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UK Precision Medicine Clinic

Bringing precision medicine to our patients with cancer

Jill Kolesar, PharmD

Written by Jill Kolesar, PharmD, a professor in the UK College of Pharmacy, co-director of the UK Markey Cancer Center Molecular Tumor Board and director of Markey’s Precision Medicine Clinic.

Historically, cancer treatment has been offered through one-size-fits-all therapies based on the average person.

But that is changing as we learn more about cancer and why it occurs. Scientists and doctors – including those at the Markey Cancer Center and UK HealthCare – are increasingly using an exciting new treatment option called precision medicine.

Precision medicine a kind of treatment that takes into account each patient’s individual genetics, environment and lifestyle to find a tailored therapy that works for their specific cancer.

Recently, we launched our very own Precision Medicine Clinic at UK, the first of its kind in Kentucky. Our team at the Precision Medicine Clinic specializes in finding personalized treatment options that will be most effective for our patients.

What is the Precision Medicine Clinic?

Because precision medicine is a relatively new approach to treating cancer, many of the therapies are still being studied in early-phase clinical trials.

The Precision Medicine Clinic is a dedicated treatment center for patients with cancer who are enrolled in or eligible for early-phase precision medicine clinical trials. The clinic provides a space for patients to receive clinical trial treatments, with staff highly experienced in precision medicine and clinical trials.

What does the Precision Medicine Clinic offer?

As part of Markey, the only National Cancer Institute-designated cancer center in Kentucky, the clinic provides access to early-phase precision medicine clinical trials. Through these trials, we offer many cancer treatment services, including:

  • Infusion therapy, treatment delivered intravenously (IV).
  • Targeted therapy, treatment that works based on a patient’s genetics.
  • Immunotherapy, treatment that works with a patient’s immune system.
  • Oral cancer therapies, treatment patients can take by mouth at home, making treatment more convenient and accessible.

The clinic is also connected with Markey’s Molecular Tumor Board. This multidisciplinary team of scientists and clinicians meets regularly to discuss specific cases and use the members’ shared expertise to find treatment options for patients with cancer.

Who works in the Precision Medicine Clinic?

Our clinic is fully staffed with experts in the field of precision medicine and clinical trials:

  • Precision medicine nurses specialize in administering infusion, or IV, treatments to patients, ensure patients are comfortable, and address any unexpected complications during the infusion.
  • Clinical research nurses work with patients to find the best-fit clinical trial for their specific cancer and health conditions.
  • Precision medicine pharmacists are experts in ensuring investigational and standard-of-care therapies fit with each patient’s other medications and conditions, preventing adverse effects, and in educating patients on how to take their medications.
  • Clinical service technicians work with patients, physicians and pharmacists to ensure all treatments run smoothly and effectively.
  • Medical oncologists and hematologists from a variety of specialties provide their expertise for each patient and their individualized treatment.

How can you contact the Precision Medicine Clinic?

If you or someone you know could benefit from the Precision Medicine Clinic, please contact us at 859-323-7750.


Watch a video interview with Dr. Kolesar, where she tells us more about the Precision Medicine Clinic and how cancer patients can benefit from its services.


Next steps:

  • Get to know Dr. Kolesar and find out why she is so passionate about cancer research.
  • Markey is Kentucky’s only NCI-designated cancer center, providing world-class cancer care right here in the Commonwealth. Learn more about why patients choose Markey for their cancer treatment.
Precision Medicine Clinic

New Markey clinic gives patients access to latest cancer treatments

In its ongoing efforts to offer Kentuckians the latest, most innovative cancer treatments available, the UK Markey Cancer Center recently launched the Precision Medicine Clinic, a new space dedicated to providing patients with increased access to Phase I and Phase II clinical trials.

Before a new drug can be approved by the Food and Drug Administration for widespread use, it must first be proven safe and effective in clinical trials. When patients are enrolled in Phase I trials, they are often among the first people to receive a promising new drug or treatment. Phase II trials build on the information gathered in a Phase I trial and often compare its efficacy with the current standard treatment for that specific cancer.

Many of the early-phase clinical trials offered at the Precision Medicine Clinic will be investigator-initiated trials from Markey physician-scientists, as well as national clinical trials sponsored by the National Cancer Institute and Early Therapeutic Clinical Trials Network. Leading-edge trials like these are not usually available to patients treated outside an NCI-designated cancer center such as Markey.

Understanding cancer in Kentucky

Markey’s Molecular Tumor Board, which launched in November 2016, is providing ongoing guidance for the types of clinical trials the Precision Medicine Clinic will facilitate. As the tumor board members learn more about the types of mutations causing cancer in here in Kentucky and the region, new trials can be designed to target those specific mutations.

“Cancer treatment has traditionally been based on tumor types, but with more data obtained from genetic analyses, we are using that information to target specific mutations,” said Markey Director Dr. Mark Evers. “The more data we gather through the Molecular Tumor Board, the more precise therapies we’ll be able to offer through clinical trials at the Precision Medicine Clinic.”

A team of research experts

The Precision Medicine Clinic is directed by clinical pharmacologist Jill Kolesar, PharmD, a professor in the UK College of Pharmacy and a nationally known expert in oncology pharmacogenomics, alongside medical oncologist Dr. Susanne Arnold and surgical oncologist Dr. Rachel Miller. All have extensive experience in clinical trial implementation.

Additionally, the clinic employs a staff of multidisciplinary experts who have a high level of experience with research, including chemotherapy nurses, pharmacists, and research nurses. Cancer patients who are enrolled in early-phase clinical trials will receive much of their care in this new space.

Located on the second floor of UK Albert B. Chandler Hospital Pavilion H, the Precision Medicine Clinic includes two exam rooms and four infusion chairs. Kolesar anticipates the clinic will see up to six patients a day and about 300 new patients each year.

Helping patients across the Commonwealth

The clinic will receive many internal referrals from UK HealthCare physicians, but community physicians from across the Commonwealth will also be able to refer patients to Markey for these unique trials and treatment options.

“The Precision Medicine Clinic provides trials that aren’t available anywhere else in Kentucky,” Kolesar said. “It truly benefits the entire state by providing access to the newest cancer treatments. Referring community physicians will be able to keep their patients here in Kentucky instead of sending them to other facilities far from home.”


Next steps:

  • Get to know Dr. Kolesar and find out why she is so passionate about cancer research.
  • Markey is Kentucky’s only NCI-designated cancer center, providing world-class cancer care right here in the Commonwealth. Learn more about why patients choose Markey for their cancer treatment.

Cancer is her fight, precision medicine is her weapon

Making the RoundsIn our latest Making the Rounds conversation, we had a chance to chat with Jill Kolesar, PharmD, a professor in the UK College of Pharmacy, co-director of the UK Markey Cancer Center Molecular Tumor Board and director of Markey’s Precision Medicine Clinic.

Dr. Kolesar came to UK HealthCare last year from the University of Wisconsin. Her research is focused on precision medicine, the field of finding new drugs to treat specific cancer mutations. 

Tell us about your precision medicine research.

Precision medicine is a type of treatment that targets a specific genetic mutation in a tumor. Clinical trials have shown that, if you have one of these mutations, not only will the precision medicine work better, but you’ll have fewer side effects. There’s no question that they’re better. Unfortunately, not everyone has a mutation that we have a drug for, but that’s really what we’re working on with our research.

My research is focused on finding new drugs. We look at particular mutations and then use different drugs to target those mutations to determine what the most effective therapy is.

What is the Molecular Tumor Board?

The Molecular Tumor Board brings these precision medicine options to patients and their doctors. The board is made up of doctors, pharmacists and scientists who are experts in genetic sequencing and the treatment of cancer. These people come together to look at each patient’s genetic report and make a treatment recommendation specific to that person.

It’s a real benefit to the patients of Kentucky and their physicians. The treating physician usually knows the patient much better, but the Molecular Tumor Board usually knows the genetics and the new treatments much better. It’s really a partnership between the physician, the patient and the Molecular Tumor Board.

What types of patients benefit most from the Molecular Tumor Board?

The types of patients that are candidates for the Molecular Tumor Board are patients with rare tumors, as well as patients who haven’t responded to standard therapies. And actually, patients with lung cancer can be seen by the tumor board after their initial diagnosis.

Why did you decide to pursue research?

When I was a junior in college, I saw a TV program on PBS about tumor-infiltrating lymphocytes (white blood cells) and how they could be taken out of a patient and activated and then given back to make a positive impact.

And so that was the day I decided I was going into cancer research. I’ve never looked back and I’ve always been happy with that decision.

What do you do in spare time?

I like to garden, I like to travel, I like to cook – and I enjoy good food.


Check out our video interview with Dr. Kolesar, where she talks more about the benefits of the Molecular Tumor Board.


Next steps:

  • Watch our TV spot that features the work of our Molecular Tumor Board.
  • Markey is Kentucky’s only NCI-designated cancer center, providing world-class cancer care right here in the Commonwealth. Learn more about why patients choose Markey for their cancer treatment.
molecular tumor board

Watch: Our new TV spot highlights precision cancer care at Markey

Our new TV spot tells the exciting story of how the UK Markey Cancer Center is using precision medicine to target cancer treatment to patients’ unique cancer cells. Watch the video below and learn more about how we’re harnessing the power of advanced medicine to find the best treatment for each patient.

Treating cancer at the molecular level

The future of cancer treatment is fighting the disease at the level of an individual gene, breaking down a diagnosis by analyzing each patient’s unique genetic characteristics. At Markey, our Molecular Tumor Board is leading this fight, bringing personalized, precision medicine to patients across Kentucky.

The Molecular Tumor Board, which is made up of more than a dozen leading clinicians and scientists, meets monthly to review individual cancer cases from across the Commonwealth, diving deep into patients’ genetic information, then collectively tailoring a precision treatment specifically for them.

Tailoring a precision treatment

Dr. Jill Kolesar

Dr. Jill Kolesar

“It’s well accepted that cancer is chiefly a genetic disorder,” says Dr. Jill Kolesar, a founding member and co-director of Markey’s Molecular Tumor Board. “The first genome that was sequenced took 13 years and $2.7 billion dollars. Now we can sequence a genome in an afternoon.”

Such significant advances in technology have helped spur precision medicine, but have also created large quantities of genetic information, Kolesar said. It’s up to the Molecular Tumor Board to interpret that vast amount of data and apply it to an individual’s cancer diagnosis and treatment.

Dr. Susanne Arnold

Dr. Susanne Arnold

Medical oncologist Dr. Susanne Arnold, Markey’s associate director for clinical translation and member of the Molecular Tumor Board, is helping lead this individualized approach to cancer treatment. A precision approach to diagnosis and analysis is the future of care, she said.

“You take a biopsy and do the genomic analysis, called next-generation sequencing, which helps us understand exactly what happened with that cell that resulted in cancer,” she explained.

But what might sound like a routine test in modern medicine is much more remarkable in these particular cases.

“Molecular medicine is actually discovering the information about a unique cancer in a specific person at a precise point in time,” she said. “Pinpointing this allows us to understand why it happened, why our treatment did or didn’t work, and how we can potentially stop (the cancer).”

In short, these tests allow for a remarkably detailed understanding of what goes wrong in cancerous cells. And that sort of comprehensive knowledge helps the tumor board choose the best treatment from among the many options available at Markey.

How the molecular tumor board works

Markey’s Molecular Tumor Board is not the first of its kind, but it is the first in Kentucky. And that’s significant, given the unprecedented rates of cancer across the state, most notably in the rural, eastern parts of Kentucky.

With the board meeting twice monthly, oncologists across the state can reach out for a recommendation for therapy based on their patient’s molecular signature.

There are more than a dozen scientific specialties represented on the board, and more than 300 years of experience in total. All of this is applied to a single patient as cases are presented to the board, and the inclusion of each patient’s own physician in the process ensures an intimate understanding of that patient’s condition and outlook.

Each patient’s cancer will be tested for all genetic mutations that are known to cause cancer, regardless of what type of tumor the patient has. The tumor board then uses the results of that test to choose possible treatment options that target the genetic mutations. Each mutation is evaluated for FDA-approved therapies for the patient’s tumor type, FDA-approved off-label therapies and any clinical trials available related to the patient’s specific mutations.

Taking into consideration the available treatment options, the Molecular Tumor Board will make a recommendation based on the best possible outcome for the patient.

For a single patient, for all of Kentucky

As more tumor boards are established across the country and more cases are reviewed, a bank of information will be available to doctors to help them determine the best course of action for patients with similar cases.

“Everything we discover is designed to help you, and by sharing this information in an anonymous way, it can help people across the country suffering with cancer. We’re all being connected through this process, and that’s a beautiful, beautiful story to tell,” Arnold said. “Imagine you are ‘Anne’ from Pikeville, Kentucky, but behind you is your doctor, the Markey Cancer Center, other NCI-designated cancer centers, the National Cancer Institute … and ‘John’ in New York City, who has the same mutation as you. The six degrees of separation suddenly disappear, and ideally you each benefit from the experience of the other.”

Dr. Mark Evers

Dr. Mark Evers

That is the crux of Markey’s ambitions: an individualized approach to each patient, but on a large scale. In an open letter released at the end of 2016, Dr. Mark Evers, director of Markey, made public a goal of the organization: to significantly reduce cancer incidence and mortality across the state, and the region, by the year 2020. It’s a lofty aspiration, but initiatives like the Molecular Tumor Board position Markey for success.

As Kolesar said, “When researchers and clinicians at the Markey Cancer Center decide something is going to benefit patients, like the Molecular Tumor Board, they say, ‘Let’s do it.’”

This team spirit spans the entire organization. Kolesar noted the collegiality and support for accomplishing goals at UK HealthCare.

“Dr. Evers, says, ‘You just tell me what you need, and we’ll make it happen, because that’s what we think the patients of Kentucky need,’” she said.

Such sweeping change, especially when it comes to issues as complicated and extensive as healthcare, rarely happens quickly. But a series of small successes, over time, can have an enormous ripple effect. The experts who make up the Molecular Tumor Board understand this, and it’s their reason for participating in and offering their time to such programs.

“By understanding the genetic makeup of our patients and their tumors, we can then help to direct their therapy,” Evers said.

The future of advanced medicine

Treatment options at UK HealthCare are more abundant than ever before. The Early Therapeutics Clinical Trials Center focuses on increasing patient access to phase I and phase II clinical trials will also have a major impact for Markey patients.

“[Previously,] if patients in Kentucky needed an earlier-phase clinical trial, they would have to go out of state,” said Kolesar, explaining the advantage of the initiative.

These early-phase studies can offer patients new treatment avenues for cancers that have proved difficult to target using standard therapies. Essentially, it allows Markey to participate in the development of new and novel treatments while offering patients first access.

Being at the forefront of medicine means incredible discovery, but for every breakthrough, there are new unknowns. This uncharted territory is a product of advancement and a reason for optimism.

“Do we have a therapy for every gene that’s broken? No. But we do have therapies for genes that are broken in non-small cell lung cancer, melanoma, breast cancer, colon cancer and a growing list every day. They are defined by their gene signature and by the gene that’s broken. That’s called targeted therapy,” Arnold said.

The hope is that this sort of targeting can be applied to all types of cancer, and Markey’s patients could be among the first to benefit.

“The Power of Advanced Medicine” is more than a slogan. It’s a guiding principle and a reminder that UK HealthCare prioritizes discovery in the name of our patients.


Next steps:

  • Markey is Kentucky’s only NCI-designated cancer center, providing world-class cancer care right here in the Commonwealth. Learn more about why patients choose Markey for their cancer treatment. For a second opinion or appointment, call Markey at 859-257-4488 or 866-340-4488 (toll free).
  • Learn more about the power of advanced medicine at UK HealthCare.
Dr. Mark Evers

Video: Markey hosts inaugural Precision Medicine Symposium

The UK Markey Cancer Center on Wednesday hosted its inaugural Precision Medicine Symposium, aimed at teaching oncology healthcare providers how to implement precision medicine into their clinical practice.

Precision medicine in cancer treatment focuses on understanding genetic mutations and using those mutations to select the best therapy for patients. Precision medicine is one of the recommendations highlighted by the White House Cancer Moonshot’s Blue Ribbon Panel. Presentations at Wednesday’s symposium included discussions about oncogenomic testing, Markey’s new Molecular Tumor Board, clinical trials and more.

Attending the symposium were more than 190 providers, including oncologists, hematologists, pathologists, radiologists, oncology nurses, researchers, pharmacists, genetic counselors, and cancer center administrators and leaders representing more than 20 different medical centers and healthcare entities across the region.

Breakout sessions allowed providers to meet in smaller groups with presenters and ask questions about precision-medicine issues, such as payment and reimbursement for Molecular Tumor Board recommendations.

The symposium concluded with a keynote speech from Dr. Shridar Ganesan, chief of molecular oncology at the Rutgers Cancer Institute of New Jersey.

“This event is so important because we want to bring precision medicine to all patients with cancer in Kentucky,” said Jill Kolesar, PhD, co-director of the Markey’s Molecular Tumor Board. “We’re bringing together clinicians and scientists to bring initiatives from the Markey Cancer Center to the entire Commonwealth of Kentucky.”

Watch a video below for more highlights from this exciting event.


Next steps:

The Molecular Tumor Board is codirected by Dr. Rachel Miller and Jill Kolesar, PharmD.

Molecular Tumor Board gives Markey patients expanded access to precision medicine

The UK Markey Cancer Center recently launched its own Molecular Tumor Board, an approach to cancer care that uses genetic analysis to help oncologists choose cancer therapies tailored to each patient’s individual needs. The Molecular Tumor Board is the latest precision medicine initiative to come online at Markey.

“Oncology is now more genetic-based, instead of being based upon tumor types,” said Dr. Mark Evers, director of the Markey Cancer Center. “By better understanding the genetic makeup of our patients and their tumors, we can help direct their therapy.”

The Molecular Tumor Board is co-directed by clinical pharmacologist Jill Kolesar, Pharm.D., who recently joined Markey and the UK College of Pharmacy after starting a similar initiative at the University of Wisconsin-Madison and Markey gynecologic oncologist Dr. Rachel Miller.

How the tumor board works

Currently, clinical trials often target tumors with certain molecular or genetic characteristics, then search for patients with tumors that matched those criteria ­– like looking for a needle in a haystack. The information gleaned by the Molecular Tumor Board will instead allow researchers to develop clinical trials targeted to the needs of the patients Markey treats; in other words, it means starting with the needle, rather than the haystack.

Here’s how the tumor board process will work at Markey: when a patient undergoes a biopsy, the physician may choose to request a Molecular Tumor Board review of that case. The patient’s tissue will then be sent to UK’s in-house pathology lab for genetic type testing. Using technology known as next-generation sequencing, pathologists will run tests to compare the patient’s genes against a panel of 198 gene mutations that are associated with all types of cancer – 94 are for blood cancers and an additional 104 are added for solid tumors.

Once the sequencing is complete, the final report ­– containing the findings of any possible gene mutations – is sent to Molecular Tumor Board members. The report will be evaluated for three types of potential care: FDA-approved therapies for that patient’s cancer type, FDA-approved therapies in another tumor type (also known as “off-label use”) and potential clinical trials.

For example: a lung cancer patient who undergoes genetic type testing may receive pathology results showing they have three gene mutations of the 198-gene panel that are associated with cancer. It is possible that any one of these mutations may have caused the cancer and there may be either FDA-approved drugs or clinical trials targeting each of these mutations.

It’s the job of the Molecular Tumor Board itself to evaluate all of these potential therapies to ultimately determine which of the therapies will yield the best possible outcome for the patient.

‘The essence of precision medicine’

The tumor board comprises a vast array of experts across both the UK medical and academic campuses, including oncologists, hematologists, surgeons, pharmacists, pathologists, biostatisticians, basic scientists and epidemiologists, who meet on a regular basis to discuss each individual case in person. Each member brings their own expertise to discuss the available options and ultimately make a recommendation for the best course of care for that patient.

“It’s the essence of precision medicine,” Miller said. “The Molecular Tumor Board provides not only an opportunity for our patients, but also an opportunity for a physician to gain a better understanding of these molecular characteristics while providing the latest in optimal care for our patients.”

Improving cancer care across Kentucky

By analyzing the molecular characteristics of cancer tumors on a case-by-case basis, the Molecular Tumor Board will also create a cache of information to direct the development of new therapies that target the types of cancers found at Markey and throughout Kentucky.

“The Molecular Tumor Board will bring a fuller understanding of the cancers faced by Kentuckians,” Kolesar said. “Going forward, this will guide us in developing clinical trials and novel therapies best matched to our patients in the Commonwealth.”

Across the country, only a few medical centers currently have a Molecular Tumor Board to help direct cancer care. This type of precision medicine was one of the key opportunities highlighted earlier in the year with the Cancer Moonshot initiative. Established by President Barack Obama during the 2016 State of the Union address and led by Vice President Joe Biden, the goal of the Cancer Moonshot is to double the rate of progress in cancer prevention, diagnosis, treatment and care over the next five years and to ultimately end cancer.

“As the state that leads the nation in cancer incidence and mortality, nowhere in the country is it more important for patients to have access to this type of personalized medicine,” Evers said. “This is an opportunity for us to make a direct impact on the dire cancer statistics here in Kentucky.”


Next steps:

  • Check out our infographic to see how a patient with lung cancer would benefit from the Molecular Tumor Board.
  • Clinical trials can give cancer patients access to the latest treatments and breakthroughs. Learn more about the clinical trials open right now at Markey.