UT MD Anderson Cancer Research Articles

Abstract IA14: Translating science into policy for public benefit

Abstract The effective prevention of cancer is based upon cancer control, which, historically, has been defined somewhat differently across institutions. UT-MD Anderson defines cancer control as implementation and dissemination of evidence-based products in three domains: 1) public policy, 2) education (both public and professional), and 3) community-based clinical service delivery and delivery enhancement. Comprehensive cancer control programs combining all three of these elements are typically most impactful. Although behavioral/clinical interventions and educational initiatives will always be necessary, public policy interventions applied at any organizational level (e.g., institutional, regional, statewide, national, international) represent a critical component of cancer control, given their broad reach, sustained impact across time, and potential to promote and reinforce cultural transformation. The mission of UT-MD Anderson's Cancer Prevention & Control Platform (CP & CP) is to develop and implement clinic and community-oriented, evidence-based projects in cancer prevention, screening, early detection, and survivorship to achieve a measureable and lasting reduction in the cancer burden, particularly among the poor and underserved of our catchment area, and extending to the global community. This translational goal is entirely consistent with our institutional mission “…to eliminate cancer in Texas, the nation, and the world.” Although the CP & CP has a broad mandate and numerous actions involving the full range of control activities, it currently supports a number of policy-driven initiatives through partnerships with various organizations, including the American Cancer Society, the Centers for Disease Control & Prevention and various other local, state and national public health agencies and coalitions. The recent passage of legislation restricting minors' access to tanning beds in Texas represents just one policy-related, educational component of a comprehensive strategy undertaken by the CP & CP to promote skin cancer awareness and preventive actions. As part of a comprehensive approach to tobacco control, the Platform is also educating the public regarding Smoke-Free Texas legislation. Additionally, the Platform recently convened a large public forum involving leading tobacco control representatives to discuss, deliberate, and prioritize potential policy, public education, and clinical service initiatives that could be considered to reduce tobacco use in our population. Recently, our faculty and staff developed a comprehensive set of evidence-based, strategic and tactical recommendations entitled, “EndTobacco” to guide UT-MD Anderson's and partners' efforts to collaboratively reduce the tobacco burden in our population. As one component of the EndTobacco program, UT-MD Anderson has implemented a new tobacco-free hiring policy. We aspire to develop public education, clinical service, and policy initiatives that will promote the effective delivery and dissemination of cancer preventive vaccines (such as HPV vaccines) in our population, as well. Continued partnering to inform and support policy change is critical to our success in translating compelling scientific discoveries into tangible actions to improve the public's health and reduce cancer's burden in our population. Submitted on behalf of the UT-MD Anderson Cancer Center's Cancer Prevention & Control Platform Leadership Team - Mark Moreno (co-lead), Jenny Tektiridis, Lewis Foxhall, David Wetter, Martha Salas, Kendra Woods, Stephanie Kim, Rosalind Bello, Shibu Varghese Citation Format: Ernest Hawk. Translating science into policy for public benefit. [abstract]. In: Proceedings of the Seventh AACR Conference on The Science of Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; Nov 9-12, 2014; San Antonio, TX. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2015;24(10 Suppl):Abstract nr IA14.

Clinical next-generation sequencing reveals aggressive cancer biology in adolescent and young adult patients.

The aggressive biology of cancers arising in adolescent and young adult (AYA; ages 15-39 years) patients is thought to contribute to poor survival outcomes. We used clinical next-generation sequencing (NGS) results to examine the molecular alterations and diverse biology of cancer in AYA patients referred to the Phase 1 program at UT MD Anderson Cancer Center. Among the 28 patients analyzed (14 female and 14 male), 12 had pediatric-type cancers, six had adult-type cancers, and ten had orphan cancers. Unique, hitherto unreported aberrations were identified in all types of cancers. Aberrations in TP53, NKX2-1, KRAS, CDKN2A, MDM4, MCL1, MYC, BCL2L2, and RB1 were demonstrated across all tumor types. Five patients harbored TP53 aberrations; three patients harbored MYC, MCL1, and CDKN2A aberrations; and two patients harbored NKX2-1, KRAS, MDM4, BCL2L2, and RB1 alterations. Several patients had multiple aberrations; a patient with wild-type gastrointestinal stromal tumor harbored five alterations (MDM4, MCL1, KIT, AKT3, and PDGRFA). This preliminary report of NGS of cancer in AYA patients reveals diverse and unique aberrations. Further molecular profiling and a deeper understanding of the biology of these unique aberrations are warranted and may lead to targeted therapeutic interventions.

Effect of provider communication style on the improvement of pain and function in patients with knee osteoarthritis

s / Osteoarthritis and Cartilage 20 (2012) S54–S296 S255 assessment at baseline assessing pressure-pain sensitivity of the lower leg. During cuff inflation patients rated the pressure-pain intensity continuously on an electronic visual analogue scale (VAS), with 0 indicating “no pain” and 10 defined “worst pain imaginable”. The patients pressed a button, when the pressure-pain intensity was intolerable (pain tolerance threshold, PTT recorded in kPa) and the corresponding VAS score defined the pressure-pain limit (PTL). The PTT and PTL were measured before a 16-week intensive dietary intervention resulting in a significant weight loss. Treatment response was defined according to the Outcomes Measures in Rheumatology Clinical Trials and Osteoarthritis Research Society International (OMERACT-OARSI) responder criterion (yes/no). The associations between baseline PTT and PTL and lack of clinical response according to the OMERACT-OARSI criterion despite receiving intensive dietary therapy were assessed using logistic regression analysis; adjustments for potential confounding factors (gender, age, radiographic disease severity and baseline BMI) were performed. Results: Baseline PTT was associated with lack of response to weight loss according to the OMERACT-OARSI responder criteria, showing that patients with higher PTT had lower odds of non-response (odds ratio 1⁄4 0.966; 95% confidence interval (CI) 0.94 0.99, P1⁄4 0.0066) implying a better prognosis. There was no association between baseline PTL and treatment response (odds ratio 1⁄4 0.998; 95% confidence interval (CI) 0.85 1.17, P 1⁄4 0.9761). Conclusions: This study indicates that obese knee OA patients with low pressure pain tolerance (i.e. high sensitivity) at baseline have a reduced likelihood of symptomatic response to a weight loss intervention as compared to patients with high pressure pain tolerance (i.e. low sensitivity). Central sensitization of the nociceptive system may explain the relative high pressure pain sensitivity in the patients responding less efficient to the weight loss. Pain sensitivity assessment may aid clinical decision making as a prognostic tool. 504 EFFECT OF PROVIDER COMMUNICATION STYLE ON THE IMPROVEMENT OF PAIN AND FUNCTION IN PATIENTS WITH KNEE OSTEOARTHRITIS M.E. Suarez-Almazor , M.A. Kallen , V. Cox , R.L. Street, Jr. . UT MD Anderson Cancer Ctr., Houston, TX, USA; 2 Texas A & M Univ., College