Nemours Biomedical Research
The goal of our work in cancer and blood disorders is, very simply, to find a cure. To do so, we’re constantly searching for new biomarkers (molecules that show whether bodily conditions are normal or cancerous) and better treatments.
Our work is organized within the Nemours Center for Cancer and Blood Disorders (NCCBD), a pediatric cancer center that includes our clinical and pediatric cancer research programs at the Nemours/Alfred I. duPont Hospital for Children in Wilmington, Del., Nemours Children’s Hospital in Orlando and the Nemours Children’s Clinics in Jacksonville, Orlando and Pensacola, Fla. Each of our locations has been recognized for having outstanding participation in clinical trials, and for clinical trial access and management.
Nemours supports many Children’s Oncology Group (COG) clinical trials and investigator-initiated studies, with collaboration among our clinicians, hematology/oncology specialists, and researchers. Across all of our sites, we’re currently involved in approximately 96 COG and 25 non-COG studies and more than 90 industry-sponsored clinical trials. We also conduct additional studies in our research labs.
Many of our patients participate in clinical trials of one type or other — in 2011 and 2012, for example, we enrolled 60% of our new cancer patients in clinical trials. We also maintain research affiliations with National Cancer Institute-designated cancer centers, including the Kimmel Cancer Center at Thomas Jefferson University in Philadelphia and the Helen F. Graham Cancer Center at Christiana Care Health System in Newark, DE.
The Nemours Center for Cancer and Blood Disorders (NCCBD) works to maximize Nemours’ resources across all of our locations. Our mission is to develop and implement a coordinated research strategy for cancer and blood disorders, enable quality clinical and research efforts, and develop educational resources and programs for our staff across all disciplines. We operate focused programs in pediatric cancer research (the Nemours Center for Childhood Cancer Research) and sickle cell disease (the Comprehensive Sickle Cell Research Program).
Our care has been regularly named among the nation’s best in pediatric cancer care by U.S. News and World Report. We believe that our rigorous approach to research, combined with our excellent clinical care is a big reason why.
We’ve been a full member of the Children’s Oncology Group (COG) since it formed in 2000, a member of the Sarcoma Alliance for Research through Collaboration (SARC), and a founding member of the Pediatric Preclinical Testing Program (PPTP). In addition, Nemours locations in Delaware and Florida have received accreditation from the internationally-recognized Foundation for the Accreditation of Cellular Therapy (FACT). This group of leading experts recognizes our work in the field of cellular therapy transplantation.
At Nemours, pediatric cancer research is very much a group effort. Our physicians not only deliver care, they’re actively involved with research and in constant contact with the research scientists in our labs.
Located in Wilmington, Del., the Nemours/Alfred I. duPont Hospital for Children is the home of the Nemours Center for Cancer and Blood Disorders (NCCBD). Our hematologist/oncologists, geneticists, research scientists and other physicians are partially or completely involved in cancer research, helping to improve patient care with what’s learned in research.
The NCCBD is a comprehensive, community-based cancer program offering preventive, diagnostic, treatment and support services, as well as an active clinical research program. Regularly named among the nation’s best in pediatric cancer care by U.S. News and World Report, we’re also fully accredited by the internationally-recognized Foundation for the Accreditation of Cellular Therapy (FACT), recognizing our work in cellular therapy.
All of our research and clinical sites involved in cancer and blood disorders benefit from the 330 square-foot Nemours Biobank (located at 1701 Rockland Road in Wilmington, DE). The Biobank was established in 2009 to provide tissues, blood, and bone marrow to researchers across all of our locations. The Biobank also houses our Pediatric Tumor Bank — one of only a few pediatric tumor banks in the United States — and helps to facilitate our translational research by providing a direct link from our physicians to our researchers. This enhances our efforts to identify biomarkers (molecules found in body fluids (such as blood) or tissues that are signs of a normal or abnormal process, or of a condition or disease) for early disease diagnosis, predict disease progression, and track treatment outcomes.
Nemours Children’s Clinic, Jacksonville, and Wolfson Children’s Hospital have been partners in pediatric oncology care since 1985. The two campuses are connected by an enclosed walkway above Interstate 95, creating a combined facility for pediatric care. All children with a cancer diagnosis are treated in this joint program, which has a common faculty and a combined Tumor Registry and Cancer Committee, and has been a unified program within the Children’s Oncology Group (COG). We’ve been a full member institution of the Children’s Oncology Group since its inception in 2000 and were previously members of the Pediatric Oncology Group (which merged with three other groups to form COG). Our participation in COG is robust, with 129 participants in COG trials last year alone, and 48 participants in non-COG trials.
Our joint cancer program with Wolfson has been recognized for its excellence — receiving the Outstanding Achievement Award from The American College of Surgeons’ Commission on Cancer. We’re the only program, adult or pediatric, in Florida to receive the American College of Surgeons award and one of only two pediatric programs in the nation to earn the distinction.
We have a comprehensive neuro-oncology program for our patients with brain tumors, under the direction of Eric S. Sandler, MD, staffed with a nurse coordinator, and attended by key physicians from neurosurgery, neurology and radiation therapy. A majority of these patients receive proton therapy through our collaborations with The University of Florida Proton Therapy Institute and St. Jude Children's Research Hospital. We also work with the Mayo Clinic Cancer Center.
Although new (having just opened in the fall of 2012), Nemours Children’s Hospital is actively involved in clinical trials. Our program participates in co-operative group clinical trials such as the Children’s Oncology Group and the Pediatric Brain Tumor Consortium. The General Clinical Research Center in the hospital is a well-equipped 500-square-foot clinical research lab.
This clinic, while transitioning some trials to Nemours Children’s Hospital, has continued its own work with clinical trials. In fact, we’ve enrolled up to 56 percent of our new patients in clinical trials since 2009. Our clinic has had an active membership with Children’s Oncology Group for more than five years, and has enrolled patients on Phase I, Phase II, Phase III and Cancer Control Trials. The clinic also has been affiliated with the Suncoast Research Base (formerly the Moffitt Research Base) out of the University of South Florida for more than five years, giving us additional access to Cancer Control trials for our children.
Nemours Children’s Clinic, Pensacola is closely affiliated with our next-door neighbor, Sacred Heart Children’s Hospital. The Division of Pediatric Hematology/Oncology in Pensacola first began enrolling patients in Pediatric Oncology Group (POG) studies in 1983 and has been enrolling patients in Children’s Oncology Group (COG) studies since its inception in 2000. Our biomedical research space occupies approximately 1,400 square feet on the 6th floor of the clinic. A group of pediatric hematologist/oncologists sees approximately 35-40 patients per year and has enrolled more than 200 patients in various trials over the past three years. Our staff also includes two full-time research nurse coordinators, who are certified clinical research professionals (with certification from the Society of Clinical Research Associates or SoCRA). The clinic is also an active member of the Suncoast Research Base (formerly the Moffitt Research Base).
The Nemours Leukemia Research Program has access to the only high-throughput drug screening lab in the country dedicated to pediatric cancer. We’re leveraging this resource (located at the Nemours/Alfred I. duPont Hospital for Children in Wilmington, Del.) to develop therapies specific to pediatric cancer targets so that we can develop drugs designed specifically for children to cure childhood cancers.
At this lab in Wilmington, Del., we’ve optimized a lab model of leukemia that mimics the human disease and allows us to perform pre-clinical testing of novel drugs and to study leukemia biology. Cells from our pediatric patients are duplicated repeatedly in this lab model. This novel model and system makes it possible for the Nemours Leukemia Research Program to discover and study therapies designed specifically for children. We continue to generate more models as we receive samples from the Nemours Biobank. Patients and families are enthusiastically participating in this opportunity to immortalize their leukemia cells for continued study well in the future.
Epigenetics is the study of what effects specific genetic codes have, and why we don’t always get those results. Compared to genetics, when mutations (changes) in DNA cause certain results, epigenetics is when parts of a gene don’t get to do their intended jobs. This often is because the presence of certain proteins “turning off” part of a cell’s DNA. Such actions can affect, among other things, a normal cell’s change into a cancerous cell, so the study of epigenetics holds great promise for cancer prevention, detection, and therapy.
Our lab in Wilmington, Del., is investigating how the growth and differentiation of brain cells is regulated by epigenetic mechanisms, so they can develop new, unique therapies for pediatric brain cancer. We’re also exploring nanotechnology-based drug delivery to the brain (nanotechnology means working with tiny particles) to get lifesaving therapy past the blood-brain barrier (a structure in the brain’s blood vessels that prevents many types of microscopic objects, like therapeutic drugs, from entering the brain’s tissue and fluids).
The Cancer Therapeutics Lab is currently studying novel therapies in pediatric tumors. The lab is involved with the Pediatric Preclinical Testing Program (PPTP) and clinical trials sponsored by the Cancer Therapy Evaluation Program (CTEP).
With the use of robotic equipment, Nemours researchers at our high-throughput lab (based at Nemours/Alfred I. duPont Hospital for Children in Wilmington, Del.) are able to screen thousands of potential drugs in a short time (this is called, “high-throughput”). Currently, we’re working to identify more effective treatments for childhood leukemia.
The Nemours Center for Cancer and Blood Disorders is fortunate to have excellent leadership. Our physician leaders participate or play a leadership role in a variety of national cancer organizations and studies.
The program is led by Dr. Kolb, who is heavily involved in advanced research programs to find new cancer drugs that are more effective, with fewer side effects. A founding member of the Pediatric Preclinical Testing Program (PPTP) and the newly appointed chair of the Myeloid Disease Committee of the Children’s Oncology Group (COG), Dr. Kolb also led the effort to obtain Foundation for the Accreditation of Cellular Therapy (FACT) accreditation for Nemours/Alfred I. duPont Hospital for Children. In addition, Dr. Kolb is the Director of the Nemours Center for Cancer and Blood Disorders and Associate Director of Nemours’ Community Clinical Oncology Program (CCOP). He’s on a number of COG and the Sarcoma Alliance for Research through Collaboration (SARC) committees, and a member of the Pediatric Working Group of the American Association of Cancer Research.
In 2000, when COG was first formed, Dr. Frantz led the hospital to becoming a full member. He became the hospital’s division chief in 2003 and its COG principal investigator in 2009. Dr. Frantz has been a member since 1995 of the Pediatric Editorial Board, PDQ (Physician Data Query) National Cancer Information Systems sponsored by the National Cancer Institute. He is also a member of the COG voting body and on a number of COG committees and study committees.
Dr. Miller serves as duPont Hospital for Children’s Cancer Control Champion for COG. She is the director of the Sickle Cell Program at the hospital and has been awarded the Delaware End-of-Life Coalition Physician Excellence Award.
Dr. Sandler serves as director of Nemours’ Community Clinical Oncology Program and Associate Director of the NCCBD. Dr. Sandler is on several COG committees, including the Voting Body Steering committee, and is a member of the COG voting body. He has chaired or served on study committees for a number of clinical trials and has been the Jacksonville institutional Principal Investigator for COG since 2000. He also serves on the Cancer Control Subcommittee on Nutrition, the Florida Governor’s Cancer Control and Research Advisory Board, Board of Directors of Wolfson Children’s Hospital, and as chair of the Nemours Pharmacy and Therapeutics Committee. Dr. Sandler was also recently honored with the National Lane Adams Award for compassionate care from the American Cancer Society.
Dr. Bradfield is our Cancer Control Champion for Florida, and committee member of our Community Clinical Oncology Program. Dr. Bradfield is an assistant professor of Pediatrics at Mayo School of Medicine and Associate Division Chief at Nemours Children’s Clinic, Jacksonville. He has been the Cancer Committee Chairman in Jacksonville for many years, emphasizing quality of care with improved outcomes. His main research focus is in cancer control, currently serving as the Study Principal Investigator for a Suncoast Research Base cancer study.
A nationally recognized expert in pediatric bleeding disorders, Dr. Gauger has been at Nemours Children’s Clinic, Jacksonville since 2000. She is an Assistant Professor of Pediatrics at the University of Florida Medical School. She also serves as the Medical Director of the Hemophilia Treatment Center and is very active with the national and state Hemophilia Foundations. Dr. Gauger’s primary areas of interest are in hemostasis (a process which causes bleeding to stop), sickle cell disease thrombosis (blood clots in sickle cell patients), and benign hematology (the study of blood, blood-forming organs, and blood diseases).
Dr. Joyce has been with Nemours Children’s Clinic, Jacksonville since 1990 and has run our hematopoietic stem cell transplantation (HSCT) program since 1994. He currently serves as both the overall program director and director of the pediatric Blood and Marrow Transplantation Program of the Mayo Clinic, Nemours Children’s Clinic, and Wolfson Children’s Hospital. He’s also served as the Chair of the Institutional Review Board (IRB), which ensures that safe research protocols are followed and that participants are protected for the Baptist Health Care System since 2004. Dr. Joyce’s interests include stem cell and umbilical cord blood transplantation.
At our Nemours Children’s Hospital and Nemours Children’s Clinic, Orlando, Dr. Nagasubramanian is the division chief of Pediatric Hematology-Oncology for our clinic, and has a distinguished history in cancer care and research. He is a member of the COG voting body, and serves as the Site Lead Investigator for our Orlando site.
At Nemours Children’s Clinic, Pensacola, Dr. Schwartz, MD is our Principal Investigator. He is a Clinical Assistant Professor of Pediatrics for Florida State University and serves as Center Director for the Florida Association of Pediatric Tumor Programs. He serves on many committees for Nemours and for Sacred Heart Hospital. He is also a member of the COG voting body.
Browse a listing of publications from Nemours researchers related to cancer biomarkers and therapeutics research.
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