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1976

Since its founding, Fox Chase has been renowned for the high quality of care provided by its nurses, care that has resulted in numerous individual nursing awards, as well as being honored with the American Nurses Association Magnet Award for Nursing Excellence six consecutive times.

 

BLAZING A PATH IN CLINICAL INNOVATION

Fox Chase and its precursors have been at the forefront of the fight against cancer both scientifically and clinically for 120 years. Its crowning achievements include the discovery of the Philadelphia chromosome, the first genetic abnormality associated with a human cancer, as well as the development and testing of thousands of novel therapies. This work has resulted in hundreds of national awards, including Nobel prizes in medicine in 1976 and in chemistry in 2004.

As Fox Chase moves into the next decade, the goal is to remain at the forefront by focusing on areas that will contribute most to continued growth in clinical development. In the coming years, Fox Chase will work to improve the ability of patients to access care and participate in research. It will also improve the education of trainees, enhance translational interactions, and increase clinical research focus on areas where Fox Chase can partner with Temple Health to make meaningful progress.

With these goals in mind, Fox Chase will aim to create a culture of collaborative communication starting at the trainee level. It will also develop easily accessible databases of ongoing clinical trials and of relevant lab, clinical, and pharmaceutical connections. Additionally, Fox Chase will work to increase the visibility of its research within industry settings and support investigator-initiated trials by helping investigators access the expertise and tools they need.

To address the areas most in need of critical research, Fox Chase plans to focus on areas of concern that have been studied within the community. These include malignancies that could most benefit from streamlined services because they are disproportionately affecting the community and more research to investigate the disparities experienced by some members of the community.

Additionally, a major focus of the next 10 years will be the development of crucial clinical trials. In recognizing that its clinical trials are only effective with the help of willing participants, Fox Chase plans to build awareness of, and trust in, its clinical trials so that patients can feel more at ease in contributing to these research efforts. Fox Chase will also make a concerted effort to improve visibility and accessibility of translational research.

Fox Chase is committed to addressing clinical needs through longstanding relationships with patients that enable identification, management, and understanding not only of their primary treatments but of secondary consequences of those treatments as well. Fox Chase seeks to establish a culture in which patients and community members have an active and enthusiastic role in helping develop a clinical roadmap by defining treatment priorities, building resources, and protecting the next generation from the scourge of cancer.

IMMUNOTHERAPY EFFECTIVE FOR BOTH BLACK AND WHITE PATIENTS

While race can influence treatment recommendations for certain forms of cancer, a study by researchers at Fox Chase has shown that immune checkpoint inhibitor-based treatment (ICI), a type of immunotherapy, is an equally effective frontline treatment for both Black and White patients with metastatic renal cell carcinoma.

Previous research into the immune gene signatures that are used to predict a patient’s response to ICI-based treatment for renal cell carcinoma has found differences between Black and White patients. The study was conducted to compare whether these differences in gene signatures translated into differences in real-world progression-free survival for Black and White renal cell carcinoma patients.

The team, including senior author Pooja Ghatalia, MD, an Associate Professor in the Department of Hematology/Oncology at Fox Chase, retrospectively reviewed anonymous records from Flatiron Health, a health technology company, for 2,592 Fox Chase patients who received either ICI-based therapy or sunitinib, a targeted cancer drug, as frontline treatment for metastatic renal cell carcinoma after 2011.

“There is a potential benefit of ICI in both Black and White populations, so we should not differentiate the treatment options based on race,” said Jasmeet Kaur, MD, the lead author on the study and a second-year fellow in the Department of Hematology/Oncology at Fox Chase.

 

REDUCED IMMUNE SIDE EFFECTS WITH NIVOLUMAB

Researchers at Fox Chase published the results of a phase 1 study that showed that the cytokine interferon-gamma may help reduce serious immune-related adverse events that can occur with the use of the immune checkpoint inhibitor drug nivolumab.

Immune checkpoint inhibitors block immune checkpoint proteins from binding with their partners, allowing immune cells to target and kill cancer cells. Interferon-gamma is a cytokine, a signaling molecule secreted to target immune cells, that plays an important role in regulating immune responses.

Immune checkpoint blockade offers the potential for durable response in some cancer patients. However, most patients either do not respond to this therapy or develop resistance.

Discovering new ways to optimize immune checkpoint blockades in tumors that are less likely to respond or that have become resistant to these single drugs without increasing immune-related side effects is crucial.

“What was most interesting during this trial was that although we did not see a significant increase in tumor regressions, we did observe fewer immune-related side effects than we thought we would see with nivolumab alone, which was unexpected,” said Matthew Zibelman, MD, lead author on the study and Associate Professor in the Department of Hematology/Oncology at Fox Chase.

“My hope is to pursue more research to understand if the interferon-gamma could work to help minimize or prevent side effects that patients experience from immune checkpoint inhibitors,” he added.

 

GRANT HELPS BOOST CLINICAL TRIAL ENROLLMENT

A team of nursing researchers from Fox Chase and Temple Health received a $564,000 grant from the U.S. Department of Defense to fund research into increasing clinical trial enrollment of underrepresented kidney cancer patients by making it easier for them to participate in such trials.

It has been shown that there are many barriers for racial and ethnic groups, women, older adults, and patients of low socioeconomic status who want to participate in oncology clinical trials. Lower-income patients are less likely to enroll in clinical trials due to concerns about affording the extra costs associated with participating in them.

“Equal access to trials is essential in determining the effectiveness of therapy in a real-world patient population,” said Susan Rux, PhD, RN, ACNS-BC, CNE, the Principal Investigator for the grant and Associate Vice President of Professional Nursing Practice and Research at Fox Chase. “Through education and alleviation of financial toxicity enabled by our research program, we will improve access to kidney cancer clinical trials, thereby increasing enrollment of underrepresented patients.”

Rux is conducting the research with Rutika Kokate, PhD, MS, Scientific Manager for the GU Research Team in the Office of Clinical Research (OCR) at Fox Chase. Other co-investigators include Kimberly Costello, RN, BSN, OCN, CCRC; Courtney Lambert, RN, BSN, OCN; and Kristin Virag, RN, MSN, OCN, who are all nurses at Fox Chase and members of the OCR.

 

MODEL ESTIMATES INCREASED CURE RATES WITH NIVOLUMAB

Patients with muscle-invasive urothelial carcinoma who underwent surgery to remove their tumor appeared to have an overall survival benefit from subsequent systemic therapy with the immune checkpoint inhibitor nivolumab, according to an analysis by researchers at Fox Chase.

The previously published CheckMate-274 trial randomly assigned patients with muscle-invasive urothelial carcinoma to adjuvant nivolumab, also known by its brand name Opdivo, or placebo and showed that nivolumab significantly prolonged disease-free survival. However, data on whether or not nivolumab prolongs overall survival are not yet mature and are unavailable.

Daniel M. Geynisman, MD, Chief of the Division of Genitourinary Medical Oncology at Fox Chase, and colleagues used a mathematical model called mixture cure models to estimate survival curves for patients assigned to nivolumab or placebo who were considered “cured” or “not cured.”

Among the entire study population, the model estimated a 6% to 9% absolute increase in the cure rates when patients were treated with adjuvant nivolumab compared with placebo. Between 43% and 45% of patients treated with nivolumab were cured compared with 36% to 37% of patients assigned to placebo.

“Although we don’t have mature overall survival data from the trial, this model seems to support an overall survival benefit associated with adjuvant nivolumab,” said Geynisman.

 

ASSESSING SOCIOBIOLOGICAL FACTORS OF RENAL CANCER

In a recent study, Fox Chase researchers found that while sociodemographic, clinical, and pathological factors may affect racial and ethnic disparities in outcomes of patients with locally advanced rectal cancer, non-Hispanic Black patients consistently saw less favorable treatment outcomes independent of those factors.

Shannon Lynch, PhD, MPH, co-lead author, Assistant Professor in the Cancer Prevention and Control Research Program, and Assistant Director of the Office of Community Outreach and Engagement at Fox Chase, worked on this study alongside Sanjeevani Arora, PhD, co-lead author and an Assistant Professor in the Cancer Prevention and Control Research Program.

Lynch and Arora used the National Cancer Database to examine social determinants of health, as well as demographic, clinical, and pathological factors known to predict response to neoadjuvant therapy for locally advanced rectal cancer.

“Our findings suggest that other factors we weren’t able to measure or evaluate using this existing data resource, such as access to services or more detailed socioeconomic or clinical data, could be playing a role in differences we see in treatment response by race/ethnicity,” said Lynch.

Both agree that the study is the first step in assessing some of the sociobiological factors that may influence treatment outcomes and highlights the importance of cultivating diversity in clinical trials that assess treatment response.

 

FOX CHASE, TEMPLE RECERTIFIED FOR QUALITY CARE

Fox Chase Cancer Center and Temple University Hospital - Main Campus have been recognized by the QOPI Certification Program LLC as successfully completing a three-year recertification for outpatient hematology-oncology practices that meet nationally recognized standards for quality cancer care. The QOPI program is a wholly owned subsidiary of the Association for Clinical Oncology and an affiliate of the American Society of Clinical Oncology (ASCO).

QOPI is a voluntary self-assessment and improvement program launched by ASCO in 2006 to help hematology/oncology and medical oncology practices assess the quality of care they provide to patients.

“This recognition is significant because it includes for the first time hematology-oncology outpatient services at Temple University Hospital - Main Campus,” said Abhi Rastogi, MBA, MIS, President and CEO of Temple University Hospital Inc. and Executive Vice President of the Temple University Health System. “Our certification recognizes the exceptional dedication of all at Fox Chase and TUH - Main Campus who contribute to the care of our cancer patients.”

 

ONE YEAR REVIEW OF ADAPTIVE RADIOTHERAPY

Over the past year, the team led by Eric Horwitz, MD, FABS, FASTRO, Chair of the Department of Radiation Oncology at Fox Chase and the Lewis Katz School of Medicine at Temple University, has boldly moved adaptive radiation therapy into the mainstream, demonstrating its clinical advantages for treating prostate, bladder, liver, pancreas, breast, lung, and head and neck cancers.

At Fox Chase, clinicians and physicists use the Ethos cone-beam computed tomography (CBCT)-based adaptive radiation therapy system of Adaptive Radiation Therapy. This Food and Drug Administration-approved technology combines a linear accelerator that includes CBCT imaging technology and artificial intelligence-based software to power the adaptive treatment process.

The Fox Chase team took years to develop the resources, clinical knowledge, and infrastructure to bring adaptive radiation therapy to patients. Every Fox Chase radiation oncologist is cross trained to offer adaptive radiation as an option to every eligible cancer patient.

“Fox Chase is taking a newly established technology and exploring how far we can advance it: to treat a patient’s cancer with as few side effects as possible for the best quality of life. It’s our mission as a National Cancer Institute-designated Comprehensive Cancer Center,” said Horwitz.

 

1,000 PATIENTS TREATED WITH BREAST-CONSERVING SYSTEM

In the spring of 2024, Fox Chase physicians reached a new milestone: 1,000 patients have now been treated using the EnVisio real-time Surgical Navigation System and Smart-Clip Tumor Marker since Fox Chase became the first cancer center in the Northeast to implement the technology in 2020.

The system, made by Elucent Medical, allows surgeons to better navigate to the precise location of malignant breast tissue during a lumpectomy or partial mastectomy, resulting in less unnecessary breast tissue removal and shorter surgery times for patients.

The system has significantly advanced breast care for surgeons who previously had few tools available to guide them in the removal of cancerous breast tissue. The system’s real-time 3D rendering helps surgeons navigate their tools directly to the tumor to remove the affected tissue, something akin to surgical GPS.

“The navigation system has transformed how we do breast surgery because it shows a three-dimensional picture relative to the detector, making it easier for the surgeon to assess where the tumor is and how best to resect it,” said Richard Bleicher, MD, FACS, Chief of the Division of Breast Surgery at Fox Chase. “It is remarkable that we have reached 1,000 cases already, but it reflects the increase in our breast surgical volumes from the trust that the public puts in us as Philadelphia’s premier cancer center.”