PHILADELPHIA INTERNATIONAL MEDICINE® NEWS BUREAU
Contact: Leonard N. Karp
lkarp@philadelphiamedicine.com
215-735-3989
November 1, 2004

For immediate release:

In this month's issue:

1. Crozer-Keystone and Fox Chase Cancer Center Create Clinical and Research Partnership
2. Jefferson Research Shows Red Wine Is Heart Healthier
3. Penn Researcher Receives $1 Million Grant for Cancer Gene Therapy Research

Editors note: Research by Philadelphia International Medicine physicians and hospitals may lead to new ways to treat some of our most challenging diseases. Below are just some examples from our hospitals.

Crozer-Keystone and Fox Chase Cancer Center Create Clinical and Research Partnership

Philadelphia - Crozer-Keystone Health System and the Fox Chase Cancer Center, both founders of Philadelphia International Medicine and among the leaders in health care in the U.S., have linked their strengths and resources to form the Fox Chase Crozer-Keystone Cancer Partnership.

Through this new partnership, Crozer-Keystone and Fox Chase physicians and hospitals will work together on a range of clinical and research initiatives. Patients treated within the Crozer-Keystone Health System will have even broader access to new clinical trials and programs related to cancer prevention, diagnosis and treatment.

"Crozer-Keystone Health System is dedicated to providing our patients with the latest advances in cancer care prevention and treatment. Fox Chase recognized our commitment and our presence in this community, and seized the opportunity to form a unique partnership," says Gerald Miller, president and chief executive officer of the Crozer-Keystone Health System.

Joan Richards, chief operating officer of Crozer-Keystone Health System and president of CKHS Hospitals, adds, "Fox Chase and Crozer-Keystone have created a partnership that will be unmatched regionally in terms of its resources and its commitment to excellent cancer care and research. We look forward to a mutually advantageous relationship that will ultimately benefit our patients."

The partnership expands on the relationship that the Delaware County Regional Cancer Center at Delaware County Memorial Hospital has had with Fox Chase Cancer Center since 1990 through its Fox Chase Network.

"Delaware County Memorial's outstanding clinical capabilities and high standards for patient care are among the reasons Fox Chase chose to expand this partnership with Crozer-Chester Medical Center, Springfield Hospital and Taylor Hospital," said Robert C. Young, MD, president of Fox Chase Cancer Center. "Fox Chase has been providing leading cancer care for more than a century. Our expanded relationship with Crozer-Keystone Health System will enable us to reach out to many more people."

"Over the past 14 years, our partnership with Fox Chase has been the cornerstone in our efforts to create an academically oriented cancer program that, in my opinion, is second to none," says John Sprandio, MD, chief of Hematology/Oncology at Delaware County Memorial Hospital and medical director of the Delaware County Regional Cancer Center. "We are excited to see the extension of the Fox Chase affiliation across our health system. This is truly an opportunity to standardize oncology care."

Crozer-Keystone Health System patients will benefit from this partnership by having access to more than 100 cancer treatment and prevention clinical trials approved by Fox Chase Cancer Center and the National Cancer Institute. Patients will also have access to Fox Chase's innovative programs, such as a new cancer-pain program.

"For patients, this partnership means access to broad-based clinical expertise for the diagnosis and treatment of all kinds of cancer, the latest technology, and access to national clinical trials as well as those conducted for Fox Chase patients," says Paul F. Engstrom, MD, senior vice president of population science and medical director of Fox Chase Network.

"Crozer-Keystone and Fox Chase share a similar approach to cancer care. Cancer is a complex disease with many emotional and physical consequences, and effective care must tend to the whole patient," says Raymond Vivacqua, MD, chief of Hematology/Oncology at Crozer-Chester Medical Center and medical director of the Crozer Regional Cancer Center. "Fox Chase also shares our commitment to community health, which we demonstrate by providing a range of free cancer screenings throughout the year."

Crozer-Keystone and Fox Chase physicians will work together in clinical research and apply for grants for the study of treatment outcomes, prevention and education efforts as well as cancer-related public health issues. In addition, Crozer-Keystone and Fox Chase physicians will be able to consult on difficult cancer cases, and CKHS physicians and staff members will have the opportunity to attend Fox Chase continuing education programs.

"This is a true clinical partnership. We are excited about the opportunity to collaborate with the physicians of the Fox Chase Cancer Center in a number of ways as we both work toward new methods for preventing and treating cancer," says Joel Noumoff, MD, chief of Gynecologic Oncology at Crozer-Chester Medical Center and Crozer's clinical liaison with Fox Chase.

Lee Bogart, MD, chief of Hematology/Oncology at Taylor Hospital, says, "Like all of our endeavors, the overriding goal of this new partnership is to enhance patient care. I'm confident that our colleagues at Fox Chase share our enthusiasm for this new era."

The hospitals of the Crozer-Keystone Health System provide a comprehensive approach to cancer care, combining state-of-the-art diagnosis and treatment with supportive care. Physicians and staff work as a multidisciplinary team, using the newest technologies and therapies, to tailor treatment to each patient's condition and situation.

Fox Chase Cancer Center, an independent, nonprofit institution, was founded in 1904 as the nation's first cancer hospital. In 1974, Fox Chase became one of the nation's first comprehensive cancer centers designated by the National Cancer Institute. Fox Chase conducts basic, clinical, population and translational research; programs of cancer prevention, detection and treatment; and community outreach.

Jefferson Research Shows Red Wine Is Heart Healthier

When the choice is red wine or gin, choose red wine - at least when considering your heart's health.

That's according to a recent study by Jefferson Medical College researchers, who compared the effects of drinking either red wine or gin on several biochemical markers in the blood. Red wine contains many complex compounds including polyphenols, which are absent from gin. They found that drinking red wine had a much greater effect in lowering levels in the bloodstream of so-called "anti-inflammatory" substances that are risk factors in the development of heart disease and stroke.

The results, which appeared recently in the journal Atherosclerosis, didn't surprise co-author Emanuel Rubin, MD, who led the study.
"It's clear from these results that while drinking some form of alcohol lowers inflammatory markers, red wine has a much greater effect than gin," says Dr. Rubin, Distinguished Professor of Pathology at Jefferson Medical College of Thomas Jefferson University in Philadelphia.

While there are well known associations between alcohol and a lowered risk of heart attack and stroke - the so-called "French paradox," for example - Dr. Rubin says that "breaking down the data epidemiologically" has been difficult.

To find evidence related to alcohol's effect in reducing heart attack and stroke, he and his colleagues at the University of Barcelona turned to "surrogate" or substitute markers of disease. Inflammation, he notes, has long been implicated in the development of atherosclerosis and coronary artery disease. "High levels of c-reactive proteins and other markers of inflammation in the blood are risk factors that have been implicated in coronary artery disease and ischemic stroke," he says.

The Jefferson-led team compared the effects of red wine and gin on the levels of inflammatory biomarkers in the blood, including adhesion molecules, chemokines and white blood cells that are related to atherosclerosis. According to Dr. Rubin, no clinical trials have been done comparing the effect of red wine to that of alcoholic beverages with low levels of non-alcoholic substances, such as polyphenols.

In the first part of the study, the researcher gave 20 subjects in two groups two drinks a day of either wine or gin for 28 days. That was followed by a "washout period" of 15 days with no alcohol. In the second part of the trial, those who received red wine the first time then were given gin. Those who had gin first then received red wine. The researchers measured levels of biomarkers before and after each half of the trial. They attempted to rigorously control subjects' diets.

Both wine and gin showed anti-inflammatory effects. Both groups had reduced levels of fibrinogen which clots blood but is not an inflammatory marker, and IL-1, which is. Raised levels of fibrinogen are a risk factor for heart attack.

But red wine also dramatically lowered the levels of inflammatory molecules such as adhesion molecules, and proteins in monocytes and lymphocytes.
Dr. Rubin argues that one or two glasses of red wine a day may be beneficial, and that there is some degree of protection from heart disease and stroke by alcoholic beverages in general. Still, the results are only indirect evidence and can't prove a protective effect against the development of atherosclerosis. The study is far too brief to analyze a process that takes years to develop, he says.

"It's tough to root out just what is going on," he says. "There will have to be long-term epidemiological studies done."

Penn Researcher Receives $1 Million Grant for Cancer Gene Therapy Research

Carl June, MD, director of Translational Research at the Abramson Cancer Center of the University of Pennsylvania and professor of Pathology and Laboratory Medicine in Penn's School of Medicine, is one of two recipients of the first grant awarded by the Alliance for Cancer Gene Therapy Inc. (ACGT) for research in treating lymphoma and leukemia. As the only national foundation devoted exclusively to funding cancer gene therapy research, the mission of ACGT is to identify and fund innovative scientific research on the causes, treatment, and prevention of all types of cancer, using cells and genes as medicine.

"We have recently developed a new strategy to create T cells that express a hybrid gene that endows the engineered T cells with the ability to specifically kill leukemia cells," says June. "With this grant from the Alliance for Cancer Gene Therapy we plan to carry out a Phase 1 clinical trial - an initial trial designed not to assess effectiveness, but rather to determine the optimal dose and measure toxicity - in patients with advanced or recurrent leukemia who have not responded to prior chemotherapy."

June and his collaborator, David Porter, MD, associate professor of Medicine, will receive about $1 million over the next three to four years to use genetically engineered T cells to target leukemia and lymphomas. If properly activated, T cells have a strong capacity to kill tumor cells.

Michel Sadelain, MD, PhD, from Memorial Sloan-Kettering Cancer Center in New York also received a $1 million ACGT grant for a parallel study, which uses a different vector to carry hybrid genes into T cells. Comparing the outcomes of these two clinical trials will provide important information to better engineer the immune system to fight leukemia and lymphoma. June and Sadelain were selected by ACGT's 12-member Scientific Advisory Council, which includes some of the nation's most preeminent physicians and researchers in cancer gene therapy.

Philadelphia International Medicine is an organization that provides medical and patient support services to international patients. It also provides continuing medical education and health care training and education to international physicians, administrators and other practitioners. As the international department of several Philadelphia-area hospitals, international patients gain access to physicians and hospitals rated among the best in the world through one telephone call to PIM. You can reach PIM by calling 1-215-735-3575; fax, 1-215-790-1267; or e-mail, physicians@philadelphiamedicine.com . You can find out more about PIM through its Website at www.philadelphiamedicine.com .