Novel therapy developed for inherited breast cancer

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UT Health San Antonio researchers have discovered a novel way to kill cancers that are caused by an inherited mutation in BRCA1, the type of cancer for which actress Angelina Jolie had preventive double mastectomy and reconstructive surgery in 2013.

“This represents a new treatment for inherited breast and ovarian cancer, which are higher in our region,” said Robert A. Hromas, M.D., FACP, professor and dean of the Joe R. and Teresa Lozano Long School of Medicine at UT Health San Antonio. Dr. Hromas is senior investigator on the research, published in the journal Proceedings of the National Academy of Sciences. (Reference: “MiR223-3p promotes synthetic lethality in BRCA1-deficient cancers,” Aug. 8, 2019.)

A tiny molecule called microRNA (miR) 223-3p prevents normal cells from making mistakes while repairing their DNA. However, cancers with BRCA1 mutations repress miR223-3p to permit their cells to divide. Adding back miR223-3p forces the BRCA1-mutant cancer cells to die, said study co-author Patrick Sung, D. Phil. Dr. Sung, who joined UT Health San Antonio in 2019 from Yale, is a BRCA1 cancer expert who occupies the Robert A. Welch Distinguished Chair in Biochemistry.

MiR223-3p acts like a light switch, turning off proteins that BRCA1-mutant cancers need to divide properly. Without these key cell division proteins, BRCA1-mutant tumors commit suicide, Dr. Hromas said.

“It’s kind of a cool way of thinking about treatment,” Dr. Hromas said. “We are using the very nature of these BRCA1-deficient cancer cells against them. We are attacking the very mechanism by which they became a cancer in the first place.”

There is evidence that restoring miR223-3p before cells convert to cancer can even prevent BRCA1-related disease, he said.

BRCA gene mutations affect 1 in every 400 people in the United States — an estimated 825,000. After Ashkenazi Jews, Hispanics have the second-highest prevalence of BRCA1 disease-causing mutations. The disease’s burden in San Antonio and South Texas is therefore among the highest in the country.

 

Women’s Comprehensive Health Conference set

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UT Health San Antonio invites you to the 5th annual Women’s Comprehensive Health Conference, 8 a.m. to noon, Saturday, Nov 16, at the Witte Museum.

This year’s conference, Heart, Health & Happiness, is bigger and better than ever with a gourmet catered breakfast, empowering patient stories, expert health information, free health screenings, a walk-thru inflatable heart, door prizes, swag bags and more.

UT Health San Antonio speakers will focus on heart health, prescription pain medications, food as medicine, dermatology and more.

Learn more and purchase your ticket here.

FDA approves new drug to treat a rare blood cancer

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The U.S. Food and Drug Administration recently approved the first new medication in nearly a decade for patients with myelofibrosis, a rare blood cancer.

Ruben Mesa, M.D., FACP, director of the Mays Cancer Center, home to UT Health San Antonio MD Anderson Cancer Center, was part of the international research team that led development of the new drug.

And due to the drug’s effectiveness in treating myelofibrosis, fedratinib (brand name Inrebic), is being studied to see if it may also be beneficial for patients with other blood cancers, inflammatory diseases and possibly, one day, for diseases related to aging or that involve blood clots, such as heart attacks or stroke.

On Aug. 16, the FDA approved fedratinib for adults with intermediate-2 or high-risk primary or secondary myelofibrosis. Myelofibrosis is a blood cancer that begins in the bone marrow, where red blood cells, white blood cells and platelets are made. It is one of a related group of blood cancers and chronic leukemias called myeloproliferative neoplasms, or MPNs, that can lead to acute leukemia. Patients with myelofibrosis may experience severe anemia, night sweats, weight loss and significant and painful enlargement of the spleen, an organ involved with filtering the blood.

Ruben A. Mesa, M.D., FACP, is director of the Mays Cancer Center, home to UT Health San Antonio MD Anderson Cancer Center.

“Think about a healthy spleen as being about the size of your fist. With myelofibrosis, the spleen can swell to the size of a football or even a full-term pregnancy,” explained Dr. Mesa. He was an investigator on the fedratinib studies while he was a researcher, chair of the Division of Hematology and Medical Oncology, and deputy director of the Mayo Clinic Cancer Center in Scottsdale, Ariz. Dr. Mesa continued his research and advocacy for the approval of fedratinib after being recruited to UT Health San Antonio’s cancer center in August 2017

He has assembled a team of myelofibrosis experts at the Mays Cancer Center who provide care to patients from around the world. And now that the new drug has been approved, the team can now prescribe fedratinib to eligible patients.

“The pressure of the enlarged spleen can be very painful, pressing on nearby organs. Patients also may experience fatigue, night sweats or shortness of breath associated with anemia. Bone pain and weight loss are also common,” Dr. Mesa said. There is no cure for most myelofibrosis patients.

According to the MPN Research Foundation, about 18,000 individuals in the United States have myelofibrosis and approximately 300,000 live with one of the three MPN blood marrow disorders, which also include essential thrombocythemia and polycythemia vera.

Until fedratinib was approved, ruxolitinib was the only drug available to treat patients with myelofibrosis. “Now with fedratinib, physicians and patients have another treatment option, especially for patients who do not respond well to ruxolitinib,” said Dr. Mesa, who also was involved in the ruxolitinib research.

Dr. Mesa also led development of the National Comprehensive Cancer Network’s Guidelines for Myeloproliferative Neoplasms, published in 2017. In 2018 he was appointed to the national board of directors of the Leukemia & Lymphoma Society.

New head of cardiology named

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UT Health San Antonio has recruited Allen S. Anderson, M.D., FACC, FAHA, to direct and expand the university’s many initiatives in cardiology and cardiovascular disease education and research.

Dr. Anderson is a nationally recognized leader in heart failure and cardiac transplantation at the Northwestern University Feinberg School of Medicine in Chicago. On Nov. 1, he will assume duties as professor of medicine and chief of the Janey and Dolph Briscoe Division of Cardiology at UT Health San Antonio.

Brian Reeves, M.D., chairman of medicine in the university’s Joe R. and Teresa Lozano Long School of Medicine, announced the recruitment. “Dr. Anderson built very successful programs at the University of Chicago and at Northwestern,” Dr. Reeves said. “Working collaboratively with other teams within our university and in very close partnership with University Health System, I am confident that the Division of Cardiology and the Heart and Vascular Institute will enhance our role as the premier provider for complex cardiovascular care in this region. These are very exciting times, and I believe our academic health center is about to enter a new era in cardiovascular medicine.”

The Heart and Vascular Institute, a clinical partnership between UT Health San Antonio and University Health System, encompasses cardiac surgery, interventional and structural cardiology, electrophysiology and advanced cardiovascular disease diagnosis, among its programs. University Health System is supporting Dr. Anderson’s recruitment and expansion of the cardiology programs.

Dr. Anderson is professor of medicine and section chief for heart failure and cardiac transplantation at Northwestern and created a ventricular assist device program there. Under his leadership, the Northwestern program performed 57 heart transplants in 2018, the most ever in the state of Illinois, and implanted 75 left ventricular assist devices.

Dr. Anderson also has significant experience in implementing early phase clinical trials of novel therapies in cardiology.

“Dr. Anderson is an outstanding program builder, clinician, clinical trials designer and educator who has trained many fellows in the treatment of heart failure,” said Robert A. Hromas, M.D., professor and dean of the Long School of Medicine. “His expertise fits perfectly with our interest in obesity and diabetes, because people with these conditions often develop heart failure. Diabetic heart disease is a major health concern in our region. UT Health San Antonio is home to one of the top research programs in Type 2 diabetes in the world, and Dr. Anderson’s recruitment will facilitate the development of new treatments to prevent or reverse diabetic heart disease.”

Dr. Anderson is a graduate of Mercer University and the Emory University School of Medicine. He was a medical resident, including senior chief medical resident, at NYU Medical Center/Bellevue Hospital Center in New York. He completed a fellowship in cardiovascular diseases at the University of Chicago and a fellowship in heart failure and transplantation at Columbia Presbyterian Medical Center in New York.

Noted heart failure expert to join UT Health San Antonio

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Cardiologist Allen S. Anderson, M.D., FACC, FAHA, will join UT Health San Antonio effective Nov. 1.

UT Health San Antonio has recruited Allen S. Anderson, M.D., FACC, FAHA, to direct and expand the university’s many initiatives in cardiology and cardiovascular disease education and research.

Dr. Anderson is a nationally recognized leader in heart failure and cardiac transplantation at the Northwestern University Feinberg School of Medicine in Chicago. On Nov. 1, he will assume duties as professor of medicine and chief of the Janey and Dolph Briscoe Division of Cardiology at UT Health San Antonio.

Brian Reeves, M.D., chairman of medicine in the university’s Joe R. and Teresa Lozano Long School of Medicine, announced the recruitment. “Dr. Anderson built very successful programs at the University of Chicago and at Northwestern,” Dr. Reeves said. “Working collaboratively with other teams within our university and in very close partnership with University Health System, I am confident that the Division of Cardiology and the Heart and Vascular Institute will enhance our role as the premier provider for complex cardiovascular care in this region. These are very exciting times, and I believe our academic health center is about to enter a new era in cardiovascular medicine.”

The Heart and Vascular Institute, a clinical partnership between UT Health San Antonio and University Health System, encompasses cardiac surgery, interventional and structural cardiology, electrophysiology and advanced cardiovascular disease diagnosis, among its programs. University Health System is supporting Dr. Anderson’s recruitment and expansion of the cardiology programs.

Dr. Anderson is professor of medicine and section chief for heart failure and cardiac transplantation at Northwestern and created a ventricular assist device program there. Under his leadership, the Northwestern program performed 57 heart transplants in 2018, the most ever in the state of Illinois, and implanted 75 left ventricular assist devices. For patients suffering from advanced heart failure, these battery-powered devices serve as a bridge to a heart transplant or other lifesaving surgery.

Dr. Anderson also has significant experience in implementing early phase clinical trials of novel therapies in cardiology.

“Dr. Anderson is an outstanding program builder, clinician, clinical trials designer and educator who has trained many fellows in the treatment of heart failure,” said Robert A. Hromas, M.D., professor and dean of the Long School of Medicine. “His expertise fits perfectly with our interest in obesity and diabetes, because people with these conditions often develop heart failure. Diabetic heart disease is a major health concern in our region. UT Health San Antonio is home to one of the top research programs in Type 2 diabetes in the world, and Dr. Anderson’s recruitment will facilitate the development of new treatments to prevent or reverse diabetic heart disease.”

In an interview at Northwestern in 2013, Dr. Anderson said: “I always wanted to be a physician. My dad had lifelong cardiac problems, so I became interested in cardiology at an early age. I discovered during fellowship that I really enjoyed caring for heart failure patients. I was lucky to enter a field that was just blossoming with respect to therapies, so I had the opportunity to care for really sick people who could be helped with novel evolving therapies.”

Dr. Anderson is a graduate of Mercer University and the Emory University School of Medicine.He was a medical resident, including senior chief medical resident, at NYU Medical Center/Bellevue Hospital Center in New York. He completed a fellowship in cardiovascular diseases at the University of Chicago and a fellowship in heart failure and transplantation at Columbia Presbyterian Medical Center in New York.

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Stay connected with UT Health San Antonio on Facebook, Twitter, LinkedIn, Instagram and YouTube.

The University of Texas Health Science Center at San Antonio, now called UT Health San Antonio®, is one of the country’s leading health sciences universities. With missions of teaching, research, healing and community engagement, its schools of medicine, nursing, dentistry, health professions and graduate biomedical sciences have produced 36,500 alumni who are leading change, advancing their fields and renewing hope for patients and their families throughout South Texas and the world. To learn about the many ways “We make lives better®,” visit www.uthscsa.edu.

Study identifies easier way to assess what stroke does to the brain

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Stroke

Highlights:

  • A small genetic “fingerprint,” known as a microRNA, was linked with stroke and the long- term effects of stroke on your body.
  • MicroRNA levels can be measured from a simple blood test, creating the opportunity for a more affordable and more practical option than examining actual brain tissue or using other conventional tests.
  • MicroRNAs naturally point to promising drug targets, so the findings of this study are more likely to lead to new medications that can reduce the extent of brain injury after stroke and help patients recover faster and more fully.

 

By Dr. Joel Salinas with staff insertions

Researchers at UT Health San Antonio and Massachusetts General Hospital identified a connection between a small genetic “fingerprint,” called a microRNA, and people who have experienced a stroke. MicroRNAs, which are products of gene functioning, were previously believed to be as insignificant as snippets of film left on a film editor’s cutting-room floor. However, over many years scientists have come to appreciate how these small pieces of genetic material found all over the body are more than leftovers—they play a critical role in turning genes on or off. This has major consequences on bodily functions and central processes in health, disease and recovery from injury.

“We wanted to see if there was an easier, non-invasive method to know what was going on at the molecular level in the brains and bodies of people at risk for stroke or who have experienced a stroke,” said Joel Salinas, M.D., M.S., M.B.A., a neurologist at the Massachusetts General Hospital McCance Center for Brain Health and one of the researchers leading the investigation at the Framingham Heart Study along with colleagues at the Glenn Biggs Institute for Alzheimer’s and Neurodegenerative Diseases at UT Health San Antonio. “Studying microRNAs in blood samples from hundreds of people who have had a stroke or who went on to have stroke seemed promising to us, because discovering patterns in microRNA levels might give hints about genetic chain reactions leading to stroke or that occur as a consequence of stroke. The added benefit of any links is that they almost immediately point to potential applications in drug development, because microRNAs by default are targets for pharmacologic intervention.”

Framingham Heart Study

Building off a prior study, researchers measured microRNA (miR) levels in available blood samples routinely collected in one of the largest and longest-running community-based research cohorts in the U.S., the Framingham Heart Study. They identified a significant reduction in miR-574-3p levels in the blood of people who had a stroke months and even years prior. To be as confident as possible in this finding, the researchers accounted for many other factors that could falsely influence their results, yet the findings remained the same.

“When we felt confident enough that spotting this link was unlikely to be just a fluke, we dug deeper to see what this finding with miR-574-3p meant for the biology of your brain and your entire body if you’ve had a stroke,” Dr. Salinas said. “We found this specific miRNA seemed to serve as an indicator of your brain’s response, and of systemic cellular response, to stroke in the short, medium and long term.”

Implications

The findings of this study will help inform future investigations into how these small—yet powerful—genetic mechanisms influence many related diseases and how targeting microRNAs with new potential drugs might confer a protective effect on a person’s resilience and recovery after stroke.

“We know many of the risk factors for stroke, such as hypertension, and have developed new drugs and interventions for the treatment of an acute stroke,” said Sudha Seshadri, M.D., professor of neurology at UT Health San Antonio, director of the university’s Glenn Biggs Institute and senior investigator with the Framingham Heart Study. “But we do not yet understand all the molecular and biological changes that occur in people who are at risk for stroke and those who have had a stroke. If we did, we could better predict and prevent downstream complications like dementia.”

MicroRNAs are messengers in the communication pathways within the cell and are emerging as an efficient way to understand and intervene in many brain diseases, Dr. Seshadri said. “We are excited to further expand our studies to more persons, and to persons of different race and ethnic backgrounds,” she added.

The study appeared in August in the journal PLOS ONE.

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Stay connected with UT Health San Antonio on Facebook, Twitter, LinkedIn, Instagram and YouTube.

The University of Texas Health Science Center at San Antonio, now called UT Health San Antonio®, is one of the country’s leading health sciences universities. With missions of teaching, research, healing and community engagement, its schools of medicine, nursing, dentistry, health professions and graduate biomedical sciences have produced 36,500 alumni who are leading change, advancing their fields and renewing hope for patients and their families throughout South Texas and the world. To learn about the many ways “We make lives better®,” visit www.uthscsa.edu.

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Massachusetts General Hospital, founded in 1811, is the original and largest teaching hospital of Harvard Medical School. The MGH Research Institute conducts the largest hospital-based research program in the nation, with an annual research budget of more than $925 million and major research centers in HIV/AIDS, cardiovascular research, cancer, computational and integrative biology, cutaneous biology, genomic medicine, medical imaging, neurodegenerative disorders, regenerative medicine, reproductive biology, systems biology, photomedicine and transplantation biology. The MGH topped the 2015 Nature Index list of health care organizations publishing in leading scientific journals and earned the prestigious 2015 Foster G. McGaw Prize for Excellence in Community Service. In August 2018 the MGH was once again named to the Honor Roll in the U.S. News & World Report list of “America’s Best Hospitals.” To learn more about the MGH Henry and Allison McCance Center for brain health, visit www.massgeneral.org/brain-health.