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Top US cancer institute eyes Qatar

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Top US cancer institute eyes Qatar venturePublished: Saturday, 17 June, 2006, 10:19 AM Doha Time

By Bonnie James

Prof Deborah A Kuban speaking to Gulf Times

THE University of Texas M D Anderson Cancer Center (MDACC), described as one of the world’s most respected institutions of its kind, is exploring options to offer its expertise and services to Qatar, two top officials have told Gulf Times.

“We have been invited to look at how we might be able to help the Qatar Foundation (QF), the National Health Authority (NHA), and Hamad Medical Corporation (HMC),” radiation oncology Prof Deborah A Kuban and International Business Development director Wendeline Jongenburger explained in an interview.

In Qatar during a tour of the region, they held initial discussions with officials of QF, NHA and HMC, apart from touring HMC’s Al Amal Hospital, which specialises in cancer care, and QF’s Education City.

Asked what would be the main focus area in the event of a tie-up, the officials maintained that would need to be determined given that MDACC has outstanding programmes that integrate patient care, research and prevention, and education for students, trainees, professionals, employees and the public.

“There are multiple things that we could offer, and it depends on the hospital we are aligned with, and there can be slightly different purpose with each one, if you look at our partnerships around the world,” professor Kuban said.

For instance, MDACC, based in Houston, in the US, has set up a facility in Madrid, Spain, and has been involved since the start and in all aspects of establishing and running the institution.

“With some other institutions, we have more of an education agreement with a physician exchange programme for teaching and giving lectures, while with some others we collaborate on research projects,” she said.

Considering the similar interests being pursued at both Al Amal Hospital and MDACC, the probable tie-up could be between the two, the officials felt.

The fact that Al Amal is being run by the University Clinics of Heidelberg (UCH), Germany, should not be a hindrance for any collaboration with MDACC.

“Our mission is to eradicate cancer, we work with colleagues around the world to try to do that, and working with UCH is not a deal breaker, we would welcome their participation and input if there is something we could do together,” Jongenburger observed.

Though MDACC, established in 1941 as a component of The University of Texas System, has several alliances in Asia, it has none in the Middle East and the Gulf region.

“But, we are very familiar with this part of the world as we have very long relationships with treating patients from all these countries at Houston,” she pointed out.

Jongenburger recalled that apart from the government of Qatar sending nationals to MDACC for treatment, several Qataris have been to the institution on their own.

MDACC firmly believes in the concept that cancer patients ought to receive care in their home countries themselves, for emotional and a host of other reasons, and hence the efforts to make available its services at all possible destinations.

“We see about 28,000 newly diagnosed patients every year, of whom 30% are from Houston and the surrounding area, another 30% come from Western Texas which is a very large area, about 30 to 35% are from the rest of the US, and the remaining from abroad,” the official said.

Since 1944, almost 700,000 patients have turned to MDACC for cancer care in the form of surgery, chemotherapy, radiation therapy, immunotherapy or combinations of these and other treatments.

This multidisciplinary approach to treating cancer was pioneered at MDACC, and because they focus only on cancer, the experts there are renowned for their ability to treat all types of cancer, including rare or uncommon diseases.

MDACC has ranked among the top two cancer hospitals in US News & World Report’s ‘America’s Best Hospitals’ survey since its inception in 1990, and has ranked number one four times in the last six years.

“If you rate a cancer centre by the amount of research funds it is able to attract from the government, ours is the number one recipient both in number of grants and in the dollar value of grants,” explained Jongenburger.

The officials stated that research is the driving force that has propelled MDACC to its international reputation for scientific excellence and outstanding cancer care.

“Today, people everywhere benefit from research-based discoveries made at MDACC over the past 60 years,” they said while claiming that the best is yet to come.

What sets MDACC apart is its ability to translate emerging knowledge gained in 575 laboratories into better treatments for patients with nearly all forms of cancer - and to do so in the shortest possible time.

“Our translational research maintains a two-way bridge for multidisciplinary scientists and clinicians to work together on every aspect of the cancer problem,” professor Kuban and Jongenburger said.

The most encouraging recent findings providing targets for clinical interventions focus on the relatively few genes involved in cancer initiation and proliferation. Of the estimated 100,000 genes within every human cell, only about 400 appear to be critical to cell division and growth.

Identifying the molecular mutations or malfunctions in those key genes is possible with technical tools not even conceived of a decade ago.

“But researchers now can examine thousands of genes in tumour cells simultaneously and superimpose them over normal cells to determine the subtlest molecular differences,” they pointed out.

This 21st century technology is giving rise to the exploding field of genomics. A Cancer Genomics Core Laboratory at MDACC supports research to expand molecular therapeutics and diagnostics.

In the future, it should be possible to use molecular level knowledge to design individual treatments for each patient’s cancer as well as to intervene before many people ever develop the disease.

One fruitful area of gene-based translational research concerns the p53 tumor suppressor gene, which is either missing or mutated in a majority of human cancers.

Landmark research reported from MDACC during the 1990s included the first successful correction of a defective p53 gene in lung cancer patients and extension of that gene therapy method to treat head and neck, prostate, bladder and other cancers.

Progressively positive results have been observed in expanding clinical trials that combine p53 gene therapy with chemotherapy and radiation.

Other techniques to replace or repair abnormal genes also have been developed at MDACC for brain tumours as well as breast and ovarian cancers. Several types of gene therapies have progressed from laboratory studies in experimental animals to clinical trials in only a few years because of the collaboration among research and clinical faculty and the institution’s capacity to care for a large number of patients, including those with uncommon cancers.

“Over the years, more clinical trials comparing new treatments to standard therapies have been conducted at MDACC than at any other centre,” the officials said.

About 15% of patients now participate in clinical trials that are demonstrating the efficacy of new anti-cancer drugs and biologic compounds, less-invasive surgical procedures and more precise radiation techniques.

Of the various standard cancer therapies administered today, many were evaluated, wholly or in part, through clinical trials at MDACC.

“Nowhere has more progress been made to understand why and how cancer metastasises or spreads from primary sites to other organs than at MDACC, where teams of researchers are devising novel ways to overcome the insidious problem of metastasis,” they maintained.

Their researchers’ efforts concentrate on either altering the highly specialised genetic components in metastatic cells or changing the organ environment so those cells will not thrive - or using both approaches to produce a synergistic effect.

An increasingly important area involves interrupting angiogenesis, the process by which blood vessels form and feed cancer cells, allowing them to multiply and metastasise.

MDACC scientists are leaders in investigating biological agents and growth factors that in laboratory animals can prohibit new blood supply to tumours.

The field of chemoprevention, which has been pioneered at MDACC, offers far-reaching opportunities to use drugs and natural substances for reversing pre-malignant lesions and preventing first or second primary cancers in individuals at high risk.

“Promising chemoprevention methods are being analysed for cancers of the head and neck, breast, cervix, colon, skin, prostate, bladder, lung and ovaries,” Prof Kuban and Jongenburger added.

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