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Cancer — Dan L Duncan Comprehensive Cancer Center

Innovative health care in Houston, Texas

Baylor St. Luke’s Medical Center is an internationally recognized leader in research and clinical excellence that has given rise to breakthroughs in oncology, cardiovascular care, neuroscience, transplantation, and more. Our team’s efforts have led to the creation of many research programs and initiatives to develop advanced treatments found nowhere else in the world.

Our strong alliance with Baylor College of Medicine and other community partners allows us to bring our patients a powerful network of care unlike any other. Our collaboration is focused on increasing access to care through a growing network of leading specialists and revolutionizing healthcare to save lives and improve the health of the communities we serve. 

Baylor St. Luke’s Medical Center is also the first hospital in Texas and the Southwest designated as a Magnet® hospital for Nursing Excellence by the American Nurses Credentialing Center, receiving the award five consecutive times.

The newest addition to the beautiful McNair Campus

Baylor St. Luke’s Medical Center is the clinical home for the Dan L Duncan Comprehensive Cancer Center (DLDCCC) at Baylor College of Medicine, one of only three NCI-designated Comprehensive Cancer Centers in Texas. 

The Dan L Duncan Comprehensive Cancer Center at Baylor St. Luke's Medical Center extends innovative cancer care to the Greater Houston area community. In collaboration with Baylor College of Medicine, the DLDCCC is equipped to pave the way for even more revolutionary discoveries and groundbreaking approaches to cancer prevention, diagnosis, and treatment. Our team is committed to providing a full continuum of care, high-touch patient support, and access to advanced resources.

Patients at the Dan L Duncan Comprehensive Cancer Center receive access to:

  • 80 infusion suites
  • 70+ new exam rooms
  • A 3 Tesla MRI exclusively serving breast cancer patients at the Breast Center
  • Multi-disciplinary team care for cancer patients
  • Natural lighting and balcony gardens that nurture an environment of healing


Researchers develop new compound that reduces tumor growth and overcomes therapeutic resistance in mutant p53-bearing cancers

In the search for new treatments for hard to cure cancers, researchers at Baylor College of Medicine employed computer modeling to discover a new compound that suppresses the growth of cancer cells bearing a specific mutant gene.

Previous studies have shown that cancer cells with mutant gene p53 appear to be more dependent on DNA2, an enzyme that binds to DNA and plays a role in its replication and repair. DNA2 is overproduced in cancer cells, particularly in those carrying a p53 mutation, for survival than cells with normal p53. 

DNA2 stood out as a potential therapeutic candidate for mutant p53 cancers because DNA2 overexpression driven by mutant p53 gives cancer cells a survival advantage: It is associated with advanced disease, poor outcomes, and acquired resistance to therapies.

Baylor researchers investigated whether inhibiting the DNA2 function associated with the p53 mutation would stop cancer progression in cell-based and in animal models. They searched for DNA2 inhibitors not by screening many compounds but with a computational approach that enabled them to identify the structures that are involved in DNA2 function. Then, they developed compounds that would fit into and bind to those structures, thus preventing DNA2 from binding to DNA and conducting its function. 

Using this approach, researchers identified compound d16, which they tested in cell-based and in animal models and showed that it can suppress cancer growth when compared to placebo treatment.

The team also discovered that d16 can inhibit a DNA repair process and make cancer cells sensitive to PARP inhibitors. PARP inhibitors are a class of FDA-approved drugs that only work in certain cancers with mutations in BRCA1 or BRCA2. Now, the combination of d16 with PARP inhibitors can work to treat many cancer cells harboring wild-type BRCA genes. They also found that treating with inhibitor d16 was able to overcome some conventional therapy resistance, making the cells susceptible again to other drugs that were ineffective before.

Researchers are hopeful these new findings will lead to new, more effective drug therapies in people with hard to cure cancers.

Targeting specific protein in treatment of triple-negative breast cancer shows promise of more effective treatments

Researchers at Baylor College of Medicine and collaborating institutions have investigated potential vulnerabilities in triple-negative breast cancer (TNBC), an aggressive tumor with very poor prognosis and limited therapeutic targets, that could lead to novel therapies and improved outcomes for this devastating condition.

In diverse TNBC animal models, researchers found that targeting the protein eIF4A with the small-molecule drug Zotatifin not only suppresses tumor cell proliferation by robustly inhibiting the production of several tumor-promoting proteins, but also remodels the tumor immune microenvironment into one that favors tumor elimination. 

Combining Zotatifin with chemotherapy drug carboplatin, which is typically used as standard treatment for TNBC, produced significantly better results than each treatment alone, as the combination markedly prolonged survival in the animal models. 

Another benefit of the small molecule is that it allows for lowering the dose of chemotherapy. Currently, patients are treated with a maximum tolerated dose of chemo, which carries many toxicities and negative side effects. But when chemo is combined with the small inhibitor, its dosage can be cut in half (the minimum effective dose), and achieve good survival benefits and reduce the toxicity.

Targeting the process for synthesizing proteins the cancer needs to grow is producing promising results. Researchers are hopeful these findings could help inform future clinical trials and positively impact the treatment of TNBC patients.

Delivering on the promise of personalized breast cancer therapy

A team led by researchers at Baylor College of Medicine is coming closer to delivering on the promise of personalized breast cancer therapy with a strategy to predict the most likely response of a cancer to a specific, less toxic treatment regimen.

In a study recently published in the journal Clinical Cancer Research, scientists developed and validated in clinical trials a multiparameter molecular classifier test to predict with a high degree of confidence which patients with HER2-positive (HER2+) breast cancer would be candidates for anti-HER2 therapy alone, without the need for chemotherapy. The molecular classifier also accurately identifies patients whose tumors may need chemo or other targeted therapies.

HER2+ breast cancer, which represents about one of every five breast cancers, expresses high levels of HER2 proteins. The cancer cells are physiologically dependent on the abundance of this protein to grow fast and metastasize or spread to other organs. Historically, HER2+ breast cancer was treated only by chemotherapy, but patient outcomes were poor. This changed in the late 1990s when the introduction of anti-HER2 therapy, drugs that block the growth effects of HER2, transformed the treatment of this disease.

Baylor College of Medicine researchers have been studying for years the most effective approach to treat HER2+ breast cancer. 

Researchers first observed that blocking HER2 with two different drugs in breast cancer cells growing in culture was superior to one drug, and then confirmed this in mice with HER2+ human tumors. The tumors disappeared quickly in all mice, something they had never seen before. 

They then translated these discoveries to patients. Specifically targeting the HER2 protein with two anti-HER2 drugs (lapatinib and trastuzumab) before surgery resulted in a complete response—meaning disappearance of all cancer in the breast—in about 25-30% of cases to the extent that chemotherapy, which typically is part of the treatment, was no longer needed, sparing patients the toxic effects and cost of chemo. The challenge was to identify those 30% at the time of diagnosis, which would permit a therapy de-escalation approach. Once they accomplished that, researchers would then work to develop a strategy that would distinguish the patients who would respond to anti-HER2. 

The discovery promises a way of identifying these patients so they can get the proper, personalized treatment for their cancer that avoids unnecessary treatments and preserves the quality of their lives.

Clinical trials, immunotherapy offer hope for treatment of pancreatic cancer

At only 8 percent, pancreatic cancer has the lowest five-year survival rate of any major cancer in the United States. In fact, It's the third leading cause of cancer-related deaths. Last year, more patients died from pancreatic cancer than breast cancer. 

Unlike breast cancer or colon cancer, however, there isn't a reliable screening method for pancreatic cancer—yet. Researchers at the Dan L Duncan Comprehensive Cancer Center and the Liver and Pancreas Center at Baylor St. Luke's Medical Center are working together to change that with their research into early detection methods, including genetic testing, which updated national guidelines recommend for anyone diagnosed with pancreatic cancer, regardless of age or family history. 

Up to 20 percent of pancreatic cancers are thought to be inherited. Some patients will be found to harbor a mutation that explains why that person developed pancreatic cancer. The most common mutation is the BRCA mutation, which predisposes carriers to breast, pancreatic, ovarian, and other cancers. PALB2 is another mutation that increases the risk for breast and pancreatic cancer.

It's important for someone to know if they have a genetic cause of their pancreatic cancer because it means other family members are also at risk if they carry that gene. There is also a targeted medication for BRCA-related pancreatic cancer, another reason why genetic testing is recommended.

Pancreatic cancer can be difficult to diagnose. Symptoms of pancreatic cancer can be vague, and include back pain, trouble eating, and weight loss. Besides inherited mutations, risk factors for pancreatic cancer include smoking, obesity and heavy alcohol consumption.

While pancreatic cancer is challenging to manage and highly lethal, there's hope for improved treatments coming from the patients themselves, in the form of clinical trials. One of the most promising components of pancreatic cancer clinical studies is immunotherapy, which relies on the patient's own built-in defense system against cancers. 

Multiple clinical trials testing novel immunotherapies in all stages of pancreatic cancer studies are underway at the Dan L Duncan Comprehensive Cancer Center at Baylor St. Luke's Medical Center. 

The most recent clinical trial is for patients with early-stage cancer who are candidates for surgery. It combines chemotherapy with immunotherapy, followed by surgery. The chemotherapy is used to change the tumor to make it more responsive to immunotherapy before the tumor is surgically removed, creating a strong immune response to where the patient gets lasting protection.

Deciding which trial is best for individual patients depends on whether the tumor is operable, if the patient has already had surgery or not, if the cancer has metastasized and what stage it's currently in. With only about 5 percent of patients with pancreatic cancer participating in such studies, however, improving outcomes will need more patients enrolling in clinical trials.

Research projects aim to improve colorectal cancer care

Colorectal surgeons at Baylor College of Medicine are leading several ongoing, cutting-edge research projects that aim to enhance patient care. 

Two National Cancer Institute studies being co-led by Baylor colorectal surgeons are trying to determine if circulating tumor DNA (CtDNA), a new blood test that looks at specific tumor cells circulating in the blood, has a role in colorectal cancer treatment. 

Currently, cancer staging and the need for chemotherapy is determined by the presence of cancer in the lymph nodes. The CtDNA has the potential to be better than testing lymph nodes  to determine the need for further chemotherapy. 

Baylor colorectal surgeons are leading these National Cancer Institute trials with about 250 sites. One trial is looking at patients with stage 2 colon cancer who typically do not get chemotherapy. The trial aims to determine whether chemotherapy might benefit patients who test positive for CtDNA. The second trial is looking at patients with stage 3 cancer who usually get chemotherapy. The trial is investigating the possibility of avoiding chemotherapy if the patient tests negative for CtDNA.

Patients with rectal cancer usually need chemotherapy and radiation before surgery but have different degrees of responses to treatment. The degree of response determines the need and type of surgery needed. Researchers are investigating which patients are going to respond and why, so treatment can be tailored for the best response and improving patient outcomes.

Baylor colorectal surgeons are also studying the efficacy of prehabilitation—that is, physical therapy prior to surgery—in colorectal cancer patients needing surgery. Prehabilitation has been shown to improve postoperative outcomes overall. However, patient compliance with physical therapy exercises before surgery is poor for various reasons. In this study, researchers are providing a novel, in-home table game that makes the patient move and exercise before surgery to see if it improves the wellness of the patient after surgery. The study is looking at the impact of not only prehabilitation but interactive gaming as a tool to motivate and increase compliance.

New study may change surgical approach for treating patients with muscle-invasive bladder cancer

Results of a new clinical trial involving patients with muscle-invasive bladder cancer may alter the way surgical oncologists typically treat the disease.

The procedure, known as an extended lymphadenectomy, is considered a standard of care and is increasingly used, especially for patients with locally advanced bladder cancer who have a higher risk of lymph node metastases. Removing the bladder as well as all of the lymph nodes in the primary area around the bladder is believed to significantly reduce the risk of cancer recurrence within the pelvis. 

But researchers at Baylor College of Medicine and the Southwest Oncology Group (SWOG) Cancer Research Network sought to address an important surgical question: Was the extended lymphadenectomy actually benefiting patients and reducing the risk of recurrent disease or mortality?

With support from the National Cancer Institute and the Canadian Cancer Society, researchers launched a clinical trial and enrolled 658 patients—618 of whom were eligible to be randomly assigned to receive either extended or standard lymphadenectomy—and recruited 36 surgeons, who were required to undergo a credentialing process designed specifically for the study. The researchers then examined whether the patients benefited from extended lymphadenectomy to remove even more lymph nodes from a wider area.

The patients involved in the trial were randomly assigned during their surgery, after the surgeon had determined that the disease had not metastasized beyond the pelvis. All of the patients underwent a standard bilateral pelvic lymphadenectomy. However, those randomly assigned to the investigative arm also underwent an extended lymphadenectomy, with nodes removed at least up to the aortic bifurcation.

Compared with those in the control group, patients in the extended lymphadenectomy group had a median of 39 nodes vs 24 nodes removed, but the percentage of nodes found to contain metastatic disease was similar in both groups. The researchers hypothesized that the patients in the extended lymphadenectomy group would experience improved disease-free and overall survival compared with those in the control group. However, no significant statistical differences were observed between the two groups in disease-free survival. 

Further, almost half of patients in the extended lymphadenectomy group experienced adverse events within 90 days of surgery, regardless of attribution, compared with 42% of patients in the control group. The researchers also reported that the number of deaths within 90 days of surgery was greater in the extended lymphadenectomy group (19 vs. seven patients).

The researchers noted that a definitive phase III surgical trial of this sort was an ideal fit for the National Cancer Institute’s National Clinical Trials Network (NCTN) and was uniquely suited for such practice-changing trials led by surgical oncologists.

Glioblastoma invasion driven by remote neuronal connections

Glioblastoma (GBM) is the most aggressive and lethal form of brain tumor. Yet, the underlying molecular mechanisms driving GBM infiltration are not fully understood. 

Now, researchers from Baylor College of Medicine working in animal models have uncovered a novel process by which neurons in locations remote to the primary tumor provoke expression of genes from glioblastoma that subsequently drive tumor infiltration.

The findings are published in Nature (June 28, 2023).

Researchers found that “the tumor microenvironment plays an essential role in malignancy, and neurons have emerged as a key component of the tumor microenvironment that promotes tumorigenesis across a host of cancers.

Recent studies on GBM highlight bidirectional signaling between tumors and neurons that propagates a vicious cycle of proliferation, synaptic integration, and brain hyperactivity. However, the identity of neuronal subtypes and tumor subpopulations driving this phenomenon is incompletely understood. 

Researchers showed that callosal projection neurons located in the hemisphere contralateral to primary GBM tumors promote progression and widespread infiltration.

The findings suggest that GBMs receive neuronal inputs from a host of brain regions, implying that exposure to a diverse range of neuroactive compounds can potentially influence tumor growth. It’s now clear that tumor-neuron interactions are more widespread than previously thought.

The study demonstrates that subsets of neurons in locations remote to primary GBM promote malignant progression, and also show new mechanisms of glioma progression that are regulated by neuronal activity.

Award-winning Baylor scientist innovates device for detecting cancer directly on tissues

Livia Schiavinato Eberlin, Ph.D. an associate professor of surgery at Baylor College of Medicine, has won a prestigious award for young chemical scientists in Texas and secured $3 million in funding to further develop a medical device called the MassSpect Pen, a handheld probe which she developed to detect cancer directly on tissues.

Dr. Eberlin was named the 2024 recipient of the Norman Hackerman Award in Chemical Research, which recognizes the accomplishments of chemical scientists in the state who are early in their careers. 

Dr. Eberlin runs the Eberlin Lab for Medical Mass Spectrometry at Baylor College of Medicine and is known for her groundbreaking work in the application of mass spectrometry technologies, which are changing how physicians treat cancer and analyze tissues. For her research on the use of mass spectrometry to detect cancerous tissue, in 2018 she received a McArthur Foundation “Genius” fellowship. 

Funding from The Marcus Foundation will help to further develop the MasSpec Pen technology in breast cancer surgeries. Eberlin developed the tool in 2016 while she was serving as an assistant professor at the University of Texas at Austin. 

The MasSpec Pen has also been recently used for discriminating thyroid, parathyroid and lymph node tissues during surgery. Surgery of the thyroid and parathyroid glands is most challenging, even to expert surgeons. These relatively small structures located in the neck are in contact with each other and share certain features, including color and tactile feel, making it difficult to visually identify them. 

Inadvertent parathyroid removal occurs in up to 25% of surgeries to remove the thyroid since thyroid nodules and lymph nodes can be mistakenly identified as parathyroid tissue. The MasSpec Pen is an innovative method that helps ensure resection of only the intended tissue. 

It also saves time, in real time, during surgery itself. The MasSpec Pen showed high performance for discriminating thyroid, parathyroid and lymph node tissues during surgery in about 20 seconds, whereas the processing of the sample for standard pathology analysis during surgery can take up to an hour. Not only does this add time and cost to the procedure, but the longer the operation, the higher the risk of complications. 

Using the MasSpec Pen benefits the patient by offering the power of real-time tissue identification as surgeons operate.


Staged surgical approach extends lives of patients with mesothelioma

A highly select group of patients diagnosed with mesothelioma cancer in both the thoracic and abdominal cavities (bicavitary mesothelioma) can still achieve a significant extended survival with an aggressive, lung-sparing surgery that is performed in two stages, concludes a recent study at Baylor College of Medicine.

Mesothelioma is a nearly uniformly fatal tumor that most commonly affects the protective lining of the lungs (pleura). It can also affect the lining of the abdomen (peritoneal) in up to one-quarter of all cases. A more rare form affects the protective lining of the heart (pericardial).

Patients with bicavitary mesothelioma can undergo multimodality therapy, including cytoreductive surgery (CRS) and chemotherapy. CRS for thoracic disease includes a lung-sparing operation called an extended pleurectomy/decortication (ePD) or a lung-sacrificing surgery called an extrapleural pneumonectomy (EPP). 

The benefit of CRS for bicavitary disease (chest and abdomen) has been poorly understood. So, over the course of seven-plus years (February 2014-August 2021), Baylor College of Medicine researchers evaluated 440 patients with mesothelioma. Fourteen patients (3%) underwent CRS of both chest and abdomen as a planned two-stage operation. Thirteen of the 14 patients underwent chest surgery prior to abdomen surgery. 

For the entire cohort, the median overall survival was 33.6 months, with a five-year survival of 20%. Those who underwent ePD, however, had better outcomes compared to EPP, with median overall survivals of 58.2 months versus 13.5 months, respectively.

Results of the study are one reason Baylor College of Medicine, along with many specialty centers treating mesothelioma, has moved away from the once-groundbreaking EPP surgery to the life-extending ePD procedure.

Dual agent immunotherapy increases overall survival of patients with resectable mesothelioma

Immunotherapy ahead of surgery leads to better outcomes for pleural mesothelioma patients who have tumors that can be removed with surgery, according to another recent study by Baylor College of Medicine researchers. The study lays the groundwork for neoadjuvant immunotherapy in mesothelioma.

Immune checkpoint inhibitors are drugs that activate the immune system to fight cancer. They have revolutionized the treatment of cancer in general but only recently have been recognized to have some efficacy in mesothelioma. 

Recent research on the efficacy of immunotherapy for patients with unresectable mesothelioma showed favorable outcomes, which led Baylor College of Medicine researchers to study this approach in patients with resectable mesothelioma. 

Immunotherapy can activate an immune response that will persist after the tumor is resected. If the tumor tries to recur, the body has an existing memory immune response to fight it.

The researchers continue to follow the participants in the study, who received the treatment more than three years ago. To date, they have found that dual agent immunotherapy increased the number of important types of CD8 T cells in the tumor, which serve as the “soldiers” of the immune response that kill and remember the tumor. Moreover, there has been increased overall survival in patients receiving the dual agent immunotherapy.

New, more accurate test for thyroid cancer could prevent unnecessary surgeries

A faster, far more accurate pre-operative test for thyroid cancer promises to drastically reduce the number of unnecessary thyroid removals, as well as the need for lifelong hormone replacement therapy and other negative consequences that people experience after having their thyroid removed.

About 52,000 new cases of thyroid cancer are diagnosed each year in the U.S. The most common test for it, called fine-needle aspiration (FNA), is inconclusive about 20% of the time. In those cases, the patient may receive a follow-up genetic test that also can produce false-positive results. As a preventive measure, doctors often recommend removing part or all of the thyroid. Yet, thousands of patients who have the surgery every year later learn that they don’t have cancer.

To change those outcomes, researchers at Baylor College of Medicine and The University of Texas at Austin are developing a new metabolic thyroid test that employs mass spectrometry imaging to identify metabolites produced by cancerous cells. Clinical studies have shown that the imaging acts as a kind of diagnostic fingerprint that vastly reduces the number of false-positive diagnoses.

Over a two-year period, the researchers worked on identifying these diagnostic metabolic fingerprints using 178 patient tissues before starting a pilot clinical study. During the clinical study, 68 new patients were tested, nearly a third of whom had received inconclusive FNA results. Only about one in 10 of the new metabolic thyroid tests returned a false positive, which could have prevented 17 patients in the study from undergoing unnecessary surgeries.

Dr. James Suliburk, a co-principal investigator and head of endocrine surgery at Baylor College of Medicine, collected FNA biopsies from the patients and used the technology in a pilot trial to demonstrate the accuracy of the new test.

James W. Suliburk, MD, FACS

Advances in colorectal cancer surgery dramatically reduce patient recovery times

Permanent ostomy bags, long hospitalizations, and narcotics-based pain management are quickly becoming things of the past for patients recovering from colorectal cancer surgery. Thanks to Baylor’s multidisciplinary approach to treating this type of cancer, patient outcomes have vastly improved with faster recovery times, a lower risk of mortality, and a lower rate of recurrence.

Restorative colorectal surgeons, for instance, are making the permanent colostomy bag obsolete by employing more specialized techniques than traditional surgery that reconnect the intestines with the anus. Using multiple methods, including robotic transanal total mesorectal excision, allows for better visualization, so surgeons are able to remove the entire tumor while avoiding a permanent ostomy bag. As a result of such approaches, outcomes from rectal cancer surgery are much improved, reducing the patient’s length of stay in the hospital, as well as the chances of death or the tumor coming back, notes Dr. Atif Iqbal, Chief of Colorectal Surgery at Baylor St. Luke’s Medical Center.

The use of enhanced recovery after surgery (ERAS) protocols, which rely on evidence-based medicine, has also significantly reduced the average length of a hospital stay for patients after major abdominal surgery from 7-12 days to between 1-3 days. Previously, patients were told not to eat or drink starting at midnight on the day of surgery, even if their case was later in the day. Because this can cause dehydration and low-sugar levels before they go into the operating room, patients are now told to continue their liquid diet up to three hours before the surgery.

In addition, most patients also are able to avoid tubes in their nose/mouth or drains after surgery and no longer have to wait for their bowels to start functioning before they are able to eat or be discharged from the hospital. Patients can have a liquid diet immediately following their surgery and go to a regular diet the next morning. “We have found that the quicker we feed them, the better the patients do,” Iqbal said.

New approaches to pain management have also eliminated the use of dangerously addictive opiates. Many surgeons are now giving a combination of different non-narcotic medications to provide effective pain control in both the postoperative inpatient and outpatient settings.

Choosing a multidisciplinary center like Baylor can make all the difference in colorectal cancer patient outcomes.

Patients should look for a restorative colorectal surgeon and a hospital where a high volume of similar cases have been treated and where the care is not fragmented. A true multidisciplinary program brings all specialists the patient needs into one location, which provides for better communication and allows the patient’s health care team to work together to explore the best medical or surgical option and achieve the most successful outcome for the patient.

Dr. Atif Iqbal, MD, FACS, FACRS

Over 100 ex vivo lung perfusion cases performed

Baylor St. Luke’s Medical Center’s Ex Vivo Lung Perfusion Program has performed 105 ex vivo lung perfusion (EVLP) cases since its inception in 2018 using the TransMedics Organ Care System Lung (OCS Lung) technology.

Gabriel Loor, M.D., surgical director of the Lung Transplant Program at Baylor St. Luke’s and director of lung transplantation at Baylor College of Medicine, led the first breathing lung transplantation using the OCS Lung machine in 2014 in the Midwest and the first in Texas in 2018. In fact, Dr. Loor is a pioneer in this space, having played a key role in FDA approval of the OCS Lung device.

The OCS Lung machine is designed to keep donor lungs functioning and “breathing” in human-like conditions from the time of the donor procurement all the way to the transplant surgery. The device maintains the organ in its own physiologic state with blood, oxygen, nutrients and a sophisticated monitoring system that continually assesses the organ as it travels from donor to recipient.

Typically, lungs transported in a standard ice cooler are implanted within six hours. But at Baylor St. Luke’s, cases were performed with preservation times ranging from six hours to 18 hours. Another benefit offered by using the OCS Lung machine is surgeons can accept donor offers from anywhere in the continental US and better manage logistics so that complex recipient operations can occur in the day rather than in the middle of the night.

In addition to the OCS Lung machine, the transplant team is exploring other technologies for organ preservation such as the Lungguard (Paragonix), which cools the organ without the potentially harmful effects of ice.

Baylor St. Luke’s transplant team saves lives from across the globe.

Organ transplant patients who travel great distances for lifesaving care at Baylor St. Luke's Medical Center benefit from the highest level of critical care in Baylor St. Luke’s Lung Transplant Program, which has gained an international reputation for the treatment of advanced lung disease and transplant care.

Led by Dr. Puneet Garcha, Medical Director of Lung Transplantation at Baylor St. Luke’s and Associate Professor of Pulmonary Medicine at Baylor College of Medicine, and Dr. Gabriel Loor, Surgical Director of Lung Transplantation at Baylor St. Luke’s and Associate Professor of Surgery at Baylor College of Medicine, the program serves patients from around the US and other countries who are often denied by other providers because the cost of insurance is prohibitive, the patient has a poor prognosis, or other reasons.

One recent double lung transplant patient is a case in point. A 54-year-old man, a resident of Hawaii, had developed pneumonia, which progressed to respiratory failure that severely damaged both of his lungs. Hospitalized locally, he was intubated and on mechanical ventilation. The patient, who was previously in good health and had no major health issues, also experienced respiratory and kidney failure, infection, gastrointestinal bleeding, and physical deconditioning.

Baylor St. Luke’s accepted the patient after he was rejected by other hospitals. He was airlifted over the summer from Hawaii to Houston, where he spent a month in the care of Baylor’s ICU nursing staff and therapists before being prepped for a bilateral lung transplant.

“We were able to secure a donor lung pretty quickly, and his health improved dramatically soon after the procedure,” said Dr. Loor.

Three months after the double transplant, the patient continued his recuperation in Houston, where he received physical therapy and occupational therapy every week, and re-established living independently. His prognosis is good for a complete recovery, Dr. Loor added. This patient’s experience is just one of many stories that reflect the quality of the critical care at Baylor St. Luke's Lung Transplant Program.



New research shows the promise of biomarkers in early detection and treatment of primary graft dysfunction in lung transplant patients

The discovery and application of biomarkers have revolutionized the treatment of patients with lung cancer, heart failure, and myocardial ischemia. Yet it has not yet been applied to the care of patients in whom complications develop after a lung transplant. 

Recently, a team of researchers from Baylor College of Medicine and the Texas Heart Institute conducted one of the largest single-center studies of biomarkers in lung transplant patients experiencing primary graft dysfunction (PGD) to discover what biomarkers might aid in earlier detection and improved patient care and outcomes. 

PGD is the main cause of chronic illness and death for patients who undergo a lung transplant. There is no cure for PGD. While patients can be successfully treated with supportive care, that alone cannot prevent the potential for irreversible harm to the donor allograft or other end organs. 

Early detection of PGD could be improved, however, with the ability to accurately map its molecular signature and specific biomarkers.

The study sought to validate the utility of protein biomarkers for detecting the severity and duration of PGD. The researchers used the most updated PGD grading guidelines, a contemporary cohort of 40 lung transplant recipients, and novel statistical methods to aid in detecting a wide breadth of biomarkers.

Their findings suggest that unique inflammatory protein expression patterns may indicate the severity and duration of PGD. The clinical use and continued examination of these biomarkers may not only help detect PGD early on, but also predict its progression, provide insights for drug development, and establish better treatment benchmarks. 

The study was published in September 2022 in Nature.


DNA fracturing rewires gene control in cancer

Understanding the mechanisms that mediate widespread DNA damage in the cancer genome is of great interest to cancer physicians and scientists because it may lead to improved treatments and diagnosis. In this study, a multi-institutional team led by researchers at the Dan L Duncan Comprehensive Cancer Center, in partnership with Baylor College of Medicine, has brought attention to genomic structural variation as a previously unappreciated mechanism involved in altering DNA methylation, a form of gene control, in human cancers.

The researchers brought together data from whole genome sequencing, gene expression, and DNA methylation from more than 1,400 human cancers. They report in the journal Genome Biology that structural variations consistently altered DNA methylation affecting hundreds of genes, overall reducing the global level of DNA methylation across cancers

In this study, Creighton and his colleagues looked at the effect genomic structural variation has on both DNA methylation and gene expression in human cancers. They analyzed data from two different large science consortiums, the Cancer Genome Atlas and the Pancancer Analysis of Whole Genomes. These data include molecular alterations across the entire genome; that is on both protein-coding genes and on their regulatory regions for thousands of cancers. The datasets include the same information from non-cancerous tissues for comparison.

Working with so many patient samples gave more statistical power to the researchers’ analyses and enabled them to find new genes that might be involved in cancer.


New grants support research of immunotherapy in thoracic cancers

Three surgeons at the Baylor College of Medicine Division of Thoracic Surgery have secured research grants from the National Institutes of Health to study mechanisms of immunotherapy and carcinogenesis in malignant pleural mesothelioma and non-small cell lung cancer. Dr. Bryan M. Burt and Dr. R. Taylor Ripley are two of the grant recipients studying these two forms of lung cancer. Additionally, Dr. Hyun-Sung Lee, Director of the Divisions’ Systems Onco-Immunology Laboratory, was awarded an industry-sponsored $1.94M research grant to investigate and study the role of anti-MIC (MHC class I chain-related protein) antibodies in overcoming resistance to checkpoint immunotherapy.

Cynthia's story: living cancer and scar-free

Cynthia Doyle was familiar with papillary thyroid cancer because it had affected several members of her family before. She knew her cancer was treatable with surgery, but she had witnessed the side effects. She wanted to avoid trouble with her voice and the scar on her throat so she began to hunt for scarless thyroid surgery.

She soon discovered Dr. Raymon Grogan, section chief of endocrine surgery at Baylor St. Luke’s Medical Center. He is one of the only doctors in the nation who performs transoral thyroidectomy, or TOETVA—a scarless thyroid surgery that allows for the safe and total removal of the thyroid or parathyroid glands without any external scarring to the neck. Shortly after surgery, Cynthia was informed her cancer was entirely removed with negative surgical margins.

“No one would ever think that I had such a serious surgery because I don’t have a scar,” Cynthia said. “I am extremely grateful for Dr. Grogan and his amazing team.”

Leading bladder cancer research

As part of our affiliation with Baylor College of Medicine, our urology team takes part in innovative research that we translate into state-of-the-art clinical options for those we serve.

Applying Genomics to Bladder Cancer Treatment

Dr. Seth Paul Lerner, urologist at Baylor St. Luke’s, and his colleagues at Baylor College of Medicine study the genomic underpinnings of diverse characteristics in patients with muscle invasive bladder cancer as part of the Cancer Genome Atlas Research Network.

He and his team found a connection between cancer subtype and outcomes. “We were able to show that mutation signatures, molecular subtypes, load of new cancer-associated molecules, and known clinical and pathological factors have a very clear influence on overall patient survival,” says Dr. Lerner.

Taking these factors into account allows for more personalized and effective treatment for patients. “Of the 11 patients we identified as having a neuronal subtype, all of those evaluable for objective response responded to the treatment (two complete response, six partial response), or 72% overall. This translated to a very high survival probability, which is unprecedented in advanced bladder cancer,” says Lerner.

“Although this is a small group of patients, it is very exciting to see that our basic research can be directly translated to the clinical setting, allowing us to determine which subtype of bladder cancer has a better chance to respond well to a specific treatment.”- Seth Paul Lerner, MD

Targeting Estrogen Receptors to Reduce Bladder Cancer Recurrence

Patients with low/intermediate-risk bladder cancer often experience recurrences. In the second phase of this study, researchers, including Baylor St. Luke’s and Baylor College of Medicine urologist Dr. Guilherme Godoy, sought to reduce the rate of recurrence by prescribing oral tamoxifen.

This prototypic selective estrogen receptor modulator (SERM) was given to prevent carcinogenesis in these patients. Findings revealed that this regimen reduced and even eliminated marker lesions in participants.

Read the full study here.

Advanced tumor analysis for state-of-the-art cancer care

Our system-wide Molecular Tumor Board, spearheaded by oncologists and physician scientists, provides expert analysis of genetic markers in tumor DNA and genomic markers in patient DNA to refine diagnosis and prognosis. This provides targeted treatment options for cancer patients with the most complex diagnoses as well as for tumors that are refractory to standard treatment protocol. This also allows for recommendations of targeted prevention modalities for family members.

Our Tumor Board is virtual, allowing attendance by oncologists from all over CommonSpirit Health, the parent system of Baylor St. Luke’s Medical Center. We also offer continuing education in genetic testing and diagnosis and CME credits for participating physicians.

The scarless approach to thyroid surgery

Baylor St. Luke’s Medical Center is the only center in Texas that offers the transoral endoscopic thyroidectomy vestibular approach (TOETVA). Unlike traditional thyroidectomies that require an incision in the neck, the TOETVA leaves no visible scars.

Dr. Raymon Grogan is one of only a few experts on the TOETVA procedure in the United States, and he was the first surgeon to perform this operation in the Midwest and in all of Texas.

He and his team recently performed an analysis on 1,000 patients who underwent thyroid surgery and concluded that 56% of them were eligible for and could have received the scarless procedure.

Raymon Grogan, MD

Pioneers in pancreatic cancer treatments

The Elkins Pancreas Center at the Dan L Duncan Comprehensive Cancer Center specializes in the treatment of pancreatic cancer, pancreatitis, and other pancreatic diseases through traditional surgery, minimally invasive surgery, and clinical trials.

Here, we offer the full range of pancreatobiliary procedures, including the Whipple, to address conditions like chronic pancreatitis and cancer of the pancreas, ampulla of Vater, duodenum, and the distal bile duct. In fact, Baylor St. Luke’s was among the first hospitals in the nation to offer the robotic Whipple procedure.

The Elkins Pancreas Center is recognized as a Pancreatitis Center of Excellence by the National Pancreas Foundation.

Offering alternative to laparoscopy for rectal cancer patients

For rectal cancer patients who are not candidates for laparoscopy, Baylor St. Luke’s Medical Center offers Transanal Total Mesorectal Excision (taTME), a “bottom-up” minimally invasive robotic surgery. This procedure is an alternative to conventional surgery for patients with lower rectal cancer. The benefits include better visualization for the surgeon, allowing for more aggressive removal while avoiding the anus.