APRIL 28-30, International Symposium on Cancer Metastasis and the Lymphovascular System: Stanley P.L. Leong, MD FAIRMONT HOTEL SAN FRANCISCO

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1 Presented by the Department of Surgery, University of California, San Francisco 1International Symposium on Cancer Metastasis and the Lymphovascular System: ST BASIS FOR RATIONAL THERAPY APRIL 28-30, 2005 FAIRMONT HOTEL SAN FRANCISCO COURSE DIRECTOR Stanley P.L. Leong, MD Professor of Surgery UCSF School of Medicine Supported by

2 ST 1International Symposium on Cancer Metastasis and the Lymphovascular System: BASIS FOR RATIONAL THERAPY APRIL 28-30, 2005 FAIRMONT HOTEL SAN FRANCISCO, CA In human solid cancer, the lymph node status is the most important prognostic indicator for the clinical outcome of patients. Recent developments in the sentinel lymph node (SLN) concept and technology have resulted in the application of such a revolutionary procedure to define the first draining or SLN that the cancer will metastasize to. The critical issue to be defined is the role of the SLN in the process of lymphatic metastasis. Over the past two decades, significant progress has been made in understanding the functional, anatomical, cellular and molecular aspects of the lymphovascular system, as well as the process of metastasis. SLN procedure has opened a window of opportunity to study micrometastasis in the draining lymph nodes. Follow-up data has shown that about 80% of metastasis follows an orderly pattern of progression via the lymphatic network while about 20% of the time, systemic metastasis occurs, bypassing the lymphatic system. Microarray studies are on the verge of characterizing these different patterns of metastasis on a genetic level. New advances in molecular imaging are making headways to localize early cancer more precisely. This symposium will review the basic science of metastasis through the lymphovascular system, molecular mechanisms of seed and soil of metastasis and central role of the SLN as the guardian node in the process of metastasis. Although the draining lymph nodes are the primary sites of metastasis, they are also the initial organ to launch the immune responses against foreign antigens. Immune responses to cancer in the SLNs and adjacent nodes are poorly understood. There is evidence that significant immunosuppression may be present in the SLNs. On the other hand, the adjacent draining lymph nodes may have immunoreactivity against cancer cells. By studying the immune responses of the cancer-draining lymph nodes, it is possible to direct and amplify the appropriate immune responses to cancer. Current status of the immune responses in the draining lymph nodes against cancer will be summarized. New paradigms of early cancer growth, proliferation, overcoming apoptosis and metastasis are exploited in the development of anticancer treatment. Clinical trials using molecules as inhibitors against growth factor receptors, signaling pathways and angiogenesis or those facilitating apoptosis will be reviewed. The basic mechanisms of cancer metastasis through the lymphovascular system form the basis for rational therapy against cancer. This timely symposium will bring together the basic scientists and clinicians to ask the central question of the role of the lymphovascular system in the spread of cancer and develop logical strategies to curb the process of metastasis.

3 EDUCATIONAL OBJECTIVES After participating in this symposium, participants should be able to: Characterize the anatomy and physiology of the lymphovascular system. Understand how the lymphovascular system may be imaged and how it may be targeted for therapy. Describe the mechanisms of metastasis. Describe the prognostic factors and clinical outcome of metastasis. Understand immune responses of draining lymph nodes against cancer. Explain the rationale of adopting molecular therapeutics against growth factor receptors, apoptotic factors, signaling pathways and angiogenesis. TARGET AUDIENCE CALL FOR ABSTRACTS Physicians and basic research scientists interested in recent advances in understanding cancer metastasis through the lymphovascular system and developing molecular therapeutics against cancer metastasis. Deadline for Submission of Abstracts: February 1, Please visit the conference web page at (under April 2005) for instructions on abstract submission. Submitting an abstract does not constitute registration for the conference. Chosen abstracts will be presented in a poster session. Two awards will be presented to the resident/fellow abstracts that place 1st ($500) and 2nd Place ($250). This program has the American Society of Clinical Oncology s approval for quality of educational content. ASCO endorsement does not constitute medical advice. Health care providers should exercise their own independent medical judgment.

4 FRIDAY, APRIL 29, 2005 THURSDAY, APRIL 28, 2005 PROGRAM 7:00 am Registration and Continental Breakfast 7:50 Welcome and Introduction Stanley Leong Session I: Structure-Function Relationships in the Lymphovascular System SESSION CHAIR: MARLYS WITTE 8:00 Landmarks and Advances in Translational Lymphology Marlys Witte 8:20 Embryonic Development of the Lymphatic System and Tumor Jorg Wilting Lymphangiogenesis 8:40 Lymphovascular Structure, Pathobiology, and Origin from Embryonic Michael Dictor Stem Cells 9:00 Lymph Circulation and Lymph Propulsion Noel McHale 9:20 Lymphatic Markers, Tumor Lymphatics and Tumor Lymphangiogenesis David Jackson 9:40 Panel 10:00 Break Poster Sessions Session II: Diagnostic Imaging and Therapeutic Targeting of the Lymphovascular System SESSION CHAIR: DAVID VERA 10:30 Radioimaging of the Lymphatic System Andrew Raubitschek 10:50 Molecular Imaging Using PET/CT Steven Larson 11:10 Diagnostic Imaging of the Sentinel Lymph Nodes Edwin Glass 11:30 Ultrasound Imaging of the Sentinel Lymph Nodes Jay Harness 11:50 Receptor-Targeted Sentinel Node Mapping Anne Wallace 12:10 Lunch 1:30 pm Molecular Targeting of Lymphatic Vessels Erkki Ruoslahti 1:50 Staining of Retroperitoneal Lymph Nodes; Approach to Endolymphatic Peter Hirnle Therapy 2:10 Fusion Imaging of the Lymphatic System: Therapeutic Implications Alain Pecking 2:30 Gene Therapy Approaches to Block Lymphangiogenic Metastasis Karin Jooss 2:50 Panel 3:10 Break Poster Sessions Session III: Molecular Mechanisms of Metastasis SESSION CHAIR: DAVID HOON 3:40 Cancer Microenvironment Zena Werb 4:00 Cancer Invasion Lance Liotta 4:20 Seed and Soil Mechanisms of Metastasis Martin Mihm 4:40 Adjourn 7:00 am Continental Breakfast Session III: Molecular Mechanisms of Metastasis - continued 8:00 Pre-clinical Models of Regional Lymph Node Metastasis David Nathanson 8:20 A New Breast Cancer Model for Lymphatic Metastasis Ann Chambers 8:40 Genomics of Cancer Metastasis David Duggan 9:00 Intravital Videomicroscopy of Lymphatic Metastasis Ian MacDonald 9:20 Lymphatic Pathophysiology and Metastasis Tim Padera 9:40 Detection and Characterization of Occult Lymph Node Micrometastasis Klaus Pantel in Solid Cancer 10:00 Break Poster Sessions 10:30 Facilitation of Lymph Node Metastasis by Chemokine Receptors on David Hoon Tumor Cells and Chemokine Ligands Expressed in Lymph Nodes 10:50 Molecular Predictors of Metastasis in Primary Melanoma Martin Mihm 11:10 Molecular Prognostic Factors in Cancer Metastasis Douglas Reintgen 11:30 Panel Discussion 12:00 Lunch Session IV: Clinical Patterns of Metastases SESSION CHAIR: STANLEY LEONG 1:30 Proliferation and Cancer Metastasis Blake Cady

5 SATURDAY, APRIL 30, 2005 APRIL 29, :50 Patterns of Metastasis in Melanoma Stanley Leong 2:10 Patterns of Metastasis in Breast Cancer Douglas Reintgen 2:30 Patterns of Metastasis in Head and Neck Cancer Jochen Werner 2:50 Patterns of Metastasis in Colon Cancer Julio Garcia-Aguilar 3:10 Patterns of Metastasis in Upper GI Cancer Yuko Kitagawa 3:30 Break Poster Sessions 4:00 Patterns of Metastasis in Lung Cancer David Jablons 4:20 Why is Papillary Thyroid Cancer to the Regional Nodes Relatively Benign? Blake Cady 4:40 Why Does Sarcoma Metastasize Via the Vascular System Rather Than the Stanley Leong Lymphatic System? 5:00 Panel Discussion 5:30 Adjourn 7:00 am Continental Breakfast Session V: Immune Responses in the Draining Lymph Nodes Against Cancer: Implication for Immunotherapy SESSION CHAIR: SUYU SHU 8:00 Tumor-induced Immune Modulation Facilitates the Establishment of Alistair Cochran Metastases in the Regional Lymph Nodes 8:20 Augmenting the Immune Response to Cancer Vaccines Bernard Fox 8:40 Cancer Vaccine Therapy Donald Morton 9:00 Adoptive Therapy Suyu Shu 9:20 Monitoring Immune Responses Holden Maecker 9:40 Panel Discussion 10:00 Break Poster Sessions Session VI: Inhibitors of Growth Factor Receptors, Signaling Pathways and Angiogenesis as Therapeutic Molecular Agents SESSION CHAIRS: MICHAEL GORDON, GEORGE YANCOPOULOS 10:30 VEGF Trap: A Potent Anti-Angiogenic Agent in Clinical Trials George Yancopoulos 10:50 HER2 as a Prototype for Targeted Therapy Mark Pegram 11:10 Novel Pathways for Consideration for Targeted Therapy Alex Adjei 11:30 Targeting Lymphatic and Vascular Endothelium with Antagonist Bronislaw Pytowski Monoclonal Antibodies to VEGFR-3 11:50 Lunch (on your own) 1:30 Signal Transduction Pathways and Anti-angiogenic Potential: Gabriele Bergers PDGF as a Target 1:50 Anti-angiogenic Agents in Clinical Development Michael Gordon 2:10 Panel Discussion Session VII: New Promises in the Treatment of Solid Cancer SESSION CHAIR: AXEL HAUSCHILD 2:30 Histamine Dihydrochloride: An Immunomodulator for Metastatic Sanjiv Agarwala Melanoma and Other Tumors 2:50 Drug Targeting in Metastatic Melanoma: Results from Phase I/II Trials Axel Hauschild 3:10 Biochemotherapy: Still an Option for Metastatic Melanoma? Steven O Day 3:30 Pegylated Interferons for Melanoma Claus Garbe 3:50 Break Poster Sessions 4:20 New Treatments for Metastatic Breast Cancer: Nanoparticle Paclitaxol Hope Rugo and Other Novel Taxanes 4:40 Role of In Vitro Chemosensitivity Testing for Treatment of Solid Cancer Dirk Schadendorf Based on a Prospective Phase II Trial 5:00 Panel Session VIII: Future Perspectives SESSION CHAIR: STANLEY LEONG AND MARLYS WITTE 5:20 Q&A with Session Chairs 6:20 Adjourn

6 FACULTY COURSE CHAIR Stanley P.L. Leong, MD, FACS Professor of Surgery, University of California, San Francisco GUEST FACULTY Alex A. Adjei, MD Professor of Oncology Mayo Clinic College of Medicine Sanjiv Agarwala, MD Associate Professor of Medicine, University of Pittsburgh Associate Medical Director, Melanoma Program at the University of Pittsburgh Cancer Institute Pittsburg, PA Blake Cady, MD Professor of Surgery Brown Medical School Interim Director, Comprehensive Breast Center Rhode Island Hospital Providence, RI Ann Chambers, PhD Canada Research Chair in Oncology Professor, Department of Oncology, University of Western Ontario Director Pamela Greenaway Kohlmeir Translational Breast Cancer Research Unit Senior Scientist, London Regional Cancer Centre London, Ontario, Canada Alistair J. Cochran, MD Professor of Pathology and Laboratory Medicine & Surgery David Geffen School of Medicine at UCLA Los Angeles, CA Michael Dictor, MD, PhD Associate Professor Department of Pathology Lund University Hospital Lund, Sweden David B. Duggan, MD Investigator, Genetic Basis of Human Disease Division Translational Genomics Research Institute (TGen) Phoenix, AZ Bernard A. Fox, PhD R.W. Franz Cancer Research Center Earle A. Chiles Research Inst. Portland, OR Claus Garbe, MD Professor of Dermatology Eberhard-Karls-University Tuebingen, Germany Edwin Glass, M.D. Section Chief, Nuclear Medicine V.A. Greater Los Angeles Healthcare System Los Angeles, CA Michael S. Gordon, MD Associate Dean for Research University of Arizona Phoenix, AZ Jay K. Harness, MD Medical Director, St. Joseph Hospital Comprehensive Breast Center Orange, CA Axel Hauschild, MD Professor of Dermatology Department of Dermatology University of Kiel Germany Peter Hirnle, MD, PhD Professor and Director Central Academic Clinic Bielefeld, Germany David S.B. Hoon, MD Dept. Molecular Oncology John Wayne Cancer Institute Santa Monica, CA David G. Jackson, Professor of Human Immunology, MRC Human Immunology Unit, Weatherall Institute of Molecular Medicine, University of Oxford, United Kingdom Karin Jooss, PhD Director of Preclinical Oncology and Immunology Cell Genesys, Inc. South San Francisco, CA Yuko Kitagawa, MD, PhD, FACS Assistant Professor Department of Surgery Keio University School of Medicine Tokyo, Japan Steven M. Larson, MD Chief Nuclear Medicine Service Director, Gerschel PET Center Director, Radiology Research Department of Radiology Head, Nuclear Medicine Research Lab Co-Leader, Imaging and Radiation Sciences Bridge Program Sloan Kettering Institute Memorial Sloan Kettering Cancer Center Professor of Radiology Weill-Cornell Medical College New York, NY Lance A. Liotta, MD, PhD Laboratory Chief, Laboratory of Pathology National Cancer Institute Bethesda, MD Ian C. MacDonald, PhD Associate Professor of Medical Biophysics University of Western Ontario London, Ontario, Canada Holden Maecker, PhD Senior Scientist BD Biosciences San Jose, CA Noel G. McHale, PhD Professor, Department of Physiology Director, Smooth Muscle Research Centre Queen's University Belfast Belfast, Northern Ireland Martin C. Mihm, MD Clinical Professor of Pathology Senior Dermatopathologist Massachusetts General Hospital Harvard University Boston, MA Donald L. Morton, MD Medical Director and Surgeon-in-Chief John Wayne Cancer Institute Santa Monica, CA S. David Nathanson, MD Professor, Department of Surgery Case Western Reserve University at Henry Ford Health System Detroit, MI Steven J. O'Day, M.D. Chief of Research Director of Melanoma Program Cancer Institute Medical Group, Affiliated with the John Wayne Cancer Institute Clinical Associate Professor of Medicine, Keck School of Medicine, University of Southern California Los Angeles, CA Timothy P. Padera, Ph.D. Research Fellow Department of Radiation Oncology Massachusetts General Hospital Boston, MA Klaus Pantel, MD Chairman, Institute of Tumor Biology University Hospital Hamburg-Eppendorf Hamburg, Germany Alain Pecking, MD Director, Nuclear Medicine Department Centre René Huguenin Saint-Cloud, France Mark D. Pegram, MD Associate Professor Jonsson Comprehensive Cancer Center, UCLA Los Angeles, CA Bronislaw Pytowski, PhD Senior Group Leader, Assay Development Molecular and Cellular Biology ImClone Systems New York, NY Douglas S. Reintgen, MD Surgical Oncologist Director, Lakeland Regional Cancer Center Lakeland, FL Andrew Raubitschek, MD Director, Department of Radioimmunotherapy City of Hope National Medical Center Duarte, CA Erkki Ruoslahti MD, PhD Distinguished Professor The Burnham Institute La Jolla, CA Dirk Schadendorf, MD Professor Skin Cancer Unit, German Cancer Research Center & Department of Dermatology University of Heidelberg Germany Suyu Shu, PhD Director, Center for Surgery Research The Cleveland Clinic Cleveland, OH David R. Vera, PhD Adjunct Professor Department of Radiology University of California, San Diego La Jolla, CA Anne M. Wallace, MD, FACS Director, UCSD Breast Care Unit Associate Professor of Clinical Surgery University of California, San Diego La Jolla, CA Jochen A. Werner, MD Professor and Chairman Dept. of Otolaryngology, Head and Neck Surgery Philipps University of Marburg Germany Jörg Wilting, PhD Pediatrics I Children's Hospital, University of Goettingen Germany Marlys Hearst Witte, MD Professor of Surgery and Director of Student Research, University of Arizona College of Medicine Secretary-General, International Society of Lymphology Tucson, AZ George D. Yancopoulos, MD, PhD President, Research Laboratories and Chief Scientific Officer Regeneron Pharmaceuticals, Inc. Tarrytown, NY UCSF FACULTY Gabriele Bergers, PhD Assistant Professor Department of Neurological Surgery Research Julio Garcia-Aguilar, MD Professor of Surgery Chief, Section of Colorectal Surgery David M. Jablons, MD Associate Professor and Chief Ada Endowed Chair and Program Leader Thoracic Oncology UCSF Comprehensive Cancer Center Hope Rugo, MD Clinical Professor UCSF Comprehensive Cancer Center Zena Werb, PhD Professor and Vice-Chair Department of Anatomy

7 MSU05002 MSU05002 COURSE REGISTRATION FORM 1st International Symposium on Cancer Metastasis and the Lymphovascular System April 28-30, 2005 Fairmont Hotel, San Francisco Mail to : UCSF Office of Continuing Medical Education P.O. Box San Francisco, CA Fax: (415) Registration Information: (415) Course Information: (415) Dr. Mr. Mrs. Ms. Last Name First M.I. Degree Specialty Address City State Zip ( ) ( ) Daytime Phone Fax Would you like to be on our priority list? Yes No Would you like to be on our priority fax list? Yes No Date of birth to be used as OCME registrant number / / X X Month Day Year HOTEL RESERVATION FORM 1st International Symposium on Cancer Metastasis and the Lymphovascular System April 28-30, 2005 Fairmont Hotel, San Francisco Reservation Deadline: March 28, 2005** Mail to : Attn: Reservations, Fairmont Hotel 950 Mason Street San Francisco, CA Fax: (415) Reservation Information: (415) Last Name First M.I. Degree Specialty Address City State Zip ( ) ( ) Daytime Phone Fax Arrival Date Departure Date # Persons in Room Special Request: ADA Compliant Non-Smoking Other Please indicate if you have any special needs: Registration Fees: Physician $650 Allied Health $500 Resident/Fellow/Nurse $250 Physicians in training must include a letter of verification from training program with registration to qualify for reduced tuition fee. Make checks payable to UC Regents Accommodation Rates: Single/Double $229 Method of Payment Visa MasterCard Discover Amex Carte Blanche Diner s Club Name on Card (please print) Please charge my credit card Visa MasterCard for $ Name on Card (please print) Card # Card # Expiration date Authorized Signature Expiration date Authorized Signature Refund Policy: Cancellations received in writing on or before April 27, 2005 will be refunded, less a $75 administrative fee. No refunds will be made on cancellations received after that date. **Hotel Policies: Reservations must be cancelled at least 24 hours in advance or a one-night s stay (and applicable taxes) will be charged. A credit card number is required to confirm your reservation. Checkin is 3:00 p.m.; check-out is 12:00 noon. Reservation requests made after March 28, 2005 will be honored at the conference room-rates on a space-available basis. Room rates are subject to all state and local taxes (currently 14%, subject to change without notice).

8 Office of Continuing Medical Education NONPROFIT U.S. Postage PAID Permit #470 SANTA ROSA CA UCSF Box 0742, LH-450 San Francisco, CA For more information or to register online visit our website at You may also reach us by calling the Office of Continuing Medical Education at (415) or ACCREDITATION The University of California, San Francisco School of Medicine (UCSF) is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The University of California, San Francisco School of Medicine (UCSF) designates this educational activity for a maximum of category 1 credits toward the AMA Physician's Recognition Award. Each physician should claim only those credits that he/she actually spent in the activity. Nursing Credit - The American Nurses Credentialing Center accepts AMA PRA category 1 credit issued by organizations accredited by the ACCME. GENERAL INFORMATION Pre-registration is preferred to ensure that registrants receive a syllabus and CME Certificate at the course. OFFICIAL LANGUAGE All lectures and discussions will be in English only. There will be no simultaneous interpretation. HOW TO ENROLL Tuition: $650 Physicians $500 Allied Health Professionals $250 Fellows/Residents/ Nurses* * Physicians in training must include a letter of verification from training program with registration to qualify for reduced tuition fee. Payment may be made by Visa, MasterCard or check. REGISTER VIA: Online: Mail: Complete course registration form and send with payment to: UCSF Office of Continuing Medical Education P.O. Box San Francisco, CA Fax: Fax completed registration form to: (415) (be sure to include your credit card number) To register by phone or to inquire about registration status, please call UCSF s CME Registration Office at (415) ON-SITE REGISTRATION Time: 7:00 7:50 am Date: April 28, 2005 Place: Fairmont Hotel 950 Mason Street San Francisco, CA REFUNDS Cancellations received in writing on or before April 27, 2005, will be refunded, less a $75 administrative fee. No refunds will be made on cancellations received after that date. ACCOMMODATIONS A block of guestrooms has been reserved at the Fairmont Hotel on Nob Hill, (415) , with a nightly group rate of $229. Reservations must be received by March 28, 2005, to guarantee availability of the group rate. After this date, rooms will be provided on a space-available basis only. A hotel reservation form is attached for your convenience. If you prefer to phone in your reservation, please identify yourself as a member of this conference to receive the special rate.