What’s New In Cancer Care

Michael Vander Kooy, MD

Radiation Oncologist

Agnesian Cancer Center

Know & Go Friday. . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Michael Jones, MD

Medical Oncologist

Agnesian Cancer Center

Advances In Radiation OncologyMichael Vander Kooy, MD

Radiation OncologistAgnesian Cancer Center

Radiation Oncology

Michael Vander Kooy, MD Filip Troicki, MD Timothy Korytko, MD

Radiation Therapy

Noelle B., RTT Ellie B., RTT Bonnie D., RTT

Radiation Therapy

Brian S., RTT Angie H., RN

Radiation Nursing

Tammie L., RN Mary L., RNStacy S., RN

Ancillary Associates

Tim L.Physicist

Phil B.Dosimetrist

Heather B., Oncology Supervisor

Ancillary Associates

Chris B.Oncology Navigator

Liz H., RDDietitian

Kristie M., MSW Social Worker

Agnesian Cancer Center

Linear Accelerator

THANK YOU!

Advances In Medical OncologyMichael Jones, MDMedical Oncologist

Agnesian Cancer Center

Medical Oncology

Joel Lundberg, MD Michael Jones, MD

Sara S., LPN Betsy M., LPN Rachel S., RN

Medical Oncology

Nicki W., RN Margot B., RN Terri B., RN

Medical Oncology

Kristin M., RN Cindy K., RN

Medical Oncology

Patty S.Pharmacy Technician

Travis D., PharmD, RPh

Medical Oncology

General Outline

What is cancer

Cancer heterogeneity and implications for

treatment

General cancer treatments.

Targeted cancer therapyThe Story of BCR-ABL and chronic

myelogenous leukemia.

BRAF and melanoma.

What Is Cancer?

What Has Happened?

Cancer Is a Genetic DiseaseCancer is a genetic disease that develops in a

predictable sequence of steps

Carcinogenesis Transformation of a normal cell into a cancerous cell

Occurs by a step-by-step transformation

Involves an abnormal change in cell DNA called a

mutation.

These mutations facilitate the cell to divide, invade,

and metastasize independent of normal cell

controls.

Cancer Often Involves Multiple Mutations

Multiple Mutations Influence Cancer Cells Survival

Carcinogenesis Occurs In Predictable Steps

Cancer Heterogeneity and Implications

for Treatment

How is Cancer Heterogeneous?

We Are Just Beginning to Understand

General Cancer Treatments

How Does An Oncologist Treat Cancer?

Chemotherapy

Radiation Therapy

Immunotherapy

Targeted Therapy

Targeted Cancer Therapy

Targeted Cancer Therapy

Identifying specific gene abnormalities which facilitate or allow cancer to grow and divide, and “targets” that abnormality with a specific drug.

“Dumb Cancer”- Cancer has developed just a few mutations which are vital to the cancer cell’s survival.

“Smart Cancer”- Cancer has developed multiple mutations which facilitate its growth. Each is important but not necessarily vital to cancer cell survival.

Targeted Cancer TherapyThe Story of BCR-ABL and

Chronic Myelogenous Leukemia

Chronic Myelogenous LeukemiaA Simple Cancer

Normal blood smear Leukemia blood smear

Translocation of DNA in Chromosome

Variations in Chromosomal Deletions Patterns in Patients with Glioblastoma Brain Tumor

p53locus

Chromosomal Loss:

PTENlocus

CDKN2locus

RB1locus

Chronic Myelogenous Leukemia

Normal blood smearLeukemia blood smear

Translocation of DNA in Chromosome

Imatinib (Gleevac) in Chronic Myelogenous Leukemia

Impact of Treatment on Patients Lives Treated with Gleevac

Targeted Cancer TherapyMelanoma & BRAF

Melanoma

Mutational Frequency In Melanoma

Hodis, Cell 2012

How BRAF Works in Melanoma

Drug Targeting BRAF

14-Day Response to Vemurafenib

Effects of Vemurafenib On Survival in Metastatic Melanoma

THANK YOU!