· HistoRx and RTOG Team Up on Brain Tumor Biomarkers
· Radiosurgery Expert Appointed 2007 ASTRO Fellow
· IT Specialist Siegel Joins Carestream Board of Directors
· British Hospitals Implement Oncology Information
HistoRx and RTOG Team Up on Brain Tumor Biomarkers
On September 4, HistoRx Inc, New Haven, Conn, announced it entered into a research collaboration with the Radiation Therapy Oncology Group (RTOG), a clinical cooperative group funded by the National Cancer Institute (NCI). According to the terms of the deal, HistoRx will give RTOG researchers access to its Automated Quantitative Analysis (AQUA) technology for biomarker analysis and will develop customized immunohistochemical assays to be used by RTOG in investigating the relationship between specific protein biomarkers and clinical responsiveness in brain tumor patients. In return, HistoRx will be able to commercialize assays and reagents developed over the course of the collaboration.
|HistoRx AQUA technology measures and localizes disease-specific variations in protein expression within the tumor tissue sample.|
“We selected HistoRx’s AQUA technology based on its unique ability to measure protein biomarker expression and localization in diseased tissue sections in a precisely quantitative, reproducible, and standardized way,” said Arnab Chakravarti, MD, a member of the RTOG Translational Research Program. “By eliminating the subjective interpretation inherent in conventional qualitative immunohistochemical analysis, we expect this collaboration will provide a substantial boost to our research in brain cancer by enabling RTOG researchers to reveal stronger, more reliable statistical correlations linking protein biomarker expression with prediction of patient response to therapy and disease outcome.”
The RTOG studies will use a combination of high-throughput tissue microarrays, multiplex analysis, and AQUA analysis-based assays to determine whether brain tumor patients are likely to respond to a specific targeted therapy and whether the biomarkers under investigation could be used to predict survival.
“As the relationship between protein-expression patterns and disease gains an expanding role in new drug and diagnostic development and in the way physicians treat patients and individualize therapeutic regimens, we continue to advance our goal of replacing conventional immunohistochemistry with AQUA analysis, a more precise and consistent tool that is enabling pathologists and clinicians to integrate data from predictive biomarker studies confidently into research, diagnosis, and patient treatment,” said Rana K Gupta, CEO of HistoRx.
Radiosurgery Expert Appointed 2007 ASTRO Fellow
On October 30, during the 49th annual meeting of the American Society for Therapeutic Radiology and Oncology (ASTRO) in Los Angeles, the Society will recognize its 2007 Fellows, honored for their leadership and significant service in the field of radiation oncology.
|James G. Schwade, MD|
One honoree is James G. Schwade, MD, a Miami radiation oncologist and the executive director of the CyberKnife Centers of Miami and Palm Beach, which feature radiosurgery devices manufactured by Accuray Inc, Sunnyvale, Calif. Schwade has been involved with radiosurgery since his time at the University of Miami in 1987, and was involved with working on a homegrown system in his department. “We were the first people to publish on this type of radiosurgery,” he said. “Then I was involved with the initiation of both the gamma knives that went into Miami, and for a period of time I gave refresher courses in radiosurgery at ASTRO and RSNA meetings.”
The CyberKnife Center of Miami began operations in late 2003. It’s an unusual business model, Schwade explained, under which the technology essentially operates as a community resource. “We do not work with any single physician, physician group, hospital, or facility,” he said. “But we are ready to work with whatever doctor, hospital, or organization is ready to work with us. It’s a very unique model for bringing in technology and getting adequate utilization, and it’s worked out very well. Rather than have one of the hospitals get this device and then create a horsepower race with the other hospitals, we’ve come up with a methodology under which patients are appropriately treated.”
But Schwade’s work with image-guided robotic radiosurgery began long before Accuray’s CyberKnife technology was mature enough for its own freestanding business. He has authored more than 80 scientific articles over the course of his career and worked with ASTRO and other organizations to advance the interests of radiation therapy.
“I’ve done research on a large number of areas, including radiation-sensitizing drugs; I also do clinical research in central nervous system lesions, breast lesions, prostate cancer, and many other areas,” he said. “This culminated most recently in clinical research involving radiosurgery, particularly the development and application of image-guided robotic radiosurgery.”
At this year’s ASTRO meeting, Schwade is looking forward to enjoying a more relaxed agenda, with no papers to present or refresher courses to lead. “Professionally, it’s always the high point of my year,” he said of the meeting. “You hear the latest things that are going on, you get a lot of information, you see a lot of old friends and colleagues and talk to them about how they’re dealing with a lot of the same problems you’re dealing with. The issues I’m involved with now are a little more truncated, but the ASTRO meeting is a great place to learn about what’s going on with radiation oncologists.”
IT Specialist Siegel Joins Carestream Board of Directors
On August 16, Carestream Health Inc, Rochester, NY, formerly the Health Group of Eastman Kodak Co, announced its founding board of directors. Among the six people charged with supporting Carestream’s vision “to change the landscape of health care by providing solutions that dramatically improve the quality and cost of care,” there is one clinician: Eliot L. Siegel, MD. Siegel is professor and vice chair of the University of Maryland School of Medicine Department of Diagnostic Radiology; he also serves as chief of radiology and nuclear medicine for the Veterans Affairs Maryland Healthcare System.
|Eliot L. Siegel, MD|
Under Siegel’s guidance, the VA Maryland Healthcare System became the first filmless radiology enterprise in the country. “I was a computer science minor in college and worked my way through medical school doing programming and other things,” Siegel explained. “I also worked at the NIH for a year doing computer programming related to CT scans and nuclear medicine images.”
Siegel continues to be involved with the NIH, but these days he’s there in a leadership capacity, leading the National Cancer Institute Image Archive and NCI’s caBIG In Vivo Imaging Workspace. “The theme of what I’m doing for the NCI is to try to create standards and a suite of software that will allow interoperability in such a way that we’ll be able to create national and international databases to personalize the way we treat patients in the future,” he explained. “The project is designed to create personalized or stratified medicine where we’ll be able to not just treat patients based on literature or clinical trials, but will be able to tailor specific treatments to the genetic and proteimic makeup of the tumor.”
Siegel hopes his role with Carestream will help him more directly influence the products the company releases into the market. “To reinvent where radiology’s going to, anticipate and address these issues—it’s been great to do that at a government and academic level, but I’ve never been able to influence where vendors will go in the future,” he said. “What was particularly attractive about the opportunity to join Carestream would be the opportunity to take some of the ideas and research I have and provide them directly to a commercial vendor, helping create areas of emphasis they might not think of otherwise.”
Some of those ideas include shifting the focus from efficiency and productivity to image quality, which Siegel believes can be addressed through the creation of metrics—a belief that is consistent with the ACR’s current focus. “There haven’t been a lot of metrics focusing on conventional radiographs,” Siegel noted, “though those still constitute the majority of studies that we read.”
Another of Siegel’s initiatives is an online index of images with an accompanying lexicon. “We want to literally create a lexicon that describes the terms and shows sample images,” he said, “to give people a reference for image quality.”
Above all, Siegel believes in the transformative power of technology in medicine, and wants to see radiology evolve beyond its current boundaries. “I’ve tried to combine what I know with where I see the challenges for the future, and to try to use computers and informatics to address those challenges,” he said. “I want to find ways to treat patients more effectively, reduce radiation, reduce error, and to try to give back to the medical community all the things it’s given me.”
British Hospitals Implement Oncology Information
Objectives are to reduce error, increase efficiency, and improve consistency.
When patients regularly visit multiple departments in one hospital, the work and the risk can increase: As more information is transferred and transcribed more often, there is a greater chance that an error will be introduced. Electronic systems help to remove this risk by removing the human element and to increase efficiency by reducing the need to transfer information.
These were two of the goals of a hospital network in England that selected an oncology information system from Varian Medical Systems, Palo Alto, Calif. ARIA for Medical Oncology incorporates medical, radiation, and surgical oncology into one system to create efficiencies in the oncology processes. Its applications permit clinicians to deploy a range of image-guided technologies, stereotactic radiosurgery, concomitant therapy, and dynamic adaptive radiotherapy. The newest release features a pharmaceutical module that manages the technical process of preparing and dispensing drugs.
This addition factored into the decision of the six hospitals in Northern England to implement the system. They sought to reduce their clinical risk and prescribing errors; increase the information workflow across the network; and deliver consistent care. “In the UK, NICE [National Institute for Health and Clinical Excellence of London, England] provides treatment guidelines for different types of cancers, and hospitals want to enforce them consistently across their networks,” said Steve Laws, Varian’s medical oncology sales manager in Europe.
ARIA helps to achieve these goals by replacing paper-based systems. “The electronic process eliminates manual transcription—a prescription is written just once, for instance,” Laws said. Data is where it is needed when it is needed so that physicians can log in from whichever hospital in the network they are in and access patient information in real time.