Precision Medicine Advances in Cancer Treatment Highlighted at Inaugural Sylvester Conference

Innovative advances in personalized care, immunotherapy, and targeted treatment for people with many types of cancer were the focus of the inaugural Miami Precision Medicine Conference, held April 2 at the Ritz-Carlton in Fort Lauderdale.

The event, envisioned as the first in an annual series to disseminate updates regarding this dynamic trend in oncology care to caregivers, patients, and advocates, was sponsored by Sylvester Comprehensive Cancer Center at the University of Miami Miller School of Medicine.

“Precision medicine tailored to a person’s genetic makeup and particular type of cancer holds the promise of better outcomes and fewer side effects,” said Stephen D. Nimer, M.D., director of Sylvester Comprehensive Cancer Center and holder of the Oscar de la Renta Endowed Chair in Cancer Research.

“As the only academic cancer center and the only NCI-designated cancer center in South Florida, we have an obligation to help teach the community about how to apply these advances to the patients who need them.”

The event highlighted how evolving precision medicine technologies such as next-generation sequencing, liquid biopsies, and molecularly driven clinical trials are creating a new era of hope for patients and patient advocates.

One way to apply these advances, noted the conference’s program director, Carmen Calfa, M.D., breast medical oncologist at the Braman Family Breast Cancer Institute at Sylvester at Plantation, is to refer patients to one of the many clinical trials under way at Sylvester.

Dr. Calfa is also Medical Co-Director of Cancer Survivorship & Translational Behavioral Sciences. “We have learned that precision medicine clinical trials and personalized treatments do work,” she added. “We’re seeing breakthroughs happen and lives saved every day.”

Bringing together and educating providers with varying roles in patient care were key goals of the conference. “Carving time and creating dialogue across health care disciplines increases communication and teamwork as we collectively advance precision medicine as a field.,” Dr. Nimer said.

“We are reaching out to nurses, nurse practitioners, fellows, and students so they can see the exciting potential of truly multidisciplinary, research-driven care,” said Jonathan Trent, M.D., Ph.D., program codirector, who presented on precision oncology in the diagnosis and management of sarcoma patients. “Ultimately, the goal of the conference is to bring us all together to understand the latest and greatest breakthroughs, the most urgent needs in bench research and clinical trials, and how to advance the field.”

Precision medicine is important because “blanket treatment may not work for everyone,” said Craig Moskowitz, M.D., program co-director, physician in chief at Sylvester, and a lymphoma expert. He pointed out that, for example, lymphoma used to be considered one disease. Now, thanks in large part to genetic profiling, lymphoma is classified as three different diseases, each with specific genetic abnormalities.

Transforming Cancer Care

Precision medicine can transform diagnosis, treatment, and prognosis, as illustrated by a case discussed during a multidisciplinary molecular tumor board session. The patient, a young woman of child-bearing age who sought to become pregnant, was initially diagnosed with an inflammatory myofibroblastic tumor (IMT) and recommended for a hysterectomy. However, next-generation sequencing detected a genetic mutation present in a majority of benign uterine leiomyomas while ruling out the initial diagnosis.

“It was good news for the patient,” said Marilyn Huang, M.D., director of translational gynecologic oncology research at Sylvester.

“Sylvester’s strategic decision to have precision medicine tumor boards can change the trajectory of a patient's cancer journey,” said Richard L. Schilsky, M.D., who served as keynote speaker.

Some cancers such as cutaneous melanoma have multiple genetic mutations that can be effectively targeted with precision therapies.

Precision medicine also represents “an opportunity to identify effective and less toxic treatments for glioma [primary brain tumor] patients,” said Macarena de la Fuente, M.D., neuro-oncology clinical service leader for the Oncology Service Line at Sylvester, during her presentation. Dr. de la Fuente is also chief of the Neuro-Oncology Division in the Department of Neurology at the University of Miami Miller School of Medicine.

The search for precision medicine therapies for pediatric malignancies is still in its early stages, said Asha B. Pillai, M.D., of Sylvester’s departments of pediatrics, microbiology and immunology, whose multiple roles at the cancer center also include serving as deputy director of translational research. However, Dr. Pillai noted that there is intense interest in advancing this work through, for now, basic science studies.

In his presentation, Dr. Schilsky, former chair of the American Society of Clinical Oncology (ASCO), provided an update on the ASCO TAPUR study, which evaluates the role of molecularly targeted cancer drugs in the treatment of several types of malignancies, collects outcomes data to inform potential additional uses of these drugs beyond approved indications, and educates oncologists about implementation of precision medicine in clinical practice.

The potential of precision oncology medicine to revolutionize the treatment of malignancies such as acute myeloid leukemia and cutaneous, GI, gynecologic, hematologic, and lung cancers was explored in numerous presentations. Other topics showcased by Sylvester physicians, researchers, and patient care team members included the roles of patient-reported outcomes and artificial intelligence in advancing the field.

A special feature of the event was a series of concurrent sessions specifically geared toward cancer patients and their families, patient advocacy groups, and representatives from organizations focused on rare cancer types.

These sessions presented “a variety of offerings focusing on the potential of precision medicine to extend survivorship, improve quality of life, and expand treatment options for patients with treatment-resistant cancers,” said Estelamari Rodriguez, M.D., thoracic oncology co-lead of the Thoracic Site Disease Group at Sylvester and voluntary assistant professor of clinical medicine. “Our goals are to empower patients and their caregivers with information and to build a community of support for all patients.”

“Meeting the patients who attended was a privilege and a joy,” Dr. Schilsky said. “Our patients’ willingness to participate in research so that we might all learn from them was truly inspiring.”