Progress in the Conquest of Cancer

Thirty-five years ago, death rates were high for all types of cancer. The first major chemotherapeutic advances were just being tested. Combination therapies using radiation and surgery were being developed. And genes associated with increased risks of cancer had not yet been identified.

Thirty-five years ago, the USC/Norris Comprehensive Cancer Center became one of the first in the country to be designated by the National Cancer Institute as a comprehensive cancer center.

“Since that time, we have evolved as a leader in cancer research and treatment,” says Peter Jones, Ph.D., director of the USC/Norris Comprehensive Cancer Center.” We have made huge strides in understanding the epidemiology of hormonal cancers and in developing tailored therapies, the concept of epigenetic therapy and advanced surgical procedures. All of these represent substantive advances in the field of cancer.”

Carmen A. Puliafito, M.D., M.B.A., dean of the Keck School of Medicine of USC, calls the cancer center “one of the jewels in the Keck School of Medicine crown. As we focus attention on building our overall clinical enterprise, we want

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to enhance the ease of patient access to our cancer experts at Norris, as well as patient access to clinical trials, which offer innovative therapies not yet available in the community.”

USC Health asked six cancer experts from the Keck School of Medicine of USC and USC/Norris about current progress in the conquest of cancer.

Colorectal Cancer

Heinz-Josef Lenz, M.D., chair of the Gastrointestinal (GI) Oncology Program and co-director of the Colorectal Center, says, “Our program has established itself as one of the most cutting-edge clinical programs. We are one of the world leaders in pharmacogenetics, giving us an advantage in the development of new treatment strategies. Recently, we have begun our own drug development in collaboration with researchers from the Department of Pathology at the Keck School, the USC stem cell program and the USC School of Pharmacy.”

An oncologist and molecular biologist, Lenz focuses his laboratory on molecular changes in cancers to develop more effective treatment strategies for cancers of the colon, stomach, pancreas and liver. The GI Oncology Program is one of the largest in the country, with more than 10,000 patient visits per year.

“We work closely with basic scientists, colorectal surgeons, hepatobiliary surgeons, radiation oncologists, genetic counselors, dietitians and social workers,” Lenz says. “With the progress we have made, we are now able to cure patients with metastatic colon cancer, which is a dramatic change in the paradigm of cancer patients. We have effective therapies that allow significant shrinkage of the tumors and open the window for resection [surgical removal] and the chance of cure. Many of our patients who have been cured with our approach had been told they had only six months to live.” 

Bladder and Prostate

John P. Stein, M.D., professor of urology, has helped pioneer—with an excellent team of physicians—some of the surgical approaches and reconstructive options now available for patients who are faced with various urologic malignancies, particularly bladder and prostate cancer. This includes nerve-sparing techniques for men with prostate and bladder tumors that allow patients to maintain erectile function following surgery.

In addition, he has helped develop a reconstruction option called the “T-pouch neobladder,” which is connected to the urethra and allows both men and women the option of continence. These important surgical techniques ultimately improve the quality of life of those patients afflicted with certain urologic malignancies.

“I have personally been very passionate and academically active in promoting an aggressive surgical rationale and approach for both men and women faced with invasive bladder cancer who would benefit from removal of their bladder,” says Stein. “This work has involved clinical research and is intensely focused on clinical results and outcomes in these patients.

“It is important to help provide patients a similar quality of life following surgery. Reconstruction options, including nerve-sparing techniques and creations of neobladders with a portion of the patients’ intestine, help maintain the quality of life, and may also stimulate patients and even physicians to act earlier and more aggressively with removal of the bladder for cancer when the potential for cure is highest.”

Cancers of the Blood

Allen Yang, M.D., Ph.D., hematologist and assistant professor in the Department of Medicine, treats patients with cancers of the blood and studies cancer in the laboratory, bringing the latest and most advanced treatments to his patients. Almost all of his patients have either myelodysplastic syndrome (a group of diseases in which the production of blood cells by the bone marrow is disrupted) or leukemia.

“Three years ago there were no treatments for myelodysplastic syndrome, and now there are three Food and Drug Administration-approved drugs to treat this disease,” Yang says. “Two of these drugs are a new class of drugs called ‘epigenetic’ therapies that were developed at USC.”

“Epigenetics” is the study of how genes in our DNA are turned on and off.  In his laboratory, Yang is trying to develop a better understanding of how epigenetics goes wrong in cancer, and how epigenetic therapies can fix these aberrations.

Yang and his lab are applying some of the latest technologies available through the new USC Epigenome Center to study leukemia.  “We also have established a bank where we store leukemia samples from patients before and after treatment so we can study them in the laboratory,” he says. “Every sample we study was donated by a patient, has a story and represents someone fighting cancer."