NewYork-Presbyterian/Columbia & Cornell Cancer
As the nation’s largest not-for-profit, nonsectarian hospital, NewYork-Presbyterian provides state-of-the-art care at five major centers and is consistently ranked among the country’s best academic medical institutions by U.S. News & World Report.
The hospital’s academic affiliations with Weill Cornell Medical College and Columbia University College of Physicians and Surgeons are producing groundbreaking advances in oncology research and patient care.
Established in 2008, the Weill Cornell Cancer Center is a premier center for several oncology specialties, diagnosing and treating over 4000 new patients each year and, in many specialties, conducting more clinical trials than its regional peers. Cancer research at Columbia-Presbyterian Medical Center dates back to the 1911 creation of the Institute of Cancer Research. Armed with the findings of investigators deciphering cancer’s molecular biology, Herbert Irving Comprehensive Cancer Center scientists are intensely involved in the study of cancer epidemiology.
In September 2012 the new joint Cancer Center at Weill Cornell Medical College and NewYork-Presbyterian Hospital was established, bringing together basic, translational, and clinical researchers to operate within a vast, collaborative infrastructure. The new expansive Cancer Center will open its new headquarters in the soon-to-be-completed Belfer Research Building in 2014.
One standout among the prolific research of Columbia/Cornell scientists is their work related to nonchemotherapeutic agents in the fields of thoracic and hematologic oncology.
Tarceva and Xalkori: Changing the Thoracic Oncology Landscape
Balazs Halmos, MD, section chief of Thoracic Oncology at NewYork-Presbyterian Hospital/Columbia University Medical Center, has witnessed dramatic transformations in thoracic oncology from as recently as 5 years ago, when multiple toxic chemotherapy treatments produced only modest benefits. He describes the identification of major genetic mutations in adenocarcinoma as particularly exciting, and cites two FDA-approved nonchemotherapeutic oral agents as especially promising: the EGFR-4 inhibitor erlotinib (Tarceva), approved for treatment of advanced non–small cell lung cancer (NSCLC), and crizotinib (Xalkori), an ALK inhibitor approved for treatment of late-stage ALK-positive lung cancers, and also being investigated for use in other tumor types in which ALK plays an important role.
Balazs Halmos, MD
“Many patients whose tumors harbor one of these abnormalities are reaping the benefits of our enhanced understanding of the molecular underpinnings of lung cancer, with oral targeted agents that, compared to chemotherapy, are less toxic and significantly more efficacious,” said Halmos. “This is producing frequently quite lasting major remissions in roughly two-thirds of patients. Our hope is to cure larger numbers of patients by introducing such agents earlier in the course of the disease.”
Every adenocarcinoma patient at Columbia is now tested for these and other mutations. Those testing positive can be treated with an approved agent or enrolled in clinical trials, with patient samples used as laboratory models for the next wave of drug development. Halmos uses ALK to illustrate the importance of such screening. “While only 5% of patients with NSCLC have the ALK mutation targeted by Xalkori, the disease is so common that this percentage represents approximately 9000 individuals annually.” With mutations in other key genes being rapidly identified, it is hoped that even more patients will benefit.
Halmos and colleagues were among those who made key observations on these and other genetic abnormalities; in particular, through research on the mechanisms of the acquired resistance to EGFR and ALK inhibitors. The team also participates in multiple trials of such targeted agents, including the key studies that led to Xalkori’s approval.