Committed to Excellence in Cancer Research, Education and Patient Care
Inroads
May 2020
Tulane Seeks Recovered COVID-19 Patients to Volunteer as Plasma Donors for Clinical Trial
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If you've already had COVID-19, your blood plasma could help patients currently fighting the virus.
 
Tulane Medical Center and The Blood Center are seeking people fully recovered from COVID-19 to donate their plasma - known as convalescent plasma - for a clinical trial that will test whether it is effective in treating current coronavirus patients at different stages of disease. 
 
"If individuals have been tested and diagnosed with COVID-19 in the past and have been feeling well for more than 14 days, their blood plasma could contain antibodies capable of neutralizing the coronavirus," said Dr. Nakhle Saba, associate professor of clinical medicine in Hematology & Medical Oncology at Tulane School of Medicine and one of the principal investigators on the trial. 
 
Plasma is the liquid portion of the blood that carries the blood cells and other proteins, including antibodies. When someone recovers from an infection, their immune system produces antibodies to help protect against future infections. This protection can also be extended to others via a plasma transfusion.
 
Convalescent plasma has been used successfully for hundreds of years to help treat other diseases, including polio, measles, influenza, Hepatitis B, Ebola and SARS, another type of coronavirus. And there are many studies ongoing throughout the U.S. and the world right now to test whether it is a viable option for treating COVID-19. "So far, based on anecdotal and historical evidence we believe it can work," said Saba. "Of course, additional data is needed before we can be sure."
 
Plasma is collected similarly to blood product donation.  Donors must be able to document their positive COVID-19 test and must be completely recovered and symptom-free for 14 days. A typical donation consists of 200 - 800 milliliters of plasma, equivalent to 1 - 4 units of blood, which is screened for safety per The Blood Center's standard guidelines. The donation process takes approximately two hours, and donations can be made monthly.
 
The donated plasma will be transfused into patients who have been diagnosed with COVID-19 in the previous 14 days - one group with more severe symptoms, including pneumonia, and a second group with more moderate disease who are within 3 - 7 days of symptom onset. In most cases, a single unit transfusion is all that will be administered.
 
If you are interested in donating plasma, please click here to register or call 504-321-1740 to speak with a representative to determine your eligibility for donation.

Read Dr. Saba's interview with WWNO - New Orleans Public Radio.
A Ray of Hope in the Crisis, Dr. Kendra Harris Shines Light on Needs of Healthcare Providers
On her home porch, Dr. Kendra Harris is making phone calls to former Tulane medical school residents and others to ask for their support for frontline healthcare providers. Harris is chair of the Department of Radiation Oncology at the Tulane University School of Medicine. (Story by Mary Ann Travis; photo by Paula Burch-Celentano)
Leave it to Dr. Kendra Harris to find the silver lining in the coronavirus epidemic that has so greatly affected New Orleans. Harris, chair of the Department of Radiation Oncology at Tulane University School of Medicine, is optimistic by nature and has a can-do spirit. As the city has been one of the hardest hit during the COVID-19 pandemic, Harris has discovered among the Tulane team an “outpouring of love and care” — some of it instigated by her.

In mid-March when the first COVID-19 case was recorded at Tulane Hospital, Harris became alarmed that “we were going to have a lot of unmet needs on our frontline teams.” She was particularly worried about residents, the doctors in training at the medical school, who would suddenly have unexpected childcare expenses because schools and daycare centers were closing.

She also wanted to give support to other frontline healthcare workers, including nurses, custodians and registrars. “They are coming to work. They are risking themselves and their families. They’re showing up and saving lives.”

Harris, under the leadership of School of Medicine Dean Lee Hamm, partnered with university administrators to establish the Tulane Frontline Providers Fund: Green Wave Heroes.

In the meantime, the university has offered emergency stipends for childcare expenses to the families of affected medical residents, at a cost of more than $10,000 per week, through the natural end of the school year.

 “My intention is to pay that back in full through fundraising,” said Harris.

To raise funds, Harris started calling a list of 1,000 former Tulane medical school residents, who have gone on to jobs in other states. Now current medical school students are helping her make calls. “We’re making our way through the list, and the generosity is breathtaking.”

She also turned to other needs at the hospital and clinic. “When we reached out to the program directors, the first need called out was food — coffee, breakfast, lunch.”

With contributions from individual donors, as well as corporate grants and a significant gift from a community fund, the Frontline Providers Fund had delivered 9,540 meals to nurses and doctors by late May.

The fund has also provided scrubs to medical staff. And early on, the fund decided that all meals and additional needs would be purchased from locally owned businesses exclusively.

“This is a way to show the team members the love that is felt for them in the community for the work that they are doing,” said Harris. “This is a small way to say we see you; we value you. Your work is important. And we’re going to try to get you the things you say you need.”

As chair of radiation oncology at the Tulane Cancer Center, Harris has taken dramatic steps to keep her patients in need of daily radiotherapy protected from COVID-19. Patients receive radiation treatment outside of regular clinic hours, in the early morning and late afternoon. She is determined to not let the coronavirus crisis interfere with treatment plans — and she does not want her patients exposed to COVID-19.

As a result of these precautions, “We’ve not had a single patient or single person who is needed in person at work each day in my department test positive for COVID,” she said.

“Cancer does not care about the epidemic,” she added.

She said she feels pride in Tulane medical school and the university’s reaction to the crisis. “A natural disaster has a start, a finish and an aftermath. This epidemic is different — and we expect to need plans over the intermediate and long term, or until a high-quality vaccine is developed that works over time.”

Long-term support for frontline workers is essential for Tulane to continue to do what it has done to provide exemplary health care, said Harris. The needs among Tulane family frontline members are unlikely to dissipate.

“I think, honestly, no one in the Tulane family thinks we’re going back to the way things were, and the pride we all feel about meeting this crisis head-on is palpable. Everyone is showing up, really doing their part,” said Harris.

But to be in a position “to recognize the needs and to partner with our gifted faculty and strong leadership to clarify the nature of the need in partnership and to meet it in real time have been such a gift to my heart.”

“You know, I love Tulane. I love it even more.”

To see the community come together to help one another is a “great blessing,” said Harris. “All of us need to shine our little lights brightly and continue to bring that light to the darkness of this disease.”

Click here for information on giving to the Tulane Frontline Providers Fund: Green Wave Heroes.
ACS Grant to Help Cancer Patients Overcome Transportation Barriers Especially Critical Now
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Cancer patients undergoing treatment frequently require assistance getting to and from facilities, often adding stressful financial and logistical burdens on top of their diagnosis. To help address this issue, the American Cancer Society (ACS) has awarded Tulane Cancer Center a $10,000 transportation grant.
 
An estimated 26,480 Louisiana residents will learn they have cancer this year and getting to their scheduled treatments may be one of their greatest roadblocks to recovery, especially now. To help patients get the critical care they need, ACS community transportation grants are awarded at a local level to health systems, treatment centers and community organizations. These grants are available in select communities through an application process and focus on addressing the unmet transportation needs of cancer patients, particularly vulnerable populations experiencing an unequal burden of cancer. 
 
Much of the population in the Greater New Orleans region live at or below the federal poverty line and many of these individuals are chronically un- or underinsured.  They also disproportionately suffer higher cancer incidence and mortality rates.   Additionally, there is a widespread lack of access to clinical care among this socio-economically disadvantaged population, and transportation issues are often to blame.

“Disparities predominantly arise from inequities in work, wealth, income, education, housing and overall standard of living, as well as social barriers to high-quality cancer prevention, early detection and treatment services,” said Kate Kelley, executive director of the American Cancer Society in Louisiana. “The Society collaborates with community health partners to reach individuals in areas with higher burdens of cancer and limited or no access to transportation.”
 
Assistance provided through this grant will supplement the American Cancer Society's current Road To Recovery program, through which volunteers use their personal vehicles to transport patients to and from appointments. In as many cases as possible, Road To Recovery rides will be utilized first, and only when that program cannot fulfill a need will the grant assistance kick in.

"Our patients travel varying distances to receive their care here - from 5 miles to several hundred miles across the Gulf Coast," said Melissa Barrois, LMSW, Tulane Comprehensive Cancer Clinic social worker, who will oversee distribution of the grant funds. "Of course, if transportation issues block access to care, five miles can seem like several hundred. An ACS transportation grant can help us to alleviate that problem for many."
 
Prescott Deininger, PhD, Tulane Cancer Center director, says that removing these obstacles and the stress that comes with them can help patients to follow their treatment plans and focus more intently on their journey to survivorship. "We are deeply grateful to the American Cancer Society for their partnership and support in this incredibly important effort," said Deininger.
Study Targeting Tumor Genetic Mutations Yields ‘Practice Changing’ Results for
Prostate Cancer Treatment
Oliver Sartor, MD, head of Tulane Cancer Center’s Prostate Cancer Research Program, co-authored a study that revealed therapies based on tumor genetics may also show promise in treating some men with metastatic castration-resistant prostate cancer. (Photo by Paula Burch-Celentano)
Prostate cancer therapies have shown significant advances during the past decade, with multiple new therapies being introduced for patients with advanced disease. 

Now, the early results of a clinical trial published in the  New England Journal of Medicine (NEJM)   reveals for the first time that therapies based on tumor genetics – specifically DNA repair defects – may also show promise in treating some men with metastatic castration-resistant prostate cancer (mCRPC). 

“This trial has shown a new breakthrough which I believe will lead to FDA approval,” said Oliver Sartor, MD, head of Tulane Cancer Center’s Prostate Cancer Research Program and a member of the Steering Committee that designed and implemented the international study. The study, called the PROfound trial, has enrolled 387 patients at 221 sites across the globe, including Tulane. Sartor is also a co-author of the NEJM article.

The purpose of this phase-three study is to evaluate the efficacy and safety of olaparib versus enzalutamide or abiraterone acetate in subjects with mCRPC who have failed prior treatment with a new hormonal agent and who have a qualifying mutation in one of 15 genes involved in a particular DNA repair pathway. DNA repair is essential for cellular life given the frequent damage that DNA sustains during the normal course of events.

Olaparib is a drug that belongs to a class of medications called PARP inhibitors, which inhibit the enzyme poly ADP ribose polymerase (PARP). PARP inhibitors have been used to treat selected cancers, including breast cancer, pancreatic cancers and ovarian cancer; however, this is the first published large trial in prostate cancer. PARP inhibitors selectively kill cells that lack certain forms of DNA repair (homologous recombination repair), but have relatively minor effects on cells with intact DNA repair pathways.

The trial divided patients into two cohorts based on the type of genetic defect. Cohort A (245 patients) had at least one alteration in selected homologous recombination genes BRCA1, BRCA2, or ATM; cohort B (142 patients) had alterations in any of 12 other pre-specified homologous recombination repair genes. The patients were then randomly assigned (in a 2:1 ratio) to receive olaparib or the physician’s choice of enzalutamide or abiraterone (control).

The results show that in cohort A, progression-free survival – the primary endpoint of the trial – was significantly longer in the olaparib group than in the control group (median, 7.4 months vs. 3.6 months). The median overall survival in cohort A was also longer – 18.5 months in the olaparib group vs. 15.1 months in the control group. Eighty-one percent of the patients in the control group who had progression crossed over to receive olaparib.

“This is important not only because of the potential benefit that patients can receive, but it also represents a conceptual advance based on tumor genetics in terms of selecting therapies that can offer hope for mCRPC patients,” said Sartor. “With this advance, there will be increasing focus on underlying genetic alterations in tumors and the application of specific therapies based on those alterations – something we call precision oncology. Precision oncology has advanced in other tumors, notably lung and melanoma. This represents the first such advance in prostate cancer, which is practice changing.”
Gunning for a Cure 2020 Raises $220K
for Prostate Cancer Research


The 2020 Gunning for a Cure Sporting Clays fundraiser - held in early March before the statewide quarantine - has thus far raised approximately $220,000 for Tulane's Prostate Cancer Research Program.
"The event was absolutely incredible - as always - with so many good people eager to support the research that is vital to progress in the fight against this disease," said Oliver Sartor, MD, head of Tulane's program. "I am deeply grateful to everyone involved - especially the Perez family and friends and all of the other Planning Committee members, sponsors, shooters and volunteers - for their overwhelming generosity and commitment. Their support is not only humbling but comes with a great deal of responsibility to use these funds as wisely as possible in our search for new treatment options and targets for those with advanced disease."
Dr. Sartor and his team will continue to utilize funds raised through Gunning for a Cure - over $1.2 million thus far since the event began in 2013 - to support a variety of projects, including testing to determine whether genetic defects contribute to prostate cancer risk and basic laboratory research designed to better understand the biology of the disease.