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Physicians Update


Physicians Update

Winter 2012

Transitioning Solid-Tumor Oncology to Santa Monica Opened Program to More Patients

The move offered opportunities to develop centralized and multidisciplinary centers in a community location with easy access for patients.

Moving UCLA's solid-tumor oncology program from Westwood to Santa Monica made sense on several levels. Except in cases that require a higher level of monitoring and nursing care - patients receiving consecutive days of infusion or extremely toxic chemotherapy, for example, or who are older or more fragile - most of today's modern cancer treatment is delivered in outpatient clinics rather than in the hospital, notes oncologist Arash Naeim, M.D. Santa Monica offered opportunities to develop centralized and multidisciplinary centers that provide services including surgery, medical oncology and radiation oncology in a community location with easy access for patients.

At present, 21 oncologists treat patients out of two outpatient locations in Santa Monica, notes Sandra Binder, director of operations for the UCLA community practices. The combined clinics can treat up to 29 patients at a time - an average of 40 to 50 patients are treated daily - and therapies range from standard chemotherapy to biological therapies and investigative agents.

Five years ago, the inpatient program also relocated to Santa Monica, and it now occupies a dedicated 26-bed unit on 4SW of UCLA Medical Center, Santa Monica. "Moving the inpatient service from Westwood to Santa Monica mirrored the move that had been occurring in terms of where the concentration of our outpatient oncology was taking place,"
Dr. Naeim says.

In addition to opening space for more patients, the move also allowed Dennis Slamon, M.D., chief of the Division of Hematology/Oncology and director of clinical/translational research at UCLA's Jonsson Comprehensive Cancer Center, to centralize his Clinical Research Unit, which oversees all cancer clinical trials at UCLA and at affiliated oncology offices throughout California and across the country, in Santa Monica.

"In the Santa Monica clinics, we are able to see more patients and we're hoping that many of those patients will be able be treated in clinical trials, where we are testing the leading-edge targeted therapies that are being developed based on our laboratory research," Dr. Slamon says.

Transitioning from Westwood to Santa Monica was not without its potential issues, Dr. Slamon notes. "Everything we did in solid-tumor oncology was built around the Westwood campus to support the laboratory and clinical research that we were then taking into the clinic," he says. Moving clinical services to Santa Monica but leaving research in Westwood "presented a scenario where the faculty would have to be shuttling back and forth from their labs in Westwood to the new clinics in Santa Monica."

To address that issue, Dr. Slamon moved the clinician-scientists doing research in solid-tumor oncology to new labs in Santa Monica, called the Translational Oncology Research Laboratories, near the clinics. The new lab space, like the new clinic space, allows Dr. Slamon to centralize the research operations and also place the oncologists closer to the clinics where they are seeing patients. "In the end, the move of both our clinical and research efforts worked out better than we could have hoped. We now have centralized clinic space as well as centralized research space just down the street," he notes.

The translational labs in Santa Monica boast 18,000 square feet of research space and house all the pre-clinical laboratory programs for solid-tumor oncology. Within these spaces, clinician-scientists work to uncover targets for therapeutics, looking for mutated genes that result in protein over- or under-expressions that lead to cancer. Most cancers now are not being treated by organ location, but by the underlying mutation or oncogene that causes the malignancy.

"The Santa Monica lab space has given us much more space in one place than we would have been able to put together in Westwood, and certainly has made it easier for us to interact," Dr. Slamon says. "It's been a really great thing."

The translational oncology labs in Santa Monica have more than 500 human-cancer cell lines established that represent several malignancies, including breast, lung and colorectal cancers, as well as sarcoma and melanoma.

Expansion of both the clinical and research functions in Santa Monica fits well within Dr. Slamon's continuing plans to enlarge UCLA's footprint when it comes to both treatment and study of cancer. In 1996, for example, he launched an ambitious program called Translational Oncology Research International (TORI), in which UCLA partners with research institutions, companies and healthcare providers across the United States to offer clinical trials and research studies to patients in their own communities. TORI not only makes enrolling in a clinical trial easier for patients, it also helps diversify the population represented in the studies.

TORI currently has 25 affiliated oncology practices with 130 physicians enrolling patients in UCLA clinical trials. Affiliated TORI sites are located in California from Santa Maria south to Long Beach and east to the Inland Empire and in Colorado, Florida, Georgia, Indiana, Maryland, Nevada, New Mexico and Texas. Each participating practice has a UCLA study coordinator on site. Data from the trials are sent back to the Clinical Research Unit in Santa Monica. To date, the TORI network has placed more than 5,000 patients on UCLA clinical trials, Dr. Slamon says.

"We have two models that drive this, both of which are important to us," Dr. Slamon says. "One is that we establish practices where there is a need, and the other is where we work with established practices to include more sites to get more data."

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