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A Fuller Measure of Cancer Treatment

In a cancer clinical trial, the standard yardstick for success is survival. Did a particular drug or treatment regimen extend the life of the patient, and by how long? But in addition to looking at the length of life made possible by a new therapy, the FDA now considers quality of life a key outcome for clinical trials. Thanks to the work of nursing professor Patricia J. Hollen (Nursing '67), there is now an effective way to make such assessments for patients with lung malignancies.

Professor Hollen, who recently joined the faculty as the Malvina Yuille Boyd Professor of Oncology Nursing, helped develop and test an easy-to-answer questionnaire that enables cancer patients to give a clear sense of whether a therapy improved their quality of life. Indeed, the measure is so brief and simple to use that patients willingly respond even in the final stages of their disease.

For two recent drug trials sponsored by Eli Lilly and Company, the questionnaire was translated into forty-one languages and was given to 512 patients on five continents. Over the course of their illnesses, more than 90 percent of the patients completed the form. The data they provided helped to show that the new therapy increased both the length and quality of life for these patients, whose median survival rate would have been six to eight months if untreated.

"Patients are happy to fill it out because they know it will help others in clinical trials," said Professor Hollen, who was formerly on the faculty at Northeastern University in Boston.

Telemedicine also plays an important role in the University's efforts to serve outlying areas. Under the leadership of Dr. Karen Rheuban, the University's expanding Telemedicine Network delivers confidential clinical, consultative, and medical education services to more than forty-four sites throughout the Commonwealth, including correctional facilities and schools. Since its founding in 1997, the Tele-medicine Network has handled more than 5,600 cases and has tapped the expertise of professionals in twenty-six specialties.

  Breaking New Ground
Under the Decade Plan, the Health System will promote collaborative research across disciplines and between researchers and clinicians. In doing so, it will build on a thriving research enterprise. Among breakthroughs this year:
  • A multidisciplinary team of scientists led by Dr. Dan Theodorescu, professor of urology and molecular physiology, used advanced DNA technology to discover a gene that could suppress the spread of cancer.
  • Dr. Zandong Yang in the division of endocrinology and metabolism found that an anti-inflammatory drug called lisofylline, originally developed as an infection fighter for cancer patients, could benefit people at risk for Type 1 diabetes.
  • Researchers led by Dr. Jonathan Lindner, a cardiologist, are investigating the use of millions of tiny microbubbles injected into the bloodstream, coupled with contrast-enhanced ultrasound, to detect blood vessel growth in cancerous tumors and even to predict how fast the tumors might spread.

Investigators in the Health System continue to attract exceptional levels of grant support for their work. Some examples:

  • The National Institutes of Health has awarded $5.5 million over five years to the Center for Research in Reproduction for the study of polycystic ovarian disease, a common hormonal disorder in women. Dr. John Marshall, professor of internal medicine, heads the study.
  • E. coli is a leading cause of acute kidney failure in young children, who can die from a complication called hemolytic uremic syndrome. Thomas Obrig in the Division of Nephrology has received a $2.8 million grant from the NIH to develop new therapies for hemolytic uremic syndrome in partnership with Charlottesville-based Adenosine Therapeutics.
  • Elizabeth Merwin, associate professor of nursing and director of the Southeastern Rural Mental Health Research Center, received $927,743 from the National Institutes of Mental Health for her project aimed at addressing shortages of health professionals in rural areas.
  • The NIMH also awarded Emily Hauenstein, associate professor of nursing, $504,880 for her three-year study of mental health treatment for the rural poor and minorities.
  • The Department of Defense has awarded a team led by Gary Balian, a professor of orthopaedic research as well as biochemistry and molecular biology, $500,000 to investigate promising treatments that may halt the spread of prostate cancer to bone.
  • A $1.5 million research initiative with IBM will enhance the efforts of biomedical engineers to grow replacement tissue, improve ultrasound and MRI technology, and study the progress of vascular disease.
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