GAP - Overall Goal
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Transcript of GAP - Overall Goal
GAP - Overall Goal
Facilitates and administers MD Anderson's Sister
Institution Network (the largest network of cancer
centers) working collaboratively on education,
research, patient care aimeing at lessening the
world's cancer burden
MDACC Global Academic ProgramsSister Institution Network (N= 26)
SINF
National Breast Cancer Foundation: $300,000
Joint Publications
Joint Publications
1. Yang W, Xia Y, Ji H, Zheng Y, Liang J, Huang W, Gou X, Aldape K, Lu Z. Nuclear PKM2 regulates β-catenin transactivation upon EGFR activation. Nature, 480(7375):118–22, 2011.
2. Dietrich S, Glimm H, Andrulis M, Kalle von C, Ho AD, Zenz T. BRAF inhibition in refractory hairy-cell leukemia. N Engl J Med, 366(21):2038–40, 2012.
3. Yang W, Xia Y, Hawke D, Li X, Liang J, Xing D, Aldape K, Hunter T, Alfred Yung WK, Lu Z. PKM2 Phosphorylates Histone H3 and Promotes Gene Transcription and Tumorigenesis. Cell, 150(4):685–96, 2012.
4. Zhang M, Maiti S, Bernatchez C, Huls H, Rabinovich B, Champlin RE, Vence LM, Hwu P, Radvanyi L, Cooper LJ. A New Approach to Simultaneously Quantify Both TCR - and -Chain Diversity after Adoptive Immunotherapy. Clin Cancer Res, 18(17):4733–42, 2012.
Nasopharyngeal Carcinoma
MDACC
RTOG
CUHK CGU, NTU
Nasopharyngeal Carcinoma 5-Year Disease Specific Survival Rate
Source: Anne Lee, Pamela Youde Nethersole Eastern Hospital, Hong Kong
1985 200019691930
~80%
~50%
~35%
0%
NPC: Stage at Diagnosis
Anne Lee (PYNEH-Hong Kong) 1994-2005: 1185 patients
Nasopharyngeal Carcinoma 5-Year Disease Specific Survival Rate
Source: Anne Lee, Pamela Youde Nethersole Eastern Hospital, Hong Kong
1985 200019691930
~80%
~50%
~35%
0%
Cobalt
LINAC
Chemotherapy& IMRT
Standard Therapy for Locally Advanced NPC IMRT+ CDDP CDDP+FU x3
P= 0.005
Al-Sarraf et al., JCO, 1998Validation: Wee et al., JCO, 2005
7060504030201000
10
20
30
40
50
60
70
80
90
100
N= 87 Median FU=30 months
Months
Perc
ent
5-Y nodal control: 97%5-Y primary tumor control: 94%5-Y metastasis-free: 66%
Lee et al., IJROBP, 2002
Intergroup Trial
IMRT + Chemotherapy for NPC
Series N Stage FU(Mos) LC DM-Free
BucciIJROBP, 2004 (US) 118 50%
T3-4 30 96%(4-Y)
72%(4-Y)
KamIJROBP, 2004 (HK) 63 51%
T3-4 29 92%(3-Y)
79%(3-Y)
WoldrenIJROBP, 2005 (Canada) 74 50%
T3-4 35 91%(3-Y)
78%(3-Y)
LeeJCO, 2005 (RTOG) 68 58%
T2-4 30 93%(2-Y)
85%(2-Y)
Nasopharyngeal CarcinomaImpact of Post-Rx EBV Titer on Outcome
Chan et al., JNCI 94: 1614, 2002 (Chinese University of Hong Kong)Validation: Lin et al., NEJM, 2004 (Taiwan); Le et al., CCR, 2004 (US)
<500 copies <500 copies
>500 copies>500
copies
REGISTER
NPC Trial Concept
T≥2 or N+
WHO I-III
CDDP + 5FU x3
IMRT (70 Gy)
+ CDDP
(40 mg/m2
X7) Taxane+ Gem
EBV>0 R
REBV= 0
Observe
IMRT Credentialing & QAEBV Assay Harmonization
Phase III: 770
Phase IIR: 156
Credentialing & QA: IMRT H&N Phantom Primary PTV
4 cm diameter4 TLD
Secondary PTV2 cm diameter2 TLD
Organ at risk1 cm diameter2 TLD
Axial and sagittal radiochromic films 1º PTV treated to 6.6 Gy
2º PTV treated to 5.4 GyOAR limited to < 4.5 Gy
Secondary PTV
Primary PTV
Organ at Risk
Designed in collaboration with RTOG; Molineu et al, IJROBP, October 2005 MDACC (P01 funded)
Results of Two Centers
EBV Assay
An International Collaboration to Harmonize the Quantitative Plasma Epstein-Barr Virus (EBV) DNA Assay
for Future Biomarker-Guided Trials in Nasopharyngeal Carcinoma
Le QT1, Zhang Q2, Cao HB1, Cheng AJ3, Pinsky BA1, Hong RL4, Chang JT3, Wang CW4, Kuo-Chien Tsao KC3, Lo YMD6, Lee N5,
Ang KK7, Chan ATC6, Chan AKC6
1Stanford University, 2RTOG Statistical Center, 3Chang-Gung University,4National Taiwan University Hospital, 5Memorial Sloan Kettering Cancer Center,
6The Chinese University of Hong Kong, 7M.D. Anderson Cancer Center