Download Abramson Cancer Center Director`s Leadership

Abramson Cancer Center
Director’s Leadership Council
March 13, 2017
“Bringing the Noise: Changing the Face of the Silent Killer”
Gynecologic Oncology Program
Ronny Drapkin, MD, PhD
Director, Penn Ovarian Cancer Research Center
Director, Gynecologic Oncology Research, Basser Center for BRCA
Robert Burger, MD
Director, Clinical Research
Mark Morgan, MD
Chief, Gynecologic Oncology
• There are 240,000 new
cases of ovarian cancer
diagnosed each year
– 152,000 deaths/yr
• 70-80 % of women are
diagnosed with late stage
disease
• Lack of screening tool for
early detection
• Limited understanding of
molecular pathogenesis
• Most lethal gynecologic
malignancy
% 5-year survival
Ovarian Cancer – The ‘Silent’ Killer
90
80
70
60
50
40
30
20
10
0
1
2
3
4
Clinical Stage
Tumor
Why Penn?
•
•
•
•
Unique commitment to Gynecologic Cancers
Penn Ovarian Cancer Research Center - 2007
Basser Center for BRCA – 2012
Collaborators across other Philadelphia-based
institutes
• Collaborative environment
“In the long history of humankind (and animal kind, too)
those who learned to collaborate and improvise most
effectively have prevailed.”
Charles Darwin
On the Origin of Species, 1859
Goals of Ovarian Cancer Research Center
(OCRC)
• Develop a comprehensive understanding of
ovarian cancer pathogenesis.
• Develop new methods for early detection and
prevention of ovarian cancer.
• Characterize the genetic factors that drive the
development of hereditary (BRCA) and sporadic
forms of ovarian cancer.
• Develop new approaches to treat and prevent
ovarian cancer.
• Support clinical trials to assess safety and efficacy
of new treatments.
BRCA as a Model for Early Ovarian Cancer
Opportunity to evaluate the tubes and ovaries in women who
undergo prophylactic salpingo-oophorectomy and detect
tumors early in their course
“Ovarian Cancers” actually start in the Fallopian Tube, not the Ovary!
Impact of Fallopian Tube
• Prevention:
– Remove tissue at risk  complications:
• “Surgical menopause”
– SGO recommendation for women at risk:
• Two-step risk reduction
– Recommendation for women at average risk:
• Opportunistic salpingectomy at time of hysterectomy, in lieu of
tubal ligation, other pelvic surgery
• Early Detection:
– CA125: inadequate for early detection
– Transvaginal Ultrasound: inadequate for early detection
– New BINARY biomarkers for ovarian cancer
Perets and Drapkin, Cancer Res, 2016
Gyn Oncology Immunotherapy
• CAR T-Cell Therapy Trials:
– Mesothelin
– Folate Receptor
• Vaccine Trials:
– Mesothelin
– Survivin
• Chemo + Checkpoint
inhibitors:
– Ab against PD-L1 (Avelumab)
– Ab-drug conjugate against
Folate Receptor
– Dual checkpoint inhibitors
Janos Tanyi, Dan Powell, Robert Burger
Penn Ovarian Cancer Research Center
PDX Platform
•
Primary Orthotopic PDX model
with patient-matched immunity
– PI: F. Simpkins lab
•
Metastatic Orthotopic PDX models
– PI: R. Drapkin lab
George et al., JCI Insight, 2017
Liu et al., CCR, 2017
Volume of GYN Biospecimens
Tumor type
HUP
PAH
CCH
Penn MedVirtua
Ovarian
80
35
20
emerging
Endometrial
100
100
90
emerging
Cervix
40
25
10
emerging
Other
40
30
10
emerging
LONGitudinal Genomic
PROFILing
(LONG PROFILE)
PDX-Assisted
THerapeutics FOR
Women At Recurrent
Disease (PATH FORWARD)
BIOmarkers for
Ovarian Cancer
(BioOvCa)
Diagnosis
OCRC Tumor Bank
Treatment
Recurrence
Rationale Evidence-Based
MAINtenance
(REMAIN)
Rapid Autopsy
Program (RAP)
Death
CAR T-Cell
Therapy
?
ncRNAs
?
Clinical
Trials