spring 2012 | vol. 2 | … · class cancer care closer to home. “the institute is working to...

Levine Cancer Institute is

changing the course of cancer

care by removing the barriers that

separate patients from world-class

research and treatment.

Nationally Recognized Cancer Experts Join Levine Cancer Institute“A CANCER INSTITUTE WITHOUT WALLS.”

THIS IS THE PLEDGE OF CAROLINAS

HealthCare System's (CHS) Levine Cancer

Institute to the community—to bring world-

class cancer care closer to home.

“The Institute is working to define the

future of cancer care—where innovations in

research and treatment are brought closer to

home for patients to improve outcomes and

quality of life,” says the Institute's President,

Derek Raghavan, MD, PhD.

While there are many integral

components to building a leading cancer

program, one of the key pieces is being able

to offer patients access to the latest research

and treatment options. To help fulfill this

mission, the Institute has brought on board

several nationally recognized cancer experts.

EDWARD S. KIM, MD

Joining the Institute

from the University of

Texas MD Anderson

Cancer Center is Edward

S. Kim, MD, who will

serve as chair of the

Department of Solid Tumor Oncology and

Investigational Therapeutics. Dr. Kim is

recognized as a national leader in molecular

CANCERN A V I G AT O R

L E V I N E

prognostication for lung cancer and specializes

in thoracic oncology and head and neck cancers.

In his previous role as professor and oncologist

at MD Anderson, he also served as the center's

principal investigator for Southwest Oncology

Group, one of the largest of the National

Cancer Institute-supported cancer clinical trials

cooperative groups. Named a top physician by

U.S. News & World Report, Dr. Kim received his

medical degree from Northwestern University

through the Honors Program in Medical

Education. He completed his residency at Baylor

College of Medicine in Houston, TX, and a

medical oncology fellowship at MD Anderson.

Dr. Kim's clinical trial experience will

strengthen the robust clinical trials program

currently in place at the Institute.

EDWARD A.

COPELAN, MD, FACP

Edward A. Copelan, MD,

comes to the Institute

from a leadership role

at the Cleveland Clinic’s

Taussig Cancer Institute

and will serve as chair of the Department of

Hematologic Oncology and Blood Disorders.

His clinical specialties include leukemia,

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C H A N G I N G T H E C O U R S E O F C A N C E R C A R E

INSIDE ...

SIGN UP TO RECEIVE LEVINE CANCER NAVIGATOR

If you’re interested in receiving

a copy of Levine Cancer Navigator

via email or mail, visit

www.levinecancerinstitute.org/

physician and fill out the short

sign-up form.

Privacy policy: Your information will not be used for third-party distribution.

Continued on page 2

Institute Spotlight: CMC-NorthEast Batte Cancer CenterPAGE 6

Institute Update: Improving Conception After Cancer PAGE 4

Research/Clinical Trials: Fixing the Drug Shortage PAGE 3

LEVINE CANCER NAVIGATOR | WWW.LEVINECANCERINSTITUTE.ORG 2


LEVINE CANCER NAVIGATOR | WWW.LEVINECANCERINSTITUTE.ORG 2

multiple myeloma and myelodysplastic syndromes.

Dr. Copelan will lead efforts to develop a 16-bed bone

marrow transplant unit at CHS' Carolinas Medical Center

to support Institute treatment options.

Named a top doctor by U.S. News & World Report;

Best Doctors in America; and Castle Connolly Medical

Ltd., America’s Top Doctors; Dr. Copelan received his

medical degree with honors from Tufts University in

Boston. Following his residency at Ohio State University

Hospital in Columbus, he completed fellowships in

hematology and oncology at Ohio State University

Hospitals and bone marrow transplantation at UCLA.

BELINDA AVALOS, MD

Belinda Avalos, MD, formerly of

Ohio State University Hospital, joins

the Institute’s cancer team as vice chair

of the Department of Hematologic

Oncology and Blood Disorders.

Dr. Avalos, who specializes in

hematology and bone marrow transplantation, will lead the

Institute's efforts to develop collaborative research initiatives

with scientists at The University of North Carolina-Charlotte,

as well as focus on stem cell biology of blood disorders. Over

the years, she has held numerous academic appointments

and worked with many national organizations, such as the

National Cancer Institute, on various projects and studies.

Dr. Avalos received her medical degree from Ohio State

University as a member of the Alpha Omega Medical Honor

Society. She completed her residency at Ohio State University

Hospital and a hematology fellowship at the University of

Washington in Seattle, as well as a hematology-oncology

fellowship at Ohio State University Hospital and UCLA.

Dr. Kim joins the faculty in July, with Drs. Avalos and

Copelan following in September. The Institute welcomes

these nationally ranked physicians and the vast knowledge

and expertise they will bring to our patients.

Nationally Recognized Cancer

Experts Join Levine Cancer Institute

Continued from page 1

Levine Cancer Institute, Charlotte, NCOpening October 2012

WELCOME OUR NEWEST TEAM MEMBERS

The Institute would also like to welcome

Ram Ganapathi, PhD, FAAAS, and

Marukh Ganapathi, PhD, who will join

the pharmacology lab team in July.

The team will drive an increased understanding

of the science of oncology drug interactions

and effectiveness.

Look for our summer issue for more information about additional Levine Cancer Institute recruitment efforts.

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FOR THE PAST 30 YEARS,

I’VE WORKED DILIGENTLY

to improve the results of treatment

for patients who have advanced

cancer, and together with my fellow

clinicians, we've made significant

gains.

Yet, I’ve also witnessed the

unfortunate reality that timing

is crucial. Previously, lives may

have been lost due to the lack of

available treatments, but today,

there’s a different issue—access.

AN INVENTORY CRISIS

The shortage of some

intravenous cancer treatment drugs

should be seen as nothing less

than a travesty which, if left

unchecked, could lead to avoidable

deaths.

While performing patient rounds

several years ago, I recall being

warned by an oncology pharmacist

that we were running short on some

of our cancer medications and to

be prepared to have to make tough

choices.

Years later, it has become

increasingly clear that this

continues to be a major problem,

and it seems as though very

little has been done to fix it.

People are at risk of dying of

cancer unnecessarily because

of the unavailability of crucial,

irreplaceable therapeutic agents.

Last fall, the American Society

of Clinical Oncology, a national

cancer physician’s group, convened

for a meeting in Washington, DC.

The group concluded there’s an

urgent need to do the following

to mitigate the drug shortage:

Improve rapid communication

between the pharmaceutical supply

chain and providers, so providers

have more advance notice and

can better understand, prepare

Derek Raghavan, MD, PhD President, Levine Cancer Institute

Continued on page 8

Fixing the Drug Shortage: It’s About Time

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WITH EARLY DETECTION

AND INCREASINGLY

effective treatments, more patients are

surviving cancer and wanting to start

families. Fertility preservation options

are available before chemotherapy,

radiation or surgery and after cancer

treatment for patients who aren’t ideal

candidates or elect not to pursue

fertility preservation options prior to

cancer therapy.

Through a partnership between

Carolinas HealthCare System’s

Levine Cancer Institute and

the Women’s Institute, REhope

is a new program that takes

a multidisciplinary approach

to providing comprehensive

reproductive care to patients

through a team of experts,

including:

oncologists

reproductive endocrinologists

urologists

specialty trained nurses

psychologists

genetic counselors

certified embryology lab staff

members who have expertise

in sperm, oocyte and embryo

cryopreservation

TECHNOLOGICAL ADVANCES

EXPAND PATIENT OPTIONS

Fertility preservation is a rapidly

evolving field that includes medical

and surgical treatments to decrease

the impact of cancer on future

fertility. It has been reported that

approximately 75 percent of patients

express significant distress over loss

of fertility related to their cancer

Improving Conception After Cancer

Michelle Matthews, MD Director, Fertility Preservation, Levine Cancer Institute

technique called vitrification, there

have been more than 900 pregnancies

reported worldwide. Vitrification

uses modifications in traditional

cryopreservation techniques and

oocyte cryoprotectants that result in

up to 90 percent of oocytes surviving

the freezing and thawing process.

Ovarian tissue cryopreservation

has also been evaluated as a

modality to preserve future fertility.

A portion of the ovarian cortex is

treatments. Fortunately, recent

advances are providing more options

than ever for patients to receive

necessary cancer treatments while

maintaining hope for having a family

in the future.

FOR MEN

Sperm may be cryopreserved

(frozen) prior to cancer treatments

and stored for future use.

For male cancer patients

who don’t store sperm prior to

chemotherapy or radiation and

subsequently have extremely low

sperm counts, physicians can now

perform microsurgical techniques

to obtain sperm directly from small

areas in the testicles that may be

producing limited numbers of

sperm.

Sperm are obtained by testicular

sperm extraction and used to

achieve a pregnancy through in vitro

fertilization (IVF). This technique

has recently been shown to be

effective for some men who have

no ejaculated sperm present after

chemotherapy.

FOR WOMEN

Options are also expanding for

female cancer patients. Oocytes (eggs)

or fertilized oocytes (embryos) may be

cryopreserved prior to chemotherapy

or radiation. The first pregnancy

from oocyte cryopreservation

was reported in 1986, but few

pregnancies were subsequently

reported due to poor survival rates

for cryopreserved oocytes. Thanks

to a new oocyte cryopreservation


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Improving Conception After Cancer

surgically removed, cryopreserved

prior to cancer treatment and then

transplanted back into the patient

after her treatment is complete.

Although more research is needed,

this option holds significant promise

for the future.

Until recently, preserving oocytes

or embryos required a delay in

cancer treatment of up to four to

six weeks to complete the IVF

process. We’re now able to complete


the process in two to three weeks to

expedite initiating cancer therapy

by using new IVF regimens.

For men and women with

hereditary cancers, embryos created

through IVF can also be genetically

screened for specific cancers through

a process called preimplantation

genetic diagnosis. This offers

patients the option of decreasing

the risk of transmitting their specific

cancer to children.

FERTILITY HELP FOR PATIENTS

Call 704-446-5110 to

speak to a REhope patient

care coordinator if you

would like more information

about our program.

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A TRADITION OF

EXCELLENCE WAS

established in 1937, when Charles

A. Cannon and a group of local

businessmen founded Cabarrus

County Hospital. Their mission was

to bring a higher level of healthcare

to local textile workers and their

families as well as the entire

community. Over the past 75 years,

Carolinas Medical Center-NorthEast

(CMC-NorthEast) has evolved from

a small, county-owned hospital into

a tertiary care facility with 457 acute

care beds, a comprehensive mix of

outpatient services, a large physician

network with more than 60 clinics

and a Level 3 trauma center.

As one of several Carolinas

HealthCare System (CHS) locations,

CMC-NorthEast offers patients access

to a vast network of medical expertise

CMC-NorthEast Batte Cancer Center

and advanced technology. We

actively promote healthy lifestyles by

contributing to local organizations and

schools and offer a range of outreach

programs and health seminars.

We’ve introduced new services

and technologies and brought major

facility expansion and renovation

projects to accommodate a growing

community, including a pediatric

pavilion (see Children’s Specialty Care);


Batte Cancer Center offers state-of-the-art treatments

and therapies.

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a rehabilitation facility; a breast health

center and mobile mammography

unit; a renovated surgery center

and radiation oncology unit; and a

new inpatient pharmacy distribution

system.

ACCESS TO LEADING-EDGE

CANCER CARE

CHS’ Levine Cancer Institute is

changing the course of cancer care by

removing the barriers that separate

patients from world-class research,

breakthrough treatments and quality

cancer care. The Institute and Batte

Cancer Center are working together

to offer patients from Cabarrus, Rowan

and surrounding counties access to

national and international cancer

clinical trials.

NorthEast Oncology Associates

is a part of the Institute’s team of

experts. This highly trained staff

consists of seven board-certified

physicians and

four advanced

oncology-

certified nurse

practitioners.

Garry Schwartz,

MD, has been

Director of

Research at

NorthEast

OUR GROWTH FOR YOUR FUTURE

To meet the community’s growing need for our services, CMC-NorthEast is building a new eight-story

patient tower and adding a second story to the Surgery Center, located on the hospital’s campus. The patient

tower will house the cardiology, maternity, oncology, interventional radiology and nuclear medicine, nephrology

and medical/surgical departments. Renovations to the first and second floors of the Mariam Cannon Hayes Family

Center will make room for the neurosciences department as well as medical/surgical and patient observation units.

Garry Schwartz, MD Director of Research,

CMC-NorthEast

Oncology Associates since 2005,

upon completion of his U.S. Army

commitment. During his time at

Brooke Army Medical Center,

Dr. Schwartz ran the Investigational

Drug Development Unit, focusing

on Phase I and Phase II trials. “I was

both anxious and excited about

offering patients investigational drug

therapies,” says Dr. Schwartz. “It

was during this time that I realized

the importance of clinical research.”

Today, Dr. Schwartz partners with

the Institute, Duke University,

UNC at Chapel Hill and Wake

Forest University to offer patients

at Batte Cancer Center treatment

that offers hope for tomorrow. “Our

research team is now integrated with

Carolinas Medical Center to offer

our patients an even more dynamic

choice of investigational therapies

than ever before,” adds Rebecca

Witkowski, RN, BSN, supervisor of

the clinical research staff at Batte

Cancer Center.

CHILDREN’S SPECIALTY CARE

Jeff Gordon Children’s Hospital, at CMC-NorthEast, is a

53-bed hospital affiliated with Levine Children’s Hospital. The hospital

offers pediatric cancer care and access to Phase I and Phase II clinical

trials as well as pediatric specialties in cardiology, endocrinology,

gastroenterology, neurology, pulmonology, surgery and urology. The

Children’s Epilepsy Center at Jeff Gordon’s Children’s Hospital is home

to the only Level 3 pediatric center in North Carolina designated by the

National Association of Epilepsy Centers.

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CANCERN A V I G AT O R

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Fixing the Drug Shortage:

It's About Time

Continued from page 3

and manage through shortages.

Remove barriers faced by drug

manufacturers and the FDA to

minimize the impact of drug shortages.

Improve the clarity of the

definition “medically necessary,”

the term that prompts advance

notifications of drug shortages

to the FDA, to ensure the FDA is

aware of pending shortages like

those the oncology community is

experiencing.

GOVERNMENT INTERVENTION

Some months ago, both houses

of Congress introduced bills that

began to cover some of these issues

and required the pharmaceutical

industry to notify the government of

impending shortages. As is so often

the case, these bills have slowly

and steadily been working their way

through the political process, in a

period when patients continue to

suffer from drug shortages.

At Carolinas HealthCare System,

throughout our 33 hospitals, we

see more than 11,000 new cases of

cancer a year. This volume of care

provides us with stronger negotiating

The time to sit by, worrying about

our patients, concerned about the

challenging decisions we need to

make to compensate for an industry

that’s behaving irresponsibly, may be

nearing an end.

POSITIVE PROGRESS

I’m encouraged by President

Obama’s issuance of an executive

order for the FDA to take action

to reduce the shortage. It’s the first

step on a long road to fixing this

problem, and we hope Congress

will make meaningful contributions

to the process.

Let’s continue the momentum

to find a long-term solution to drug

shortages. Professional organizations,

patient advocacy groups, everyone:

Keep this issue in public debate

and urge legislators to continue

their work!

power for drug acquisitions as well

as the ability to move medications

around the system to areas of

greatest need. Our pharmacy

team has been outstanding in

monitoring this issue, watching

supplies, negotiating to obtain

drugs and warning the oncology

staff of impending shortages. Our

teams have convened a systemwide

committee that helps prioritize and

manage available supplies, but as

the problem worsens, prioritization

has become an increasing challenge.

DIFFICULT CHOICES

How does one prioritize between

a patient with curable Hodgkin’s

disease who’s due to receive one

combination of drugs and a patient

with curable testicular cancer who’s

due to receive another combination

using similar, dwindling ingredients?

LEADING THE WAY IN CANCER CARE

Sign up to receive Levine Cancer Navigator, a free quarterly newsletter

for physicians. Visit www.levinecancerinstitute.org/physician.

For more information about Levine Cancer Institute specialists,

clinical trials and system partners, call 704-355-2884 or toll free

1-800-804-9376.

spring 2012 | vol. 2 | … · class cancer care closer to home. “the institute is working to...

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