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Broadening the Conversation About CancerSPRING/SUMMER 2015A STEP AHEADClinical Trials Give Patients anAdvantage in Cancer CareALSONEW FEATURE STORY TBDMEET WOMEN TRAILBLAZERSIN CANCER RESEARCHCANCER SURVIVORS CELEBRATEWITH ART MAKING

FORWARD THINKINGP R E S I D E N T ’ SM E S S A G Espring/summer 2015OPENING DOORSothers. In fact, their participationis the only way forward.Other positive developments atFox Chase are also contributing tonew options for patients. In 2014,the number of NIH grants awardedto our investigators grew 50 percentfrom the prior year (from 18 to 27),allowing us to pursue exciting possibilities in basic and translationalresearch. Under the direction ofWafik El-Deiry, MD, PhD, FACP, aninternationally renowned scientistand innovator, an invigorated division of translational research ishelping us move research frombench to bedside efficiently.El-Deiry is one of 17 physiciansand researchers who have joinedthe Fox Chase faculty over the lastyear. Aggressive faculty recruitment and the addition of innovativetechnologies will sustain this momentum. On page 5, you can readabout one new technology, 3-D tomosynthesis mammography, whichwill become available at Fox Chasethis summer. While improving cancer detection, breast tomosynthesisreduces the number of women whoF E AT U R E S6 A Step AheadClinical trials offer patients the promise of betteroutcomes. They expand treatment options for thefuture, just as earlier trials led to improvements intoday’s standards of care. As a national and globalleader in clinical trials, Fox Chase is advancingthe entire field, while providing a high-level ofcare for its patients.must experience the anxiety of unclear results on a mammogram.Finally, we hope you enjoy reading about a Fox Chase program thatis expanding options in a differentway. The Postdoctoral Fellowshipprogram, featured on page XX, provides hands-on research experiencefor recent PhD-trained scientists.The program, which offers mentorship and financial support, is acritical milestone for the scientistswho will strengthen cancer care forgenerations to come.12 TK New Feature StoryTK Clinical trials offer patients the of betteroutcomes. They expand treatment options for thefuture, just as earlier trials led to improvements intoday’s standards of care. As a national and globalD E PA R T M E N T S2Richard I. Fisher, MDPRESIDENT AND CEOADVAnCe:TKResearch HighlightsHow a new target for anti-cancer drugs couldadvance lung tumor treatment Improvingcriteria for breast cancer staging to better reflectsurvival rates New findings on the relationshipof asbestos, genetics, and mesothelioma A betteroption for detecting breast cancerED CUNICELLIOptions. Whether at first diagnosis or following a recurrence, patients wantthe best options for carethat modern medicine canoffer. Strengthening the options atevery stage, for every cancer, iswhat Fox Chase is all about, and itis why we are particularly encouraged by the 60-percent increase inpatients who enrolled in Fox Chaseclinical trials over the past year.Much of that increase can be attributed to the success of our Be theBreakthrough campaign, which encourages patients and their familiesto learn about the options availableto them through the Center’s extensive program of clinical trials. Asyou will read in our cover story, onpage 12, some of these patients weresurprised to learn that all participants in clinical trials, includingthose in control groups, receive thehighest standard of care existingtoday. Many of the participants alsogain access to potentially more effective treatments. These patientsexpand their own options, whilethey help us develop better care forMENU16FOCus:TrailblazersThree female pioneers in cancer research discusstheir own careers and what the future holds foryoung researchers in science and medicine18CLOse-up:Finding a Family at Fox ChaseWhen Oklahoman Denise Coldwater is diagnosedwith kidney cancer for the second time, she goesthe distance to get treatmentspring/summer 2015FORWARD magazine is published twice a year for friendsof Fox Chase Cancer Center by the communications departmentof Fox Chase. One of the leading cancer research and treatmentcenters in the united states, Fox Chase was founded in 1904as one of the nation’s first cancer hospitals, and was amongthe first institutions to be designated a national Cancerinstitute Comprehensive Cancer Center in 1974. Fox Chasejoined Temple university Health system in 2012.Temple Health refers to the health, education and researchactivities carried out by the affiliates of Temple university Healthsystem (TuHs) and by Temple university school of medicine. TuHsneither provides nor controls the provision of health care. All healthcare is provided by its member organizations or independent healthcare providers affiliated with TuHs member organizations. eachTuHs member organization is owned and operated pursuant to itsgoverning documents.333 Cottman Avenue, Philadelphia, PA 19111-2497foxchase.org 1-888-FOX-CHASEJ. robert Beck, mDJoshua e. meyer, mDChief Academic and Administrative OfficerAttending physician, radiation OncologyCarolyn Y. Fang, phDglenn F. rall, phDCREATIVE SERVICESCo-leader, Cancer prevention and ControlAssociate Chief Academic OfficersteegeThomsonCommunicationsWafik el-Deiry, mD, phD, FACpJohn A. ridge, mD, phDDeputy Cancer Center Director forTranslational researchVice Chair, surgical Oncologynestor F. esnaola, mD,mpH, mBA, FACssenior Director, major and planned giftsmeredith ripamadeline WeberDesign byB&g Design studiosCover byC.J. Burtoninquiries:[email protected] surgeon, gastrointestinalOncology, melanoma, sarcomaerica A. golemis, phDDeputy Chief scientific OfficerAnne Jadwin, rn, msn, AOCn, ne-BCChief nursing Officermichael H. Levy, mD, phDDirector, pain & palliative Care program20LEADERSHIPEDITORIAL ADVISORY BOARDrich santoroDr. Richard I. Fisher, MDpresident andChief executive OfficerJeremy Moore22senior Director ofCommunicationsA Day of CelebrationreVieW:News of NoteLaurel Society dinner honors important donors Fox Chase hosts educational sessions on lung andgynecologic cancers A traveling fellowshipsupports an oncologist abroad Honoring theLegacy of John P. HoffmanLisa BaileyDirector of public AffairsMeredith Ripapublications editormAking A DiFFerenCe:Cancer survivors, their caregivers, and thecommunity paint a mural that brightens Fox ChaseCOUPLE: ADAM MURPHYEDITORS2418reWinD:Moments in Fox Chase HistoryThe Dorrance family’s passion for advancingcancer care had helped make Fox Chase thedistinguished place it is todayranee mehra, mDAttending physician, medical OncologySPRING/SUMMER 20151

ADVANCER E S E A R C HH I G H L I G H T SA NEW TARGET FOR ANTI-CANCER DRUGSTransporter membrane proteins, which are located onthe cell surface and act as apump that moves drugsout of the cell, have longbeen a focus of cancer researchbecause of their ability to increasedrug resistance and affect biologicalprocesses involved in cancer’sprogression. Because of theseproteins’ complex role in cancerprogression, the search for aninhibitor to halt their contributionto drug resistance has thus farproved challenging. Now, however,preliminary studies by researchersat Fox Chase Cancer Center haverevealed a specific transporterSETTINGSURVIVALRATESmembrane protein, called ABCC10,as a potentially viable target foranti-cancer drugs.A study by molecular biophysicist Elizabeth Hopper-Borge andcolleagues, published in the BritishJournal of Cancer, examinedwhether inhibiting ABCC10 wouldmake mice with mammary tumorsmore responsive to docetaxel, adrug commonly used to treatbreast cancer. They found that theloss of ABCC10 affected multipleaspects of the mice’s tumors andincreased their chance of survival.Hopper-Borge believes ABCC10In breast cancer, tumors thatgrow into the skin are automatically classified by the AJCC(TNM) staging system as stageIII, suggesting that they are relatively serious cases with potentiallypoor survival rates. Although theTNM system is based on standardized criteria and used widely in theU.S. and internationally, Fox Chasescientists cast doubt on this standard classification by showing thatwomen with breast cancers involving the skin have widely varied survival rates. In the study, published inthe Journal of the American Collegeof Surgeons, the researchers examined data from the SEER-MedicareLinked Database and found that apatient’s survival depends more onthe tumor’s size and whether it hasinfiltrated the lymph nodes than onwhether it has spread to the skin.“Classifying all tumors with skininvolvement as stage III belies thepurpose of staging, which is to grouptumors with a similar prognosis,”says surgical oncologist Richard J.Bleicher, leader of the breast cancertreatment program at Fox Chase.“Women with tumors that happento have spread to the skin may begiven an inaccurately dire prognosis—along with, perhaps, some un-2S P R I N G /SUMMER 2015JARED CASTALDIwill prove to be an even better target in treating lung tumors, andher team is preparing to explorethis theory.“Our ultimate goal is to movethis research into a clinical trial,once we find an optimizedABCC10 inhibitor compound,”Hopper-Borge says. She andTemple organic chemist RodrigoAndrade are testing candidatedrugs, and have teamed up withFox Chase molecular modelingspecialist Roland Dunbrack todevelop predictive models tounderstand how the ABCC10inhibitor would work and how tostrengthen it.PAUL GARLANDThey found thatthe loss of ABCC10affected multipleaspects of themice’s tumors andincreased theirsurvival.Surgical oncologist Richard J. Bleichernecessary treatment. We need toupdate our staging criteria to moreaccurately reflect a woman’s truechances of surviving her cancer.”"Women with tumors that happen tohave spread to the skin may be givenan inaccurately dire prognosis—alongwith, perhaps, some unnecessarytreatment."— R I C H A R D J . B L E I C H E R , B R E A S T C A N C E R T R E AT M E N T D I R E C T O RBleicher and his colleaguesrecommend adding a new stagingcategory for tumors with skininvolvement, and giving moreweight to other criteria—such as atumor’s size and whether it hasspread to the lymph nodes—whendetermining cancer stage. Theserecommendations are just oneexample of how Fox Chase doctorsare moving the standard of cancercare forward, helping patients tobetter understand their survivalchances and determine the besttreatment options.SPRING/SUMMER 20153

ADVANCEASBESTOS, GENETICS, AND CANCERA BETTER MAMMOGRAMNammograms can be lifesaving. An annual mammogram can reducemortality rates of breastcancer by 15 to 50 percentfor a population. Despite the benefits, as many as 20 percent of casesare missed by traditional mammograms. Ten percent of women arebrought back for additional diagnostic work, yet many are found tohave no abnormalities—often thiscancer scare is a result of equipmentlimitations, yet the anxiety and inconvenience it may cause are real.The good news is that Fox Chasenow offers a better option for detecting breast cancers: tomosynthesis.A traditional mammogram takesa 2-D image in which breast tissuesare superimposed on one another. Atumor can hide behind other tissues, or healthy tissues can combineto look like a tumor. With tomosyn-Mew findings by Fox Chasegeneticist Joseph R. Testaand colleagues are illuminating the relationship between asbestos exposure,genetic factors, and cancer.Exposure to asbestos, a threadlike mineral used in building andmanufacturing, puts people at riskof developing the highly fatal cancermesothelioma, which affects themembranes lining the chest andabdominal cavities as well as thosearound the lungs and other organs.In previous studies, Testa and4S P R I N G /SUMMER 2015"Reducing thecall-back rate formammographymeans reducinga major sourceof stress andanxiety for ourpatients."— K AT H R Y N E V E R SDIRECTOR OF MAMMOGRAPHYregarding tomosynthesis, breastultrasound, and breast MRI forevaluation in various patientgroups including women withdense breasts.” Breast tomosynthesis will be available at Fox Chasestarting in early summer 2015.BAP1 mutation. Mesotheliomas inBAP1-mutant mice also appearedsooner and were more aggressive.However, the mutant mice thatwere not exposed to asbestos remained mesothelioma-free for thelength of the experiment. “To getmesothelioma, having a BAP1mutation does not appear to beenough,” says Testa. “Our studiessuggest that you generally need tobe exposed to asbestos as well.”Asbestos as-BES-tous A group of minerals that naturally occur as bundles of fibers that can be separated intothin, durable threads. Often put in buildings as insulation against fire and heat, asbestos hasbeen heavily used in construction since the late 1800s. The occupational risks of asbestosexposure were widely recognized starting in the 1920s following several studies bypathologist W. E. Cooke. However, the first connection between asbestos and mesotheliomais often considered to be made in a 1943 paper by German doctor H.W. Wedler.Source: National Cancer Institute and The Mesothelioma CenterCOURTESY OF HOLOGIC, INC.colleagues found that a small number of people are also predisposedto getting mesothelioma becauseof mutations in the BAP1 gene.While BAP1 suppresses tumoractivity, the mutations cause it tostop working, leading to moreaggressive cancers. But can peopledevelop mesothelioma simply because they have a BAP1 mutation,or do they also need to be exposed toat least small amounts of asbestosto trigger it?In a study published in CancerResearch, Testa’s team exposedmice with and without BAP1 mutations to asbestos. They also followed a group of mice with BAP1mutations who were not exposed toasbestos to see if they developedany cancers. By the end of thestudy, 73 percent of BAP1-mutantmice exposed to asbestos had developed mesothelioma, compared toonly 32 percent of mice without aISTOCKBy the end of thestudy, 73 percentof BAP1-mutantmice exposedto asbestoshad developedmesothelioma,compared toonly 32 percentof mice withouta BAP1 mutation.thesis, the physician takes a traditional 2-D scan, then compiles a 3-Dimage using multiple X-rays takenat different angles.One study, published in the June25, 2014 issue of The Journal ofthe American Medical Association,combined data from more than170,000 examinations and foundthat using breast tomosynthesis increased cancer detection rates anddecreased call-backs. “Reducing thecall-back rate for mammographymeans reducing a major source ofstress and anxiety for our patients,”says radiologist Kathryn Evers, director of mammography. Tomosynthesis may also require less compression, causing less discomfortfor patients, and X-ray dosage issimilar to a regular mammogram.“With this technology,” saysEvers, “we will be able to participate in planned clinical trialsA malignancy easily missed with a2-D mammography is clearly seenwith a 3-D image.SPRING/SUMMER 20155

CLINICAL TRIALS GIVE PATIENTS AN ADVANTAGE IN CANCER CAREB. Mark Wilson values innovation. It isa conviction Wilson and his father,brother, and son have applied to thefamily business, Wilson-Legacy Farmsin Smyrna, Delaware, where technology and conservation practices havekept their farm—founded in 1956 bythe father, George—a leader in seedand cereal grain cultivation. It is no surprise, then, that when Wilson was diagnosed with Stage IV throat cancer, hesought out the most innovative treatment option available. BY TOGO TRAVALIA PHOTOGRAPHY BY C.J. BURTON12S P R I N G/SUMMER 2015

A Step AheadCLINICAL TRIALS OFFER THE PROMISE OF BETTER OUTCOMESn May 6, 2014, Wilson walked into Fox ChaseCancer Center accompanying his father, whowas on a follow-up visit for the kidney cancerhe had overcome less than a year earlier.Tucked under the younger Wilson’s arm waspaperwork from another hospital and a CT scan of his neck.He was scheduled for a tonsillectomy and either a laryngectomy or a tracheostomy at another facility in three days. Before going through with the operation, he wanted to know ifthere was another way to fight the cancer threatening hislife—and his quality of life.Fortunately, one of the nation’s top oncologists specializing in head and neck cancers was on duty. In fact, surgicaloncologist John A. Ridge, the Louis Della Penna FamilyChair in Head and Neck Oncology, was in the midst of leading a clinical trial for patients just like Wilson. The trial, forpatients with tumors of more than four centimeters in atleast one dimension, involves substituting a protein antibody, Cetuximab, for a chemotherapy agent.“The trial is examining whether this new approach can beless toxic to the patient, with fewer side effects. Like every clinical trial, we are trying to cure as many patients as possiblewith the best quality of life,” says Ridge, who has spent much ofhis 35-year career seeking better outcomes for patientsthrough trials. “It is never certain a given trial will create a better outcome, but it is unlikely to produce a less effective one.”Wilson’s father had also enrolled in a Fox Chase clinicaltrial seeking to prevent a recurrence of kidney cancer and hismargins were still clear. Wilson seized the opportunity. Hecanceled his surgery and enrolled. Best of all, by undergoingthis treatment—only available to patients at Fox Chase andother specific cancer centers conducting this research—hecould avoid the possibility of losing the ability to speak naturally, a common outcome of surgery in cases such as his.Wilson felt lucky from day one. “I was at the best possibleplace, and the preparation you get at Fox Chase is impeccable. My physicians and nurses put me at ease and put everything into terms I could understand.” He singles out eachteam member: medical oncologist Ranee Mehra, radiationoncologist Thomas Galloway, nurse practitioner KristenKreamer, and physical therapist Jeannie Kozempel.Indeed, clinical trials are a team endeavor at Fox Chase,where research nurses are at the nexus, attending to patientsafety and well-being while ensuring that clinical trial protocols are being met and the trial’s sponsors are kept informed.“I’m the first point of contact for the patient after thephysician presents the trial,” says Lois Malizzia, a clinicalresearch nurse who coordinates clinical trials for patientswith genitourinary (GU) cancers. She says the GU teammeets biweekly to share information, and the team approach benefits patients. “Everybody on the team is kept upto date, and there’s a lot of communication. If there’s newinformation to share, everyone is aware. It’s very rewardingand exciting to see the work you are doing affect the standardof care for patients.”Wilson’s tumor responded to the chemotherapy regimenincluding Cetuximab and today he is cancer-free. “Evenwhen my family doctor thought there might not be a glimmer of hope, I believed there still was,” he says. “It teachesyou not to settle for the first opinion and not to be scared of aclinical trial. It might offer the best option of all. I think itsaved my life. Plus it offers the chance to be the breakthrough for others.”Phases of a Clinical TrialTODAY’S CLINICAL TRIALS ARE TOMORROW’S TREATMENTSThe FDA requires that new medications undergo a seriesof three phases of testing to ensure safety and efficacy inorder to be approved. Fox Chase offers all three phasesand is particularly strong in Phase I studies. On average,it takes nearly 15 years for cancer drugs to go through allthree phases of a clinical trial and receive approval.PHASE 1 (15–30 participants) aims to find a safe dose ofa new drug and explore how best to administer the drugPHASE 2 ( 100 participants), using a now-standarddose, gathers more information about how a drug affects cancer and how it affects the bodyPHASE 3 (100–1,000 participants) compares a new option with the current standard of care, often by means ofa randomized study14S P R I N G/SUMMER 2015ore options. Newer options. Better options.Ask people with advanced cancers whatmatters most, and “options” is going to bea likely answer.Clinical trials expand treatment options for the future, just as clinical trials years ago led to improvements in today’s standards of care. Simply put, trialstranslate the results of basic scientific research into more effective clinical strategies for screening, preventing, diagnosing, and treating cancer. For new drugs, trials are thenecessary step between experimentation and FDA approval.Fox Chase is a national and global leader in cancer clinicaltrials, with more than 150 trials underway at any given timeand an enrollment rate that increased by 60 percent over thelast year. Leadership requires a special commitment acrossthe entire institution and a shared appreciation for the valuethat clinical trials bring to cancer care.“Even when my family doctorthought there might not be aglimmer of hope, I believedthere still was.I think[a clinical trial] saved my life.Plus it offers the chance to bethe breakthrough for others.”— MARK WILSON“Trials are expensive to execute,” explains Ridge. “Theyentail costs and time commitment that are not part of everyday practice for most hospitals. It’s also hard to undertakeclinical trials outside of specialized environments, which isparticularly true of trials not supported by industry.”Patients who qualify for a clinical trial, because of the specific circumstances of their cancer and on the recommendation of their oncologists, are invited to enroll. There is nofinancial incentive. As for costs, Fox Chase works with eachpatient in the pre-certification process to assess coverage options by the patient’s insurance company and the trial sponsor(often a pharmaceutical company). Rarely do insurance com-panies not allow coverage for clinical trial-related costs. Somecosts may be borne by the patient, but for the majority of patients, the financial arrangement is not a barrier to entry.With a detailed plan of care in place, enrolled patients receive either the existing high standard of care available to allFox Chase patients, or are among the first to benefit from apotentially more effective treatment. In the case of clinicaltrials that are demonstrating clear benefits, trials are oftenhalted midway so that the medications under review can bemade available to all patients on a uniform basis.“WE ALL NEED TO DO OUR PART”very patient has his or her own reasons for joining a clinical trial. Having good information waskey for Lael Swank, who, despite having no history of the disease in her family, discoveredbreast cancer in a self-examination days aftershe turned 39. “I enrolled in a trial with the drug Avastin,”says Swank, who traveled two hours from her Mountain Top,Pennsylvania home to Fox Chase for chemotherapy treatment following a bilateral mastectomy. “My decision wasbasically made because I was well informed about the trial—and scared. I would’ve tried anything to fight this cancer andsave my life.”Swank, who recently celebrated her five-year “cancerversary,” also saw a benefit she wanted to share with others.SPRING/SUMMER 201515

A Step Ahead“When I signed up for the trial, I thought: I will do this trialin the hopes that a cure for breast cancer will be found. Onein eight women diagnosed is far too many. We all need to doour part.”Clinical trial participation can extend to patients posttreatment as well.Charlette Gray, of Princeton Junction, New Jersey, who wastreated for breast cancer at Fox Chase, has been declared cancer-free since 2011 but participates in a clinical trial in whichMetformin, a drug used for diabetes, is being tested to see if itcan prevent the recurrence of breast cancer. As in many clinical trials, Gray does not know if she is receiving the therapeutic or a placebo, but either way, she hopes her participation willadvance cancer treatment. She meets regularly with a clinicaltrial nurse to review medications and manage symptoms.“I am the daughter of a mother who waged a long andvaliant fight against cancer before it overcame her,” Graysays, adding that she is also the mother of a daughter “who Ipray will never have to face this fight. For these reasonsalone, I want to do what I can to further cancer research. Forme, that includes participation in clinical trials.”UNFOUNDED FEARS STAND IN THE WAY OF BETTER OUTCOMESot everyone who is eligible for a clinical trialparticipates. Every year, there are 1.5 millionnew cancer diagnoses in the United States.Of these new patients, about 200,000 (13%) aretypically eligible for clinical trials that candeliver a high-standard care.However, only about one-third of the potential patientsenroll in cancer clinical trials. Why? Reasons range from patients and their families not knowing about the opportunity,to mistaken fears about the process, to the inability to get to aclinical trial. Whatever the reason, the result is that the pa-— JOHN A . RIDGEtient has fewer options for his or her care, and the answersthat move cancer treatment forward are delayed.“One of the most common misconceptions is that by participating, you’re being experimented on,” says medical oncologist Margaret von Mehren, director of Fox Chase’ssarcoma program and associate director of clinical research.“Every study is being conducted with lots of information andis done in the safest possible way. Patients are followed notonly by their care team of doctors but also by their researchteam. They are getting better care by having that second setof eyes. Plus the possible benefit is tremendous. It may allowpatients access to a drug they wouldn’t have any other way.”Another misconception revolves around randomized trials, which compare a control group against one receiving thenew treatment. Some trial candidates think the controlgroup will receive a placebo instead of treatment. Nothingcould be further from the truth.“Yes, they are being assigned therapy in a random fashion. But the control group will receive the same high standard of care everyone receives,”esays von Mehren. “If theyare in the group receiving the new treatment, their outcomesmay be the same or better than with the standard treatment.”The difference can advance care and outcomes for clinicaltrial patients—and eventually, for everyone.Find a Trial OnlineA MORE VIBRANT FUTURE FOR CANCER RESEARCHFor information about trials underway at Fox Chase,patients can browse studies or search by disease site at:fccc.edu/cancer/clinicaltrials/The National Cancer Institute maintains a searchabledatabase at cancer.gov/clinicaltrials. Last year, thisclearinghouse, which aggregates research at 3,100institutions, provided information about more than12,000 ongoing trials, as well as trials just launching.The National Institutes of Health, which maintainscancer.org, tracks all medical clinical trials—more than180,000—taking place in all 50 states and in 187 countries. This larger database, which includes interventionalstudies around cancer, can be found at ClinicalTrials.gov.16S P R I N G/SUMMER 2015EXPANDING ACCESS FOR EVERYONE“What makes Fox Chasespecial has been a resolutecommitment to designingclinical trials and carrying outstudies that offer itsfaculty intellectual andprofessional growth.”he positive impact of having a robust clinical trialprogram extends throughout the institution.“What makes Fox Chase special has been aresolute commitment to designing clinical trialsand carrying out studies that offer its faculty intellectual and professional growth,” says oncologist Ridge.“Clinical trials are part of the academic advancementprocess. Investigators and faculty are tenured through clinical research so there are clear benefits to researching andpracticing medicine at Fox Chase and Temple Health.”For young oncologists and researchers, Ridge sees an almost limitless future. “Our understanding of biology hasgrown tremendously in the last decades. The same advancesin computing that made the electronic age possible also enable us to learn the molecular structure of cellular components in such a way that we can design and test drugs thatwould not have been possible only a short time ago. Wholenew ways of treating cancer patients are just emerging.”Clinical trials are the linchpin of this potential.GROWING NATIONAL SUPPORT FOR CLINICAL TRIALSrowing infrastructure, information and supportfor clinical trials is happening at the nationallevel, too, with the establishment in 2014 of theNational Clinical Trials Network. The NCTNwas formed by the National Cancer Institute(NCI), where cancer clinical trials began six decades ago withstudies of chemotherapy treatment for acute leukemia.“The new network represents an unmatched effort to integrate and streamline the process of cancer clinical trials research,” says James Doroshow, deputy director for clinical andtranslational research at NCI. “The conduct of NCI-supportedtrials, which are publicly funded, involves a complex system ofdesigning, reviewing, and initiating studies. The new NCTNreplaces a structure that was more than 55 years old.”Former NCI Director Harold Varmus adds, “We mustwork together to adapt swiftly and effectively to achieve thegoals of the new system—namely, to take advantage of recentadvances in our understanding of cancer and to bring newknowledge into clinical trials conducted in the community.Our patients deserve nothing less.”ox Chase and Temple Health continue to make concerted effortsto ensure that all patients haveaccess to cancer clinical trials. The“Be the Breakthrough” campaignlaunched in July 2014 was specifically designed to raise awareness about cancer clinicaltrials and encourage discussion between patients and their care team. With brochures,posters in patient rooms and doctors sportingbuttons that say, “Ask Me About Clinical Trials,” the highly visible campaign has led to a60 percent increase in the number of patientsparticipating in clinical trials compared withthe previous year.Also on the uptick are phone calls to thepatient resource education center. Staffed bythree clinical trial educators, medical

joined Temple university Health system in 2012. Temple Health refers to the health, education and research activities carried out by the affiliates of Temple university Health system (TuHs) and by Temple university school of medicine. TuHs neither provi