City of Hope Uses Genetics to Fight Cancer – Orange County Register


Tabitha Paccione was 34 years old and in the best shape of her life.

So when her cough wouldn’t go away, she thought it was because of the usual germs roaming around the first grade classroom where she taught Downey.

This was Dec 2015.

Doctors gave her antibiotics, but the cough persisted, so much so that she sometimes woke up gagging. Then her voice became hoarse and her back began to hurt.

It wasn’t until nearly a year later that a doctor discovered the problem: stage four non-small cell lung cancer. Her prognosis: 3-6 months.

“By the time I was diagnosed, the cancer was everywhere. All because of my ribs. All through my bones. It was in my spine. I had several lesions in my brain, one in my liver,” she says, tearing at the memory. “How can I have lung cancer? Lung cancer is for people who smoke. I’ve never touched a cigarette.”

Her first thought was what would her two children do without their mother. Then a TV commercial popped into her head. It was for City of Hope.

“I remember seeing that when I was a kid and thinking, ‘Wow, what an amazing place,’” she says. “So that was the first phone call I made.”

Paccione got an appointment with Dr. Ravi Salgia, chair of medical oncology and therapeutic research at City of Hope.

dr. Ravi Salgia, Chair of Medical Oncology and Therapeutic Research at the City of Hope in Duarte on Thursday, August 26, 2021. Dr. Salgia was part of a team of international researchers who discovered a biomarker for a genetic mutation that causes about 5 percent of lung cancer. He then developed a therapeutic pill to treat the cancer. (Photo by Keith Birmingham, Pasadena Star-News/SCNG)

In 2007, Salgia was part of a team of international researchers who helped discover a therapy against a genetic mutation (ALK+) that causes about 5 percent of lung cancers.

Now fast forward to Paccione walking into his office in City of Hope. Salgia did a genomic profile of her – and bingo, she had the ALK+ mutation. He prescribed her the pill that had been developed on the basis of his research.

“Within about a month of taking the pills, the coughing stopped. I was able to sleep,” Paccione says.

Within three months, a scan showed that her tumors had shrunk, the liver lesion had disappeared, and her bones showed healed scar tissue where the cancer used to be.

Three years after starting the therapy, the cancer had disappeared.

“I still have to pinch myself a little bit when I say it,” she says.

Now five years cancer-free, Paccione, who recently moved from Cypress to Houston, still takes eight pills a day. Her only side effects are occasional muscle aches and fatigue.

“But I’m here and I’m alive,” she says.

dr. Edward Kim is deputy chief physician of City of Hope National Medical Center and chief physician of City of Hope Orange County, which is building a premier cancer center in Irvine, set to open in 2022.

“Ten years ago I would have said Tabitha is a miracle,” he says. “Right now (her recovery) is what we hope to see and see more of.”

dr. Edward S. Kim, a renowned oncologist, is the new Chief Physician for City of Hope Orange County. Kim will play a key role in developing what City of Hope plans to be a world-class Orange County healthcare network, anchored on the Cancer Care Campus in Irvine. (Photo courtesy of City of Hope Orange County)

When Kim first started, in the early 2000s, lung cancer patients were given a generic chemotherapy regimen that was not tailored to the patient.

“We were just hoping it wouldn’t make you too sick and shrink the tumor,” he says.

However, it only worked in 15 to 20 percent of the cases.

“And people got really sick,” Kim says. “Nausea, vomiting.”

Genomic profiling changed everything. Once researchers could identify the gene mutation responsible for a particular cancer, they could develop therapies to thwart it.

Currently, eight biomarkers/therapies have been discovered for nearly half of the genetic mutations that cause lung cancer.

Unfortunately, not every lung cancer patient knows this. According to Kim, it is estimated that only 50-70 percent of cancer patients nationwide are tested for biomarkers by their doctors.

That costs a lot of people their lives. By 2021, lung cancer will kill nearly 132,000 American men and women — and as many as 20% of lung cancer patients are nonsmokers, according to the U.S. Centers for Disease Control and Prevention and the American Cancer Society.

“Every lung cancer patient should have a genomic profile,” Salgia says.

Earlier this month, City of Hope acquired Pacific Shores Medical Group, which has seven Southern California locations, including Irvine, Huntington Beach, Newport Beach, Glendale, Torrance and Long Beach.

“We’ve grown our family,” Kim says.

And as part of the family, these caregivers now have access to City of Hope’s research capabilities, clinical trials and expertise.

“We are going to learn from them; We have enough humility to know that providing quality care is something they have been successful at,” Kim says. “But we can now empower these talented doctors with our deep expertise. Our bank is full of experts who only focus on one particular form of cancer. We eat sleep and respiratory cancer.”

City of Hope is also set to open a second comprehensive cancer center in Irvine in late 2022. It is being touted as a destination center that is expected to attract patients from all over the world.

For locals, this means more opportunities to receive highly specialized cancer care and participate in advanced clinical trials – without having to travel far. Twenty percent of cancer patients in Orange County currently travel abroad for their care, which can be a challenge and even a deterrent.

“I really believe we need to bring opportunities to people closer to where they live, and ease the burden on patients,” Kim says.

In addition to clinical trials and specialty treatments, the Orange County campus will have a research center where doctors will continue to search for more breakthroughs — and more biomarkers.

“It’s really thanks to the research that I can get to that next lily pad,” Paccione says. “Until we can find a cure, we hold on and fight.”