Research could lead to more options for treating patients
SAN ANTONIO (Oct. 31, 2013) — Thanks to $450,000 from the Max and Minnie Tomerlin Voelcker Fund, physician researchers at the Cancer Therapy & Research Center (CTRC, a component of UT Medicine San Antonio) are digging deeper into how a tuberculosis vaccine fights bladder cancer. The CTRC is the only National Cancer Institute-designated Cancer Center in South Texas.
The clinician scientists are analyzing immune system attributes in bladder cancer to learn why only some bladder cancers are effectively treated by the TB vaccine, called BCG. The researchers also seek to understand why some patients who are initially treated effectively with BCG later develop a resistance to it.
The ultimate goals are to make the TB vaccine highly effective to treat bladder cancer and prevent resistance to it, and to develop additional highly effective treatments.
Young investigator award
A Voelcker Fund three-year, young investigator award is supporting the research program of bladder cancer surgeon Robert S. Svatek, M.D., M.S., assistant professor of urology. Cancer immunologist and medical oncologist Tyler J. Curiel, M.D., M.P.H., professor of medicine, is Dr. Svatek’s project collaborator.
“We put the BCG vaccine directly into the bladder and the body’s natural immune response to the vaccine kills the bladder cancer,” Dr. Svatek said. “Even after decades of use of this vaccine, which is a kind of immunotherapy, we don’t know enough about how it is working. With the Voelcker grant, we seek new understanding with an eye on using immunotherapy for other cancers.”
The labs are testing if the addition of another approved drug, rapamycin, improves the response to BCG therapy.
Dr. Curiel noted that the study includes in vitro analyses in test tubes and tests in mice to complement immune studies in human patients with bladder cancer who are treated with BCG and rapamycin. “Combining these different research approaches helps us identify the fastest way to get better treatments to patients,” Dr. Curiel said.
“We have some ideas of how BCG works, but we don’t fully understand the immune response to it or why certain patients and certain tumors don’t respond,” he said.
Bladder cancer is one of the most expensive cancers to treat because it tends to recur, Dr. Svatek said. The greatest risk factor is smoking, although non-smokers can have genes that predispose them to the disease. BCG is one of the mainstays of bladder cancer treatment.
“At some point, BCG loses its effectiveness in many patients,” Dr. Curiel said. “If we can understand why this happens and find ways to prevent resistance to treatment, we can reduce the risk of losing the bladder entirely and increase the patient’s quality of life.”
Voelcker Fund’s continuing support
He noted that the Voelcker Fund has given grants to the Health Science Center that have translated into millions of dollars of National Institutes of Health grants and led to important medical advances. For example, a study by Dr. Curiel and coauthors showed that some types of immunotherapy previously thought to work only in younger patients can be used to help the elderly by taking into account age-related changes in the immune system.
Voelcker funding also supported an innovative study of lymphoma, which are cancers that start in cells of the immune system called lymphocytes.
Dr. Svatek came to the School of Medicine in 2010 from the UT M.D. Anderson Cancer Center in Houston. He said it is gratifying to work with Dr. Curiel because the two have different backgrounds and approaches to research, and working together promises to do more ultimately for patients.
Here are statistics for Bexar County bladder cancer and other cancers.
The Cancer Therapy & Research Center (CTRC) at The University of Texas Health Science Center at San Antonio is one of the elite academic cancer centers in the country to be named a National Cancer Institute (NCI)-designated Cancer Center, and is one of only four in Texas. A leader in developing new drugs to treat cancer, the CTRC Institute for Drug Development (IDD) conducts one of the largest oncology Phase I clinical drug programs in the world, and participates in development of cancer drugs approved by the U.S. Food & Drug Administration. For more information, visit www.ctrc.net.