Category: Bladder Cancer

Aligned with Cancer Cures in Mind

Cancer CureThrough clinical trials, we are able to develop safe and more effective ways to detect, diagnose and treat cancer. All clinical trials have a sponsor, which means there is an organization or person involved in the design and support of the study. The sponsor is usually a pharmaceutical company, academic institution or government body. In the United States, there has been a fairly recent increase in the number of government-sponsored studies.

The majority of cancer clinical trials are led by the National Cancer Institute (NCI)-sponsored cooperative groups. This means that cancer specialists across hospitals, medical centers and community clinics can more easily collaborate with one another through a formalized group. One major advantage of NCI-funded cooperative group clinical trials is the ability to study diseases and/or treatments that may be less interesting or practical for pharmaceutical companies or individual academic centers.

Following a series of recommendations leading to mergers, there are now five main groups in the US that form the NCI Clinical Trials Network (NCTN). One of these main groups, the Alliance for Clinical Trials in Oncology, was formed in 2011 after the merger of Cancer and Leukemia Group B (CALGB), North Central Cancer Treatment Group (NCCTG) and the American College of Surgeons Oncology Group (ACOSOG). These mergers streamlined many research efforts that were previously happening on parallel or competing trajectories.

Weill Cornell Medicine (WCM) has investigators involved in all five of the major cooperative groups, but is most heavily involved in the leadership of the Alliance. Dr. Scott Tagawa, Medical Director of the Genitourinary (GU) Oncology Program, serves as Weill Cornell Medicine’s Principal Investigator for the Alliance and a member of the Board of Directors. Dr. John Leonard serves as Chair of the lymphoma committee and member of other leadership committees.

There are many WCM investigators currently leading studies within the Alliance group. The GU committee has a high level of involvement by our medical oncologists, Drs. Tagawa, Beltran, Molina, Nanus, and Faltas. Additionally, Dr. Barbieri and other urologists from our team have recently become more involved in the Alliance.

We have a long history of participation in the GU oncology studies through CALGB and the Alliance, most recently with completed studies in early stage prostate cancer. These include testing:

  • Dietary intervention in men with low risk disease who are on active surveillance (Clinical Trial ID: 70807)
  • Chemohormonal therapy prior to surgery in men with high risk disease (90203)
  • The addition of antiangiogenic therapy in addition to chemotherapy for advanced urothelial carcinoma (90601)
  • Testing the impact of targeted oral therapies in curbing the spread of cancer in patients with intermediate to high risk, advanced renal cell carcinoma (RCC) (A031203)

Through our cooperative groups, we are currently accruing to studies in advanced prostate cancer and early stage bladder cancer with additional new clinical trials in the works.

Prostate cancer:

Bladder cancer:

The Alliance for Clinical Trials in Oncology is committed to reducing the impact of cancer on people by uniting nearly 10,000 scientists and clinicians across the United States and Canada, from many disciplines, hospitals, medical centers and community clinics. Together we’re discovering, creating, validating and implementing new, more effective strategies to prevent and treat cancer; we’re proud to be part of it!

Doing Better on Behalf of Bladder Cancer Patients

Scott Tagawa_IMG_5903On Monday, April 18th, Dr. Scott Tagawa presented promising bladder cancer clinical trial results at the 2016 AACR Annual Meeting.

This phase II study of the antibody-drug conjugate (IMMU-132), demonstrated positive results in a group of adults with metastatic urothelial cancer who did not respond to standard chemotherapies or relapsed after receiving several rounds of the standard chemotherapy treatment regimens.

A form of immunotherapy, antibody drug conjugates are a targeted therapy that leverages the capability of monoclonal antibodies to attach to specific targets on cancer cells. By attaching a drug to the monoclonal antibodies, treatments are able to “hitch a ride” into the cancer cells.

“In this study, eighty-four percent of patients were alive at the nearly one-year mark, compared with an average overall survival of 4-9 months in similar patients who received chemotherapy regimens,” says Dr. Tagawa.

Some side effects were reported, including neutropenia, a low count of a type of white blood cells (neutrophils) in the blood and some diarrhea, but less than would be expected with the free form of the parent drug irinotecan. Irinotecan is a chemotherapy drug mostly used for the treatment of colon cancer. In the body, it is metabolized and breaks down into SN38, which is a more potent molecule. Because of its potency, it would be too toxic to deliver SN38 into the body in general.

IMMU-132 is a drug in which SN38 is linked to an antibody which recognizes Trop2. Trop2 is a protein in the surface of several different types of cells and is over-expressed on many common cancer types, including urothelial cancer. Since the drug shuttles SN38 preferentially into tumors, patients benefit from the potent drug without as many side effects as general chemotherapy.

This drug is also known as Sacituzumab Govitecan, and has already received FDA-breakthrough designation for the treatment of patients with triple negative breast cancer.

The Weill Cornell Medicine clinical trial continues to enroll patients with advanced urothelial cancers (tumors arising from the bladder, renal pelvis, and ureters). For more information about eligibility and enrollment, click here.

Navigating Dinner When the Food Tastes Worse Than the Plate

By Shayne Robinson, R.D., C.S.O, C.D.N

Food photo_Cancer Taste ChangesSweet, salty, savory and sour are words we often use to describe different flavors in the foods we eat, but cancer and its treatments can turn your sense of taste upside down. It is normal to experience taste changes as a result of cancer and cancer treatment. Some people report a bitter or metallic taste in their mouth, while others find that their overall sense of taste has diminished.

How foods taste and smell can change from day to day, and these changes may affect your appetite. To find foods that are appealing, try experimenting with new foods or cuisines, marinades and spices. It can even help to try new ways of preparing the foods you typically eat. Good oral care is also important.

Here are some tips to help combat common cancer-related taste changes:

Loss of Taste

  • Choose foods with strong and/or tart flavors, such as citrus fruits, vinegar and pickled foods. Marinate meats, chicken and fish to infuse flavor. Try strong flavored greens such as arugula or mizuna greens. Caution: avoid acidic foods if you have a sore mouth or throat.
  • Zinc deficiency can decrease your sense of taste. Discuss testing your zinc level and/or supplementing zinc with your health care provider.

Unpleasant Salty, Bitter, Acidic or Metallic Tastes

  • Add a sweet flavor to foods such as topping salad with fruit. Try topping meats, chicken and fish with a fruit chutney.
  • Use plastic utensils or chopsticks if metal forks and spoons taste unpleasant.
  • Add lemon juice, cucumber slices, cranberries or other flavorings to water.
  • Suck on slices of Granny Smith Apples or frozen chunks of pineapple.

Meat Tastes Strange

  • Choose other protein-rich foods (such as poultry, fish, eggs, dairy products, beans, tofu or soy milk) instead of meat.
  • Marinate and cook meats, poultry and fish in sweet juices, soy sauce, acidic dressings or wine.

Overwhelming Food Odors

  • Choose foods that are served cold, such as sandwiches, crackers and cheese, yogurt and fruit, or cold cereal and milk. Foods served hot often have stronger odors.
  • Carry a handkerchief dabbed with oil that has a pleasant odor such as mint or lavender.
  • Eat in cool, well-ventilated rooms that don’t have any food or cooking odors.
  • Drink oral supplements in a covered cup and with a straw to reduce the odor of the supplement.

Oral Care Tips

  • To keep your mouth clean and healthy, rinse and brush your teeth after meals and before bed (or every four hours during the day).
  • Before eating, rinse your mouth with a solution of 1 quart water, ¾ teaspoon salt, and 1 teaspoon baking soda. This rinse can help keep your mouth clean and improve your sense of taste.

While taste changes can be common during cancer treatment, eating well during treatment can decrease side effects. Good nutrition will help you maintain your weight, your strength, and maximize your quality of life.

If you are struggling with taste changes or any treatment side effects that affect your ability to eat, consult with a Registered Dietitian (RD). Nothing replaces the individualized counseling you will receive from working with an RD on a one-on-one basis. To see a dietitian at the NewYork-Presbyterian Outpatient Nutrition Practice call (212) 746-0838 (physician referral required).