Phila. cancer summit examines promise of precision medicine

Nearly a week after Vice President Biden visited Philadelphia to announce a new federal "moon shot" to battle cancer, the heads of six leading Pennsylvania cancer centers and other experts gathered in Center City on Thursday to discuss treatment and prevention developments, and sort the promise from the hype.

The six directors were panelists at "Cancer Precision Medicine, Big Ideas in Research, Treatment and Prevention," a half-day conference at the College of Physicians of Philadelphia. The event was sponsored by Philadelphia Media Network, owner of The Inquirer, and the American Association for Cancer Research.

President Obama recently announced a $215 million Precision Medicine Initiative to use human genomics and big data to launch "a new era in medicine."

But experts Thursday urged caution.

"We have the ability to take certain cancers off the face of the earth," said Richard Fisher, president and CEO of Fox Chase Cancer Center. "We're very excited about the new progress, but we don't want to overpromise."

Precision medicine, unlike older therapies, targets a tumor's specific set of mutations. These therapies also may take into account a patient's genetic makeup, lifestyle, and environment.

The new federal focus signals "a new day" in cancer research, said Dario Altieri, CEO and director of the Wistar Institute Cancer Center. But the consensus was that it will take many approaches to battle cancer.

"Treating cancer is like playing Wack-a-Mole," said Chi V. Dang, director of the Abramson Cancer Center at the University of Pennsylvania. "You think you got it, and it reappears somewhere else."

Traditional treatments, including surgery, chemotherapy, and radiation, remain primary weapons. Precision medicine, however, allows researchers to better understand the tricks cancer cells use to evade the body's usual defenses, Altieri said.

What could offer even more promise, panelists said, is combining new methods with older therapies.

Dang said using radiation with a new precision therapy had helped reawaken the immune systems of patients by allowing the body to "see" the cancer to which it was previously blind.

Dang described a patient with end-stage melanoma who had made arrangements to enter hospice. But after the combined treatment, Dang said, a chest X-ray revealed the metastatic lesions had disappeared.

Karen Knudsen, director of the Kimmel Cancer Center at Thomas Jefferson University, is a prostate cancer specialist who spoke of what precision therapies could mean for a disease that does not respond well to traditional chemotherapy.

George C. Prendergast, CEO of the Lankenau Institute, said changing a patient's microbiome may produce a better response to cancer treatments. Patients who do not respond to one regimen might benefit from the same treatment after a fecal transplant recalibrates their gut flora, he said.

William N. Hait, head of research and development at Janssen Pharmaceuticals, spoke of his work looking for ways to "intercept" cancer in its premalignant state, much as polyps can be removed during colonoscopies. Multiple myeloma, an extremely painful cancer that resists treatment, is a particular target of his research.

All the panelists emphasized prevention, saying the most important thing people can do to fight cancer is to avoid tobacco. Nancy Davidson, director of the University of Pittsburgh Cancer Institute, called on Pennsylvanians to support banning tobacco sales to anyone under age 21, as Hawaii has done.

Also essential, panelists agreed: regular cancer screenings, maintaining a healthy weight, exercising, and immunizing children with the HPV vaccine to stop a virus implicated in a growing list of cancers.

The event was bracketed by the dramatic story of Emily Whitehead, now 10, the central Pennsylvania girl who was dying of leukemia until doctors at Children's Hospital of Philadelphia engineered her own T-cells to attack her cancer cells. Her oncologist, Stephan Grupp, started the program by explaining the therapy, wowing the crowd with video of engineered T-cells devouring cancer cells.

At the end of the program, Emily's father, Tom, held the crowd rapt with his family's account of battling cancer, and Emily's recent adventures meeting Obama and Biden. She may be, her father said, the only child to receive school excuses from both of the country's top leaders.

samwood@phillynews.com

215-854-2796@samwoodiii