For information on clinical trials at this NCCN Member Institution click here.

City of Hope, an innovative biomedical research, treatment and educational institution, is dedicated to the prevention and cure of cancer and other life-threatening diseases, guided by a compassionate, patient-centered philosophy and supported by a national foundation of humanitarian philanthropy.

• City of Hope is one of the world’s leading research and treatment centers for cancer and other life-threatening diseases, including diabetes and HIV/AIDS. A pioneer in the fields of bone marrow transplantation and genetics, City of Hope is a National Cancer Institute-designated Comprehensive Cancer Center.
• At any given time, City of Hope conducts more than 300 clinical studies, involving 30 to 40 percent of its eligible patients. The national average is less than 5 percent.
• Many important treatments are based on research pioneered by City of Hope scientists, including the cancer drugs Herceptin, Rituxan, Avastin and Erbitux.
• City of Hope surgeons were among the first to utilize robotic technology for the treatment of cancer, significantly improving the outcomes for patients with prostate cancer and other malignancies. The institution performs more robotic-assisted laparoscopic radical prostatectomies than any other site in the western U.S.
• An early pioneer in bone marrow transplantation, City of Hope has performed more than 8,000 bone marrow and stem cell transplants and maintains one of the largest, most successful programs of its kind in the world.
• City of Hope is dedicated to preserving the quality of life of patients. It is well-known for its expertise in pain management and end-of-life care. City of Hope is also conducting training for nurses across all settings including hospice and palliative care through a project, the End of Life Nursing Education Consortium (ELNEC), funded by the Robert Wood Johnson Foundation.

City of Hope employs more than 2,700 staff members, including approximately 140 physicians and more than 500 scientists, and has nearly 300,000 volunteers and donors nationwide. City of Hope has 217 licensed beds.

City of Hope
Adult Oncology Services

Introduction

For millions of people living with cancer, and for those at risk of developing cancer, medical research provides hope.

At City of Hope, our research helps patients manage and ultimately conquer cancer and other life-threatening diseases. As a National Cancer Institute-designated Comprehensive Cancer Center and a founding member of the National Comprehensive Cancer Network, we help set the standard for cancer care throughout the nation.

City of Hope is home to some of the brightest minds in research and treatment. Our skilled scientists and physicians work as interdisciplinary teams to quickly translate promising laboratory discoveries into new treatments – and new hope.

Every day, our efforts save lives and improve the quality of life for patients and their families.

General Information

Treatment

Hematopoietic Cell Transplantation Program:

Hematopoietic cell transplantation (HCT) is an important and often lifesaving approach for many different disorders including cancer and other diseases of the bone marrow and immune system. Initially used to treat leukemia, it is now being used to treat a variety of other cancers as well as non-cancerous diseases. City of Hope is the largest provider of HCT in California and one of the largest and most successful HCT research and treatment centers in the world.

City of Hope provides autologous stem cell and allogeneic bone marrow transplants (BMT). Autologous stem cell transplants are used to treat acute leukemia, Hodgkin’s disease, malignant lymphomas, multiple myeloma and solid tumors. City of Hope also offers a non-myeloablative BMT, or “mini-BMT,” which uses less intense doses of chemotherapy and radiation. This treatment is being used on older patients who previously were not candidates for BMT.

Alternative/Complementary Medicine:

City of Hope’s Department of Supportive Care, Pain and Palliative Medicine also offers a wide variety of complementary medicine, including art and music therapy, biofeedback, recreation therapy, support groups and pastoral care.

Late Effects Clinic:

City of Hope pediatric physician investigators are focusing attention on long-term complications due to radiation and other therapies that childhood cancer survivors encounter. One of the institution’s major accomplishments has been the development of national guidelines for follow-up of childhood cancer survivors. Projects are ongoing to describe the long-term complications among survivors of childhood cancer, and to understand how they impact the quality of life of the survivors. City of Hope’s Division of Population Sciences has also established a Center for Cancer Survivorship, which will include a multidisciplinary survivorship clinic for childhood cancer survivors. This clinic will provide comprehensive follow-up care to cancer survivors and serve as a resource for future research of cancer survivor populations.

Cancer Prevention and Screening

Representatives from City of Hope offers information on cancer prevention and screening through its Web site and through distribution of materials at community events distribute pamphlets containing cancer prevention strategies at health fairs.

City of Hope also provides a free Ask The Experts community lecture series. This program is offered monthly by the Patient, Family and Community Education Department, and features leading medical and scientific experts from City of Hope.

An annual Community Health Fair is held at City of Hope for the Community where free information on cancer and cancer screenings is offered.  Physicians and other clinical staff, including cancer genetic specialists are available for questions by the community. 

City of Hope also features a “Cancer Screening and Prevention Program” to help individuals understand their personal risks, including hereditary and genetic factors, for cancer and how to minimize those risks.  These City of Hope Cancer Screening and Prevention Programs can be accessed online at www.infosci.coh.org/ccgp/cspp.htm.

Support Services

A variety of psychosocial support services are available through the Department of Clinical Social Work. The Medical Center's team of oncology social workers provides short-term and crisis counseling to inpatients and outpatients, as well as members of their families.

City of Hope has special survivorship programs for adults, adolescents and pediatric patients.  Staff is available to address employment issues, childcare issues, problems, etc.
The Sheri & Les Biller Patient and Family Resource Center offers an array of support services to help patients and their families cope with cancer diagnosis and treatment.  Services include:

• Evaluation of the emotional, social and psychological well-being of patients, and counseling for patients who need assistance.
• Patient navigators, specially trained, understanding staff members who knowledgeably help each patient access City of Hope services.
• Patient peer pals who provide one-on-one, patient-to-patient support.  Volunteer peer pals are current or former patients who understand the cancer experience.
• Health information, including a library of publications, as well as workshops, on topics such as nutrition and managing side effects of cancer treatment.
• Nutrition education and counseling from dietitians trained in the needs of people with cancer and other serious illnesses.
• Support groups for patients with specific types of cancer or specific needs, as well as links to other support groups in the community
• The Child Life Program, a suite of services to support children and teens through their hospital experience, reducing their stress and helping them deal with illness.
• Healing arts program encompassing music, writing and other creative outlets.
• Spiritual care provided by dedicated staff from a variety of faiths.
• Patient advocates who help patients and their families if they feel their physical, emotional or spiritual needs are not being met.
• Pet visitation, which uses trained dogs to lift patients’ spirits and help them manage stress.
• The Positive Image Center, a place to turn for help with appearance and self-image during illness.
• Customized patient Web sites, called CarePages, to keep friends and families informed of patients’ progress and share photos and good wishes.
• End-of-life and bereavement support, assistance for those dealing with grief and loss.

Additional services include support groups; grief/bereavement counseling; and patient/family conferences.

City of Hope has a special survivorship programs for adults, adolescents and pediatric patients.
Staff is available to address employment issues, childcare issues, problems, etc.

Supportive Care

Pain Service & Palliative/Supportive Services:

Supportive Care & Palliative Medicine at City of Hope consists of a specialized interdisciplinary pain and symptom management team that works with a patient’s primary physician to develop individual pain management plans. The team includes a medical pain specialist, nurse practitioner, clinical social worker, psychologist, rehabilitation therapist, pharmacist, psychiatrist, patient educator, research and triage nurses and members of pastoral care. Team members provide comprehensive medical, nursing and psychosocial evaluations for each patient and make recommendations to the primary physician regarding Follow-Up, medication adjustment and consideration of complementary therapies.

Nutrition Services:

Patients with special dietary needs can be referred to nutrition services by their City of Hope physician.

Rehabilitation Services:

Rehabilitation Services is committed to the philosophy of healing the whole person throughout his/her treatment and recovery from cancer. Patients undergoing treatment for cancer may experience many changes in their physical abilities and levels of day-to-day function. Often, problems with activity can be reversed or minimized through appropriate treatment and education. Rehabilitation specialists at City of Hope assist patients in achieving the levels of activity, independence, and day-to-day function necessary to support quality of life.  Professionals from four disciplines staff Rehabilitation Services: occupational therapy, physical therapy, recreation therapy and speech and language pathology.

Clinical and Research Efforts

Guarding Young Lives: Children’s Oncology Group

The diagnosis of cancer in a child is overwhelming to families. Even after successful treatment, fears remain. Will it return? Will a different cancer arise later in life? What side effects can be expected — and can they be avoided?

Research has dramatically improved survival rates for children with cancer, from less than 25 percent in the 1960s to nearly 80 percent today. More than 250,000 childhood cancer survivors are living in the United States alone. But as they mature, two-thirds will suffer chronic problems and long-term complications, such as issues related to growth and development; one-third will have a problem that can be life threatening. Many will develop secondary cancers, either due to cancer treatment or underlying causes.

Because “late effects” may not arise until decades after treatment, and because pediatric cancers are fortunately rare, researchers and care providers must pool their resources and share their experiences to improve long-term outcomes. City of Hope researchers are national leaders in this effort.

Smita Bhatia, MD, M.P.H., chair of the Division of Population Sciences at City of Hope, and medical director, Center for Cancer Survivorship, chairs the Late Effects Committee of the Children’s Oncology Group (COG), a consortium funded by the National Cancer Institute.

COG brings together pediatric cancer experts from 238 hospitals in the U.S., Canada, Australia, New Zealand, the Netherlands and Switzerland. It facilitates the organization of large-scale, definitive multicenter research studies needed to improve treatments, practices and outcomes. Today, more than 90 percent of children with cancer in the U.S. are treated at COG-affiliated cancer centers, and about 70 percent participate in clinical trials.

Bhatia serves as principal investigator for a COG research study looking at key adverse events in childhood cancer survivors. Patients who develop a secondary cancer or other problem such as congestive heart failure or stroke are invited to participate in the study so that the causes of these complications can be investigated, potentially improving future treatments.

At City of Hope, cancer research is strongly integrated with clinical care, and nursing is a central focus of that strategy. Wendy Landier, R.N., M.S.N., serves as clinical director of the Center for Cancer Survivorship, and also leads the Nursing Clinical Practice/Survivorship Subcommittee of COG, where she serves as vice chair of the Nursing Discipline. As leaders within both City of Hope and COG, Landier and Bhatia have collaborated on landmark projects including the establishment of long-term follow-up guidelines for young cancer survivors and a resource guide for all COG centers to use in their own follow-up programs.

Participation in COG encourages alliances. Close ties have been established with researchers at St. Jude Children’s Research Hospital, The Children’s Hospital of Philadelphia, Memorial Sloan-Kettering Cancer Center and dozens of other institutions. A Web-based version of the long-term follow-up guidelines that can be tailored for individual patients will soon be launched in partnership with Baylor School of Medicine. As a pilot test center for the new system, City of Hope and its patients will benefit from instant access to the cumulative knowledge of pediatric cancer experts from around the world.

Speeding Gene Therapies: National gene vector laboratory

The most powerful weapons against cancer, diabetes and other serious diseases cannot be seen. They are genes — bits of DNA that can be delivered to wayward cells, fixing problems at the source.

Gene therapy holds huge potential for future cures. But refining these genetic tools, manufacturing them in quantity and getting them into clinical trials is a major challenge on all fronts: technical, analytical and regulatory.

The two-story, 20,000-square-foot Center for Biomedicine & Genetics (CBG) facility was built in 2000 with the purpose of creating an unlimited array of novel therapeutics. Led by Larry A. Couture, PhD, the CBG currently produces islet cells that treat type 1 diabetes, monoclonal antibodies that fight cancer, engineered T-cells for immunotherapeutic clinical trials, cancer vaccines, viral vectors for gene therapy against HIV, and hematopoietic cell products to treat blood disorders. Process development is also beginning on two types of recombinant proteins, similar to the way City of Hope achieved a breakthrough in the development of synthetic human insulin nearly 20 years ago.

The CBG’s prolific output, scientific expertise and certification as a Good Manufacturing Practices facility led the National Institutes of Health (NIH). Specifically, the laboratory produces clinical-grade DNA plasmid vectors for use in phase II clinical protocols and I. DNA plasmids, also called “naked DNA,” are circular pieces of DNA carrying genes that can be transferred into cells with therapeutic effects.

Plasmids are in demand by researchers because unlike viral vectors, they have the advantage of producing little or no immune response. As the only NIH-supported plasmid manufacturer in the U.S., City of Hope produces DNA plasmids for all qualified, federally funded laboratories nationwide. In addition, the facility also has produced a lentivirus vector and is a designated back-up site for the production of adenovirus gene therapy vectors.

With its robust manufacturing capacity and ability to quickly produce novel therapeutics at a small scale, the CBG provides a fast track for scientists seeking to move their research from bench to bedside. It also generates valuable collaborations between City of Hope and other institutions. With material from the NGVL, Jennifer Grandics, MD, at the University of Pittsburgh has made rapid progress in antisense gene therapy that can inhibit cancer of the head and neck. At the University of Wisconsin, Douglas McNeel, MD, PhD, is taking a promising DNA plasmid vaccine that fights prostate cancer into phase II clinical trials. In the search for better, faster cures, City of Hope is giving researchers across the country the genetic tools they need today.

Advancing Against Diabetes: islet cell transplantation

The greatest challenge in medical research is to find a permanent cure for a life-threatening disease. For 5 million people around the world, that disease is type 1 diabetes.

Also called insulin-dependent diabetes, type 1 diabetes is an autoimmune reaction that destroys the beta cells of the pancreas. The result is a lifetime of insulin injections, threats of cardiovascular, nerve and kidney disease, and dangerous low-blood-sugar episodes. While healthy insulin-producing pancreatic islet cells can be transplanted from donor organs, donors are in short supply. And transplant procedures require special technology, immune suppressing drugs and considerable expertise.

City of Hope is a leader in diabetes research, having pioneered the development of Humulin, the synthetic human insulin that was the first biotechnology product approved by the Food and Drug Administration, now used by millions of diabetics worldwide. That leadership continues with advancing islet cell transplantation. As one of only seven islet cell resource (ICR) centers funded by the National Institutes of Health, City of Hope performed the most islet transplants in the United States in 2004 and 2005 and has distributed the largest number of islets to basic science programs in the U.S. since 2004. City of Hope is the only currently funded ICR center in the western U.S. In 2006, the Juvenile Diabetes Research Foundation (JDRF) designated City of Hope as a JDRF Islet Cell Transplant Center, making it one of only 14 in the nation and the only Southern California organization to receive this distinction.

Three clinical trials involving islet cell transplantation are under way at the City of Hope Leslie and Susan Gonda (Goldschmied) Diabetes and Genetic Research Center led by Fouad R. Kandeel, MD, PhD, director, Department of Diabetes, Endocrinology & Metabolism. One study seeks to improve upon the Edmonton Protocol, a widely adopted transplant procedure requiring two to three islet cell infusions. Multiple infusions and organ donors are needed because the drugs used to overcome transplant rejection are toxic to islet cells. As an alternative, the City of Hope phase I/II trial is employing a different immune suppression strategy together with the use of growth factors to expand the number of islet cells before and after transplantation. The goal is to develop a single infusion that can free patients from insulin dependence.

Kandeel also directs the Southern California Islet Consortium (SC-IC), a group of institutions sharing resources and expertise. Hosted by City of Hope, the SC-IC includes Cedars-Sinai Medical Center, Harbor-UCLA Medical Center, Loma Linda Medical Center, the Southern California Transplantation Institute, St. Vincent Medical Center, and the Whittier Institute for Diabetes/Scripps Green Center for Organ & Cell Transplantation and the UCLA Center for Health Sciences. Because kidney disease is a complication of diabetes, the SC-IC’s first multicenter clinical trial focuses on islet cell transplantation after kidney transplant. City of Hope performs the majority of transplant procedures for the consortium, handles regulatory requirements and trains physicians in islet cell techniques.

With diabetes on the rise worldwide, the absolute shortage of islet cell donors is stimulating the search for new islet cell strategies, including stem cells. Looking beyond diabetes, progress in immune tolerance achieved through islet cell research could pave the way for advances in solid organ transplants, cellular and gene therapies and treatments for autoimmune conditions, Parkinson’s disease and many other conditions that would benefit from cell replacement.

Designing Smarter Drugs: Modeling g-protein coupled receptors

Many drugs in use today were created by “trial and error” methods that result in a compromise: The drugs work, but carry risks of unwanted side effects. Yet clues to designing smarter pharmaceuticals with fewer side effects are hidden within the three-dimensional structures of biomolecules that these drugs turn on or off.

Among the most important therapeutic drug targets in the human body are G-protein coupled receptors (GPCRs) a large, diverse group of proteins that play crucial roles in health and disease. Woven through cell membranes, GPCRs act as signal posts, sensing changes in the environment and directing the cell to respond. By binding with neurotransmitters, hormones, immune substances, odorants and other molecules, GPCRs influence growth, metabolism, brain response and other central life processes. GPCRs called chemokine receptors are also implicated in the spread and growth of many cancers, including those of the lung, breast, prostate and colon. With rising rates of age-related and environmental cancers, better-targeted “magic bullet” GPCR drugs would have widespread benefits.

In fact, half the drugs in use today target GPCRs, activating or inhibiting them. They are used to lower blood pressure, combat allergies, treat depression, calm arthritis, heal stomach ulcers and block pain. Yet their actions are often too broad, leading to side effects that can be serious, even dangerous.

Designing the next generation of GPCR drugs requires data on the three-dimensional structure of each receptor protein. But because membrane-bound proteins are hard to crystallize, their structures cannot be visualized directly. One solution is to construct virtual models of these receptor proteins using computational methods based on the fundamental laws of physics. It is a challenge that takes teams of chemists, physicists and computer scientists to solve.

At City of Hope’s Division of Immunology, Nagarajan Vaidehi, PhD, is leading the charge. Starting with basic atomic forces, she and her colleagues predict the theoretical 3-D structures and binding sites of small molecules within GPCRs. Each structure requires months to generate, using dozens of computers. Then, further experiments are needed to validate and refine the model.

But while the structures may be theoretical, the need for progress in GPCR drugs is real. Interest in GPCR structures is attracting pharmaceutical companies to work with City of Hope, and promotes collaborations with the universities of California, Texas, Pittsburgh and North Carolina, California Institute of Technology, Jet Propulsion Laboratory, New York University and Imperial College London, among others.

At the University of Washington, scientist Randall T. Moon, PhD, had evidence that a certain GPCR was involved in cancer, but needed to understand its structure, as well as identify small molecules that could turn the receptor on or off. Working together with Moon, Vaidehi’s team predicted the receptor’s structure and rapidly identified 20 possible modulators from a database of hundreds of thousands of molecules — one of which may be a perfect fit.

Defeating Drug Resistance: ribonucleotide reductase inhibitors

Many cancer drugs seem to work well at first. But too often, the disease returns. And when it does, it can hit even harder and faster than before. Many cancers actually develop resistance to chemotherapy.

Finding a way to defeat this drug resistance is a significant step toward finding a cure.

At City of Hope, Yun Yen, MD, PhD, director of Clinical and Molecular Pharmacology and co-leader of the developmental Cancer Therapeutics Program, believes the answer may be found in an enzyme that cells use naturally to repair and restore themselves. The enzyme ribonucleotide reductase (RR) converts ribonucleotides into the building blocks of DNA, an essential part of the normal process of cell growth, including the ability to fix damaged genes. But in cancer cells, RR production can go into overdrive, allowing cancers to survive attacks by chemotherapy and promoting the spread of new malignant cells that can invade healthy tissues.

For 17 years, Yen’s research has focused on understanding the gene that codes for RR and how the enzyme itself helps cancer spread. One well-known chemotherapy drug, hydroxyurea, is known to work by inhibiting RR. But if surviving cancer cells learn to resist the drug, it can lead to recurrence.

Today, Yen’s group is pressing to find more effective anticancer agents, including combining newer RR inhibitors with gemcitabine, the only drug approved for pancreatic cancer. Yen discovered the mechanism by which cancer cells become resistant to gemcitabine — a finding that is actively being exploited in the search for new cancer drugs.

Collaborative research is accelerating progress in overcoming drug resistance. Within City of Hope, David Horne, PhD, director of the Synthetic Chemistry Core Facility, and Yate-Ching Yuan, PhD, manager of the Biomedical Informatics Core Facility, are designing new compounds with the ability to inhibit RR. These are tested at City of Hope’s High Throughput Screening Core, directed by M.L. Richard Yip, PhD The core facility is a resource where newly synthesized chemicals and thousands more from a library of molecules can be screened rapidly to assess whether they hold potential as possible treatments.

Meanwhile, Yen is also working with John Rossi, PhD, Lidow Family Research Chair in the Division of Molecular Biology, to investigate the use of small interfering RNA (siRNA) to “silence” the genes that produce RR through a mechanism called RNA interference (RNAi). Rossi is using the RNAi approach to fight HIV, and this approach is one of the most promising new investigational therapies for many diseases. The 2006 Nobel Prize in Medicine was awarded for the discovery of the RNAi mechanism.

Taking the siRNA strategy a step further — to a level reminiscent of science fiction — City of Hope researchers are pursuing an inter-institutional project with Mark E. Davis, PhD, Warren and Katharine Schlinger Professor of Chemical Engineering at the California Institute of Technology, and a local startup company called Calando Pharmaceuticals. Davis has engineered nanoparticles made of polymers that can deliver drugs directly to cancer cells.

Preclinical studies conducted by Calando Pharmaceuticals suggested that nanoparticles containing siRNA to inhibit RR can serve as safe, effective drug-delivery vehicles. Plans for a clinical trial with cancer patients are already under way.

Uniting Against Infection: cytomegalovirus vaccine

Stem cell and organ transplants offer hope to patients with cancer and other serious illnesses. But for the transplant to succeed, the patient’s own immune system must be suppressed to reduce the chance of transplant rejection. And that opens the door to infection.

Too often, patients whose immune systems have been weakened fall victim to cytomegalovirus (CMV), a common herpes virus that can be found in 50 to 80 percent of adults in the United States. Normally, infections are mild; afterward, the virus remains dormant, held in check by a healthy immune system. But after a transplant or other immune-compromising event, CMV can reactivate, causing pneumonia and other deadly diseases. About half of bone marrow transplant patients develop active CMV infections; the virus also is a major cause of death in organ transplant patients.

The list goes on: CMV harms dialysis patients, causes blindness in HIV patients and is the leading congenital infection in newborns. CMV is responsible for hundreds of infant deaths and thousands of serious birth defects in babies annually. The Institute of Medicine has called the development of a CMV vaccine a national medical priority.

While antiviral drugs can be effective against CMV, they are undesirably toxic. As a much-needed alternative, City of Hope scientists have teamed up to develop a CMV vaccine, based on years of accumulated research. Their efforts took a giant leap forward in 2006, when the Food and Drug Administration approved the first human clinical trial of a synthetic CMV vaccine.

Don J. Diamond, PhD, director of the Laboratory of Vaccine Research, is heading a project in which two formulations of the vaccine are being tested, each with and without a biochemical regulator called an adjuvant. At the heart of the vaccine is a peptide molecule that originated at City of Hope and is now being produced for further studies by the National Cancer Institute (NCI).

In the phase I clinical trial, currently under way, healthy adult volunteers are being given the vaccine in one of its forms to gather data on safety, metabolism and other parameters. Parties collaborating in this groundbreaking project include Corinna La Rosa, PhD, assistant research scientist, and Simon F. Lacey, PhD, associate research scientist in the Division of Virology, John A. Zaia, MD, chair of the Division of Virology, and Stephen J.  Forman, MD, Francis and Kathleen McNamara Distinguished Chair in Hematology and Hematopoietic Cell Transplantation. Coley Pharmaceutical Group is contributing the adjuvant. SAIC-Frederick and the NCI sponsored the development of early data, and the Pasteur Institute furnished preclinical models used in establishing the potency of the vaccine.

In the next phase, transplant donors will receive the vaccine to evaluate whether immunity to CMV can be transferred along with their bone marrow or other tissues. Meanwhile, Diamond and his colleagues are pressing ahead with a second generation vaccine engineered by Zhongde Wang, PhD, MD, assistant research scientist in the Division of Virology, to combat congenital CMV, with broader applicability in transplant recipients; the project has received long-term funding from the NCI. The National Institute of Allergy and Infectious Diseases and Bernard Moss, MD, PhD, chief in the Laboratory of Viral Diseases, have provided a crucial component to this project, which is anticipated to assist in regulatory approval.

Statistics

Adult Oncology Program

Cooperative Group Membership

City of Hope
Pediatric Oncology Services

Introduction

City of Hope Cancer Center is committed to fighting serious diseases that afflict children and adolescents. Physicians and scientists are aggressively pursuing the causes of and new treatments for childhood cancers, blood diseases, and other disorders. An important element in the care of all pediatric patients at City of Hope is the unique ability to integrate advanced research and treatment within a humanitarian environment that provides emotional and spiritual support to patients and their families. Whenever possible, treatment programs are developed that minimize hospitalization and maximize the time spent at home and in other normal childhood activities.

The pediatric oncologists have expertise in the management of all childhood cancers and are world-renowned experts in the areas listed below.

General Information

Clinical and Research Information

Research Efforts

The Pediatric Neuro-oncology program at City of Hope is evaluating the potential of augmenting the antitumor response of T-cells, a class of white blood cells that are part of the body’s immune defenses against infection or cancerous cells. Through a process called adoptive T-cell therapy, T-cells that can recognize and attack cancer cells are isolated from patients, their numbers significantly increased outside of the body, and then reinfused back into the patients, delivering highly specific and potentially minimally toxic therapy.

Special Expertise

Hematopoietic Cell & Bone Marrow Transplantation:

City of Hope’s Pediatric Hematopoietic Cell Transplantation (HCT) Program provides lifesaving treatment to patients from infancy to early adulthood.  Numerous blood diseases, including leukemia, lymphoma, Fanconi anemia and acquired aplastic anemia are treated.  Also, HCT after high dose chemotherapy is performed for solid tumors such as neuroblastoma and sarcoma.  In addition, unique clinical research protocols are offered, ensuring innovative therapy is available to appropriate patients.

Musculoskeletal Tumors including Sarcomas:

Our comprehensive musculoskeletal tumor program focuses on the diagnosis and treatment of pediatric cancers of the bone, muscle and cartilage.  The multidisciplinary program is directing novel clinical studies investigating new therapies for children with these and other types of cancer, integrating precise surgical and reconstructive techniques thus optimizing their ability to be cured of their cancer while allowing them to continue to walk on their own limbs.

Hemophilia and Sickle Cell Disorders:

The Pediatric Hemophilia and Sickle Cell Program provides care to children and young adults with inherited coagulation disorders such as hemophilia, and blood cell disorders such as sickle cell anemia.  Current research focused on the accurate diagnosis and treatment of these diseases.  Researchers are investigating risk factors leading to bleeding factor inhibitor development and immune tolerance induction regimens.

Immunotherapy:

Immunotherapy, which stimulates or boosts the body’s immune system so it can fight cancer more effectively, offers hope as a therapy for cancers that are incurable or difficult to treat such as relapsing leukemia, neuroblastoma and brain tumors.  In addition to killing cancer cells, immunotherapy stimulates the patient’s immune system to “watch out” for other cancer cells – known as immunosurveillance – and thus become part of the patient’s continuing defense against cancer.

Solid Tumors including Brain Tumors:

Our pediatric oncologists focus on developing innovative strategies for the treatment of high risk, poor prognostic solid tumors, including brain tumors. Investigating pediatric neuro-oncologic disease in the laboratory and then applying these strategies to clinical patient care is a special focus of research at City of Hope. Immune-based therapies are developed in the laboratory and then used to treat malignancies including neuroblastoma, malignant tumors formed from embryonic nerve cells outside of the brain and spinal cord; and medulloblastomas and gliomas, cancers of the brain and spinal cord. Patients suffering from brain and spinal cord tumors are treated using advanced radiological techniques to tumors, which are then removed surgically. City of Hope was the first in the Western U.S. to use the advanced radiological helical TomoTherapy® system which couples three-dimensional imaging with innovative intensity-modulated radiation therapy (or IMRT), to target only the tumor while sparing the healthy tissues around it, thus reducing the risk of long-term cognitive problems.  Prior to surgery, advanced technology called magnetic resonance spectroscopy is used to gather information on the cellular metabolism of the patient’s brain, which is then combined with anatomical images of the brain, resulting in optimal removal of cancerous tissue.

Survivorship and Late Effects:

While almost 80 percent of all children with cancer are being cured of their diseases, the late effects of their treatment must be examined.  City of Hope researchers have developed and continue to test their widely used quality-of-life survey in one of the largest cohorts of patients in the United States.  Analysis of their results is critical to the development of future protocols.  Extensive research, supported by the National Cancer Institute, the Leukemia and Lymphoma Society, and the Lance Armstrong Foundation, is focusing on the health and well-being of the cancer survivor.  Several studies are exploring the physical, psychological and neurocognitive health of our children treated for cancer.  Furthermore, studies are under way to understand the contribution of genetic susceptibility and the environment in the development of late complications after successful treatment of childhood cancer.

Statistics

Percent of children treated in each age range

Pediatric Oncology Program, 2002

City of Hope
Genetic Counseling and Testing Service

City of Hope’s Cancer Screening & Prevention Program Network (CSPPN) is a comprehensive interdisciplinary center of excellence in clinical cancer genetics serving the Los Angeles, Santa Barbara and Orange counties of Southern California and through the Banner Health System of Phoenix, Arizona. The CSPPN provides genetic cancer risk assessment, genetic testing and risk management counseling, including individually-designed surveillance programs for early detection and prevention of cancer for high-risk individuals. A clinical volume of more than 45 new patients every month provides a significant resource for collaboration in a number of cancer prevention and control, epidemiological, behavioral and ELSI-related research through enrollment in the CSPPN Familial Cancer Registry (IRB #96144). All cases are reviewed weekly by a multidisciplinary Clinical Cancer Genetics Working Group.

Intake Process

Testing

Post-Test Counseling and Follow-Up

Research

City of Hope Cancer Center and Beckman Research Institute have been actively involved in genetic research for more than 50 years. The Cancer Screening & Prevention Program Network (CSPPN) provides a valuable resource for investigators to translate research findings into medical practices for cancer prevention and control. Genetic, behavioral, and outcomes studies, including long-term follow-up and clinical investigations for prevention or early detection of cancer, are available through the CSPPN.

Other Components of Genetic Services

Last updated: 2/7/2008