From a first-in-class kidney cancer drug to the development of new surgical and radiation approaches, a uniquely collaborative environment catalyzes transformative research.
Recognized by the National Cancer Institute with a prestigious Specialized Program of Research Excellence (SPORE) Award along with the Harvard Cancer Center.
Recognized by D CEO Magazine and Dallas Innovates for its innovation and transformational creativity as a finalist for the inaugural 2020 Healthcare Innovation Award.
Expertise Improving Survival
Patient survival rates three times higher for stage 4 kidney cancer and exceeding national benchmarks across all stages.
Supportive care and services helping patients navigate the cancer landscape while creating a sense of community.
Dr. Janie Qin receives $1M Frenkel Endowed Scholar Award
Janie Qin, M.D., Assistant Professor of Internal Medicine/Hematology-Oncology and Kidney Cancer Program (KCP) member, was awarded the Eugene P. Frenkel, M.D., Endowed Scholar Award in Clinical Medicine to support the development of novel radiology tests for kidney cancer patients.
Dr. Qin joined the Simmons Comprehensive Cancer Center and KCP upon completing her fellowship in Hematology and Medical Oncology at the Icahn School of Medicine at Mount Sinai, New York, in September 2021. With the $1 million award, Dr. Qin will be driving the development of new molecular probes to characterize kidney cancer in patients.
Dr. Qin is currently co-principal investigator of two clinical trials evaluating novel radiology probes. A PD-L1 probe seeks to evaluate the expression of this most important checkpoint protein in kidney cancer patients and assess its potential in predicting response to immunotherapy (NCT04006522). A second trial focuses on the evaluation of HIF-2α in tumors (NCT04989959). HIF-2α is the target of belzutifan, an FDA approved drug for the treatment of familial kidney cancer, which was developed by Peloton Therapeutics in the UTSW BioCenter based on lead compounds discovered at UTSW. Previous research by the Brugarolas Lab suggests that HIF-2α levels in tumors may be predictive of response to drugs such as belzutifan. Both studies represent a partnership with Xiankai Sun, Ph.D., Director of the Cyclotron and Radiochemistry Program, who is synthesizing the probes.
Dr. Qin follows on the footsteps of Hans Hammers, M.D., Ph.D., Associate Professor of Internal Medicine/ Hematology-Oncology, KCP Co-Leader of Immunotherapy, and inaugural recipient of the Frenkel Scholar Award.
“Janie is a most meritorious recipient working on a cutting-edge research area and we are delighted of her selection by the Frenkel Award Committee,” said KCP Director, James Brugarolas, M.D., Ph.D. “Awards like this are instrumental in launching the careers of junior faculty and enable us to recruit investigators with the greatest promise.”
International partnership evaluates UTSW-developed approach to locally advanced kidney cancer
Up to 15 percent of kidney cancer patients are diagnosed with tumor thrombus, a locally advanced form of the disease where the tumor extends into the renal vein progressing sometimes into the inferior vena cava (IVC), the body’s largest vein. Once in the IVC, the tumor has open passage to the heart.
Surgery is the standard of care, but operating on such tumors is challenging, particularly if they have reached the heart. One third of the patients experience complications and mortality can be as high as 15 percent.
“These extensions can be problematic. They can block drainage of the blood into the heart causing backup, liver congestion, and swelling,” says Vitaly Margulis, M.D., a urological surgeon with expertise in this type of surgery.
In 2015 , Kidney Cancer Program (KCP) investigators developed a novel approach involving stereotactic ablative radiotherapy (SAbR). By targeting the tumor thrombus with high doses of radiation delivered from multiple angles, researchers were able to show that tumor thrombus could be controlled.
While the approach is still being evaluated in a clinical trial at UTSW (NCT02141919), an unmet medical need has led to its early adoption by institutions across the world.
A recently published report chronicles initial findings from the global experience. Fifteen patients with a tumor thrombus reaching the IVC were treated with SAbR at six leading centers in the US, UK, Italy and Australia. In 50 percent of patients the tumor thrombus approximated or invaded into the heart. About half of the patients were poor candidates for surgery and in 20 percent the tumor came back after surgery.
SAbR controlled the tumor thrombus in over 80 percent of patients relieving them from symptoms including liver congestion, swelling, bleeding and pain. While medication therapy may have contributed to thrombus control, similar benefit was observed in a subset of patients that received only SAbR.
“We are delighted to see that our pioneering efforts are benefiting patients across the world,” said Raquibul Hannan, M.D., Ph.D., co-Leader of radiation oncology at the KCP.
“This is an example of the innovation and team approach that characterizes the KCP,” said Kidney Cancer Program Director James Brugarolas, M.D., Ph.D.
DoD awards $1.3 million to UTSW investigators for kidney cancer research
Two UTSW Kidney Cancer Program investigators have been awarded more than $1.3 million in research funding from the Department of Defense Congressionally Directed Kidney Cancer Research Program.
Peter Ly, Ph.D., Assistant Professor of Pathology and Cell Biology, received an Early Career Investigator Award for $1,189,000 to explore how recurrent chromosomal abnormalities drive the development of clear cell renal cell carcinoma (ccRCC), the most common form of kidney cancer.
Gopinath Prakasam, Ph.D., a Postdoctoral fellow with the Brugarolas Lab, received a Concept Award for $123,000 to assess a novel therapeutic approach against translocation renal cell carcinoma (tRCC) a rare and highly aggressive subtype of kidney cancer largely found in children and young adults.
Pioneer in kidney cancer radiation and long-term KCP collaborator named new chair of radiation oncology
An expert in diseases of the central nervous system, including cancer of the brain and spine, as well as lung cancer, Dr. Timmerman has championed the use of precise, noninvasive radiosurgical tools to deliver radiation. He is credited for leading the development of stereotactic ablative radiotherapy (SAbR), also called stereotactic body radiation therapy (SBRT), which uses sophisticated image guidance and tracking to improve radiation therapy. This seminal contribution is widely regarded to have transformed the field of radiation oncology.
Dr. Timmerman has spearheaded new applications of radiation therapy for kidney cancer, most notably the first report for SAbR for inferior vena cava (IVC) tumor thrombus.
Beyond the conventional uses for bone and brain metastases in the Kidney Cancer Program (KCP), SAbR is being investigated for the treatment of small renal masses; tumor thrombi ˗ regionally advanced tumors that have grown into the IVC; oligommtastases, oligoprogression, and in combination with immunotherapies. Most recently, radiation oncology efforts have centered around PULSAR, a strategy that seeks to maximize the immunological effects of radiation therapy.
Dr. Timmerman joined UT Southwestern in 2004 as Professor and Vice Chair for Clinical Affairs in the Department of Radiation Oncology and Director of the Annette Simmons Stereotactic Treatment Center. He also served as Director of Clinical Research since 2014.
He graduated from Iowa State University with a bachelor’s degree in nuclear engineering and from the University of Tennessee with a master’s degree in reactor physics. After finishing medical school at the University of South Dakota, he completed a residency in Radiation Oncology at The Johns Hopkins Hospital.
He is a Fellow of both the American Society for Radiation Oncology and the American College of Radiology. In 2019, Dr. Timmerman received the Patricia and William L. Watson Jr., M.D. Award for Excellence in Clinical Medicine.
Higher doses of cabozantinib may offer hope to kidney cancer patients with few other options
Metastatic kidney cancer is largely incurable. Despite the growing landscape of available drugs, most tumors eventually develop resistance, with each successive line of therapy generating progressively lower returns. Some patients eventually run out of options. Investigators with the Kidney Cancer Program (KCP) at UT Southwestern’s Harold C. Simmons Comprehensive Cancer Center report that increasing the dose of an already FDA-approved medication may benefit some patients.
Cabozantinib (Cabometyx®), is one of the most potent drug therapies currently available for kidney cancer and is administered at 60 mg daily. In a manuscript published today, KCP investigators report that increasing cabozantinib by 30% controlled tumors that had progressed on the drug’s conventional dosing. Investigators found that increasing to 80 mg kept kidney cancer under control for up to 2.5 years.
“This higher dose of cabozantinib is not that different from what is used for thyroid cancer,” said Roy Elias, M.D., an author on the report who is a former KCP researcher and is currently a medical oncology fellow at Johns Hopkins Sidney Kimmel Cancer Center.
As part of the study, investigators reached out to 14 leading kidney cancer institutions, both domestic and internationally, and identified a Canadian program that had attempted a similar strategy. Tackling the same dilemma of lack of treatment options, Dr. Georg Bjarnason, M.D., medical oncologist and senior scientist at Odette Cancer Centre in Toronto, deployed the same dose-escalating approach for patients, observing similar success.
Investigators noted that the strategy is unlikely to work for patients with primary resistance and can only be attempted in patients who tolerate the standard 60 mg dose.
UTSW kidney cancer patient Kerry Gabel was one of half a dozen patients who benefited from the approach. A high school golf coach and father of two teenage daughters, Mr. Gabel was diagnosed with stage IV kidney cancer in 2016. A textbook case, Mr. Gabel experienced drug resistance on 4 therapies, including dual immunotherapy, prior to starting cabozantinib in 2018. He was on conventional doses of cabozantinib for over a year, but his disease progressed. At that point, he had progressive disease in the lung, suspected liver involvement, and one of the chest metastases appeared to invade the heart. He also developed several brain metastases. Brain metastases were treated with radiosurgery and after a discussion, and given limited availability of other treatment options, the patient elected to increase cabozantinib to 80 mg. Today, 2.5 years later, his cancer remains under control and his overall burden of disease is lower than at the outset.
“The findings suggest that this strategy could be helpful for some patients,” said Kidney Cancer Program Director James Brugarolas, M.D., Ph.D., “but clinical trials will be needed to formally evaluate the potential of the approach.”
Clinical Trial Development
KCP investigators are currently designing a trial to evaluate the effectiveness of cabozantinib 80 mg in kidney cancer patients progressing on conventional doses. The trial is anticipated to open in the last quarter of 2022 at the UTSW Simmons Comprehensive Cancer Center and at Baylor Scott & White Charles A. Sammons Cancer Center, both in Dallas.
Kidney Cancer Patient Story – Kerry Gabel
Husband, father, and high school PE teacher Kerry Gabel shares his story on battling aggressive metastatic kidney cancer and how increasing a medication beyond the conventional dosage saved his life when he was running out of treatment options.
CPRIT awards more than $2 million in research funding to UTSW kidney cancer investigators
Thomas Carroll, Ph.D., received $1,040,229 to study the underlying mechanisms of sarcomatoid differentiation in renal cell carcinoma. Satwik Rajaram, Ph.D., was awarded $1,172,136 to dissect intratumor heterogeneity in kidney cancer using deep learning AI (artificial intelligence).
In total, CPRIT awarded 74 cancer research and prevention grants, of which 65 were for academic research being conducted at 10 institutions. Among the 65 investigators awarded, 16 were from UTSW, garnering more than $17 million in combined research funding.
Dr. Satwik’s award was one of only three academic research grants bestowed for computational systems biology, spotlighting UTSW’s efforts on behalf of kidney cancer in this area. PRESS RELEASE
Scott Schwartzman, M.D., joins KCP as Co-Leader of Education
William Scott Schwartzman, M.D., third year Internal Medicine Resident, has joined the UTSW Kidney Cancer Program (KCP) leadership team as Co-Leader of Education. Dr. Schwartzman has been a collaborating researcher with the KCP for the past three years. In his new leadership role, he will help recruit and train medical students, resident scholars, and early-career physicians. He will assist in identifying laboratory and clinic mentors, build mentoring teams, and develop educational opportunities for trainees.
“I’m excited to step into this new role,” said Dr. Schwartzman. “It’s a great opportunity to introduce trainees to the different types of research that the KCP facilitates. As a new intern, the program provided me with outstanding mentorship and learning opportunities. Going forward, I hope to help build enthusiasm around translational and clinical research and do my best to maintain the high levels of productivity within the kidney cancer program.”
Expanding the pool of investigators with translational research knowledge is a key focus area for the KCP. This position plays an instrumental role in supporting and training clinicians looking to build careers as researchers.
“There’s a growing demand for a new generation of physicians with the skillsets to conduct rigorous scientific research,” said KCP Director James Brugarolas, M.D., Ph.D. “Among our long-term goals is to help build a sustainable workforce of physician-scientists who will make and translate kidney cancer discoveries that lead to improved health.”
Dr. Schwartzman, who will be joining the Hematology Oncology Fellowship Program at UT Southwestern, has co-authored several research publications including studies on the use of active surveillance in patients with indolent kidney cancer and predictors of response to immunotherapy.
Dr. Schwartzman earned his M.D. from the Keck School of Medicine of USC. He began his training in internal medicine at UTSW in 2019.
CenterTimes: Addressing the most feared kidney cancer complication
Kidney cancer has the unusual ability to use blood vessels as channels for growth. In about 15% of cases, the tumor grossly invades the veins responsible for carrying filtered blood from the kidneys directly to the heart, including the inferior vena cava (IVC), the body’s largest vein – a condition known as tumor thrombus. A dangerous complication, the only treatment option for decades has been surgery, but it is associated with generally poor outcomes. Further, half of patients who survive the procedure go on to develop metastatic disease. With little to no treatment advancement made in the last 50 years, this CenterTimes plus article spotlights the efforts of UTSW clinicians and researchers who set about to change the odds in patients’ favor by investigating the use of highly-targeted radiation to the tumor inside the vein.
Not limiting their efforts to simply exploring new treatment options, UTSW investigators also wanted to understand the biology of this rare and aggressive form of kidney cancer… and why it doesn’t always metastasize. By understanding the determinants of invasion and metastatic competence, we might be able to prevent tumor cells from invading in the first place. ARTICLE
Clinical trial shows stereotactic radiation extends systemic therapy and slows kidney cancer progression
A new study by Kidney Cancer Program investigators with the UT Southwestern Simmons Comprehensive Cancer Center supports the expanded role of stereotactic ablative radiation (SAbR) in the treatment of metastatic kidney cancer. The phase 2 trial results show SAbR to be effective at controing renal cell carcinoma (RCC) and prolonging ongoing systemic therapy for patients. PRESS RELEASE
Maralice Conacci-Sorrell, Ph.D., named inaugural Co-Leader for Diversity, Equity, and Inclusion
Maralice Conacci-Sorrell, Ph.D., Assistant Professor of Cell Biology, has joined the UTSW Kidney Cancer Program (KCP) leadership team as the inaugural Co-Leader of Diversity, Equity, and Inclusion. A collaborating researcher, Dr. Sorrell has been actively involved with the KCP SPORE, serving as Co-Director of the Career Enhancement Program. In her new leadership role, she will help promote inclusion and diversity by fostering a welcoming and supportive environment for all.
“Inclusiveness is not accomplished through the efforts of one person,” said Dr. Sorrell. “It requires all of us. My hope in this new role is to collaboratively map out and develop strategies that embody UTSW’s rich tradition of innovation and teamwork so that everyone who partners with the Program feels a deep sense of belonging.”
The recruitment and career advancement of faculty, postdocs, and residents of diverse backgrounds is a key aspect of the KCP. SPORE funds provide support to junior and mid-career investigators for projects related to kidney cancer research. The Program also provides feedback and resources to help foster success and project continuity. Dr. Sorrell, herself a recipient of a SPORE career award, will further enhance these efforts to advance a community where all feel safe, included, and stimulated to discuss scientific ideas and discoveries.
“We strive for equity and diversity, and the creation of a leadership post tasked with these objectives will further this goal. We are excited for Mara to take on this new role,” said KCP Director Dr. James Brugarolas. “Her background as a scholar, scientist, and campus leader makes her an outstanding candidate. Her data-driven approach, ability to cultivate support in both the campus and wider communities and expertise in developing and implementing best practices will greatly benefit the Program.”
Active with numerous campus organizations, Dr. Sorrell currently serves as Director of Diversity and Inclusion for the Department of Cell Biology and Chair of the Graduate School Admissions Committee.
Dr. Sorrell earned her Ph.D. in Molecular Cell Biology from the Weizmann Institute of Science in Israel and completed a postdoctoral fellowship in the lab of Dr. Robert Eisenman at the Fred Hutchinson Cancer Research Center. Dr. Sorrel’s Lab studies molecular mechanisms regulating nutrient uptake and biomass production in cancer cells. Her research particularly focuses on characterizing key regulators of aberrant nucleolar size and activity in kidney cancer cells with the goal of identifying novel drug targets.
SPORE-funded kidney cancer tumorgraft platform to advance precision medicine
Drug development in cancer is often hindered by a lack of suitable tumor models for preclinical studies. A newly published study in Cell Reports spotlights the comprehensive tumorgraft platform built by UTSW Kidney Cancer Program researchers over the course of a decade which closely mirrors human kidney cancer, surpassing current conventional models in an effort to advance precision medicine. PRESS RELEASE
CPRIT award brings prominent kidney cancer investigator to UTSW
More than $19 million dollars were awarded by CPRIT to UTSW recently, including a $4 million CPRIT Scholar Rising Star Award to recruit Tian Zhang, M.D., M.H.S., a medical oncologist and clinical researcher from the Duke Cancer Institute.
“Dr. Zhang is one of the first clinical researchers to receive a Rising Star Award,” said Dr. James Brugarolas, Director of the Kidney Cancer Program, “which speaks to her strong credentials.”
Dr. Zhang is the co-chair of the National Cancer Institute Renal Task Force and leads the largest investigator-initiated phase 3 clinical trial in kidney cancer, the PDIGREE trial. She earned her medical degree from the Health Sciences and Technology program at Harvard Medical School and her Masters of Health Sciences degree from Duke University School of Medicine, where she trained in Internal Medicine and Hematology-Oncology.
Specializing in genitourinary (GU) malignancies, Dr. Zhang’s research interests involve developing novel therapeutics and biomarkers. She has actively cultivated a dynamic clinical research program in GU oncology with special interests around kidney and bladder cancers.
Her funded CPRIT proposal focuses on three kidney cancer projects. As the principal investigator of the PDIGREE trial, she will perform biomarker studies with the ultimate goal to optimize patient treatment selection. Her second project repurposes a PCSK9 inhibitor to enhance tumor antigen presentation and promote an immune anti-tumor response. Finally, she will leverage a device she developed to capture circulating kidney cancer cells to study tumor evolution.
“The broad repertoire of approaches and projects speaks to Dr. Zhang’s ingenuity,” said Dr. Brugarolas.
Fascinated by the intersection of science and medicine, Dr. Zhang credits her pursuit of oncology to an early passion for biochemistry. However, she acknowledges the sustaining rewards from special connections with her patients.
“My patients are my inspiration and the source of research questions I strive to answer with clinical trials,” said Dr. Zhang. She is also passionate about mentoring the next generation of trainees and early career investigators, an area where she has also established a track record.
Dr. Zhang’s husband, Andrew Wang, M.D., also recently joined UTSW as Professor and Associate Vice Chair for Research in Radiation Oncology.
Novel kidney cancer study sheds light into how cancers invade and metastasize
It’s often cancer’s spread, not the original tumor, that poses the disease’s deadliest risk. And yet, metastasis is one of the least understood aspects of cancer biology.
In a newly published study in Nature Communications, UTSW KCP researchers leverage a unique aspect of kidney cancer, where the tumor grossly invades into the vasculature, to lift the veil on how cancer invades and metastasizes. They show that tumor invasion involves the transient activation of an abnormal cell fate program, and that invasion is not always driven by the most evolved and aggressive cells in the tumor. PRESS RELEASE
Study highlights diagnostic advances in classifying oncocytic tumors
A persistent challenge in kidney cancer diagnosis is the ability to reliably determine whether a tumor is cancerous. Oncocytic kidney tumors are particularly challenging due to their overlapping benign and malignant features.
In a newly released report published in Modern Pathology, a team of UT Southwestern Kidney Cancer Program (KCP) researchers led by Dr. Payal Kapur lays out a systematic approach for understanding the molecular biology of a novel oncocytic tumor using morphologic, immunohistochemistry, and molecular findings. Researchers pinpoint the unique gene signatures for a new kidney tumor entity called LOT (low-grade oncocytic tumor), noting the common occurrence of mTOR mutations, association with a rare hereditary condition, and general overall benign behavior. The findings are the latest in a series of studies by the KCP outlining diagnostic advances in kidney tumor classification.
KCP welcomes new faculty member
We are pleased to welcome Qian (Janie) Qin, M.D., Assistant Professor of Internal Medicine, as the newest faculty member supporting the Kidney Cancer Program. Dr. Qin joins UT Southwestern and the Simmons Cancer Center GU oncology team from the Icahn School of Medicine at Mount Sinai, where she most recently completed her fellowship in Hematology and Medical Oncology. A graduate of Baylor College of Medicine in Houston, she trained in Internal Medicine at Houston Methodist Hospital.
Dr. Qin’s research interests focus on novel biomarkers and therapeutics for genitourinary cancers, including kidney cancer, particularly in the context of early phase clinical trials. She is experienced in developing investigator-initiated studies with biomarker correlatives and will be deploying new molecular imaging approaches to study kidney cancer.