Update from the Section of Oncology – Division of Hematology, Oncology and Blood & Marrow Transplantation

The following is a guest post from Mohammed Milhem, MBBS, Chief of the Section of Oncology. It is part of an ongoing 2019 series of division updates.

The Division of Hematology, Oncology and Blood & Marrow Transplantation has grown dramatically over the last 15 years as the care of patients with cancer and blood disorders has become more complex and more treatment options have become available.

During the past year, the Division reorganized administratively into two Sections: Hematology, directed by Steven Lentz, MD, PhD, and Oncology, directed by me. In this post, I provide some highlights of recent achievements by the Section of Oncology.

Clinical Research
One of the most noteworthy areas of growth the past few years has been in the area of clinical research. With the assistance of support staff in the Holden Comprehensive Cancer Center (HCCC), the number of patients participating in cutting-edge clinical research is projected to increase by more than 30% in calendar year 2019 compared to 2018.

This speaks to our ability to provide excellent options for patients diagnosed with cancer across many tumor types. Over the last five years, our Phase I studies have increased exponentially, providing several novel treatment options to our patients. The number of patients participating in Phase I studies has already surpassed 2018 numbers and is projected to more than double our five-year average number of patients enrolled in these unique studies.

Leading this effort is Yousef Zakharia, MD, who was recently appointed as the Associate Director of the Phase I Clinical Trials Program. In this role he will work closely with me while I direct the overall clinical research program. Douglas Laux, MD, MS, is also assisting in clinical research oversight as the Medical Director of Clinical Research Services for the HCCC. There is a very strong commitment in opening trials that serve Iowans with cancer and continuing to offer ongoing trials of breakthrough therapies.

Growing clinical trial areas include :

• Genitourinary tumors led by Zakharia and Rohan Garje, MBBS
• Neurological tumors led by Varun Monga, MD
• Thoracic oncology led by Muhammad Furqan, MD, and Taher Abu Hejleh, MBBS

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Inpatient
Laurel Lyckholm, MD, leads our inpatient hematology/oncology efforts. This is a very active inpatient service, teaching housestaff on the treatment options and management of complications for patients with hematological and oncological diseases. Lyckholm has been instrumental in revising the curriculum and in coordinating the faculty that work as attendings on this service. She was recognized this year by the Clinical Documentation Improvement Program for being a vital member of the team and for her consistent, timely, and thorough responsiveness to questions.

Iowa Oncology Network
In coordination with the HCCC, we have developed a network planning committee to evaluate and organize the hematology-oncology services at off-site locations. Our goal is to provide high-quality, cutting-edge cancer care to the people of Iowa, close to their homes. M. Obinna Nwaneri, MD, MBA, leads this effort as the Director of the Iowa Oncology Network.

This past year we have expanded provider services at two of our off-site locations. We have hired 1.5 FTE advanced practice providers to work at the Cancer Center of the Quad Cities in Bettendorf, Iowa. Shannon Kussatz, ARNP, and Katie Browne, ARNP, joined Shobha Chitneni, MD, and Mario Sy, MD, in spring 2019. We are continuing to actively recruit additional physicians to practice as this location.

In addition to expanding our Quad Cities practice, last fall we expanded our Physician Services Agreement with Jefferson County Health Center in Fairfield, Iowa. Praveen Vikas, MBBS, practices there two days a week, and Mark Karwal, MD, began a third days’ presence there last fall. Nwaneri will replace Karwal at this practice site in October.

New / Expanded Clinical Service
Furqan is the Medical Director of Outpatient Cancer Services for the HCCC. This past year he has worked closely with the administrative team as the center has implemented new and expanded services. A few of them are noted below.

• Psychosocial Oncology – Arwa Aburizik, MD, MS, was recently appointed as Director of the Psychosocial Oncology Program. She manages a behavioral oncology clinic and cancer patient therapy groups. This past year she has initiated a new group therapy service for family and friend caregivers of people with cancers. Aburizik collaborates with other psychosocial oncology providers, including those in the Departments of Psychiatry and Social Work to strengthen the clinical, educational, and research activities of the HCCC.
• Diagnostic Clinic – In spring 2019 we implemented a new clinical service for people with a suspicion of cancer. Abu Hejleh directed the implementation of this service where patients are seen sooner, evaluated and then referred to the appropriate subspecialty oncology or hematology provider. This clinic expedites cancer diagnosis and care for patients within University of Iowa Health Care and across the state of Iowa.
• Adolescent and Young Adult (AYA) Cancer Program – Monga represents the Section of Oncology in the development and implementation of this program. The AYA program specializes in addressing the individual needs of young people aged 13 to 31 as they navigate their cancer journey.  This specialized program is a joint effort between University of Iowa Stead Family Children’s Hospital and the HCCC.
• Liquid Biopsies – This new diagnostic has the potential to revolutionize cancer care. As tumors shed their DNA into a person’s bloodstream, they can be detected in much the same way that the sex or genetic abnormalities of a fetus can be identified in prenatal blood. Under the leadership of recent arrival Pashtoon Kasi, MD, MS, the administration of this diagnostic tool places the University of Iowa at the vanguard of early detection of cancer. We are not only able to detect actionable mutations in people but mechanisms of resistance sooner, enabling us to shift treatments when a particular therapeutic is no longer effective.

Iowa City VA Medical Center 
This past year we have spent significant effort in recruiting oncology faculty to work at the VAMC. Chandrikha Chandrasekharan, MBBS, Chief of Hematology/Oncology at the VA, was instrumental in not only our successful recruitment efforts, but also in ensuring the clinical needs of our veteran population were met this past year. We successfully recruited three faculty members who assist us in addressing the clinical needs at the VA:  Dhivya Prabhakar, MBBS; Susan Roeder, DO; and William Zeitler, MD. Special recognition should be given to Chandrasekharan for all her efforts this past year.