As a consortium partner of the NCI-designated University of Kansas Cancer Center and Stowers Institute for Medical Research, Children’s Mercy Kansas City is part of an elite group of pediatric cancer research centers. The strength in pharmacogenomics and genomics at Children’s Mercy, opens up new avenues for diagnosis and treatment of various forms of childhood cancer. Combining these strengths with the full range of expertise at The University of Kansas Cancer Center offers hope for current and future patients fighting cancer.
Join us as Alan Gamis, MD, discusses the importance of NCI designation and what it means to pediatric research and patient care.
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Collaborating to Cure Pediatric Cancer
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Learn more about Alan Gamis, MD
Alan Gamis, MD
Alan Gamis, MD, MPH, is Associate Division Director, Section of Oncology at Children’s Mercy Kansas City, and Professor of Pediatrics at the University of Missouri-Kansas City. Dr. Gamis received his medical degree and master’s degree in public health from the University of Illinois. He completed a residency in pediatric at Children’s Mercy and fellowship in Pediatric Hematology/Oncology at the University of Minnesota. Dr. Gamis is board certified in Pediatric Hematology/Oncology. Dr. Gamis’ special interests are in acute myeloid leukemia, neuroblastoma, supportive care, transplantation and late effects.Learn more about Alan Gamis, MD
Transcription:
Collaborating to Cure Pediatric Cancer
Dr. Michael Smith (Host): So, our topic today is collaborating to cure pediatric cancer. My guest is Dr. Alan Gamis. Dr. Gamis is associate division director, section of oncology at Children’s Mercy Kansas City and professor of pediatrics at the University of Missouri, Kansas City. Dr. Gamis, welcome to the show.
Dr. Alan Gamis, MD (Guest): Thank you.
Dr. Smith: So, let’s start with what is the NCI designation. What does that mean?
Dr. Gamis: Alright, well the NCI stands for the National Cancer Institute and there are only 60 some research organizations within the United States that have been awarded the designation of an NCI Cancer Center. We were identified as a consortium member of the University of Kansas Cancer Center’s NCI designation as of this year, based upon our collaboration with the University of Kansas as well as our ongoing research efforts here at Children’s Mercy in the field of childhood cancer.
Dr. Smith: So, when you look at this kind of collaboration, what does that really mean then to pediatric cancer research and ultimately patient care?
Dr. Gamis: Okay, well one of the critical elements of childhood cancer is collaboration. Childhood cancer fortunately is rare and so to achieve advances in therapy, it’s critical to combine forces. In this arena, what we are doing is combining the strength of our large population of childhood cancer patients that we take care of at Children’s Mercy, along with our genome lab, or pharmacology program, our immunotherapy program with the researchers and expertise in adult cancer at the University of Kansas. Combining those strengths, we can more efficiently and more rapidly make advances in curing more and more children with childhood cancer.
Dr. Smith: So, you touched on a couple of research topics that I think most of us find very interesting, right, that’s the cancer genomics and the immunotherapy. Let’s talk a little bit about both of those. What are some of the advances that we have made in those two areas that excite you the most and where you think there is the most potential?
Dr. Gamis: Well, traditionally, cancer has been treated by the modalities of initially surgery, then radiation, and then finally chemotherapy. All certainly have their well-known complications and their well-known failures of not curing everyone. Fortunately, in childhood cancer, our cure rates have improved to nearly 80% with those traditional methods. However, we still have 20% who are dying of their cancer. We also have numerous children who have long-term side effects. So, through the additional new therapies based upon genomics and our immune system; we are making new advances after a decade of stagnation in improvements. We know that cancer is a disease of the genes. There are mutations that are acquired in our normal cells that cause the cells to proliferate or divide out of control.
Over the last decade, we have become very adept at identifying many of these mutations and through our laboratories here at Children’s Mercy in genomics; we are furthering this discovery effort. Identifying these mutations are the first step and then developing targeted agents to block these mutations or to eliminate those mutations so that the cancer itself then dies, leaving only our normal healthy cells. The first effect of this was seen actually in a leukemia that was shared by both adults and children called chronic myeloid leukemia and that was the BCR ABL mutation. That used to be a leukemia that could only be cured by bone marrow transplant. With the discovery of that mutation, and then an agent that blocked that mutation called imatinib or Gleevac, the disease became a well-controlled highly curable cancer of greater than 90% cure rate by taking simply a pill a day.
So, that was the first attack via genomics and we have now had numerous other advances in the field of genomics and cancer therapy. So, our labs here, at Children’s Mercy have taken the field of genomics and worked to rapidly accelerate the discovery and the results that we can discern from the tests patient’s normal genetics and now their cancer genetics. We can turn around whole genome sequencing in approximately 48-72 hours. Some of the fastest in the world at this point. And so, we have cancer researchers here at Children’s Mercy who are further exploring new mutations and variations on those mutations because even discovering those mutations is not the final step because there is so much variability.
Then the field of immunotherapy is now the newest and also perhaps the most exciting, in that we can now take our knowledge of genomics and actually go into the genes of our immune system, clip out a piece that we don’t need, insert a new gene into our immune system. That gene then drives the person’s own immune system to specifically attach to cancer cells and then that triggers our immune system to attack that cancer cell and destroy it again, sparing our normal cells. So, we have seen – we were one of the first childhood cancer centers in the country to pilot the now FDA approved Car T cell or CarT19 T cell therapy which has seen dramatic improvement. Our labs are now or have been designing newer and newer generations of those CarTCells so, that they can persist throughout the life of a person and therefore continuously monitor to fight that particular cancer, so it doesn’t come back. And we are expanding that further and further and those are collaborations – results of collaborations with our efforts at the KU Cancer Center as well as here at Children’s Mercy.
Dr. Smith: So, Dr. Gamis, just kind of in summary then, what would you like people to know about pediatric cancer?
Dr. Gamis: Pediatric cancer is a success story that has not yet written the final chapter. We are seeing 80-85% cure rates, but until the last child is cured; we won’t be satisfied. And as I said, there are still many children out there who have long-term side effects of past therapies or even of today’s therapy and, so we need to continue to improve our therapies and to continue to support our children who have gone through this therapy well into their adulthood and hopefully, into their elderly years. So, it’s a story that is ongoing but one that is becoming ever brighter.
Dr. Smith: Yeah, that’s awesome. Dr. Gamis, thank you for the work that you are doing at Children’s Mercy and thank you for coming on the show today. You’re listening to Transformational Pediatrics with Children’s Mercy Kansas City. For more information, you can go to www.childrensmercy.org . That’s www.childrensmercyorg . I’m Dr. Mike Smith. Thanks for listening.
Collaborating to Cure Pediatric Cancer
Dr. Michael Smith (Host): So, our topic today is collaborating to cure pediatric cancer. My guest is Dr. Alan Gamis. Dr. Gamis is associate division director, section of oncology at Children’s Mercy Kansas City and professor of pediatrics at the University of Missouri, Kansas City. Dr. Gamis, welcome to the show.
Dr. Alan Gamis, MD (Guest): Thank you.
Dr. Smith: So, let’s start with what is the NCI designation. What does that mean?
Dr. Gamis: Alright, well the NCI stands for the National Cancer Institute and there are only 60 some research organizations within the United States that have been awarded the designation of an NCI Cancer Center. We were identified as a consortium member of the University of Kansas Cancer Center’s NCI designation as of this year, based upon our collaboration with the University of Kansas as well as our ongoing research efforts here at Children’s Mercy in the field of childhood cancer.
Dr. Smith: So, when you look at this kind of collaboration, what does that really mean then to pediatric cancer research and ultimately patient care?
Dr. Gamis: Okay, well one of the critical elements of childhood cancer is collaboration. Childhood cancer fortunately is rare and so to achieve advances in therapy, it’s critical to combine forces. In this arena, what we are doing is combining the strength of our large population of childhood cancer patients that we take care of at Children’s Mercy, along with our genome lab, or pharmacology program, our immunotherapy program with the researchers and expertise in adult cancer at the University of Kansas. Combining those strengths, we can more efficiently and more rapidly make advances in curing more and more children with childhood cancer.
Dr. Smith: So, you touched on a couple of research topics that I think most of us find very interesting, right, that’s the cancer genomics and the immunotherapy. Let’s talk a little bit about both of those. What are some of the advances that we have made in those two areas that excite you the most and where you think there is the most potential?
Dr. Gamis: Well, traditionally, cancer has been treated by the modalities of initially surgery, then radiation, and then finally chemotherapy. All certainly have their well-known complications and their well-known failures of not curing everyone. Fortunately, in childhood cancer, our cure rates have improved to nearly 80% with those traditional methods. However, we still have 20% who are dying of their cancer. We also have numerous children who have long-term side effects. So, through the additional new therapies based upon genomics and our immune system; we are making new advances after a decade of stagnation in improvements. We know that cancer is a disease of the genes. There are mutations that are acquired in our normal cells that cause the cells to proliferate or divide out of control.
Over the last decade, we have become very adept at identifying many of these mutations and through our laboratories here at Children’s Mercy in genomics; we are furthering this discovery effort. Identifying these mutations are the first step and then developing targeted agents to block these mutations or to eliminate those mutations so that the cancer itself then dies, leaving only our normal healthy cells. The first effect of this was seen actually in a leukemia that was shared by both adults and children called chronic myeloid leukemia and that was the BCR ABL mutation. That used to be a leukemia that could only be cured by bone marrow transplant. With the discovery of that mutation, and then an agent that blocked that mutation called imatinib or Gleevac, the disease became a well-controlled highly curable cancer of greater than 90% cure rate by taking simply a pill a day.
So, that was the first attack via genomics and we have now had numerous other advances in the field of genomics and cancer therapy. So, our labs here, at Children’s Mercy have taken the field of genomics and worked to rapidly accelerate the discovery and the results that we can discern from the tests patient’s normal genetics and now their cancer genetics. We can turn around whole genome sequencing in approximately 48-72 hours. Some of the fastest in the world at this point. And so, we have cancer researchers here at Children’s Mercy who are further exploring new mutations and variations on those mutations because even discovering those mutations is not the final step because there is so much variability.
Then the field of immunotherapy is now the newest and also perhaps the most exciting, in that we can now take our knowledge of genomics and actually go into the genes of our immune system, clip out a piece that we don’t need, insert a new gene into our immune system. That gene then drives the person’s own immune system to specifically attach to cancer cells and then that triggers our immune system to attack that cancer cell and destroy it again, sparing our normal cells. So, we have seen – we were one of the first childhood cancer centers in the country to pilot the now FDA approved Car T cell or CarT19 T cell therapy which has seen dramatic improvement. Our labs are now or have been designing newer and newer generations of those CarTCells so, that they can persist throughout the life of a person and therefore continuously monitor to fight that particular cancer, so it doesn’t come back. And we are expanding that further and further and those are collaborations – results of collaborations with our efforts at the KU Cancer Center as well as here at Children’s Mercy.
Dr. Smith: So, Dr. Gamis, just kind of in summary then, what would you like people to know about pediatric cancer?
Dr. Gamis: Pediatric cancer is a success story that has not yet written the final chapter. We are seeing 80-85% cure rates, but until the last child is cured; we won’t be satisfied. And as I said, there are still many children out there who have long-term side effects of past therapies or even of today’s therapy and, so we need to continue to improve our therapies and to continue to support our children who have gone through this therapy well into their adulthood and hopefully, into their elderly years. So, it’s a story that is ongoing but one that is becoming ever brighter.
Dr. Smith: Yeah, that’s awesome. Dr. Gamis, thank you for the work that you are doing at Children’s Mercy and thank you for coming on the show today. You’re listening to Transformational Pediatrics with Children’s Mercy Kansas City. For more information, you can go to www.childrensmercy.org . That’s www.childrensmercyorg . I’m Dr. Mike Smith. Thanks for listening.