More than 260 of UNC Lineberger's most generousdonors attended the January 7 Lineberger Clubluncheon and saw the Tar Heel men's basketballteam beat NC State.

Guest speaker Elizabeth Edwards shared withthe group her experience with breast cancer andthanked them for their vital support which hasadvanced research and enhanced UNC's teamapproach to care for cancer patients.

Thanks to sponsors Lee-Moore Oil Company,Café Carolina, Sprint, Stock Building Supply andWachovia Wealth Management for their sustainedsupport of the lunch. This annual event is open toall members of the Lineberger Club, annual donorsof $1,000 or more to the Cancer Center.

Silent auction items, including several pairs ofbasketball tickets and a basketball signed by the2005-06 UNC men's basketball team, netted over$3,000.•

Scientists at UNC Lineberger are using nanotechnology toimprove the diagnosis and treatment of cancer.

Nanotechnology involves controlling atoms andmolecules on length scales of hundreds of nanometers (onebillionth of a meter) or less. The diameter of a human hair isoften used to describe the size of microtechnologies.Nanotechnology involves itemsthat are 1000 times smaller.

The National CancerInstitute named UNCLineberger one of seveninstitutions nationwide in theNCI Alliance for Nano-technology in Cancer. The fundsfor the first year of this five-yearaward totaled $3,899,965 andestablished the Carolina Centerof Cancer NanotechnologyExcellence.

Rudy Juliano, professor ofpharmacology in UNC's Schoolof Medicine and a UNCLineberger member, isprincipal investigator of thegrant. Joe DeSimone, WilliamR. Kenan Jr. DistinguishedProfessor of Chemistry andChemical Engineering, is co-principal investigator.

"This exciting new thrust in cancer nanomedicine comesas a result of a convergence of the biological and physicalsciences," Juliano says. "Scientists have learned that cellsfunction as assemblies of biological nanomachines," he

explains. "The abnormalities of cancer and other diseases areoften based on malfunction of those nanomachines, forexample, ones involved in cell growth regulation, cellularenergy metabolism, or control of DNA stability."

Despite the tiny size, complex nanoscale devices can nowbe created and manipulated. "This offers the possibility ofbringing the power of physical science to bear on problemsof biomedical research," he says, "with exciting implicationsfor therapy, diagnosis, and early detection of cancer andother diseases."

Multidisciplinary SolutionsTurning theory into practice, associate professor ofchemistry Wenbin Lin leads a team makingmagnetic nanoparticles that will selectively bind tothe surfaces of brain tumor cells. Thesenanovectors can then be used to deliver imagingand therapeutic agents to brain tumors in mice.

Think of it as the express laneto a tumor.

But getting there requiresexpertise from otherdisciplines, Lin says."Professor Richard Superfine'sgroup in the PhysicsDepartment will then carryout fundamental studies on

magnetic targeting in tissues, while Professor Terry VanDyke's group in the Genetics Department will test these newimaging and therapeutic agents on genetically engineered

U N C L i n e b e r g e r C o m p r e h e n s i v e C a n c e r C e n t e rcancerThe Cancer Program of UNC-Chapel Hill & UNC Health Care Winter 2006

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7 Tickled Pink

2Director’s Messageand DigitalMammography

LINEBERGER COMPREHENSIVECANCER CENTER

N.C. CANCER HOSPITAL

4 Profile: Careyand Ewend

Tiny Technology Promises Big Results

3Head and NeckCancer

Lines

continued on page 5

Front row (left to right): UNC Lineberger associate director Dr. Rich Goldberg, speakerElizabeth Edwards, speaker Dr. Etta Pisano. Second row (left to right): Dr. Lisa Carey,co-director, UNC Breast Center; Dr. Shelley Earp, Lineberger director; Dr. WilliamRoper, CEO, UNC Health Care and Dean, UNC School of Medicine.

Lineberger Club Event Features Elizabeth Edwards

Personalizing the cure for cancer with

physical science (top to bottom):

Biocompatiblenanoparticles

tagged with a protein biosensor;biocompatible nanoparticles

loaded with DNA; and nano-carriersembedded in a surgical adhesive.

Graphics courtesy of DeSimone lab.

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This issue ofCancer Lines isabout teamworkand highlights twoof our multi-d i s c i p l i n a r yprograms: theHead and NeckCancer Programand the ThoracicOncology Program,celebrating its 10th

anniversary. These programs function as ateam for patients and families who benefit

from the expertise of many specialistsworking together to develop a com-prehensive treatment plan and coordinatecare.

Collaboration and collegiality arehallmarks of UNC Lineberger. Readabout the most recent example - the newCarolina Center of NanotechnologyExcellence (CCNE) that involves anincredible cross-campus team ofscientists at UNC and other institutions.

Our teamwork extends beyond ourown campus and faculty. Dr. Etta Pisanoled a national study of 49,528 women

comparing x-ray and digitalmammography. And I am honored tohave just begun a two-year term aspresident of the Association of AmericanCancer Institutes.

We are fortunate to have a dedicatedand passionate group of communityvolunteers who are another critical partof our team and who work diligently toraise money for cancer research andtreatment. Thank you to these volunteerswho organize our successful specialevents. As you will read, they have beenbusy with the Tickled Pink luncheons,the Beach Ball and the first annual FastBreak with Roy Williams! Their efforts,coupled with those of our faculty andstaff, inspire and extend superb UNCLineberger teamwork.•

Tepper NNamed MMacLean DDistinguished PProfessor

Dr. Joel Tepper, professor and chair of radiation oncology, has been named the HectorMacLean Distinguished Professor in Cancer Research. Tepper is principal investigator ofthe UNC Lineberger GI Specialized Program of Research Excellence (SPORE). He is pastpresident of the American Society for Therapeutic Radiology and Oncology and he co-chairs the National Cancer Institute's Gastrointestinal Integroup, which is the organizingbody for the nine cooperative groups involved in gastrointestinal cancer.

He delivered the 2005 UNC School of Medicine Berryhill Lecture in September 2005.This annual lecture, named in honor of Norma Berryhill who, along with her husband Dr.Reece Berryhill, contributed immeasurably to the development of the UNC School ofMedicine, is delivered by an eminent member of the School's faculty.•

Dr. Etta Pisano was the lead author of a major breastcancer screening study, the results of which wereannounced in September and publishedin the October 27, 2005 issue of theNew England Journal of Medicine. Pisanois Kenan professor of radiology andbiomedical engineering at the Universityof North Carolina at Chapel Hill,director of the Biomedical ResearchImaging Center at UNC and member ofthe UNC Lineberger ComprehensiveCancer Center.

Study scientists found that digitalmammography detected significantly (up to 28percent) more cancers than screen filmmammography in women ages 50 and younger,premenopausal and perimenopausal women, andwomen with dense breasts, according to results fromthe ACRIN Digital Mammographic ImagingScreening Trial (DMIST).

However, the American College of Radiology

Imaging Network (ACRIN) trial, one of the largestbreast cancer screening studies ever performed,

showed no difference between digital andfilm mammography in detecting breastcancer for the general population ofwomen.

The trial, funded by the National CancerInstitute (NCI), was conducted by ACRINand included researchers at 33 sites acrossthe United States and Canada.

Starting in October 2001, DMISTenrolled 49,528 women at 33 sites in theUnited States and Canada who had no signs

of breast cancer. Women in the trial were given bothdigital and film mammograms. Mammograms wereinterpreted independently by two differentradiologists.

Digital mammography takes an electronic image ofthe breast and stores it directly in a computer,allowing the recorded data to be enhanced, magnifiedor manipulated for further evaluation. The electronic

image also can be printed on film. Filmmammography units use film to both capture anddisplay the image. The sensitivity of filmmammography is somewhat limited in women withdense breasts, a population at higher risk for breastcancer. •

2 cancerLines Winter 2006

UNC Lineberger is designated acomprehensive cancer center by theNational Cancer Institute.

Cancer Lines is a publication of theUNC Lineberger ComprehensiveCancer Center, The University ofNorth Carolina School of Medicineat Chapel Hill.

Dr. H. Shelton Earp, III, DirectorDr. Joseph S.Pagano, DirectorEmeritusDebbie Dibbert, Assistant Dean forInstitutional AdvancementDianne G. Shaw, Director ofCommunications/Executive EditorAlyson Newman, Design & Layout

Please add the following to theCancer Center’s mailing list.

Name

Address

City, State, Zip

Please remove me from yourmailing list

Name

UNC Lineberger Comprehensive Cancer Center

CB# 7295School of MedicineUniversity of North Carolina at Chapel HillChapel Hill, NC 27599-7295(919) 966-5905www.unclineberger.org

Printed on Recycled Paper

Director’sMessageDirector’sMessage

Dr. H. Shelton Earp, III

LINEBERGER COMPREHENSIVECANCER CENTER

N.C. CANCER HOSPITAL

Comparison of digital and film mammogram (left: digital,right: film) Questionable area, just below the nipple, is moreeasily visible in the digital image. Image courtesy of UNC-Chapel Hill School of Medicine Department of Radiology,Breast Imaging

Pisano Leads Major Mammography Study

UNC Lineberger Director Shelley Earp began a two-year term aspresident of the Association of American Cancer Institutes(AACI), an association of the nation's 85 leading academic andfreestanding cancer centers, in October. AACI coordinates thework of universities, foundations and private and governmentalorganizations toward the eradication of cancer.

Earp, Lineberger Professor of Cancer Research and aprofessor of pharmacology and medicine, also serves asprincipal investigator of a National Cancer Institute CancerCenter Support Grant and of a Specialized Program of Research

Excellence in Breast Cancer (SPORE), one of only 11 breastSPORES funded by NCI.

His laboratory studies growth and differentiation signalingfrom both receptor and non-receptor tyrosine kinases. His long-standing interest in the EGF receptor family is currently focusedon HER4/ErbB4 and its unusual growth inhibitory signal inbreast cancer cells. A second project is investigating the actionof Mer and Ack1 receptor and non-receptor tyrosine kinases, inthe regulation of prostate cancer cell tumorigenesis, in vitro andin vivo.•

Earp NNew PPresident oof AAssociation oof AAmerican CCancer IInstitutes

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Dave Holton of Kitty Hawk, NC, a throat cancerpatient treated at UNC, summarized it this way: "Oneof the best things about my UNC experience was thecoordination of my care. All my doctors talked witheach other and really worked together as a team."(Read more about Holton’s experience atwww.nccancerstories.org.)

That comment is just what program leader Dr.Mark Weissler and program members like to hear."We do take a team approach," said Weissler, "and ourspecialists work closely together to help our patientswith all the issues involved in treating head and neckcancers. We are fortunate to collaborate with facultyin the UNC School of Dentistry since not manyprograms have ready access to a dental school as partof the health affairs complex."

The UNC Lineberger Multidisciplinary Head andNeck Cancer Program serves referring physicians andpatients from across North Carolina and beyond. Theprogram is broad-ranging, from the largestpopulation-based study in the nation involving NorthCarolina head and neck cancer patients from 46counties, to innovativeclinical trials, to molecularstudies to help predicttreatment outcomes.

At the heart of theprogram is patient care."Referring physicians sendus their patients becausethese patients requiremuch complex care, andUNC has the services theyneed all in one place,"explained Dr. Weissler."Over half of the newpatients we see each yearhave already had previoustherapy - chemo orradiation - and have had arecurrence of their disease."

When calling UNC,referring physicians andpatients will first talk withprogram assistant LauraMiller. Patients who visitUNC are followed bySylvia Wrenn, theprogram's nurse coordi-nator. "Many patients ortheir families just need aperson with whom theycan talk about what isgoing on with them. Thenurse coordinator is asingle contact person thatthey can talk to withouthaving to make a phonecall to each part of theteam in order to get aquestion answered. "

At UNC, in addition tosurgical, radiation andmedical oncologists, patientshave access to nutritionists,dentists and a speech andswallowing specialist.

Specialty CareBrian Kanapkey, thespeech pathology and

swallowing therapist, explains that "the goalof therapy is to give the patient as muchnormal function - voice and swallowing - aspossible." He works with patients who willundergo a laryngectomy (removal of thevoice box) to understand the procedure andhow it will affect their speech andswallowing. After surgery, he works withthem to adapt and to develop proficiencywith speech assistance devices.

Additionally, if patients have speechissues due to surgery or non-surgicaltreatment, he helps them with adaptivetechniques such as tongue exercises and movementsor slowing speech. "Some patients may have difficultyswallowing because of their tumor or the surgery. Wework with them to make that function as normal aspossible."

One patient. Herman Stewart of Kings Mountain,NC, calls Kanapkey his "main man." Following his 14-hour surgery, Stewart faced rehabilitation and creditsKanapkey for his expertise in helping him. (See

Stewart’s profile on page 6.)Dr. Janet Southerland,

assistant professor ofdental ecology, estimatesthat she and hercolleagues at the UNCDental School see morethan 80 percent of thepatients for evaluationprior to radiation therapy."It's important that apatient's teeth be in goodcondition prior toradiation therapy, whichcan compromise bloodflow to the area andexacerbate existinginfection or gum disease.If there are problems, wecan intervene so that thetreatment regime runssmoothly and effectively.

"If needed, Dr. GlennMinsley, professor ofprosthodontics, builds pros-theses to correct defectscaused by the cancer orcancer surgery. He makesobturators, which areprosthetic devices that closean opening caused by eithercancer or cancer surgery. Hehas constructed prostheticears and eyes as well."

Population-BasedStudies Seek Clues toCancer CausationIn addition to treatinghead and neck cancers,program members areinvolved in studying howcancer starts and factorsthat may initiate cancergrowth. The CarolinaHead and Neck Cancer(CHANCE) study involvesinterviewing 1300 patientswith head and neck

cancers and 1300 without cancer. Dr. Andrew Olshan,professor of epidemiology in the UNC School of PublicHealth and leader of UNC Lineberger's cancerepidemiology program, leads this study. He explainsthat in this project, scientists are studying gene-environment interactions of variations in genes involvedin the metabolism and repair of DNA damage from thetwo major risk factors, tobacco and alcohol. Thisconstitutes the largest population-based molecularepidemiology study of head and neck cancer everconducted in the US.

In addition, the study will evaluate disparities inaccess to health care and the occurrence andtreatment of head and neck cancer among differentethnic groups. A follow-up survivorship study of thepatient group is underway.

Clinical Research Strives to Improve Care and Treatment OutcomesCarol Shores, assistant professor of otolaryngology/head and neck surgery and Lineberger member, isdeveloping a patient clinical database. "We areconducting three retrospective studies," she explained."One, looking at how to determine cancer spread to theliver, and another looking at a cell-type variant thatmakes the cancer more aggressive. Also, we are trackingthe data to determine where our patients come fromand what are their clinical outcomes. Additionally, wejust started a prospective study looking at quality-of-lifeissues for these patients.

"In the future," she explains, "we hope to use thesedata to help us make treatment decisions, based onthe experience and outcomes of the 3100 patients inthe database."

Cachexia, or wasting disease, occurs when cancerpatients lose significant weight due in part to inabilityto eat, but also to other yet unknown causes relatedto the cancer itself. Because many head and neckcancer patients already have compromised nutritiondue to swallowing problems, cancer-related cachexiacauses worsening weight loss and nutritional status,making the patient less tolerant of any type of therapy.Two cachexia projects are underway at UNC. Oneproject involves defining cachexia in the head andneck cancer patient population and the other is a trialof the effect of celecoxib on short term weight loss inhead and neck cancer patients.

The group also is about to open a clinical trial todetermine the effect of an antioxidant-depleted dieton the effectiveness of cancer therapy. One of the

cancerLines Winter 2006 3

UNC Lineberger Head and Neck Cancer Program:

Team Expertise, Individual Patient Focus

Head and Neck Oncology team: Front row (left to right): Dr.Carol Shores, Dr. Marion Couch, Dr. Janet Southerland, MelissaSchroeder, PA, Dr. Valerie Jewells. Second row (left to right): Dr.Neil Hayes, Dr. Julian Rosenman, Dr. Andrew Olshan, Dr. MarkWeissler, Laura Miller, program assistant, Dr. William Shockley,Sylvia Wrenn, nurse coordinator, Dr. Lauren Patton, and Dr.David Morris.

Head and Neck cancers include cancers of the oralcavity (lips, hard and soft palate, tongue, gumsand tonsils); nasal area (nose, nasal cavity andsinuses); upper respiratory (larynx, trachea andmuscles in the neck and upper back); and ear.

IInncciiddeenncceeHead and neck cancers account forapproximately three to five percent of all cancersin the U.S. These cancers are more common inmen and in people over age 50.

RRiisskk FFaaccttoorrssTobacco (including smokeless tobacco) alcohol use are important risk factors. 85% ofhead and neck cancers are linked to tobacco use.Using both tobacco and alcohol increases the riskfor developing these cancers more than usingeither tobacco or alcohol alone.

OOtthheerr rriisskk ffaaccttoorrss iinncclluuddee::Sun exposure (lip)Possibly human papillomavirus (HPV) infectionRadiation to the head and neck fromdiagnostic x-rays or from radiation therapy for noncancerous conditions or cancer.Certain industrial exposures, such as wood or nickel dust inhalation, or airborne particles of asbestos.Poor oral hygienePossibly, the use of mouthwash that has a high alcohol content

CCoommmmoonn SSyymmppttoommssA lump or sore throat that does not healA sore throat that does not go awayDifficulty swallowingA change or hoarseness in the voice

Head and Neck CancerFast Facts

excerpted from the National Cancer InstituteCancer Facts webpage

www.cancer.gov/cancertopics/types/head-and-neck

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Cancer support cells may evolve,fuel tumor growth, study showsUNC Lineberger scientists have demonstrated in aliving organism that cancers may causesurrounding supportive cells to evolve andultimately promote cancer growth.

The new research offers what is believed to bethe first evidence that mutations within cancer cellscan signal surrounding tissue cells to alter theirmolecular composition in ways that promotetumor growth and proliferation.

Moreover, the findings also suggest that cellmutations that promote cancer progression mayarise in cells other than the predominant cancer cell.

The new findings were published as the coverstory in the 12/16/05 issue of the journal Cell.

While not offering immediate application to thetreatment of human cancers, the research indicatesthat new anti-tumor therapies may be moreeffective if their targets are broadened to includemolecules within supporting cells of the cancer.

Dr. Terry Van Dyke, professor of genetics andbiochemistry and biophysics in the School ofMedicine and member of the UNC LinebergerComprehensive Cancer Center, was the study'ssenior author.

Novel enzyme offersnew look at generegulation; UNCscientists' findingshave diverseimplicationsUNC Lineberger scientistshave purified a novel protein

and have shown it can alter gene activity byreversing a molecular modification previouslythought permanent.

In the study, the authors showed that a proteincalled JHDM1A is able to remove a methyl groupfrom histone H3, one of four histone proteinsbound to all genes. Until just last year, the additionof a methyl group to a histone had been regardedas irreversible.

Dr. Yi Zhang was the lead author. Zhang isprofessor of biochemistry and biophysics at UNC'sSchool of Medicine and the university's firstHoward Hughes Medical Institute investigator.

The new study appeared in the 12/18/05 onlineversion of the journal Nature.

"Human genes are so tightly compact within thenucleus that if the DNA of a single cell wereunwound and stretched, it would be a line of abouttwo meters in length," said Zhang. "Histones arenecessary to package the DNA so that it fits insidea cell's nucleus."

Because they are so intimately associated withDNA, even slight chemical alterations of histonescan have profound effects on nearby genes.Depending on the precise location and how many

methyl groups are added, their presence can eitherswitch affected genes on or off.

The implications of the new findings are asdiverse as the proteins that contain a JmjC domain.For example, hair loss occurs in individuals withmutations in the JmjC domain of a protein called"hairless," possibly due to defects in the appropriateremoval of histone methyl groups.

"Given the large numbers of JmjC domain-containing proteins that exist in diverse organismsranging from yeast to human, our discovery willkeep many people in the field busy for the years tocome," said Zhang

Other UNC scientists as well as two fromMemorial Sloan-Kettering Cancer Center wereinvolved in the work.

Less-extensive biopsy methodhelps diagnose progression of large breast tumorsNew research by David Ollila, associate professor ofsurgery at UNC and co-leader of the UNC BreastCenter and leader of the UNC Melanoma Program,showed that women with large breast tumors canbenefit from the less-invasive sentinel lymph nodebiopsy performed before chemotherapy. Theprocedure can help some patients avoid the painand discomfort of full armpit node removal, whichoften causes swelling, numbness and infection.

"We're looking at a way in which the patient hasdefinitive breast cancer and nodal staging beforeshe ever undergoes chemotherapy, so we knowexactly where she starts," Ollila says. "Performingthis procedure before neoadjuvant chemotherapy

BriefsBriefs

Lisa Carey and Matt Ewend give new meaning tothe term "married to your work." They're devoted tocancer research and treatment, and they're devotedto each other. Though this husband-and-wife teamworks in different labs - Carey focuses on breastcancer specifically, while Ewend trains his sights onall forms of cancer in the brain - their workoverlaps in the area of breast cancer brainmetastasis.

More than 200,000 U.S. women deal with breastcancer each year (about 35,000 die from it). But,Carey notes, "improvements in diagnosis andtreatment have produced about a 25 percentdecrease in breast cancer mortality since 1990." Bycontrast, metastatic brain tumors will affect 125,000Americans annually, about 4,000 to 5,000 NorthCarolinians.

"Progress by researchers such as Lisa in treatingbreast cancer, lung cancer and melanoma hasincreased the survival for these patients - that'sgood," Ewend explains. "However, many of thetreatments do not reach the brain, so isolatedrecurrence there is more common. In a way, mywife's good work is making my job harder."

An Indirect PathNeither initially intended to wind up in medicine.Carey's interest was in animals - prehistoric andotherwise. At age five, she was set on becoming apaleontologist ("I was a weird little kid"), but by 12had decided on being a vet. In high school, shesettled on medicine.

Ewend planned to follow hisgrandfather into law, thenconsidered a career as asportscaster ("Lisa says I canalways guess what theannouncers are going to say").In high school, he too chosemedicine.

The two met in the first year of medical school atJohns Hopkins. "We did have adjacent anatomytables," Ewend notes. "Isn't that a creepy story?"Carey quips.

Choosing OncologyCarey originally chose surgery as her specialty. "As Igot into the clinical part of medical school, I realizedthat I hated being in the operating room," sherecalls. "This is a problem for a surgeon."

She switched to internal medicine. "I wasinterested in oncology because it is scientificallyfascinating and because the science was being soquickly translated to benefits for people with thedisease," she notes.

This led to a career in clinical and translationalresearch. "We examine either new drugs or newcombinations of drugs by giving them to womenwith breast cancer to see whether they work," sheexplains. She also applies new technologies or teststhat are developed by her colleagues in thelaboratory "to see what role they might play eitherin diagnosis or treatment decisions."

Ewend went into med school hoping to be anoncologist and became interested in neurosurgeryduring a summer research project. "I saw that Icould combine it with my interest in tumors andfocus on brain tumors," he says.

Today, Ewend's research and clinical interests arein developing new ways to treat patients withcancer that spreads to the brain from other sites."In the clinic, we use combinations of surgery,

radiation therapy and local treatments likechemotherapy wafers to treat brain tumors," hesays. "In the laboratory, we look at the geneticfingerprints of cancers that spread to the brain to seeif we can figure out why they spread and how tobetter treat them."

The Southern Part of HeavenThey chose UNC in Chapel Hill for a number ofreasons. "The opportunities were spectacular here,"he says. "The area and the basketball were just icingon the cake."

Adds Carey, "It is hard to find a place withexcellence and needs in both neurooncologic surgeryand breast cancer. UNC Lineberger provided anincredible clinical research environment and anenvironment that fosters the junior academic faculty.What Matt calls the icing on the cake for me was thatwe could live close to where we work, it's a greattown for our kids to grow up in, and the appeal of acollege town atmosphere." They have three children:two boys, Nash, 10, and Kelly, 8, and a daughter,Abby, 7.•

4 cancerLines Winter 2006

ProfileProfile

Lisa Carey and Matt Ewend

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believe our PRINT particles will lead to new, highlyeffective therapies for the treatment of cancer,including cell-specific targeting of cancer cells tomitigate the side effects of chemotherapytreatments and to improve the efficacy of thetreatments."

Fast, Accurate, PainlessJ. Michael Ramsey, Minnie N. GoldbyDistinguished Professor of Chemistry, is usingnanotechnology to develop point-of-carediagnostic devices that include nano-scale featuresfor diagnosing the efficacy of chemo-therapeutictreatments. "These measurements require adetermination of the concentration of very specificmolecules in certain cells," he explains.

"The devices that we envision must firstseparate the overwhelming number of red bloodcells from the white blood cells," he continues.These "nanofluidics" machines, about the size of aplaying card, will analyze one drop of blood andhave almost instantaneous results on a vast array ofblood measurements.

"Then the white blood cells must be sorted toidentify only a small subset of white blood cellsand finally these sorted white blood cells arechemically characterized to determine the

concentrations of specific molecules or proteins."The concentration of these molecules willdetermine if a particular type of chemotherapy isworking or not.

It is hoped that these labs-on-a-chip, likemodern blood sugar testing devices, will produceresults during patients' office visits using very smallquantities of blood. This will allow physicians tostart each patient on the most beneficialchemotherapy program as fast as possible.

Ramsey is the project's lead investigator. Also onthe team are Ned Sharpless and Lishan Su, whodirect the biological aspects of the project; KlausHahn, who is working on fluorescent biosensorsfor identifying and quantifying specific proteins;and Glenn Walker, who is developing a device forquickly sorting red and white blood cells.

In Good CompanyOther institutions named as Centers of CancerNanotechnology Excellence are: the CaliforniaInstitute of Technology, the University of Californiaat San Diego, Emory University and the GeorgiaInstitute of Technology, the Massachusetts Instituteof Technology and Harvard University,Northwestern University, and WashingtonUniversity in St. Louis.

"The Carolina CCNE provides a means forphysicians and cancer researchers to join forces withphysical scientists," Ramsey says. "The joint venturewill hopefully allow the development of technologiesthat neither could accomplish on their own."•

Carolina Center of Cancer NanotechnologyExcellence team members: front row (left-right)core leaders Drs.Weili Lin, Rehe Liu, and TerryVan Dyke, principal investigator Dr. RudyJuliano, and project leader Dr. Otto Zhou.Second row (left-right) project leadersDrs.Wenbin Lin and Mike Ramsey, and grant co-principal investigator Dr. Joe DeSimone.

makes it easier for the medical oncologist and theradiation oncologist to know exactly what theyneed to do.

"Any woman diagnosed with breast cancershould ask her physician what role this techniquemight play in her overall treatment," Ollila suggests.

The study appeared in the September 2005 issueof the American Journal of Surgery.

Cellular molecule may providetarget for prostate cancer treatmentScientists under the direction of Shelley Earpidentified a molecule, Ack1, that stimulates tumorformation in part by signaling prostate cells to ridthemselves of a tumor-suppressor protein. "Tumorsgrew more rapidly and invaded as if they wereconverted to advanced prostate cancer," Earpexplains.

The study also identified the molecule as apotential target for developing novel drugs againstprostate cancer. In tests involving an experimentaldrug developed by the National Cancer Institutecalled geldanamycin, the Earp team found Ack1activity could be inhibited through interferencewith its molecular interactions.

"Because we found Ack1 is more active inadvanced prostate tumors, and its inhibition blocksexperimental tumor growth," Earp notes, "webelieve Ack1 should be a target for novel drugdevelopment."

The study appeared in the 11/15/05 issue of thejournal Cancer Research.

Altering time of sentinel lymphnode biopsy may improvemastectomy reconstruction processAltering the standard step-by-step procedure fromdiagnosis to surgery to reconstruction can improvethe process for mastectomy patients and helpdetermine if immediate reconstruction is the bestcourse of action.

Key to the new approach is the use of sentinellymph node biopsy (SLNB) performed as anoutpatient procedure a week or so prior tomastectomy, rather than doing the SLNB at thesame operation as the mastectomy andreconstruction.

The approach is beneficial for two reasons, sayslead study author Nancy Klauber-DeMore, assistantprofessor of surgery in UNC's School of Medicineand a member of UNC Lineberger. It eliminates theneed for another operation, axillary lymph nodedissection, or removal of all the lymph nodes underthe armpit. It also will provide better information tohelp patients and physicians determine if post-mastectomy radiation therapy is indicated.

"With the knowledge of the final pathology, thepatient can make more informed decisions indiscussion with the radiation oncologist and plasticsurgeon, to determine whether or not the patientwill need radiation after the mastectomy," Klauber-DeMore said. "This in turn will influence whetheror not the patient should have immediatereconstruction. We also know definitively if thepatient needs an axillary lymph node dissection atthe time of mastectomy."

The study appeared in the October 2005 issue ofthe American Journal of Surgery.•

mouse models of brain tumors. Thismultidisciplinary team works very closely to solvethis highly challenging problem."

This development could be a boon to braincancer patients. "Few imaging and therapeuticagents can readily cross the blood brain barrier,"Lin notes. "New approaches are desperatelyneeded."

Faster, Smaller, BetterOtto Zhou, Lyle Jones Distinguished Professor,Department of Physics and Astronomy, is theprincipal investigator for a project using nanotubesmade of a single layer of carbon atoms to createclearer x-rays faster.

"One of the unique properties of the carbonnanotubes is that they can generate electronswithout high-temperature heating," he explains.This "cold" electron technology has the potential tochange the way x-ray radiations are generated.

There are two potential benefits of thisapplication. "The technology can lead to better x-ray sources and imaging systems which aresmaller, faster, and more accurate than today'scommercial devices," Zhou explains. "For cancerpatients, the technology has the potential toprovide earlier detection at lower x-ray doses."

Get It In PRINTA new method called PRINT (Particle ReplicationIn Non-wetting Templates) allows researchers touse techniques traditionally used by the electronicsindustry for making transistors to create nano-carriers for the detection, diagnosis and treatmentof cancer.

"PRINT appears to be a platform technologythat allows us to make particles absolutely uniformin size and shape," explains Joe DeSimone, co-principal investigator for the grant. "PRINTparticles can be made from just about any material(biocompatible, bioabsorbable), can contain anycargo (imaging beacon, small moleculetherapeutic, protein, nucleic acid, viruses), and canbe surface-functionalized with almost anytargeting substances (proteins, cell-targetingpeptides, aptamers, etc.)."

The uniformity of PRINT particles stands instark contrast to traditional state-of-the-artdelivery approaches (including liposomes,micelles, dendrimers and other macromolecules)which are complex mixtures yielding veryheterogeneous and often not shelf-stableformulations. "The uniformity of PRINT particleswill raise the standard for particle technologies inregard to uniformity and efficacy, much in the wayenantiomeric purity (or uniformity) of drugs isnow the standard for today," says DiSimone, whois the principal investigator for two PRINTprograms within the grant.

Using PRINT, DeSimone and his team expect toimprove the detection limits for cancer, includingthe diagnosis and location of the proliferation. "We

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main drugs used in chemotherapy for head and neckcancers, cisplatin, works by producing oxidativestress in cells. This stress - DNA damage- is what killscancer cells. If patients are taking antioxidants, suchas Vitamins A, C and E, they may be rendering theirtherapy less effective.

Study patients will be fed either a diet depleted inantioxidant Vitamins A, C and E or a diet thatincludes these antioxidants. Scientists will thencompare treatment responses to see if taking theantioxidants alters efficacy.

The UNC Head and Neck Cancer Programconducts clinical trials of several new drugs. Said Dr.Neil Hayes, assistant professor of medicine, "Our goalis to be able to offer not only the best standard of carefor our patients, but access to new and developingcancer therapeutics. We do this by offering interestedpatients participation in one of a number of clinicaltrials investigating the most promising treatments inhead and neck cancer."

"Our program is investigating head and neckcancer from all angles," concludes Dr. Weissler. "Weprovide excellent care, effective patient and familysupport, and are conducting innovative work inclinical trials and epidemiology."•

UNC Lineberger awardedits 2005 Oncology Nursingand Clinical ServicesExcellence Awards to threestaff members in recognitionof their extraordinary hardwork, care and dedicationthat they bring to the centereach day.

Elaine Bryant won theClinical Services ExcellenceAward, and nurses Carol Marlowe and SusanMcKenney won the Oncology Nursing ExcellenceAwards. Bryant is the executive assistant to the cancercenter's administrative director, Bobbi Marks. Marlowe,RN, has worked at UNC for 15 years, most recently inthe Bone Marrow Transplant Unit. McKenney, a nursepractitioner, has worked with the multidisciplinarybreast cancer group since its inception in 1993.

The Oncology Nursing Excellence Awards are intheir fourth year at UNC. Winners receive a $1500stipend along with the award to be used towardsprofessional education activities. The award wasnamed in memory of Charmayne S. Gray, anoutstanding oncology nurse practitioner who died inan auto accident in 2002. The Clinical ServicesExcellence Awards are in their second year.•

The physicians at the Multi-disciplinary Thoracic OncologyProgram (MTOP) at UNC have onebasic premise in their approach tobattling lung cancer: Every patientcan be helped.

"These days, there are manytreatments and therapies availablethat can cure patients who have lungcancer," said Dr. Richard Feins,professor of thoracic surgery."Certainly, not all lung cancer can becured, but we can extend life andenhance the quality of that life forpatients. Every cancer is treatable." Dr. Feins came toUNC this summer from the University of Rochester.

MTOP offers leading-edge medical care to patientswith thoracic malignancies, including cancers of thelung, esophagus, thymus, chest wall andmediastinum.

This year, MTOP celebrates its 10th year ofdistinguished service to the citizens of North Carolina.

"The program's approach to treating patients isunique. Here at UNC, we have assembled a team ofexperts in the areas of pulmonary medicine, surgery,medical and radiation oncology, thoracic radiology,pathology, oncology nursing and patient counseling,"said Dr. Mark Socinski, associate professor ofmedicine. "Together, our team tailors a plan for eachpatient so that his or her treatment is individualized,coordinated and delivered in a sensitive manner."

At MTOP, the first person patients speak with isGinny Ditzel, the program assistant. She schedulestests and appointments and smoothes the way fortheir visits to UNC.

Patients receive coordinated care through the nursecoordinator, Ann Steagall, as they move among thedifferent medical specialties and among phases oftreatment and follow up. And because their doctors

practice at one of the leading academic medical centersin the country, patients have access to technologicaladvances, new therapies and clinical trials.

"MTOP physicians are committed to clinicalresearch to advance care and increase therapeuticoptions for patients," explained Socinski. "We striveto treat as many of our patients as are eligible onleading-edge clinical trials."

"When we established MTOP, we established anew standard of care and responsiveness for doctorsand patients in the community," said Dr. M. PatriciaRivera, associate professor of medicine. "Whenever aphysician in the community calls us, we help. That'sour mission, to serve the health care needs of patientsand the professional needs of physicians throughoutthe state."

For more information about the program or to makean appointment, visit: www.unclineberger.org.•

The MTOP team: Front row (left-right) Ann Steagall, nursecoordinator; Dr. Richard Feins, program co-leader; Dr. M.Patricia Rivera, program co-leader; Dr. Mark Socinski, programco-leader. Second row (left-right): Dr. Neil Hayes, Dr. Tom Egan,Dr. Tom Stinchcombe, Tammy Allred, protocol nurse, MaureenTynan, protocol nurse, Ginny Ditzel, program assistant. Notpictured is Dr. Jan Halle, program-co-leader.

6 cancerLines Winter 2006

Thoracic Oncology ProgramTurns 10

Front row (left-right) Dr. ShelleyEarp, UNC Lineberger director;award winner Carol Marlowe; BobbiMarks, administrative director, UNCHealth Care Oncology services;Elaine Bryant, award winner; SusanMcKenney, award winner; Dr. BenCalvo, chief, surgical oncologydivision and co-leader, GI CancerProgram. Second row: (left-right) Dr.Tom Shea, director UNC Bone

Marrow and Stem Cell Transplantation Program; Dr. Rich Goldberg,associate director, UNC Lineberger and director, oncology services, UNCHealth Care.

David B. Anderson is the new associatedean for Advancement and president ofThe Medical Foundation of NorthCarolina, Inc. He succeeds James L.Copeland who retired after 15 years. TheMedical Foundation is the fundraisingarm for the UNC School of Medicine andthe hospitals that comprise UNC HealthCare.

Anderson comes to UNC having justserved as the associate vice chancellor for

University Development at NorthCarolina State University. Previously,Anderson also was the executive directorof Medical Center Development at DukeUniversity and has held major fundraisingpositions at Rice University, the Universityof Pittsburgh and the University ofVirginia.•

Head and Neck Cancercontinued from page 3

2005 Oncology Nursing and Service Awards

David Anderson Named Medical Foundation President

Herman SStewart first hadcancer in 1987, but radiationto destroy the tumor that wason his vocal cords cured hisdisease. In 2004, after severalmonths of not feeling well,

he went to his doctor for what seemed to bebronchitis. When multiple courses of antibioticsdid not resolve the problem, he asked to see aspecialist. The specialist sent him to UNC to seeDr. Carol Shores who found a second cancer in thehypopharynx, behind his vocal cords.

He underwent a 14-hour surgery during whichhis voice box and upper portion of the swallowingtube were removed. His esophagus wasreconstructed using part of his small intestine,restoring his swallowing function. He underwentfurther surgery to stretch the new esophagus toimprove his ability to swallow. He worked withspeech pathology and swallowing therapist BrianKanapkey to learn how to use his speechassistance device and to swallow. “Brian wasencouraging, and thanks to him and the LordJesus I am functioning well.”

Recently elected president of his SundaySchool class, Herman and his wife Sylvia live inKings Mountain, NC with their four daughtersand their families close by. He retired from truckdriving in 1998. "These folks at Chapel Hill knowwhat they're doing. What I would tell anyone isthat if you have a problem, get it checked outsooner rather than later."•

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TTiicckklleedd PPiinnkk LLuunncchheeoonnss RRaaiissee OOvveerr $$5555,,000000Led by Margie Haber and Missy Julian-Fox,30 dedicated volunteers from Chapel Hilland Durham presented two incredibleTickled Pink luncheons to raise money forresearch for women’s cancers. The first washeld on October 6 at Squids Restaurantand the second on October 11 at GallowayRidge at Fearrington Village. Thanks totheir tremendous efforts, generoussponsors and an extremely supportivecommunity, Tickled Pink raised over$55,000!

Tickled Pink participant Rebecca Clark and organizing committee member Dianne Pledger.

PPaarrttyy FFaavvoorrss SSeenntt ttoo GGuullff CCooaasstt CCaanncceerr PPaattiieennttssCancer patients displaced by Hurricanes Katrina and Rita were"tickled pink" by gifts from women in the Triangle community.Close to 1000 gifts were sent to patients at treatment centers inLouisiana and Alabama from UNC Lineberger ComprehensiveCancer Center.

Tickled Pink organizers asked the 450 women attending thetwo luncheons to bring party favors rather than receive them,stating that their gifts would be sent to cancer patientsundergoing therapy who were forced to get their treatmentelsewhere because of the storms. Sheri Logan of MIX 101.5

heard about this effort and asked listeners to bring fun items to the station for patients. Logan attended theevent bringing two huge baskets filled with gifts.

Over 160 pounds of gifts including slippers, hats, handbags, socks, scarves, inspirational books,candles, jewelry, and toiletries were delivered to several cancer centers in Louisiana and Alabama.

Pictured (left-right) are Tickled Pink co-chairs Margie Haber and Missy Julian-Fox with the party favorssent to Gulf Coast cancer patients.•

7cancerLines Winter 2006

UNC Lineberger Comprehensive Cancer Center will host the third annual Beach Ball on Saturday, April8, 2006 in Center Court of University Mall in Chapel Hill. Please plan to be a part of this year's event!

The 2005 event was a huge success, attracting 680 guests and raising over $100,000for cancer prevention, treatment and outreach programs. This year's event will

again feature live music by East Coast favorite "Liquid Pleasure", great food,a silent and live auction, and a chance to dance the night away with your

family and friends.

Look for your invitation at the beginning of March. Tickets can bepurchased in advance for $60. Online registration will be availablethrough our website in March at www.unclineberger.org.•

Missy Julian-Fox, Jamie LaForce, General Manager, Squid'sRestaurant, Margie Haber, and Greg Overback from ChapelHill Restaurant Group.

UNC Lineberger Board of Visitors chair Anne Cates(left) and vice chair Edwina Woodbury (right) visitwith Nancy Brinker, founder of the Susan G. KomenBreast Cancer Foundation. Brinker spoke on thepower of ideas and individual determination duringthe Leader-In Residence program at Chatham Hall inChatham, Virginia last fall.

SSoollee SSiisstteerrss HHoolldd FFiivvee-YYeeaarr RReeuunniioonnThe Sole Sisters program celebrated its five yearreunion on Saturday, October 15, 2005 at the Williamand Ida B. Friday Center. Over 500 women haveparticipated since 2001. Representatives from all fiveyears attended the reunion and participated in a two-mile walk followed by breakfast, a silent auction andraffle for prizes donated by local businesses. Guestspeakers included Shelley Earp, MD, DirectorLineberger Comprehensive Cancer Center, ElizabethHopkins, President, Board of Directors, Girls on theRun and Jeanne Peck, Susan G. Komen Foundationand founder of the NC Triangle Race for the Cure.The Sole Sisters program provides education,motivation and support for women to begin andmaintain a regular exercise program and raisesawareness for breast cancer screening, prevention andtreatment.

Shown here are "Coach" and founder Judy Swaseyand 2002 Sole Sisters participant Diana Steele.•

SSiisstteerrss’’ NNeettwwoorrkk HHeeaalltthh FFaaiirrUNC Lineberger participated in the October 2005Sisters' Network Health Fair. Drs. Don Baucom,Laura Porter and their team took part to promotetheir breast cancer partners support program. UNCBreast Center nurse coordinator Beth Fogel answeredquestions for participants and UNC Lineberger breastcancer survivor Senator Jeanne Lucas was the guestspeaker. Pictured (left-right) are Beth Fogel, DurhamMayor Bill Bell, and Sisters' Network leader MaryJackson, UNC Lineberger BMT social worker andbreast cancer survivor.•

LLiigghhtt tthhee NNiigghhttTeam UNC Lineberger, led by captains TammyAllred and Rey Garcia, participated in and served asa sponsor for the Eastern North Carolina Leukemia& Lymphoma Society's "Light the Night" event inRaleigh on September 24. Dawn Hardison, a formeremployee in the oncology clinic, a cancer survivorand winner of last year's UNC Lineberger ClinicalServices Excellence Award, was one of the featuredspeakers at the event. A number of UNC patientsalso took part in the event.•

on Saturday, April 8thon Saturday, April 8th

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improving the lives of cancer patients and to preventing the disease andhaving it diagnosed early.

Chad Holbrook, father of Reece Holbrook, a pediatric cancer patientbeing treated at UNC Lineberger, talked about how he and his wife,Jennifer, discovered Reece's cancer and described Reece's treatmentregimen. (To read about Reece’s experience, go towww.nccancerstories.org.) Chad Holbrook is the UNC assistantbaseball coach while Jennifer works in the UNC men's basketballoffice.

The "Voice of the Tar Heels," Woody Durham, served as master ofceremonies and led a spirited auction that brought in almost $16,000!One of the few remaining, autographed basketballs from the 2005National ChampionshipTeam went for $5,000 -the most Woody hadever seen a for a signedbasketball.

Special thanks to PPD,the presenting sponsor ofthe event. The otherinaugural sponsors wereAtlantic Corporation,Curtis Media Group, andGlaxoSmithKline.•

Close to 300 peopleattended the first annualFast Break Against Cancer.The event was held on thefloor of the Dean E. SmithCenter on Friday, October14. The seated breakfast wasco-sponsored by UNCLineberger ComprehensiveCancer Center and theAmerican Cancer Societyand raised $90,000 tosupport cancer research inour community.

The event was the kick offto the day's activities for "Late Night with Roy Williams" and featured ashowing of "One Shining Moment" celebrating the 2005 NationalChampionship on the new video walls.

Coach Williams opened his talk by asking the audience how manypeople had had cancer or knew someone who did. All but a few of theparticipants raised their hands. "That's why we're holding this event," hesaid. "Cancer has touched almost every one of us.

"Cancer is a huge battle, a battle we must fight with the best science andthe best therapies. It's a battle we must win."

Event chair Mary Seagroves, a Chapel Hill breast cancer survivor, shared hercancer experience and stressed why cancer research is so important to

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8 cancerLines Winter 2006

calendarof eventsA P R I L 2 0 0 6

8th Third Annual Beach Ball,University Mall, Chapel Hill, NC

21st UNC Lineberger Board ofVisitors Meeting, Chapel Hill, NC

24-25th 30th AnnualScientific Symposium. Chapel Hill, NC

J U N E 2 0 0 6

10th NC Triangle Komen Race for the Cure, Raleigh, NC

UNC Lineberger Comprehensive Cancer CenterCB# 7295School of MedicineUniversity of North Carolina at Chapel HillChapel Hill, NC 27599-7295(919) 966-5905www.unclineberger.org

Return Service Requested

Nonprofit OrganizationU.S. Postage

PAIDPermit No. 71

Chapel Hill, NC 27599-1110

Coach Roy Williams with event chair Mary Seagroves

First Annual Fast Break Against CancerRaises $90,000 for Cancer Research

Fast Break attendees UNC LinebergerBoard of Visitors member Lillian Lee

from Chapel Hill and former UNCmen's basketball player King Rice.

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