Patients and advocacy groups boost adrenal cancer research

Latest advances subject of international symposium in Ann Arbor

Adrenal cancer

Visualizing new potential targets in ACC. This fluorescence microscopy image shows expression of ZNRF3 (green) in the normal mouse adrenal gland. Collaborative research efforts, including The Cancer Genome Atlas project, have recently mapped the genetic landscape of human ACC tumors and identified ZNRF3 as one of the most commonly altered genes in ACC. Image courtesy of Kaitlin Basham, Ph.D., Postdoctoral Fellow (Hammer Laboratory) and Heather Rose Kornick Adrenocortical Cancer Research Scholar


mCancerPartner sat down with Gary Hammer, M.D., Ph.D., director of the Endocrine Oncology Program in the Comprehensive Cancer Center, to discuss the program’s most recent developments in adrenal cancer research and patient care.

mCancerPartner: Why is collaboration so important in treating adrenal cancer?

Dr. Hammer: Adrenal cancer, or ACC, is very rare, with less than a thousand people diagnosed with it each year in the United States. In adults, it is most often diagnosed at an advanced stage, so for many, the prognosis is dismal. Collaboration is essential because no one hospital sees enough of these patients to advance research or clinical care. We are one of the few cancer centers specializing in both adrenal cancer research and care. Since ACC is largely a result of genetic mutations, we are working with researchers all over the world to identify common gene mutations. Only then can we offer patients personalized, precision medicine. The Cancer Genome Atlas has just mapped adrenal cancer, and that’s a project we initiated and helped steward to completion. The mapping has uncovered some previously unknown cancer drivers of this disease, including some mutations that make the cancer unique or worse. Some of these drivers are targetable by drugs that exist or are currently under development. But again, it’s sharing this information through world-wide collaboration that will allow us to move forward with developing new and effective therapies.

mCancerPartner: Michigan is on the forefront of adrenal cancer research. Why is that?

Dr. Hammer: Our U-M adrenal research and adrenal cancer team is the largest and most comprehensive in the world. It’s been exciting to build a team that the world now looks to for leadership for adrenal research and clinical care. It makes Michigan a very exciting place for research and for patient treatment. For example, Tobias Else, Victoria Raymond and Jessica Everett have recently uncovered key genes that participate in familial, or inherited, cancers including ACC, while others in our group are working to define novel blood biomarkers for detection of ACC. The research that put us in the forefront has caused adrenal advocacy groups to look to us for advice.

mCancerPartner: Earlier this year, the U-M Comprehensive Cancer Center received a $1.65 million gift from the Hirair and Anna Hovnanian Foundation to fund adrenal cancer research. What progress has this generous gift enabled thus far?

Dr. Hammer: The Hovnanian gift allows us to develop a cloud-based, adrenal-specific database linked to ACC “tumor repositories” to advance adrenal cancer research. It will be managed initially through the Michigan team, with international involvement, including the European Network for the Study of Adrenal Tumors as well as our South American, Australian and Asian colleagues. It will become a resource for that can improve our research battle against adrenal disease and especially ACC. The initial meeting and formal structuring of this network will take place at the upcoming International Adrenal Cancer Symposium that the U-M Comprehensive Cancer Center is sponsoring in October. In the next couple of months, we will launch the database, and after that, we will capitalize on The Cancer Genome Atlas’s adrenal genomics map.

Here at Michigan, there are a number of research projects that will benefit from the cloud-based database and repository. One example is our IGF2 pathway research. IGF2 is a protein that is secreted by adrenal cancer cells and stimulates their growth. There’s an existing drug that inhibits the ability of IGF2 to activate the cellular machinery, not approved yet by the FDA for adrenal cancer. The drug has had outstanding results in a very small subset of patients enrolled in one of our clinical trials that focused on the IGF2 pathway. We’re hoping the cloud-based repository will help us to figure out why only some patients responded to the drug. Perhaps then we can identify patients that will benefit most from the drug and persuade the pharmaceutical companies to invest in research, and the agencies to ultimately consider approving the drug for adrenal cancer care.

mCancerPartner: You mentioned earlier that adrenal advocacy groups turn to Michigan for advice. Why is that important?

Dr. Hammer: Being accessible and engaging patients is a critical part of how physicians approach oncology and this is especially true for a rare disease like ACC. U-M is aware of the growth in patient advocacy and its success. The adrenal cancer community has shown very well the value of these grass roots efforts. Because government agencies and pharmaceutical companies must focus on a strong return on investment, funding to develop new drugs for adrenal cancer isn’t very robust. Thus, it is patients and family advocates who have made a big difference in advancing research and therapy options. There has been significant growth in funding from these kinds of “advocacy-based” sources here at Michigan, thanks to their support.

So, we invited the adrenal cancer community, including patient/family advocates, to the first international ACC symposium that intermingled patients, advocates, scientists and clinicians. This galvanized advocacy groups to help move research forward. For example, some groups will be involved in the cloud based initiative. Others continue to raise money. For example, ACC CURE, a non-profit organization for adrenal cancer research, is sponsoring a Run4ACure here in Ann Arbor on Tuesday, October 13 that will kick off our symposium.

mCancerPartner: Tell me more about the symposium.

Dr. Hammer: This is our fifth international ACC symposium, the first starting in 2003. It takes place October 14-15 at Palmer Commons. Members of the international ACC community that includes physicians of all disciplines, nurse practitioners, physician assistants, students, and patients and their families will learn about the latest collaborative international genomic and molecular research, the most up to date diagnostic approaches and current and future therapies. A panel of international experts will discuss adrenal cancer patient cases to illustrate recurring questions and highlight common case management issues. Topics for patient sessions include survivorship, chemotherapy, financial considerations, and genetic testing, among others.


Take the next step:

Gary HammerAdrenal cancer is rare. Exceptional patient care and innovative treatment for adrenal cancer shouldn’t be. Our program, established in 2005, brings experts in related fields together to provide coordinated, exceptional patient care to those diagnosed with adrenocortical carcinoma or adrenal cancer. Patients benefit from the experience and expertise of many physicians, not just one. For those who need treatment for adrenal cancer, we offer the most comprehensive methods within the Multidisciplinary Endocrine Oncology Clinic.

Cancer-center-informal-vertical-sig-150x150The University of Michigan Comprehensive Cancer Center’s 1,000 doctors, nurses, care givers and researchers are united by one thought: to deliver the highest quality, compassionate care while working to conquer cancer through innovation and collaboration. The center is among the top-ranked national cancer programs, and #1 in Michigan according to U.S. News & World Report. Our multidisciplinary clinics offer one-stop access to teams of specialists for personalized treatment plans, part of the ideal patient care experience. Patients also benefit through access to promising new cancer therapies.