TGen Cancer Center

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As Ken Burns’ newest documentary “Cancer: The Emperor of All Maladies” starts airing on Eight PBS, we will bring you local stories about cancer. One of those stories is the research being done at the Translational Genomics Research Institute, or TGen. TGen deputy director Dr. John Carpten is one of the most respected cancer investigators in the nation, and will speak about cutting-edge developments in cancer research, including his research specialty, prostate cancer.

Ted Simons: Good evening and welcome to "Arizona Horizon." I'm Ted Simons. Governor Ducey today signed a bill that bans federal marketplace healthcare plans that include abortion coverage. The governor says that the bill provides clarity to state law. The bill also mandates that doctors must inform patients that they can reverse the effects of a drug-induced abortion, this despite critics who say that there's no medical evidence behind such a procedure. Also today, a bill allowing Arizonans to carry guns into public buildings was defeated in the state senate. The measure would have applied to those with concealed carry permits. The same measure was vetoed three times in recent years. Today's decision by the senate keeps governor Ducey from having to decide on the issue. And the senate today defeated another effort to kill common core education standards. The defeat comes a week after the governor described legislation eliminating common core as unnecessary and instead called for a full review of the standards. A new three-part Ken Burns documentary on cancer begins tonight on Eight Arizona PBS. In conjunction with the series, we look tonight at local efforts to fight the disease. One of those stories involves the translational genomics research institute, or T-gen. Joining us now is T-gen deputy director Dr. John Carpten, one of the most respected cancer investigators in the nation. Good to have you here, welcome to "Arizona Horizon."

John Carpten: Great to be here.

Ted Simons: The latest in cancer research. This documentary is all encompassing from history to the future. What's the most exciting thing about cancer research right now?

John Carpten: I think one aspect is that we're really I think finally starting to think about how do we personalize clinical management for cancer? So we've heard about personalized medicine, individualized medicine, precision medicine. We even heard the president initiate, you know, a new program to really start to get at personalized medicine and how can we really try to treat each individual patient's cancer with the best therapy for that patient. The other one is the advancements with the new immunotherapies where we're allowing the patient's immune system the opportunity to do its job and fight cancer. The cancer cells will express certain proteins that sort of allow the cells to hide from the immune system. If we can block that, we can actually allow the immune system to actually attack the cancer. And so we're really seeing some amazing outcomes with those immunotherapies. So for scientists like me, I'm really excited about how we can take the immune therapies and some of the other therapies that we've developed that are more personalized, combine these modes of treatment so that we can really see even more amazing outcomes in cancer.

Ted Simons: The immunotherapy is fascinating because the results seem pretty startling in a number of cases. Are those durable results? How long are those?

John Carpten: There's patients who have gone out years on those treatments. The toxicity, that's what's really important, the toxicities are relatively low with those therapies because it's your own immune system. And so that actually provides a benefit, you know. Many patients will not have durable responses from treatment a lot of times because they can't stay on the treatment, because the toxicity, they'll come off treatment, give cancer the opportunity to grow but with those therapies in many cases, the patients are able to stay on the treatments and so we're seeing some pretty long-term outcomes but again, there are patients who don't necessarily respond to those therapies so we still have more work to do.

Ted Simons: As far as genetics, genome science, those sorts of things, what's the latest?

John Carpten: Oh, boy. So I think so this whole aspect of personalized medicine, one of the sort of new approaches we're using, we can actually take a biopsy or a specimen from a patient that includes tumors, tumor cells. We can actually sequence the genome of the tumor cells, compare that to the patient's constitutional genome, your normal genome, and identify cancer-specific markers and mutations that are in that patient's cancer and then identify treatments to attack those specific driver mutations that are driving that cancer's behavior. And so it's a true sort of realization of applying genome science to clinical management and this is one of the areas that I think T-gen really excels in right now.

Ted Simons: Does cancer, can cancer alter genes or altered genes, do they invite cancer?

John Carpten: It's a cause and consequence thing, right? So at its most basic essence, cancer is a genetic disease, where some type of -- some factor right, it could be an intrinsic factor, extrinsic, which leads to damaged protein, damaged cells, damaged tissues and disease. So if we can understand those underlying events within the cancer, we can learn a lot about the biology of the cancer.

Ted Simons: So basically, you can know whether or not that person, because they smoked, developed cancer, the same person who didn't smoke may never have developed cancer, you look at the genome and start asking questions, right?

John Carpten: Absolutely. You talk about smoker versus nonsmoker, lung cancer that's a huge area of research, trying to understand, you know, the differences, the molecular differences between the tumors caused by smoking and lung tumors that actually arise without smoking.

Ted Simons: Right. As far as how fast all of this knowledge is, it just seems like things are going very fast. Is that how you're seeing it as well?

John Carpten: In my 20 plus year career, I would say it's the most exciting time but it's also the most challenging, right? Trying to keep up, trying to continue and keep up with the pace that we currently face right now but it is really exciting. We're seeing so many new things and technologies, our understanding of biology, it's all of these things sort of coming together at the right time, so far, an inflection point, and I think that that's why we're starting to see, you know, a little bit of an uptick right in improvements in outcomes in cancer.

Ted Simons: With that in mind, do you think within let's say the next 50 years, will cancer be beaten or will cancer ever be beaten? Is it such a thing it's so sly it moves in so many directions? Can it ever be beaten?

John Carpten: Well, some cancers are already beaten, right? And I think that that's one of the things we have to understand. I think, you know, there are wins, right? I think we tend to look at a cancer cure as the totality of cancer, right, but there are certain patients with certain tumor types where we can cure their cancer. And so I think we have already gotten there but the totality of cancer, I don't know if we'll cure every cancer but perhaps in some cases, we'll turn cancer into more of a chronic disease, right, where we can monitor and manage it over a long period of time, keeping it at bay. It's still there, but we can at least sort of keep it at bay over a long period of time, maybe the patient will have complications from something else lately but they won't die from cancer.

Ted Simons: Kind of redefines living with cancer.

John Carpten: Absolutely.

Ted Simons: Great to have you here. Thanks for joining us.

John Carpten: Great, great, thanks.

Dr. John Carpten:Deputy Director, Translational Genomics Research Institute;

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