Collaboration among Case Western Reserve University, Cleveland Clinic and University Hospitals earns high praise from expert reviewers
The Case Comprehensive Cancer Center (CCCC) again demonstrated the compelling power of partnership in securing an overall rating of “outstanding” and a five-year renewal of its grant from the National Cancer Institute (NCI).
Hosted at Case Western Reserve, the center is a collaboration among the university, Cleveland Clinic and University Hospitals Case Medical Center.
The center counts nearly 350 scientists and physicians among its members, and is one of just 41 nationwide to hold the NCI’s designation as a comprehensive cancer center. Such elite organizations must demonstrate not only the highest quality of basic and clinical research, but also engage across disciplines and actively educate the public regarding prevention and treatment breakthroughs.
The renewal comes with a recommendation the center receive more than $23 million during the course of the grant period.
“This grant renewal underscores the extraordinary value of cooperation among Northeast Ohio’s leading medical institutions and the university,” Case Western Reserve President Barbara R. Snyder said. “By combining our collective resources, we provide far greater opportunities to advance the fight against cancer and bring better answers to patients and their loved ones.”
The center has held NCI designation for the past 25 years and attained the highest recognition—comprehensive status—in 1998. Case Western Reserve and University Hospitals served as the center’s original founders, and the Cleveland Clinic joined the initiative in 2003.
As part of the most recent renewal process, the three organizations adopted a formal set of governance and operating principles, and also codified their shared commitment to the center’s sustained success. The agreement proved so pioneering that the national team of experts twice emphasized its significance within their assessment. In particular, the experts commended the “exceptional” institutional support from the participating institutions, as well as the partnership’s implications for the future.
“With the ‘Memorandum of Understanding’ (MOU) in hand, “ assessors wrote, “the Center is now much better positioned to take full advantage of the consortium partnership.”
All told, Cleveland Clinic and University Hospitals Seidman Cancer Center treat nearly 10,000 new cancer patients each year. The presence of the CCCC allows all of these individuals the opportunity to participate in clinical trials and otherwise benefit from the concentration of expertise within the three organizations. Typically, almost 3,000 patients annually participate in some form of center-related research.
In addition, the participating institutions attracted more than $115 million in cancer-related research in 2012. The MOU emphasizes the center’s role as the leading coordinating body for this research, as well as the primary authority of director Stanton Gerson, in all of the center’s operations, initiatives and appointments.
“As the evaluation team noted, we have an exceptional leader who has steered the center to impressive growth and impact since he became director in 2004,” said Pamela B. Davis, dean of the School of Medicine and vice president for medical affairs. “We look forward to even greater progress in the years to come.”
Among the center’s most noteworthy achievements over the most recent five-year review period are:
$11.3 million SPORE (Specialized Program of Research Excellence) Grant in Gastrointestinal (GI) Cancers
In 2011 Case Western Reserve became only the sixth institution in the country to win federal support for a center focused on preventing and treating cancers of the colon and esophagus. University Hospitals is a primary partner in this grant project.
Center members have demonstrated growing expertise regarding the role of genetic factors in the development of different forms of cancer—findings that, in turn, offer pathways to prevention and cures. A few of the more recent findings include:
In May, the company Genomic Health announced the release of a new, genetically based test to determine the degree of aggressiveness of a patient’s prostate cancer. Developed through research by center members, the test assigns patients a Genomic Prostate Score to help guide physicians in determining whether surgery or active surveillance represents a patient’s better option. The breakthrough promises to significantly reduce the rates of overtreatment for prostate cancer that today are as high as 90 percent.
In May, researchers identified a key genetic abnormality that appears common to a broad range of cancers, including breast, colon, melanoma and others. The finding provides a new target that medications could attack early and thus stop potential tumor growth.
In April, the National Cancer Institute began recruiting patients for a clinical trial of a drug that center researchers developed that blocks attempts to repair damaged DNA and thus makes cancerous cells more receptive to chemotherapy.
In September 2012, researchers identified a gene that appears to suppress metastasis in breast cancer.
In July 2012, the center’s research contributed to a massive colon cancer study published in Nature that is part of the national Cancer Genome Atlas Project. This study identified key genetic mutations that appear to be consistent among various colon cancer tumors—highlighting potential approaches to reverse the dangerous changes.
In April 2012, researchers identified “master switches” that turn on and off genes whose changes are a key sign of colon cancer; the research also highlighted potential indicators of differing susceptibility to the disease.
The center has made “home-grown” discoveries of potential therapeutics a priority of its work across multiple forms of cancer and research approaches. In 2012, for example, a center researcher found that two federally approved drugs could be combined to help reverse metastasis of lung cancer. In the same year, another center researcher reported promising findings regarding a potential “vaccine” for pancreatic cancer—one of the most deadly forms of the disease.
This spring, center researchers co-authored a landmark paper regarding a new approach to magnetic resonance imaging that could provide earlier identification of cancer as well as other diseases. So-called MRI fingerprinting would take place so quickly it conceivably could become part of patients’ annual physicals. The discovery is one of several pioneering discoveries that have emerged from this relatively new center emphasis; others include the use of gold nanoparticles to target therapies in brain tumors, and the development of optical imaging probes to help distinguish between cancerous and healthy tissue in lumpectomies.
The Case Comprehensive Cancer Center accelerates research progress in part through the provision of 15 shared resources—among them “core facilities” that offer equipment and consulting to advance scientists’ work in such fields as biostatistics, genomics, and cytometry and imaging microscopy. The space allotted to these offerings has grown by more than 84 percent during the grant review period, another testament to the commitment among all of the center’s institutional partners.
“At University Hospitals, our commitment to curing cancer every day has compelled us to invest more than $360 million in the last five years to growing our cancer program’s impact. During the course of the grant review period, we opened the Seidman Cancer Center, a 375,000-square-foot facility that is the region’s only hospital solely dedicated to the unique needs of the cancer patient,” said Thomas F. Zenty III, chief executive officer of University Hospitals. “This state-of-the-art, patient-centered hospital, which houses the nation’s most advanced treatments and technology, is only one of many examples of our commitment to the Case Comprehensive Cancer Center and advancing cancer cures for our patients.”
Last year, the Cleveland Clinic announced plans to expand its Taussig Cancer Institute, ranked sixth in the nation for cancer treatment by U.S. News & World Report.
“Membership in the Case Comprehensive Cancer Center demonstrates Cleveland Clinic’s commitment to collaborative research, cutting edge clinical trials and continued innovation as a way to improve people’s lives,” said Cleveland Clinic CEO and President Toby M. Cosgrove. “What these institutions can accomplish together is greater than what we can accomplish apart.”
The center also has begun to engage in collaborations with cancer centers at The Ohio State University and the University of Cincinnati to expand the scope of research projects and involve more top scientists in developing lifesaving treatments.
“Over the past five years, we have achieved remarkable new levels of strategic focus and broad engagement across the center’s membership and beyond,” said Gerson, who is also director of the Seidman Cancer Center. “Our task now is to capitalize on the talent and commitment that exists within the center to provide even greater hope to patients and their families.”
Through the renewal review process the center won endorsement for full funding based on the final year of its previous grant—an award that would total $25 million. The amount of the grant announced has been reduced by approximately 6.5 percent because of the federal government’s sequester, but could return to approved levels in coming years.
The center’s strategic plan for the next several years includes building on existing areas of strength and also establishing more formal and active initiatives to battle brain and breast cancers. The center leadership also emphasized the importance of enhanced training opportunities for future oncologists as well as improved access to clinical trials for patients throughout Northeast Ohio.
“The Case CCC is an important regional and national resource for cancer research and care,” the assessors wrote, “and it continues on a strong upward trajectory…”
Gerson emphasized that the center’s progress traces directly to its members—in particular the leaders who provide strategy, guidance and inspiration to researchers, physicians, patients and, yes, the director himself.
Among the center’s leadership team are: Ruth A. Keri, associate director for Basic Research; Neal J. Meropol, associate director for clinical research and division chief, hematology and oncology; Brian J. Bolwell, associate director for the CCCC and chair, Taussig Cancer Institute; Jaroslaw P. Maciejewski, associate director for the Lerner Research Institute; Li Li, associate director for prevention research; Clark W. Distelhorst, associate director for training and education; Mark D. Schluchter, associate director for biostatistics; James W. Jacobberger, associate director for shared resources; and Anne Duli, associate director for research administration and finance.
In addition, Gerson cited: Afshin Dowlati, deputy associate director for clinical research-translational research and director, Center for Cancer Drug Development; Robert Dreicer, deputy associate director for clinical research and director, clinical trials; Mitchel Machtay, chair, Cooperative Group Committee; Sanford D. Markowitz, principal investigator, Case GI SPORE; George R. Stark, strategic adviser to the director; G.Q. Zhang, associate director for cancer informatics.