Committed to Excellence in Cancer Research, Education and Patient Care
Inroads
October 2019
Tulane Study Reveals Dim Light at Night May Promote Breast Cancer Metastasis to Bone
While insufficient sleep has been shown to have a litany of adverse endocrine effects, a new study presented at the Endocrine Society's recent 2019 Annual Meeting here in New Orleans revealed the possible dangers of dim light exposure at night that could cause breast cancer to metastasize to the bones.
Muralidharan Anbalagan, PhD , assistant professor of structural and cellular biology, showed for the first time in a mouse study that exposure to artificial dim light at night may contribute to the spread of breast cancer to the bones.
 
Results of the study were presented at ENDO 2019, the Endocrine Society's recent annual meeting in New Orleans, and were featured in the April issue of the Endocrine News ( Pillow Talk by Derek Bagley ).
 
"To date, this is the first report that circadian disruption, via exposure to artificial dim light at night-induced suppression of nighttime melatonin production, increases the formation of bone metastatic breast cancer," said Anbalagan. "This is important, as many patients with breast cancer are likely to be exposed to light at night as a result of lack of sleep; stress; night shift work; and excess light in the bedroom from mobile phones, iPads, laptops, televisions, night lights, and even street lights."

According to the National Cancer Institute, more than 150,000 American women had breast cancer that metastasized, or spread outside the breast, in 2017. When breast cancer spreads, it often goes to the bones, where it can cause severe pain and fragility.
 
In this preliminary study funded by the Louisiana Clinical and Translational Science Center (LACATS) in collaboration with the Louisiana Cancer Research Center (LCRC) and the Tulane Center for Circadian Biology, the researchers created a mouse model of bone metastatic breast cancer.

They injected estrogen receptor-positive human breast cancer cells that have a low propensity to grow in bones into the tibia, or shinbone, of female mice. Like humans, the mice used in this study produce a robust nighttime circadian melatonin signal. This nighttime melatonin signal has been shown to produce strong anti-cancer actions and also promote sleep.
 
All mice were kept in bright light for 12 hours each day. One group of three mice was in complete darkness the other 12 hours, which allowed them to produce high levels of endogenous melatonin at night. Another group spent 12 hours in bright light followed by 12 hours in dim light at night - less that that produced by a night light or cell phone display - which suppressed their nocturnal melatonin production.
 
IVIS small animal images and x-ray images showed that mice exposed to a bright light/dim light cycle had much larger tumors and increased bone damage compared with mice kept in a standard bright light/complete dark cycle.
 
"For the first time, our research demonstrated that dim light at night suppression of the circadian nighttime melatonin signal stimulated breast cancer bone metastasis. At the same time, our study identified the importance of an intact nocturnal circadian melatonin anti-cancer signal in suppressing bone-metastatic breast tumor growth," said Anbalagan.
 
The ultimate goal of this research, according to Anbalagan, is to reveal the key players involved in promoting breast cancer growth in bone and the involvement of melatonin receptors. In the meantime, he reminds everyone that the circadian system is extremely important for overall health. "Circadian disruption by light at night is not only a risk factor in cancer, but also in other metabolic diseases," he says. 
Cancer Cells Turn to Cannibalism to Survive Chemotherapy
This video shows a doxorubicin-treated senescent breast cancer cell (green) engulfing a neighboring cancer cell (red). Video by Tonnessen-Murray et al., 2019 (Story by Keith Brannon)
Researchers from Tulane University School of Medicine have discovered that some cancer cells survive chemotherapy by eating their neighboring tumor cells. The study, which was published in the  Journal of Cell Biology, suggests that this act of cannibalism provides these cancer cells with the energy they need to stay alive and initiate tumor relapse after the course of treatment is completed.

Chemotherapy drugs such as doxorubicin kill cancer cells by damaging their DNA, but cells that survive initial treatment can soon give rise to relapsed tumors. This is a particular problem in breast cancers that retain a normal copy of a gene called TP53. Instead of dying in response to chemotherapy-induced DNA damage, these cancer cells generally just stop proliferating and enter a dormant but metabolically active state known as senescence. In addition to surviving chemotherapy, these senescent cancer cells produce large amounts of inflammatory molecules and other factors that can promote the tumor's regrowth. Chemotherapy-treated breast cancer patients with normal TP53 genes are therefore prone to relapse and have poor survival rates.

"Understanding the properties of these senescent cancer cells that allow their survival after chemotherapy treatment is extremely important," said Crystal A. Tonnessen-Murray, a postdoctoral research fellow in James G. Jackson's laboratory at the School of Medicine.

In the new study, Tonnessen-Murray and colleagues discovered that after exposure to doxorubicin or other chemotherapy drugs, breast cancer cells that become senescent frequently engulf neighboring cancer cells. The researchers observed this surprising behavior not only in cancer cells grown in the lab, but also in tumors growing in mice. Lung and bone cancer cells are also capable of engulfing their neighbors after becoming senescent, the researchers discovered.

Tonnessen-Murray and colleagues found that senescent cancer cells activate a group of genes that are normally active in white blood cells that engulf invading microbes or cellular debris. After "eating" their neighbors, senescent cancer cells digested them by delivering them to lysosomes, acidic cellular structures that are also highly active in senescent cells.

Importantly, the researchers determined that this process helps senescent cancer cells stay alive. Senescent cancer cells that engulfed a neighboring cell survived in culture for longer than senescent cancer cells that didn't. The researchers suspect that consuming their neighbors may provide senescent cancer cells with the energy and materials they need to survive and produce the factors that drive tumor relapse.

"Inhibiting this process may provide new therapeutic opportunities, because we know that it is the breast cancer patients with tumors that undergo TP53-mediated senescence in response to chemotherapy that have poor response and poor survival rates," Jackson said.
Tulane School of Medicine Welcomes
Neuro-Oncologist Christopher Trevino, MD
"I am humbled daily to work with patients with neurologic disease; their courage and perseverance motivate me. As a teacher and guide, we navigate together the most difficult challenges they face."

That's how Dr. Christopher Trevino, assistant professor of medicine, views his role.

As a neuro-oncologist, he diagnoses and treats patients with primary and metastatic tumors of the brain and spine, including glioblastoma, astrocytoma, oligodendroglioma, meningioma, ependymoma, medulloblastoma, and primary CNS lymphoma. He also manages the neurologic complications of cancer and cancer treatments, including the treatment of leptomeningeal carcinomatosis with intrathecal chemotherapy.

"Primary brain tumors - those that originate in the brain or spinal cord - are incredibly rare, accounting for only 2% of all cancer types," said Dr. Trevino. "Metastatic brain tumors occur in about 20-30% of cancer patients and that seems to be increasing primarily because our brains and bodies have evolved over time to have a blood brain barrier that protects the brain from toxic chemicals. It doesn't allow large molecules and toxins to pass through. Unfortunately, the vast majority of chemotherapies we have today don't cross the blood brain barrier. So, in response we have had to develop smaller molecules or different methods in order to treat these patients. Intrathecal chemotherapy - the delivery of chemotherapeutics directly into the fluid surrounding the brain - allows me to get the large molecules directly across and concentrated in the area where they're needed most."

Dr. Trevino graduated medical school from Baylor College of Medicine in Houston, then completed his residency training in neurology at the University of Vermont Medical Center in Burlington. He subsequently returned to Houston where he completed his sub-specialty fellowship training in neuro-oncology at the University of Texas - MD Anderson Cancer Center.

Dr. Trevino's academic interests include novel therapeutics for the treatment of gliomas, immunotherapy in glioblastoma, mechanisms of treatment resistance in glioblastoma, and the neurologic complications of cancer treatment.

One of his highest priorities is to open new clinical trials here at Tulane, particularly for glioblastoma, the most common malignant primary brain tumor and the most aggressive. "When you look at successful trials for glioblastomas in the last 40 years, there have been only three that have shown improved overall survival," said Dr. Trevino. "There are no cures currently for any of the primary brain cancers. We have made advancements in trying to help people live longer, but we have lots of room to improve."

Dr. Trevino is also interested in pursuing basic research into biomarkers or genetic mutations that correlate with brain tumors, and he feels strongly as well about advancing physician education and plans to be involved in the training of the neurology residents, the hematology/oncology fellows, and med students.

Dr. Trevino is currently accepting new patients. To make an appointment, please call 504-988-6300.
Sixth Annual NOLA Bluedoo Raises $143K for Prostate Cancer Research
Although we had to dodge a little rain at times, the Sixth Annual NOLA Bluedoo fundraiser benefiting Tulane Cancer Center's Prostate Cancer Research Program surpassed expectations on so many levels, raising $143,178 this year and approximately $890,000 since 2014!  

This simply could not have been possible without the contributions of so many who went above and beyond to make the event a huge success. "My deepest thanks go out to everyone involved," said Oliver Sartor, MD, assistant dean for oncology and head of Tulane's Prostate Cancer Research Program. "Your commitment to our mission means the world to me and is incredibly vital to my team's progress."
Cancer Crusaders Support Research/
Celebrate Life at Annual Luncheon
Accepting a check from Cancer Crusaders 2018 co-presidents Celia Deininger (second from left) and Cindy Wooderson (second from right) are Augusto Ochoa, MD, director of LSU's Stanley S. Scott Cancer Center (far left) and Prescott Deininger, PhD, director of Tulane Cancer Center (far right).
At their 19th Annual Celebration of Life Luncheon, held recently at the Marriott New Orleans Hotel, the Cancer Crusaders honored 13 local cancer survivors who serve as inspirations to others, not only in the way they faced their cancer battles but also through their community involvement.
 
This year's honorees included Dr. Nicolas Bazan, Ray Garofalo, Minnie Guas, Alison Hotard-Treas, Mary Jones, Kenneth Kerth, Julianne Lansing, Carol Ludwig, Don Mouney, Missie Noel, Yvonne Spicuzza, Phyllis Stacy and Tulane Cancer Center's own DeNean La Roche.
 
2018 co-presidents Celia Deininger and Cindy Wooderson also presented Drs. Augusto Ochoa, director of LSU’s Stanley S. Scott Cancer Center, and Prescott Deininger, director of the Tulane Cancer Center, with a check for $171,521.22, representing the results of their many fundraising efforts last year.
 
The annual survivor luncheon is one of several events planned and organized annually by this group of volunteers whose mission is to provide support for cancer research in the Greater New Orleans Metropolitan area. Funds raised are distributed annually to the Louisiana State University Health Sciences Center and Tulane Cancer Center to support important cancer research efforts. Since 1978, Cancer Crusaders has donated over $5 million to Tulane and LSU.
 
"It takes an incredible level of hard work and dedication to plan and implement the events and programs that generated this result," said Deininger. "We are humbled by the fact that the Cancer Crusaders members have over the years become much more than benefactors. They have become our true partners in every sense of the word. Their pride and enthusiasm in supporting our cancer research efforts are apparent every time we have the good fortune of joining them for a meeting or event. And, we are proud as well to call them our allies and friends."
Blue Ribbon Soiree Closing in on $1 Million Raised for Prostate Cancer Initiatives
Dr. Oliver Sartor thanks Blue Ribbon Soiree Honorary Chairwoman and LSU Women's Gymnastics Coach D-D Breaux (left) and Co-Chair Committee Member Janey Nasca (right) for their efforts to support prostate cancer research and awareness.
Organizers of the ninth annual  Blue Ribbon Soirée are closing in on the $1 million mark in money raised for prostate cancer research and awareness.

Ricky Lato, one of the event’s founders, proudly shared that information with guests at the October 3 gala, which raised a record $155,000 this year. He and his wife, Kathy, and fellow chair committee member Janey Nasca fully expect to cross the $1 million threshold at next year’s 10th Anniversary Soiree.

The event was started in memory of Larry Ferachi and Joel Nasca, who both lost their battles with prostate cancer. It was their participation in clinical trials that led them to Dr. Oliver Sartor, head of Tulane's Prostate Cancer Research Program and one of the few medical oncologists in the world specializing in the research and treatment of advanced prostate cancer.

The bulk of funds raised through the Soirée help support Dr. Sartor's research. The event also benefits the patient relief efforts of Cancer Services.

LSU women’s gymnastics coach D-D Breaux, Janey’s sister, returned this year as honorary chairwoman, along with LSU head baseball coach Paul Mainieri as the honorary chairman. Members of the LSU women's gymnastics team also volunteered their time at the event again this year.

Soiree Planning Committee members also include Jude Bernhard, Gretta Blakenship, Jason Bridges, Jordy Culotta, Joleen and Randy Hays, Jen Hebert, Janna Messina Keifer, Liz Laenger, Ronnie Maranto, Heather Termini and Daniel Williams.

"It is difficult to adequately express my gratitude for the support provided by the Soiree or its importance to my team's research progress," said Dr. Sartor. "To have the commitment and resolve of such a tremendously motivated group behind us is simply invaluable to our efforts, and I am deeply thankful for all that they do."
The 2019 Blue Ribbon Soiree Planning Committee
Kathy and Ricky Lato (right) give special thanks to Jude Bernhard and Tom Besselman, Blue Ribbon Sponsors of the 2019 Soiree.
LSU Women's Gymnastics Team members served as volunteers once again this year.
Krewe de Pink Continues Their Support
of Breast Cancer Research with $35K Gift
Krewe de Pink Social Media Director Julie Sanford (second from left) and President Carol Osborne (far right) present Tulane Cancer Center Director Prescott Deininger, PhD, (second from right) with a check for $35,000 - the results of the organization's fundraising activities for 2019. The donation is intended to support Tulane's Breast Cancer Research Program - specifically the work of Bridgette Collins-Burow, MD, PhD, and her team. Also in attendance was Margarite Motassian (far left), MD/PhD candidate in Tulane's physician scientist program and a member of the Collins-Burow lab.
Members of Krewe de Pink, a local non-profit founded by individuals who have been impacted by breast cancer and inspired by survivors, presented Tulane Cancer Center Director Prescott Deininger, PhD, with a check for $35,000 at the group's recent VIP Second Line Party, the culmination of their fundraising efforts over the past year.

These funds, which were raised through Krewe de Pink's two 2019 events - the Pink Bra Run and the Pink Prom - are intended to support Tulane Cancer Center's Breast Cancer Research Program. More specifically, this donation will continue to bolster the research of Bridgette Collins-Burow, MD, PhD, and her team into triple negative breast cancer. To date, Krewe de Pink has donated a cumulative $100,000 to the Collins-Burow lab.

"On behalf of Dr. Bridgette Collins-Burow and her research team, as well as the community we serve, I thank the members of Krewe de Pink for their inspiration, dedication, and enthusiasm," said Dr. Deininger. "Their efforts will continue to meaningfully impact the course of breast cancer research here at Tulane and throughout Louisiana."

The organization is planning a third fundraising event in 2020 - Death by Chocolate - a chocolate and champagne cocktail reception to be held Friday, February 7, 5 - 7 PM, at Jacob Schoen & Son, 3827 Canal St. in New Orleans. Tickets are $25 each. For more information, email [email protected].

"Your contributions and support are invaluable to the success of our breast cancer research team," said Margarite Motassian, MD/PhD candidate in Tulane's Physician Scientist Program and a member of the Collins-Burow lab. "We are so proud to be associated with Krewe de Pink and are looking forward to future opportunities to raise awareness of breast cancer research in the New Orleans community."
Calendar of Events
benefiting Research Into the Cure of Leukemia and Related Diseases

Wednesday, December 11, 2019
New Orleans Hyatt Regency Hotel
Kidney Cancer Day -
Connecting Patients to Care Teams

Thursday, December 12
7:15 AM - 3:30 PM
Diboll Auditorium and Gallery
First Floor, Tidewater Building
1440 Canal St., New Orleans
The Section of Hematology and Medical Oncology in the John W. Deming Department of Medicine at Tulane will host its Inaugural Kidney Cancer Day in an effort to raise awareness of this disease that is among the ten most common cancers. The event will include kidney cancer management lectures by Tulane physicians and researchers, as well as a keynote address by Dena Battle, co-founder and president of The Kidney Cancer Research Alliance, on The Role of Patient Advocacy Groups in Oncology.
The event is free and open to patients and their families, Tulane providers, staff and students and members of the community interested in learning more about kidney cancer. Breakfast, lunch and refreshments will be provided. For more information, please contact Susana Torres at [email protected] or 504-988-1236.
Champagne & Chocolates Cocktail Party benefiting Tulane Cancer Center's Breast Cancer Research Fund

Friday, February 7, 2020 - 5-7 PM
Jacob Schoen & Son
3827 Canal St., New Orleans

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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