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Penn Medicine is leading the way with groundbreaking research in ovarian cancer. Launched in 2007 under the leadership of George Coukos, MD, PhD, Penn’s Ovarian Cancer Research Center is making prevention, early detection, treatment and understanding the biology of ovarian cancer a priority.

Leaders in Ovarian Cancer Research

The Abramson Cancer Center, in collaboration with Penn’s Ovarian Cancer Research Center and the Jordan Center for Gynecologic Cancer is one of the nation’s leading programs in ovarian cancer research and patient care.

The ovarian cancer research center has three major research programs:

• Prevention and early detection of ovarian cancer including the development of new blood tests, imaging, and other tools to detect cancer as well as studying environmental causes of ovarian cancer and potential vaccines.
• Advanced therapeutics program, which focuses on developing innovative treatments for ovarian cancer including immune and biologic therapies.
• Ovarian cancer biology and pathogenesis program aimed to understand the genomics, genetics, immunology and biology of ovarian cancer

Promising Discoveries in Ovarian Cancer Research

Dr. Coukos is currently working on developing novel treatments for ovarian cancer using immunotherapy.

At the time of surgery, the patient’s tumor is saved for future use. Within the tumor are tumor-specific killer T-cells, white blood cells that help the body fight disease. Immunotherapy uses these T-cells from the tumor to develop vaccines and therapeutic lymphocytes for personalized treatment therapy.

“The vaccine that Penn is supporting takes the natural attack function of the immune system and amplifies it, thereby focusing a much higher percentage of the patient's immune system on her ovarian cancer,” says Dr. Coukos. “The ultimate objective of these cancer vaccines is to direct a larger percentage of the patient's killer T-cell army against the patient's specific cancer.”

The Future of Ovarian Cancer Treatment

Currently, immunotherapy is only available to women with ovarian cancer who are enrolled in clinical trials at the Jordan Center for Gynecologic Cancer at Penn’s Abramson Cancer Center. Penn is currently building a new facility, the Penn Regional Ovarian Cancer Network and Ovarian Tumor Processing Facility.

This new facility will connect Penn with community-based gynecologic practices and physicians throughout the Mid-Atlantic Region to collect, transport, process and store tumor tissue. After completing standard chemotherapy, patients will have access to individualized treatments using their own tumor tissue.

Connecting women to Penn’s experts in research and treatment provides new options to women with ovarian cancer and may lead to improved survival rates and quality of life.

Learn more about ovarian cancer treatment at the Abramson Cancer Center.

View the 2011 Focus On Gynecologic Cancers Conference.

Penn's Abramson Cancer Center is a national cancer center in Philadelphia providing comprehensive cancer treatment, clinical trials for cancer and is a cancer research center. The National Cancer Institute has designated the Abramson Cancer Center a Comprehensive Cancer Center, one of only 40 such cancer centers in the United States.

Cancer research is one of the cornerstones of Penn’s Abramson Cancer Center’s mission to eradicate cancer and it has helped distinguish the cancer center from other facilities across the country.

Because Abramson Cancer Center researchers work side-by-side with clinicians, these multidisciplinary cancer treatment teams are able to bring new discoveries from the lab to the clinical setting faster than ever.

Breast cancer research seeks to find new ways to prevent, detect and treat cancer.
Clinical trials at Penn may test new drugs and treatments, new screening methods, seek to determine genetic influence in a cancer diagnosis, or seek to improve the quality of life in cancer patients with nutrition, exercise or group therapy.

In the last four years, more than 800 breast cancer survivors have participated in breast cancer research at the Abramson Cancer Center. These studies have allowed Penn researchers to generate important knowledge that is used to improve the care for breast cancer survivors.

Here are some of the research highlights from research in complementary medicine and therapy for breast cancer.

Improving Communication Between Primary Care Physicians and the Cancer Team

Oncology and primary care communication can be difficult to manage. Recognizing the need to address these issues, researchers designed a study asking breast cancer survivors to identify areas where their primary care physicians could improve the quality of care for survivors. Because of this research, clinicians and researchers at Penn and in United States are working hard to enact change based on the patients’ input and concerns.
Mao JJ, Bowman MA, Stricker CT, DeMichele A, Jacobs L, Chan D, Armstrong K. “Primary Care Physicians’ Delivery of Survivorship Care: Perspectives of Breast Cancer Patients.” J Clin Oncol. Feb 20 2009; 27(6):933-8.

Integrating Complementary Therapies into Cancer Care

In this study, Penn researchers discovered the majority of the breast cancer survivors endorse the provision of therapies such as acupuncture, massage, and yoga for survivorship care. Because of this research, the Abramson Cancer Center continues to grow its patient-centered Integrative Medicines and Wellness Program.
Bonner-Millar L, Casarett D, Vapiwala N, DeMichele A, Stricker C, Velder L, Mao JJ, “Integrating complementary therapies into an academic cancer center: The perspective of breast cancer patients.” Journal of Society for Integrative Oncology. Summer 2010, 8(3), pp.106-113.

Genetic Links to Treatment Side Effects

The most recent research has led to the identification of a novel genetic variation that can be used to predict who may develop side effects to aromatase inhibitors. With this knowledge, researchers at Penn hope to create ways to determine which patients are most likely to benefit from aromatase inhibitors as well as those who may develop side effects. This effort will allow for the administration of individualized cancer care to improve quality of life and the survival of breast cancer survivors.
Mao JJ, Su HI, Feng R, Horn M, Aplenc R, Rebbeck TR, Stanczyk FZ, DeMichele A. “Association o f functional polymorphisms in CYP19A1 with aromatase inhibitor associated arthralgia in breastcancer survivors” Breast Cancer Res. 2011 Jan 20;13(1):R8.

The Abramson Cancer Center appreciates those patients who participate in this important research. Together, researchers and breast cancer survivors can make a difference in the lives of millions of women and their families whose lives have been touched by breast cancer.

Learn more about breast cancer research at Penn Medicine.
Search for a clinical trial on OncoLink’s Clinical Trials Matching Service.
Learn more about breast cancer treatment at Penn in Philadelphia.

Penn's Abramson Cancer Center is a national cancer center in Philadelphia providing comprehensive cancer treatment, clinical trials for cancer and is a cancer research center. The National Cancer Institute has designated the Abramson Cancer Center a Comprehensive Cancer Center, one of only 40 such cancer centers in the United States.

Christine Wilson, cancer survivor, shares her experiences from the Focus On Melanoma conference in the last of a series of four blog posts.  

Bernie Parent addressed the Abramson Cancer Center's Focus On Melanoma Conference on the topic of resilience — overcoming fear with purpose. Judging by the warm reception given to former Flyer goalie, Parent's contributions to two Stanley Cup winning seasons in the mid 1970s have not been forgotten. 

But for me, the real meaning of resilience became clear listening to the patients who participated in the panel discussion that followed his talk.

As I listened to the four panelists, so varied in age and background, yet sharing a common diagnosis, I thought of the program that aired last year on SHOWTIME®, called "The Big C." It purported to be a brave, gutsy, straight-on look at what it means to face a diagnosis of stage IV melanoma.  The main character, a 40-ish school teacher in Minnesota, learns she has the disease and decides to change her life, But she accepts her fate based on a single chest X-ray from a single physician (who looks like he barely finished high school). She doesn't tell a soul, not her husband, her son or a best friend, nor does she seek treatment.  I watched it twice and it made me too angry to watch again.

The voices heard at the conference could not be more different than this TV creation.  These were people who were fighting their cancers. They had formed a tight partnership of trust and hope with their treatment teams and endured multiple painful and debilitating treatments.  Every one in their own way had found meaning in the struggle.  No one suggested that there was a simple formula for becoming and remaining resilient.  They spoke of grief, anger and denial, but also of love, determination and the strength they draw from what may seem like life's smaller joys: a card from a friend, playing catch with their son.  Regardless of the state of their disease, each was deeply grateful for a continued existence, and every one of them expressed profound appreciation for the support and love provided by their friends and family.
 
Alice, the youngest of the group, was only 29 when she was diagnosed five years ago, long after Parent's heroics on the ice. She attributed some of her resilience to a form of denial, to "refusing to believe in her own end" as she put it.  She summed up the feelings of the group, and of so many people who have traveled down the cancer pathway with these words.

"I learned that despite having cancer, life marches on.  Things are still happening around you, work, vacations, babies, weddings," Alice said.  "I learned to accept the reality of the disease as a part of my life, but not as something that defines me. I will give what is due, but I won't let it become who I am."

For more information, view the Focus On Melanoma conference video and Melanoma Treatment: A Patient Video Guide, on the ACC website.

Learn more about melanoma treatment at Penn Medicine.

Christine Wilson, cancer survivor, shares her experiences from the Focus On Melanoma conference in the third in a series of four blog posts.  

One of the key concepts in medicine today is "personalized medicine."  What few people may realize is that the emerging ability to talk about individual profiles for specific cancers results entirely from the type of research being done by people like Jessie Villaneuva, PhD, and Robert Vonderheide, MD. Drs. Villaneuva and Vonderheide presented highlights of their research at the Abramson Cancer Center's Focus On Melanoma Conference.

In the last few years, it has become possible to begin identifying subsets of patients based on the molecular characteristics of their cancers, and tailor new treatments to match those specific profiles.

Identifying these molecular characteristics is critical in treating many cancers, and increasingly so in melanoma.  Mutations in the BRAF gene occur in approximately 50 percent of patients with advanced melanoma and provide a valuable target for new therapies.  These therapies, however, are only effective for those who have the BRAF mutation.  The same principle holds true for other less frequent mutations. 

Finding this target has major implications for both developing new drugs and for delivering treatment to patients with melanoma.  It means more drugs are needed to hit multiple targets and that new drugs are likely to be more potent and more specific.  They will work better and be less toxic but in smaller populations of patients.  It also makes it critical that patients be aware of the need to collect sufficient tumor tissue to allow for molecular profiling of their tumor so they can receive the therapies designed to work best for their type of cancer.  Tissue collection is vital both at the time of diagnosis and if and when metastatic disease occurs as cancers often change their genetic profiles as they grow and spread.

For more information, view the Focus On Melanoma conference video and Melanoma Treatment: A Patient Video Guide, on the ACC website.

Learn more about melanoma treatment at Penn Medicine.

Christine Wilson, cancer survivor, shares her experiences from the Focus On Melanoma conference in the second in a series of four blog posts.

Cancer research has become increasingly complex.  It is almost impossible for even the most educated non-scientist to understand the incredibly intricate mechanisms that drive normal and abnormal cell growth, and the language used to describe these phenomena is essentially foreign to all but those trained in biology, chemistry and genetics.  But, as science becomes more difficult to understand, it is also becoming more important.  It wasn't all that long ago that basic and clinical research were considered two separate worlds. Today, the gap between the lab and the clinic is narrowing, and the path between them is a two-way street. 

The presentations of Jessie Villaneuva, PhD, and Robert Vonderheide, MD, at the Abramson Cancer Center's Focus On Melanoma Conference, made it clear just how important research is in advancing the treatment of melanoma, and cancer in general.

Dr. Villaneuva researches cancer at the Wistar Institute, an independent basic research institute located on the Penn campus.  For many years, Wistar has had a top melanoma research program and maintained a highly productive collaboration with the clinical researchers and oncology team at Penn Medicine. Wistar researchers have been among the leaders in identifying specific genetic mutations that regulate cell growth along complex pathways.  For melanoma, these "broken" genes include BRAF, PTEN and several other less frequent mutations.  As Dr. Villaneuva pointed out, understanding the precise mechanisms that turn cell growth on and off is leading to new therapies. 

Basic research at the Wistar Institute and other leading centers is also critical in tackling the problem of drug resistance.  The pattern is all too clear, and too predictable.  A new cancer-fighting agent is identified.  A substantial percentage of patients respond to the drug, sometimes dramatically. But at some point, the drug becomes ineffective.  The cancer starts to grow again as the malignant cells develop ways of eluding or circumventing the action of the anti-cancer agent. 

Dr. Villaneuva described the efforts under way to understand the molecular mechanisms that lead to drug resistance and develop the next level of combination therapies to anticipate and overcome this huge challenge to successful cancer therapy.

For decades, researchers have known that melanoma is in many ways influenced by the body's immune system.  Dr. Vonderheide characterized this as an ongoing struggle between "the immune system versus melanoma."  

Immunotherapeutic approaches to treating melanoma have been consistently intriguing, promising — and disappointing. Melanoma appears to be capable of "waiting out" the body's natural immune response.  But researchers keep returning to this area, and now with their remarkably increased understanding of the complexities of the immune system, their work is bearing rich new fruit.   Immunotherapeutic approaches are the heart and soul of the new agents that are emerging for melanoma treatment. 

According to Dr. Vonderheide, these new approaches can either accelerate or activate the body's natural immune responses against the abnormal cell growth of melanoma, or "hit the brakes," actually slowing down the immune response to allow more effective interventions with vaccines and other cellular therapies.  While the immunotherapy work is proceeding on multiple fronts, the most exciting results are in the area of monoclonal antibodies, including ipilimumab, and several other targeted therapies in early stages of clinical trials.

For more information, view the Focus On Melanoma conference video and Melanoma Treatment: A Patient Video Guide, on the ACC website.

Learn more about melanoma treatment at Penn Medicine.

Christine Wilson, cancer survivor, shares her experiences from the Focus On Melanoma conference in the first in a series of four blog posts.

Dr. Lynn Schuchter

Relentless. That word was used a lot at the Eighth Annual Focus on Melanoma Conference sponsored by Penn's Abramson Cancer Center (ACC). It was the word Lynn Schuchter, MD, used to describe Lorraine Gordon's quest to educate patients and physicians about melanoma and its treatment. Lorraine received the ACC Advocacy Award at the conference. *

Relentless. It has also been used to describe melanoma, a disease that for many years has resisted all attempts to improve its treatment and outcomes: until now. The clear message that Dr. Schuchter and her colleagues delivered to the more than 300 conference attendees is that the explosion of new knowledge and new treatments for melanoma are "changing the landscape" for patients at every stage of the disease: especially for those patients with advanced or metastatic melanoma.

Oncologists are rightfully wary about expressing too much enthusiasm for emerging new therapies. They have seen too many promising clinical trials end in disappointment. Physicians know that progress, when it does occur, is frequently measured in added weeks or months of life, not cures.  They are keenly aware that even the most positive results are tempered by the reality that behind every curve lurks the problem of acquired drug resistance, the seemingly inevitable ability of cancer cells to outsmart the approaches used to stop their growth.  But this time, the excitement is real. The optimism is grounded in the growing body of evidence from clinical trials that employ new knowledge and new agents.

As Dr. Schuchter's timeline indicated, progress has been frustratingly slow and elusive, dating all the way back to the identification of the first melanoma patient in the United States in the late 1800s.  In fact, not a single new drug had been approved by the FDA for treating melanoma in more than 20 years.  If surgery failed to eliminate the melanoma, interferon and interleukin, the mainstays of therapy for metastatic disease, were both highly toxic and limited in their effectiveness.

That scenario has changed dramatically in the last five years with the introduction and approval of three new agents with demonstrated effectiveness in treating advanced and high-risk melanoma.  The future is even brighter with the prospect of several new drugs currently in the research pipeline, two of which have reported remarkably promising results from clinical trials in 2011 alone.

The Value of Cancer Education

Just 20, or even 10 years ago, it was very difficult to find information about melanoma or its treatment. Today, the problem is no longer getting information; it is getting good information, and even more so being able to interpret it.  The value of an event such as the Focus On Melanoma conference is having an enormous amount of cancer information and education all in one place. The Focus On conferences, sponsored by the Abramson Cancer Center at the University of Pennsylvania, allows patients and families to get informed and interact with nationally recognized leaders in the clinical oncology and research fields.

A conference like this illustrates the ongoing, irreducible need for patients and their health care teams to interact, to communicate, and to merge information with perspective.

For more information, view the Focus On Melanoma conference video and Melanoma Treatment: A Patient Video Guide, on the ACC website.

* Lorraine Gordon is the wife of Roger A. Gordon, who lost his battle with melanoma. An educational fund was created in his name at the Abramson Cancer Center. Money from the fund was used to create a melanoma awareness brochure and treatment video.

Learn more about melanoma treatment at Penn Medicine.