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Physicians Update

 
Fall 2011

Advancing Patient-Centered Care at the UCLA Institute of Urologic Oncology

10/26/2011

Patient Care CenterPeople diagnosed with urologic cancers must often go from office to office to receive treatment and advice from specialists ranging from medical and radiation oncologists to surgeons. It is a process that may cause unnecessary anxiety and confusion for patients, says Arie Belldegrun, M.D., director of the UCLA Institute of Urologic Oncology, chief of the Division of Urologic Oncology and surgical director of the UCLA Kidney Cancer Program. As director of the institute, Dr. Belldegrun discusses why bringing together a multidisciplinary team of experts in one space not only benefits patients, but may also expedite the development of new therapies for the treatment of urologic cancers.

How does the goal of the UCLA Institute of Urologic Oncology advance patient-centered care?
Our goal is to create an environment in which all the resources necessary to provide patient-centered care for a specific disease are integrated to deliver treatment effectively and efficiently. In a common space, practicing clinicians from many disciplines routinely interact and collaborate with basic scientists and translational researchers to develop individualized cancer therapies that produce the best long-term outcomes for each patient. Additionally, because we have multidisciplinary experts — including urologic oncologists, medical oncologists, diagnostic and interventional radiologists, pathologists, nurses, basic sciences and clinical trials — working together to treat the whole patient, we can move innovative therapies out of the lab and into practice much sooner and ensure patients receive the best treatment for any stage of disease.

How does the institute increase access to new therapies for UCLA patients?
UCLA has a long-standing tradition of working with leading pharmaceutical companies to identify the most promising therapies and shepherd them from the development phase through the clinical-trial process to FDA approval. As a result, our patients have access to advanced medical and surgical treatments long before these treatments become widely available to cancer patients elsewhere in the U.S. We are able to offer new clinical trials to early stage patients who may have failed first-line treatments, as well as experimental therapies to advanced-stage patients who have failed all standard treatments.

How specifically has the UCLA Institute of Urologic Oncology contributed to the development of leading-edge therapies for patients with urologic cancers?
All the latest bladder-, kidney- and prostate-cancer therapies are based on targeting the right population to the right drug. We are investigating ways to attack a specific tumor in a specific patient with a specific drug. There are Dr. Arie Beldegrunhundreds of different types of cancers, each with molecular signatures. The best strategy, therefore, is to develop tumor-specific therapies and use them to treat the subset of patients most likely to respond, based on the molecular signature of their tumor.

A good example of this is the drug Zytiga (abiraterone acetate), which received FDA approval earlier this year for treatment of late-stage prostate cancer. In 2005, UCLA was one of the first centers in the country to offer this promising drug to patients who failed every possible prostatecancer therapy, including chemotherapy. We first identified the drug’s potential to work in a select group of patients and now have patients who have been on the drug for more than three years and are still going strong. Some of these patients were in a wheelchair and are now walking. If you tailor the right therapy to the right patient, you can achieve dramatic results. UCLA is now involved with testing the efficacy of this drug in earlier stages of this disease. Another example is the drug Sunitinib, a new class of targeted kidney-cancer therapy that we began testing at UCLA in 2003. It was FDA approved in 2006, and there’s been a proliferation of six more drugs like it, or better, since then. We made every one of those drugs available to our patients years before being approved by the FDA.

What is the next step in achieving your long-term vision for the institute?
The institute is being housed in temporary space until a permanent, state-of-the-art facility is completed. We currently hold clinics on a separate day each week for prostate-, kidney- and bladdercancer patients. While our patients already reap benefits from our patient-centered concept, our next step is to bring all of our resources together under the same roof so that we achieve the necessary synergy to move forward at a faster pace. Such an effort will benefit not only the patients, but also the many oncology fellows from the U.S. and abroad who are trained at the institute and then move on to other academic institutions to become professors and future scientific leaders.

For more information about the Institute of Urologic Oncology at UCLA, go to: www.iuo.ucla.edu





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