cancer rev 2011

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Curriculum Vitae

Name : Dr.Johan Kurnianda SpPD-KHOM

Occupation :

-Head of Division of Hematology-Medical Oncology

Department of Internal Medicine

Medical Faculty Gadjah Mada University

-Head of Tulip Integrated Cancer Clinic

Sardjito Hospital Yogyakarta

-Fellowship Trainings :

1998 PBSCT for high-dose CT in breast cancer AZG The Netherlands2001 Head and Neck Cancer VUMC The Netherlands

2003 Immuno therapy for NHL AMC The Netherlands

-Publications :

±±±± 50 National/International seminar papers

±±±± 15 journal papers-Professional organizations :

Full member of American Society of Clinical Oncology (ASCO)

Full member of European Society of Medical Oncology (ESMO)

Full member of International Society of Hematology (ISH)

PHTDI, PAPDI

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Cancer Management :Current Updates

Johan Kurnianda

Division of Hematology-Medical Oncology

Department of Internal Medicine, Faculty of Medicine,

Gadjah Mada University Yogyakarta

16 January 2011

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My Presentation Outlines

• Cancer Problem : burden of disease

• Cancer Pathogenesis : genetic disease

• Cancer management : translational research

and customized medicine

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Cancer : World Incidence

Global Cancer Facts & Figures 2007. Atlanta, GA: American Cancer Society, 2007

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Cancer : Burden of Disease• New cases 12,332,300

• 5.4 m occurred in developed countries and 6.7 m indeveloping countries

• Claimed 7.6 m death worldwide : 2.9 m in developing

countries and 4.7 m in developing countries

• One in eight deaths cause by cancer

• Cancer is the 2nd leading cause of deaths in developed

countries and the 3rd leading cause of death in developing

countries• By 2030 the incidence is predicted to jump to 20-26 m new

cases with 13-17m mortality


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Cancers in

Developing Countries

Insidence Mortality


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World Cancer Incidence and Mortality :Disparities (1)

• Cancer rates slowly declining indeveloped countries, but . .

• Cancer incidence and mortality

significantly increased in low

and middle income countries

• Major cause of increase :

tobacco consumption, obesity,

infection-induced cancers

• Should be preventable !


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World Cancer Incidence and Mortality :Disparities (2)

• People with higher risk todiagnosed and die of

cancer :

• Low income

• Uninsured

• Underinsured

• So . . . .

• Prevention is the key !

CA Cancer J Clin 2009;59;5-7

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Cancer is a genetic disease of somatic cells

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The Hallmarks of Cancer

Cell, Vol. 100, 57–70, January 7, 2000

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Cancer as Genetic Disease :

Breast Cancer

www.agendia.com 2010

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• The deconstruction of"cancer" into its hundreds

of varieties -- each of

which can be labeled by

its own DNA mutation,chromosomal

translocation, gene

amplification or other

defect -- may be thebiggest achievement of the

war on cancer

WP April 2010

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Cancer as Genetic Disease :Clinical Implications

Personalized medicine

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Personalised medicine is dealing to

answers such QUESTIONS :

• Why do some people get cancer and others don't?

• Why is cancer more aggressive in this person compared to

that one?• Why this person have early relapse and that person not ?

• Why does this drug work for you and not me?

• Why does someone need twice the standard dose to be

effective?

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Personalized Medicine in Sardjito Hospital/GMU :

NPC Team Experiences

• The most common malignancy

in male visiting Dr.Sardjitohospital between 2001-2005

• 80% with advanced disease

(locally advanced and

metastatic)

• About 80% are WHO type III

histology

• Strongly related to EBV

• How to improve by

translational research ?

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- Strip containing EBNA1+lyticEBV proteins

- Imunodetection of IgG and IgAfrom serum

Results:

1. Different Ig G and A recognitionpattern from normal/(non-NPC)and NPC

2. NPC: broader diversity pattern by

stage3. Diagnostic value: YES

4. But, requires culture facilities &long production time

(J. Infect. Dis. 2004. (190): 53-62)

Normal/Non NPC

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Simpler sampling method for screening assaySimpler sampling method for screening assay

Serum preparation for ELISASerum preparation for ELISA

V.S.V.S.Dried-blood spot

FingerFinger--prickprick

Result:

1. Good correlation (r2 > 0.9) between serumand dried blood sampling for ELISA

2. Dried blood sampling and

IgA/[EBNA1+VCA-p18] proposed forclinical epidemiology study (pilot study:July 2006-)

(Fachiroh et al., 2008)

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Angiogenesis in cancer

development, growth & metastasis

Adapted from Poon RT,et al. J Clin Oncol 2001;19:207-25

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VEGF-A: survival curveLevel of plasma

VEGF may beuseful as aprognostic factorin diseaseprogression inadvanced stageNPC of Indonesian

as shown by thesignificantdifference ofsurvival length

between the groupof low and highlevel of VEGF-A inthe plasma.

Kurnianda J et al., 2009

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Thank You for . . .

Your Kind Attention

cancer rev 2011

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