Research and Clinical Trials
For more than 25 years, Providence Saint John's Health Center has been at the vanguard of breakthrough cancer research, internationally prominent medical expertise and leading-edge treatments. Providence Saint John's oncology team has discovered some of the world's leading cancer breakthroughs.
- Sentinel node biopsy
- Minimally-invasive brain surgery
- Hysterectomy with bilateral oophorectomy study
- Novel blood biomarker assays
- Molecular diagnostic techniques
- Vitamin A analog
Sentinel node biopsy
The late Donald L. Morton, M.D., Chief of the Melanoma Program at John Wayne Cancer Institute at Providence Saint John’s Health Center originated the sentinel lymph node technique for staging melanoma. This revolutionary diagnostic technique helps surgeons determine if a tumor has spread to nearby lymph nodes rather than simply removing them; a practice that can cause permanent side effects. The melanoma program is currently led by Steven J. O’Day, M.D., and Richard Essner, M.D.
The technique involves injecting a blue dye and radioactive substance into the lymphatic system near the tumor. As the dye is absorbed, it identifies the sentinel node so that it can be excised and analyzed for evidence of cancer spread. If cancer has not invaded the sentinel node, the surgeon may elect to leave the other healthy lymph nodes in place. The sentinel node technique has become the international medical standard for melanoma surgery, and is being adapted to many other cancers. Notably, Dr. Morton was a recipient of the Jacobson Innovation Award of the American College of Surgeons.
Anton J. Bilchik, M.D., Chief of Medicine, adapted the sentinel node technique for patients with colon cancer.
Neurosurgeons at Providence Saint John’s Health Center are internationally recognized as pioneers in minimally-invasive brain surgery. By developing and improving “kinder, gentler” brain surgery procedures and brain-mapping techniques, they minimize the need for complex, risky craniotomies while sparing the patient’s sensitive brain tissue.
Medical Director of the Brain Tumor Center, Daniel Kelly, M.D., has performed more than 1,400 minimally-invasive procedures from a number of access points. Dr. Kelly, an international leader in minimally-invasive brain surgery, has extensive experience in removing brain tumors through the nostrils as well as through keyhole incisions above the eyebrow. Recently, efforts have focused on developing a surgical tube (brain cannula) combined with detailed fiber tract mapping of the brain (tractography), to optimize the safe endoscopic removal of deeply situated brain tumors.
A landmark study led by William Parker, M.D., an obstetrician-gynecologist at Providence Saint John’s Health Center and adjunct faculty member at John Wayne Cancer Institute at Saint John's, has raised serious questions about the long-term survival benefits of removing a woman’s ovaries during routine hysterectomy.
The study, published in the May 2009 edition of Obstetrics and Gynecology, reviewed outcomes of women with benign (noncancerous) reproductive disease who were given a hysterectomy with either bilateral oophorectomy (removal of both ovaries) or ovarian conservation (leaving the ovaries intact). Results showed that removing the ovaries greatly increases the risk of heart disease, stroke and lung cancer. These findings challenge a medical practice that has been standard in women’s health for 30 years.
David Hoon, Ph.D., director, Department Molecular Oncology and his team at John Wayne Cancer Institute at Providence Saint John’s Health Center have developed novel blood biomarker assays to help research melanoma, lung and breast cancer, as well as other cancers. The goal of their research is to find biomarkers with potential clinical utility, and to speed the identification of new drug strategies and treatments. Dr. Hoon’s team has made great strides in defining specific classes of cancer, analyzing tumor-related genomic changes, and screening FDA-approved and targeted drugs.
A pioneering study led by Dr. Hoon and his colleagues found that highly sensitive molecular diagnostic techniques can effectively “upstage” early-stage colorectal cancer patients who would normally be declared to be cancer-free when evaluated using conventional tests. The findings could lead to better, more sensitive cancer detection methods. The study may also help scientists develop more consistent ways to identify patients who would benefit the most from adjuvant therapy after surgery for colorectal cancer.
Researchers at John Wayne Cancer Institute at Providence Saint John’s Health Center, the National Institutes of Health (NIH) and Children’s Hospital Los Angeles have granted CerRx Inc., worldwide exclusive rights to intellectual property and know-how related to a novel formulation of a synthetic Vitamin A analog used to treat cancer. Myles Cabot, Ph.D., director, Experimental Therapeutics and his team discovered when combined with certain other drugs or “partnering agents,” the analog 4-HPR (fenretinide) can selectively kill certain types of cancer cells in malignant solid tumors, leukemias and lymphomas. Fenretinide causes cancer cells to overproduce cellular substances (waxes) that lead to cell death. Fenretinide appears to be therapeutic when used either as a single agent or in combination with a partnering drug that slows degradation of the lethal waxes. It can be used in both adults and children, and may be particularly useful in treating recurring or relapsed malignant disease.