen@med.cornell.edu

Edward P. Gelmann, MDChief, Division of Hematology/Oncology

NewYork-Presbyterian/Columbia Deputy Director for Clinical Research

Herbert Irving Comprehensive Cancer CenterClyde Wu Professor of Hematology/Oncology

Columbia University College of Physicians and Surgeons gelmanne@columbia.edu

Howard Kaufman, MD Chief, Division of Surgical Oncology

NewYork-Presbyterian/Columbia Member

Herbert Irving Comprehensive Cancer CenterEdwin C. and Anne K. Weiskopf Associate Professor of

Clinical Surgery Oncology Columbia University College of Physicians and Surgeons hlk2003@columbia.edu

John P. Leonard, MDClinical Director, Center for Lymphoma and MyelomaDirector, Hematology/Oncology Clinical Research Program

NewYork-Presbyterian/Weill CornellRichard T. Silver Distinguished Professor of Hematology and

Medical OncologyProfessor of Medicine

Weill Cornell Medical Collegejpleonar@med.cornell.edu

David M. Nanus, MDCo-Division Chief, Hematology and Medical Oncology

NewYork-Presbyterian/Weill CornellMark W. Pastmantier Professor of Hematology

and Oncology in MedicineProfessor of Medicine and Urology

Weill Cornell Medical Collegednanus@med.cornell.edu

Alfred Neugut, MD, PhDCo-Director, Cancer Prevention Programs

NewYork-Presbyterian/Columbia Associate Director for Population Sciences

Herbert Irving Comprehensive Cancer CenterMyron M. Studner Professor of Cancer Research

Columbia University College of Physicians and Surgeonsain1@columbia.edu

Dattatreyudu Nori, MD, FACRRadiation Oncologist-in-Chief, Department of

Radiation OncologyNewYork-Presbyterian/Weill Cornell

Professor of Clinical RadiologyWeill Cornell Medical College dnori@nyp.org

Alexander J. Swistel, MD Director, Weill Cornell Breast Center

NewYork-Presbyterian/Weill CornellAssociate Professor of Clinical Surgery

Weill Cornell Medical Collegeaswistel@med.cornell.edu

Michael Weiner, MD Chief, Pediatric Oncology

Herbert Irving Child and Adolescent Oncology Centerat Morgan Stanley Children’s Hospital of NewYork-Presbyterian/Columbia

Hettinger Professor of Clinical PediatricsColumbia University College of Physicians and Surgeons mw216@columbia.edu

NewYork-Presbyterian Hospital’sCancer Prevention Newsletter andWeb site offer information for professionals on the latest developments in the field of cancerprevention and screening. Visitwww.nypcancerprevention.org.

in the original Early Lung Cancer ActionProgram study was 2.7%. In compari-son, the baseline yield for breast cancerin women over the age of 40 who arescreened with mammography has been1% or less. Early detection is likely to beeven more important in lung cancer thanin breast cancer because mortality ishigher, reaching approximately 85%currently.

Low-dose CT scan can be provided forless than $300 per case. Because about15% of lung cancer cases in the UnitedStates occur in never-smokers, periodicscreening of all middle-aged or olderadults would be an optimal step in lungcancer prevention. However, researchersmust define populations in which screen-ing is both practical and cost-effective.

“The economic analyses will be impor-tant in determining appropriate use ofhealthcare dollars for lung cancer screen-ing. We are continuing to gather thedata to recommend rational choices,” Dr.Austin said.

Editor’s Note: The utility of spiral CTscreening for lung cancer is also the focus of arandomized clinical trial, the National LungScreening Trial, being conducted under theauspices of the National Cancer Institute. Formore information, please visit http://www.cancer.gov/nlst

John Austin, MD, is Director of ThoracicImaging at NewYork-PresbyterianHospital/Columbia University Medical Centerand is Professor of Radiology at ColumbiaUniversity College of Physicians andSurgeons. E-mail: jha3@columbia.edu.

Claudia I. Henschke, MD, PhD, isAttending Radiologist at NewYork-Presbyterian Hospital/Weill Cornell MedicalCenter and is Professor of Radiology inCardiothoracic Surgery at Weill CornellMedical College. E-mail: chensch@med.cornell.edu.

David F. Yankelevitz, MD, is AttendingRadiologist at NewYork-PresbyterianHospital/Weill Cornell Medical Center and isProfessor of Radiology in CardiothoracicSurgery at Weill Cornell Medical College. E-mail: dyankel@med.cornell.edu.

3

N ewYork-Presbyterian Hospitalhas taken a leadership role inclinical innovations that are

improving outcomes and lessening therisks of therapy in colorectal cancer.Radical resections, for example, arebeing replaced with several differenttypes of minimally invasive procedures.At the same time, some of the newertargeted medical therapies are dramati-cally building on the efficacy of conven-tional chemotherapy with very tolerableside effects.

“In colorectal cancer, we are now mov-ing to less radical surgical procedureswith adjuvant chemotherapies that pro-vide rates of cancer-free survival that areat least as good as those achieved previ-ously but with less trauma,” noted AlfredI. Neugut, MD, PhD.

Within the goal of reducing the mor-bidity of radical resections, among themost exciting developments has been theuse of a combination laparoscopy andcolonoscopy procedure to reach lesionsthat would be difficult to treat witheither alone. One of the key innovators ofthis approach, Jeffrey W. Milsom, MD,said that the combined approach becamepossible when he and his co-investigatorsintroduced insufflation with carbon diox-ide (CO2) to largely eliminate the disten-sion normally produced by colonoscopyusing room air.

“We found that we had a very highsuccess rate performing laparoscopy andcolonoscopy together, and this was verywell tolerated by the patients,” he noted.“This is an example of an importantfusion of technologies that permits lesionsto be treated from the inside of the bowelusing backup support from the peritonealcavity using minimally invasive or laparo-scopic techniques. For example, in apatient with a difficult polyp in the rightcolon that is unresectable by colonoscopy,laparoscopy can be employed to position

the lesion so that it can be removed bythe colonoscope. This provides the leastamount of trauma without loss of surgical precision.”

Initially, according to Dr. Milsom,there was concern that insufflation withCO2 could dangerously alter the acid-base balance of the body. However, pre-clinical studies and clinical studies havedemonstrated a very high level of safetyusing the combined technique. The onlydrawback is that it requires both anendoscopist and a laparoscopist.

“With this combined procedure, abowel resection is avoided and no morethan an overnight stay is required,” Dr.Milsom said. “Currently, this approachhas a limited application for benign orvery early malignant lesions, but this isonly the beginning. I believe that in thefuture, more difficult lesions, includingdifficult malignant lesions, will be treat-ed in this fashion.”

Laparoscopy has been widely incorpo-rated into colon cancer resections atmany centers, but the surgeons atNewYork-Presbyterian Hospital havesought to consider variations whenappropriate. One such variation has beenhand-assisted laparoscopy, which canhave numerous advantages whenemployed in the right patient.

“The hand-assisted approach requires alonger incision than most pure laparo-scopic operations,” explained Richard L.Whelan, MD. “However, we recognizedthat some patients undergoing laparo-scopy already receive incisions largeenough to insert a hand. In many cases, ahand can facilitate resection, includingmobilization of tissue, without greatlydetracting from the advantages of theminimally invasive approach.”

Some patients need large incisionsbecause they have large tumors thatrequire a significant abdominal wall inci-sion in order to remove the specimen.

Obesity is also an issue; obese patientsoften require longer fascial incisions topermit specimen extraction. In a reviewof obese patients from NewYork-Presbyterian/Columbia who underwentstraight laparoscopic resection, a substan-tial percentage had a final incisionbetween 7 cm and 11 cm long, which islarge enough to permit hand-assistedlaparoscopy. Very tall or muscularpatients are also likely to require largerincisions during minimally invasiveresection. Thus, in these 3 groups ofpatients, who together represent almost40% of all surgical candidates, theadvantages of hand-assisted laparoscopycan be obtained without substantiallyincreasing the abdominal wall traumawhen compared with straight laparoscop-ic methods.

“We look for patients in whom a largeincision would likely be needed and thenuse the hand-assisted approach from theoutset. We now have data to support thisapproach,” said Dr. Whelan, referring toa 5-center study that included investiga-tors at NewYork-Presbyterian Hospital.

Presented at a recent meeting of theAmerican Society of Colon and RectalSurgeons, the study randomized 97patients to laparoscopy alone or hand-assisted laparoscopy for left and totalcolectomy. For hand-assisted laparoscopycompared with laparoscopy alone, theaverage duration of the procedure was 33minutes shorter for left colectomy andalmost an hour less for total colectomy.There was no significant difference inrecovery time, amount of pain medica-tion required, or length of stay. The aver-age incision length was 6.1 cm forlaparoscopy alone but only 8.2 cm for thehand-assisted approach.

Combination Procedures ImproveOutcomes in Colorectal Cancer

ONCOLOGYN E W Y O R K – P R E S B Y T E R I A N

A diagram of laparoscopic colon resection.

see Colorectal, page 6

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Pediatric and medical oncologists atMorgan Stanley Children’s Hospitalof NewYork-Presbyterian/Columbia

University Medical Center have estab-lished the Center for Survivor Wellness, aprogram that provides health educationand support to pediatric, adolescent, andyoung adult cancer survivors—includingwomen diagnosed with breast cancerbefore age 40.

Located in the Herbert Irving Childand Adolescent Oncology Center atMorgan Stanley Children’s Hospital ofNewYork-Presbyterian/Columbia, it isone of the few cancer survivorship pro-

grams in the country that treats peoplein this age range, said Michael Weiner,MD. “These individuals often have dif-ferent psychological and social needs thando survivors in their 60s, 70s, and 80s,”he said.

The program includes medical andpediatric oncologists, nutritionists, exer-cise physiologists, social workers, psy-chologists, clinical coordinators, and fam-ily nurse practitioners who treat patientsacross different age ranges.

One of the goals of the program is tosummarize each patient’s medical historyand—based on past cancer treatmentssuch as chemotherapy, radiation therapy,or surgery—develop a risk assessment offuture complications, said JenniferLevine, MD.

For example, some patients will havedefinable late effects such as troubleswallowing caused by radiation treat-ments, deformities in extremities due tosurgery, or hypothyroidism resultingfrom radiation. Other patients who

receive these same therapies may notexperience any side effects.

The psychological effects of being asurvivor also vary, said Dr. Levine. Somechildren may feel the disease has madethem stronger, whereas others may fre-quently worry about a cancer recurrence.

Patients may also have to contend withissues specific to the type of cancer withwhich they were diagnosed and the treat-ment they received. Young women whohave survived treatments may be con-cerned about fertility and how the diseasemay impact their personal relationships.

Cancer survivors may also be dealingwith neuropsychologic late effects ofchemotherapy or radiation includinglearning disabilities, said Dr. Levine.Therapy is often needed to help patientscompensate for these deficits.

Many of the health effects fromchemotherapy that long-term cancer sur-vivors face are issues that also affectyoung adult survivors of either pediatricor adult cancers, said Dawn Hershman,MD. “We have been studying the predic-tors of late effects and symptom manage-ment in adult survivors, and realize thatpediatricians are dealing with the sameproblems, such as early osteoporosis, cog-nitive changes, weight gain, infertility,and chronic pain,” she explained.

Increasing the patient’s awarenessabout these potential long-term treat-ment risks is crucial to developing a tai-lored comprehensive wellness plan, saidDr. Levine. A key part of patient educa-tion is helping survivors understand howto stay physically healthy by eating welland exercising, as well as attending toany psychological issues that may arisefrom their diagnosis and treatment, saidDr. Levine. “We’re looking at the wholeperson,” she said.

Part of looking at the whole person iscombining traditional treatment withhomeopathic care, said Dr. Weiner. TheNewYork-Presbyterian Hospital sur-vivorship and wellness program followsthe March 2006 Children’s OncologyGroup recommendations (available atwww.survivorshipguidelines.org), but italso encompasses the Hospital’s integra-

tive therapies initiative, which is usingand evaluating complementary and alter-native medicine in survivors.

Although attending to overall recoveryissues is critical, so is navigating theoften complex system of medical insur-ance, said Dr. Levine. Social workers areon staff to help patients learn aboutaccessing medical insurance throughoutthe course of their care. If they werediagnosed with cancer as children, theyeventually become ineligible for coverageunder their parents’ insurance because oftheir age or once they graduate from col-lege, she said.

Another goal of the program is to helppatients with job placement and educa-tion. For example, the survivorship ini-tiative is launching an internship pro-gram this summer with CBS radio togive cancer survivors an opportunity inmedia. Physicians will also be assessinghow patients can pursue exercise andincrease their access to healthy foods inthe program’s area neighborhoods innorthern Manhattan. “These services arenot as accessible near the Hospital as inother areas of the city,” said Dr. Levine.

Research is another important compo-nent of the program. “By combiningefforts, we will be able to build a world-class clinical and survivorship researchcenter,” said Dr. Hershman.

Researchers have already begun usingsurveys to assess the needs of the pro-gram’s diverse survivorship population.“We have found striking differences inthe issues faced by members of ourHispanic community compared to otherethnic subgroups,” said Dr. Hershman.

By understanding these differences,physicians can better intervene, sheadded. For example, the program isworking with a multidisciplinary team todevelop interventions to reduce short-and long-term side effects, to understandissues faced by survivors, and to evaluateprograms that improve their understand-ing, health behavior, and quality of life.

In addition to the current initiatives, afuture program goal is to specifically tar-get the newly diagnosed teenage andyoung adult population, said Dr. Weiner.This population may be too old for pedi-atric oncology and may feel out of placeseeing a physician who primarily treats

see Wellness, page 6

Cancer survivors tour Yankee Stadium as part of the Center forSurvivor Wellness, a program that provides health education andsupport to pediatric, adolescent, and young adult cancer survivors.

Oncologists Create Wellness ProgramFor Young Cancer Survivors

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“The hand-assisted approach is con-traindicated for small or low BMIpatients because the hand incision repre-sents a much larger percentage of theirabdominal wall and the larger incision isusually not required for specimen extrac-tion,” noted Dr. Whelan. “We believehand-assisted methods are very usefulwhen employed selectively.”

In adjuvant therapies, there have alsobeen significant developments. Whileseveral combination chemotherapy regi-mens, such as FOLFOX (5-fluorouracil,leucovorin, and oxaliplatin) and FOLFIRI(5-FU), leucovorin, and irinotecan arenow widely employed to extend survivalin advanced colorectal cancer, recent

excitement has been generated by themonoclonal antibodies, such as beva-cizumab, which inhibits vascular endo-thelial growth factor (VEGF) and isalready a standard as first-line treatmentfor stage IV disease. This and other mon-oclonal antibodies, particularly cetux-imab, an inhibitor of the epidermalgrowth factor receptor (EGFR), are nowbeing tested in the adjuvant setting.Investigators recently tested bevacizumaband cetuximab in combination for stageIV colorectal cancer.

“We recently presented a Phase IIpaper that we conducted with the NewYork Cancer Consortium. We treatedalmost 70 patients with the FOLFOXregimen in combination with beva-cizumab and cetuximab and observed anexcellent response rate with acceptabletoxicity,” said Joseph T. Ruggiero, MD.“This double antibody approach in com-bination with chemotherapy is goinginto more advanced testing and may rep-resent an important direction for futuremanagement.”

“Evaluating FOLFOX with and with-out bevacizumab will answer one of themost pressing questions about optimaladjuvant therapy,” added Dr. Neugut.

“It is an exciting chapter for patientsfrom the surgical side as well,” added Dr.Milsom. “Now more than ever we havetreatment options we can offer patientsand with much, much safer outcomes.”

Editor’s Note: All of the physicians fea-tured in the article participated in the“Advances in Colorectal Cancer Therapies”web cast on June 20, 2007. The web cast canbe accessed at: www.nypcancer.org.

Jeffrey W. Milsom, MD, is Chief, Section ofColorectal Surgery at NewYork-PresbyterianHospital/Weill Cornell Medical Center, and isProfessor of Surgery, Colon and RectalSurgery Section at Weill Cornell MedicalCollege. Email: jwm2001@med.cornell.edu.

Alfred I. Neugut, MD, PhD, is Co-Director, Cancer Prevention Programs atNewYork-Presbyterian Hospital/ColumbiaUniversity Medical Center and AssociateDirector, Population Sciences, Herbert IrvingComprehensive Cancer Center at NewYork-Presbyterian/Columbia, and is Myron M.Studner Professor of Cancer Research,Columbia University College of Physiciansand Surgeons and Mailman School of PublicHealth. E-mail: ain1@columbia.edu.

Joseph T. Ruggiero, MD, is AssociateAttending Physician, Department ofHematology/Oncology at NewYork-Presbyterian Hospital/Weill Cornell MedicalCenter, and is Associate Professor of ClinicalMedicine at Weill Cornell Medical College. E-mail: jtruggie@med.cornell.edu.

Richard L. Whelan, MD, is Chief, Section ofColon and Rectal Surgery, Herbert IrvingComprehensive Cancer Center at NewYork-Presbyterian Hospital/Columbia UniversityMedical Center, and is Associate Professor ofSurgery at Columbia University College ofPhysicians and Surgeons. E-mail: rlw3@columbia.edu.

Colorectalcontinued from page 4

“It’s an exciting chapter

on the surgical side...

Now more than ever we

have treatment options

we can offer patients

and with much, much

safer outcomes.”

—Jeffrey W. Milsom, MD

older adults, he explained. This is why hehopes to add initiatives to the model ofthe wellness program that directlyaddress this population’s needs.

Addressing the specific needs of sur-vivors is the program’s overall goal.

Dawn Hershman, MD, is Co-Director of theCenter for Survivor Wellness in the Herbert

Irving Child and Adolescent Oncology Centerat Morgan Stanley Children’s Hospital ofNewYork-Presbyterian/Columbia UniversityMedical Center and is Florence IrvingAssistant Professor of Medicine andEpidemiology in the Department of MedicalOncology at Columbia University College ofPhysicians and Surgeons. E-mail: dlh23@columbia.edu.

Jennifer Levine, MD, is Medical Director ofthe Center for Survivor Wellness in theHerbert Irving Child and AdolescentOncology Center at Morgan StanleyChildren’s Hospital of NewYork-

Presbyterian/Columbia University MedicalCenter and is Assistant Professor of PediatricOncology at Columbia University College ofPhysicians and Surgeons. E-mail: jl2381@columbia.edu.

Michael Weiner, MD, is Chief of PediatricOncology at the Herbert Irving Child andAdolescent Oncology Center at MorganStanley Children’s Hospital of NewYork-Presbyterian/Columbia University MedicalCenter and is Hettinger Professor of ClinicalPediatrics at Columbia University College ofPhysicians and Surgeons. E-mail: mw216@columbia.edu.

Wellnesscontinued from page 5

ONCOLOGYN E W Y O R K – P R E S B Y T E R I A N

6 www.nypcancer.org

involved in the development of human Bcell lymphoma, a subtype of NHL.Ongoing studies are seeking to determinethe role of chromosomal translocationsinvolving the c-Myc proto-oncogene locusand immunoglobulin loci in the develop-ment of Burkitt’s lymphoma as well as theidentification of novel oncogenes andtumor suppressors involved in the patho-genesis of lymphoma. Finally, the col-leagues are also studying the pathologicfunction of the BCL-6 gene, a recentlyidentified proto-oncogene that codes for atranscription factor expressed in B cellsand is altered in its regulatory region in asignificant number of lymphoma patients.

“The goal is to treat the problem at theroot rather than trying to trim the leaves,which is what we do with conventionalchemotherapy,” explained Dr. O’Connor,who also works closely with John GregoryMears, MD, and Morton Coleman, MD(the latter is an investigator at WeillCornell Cancer Center).

Studies at the Weill Cornell CancerCenter of NewYork-PresbyterianHospital, meanwhile, have looked at theoptimization of currently available mono-clonal antibodies (the Hospital is a world-wide leader in this area) through theaddition of cytokines and interleukin-2 aswell as the study of new monoclonal anti-bodies such as epratuzumab, anti-CD74,and anti-CD80. Researchers at NewYork-Presbyterian/Weill Cornell, under thedirection of John P. Leonard, MD, areleading trials with a number of mono-clonal antibodies—including rituximaband tositumomab—that have sincereceived FDA approval.

According to Dr. Leonard, much of thecurrent research work is also focused oncancer growth and proliferation. A majortranslational project led by Jia Ruan, MD,PhD, which is evaluating strategies to

inhibit angiogenesis and starve lym-phomas of their blood supply, has movedinto the clinical arena. Dr. Leonard andhis team have also studied the use of acustomized vaccine developed from thelymphoma cells of individual patients.

“The studies of angiogenesis have led toan ongoing clinical trial of a novel combi-nation of low-dose oral chemotherapywith new biologic therapy,” Dr. Leonardexplained. “Laboratory-based collabora-tions and clinical correlations performedwith Amy Chadburn, MD, and otherhematopathologists allow us to better tar-get treatments to patients who are mostlikely to benefit. These efforts also mayallow other patients to be spared unneces-sary toxicity.”

Studies of molecular profiling are underway so that therapies can be more appro-priately selected based on the molecularand metabolic aspects of the tumor cellbiology in individual patients. Accordingto Drs. Leonard and O’Connor, work byDr. Coleman, Dr. Stanley Goldsmith, andother colleagues has been presented in avariety of international forums. In addi-tion, the Hospital has hosted a key confer-ence on NHL, other lymphomas, andmultiple myeloma. “The Lymphoma andMyeloma 2006 meeting was held in thefall and drew nearly 800 internationalparticipants, including most of the keyleaders in this area,” noted Dr. Leonard,who was one of the co-chairs.

As important contributors to some ofthe most groundbreaking collaborativegroups working in NHL, such as theCancer and Leukemia Group B and theNew York Cancer Consortium, Dr.Leonard and his colleagues, among them

Richard Furman, MD, have received fund-ing from a broad spectrum of public andprivate organizations, including theNational Cancer Institute, the Leukemiaand Lymphoma Society, the LymphomaResearch Foundation, and the LymphomaFoundation. “We have focused on theunmet needs of these patients, largelythrough the development of more effectiveand less toxic therapies, but other effortshave been directed toward better isolatingprognostic variables in order to identifywhich patients are likely to have more orless favorable outcomes and to targettreatment accordingly,” said Dr. Leonard.

“We are looking at new paradigms oftreatment,” added Dr. O’Connor. “Theremay be no program anywhere that canoffer more options for treatment, and weexpect these advances to be reflected inbetter outcomes.”

Editor’s Note: Drs. Leonard and O’Connorwill be hosting a web cast entitled, “NewDevelopments in Lymphoma Biology andTreatment,” on October 17, 2007. For moreinformation, visit www.nypcancer.org.

John P. Leonard, MD, is Clinical Director, Center for Lymphoma and Myeloma, andDirector, Hematology/Oncology ClinicalResearch Program at NewYork-PresbyterianHospital/Weill Cornell Medical Center, and isRichard T. Silver Distinguished Professor ofHematology and Medical Oncology, andProfessor of Medicine at Weill CornellMedical College. E-mail: jpleonar@med.cornell.edu.

Owen O’Connor, MD, PhD, is Director ofthe Lymphoid Development and MalignancyProgram and Chief of the Lymphoma Serviceat the Herbert Irving Comprehensive CancerCenter at NewYork-Presbyterian Hospital/Columbia University Medical Center, and isDirector of the Lymphoid Development andMalignancy Program in the HICCC and Chiefof the Lymphoma Service at NewYork-Presbyterian/Columbia, and is AssociateProfessor of Medicine at Columbia UniversityCollege of Physicians and Surgeons. E-mail: oo2130@columbia.edu.

NHLcontinued from page 1

“Laboratory-based collaborations and clinical correlations

allow us to better target treatments to patients who are

most likely to benefit.”—John P. Leonard, MD

“There may be no program anywhere that can offer more

options for treatment, and we expect these advances to

be reflected in better outcomes.”

—Owen O’Connor, MD, PhD

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an urgent need for better treatments inadvanced disease, and we have been veryencouraged by the progress in under-standing molecular and genetic targets.”

Edward Gelmann, MD, who recentlyjoined NewYork-Presbyterian/ColumbiaUniversity Medical Center, also has astrong interest in prostate cancer research.In a recent publication, he reported onthe prostate-specific homeodomain pro-tein NKX3.1, a tumor suppressor that iscommonly downregulated in prostatecancer in humans.

Study results revealed that NKX3.1can modify the activity of the DNA-resolving enzyme topoisomerase I,which may have implications for organ-specific DNA replication, transcription,or repair (Cancer Res 2007;67:455-467).

In addition, in a study published inthe Journal of Biological Chemistry(2005;280:37853-37867), Dr. Gelmannand Liang-Nian Song, MD, proposedthat the multifunctional oncoprotein β-catenin “may play an integral role information of the androgen-receptor transcriptional complex.”

At NewYork-Presbyterian/Columbia,Dr. Gelmann will be able to work with other leaders in the field, such as Daniel Petrylak, MD, who has conductedseveral studies directed at improving out-comes in hormone-refractory prostate can-cer. “We have been looking at first- and

second-line treatments for hormone-refrac-tory prostate cancer,” said Dr. Petrylak.

Dr. Petrylak led 1 of the 2 pivotaltrials supporting the FDA approval ofdocetaxel in hormone-refractory prostatecancer and was a principal investigatorin a study evaluating the efficacy oftreatment with satraplatin, a novel oralplatinum compound, in patients whosecancer has progressed after docetaxeltreatment. The open-ended Phase Istudy is actively recruiting patients, and Dr. Petrylak hopes to have results at the end of 2008.

“An NDA for this drug has been filedwith the FDA,” Dr. Petrylak reported.If the FDA approves satraplatin, he willbe directly involved in the approval of 2 drugs for this disease.

Columbia researchers at NewYork-Presbyterian Hospital are also lookingat other ways to block the angiogenesispathways by combining different anti-angiogenesis agents. Dr. Petrylak andcolleagues are currently investigatingthe use of lenalidomide and the com-bined use of bevacizumab and erlotinib;preliminary results look promising.Currently, he is collaborating withCarlos Cardon-Cardo, MD, who wasrecently recruited to NewYork-Presby-terian/Columbia. “We need to find themarkers of resistance and progression,and why particular patients respond theway they do to certain medications,”said Dr. Petrylak.

Editor’s Note: Drs. Nanus and Petrylakwill be co-chairs of the “Current Trends inGenitourinary Malignancies” symposium tobe held on October 27, 2007. For moreinformation, please visit www.nypcancer.org.

Edward P. Gelmann, MD, is Chief,Division of Hematology/Oncology atNewYork-Presbyterian Hospital/ColumbiaUniversity Medical Center, Deputy Directorfor Clinical Research, Herbert IrvingComprehensive Cancer Center, and is Clyde Wu Professor of Hematology/Oncology at Columbia University College of Physicians and Surgeons. E-mail: gelmanne@columbia.edu.

David M. Nanus, MD, is Co-Division Chiefof Hematology/Oncology, Medical Director,Genitourinary Oncology Program, NewYork-Presbyterian Hospital/Weill Cornell MedicalCenter, and is Mark W. Pastmantier Professorof Hematology and Oncology in Medicine,and Professor of Medicine and Urology atWeill Cornell Medical College. E-mail: dnanus@med.cornell.edu.

Daniel P. Petrylak, MD, is AssociateAttending Physician in Oncology, HerbertIrving Comprehensive Cancer Center atNewYork-Presbyterian Hospital/ColumbiaUniversity Medical Center, and is AssociateProfessor of Medicine at Columbia UniversityCollege of Physicians and Surgeons. E-mail:dpp5@columbia.edu.

Prostatecontinued from page 1