Overview
As an investigator who focuses clinically on children with high-risk solid tumors, my research interests focus on translating novel therapeutic agents and combinations into early phase clinical trials to improve the outcomes for children with relapsed/refractory solid tumors. I earned a Master of Science in Clinical Research (MSCR) from Emory University and as a senior associate in Pediatric Hematology Oncology, spent an additional year of focused training in phase I/II clinical trial and 131I-MIBG therapy administration. As an attending physician at the Aflac Cancer and Blood Disorders Center, I serve as lead consultant for relapsed solid tumor patients and previously served as Interim Director of our Developmental Therapeutics Program, which is the largest phase I/II referral center in the Southeastern United States. I am Assistant Director of our 131I-MIBG and Recurrent/Refractory Neuroblastoma Program, which has administered well over 100 therapeutic 131I-MIBG treatments over the last 10+ years. I have served as institutional PI for the Children’s Oncology Group (COG) since 2017.
I have played a key role in expanding the portfolio of investigator-initiated phase I/II trials for children with recurrent brain and solid tumors. I am currently the Principal Investigator (PI) or Co-PI of four investigator-initiated, phase I/II trials (NCT02644460, NCT02574728, NCT03507491, and NCT04469530), and have recently received funding for two additional phase 1b trials in osteosarcoma. My research focus is conducting trials that combine immunotherapy with other treatment modalities. I was study chair of a recently completed national phase I trial conducted through the New Approaches to Neuroblastoma Therapy (NANT) consortium testing the systemic radiotherapy 131I-MIBG in combination with the monoclonal antibody dinutuximab +/- vorinostat (NCT03332667). Additionally, I serve as co-chair of the current COG phase 3 trial for patients with newly diagnosed high-risk neuroblastoma (ANBL2131), which is testing whether the addition of chemoimmunotherapy during Induction improves outcomes. I am on the study committee for COG trial ANBL1821 which is a randomized phase 2 trial testing chemoimmunotherapy +/- DFMO. Lastly, I recently received funding for a Phase 1b trial testing the PD-L1 inhibitor atezolizumab in combination with SBRT and surgery for patients with isolated pulmonary recurrence of osteosarcoma.
I have played a key role in expanding the portfolio of investigator-initiated phase I/II trials at our institution for children with recurrent brain and solid tumors. I am the Study chair or co-chair of four multi-institutional, investigator-initiated, phase I/II trials which are supported by peer reviewed funding.
- Aflac ST1502 (CHOAnome) (Study chair), Phase 2 trial testing sirolimus in combination with metronomic chemotherapy for patients with relapsed/refractory solid and CNS tumors (NCT02574728)
- Aflac ST1501 (Co-investigator), Phase 1 trial testing the CDK 4/6 inhibitor abemaciclib in patients with newly diagnosed DIPG and relapsed/refractory solid and CNS tumors (NCT02644460)
- Aflac ST1603 (Study co-chair), Phase 1 trial testing nab-paclitaxel in combination with gemcitabine for patients with relapsed/refractory solid tumors (NCT03507491)
- AflacST1903 (Study Co-Chair): Sirolimus in combination with metronomic chemotherapy (CHOAnome) as maintenance therapy in children with high-risk solid tumors (NCT02574728)
- NANT 2017-01 (Study chair): A national phase I trial being conducted through the New Approaches to Neuroblastoma Therapy (NANT) consortium testing 131I-MIBG in combination with dinutuximab (NCT03332667)
- Novel therapeutic agents and combinations for patients with relapsed or refractory solid tumors
- Planning novel biologic correlates that will enhance our scientific knowledge and aid in planning future trials
- Clinical trials of immunotherapy in combination with other agents including radiation and chemotherapy
Cash T, Marachelian A, DuBois SG, Chi YY, Groshen SG, Shamirian A, Stout AC, Macy ME, Pinto NR, Desai AV, Sondel PM, Asgharzadeh S, Weiss BD, Mosse YP, Matthay KK, Park JR, Goldsmith KC. Phase I Study of 131I-MIBG with Dinutuximab for Patients with Relapsed or Refractory Neuroblastoma: A Report from the New Approaches to Neuroblastoma Therapy (NANT) Consortium. DOI: 10.1200/JCO.2022.40.16_suppl.10038 Journal of Clinical Oncology 40, no. 16_suppl (June 01, 2022) 10038-10038.
Cash T, Krailo MD, Buxton AB, Pawel BR, Healey JH, Binitie O, Marcus KJ, Grier HE, Grohar PJ, Reed DR, Weiss AR, Gorlick R, Janeway KA, DuBois SG, Womer RB. Long-Term Outcomes in Patients With Localized Ewing Sarcoma Treated With Interval-Compressed Chemotherapy on Children's Oncology Group Study AEWS0031. J Clin Oncol. 2023 Oct 20;41(30):4724-4728. doi: 10.1200/JCO.23.00053. Epub 2023 Aug 31. PMID: 37651654; PMCID: PMC10602538.
Cash T, Fox E, Liu X, Minard CG, Reid JM, Scheck AC, Weigel BJ, Wetmore C. A phase 1 study of prexasertib (LY2606368), a CHK1/2 inhibitor, in pediatric patients with recurrent or refractory solid tumors, including CNS tumors: A report from the Children's Oncology Group Pediatric Early Phase Clinical Trials Network (ADVL1515). Pediatr Blood Cancer. 2021 Sep;68(9):e29065. doi: 10.1002/pbc.29065. Epub 2021 Apr 21. PMID: 33881209; PMCID: PMC9090141.
Qayed M, Cash T, Tighiouart M, MacDonald TJ, Goldsmith KC, Tanos R, Kean L, Watkins B, Suessmuth Y, Wetmore C, Katzenstein HM. A phase I study of sirolimus in combination with metronomic therapy (CHOAnome) in children with recurrent or refractory solid and brain tumors. Pediatr Blood Cancer. 2020 Apr;67(4):e28134. doi: 10.1002/pbc.28134. Epub 2019 Dec 25. PMID: 31876107.
Cash T, Jonus HC, Tsvetkova M, Beumer JH, Sadanand A, Lee JY, Henry CJ, Aguilera D, Harvey RD, Goldsmith KC. A phase 1 study of simvastatin in combination with topotecan and cyclophosphamide in pediatric patients with relapsed and/or refractory solid and CNS tumors. Pediatr Blood Cancer. 2023 Aug;70(8):e30405. doi: 10.1002/pbc.30405. Epub 2023 May 9. PMID: 37158620.
Cash T, Aguilera D, Macy ME, Hoffman L, Dorris K, McCracken C, Hanberry B, Castellino RC, MacDonald T, and Wetmore C. Phase 1 Study of Abemaciclib in Children with Recurrent and Refractory Solid Tumors Including Malignant Brain Tumors. Molecular Cancer Therapeutics 2019;18(12 Suppl):Abstract nr C002. doi:10.1158/1535-7163.TARG-19-C002.
Cash T, Aguilera D, Ginn KF, Hoffman LM, Keesari R, Petersen WC, Caywood EH, Qayed M, Connelly E, Milla SS, Castellino RC, Fangusaro J, MacDonald TJ, Wetmore C, Katzenstein HM. A Phase 2 Study of Sirolimus in Combination with Metronomic Chemotherapy in Children with Recurrent and/or Refractory Solid and CNS Tumors. Journal of Clinical Oncology. 2023; 41:16_suppl, 10024-10024.
Metts J, Ginn K, Cost C, Froug B, Watt A, Schink M, Senn S, Cash T. A Phase I Study of Nab-Paclitaxel Combined with Gemcitabine for Pediatric Relapsed/Refractory Solid Tumors. Pediatric Blood & Cancer. 2022;69 Suppl 5:e29952. doi: 10.1002/pbc.29952.
Private Foundation Funded:
COG (Children's Oncology Group): U01CA180886 - 2017-present
Role: Institutional PI
PI: Hawkins
COG (Children's Oncology Group): U01CA180886: ANBL 2131 - 2023-present
Role: Study Co-chair
PI: Hawkins
CURE Childhood Cancer - 2015-2024
AflacST1501: Phase I Study of Abemaciclib (Cdk 4/6 inhibitor) in Children with Newly Diagnosed Diffuse Intrinsic Pontine Glioma and in Recurrent Solid Tumors Including Malignant Brain Tumors
Role: Co-Investigator
PI: Wetmore
Cannonball Kids’ cancer (CKc) Foundation
AflacST1502: A Phase II Study of Sirolimus in Combination with Metronomic Chemotherapy in Children with Recurrent and/or Refractory Solid and CNS Tumors
Role: PI
Contracts:
Celgene
AflacST1603: A Phase 1 Study Using Nab-paclitaxel (Abraxane®) in Combination with Gemcitabine for Pediatric Relapsed and Refractory Solid Tumors
Role: Co-PI
Institutional:
Peach Bowl LegACy Fund -2020-2024
A Maintenance Protocol of Sirolimus in Combination with Metronomic Chemotherapy in Children with High-Risk Solid Tumors
Role: Co-PI
PI: Sutton
Peach Bowl LegACy Fund - 2022-2026
Pilot Study of Atezolizumab in Combination with Stereotactic Body Radiation Therapy (SBRT) and Surgery in Pediatric and AYA Patients with Pulmonary Recurrence of Osteosarcoma
Role: PI
Peach Bowl LegACy Fund - 2023-2026
A Phase 1b Study of Tegavivint, a TBL1 inhibitor, with Gemcitabine in Children, Adolescents, and Young Adults with Relapsed or Refractory Osteosarcoma
Role: PI
CURE Childhood Cancer
A Phase I Study of 131I-MIBG with Dinutuximab for Relapsed/Refractory Neuroblastoma
Role: PI
Cookies for Kids’ Cancer
A Multi-Center Phase I Study of Codrituzumab in Pediatric Patients with Relapsed or Refractory Glypican 3 (GPC3) Expressing Extra-Cranial Solid Tumors
Role: Co-Investigator
PI: Ortiz
Aflac Cancer & Blood Disorders Center Institutional Research Funds
NANT 2017-01: A Phase I Study of 131I-MIBG with Dinutuximab for Relapsed/Refractory Neuroblastoma
Role: PI
Aflac Cancer & Blood Disorders Center Institutional Research Funds
AflacST17B1: Immunophenotyping and Cytokine Profiling of Patients Receiving Therapeutic 131I-MIBG for Relapsed/Refractory Neuroblastoma
Role: Co-PI
Ignyta/Roche
A Phase 1/1b, Open-Label, Dose-Escalation and Expansion Study of Entrectinib (RXDX-101) in Children and Adolescents with Recurrent or Refractory Solid Tumors and Primary CNS Tumors, with or without TRK, ROS1, or ALK Fusions, 1% effort
Role: Site PI
PI: Ignyta/Roche