Genomics a focus of Plenary scientific lectures

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Dirk Elston, MD

Proof that genomics is playing a much larger role in medical treatments in general and cancer treatments in particular can be seen in four scientific lectures that will be presented at the Sunday Plenary session, from 8 a.m. to noon in the Bellco Theatre. Another lecture will look at the changing role of dermatology in light of health system reform.

The Plenary will feature addresses by AAD President Dirk Elston, MD, and President-Elect Brett Coldiron, MD. Scientific lectures that will be presented are the Clarence S. Livingood, MD, Award and Lectureship; the Eugene J. Van Scott Award for Innovative Therapy of the Skin and Phillip Frost Leadership Lecture; the Lila and Murray Gruber Memorial Cancer Research Award and Lectureship; the Marion B. Sulzberger, MD, Memorial Award and Lectureship; and the Guest Speaker.

Clarence S. Livingood, MD, Award and Lectureship

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Jack S. Resneck, Jr., MD

Jack S. Resneck, Jr., MD, will examine the challenges that lie ahead for dermatology when he presents the Clarence S. Livingood, MD, Lectureship, “The Future of Our Specialty in a Time of Unprecedented Change.”

Dr. Resneck said he believes evolving payment and delivery systems will compel dermatologists to demonstrate their value, work more closely with others, and develop methods to measure their own quality. He also will talk about how unsustainable health care cost structures will force dermatologists to identify areas where resources are wasted to protect the services and treatments that truly improve patient health.

In the near future, growing demand for care, expansion of nonphysician practice, and disruptive technologies will give patients opportunities to turn elsewhere for management of skin diseases. The traditional funding streams for dermatology’s educational and research infrastructures will likely face additional pressures, said Dr. Resneck, associate professor of clinical dermatology, department of dermatology and the Institute of Health Policy Studies, University of California, San Francisco.

He also will discuss how AAD members will have opportunities to reinforce the importance of dermatology and avoid being marginalized and commoditized, but also how continuing to thrive will demand that they engage in designing their own bright future. The specialty will provide the best care for patients for years to come, but he believes dermatologists have much work ahead to adapt in this time of extraordinary transition.

Eugene J. Van Scott Award for Innovative Therapy of the Skin and Phillip Frost Leadership Lecture

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Ervin H. Epstein Jr., MD

Decades of research have linked mutations in the PTCH1 gene to Gorlin syndrome, a heritable disorder that can lead to the development of large numbers of basal cell carcinomas (BCCs). On the heels of that research has come the development of vismodegib, a BCC treatment that holds great promise.

Ervin H. Epstein Jr., MD, a renowned dermatologist and researcher involved in these discoveries, will discuss his study of the mutations and the promise of vismodegib for treatment when he presents the Eugene J. Van Scott Award for Innovative Therapy of the Skin and Phillip Frost Leadership Lecture, “Thwacking the Hedgehog.”

“Our double-blind, randomized trial showed that basal cell carcinomas in patients with Gorlin syndrome who were taking this drug had, in all fairness, a dramatic response to the drug,” Dr. Epstein said. “It is very clear the drug has quite spectacular inhibitory effects on the growth of basal cell carcinomas in these patients.”

In his lecture, Dr. Epstein, senior scientist at Children’s Hospital Oakland Research Institute, Oakland, Calif., will discuss his years of genetic research that found similarities between retinoblastoma and a number of cancers, including BCC, and the role of the PTCH gene, which acts as a primary inhibitor of the Hedgehog signaling pathway. Dr. Epstein also was a long-time faculty member at the University of California, San Francisco, and a president of the Society for Investigative Dermatology.

Lila and Murray Gruber Memorial Cancer Research Award and Lectureship

Lynda Chin, M.D., Science Director,  and Giulio Draetta, M.D., Ph.D.. Director, of the Institute of Applied Cancer Science

Lynda Chin, MD

Advances in genomics have revolutionized cancer treatments in recent years, but these changes often have not been adopted by many physicians because of their complexity. The Lila and Murray Gruber Memorial Cancer Research Award and Lectureship will look at advances in areas of melanoma genomics and therapies, and a prototype online decision support system powered by IBM’s Watson computer to better share them with practitioners.

“Half of my talk will be on advances in melanoma genomics. The second half will be on how technology and innovations can help us address some of the challenges facing our health care system,” said Lynda Chin, MD, who will present “Genomic Medicine: Transforming Research and Patient Care.”

“A lot of that sharing of information has to do with leveraging technology, changing how we think about research versus clinical care, and then bringing those two enterprises together because they tend to be in silos in academic medicine,” said Dr. Chin, professor and chair of genomic medicine and scientific director of the Institute for Applied Cancer Science at the University of Texas MD Anderson Cancer Center, Houston.

In her discussion of melanoma, Dr. Chin said she will focus on how cancer genomics have changed the understanding, study, and management of this disease, which she called “the poster child for genomic-based therapy and immune-based therapy.”

The key to improving outcomes, though, lies in communicating information about new therapies to practicing physicians. MD Anderson is working with IBM to develop the Oncology Expert Advisor, a clinical decision support tool powered by the renowned Watson computer that beat two humans on the television show Jeopardy, and Dr. Chin will discuss the promise of that venture.

Marion B. Sulzberger Memorial Award and Lectureship

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Anthony Eugene Oro, MD, PhD

For more than a decade, medical researchers have focused much of their work on the promise of using stem cells to repair systems and organs ravaged by cancer. Today, researchers are unlocking more mysteries about the many diverse factors linked to the evolution of cells that can inhibit cancers or cause them to grow.

In his Marion B. Sulzberger Memorial Award and Lectureship, “Heal Thyself: Using Stem Cell Biology for Skin Diseases,” Anthony Eugene Oro, MD, PhD, will discuss these recent discoveries about the development of stem cells and their effect on the skin.

“There are a number of molecules that regulate the stem cells to make the skin in its current form. You have stem cells and you need to cook them in a certain way to have them create the skin the way you want them,” said Dr. Oro, professor of dermatology at Stanford University Medical School. “There are a finite number of these key regulatory molecules that are required in different orders and amounts to come out as you want them. It’s like a recipe where you have eggs, flour, milk, and baking soda, and you can make an omelet or bread depending on the order and the amount of each ingredient.”

Among the factors influencing stem cells that he will discuss are the Hedgehog pathway, which plays a key role in creating hair follicle stem cells, but with a few extra ingredients turns them into basal cell carcinomas, the most common skin cancers.

Dr. Oro also will discuss the Polarity pathway, which can help BCCs elude cancer-inhibiting agents, but also is a target for peptides to block this escape pathway and treat resistant BCCs.

Guest Speaker

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David C. Page, MD

Over the years, some researchers have developed the “rotting Y” theory, which predicts the eventual extinction of the Y chromosome because it has lost hundreds of genes in the past 300 million years. Scientist David C. Page, MD, will challenge that and other conceptions of the X and Y chromosomes in “Rethinking the Pristine X and Rotting Y Chromosomes.”

What is the importance of this chromosome debate? Several diseases outside the reproductive tract, including scleroderma, rheumatoid arthritis, and autism, are more common or severe in women or men, or vice versa, said Dr. Page, director of Whitehead Institute for Biomedical Research, professor of biology at Massachusetts Institute of Technology (MIT), and Howard Hughes Medical Institute Investigator.

“We don’t know why that’s the case, and there are very few researchers addressing the question, but I predict this will be an increasingly important topic of research and exploration in the coming years,” he said. “And I have a strong hunch that the X and Y chromosomes will be leading protagonists in the story that is eventually told.”

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