Frontline Cancer: Cancer Consortium links work of five UC cancer centers

FRONTLINE CANCER:

Among the many ways that cancer can confound successful treatment is its ability to draw upon some of the strengths and defenses of healthy cells and tissues, exploiting them to boost its resistance to therapy and its chances of survival. An unprecedented cancer consortium intends to use that same approach to more effectively address California's most pressing cancer-related problems and opportunities.

The new University of California Cancer Consortium is an alliance of UC's five cancer centers at UC Davis, UC Irvine, UCLA, UCSF and, of course, Moores Cancer Center at UC San Diego Health. These centers all enjoy Comprehensive Cancer Center designation by the National Cancer Institute, which means they represent the leading minds and practices in cancer research, treatment and education.

They are home, said UC President Janet Napolitano in a recent news conference announcing the consortium, "to physicians and scientists who are the very best at what they do: care for patients and conduct research that leads to new knowledge that benefits us all."

The need has never been greater. This year, more than 176,000 Californians will be diagnosed with cancer and nearly 60,000 will die from it. The estimated cost burden to the state and its residents is more than $14 billion annually.

The consortium represents an effort to leverage the institutional strength of UC's cancer centers, to produce results that are greater than the sum of its parts. Those parts are impressive. Each year, the five academic medical centers of UC Health provide almost 900,000 days of inpatient care and 4.5 million outpatient visits. UC Health is the state's fourth-largest healthcare delivery system, with 41,000 employees, including 12,000 nurses.

The UC cancer centers treat nearly one in five cancer patients in California. Almost half of these patients are in the late stages of cancer; many with the rarest types that cannot be treated at other hospitals lacking expertise or access to clinical trials using the latest experimental drugs.

Last year, UC medical centers conducted more than 1,600 clinical trials, a significant number focused on cancer, that involved more than 29,000 patients. They are moving the most promising treatments closer to federal approval and standard of care for all.

The pace of innovation in cancer research and treatment these days is so fast that the best care may be in joining a trial using a drug headed to market. At Moores Cancer Center, we are currently running 300 clinical trials, including groundbreaking investigations involving immunotherapies and other forms of precision medicine.

The power and possibility of the cancer consortium are obvious. Its potential is already being realized. Head and neck cancers are among the most difficult of malignancies to treat. They are a challenge compounded by the fact that many types are relatively rare. Individual doctors or centers don't see many patients, making it difficult to deepen their understanding of the disease or develop new treatments.

Recently, Ezra Cohen, M.D., associate director for translational science at Moore Cancer Center and a renowned head and neck cancer specialist, presented early results of a clinical trial at a medical conference in Spain. The trial combines two drugs in a novel way to treat head and neck cancer. The results were promising; the trial is ongoing.

The key point is that the trial could not have happened at a single center. In this case, it involves multiple UC cancer centers providing patient-participants and agreeing to abide by the recommendations of MCC's scientific review committee and institutional review board. This unified, streamlined approach helped convince the pharmaceutical company funding the trial to take the leap.

The Cancer Consortium is also uniquely positioned to partner with health insurance plans and employers to provide a seamless statewide program for oncology services. This collaboration will provide patients with cutting-edge care throughout California, including cases where a patient has to relocate within the state during their course of treatment.

There are other, similar examples of progress on the cusp of reality. They involve new collaborations among colleagues across the UC Health system, new combinations of cancer researchers and physicians coming together to devise and test ideas and treatments they could not — and cannot — do alone. In fact, an effort through this consortium was initiated three days after the Napolitano's announcement to treat pancreatic cancer, the most deadly of all forms of cancer.

Despite some dramatic improvements in the rates and treatments of some malignancies, cancer overall is expected to eclipse heart disease as the nation's top killer in coming years. The over 200 diseases we call cancer work together to create an undeniable scourge. The UC Cancer Consortium is our combined and commensurate call to arms.

Scott M. Lippman, M.D., is director of UC San Diego Moores Cancer Center. His column on medical advances from the front lines of cancer research and care appears in La Jolla Light the fourth Thursday of each month. His e-mail address is mcc-dir-lippman@ucsd.edu

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