Committed to Excellence in Cancer Research, Education and Patient Care
Inroads
June 2018
Repurposed Drug Approach
May Halt Spread of Cancer Cells
Dr. Asim Abdel-Mageed, Zimmerman Professor of Cancer Research, and colleagues aim to repurpose currently approved drugs to prevent the spread of cancer cells. (Photo by Paula Burch-Celentano)
For cancer cells to spread to other places in the body - or metastasize - they need to communicate with one another.

One way they do this is through chemical messages delivered in exosomes - molecules that carry information from cell to cell. " Exosomes are routinely biosynthesized and released by cancer cells, including prostate cancer, and are implicated in cancer progression," said Asim Abdel-Mageed, DVM, PhD , Zimmerman Professor of Cancer Research at Tulane.

Currently there are no known drugs that selectively target and inhibit the biosynthesis and release of exosomes by tumor cells. To accelerate the discovery of effective drugs, Dr. Abdel-Mageed and colleagues are focusing their research on screening drugs already approved to treat other diseases or conditions to see which, if any, could be effective in blocking the activity of exosomes.

In partnership with investigators at the National Center for Advancing Translational Science and with the support of a $4.2 million NIH grant awarded in 2014, Dr. Abdel-Mageed and his collaborators investigated 4,580 known pharmacologically active compounds and FDA-approved drugs using a rapid high-volume robotic screening technique. Twenty-two — including antibiotics, antifungal medicines and anti-inflammatory agents — wer e effective in preventing advanced prostate tumor cells from releasing exosomes or in blocking their production. Their work was published in a recent issue of Scientific Reports.

"Because drug discovery from concept to market takes an average time of 12 years, our identified drugs could be repurposed for the treatment of advanced prostate cancer within a relatively short period of time," said Abdel-Mageed. In fact, combination of the repurposed drugs with conventional therapy was promising in reducing tumor burden in a pre-clinical animal model of prostate cancer. Of course, much work remains to determine which individual drugs or combinations might be useful in patients.

Scientists believe that further research into this approach could also be useful in treating other advanced cancers, as well as diseases such as Alzheimer’s.

Dr. Abdel-Mageed thanks Tulane collaborators Debasis Mondal, PhD, and Raju Thomas, MD, who have been instrumental not only in the original grant application, but also in data and outcomes analysis.
“Because drug discovery from concept to market takes an average time of 12 years, our identified drugs could be repurposed for the treatment of advanced prostate cancer within a relatively short period of time.”
Asim Abdel-Mageed, DVM, PhD
Tulane Head & Neck Experts
Lead Call for HPV Vaccines
Photo from Thinkstock; story by Carolyn Scofield.
Human papillomavirus (HPV) has long been known as a cause for cervical cancer, but otolaryngologists are seeing a marked increase of head and neck cancers caused by HPV. From 1984 to 2004, the rate of HPV-positive oropharyngeal squamous cell carcinoma, a type of head and neck cancer, increased 225 percent. By 2020, the number of HPV head and neck cancers is expected to surpass those of cervical cancers.

Dr. Paul Friedlander, chairman of the Department of Otolaryngology at Tulane University School of Medicine, has treated patients as young as their mid-30s with HPV-related malignancies. He and a team of Tulane-based researchers are leading a call for ear, nose and throat doctors (otolaryngologists) to support a preventative strategy — HPV vaccination. Their opinion was recently published in JAMA Otolaryngology-Head & Neck Surgery

The HPV vaccine has been available for more than ten years. Unfortunately, in the United States vaccination rates are still low. In 2016, only 60 percent of U.S. teens received one or more doses of the HPV vaccine, compared with 88 percent receiving the recommended vaccination for tetanus, diphtheria and pertussis.

The Tulane team is promoting a two-prong approach to encourage HPV vaccinations. The initial thrust is a community based educational platform stressing the role of cancer prevention through HPV vaccination. The second prong is advocacy for policy change at a national level.

“We want people to get vaccinated before they’re exposed to the virus,” says Friedlander. “Otolaryngologists should be actively engaged in promoting cancer vaccinations.”

Friedlander says otolaryngologists should talk to their young patients about the HPV vaccine. The CDC recommends the shots for all kids ages 11 or 12 years old. The vaccine is also recommended for women through age 26 and men age 21.
He says ENTs should also be advocates for policy change at the national level, calling for the HPV vaccine to be included in the inoculations students must have to attend public schools.

“Otolaryngologists have a critical role to play in the HPV epidemic, and our unique perspective is vital in future vaccination education and policy design,” says Friedlander.
American Cancer Society Updates
Colorectal Cancer Screening Guidelines
On May 30, 2018, the American Cancer Society (ACS) updated its colorectal cancer screening guidelines for people at average risk, recommending screening begin at age 45, instead of 50 as recommended in the previous guideline.

ACS lowered the age for people of average risk after looking closely at evidence that new cases of colorectal cancer are occurring at an increasing rate among younger adults.

The new guideline also recommends that people who are in good health and with a life expectancy of more than 10 years should continue regular colorectal cancer screening through the age of 75. For people ages 76 through 85, the decision to be screened should be based on a person’s preferences, life expectancy, overall health, and prior screening history, and those over 85 should no longer get colorectal cancer screening.

It's important to note that health insurance plans may or may not yet cover the screening test for those in the new age range. This could result in out-of-pocket expenses. Before scheduling a screening test, it’s important to check insurance coverage for each test option. There are several screening options, and some may be more affordable than others, particularly when paid out of pocket.

People at increased or high risk of colorectal cancer might need to start colorectal cancer screening before age 45, be screened more often, and/or get specific tests. This includes people with:
  • A strong family history of colorectal cancer or certain types of polyps
  • A personal history of colorectal cancer or certain types of polyps
  • A personal history of inflammatory bowel disease (ulcerative colitis or Crohn’s disease)
  • A known family history of a hereditary colorectal cancer syndrome such as familial adenomatous polyposis (FAP) or Lynch syndrome (also known as hereditary non-polyposis colon cancer or HNPCC)
  • A personal history of radiation to the abdomen (belly) or pelvic area to treat a prior cancer
Anyone with these risk factors should speak with their health care provider about when they should begin screening and how often they should be screened.

For more information on this and other screening guidelines, please visit the American Cancer Society website at www.cancer.org.
Accolades
Robinson Honored as
"Volunteer of the Year"
Bridge House/Grace House recently named William "Rusty" Robinson, MD, "Volunteer of the Year" at their Women of Substance Annual Luncheon, held May 14 at the Audubon Tea Room.

Dr. Robinson, the Maxwell E. Lapham Professor of Gynecologic Oncology at Tulane, and his team provide free cervical cancer and STD screenings weekly at the Grace House Substance Abuse Recovery Center in the hopes of slowing/preventing the spread of these diseases.
(Photo by Gigsy; reprinted with permission from Bridge House/Grace House)
Calendar of Events
Saturday, September 15
Saturday, September 29
Thursday, October 11
Tulane offers free prostate screenings - a PSA blood test - on the second Tuesday of each month at Tulane Comprehensive Cancer Clinic, 150 S. Liberty St., New Orleans. To make an appointment, call 504-988-6300 or 1-800-588-5800.
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