Long-term survivors of childhood cancer are a growing population. Approximately two thirds of survivors are afflicted with a severe health condition that is directly related to their previous exposure to cancer therapies. Emerging research suggests that these individuals exhibit a phenotype of premature aging as indicated by substantially higher rates of cardiac dysfunction, ovarian failure, neurocognitive deficits, neurosensory deficits, and second cancers. Our overall goal is to use preclinical laboratory models to elucidate the basic mechanisms of organ damage caused by pediatric cancer treatment.
Research and Advocacy for Childhood Cancer Survivors.
Cardiac Disease in Long-term Survivors –
Cardiac disease is the second leading cause of late mortality in childhood cancer survivors and the cumulative incidence of cardiac disease by age 50 is approximately 20%. With the childhood cancer survivor population in the U.S. expected to reach 400,000 by 2020, the number of affected individuals is large and growing
Gaps in Research and Preclinica Models –
Clinical studies aimed at understanding the pathophysiology of cardiac disease in childhood cancer survivors have significant limitations:
- the decades long latent period between exposure to therapy and the development of cardiac disease;
- very low rates of long-term follow-up;
- in the heart it is not feasible to study changes at the tissue and cell level. Mouse models can overcome these limitations due to a shorter life span and the ability to expose pediatric animals to chemotherapy and serially sample heart tissue.
Childhood Cancer Advocacy
Survivorship is under-researched and underfunded. Dr. Aune is a leader in national and international efforts to increase awareness, enact legislation, and raise funds for research.
Dr. Aune was born in Eastern Washington State and grew up on a wheat farm. At age 16 he was diagnosed with Hodgkin’s Lymphoma and was successfully cured of his disease after undergoing one year of chemotherapy and radiation treatments. His cancer experience led Dr. Aune down a path to becoming a pediatric oncologist and physician scientist.
He attended Pacific Lutheran University in Tacoma, Washington, where he graduated Summa Cum Laude with separate degrees in chemistry and biology. From there he moved to Texas and pursued training in both medicine and basic science.
In 2001, he moved to the Washington D.C. area with his wife and continued graduate work at the National Cancer Institute (NCI), under the supervision of Yves Pommier, MD, PhD, director of the Laboratory of Molecular Pharmacology. Throughout the next four years, Dr. Aune continued educational activities at the University of Texas-Houston and MD Anderson Cancer Center, while conducting his research at NCI. In 2005, he graduated from the University of Texas-Houston with an MD and PhD in the field of tumor biology and experimental therapeutics. The focus of Dr. Aune’s PhD dissertation was the molecular mechanism of cytotoxicity of the novel DNA minor groove alkylator, Ecteinascidin 743. Dr. Aune completed his pediatrics residency at Johns Hopkins Hospital in Baltimore, MD in 2008 and subspecialty training in hematology-oncology in 2010 here at the University of Texas Health Science Center San Antonio.
During the beginning months of his hematology-oncology fellowship, Dr. Aune underwent open heart surgery to replace his aortic valve and bypass three blocked coronary arteries – the direct result of chemotherapy and radiation he had received 20 years prior. Similar to his teenage battle with cancer, this personal struggle guided his academic path towards developing a laboratory program investigating the basic science of pediatric cancer survivorship. He is the first graduate of the Pediatric hematology-oncology fellowship supported generously by Mr. Bill Greehey and Greehey CCRI.
Dr. Aune is board certified in both general pediatrics and hematology-oncology and maintains membership and actively participates in numerous national organizations devoted to childhood cancer research and cancer survivorship.
He is married to Christine, a major and neonatologist in the United States Army. They are blessed with two sets of twins, ages eight and three.
Pediatric Cancer Survivorship - Clinical care of long-term survivors of pediatric cancer.
Funding Agency St. Baldrick's Foundation
Title St. Baldrick's Foundation Scholar Grant
Status Active Active
Role Principal Investigator
Grant Detail Evaluation of the Long-term Cardiac Toxicity of Liposomal Doxorubicin.
Funding Agency Hyundai
Title Hyundai Hope Scholar Grant
Status Active Active
Role Principal Investigator
Grant Detail Preclinical Efficacy of Long-term Cardiac Protection by Dexrazoxane.
Clinical Survivorship & Research
Studying the basic science of cancer treatment late effects . . . Building the clinical programs to translate findings and impact cancer survivors in South Texas . . .
Over the past 60 years, research in pediatric oncology has made remarkable progress. In the 1950’s a pediatric cancer diagnosis carried a dismal prognosis, with fewer than 10% of children surviving. Today, approximately 75% of all children receiving a diagnosis of cancer survive longer than five years. With the dramatically improved success rates, survivors are now challenged with a variety of life-threatening and chronic late health effects related to their cancer therapy. These include cardiovascular disease, infertility, neurocognitive deficits, and a variety of endocrine problems. During the first decade of the 21st century epidemiologic research has clearly defined the severity of the late effects problem we face in pediatric oncology. A seminal paper published in the New England Journal of Medicine in 2004 by Oeffinger et al. reported that 67% of all long-term survivors of pediatric cancer suffer from at least one late effect. More alarming, Oeffinger’s study reported that 25% of cancer survivors suffer from a life-threatening late effect such as coronary artery disease, congestive heart failure, multiple second malignancies, or stroke. In the United States, there are approximately 325,000 survivors of pediatric cancer and the State of Texas has as many as 30,000. As our national research efforts continue to improve cure rates for all pediatric cancers, the number of survivors in the U.S. and Texas will continue to increase.
In 2012, the National Cancer Institute has a proposed budget of $5.8 billion. The vast majority of these earmarked funds will be tumor-focused and aimed at understanding the biology and basic science of cancer and the development of novel treatments. Only a small fraction will be available to fund survivorship research and an even smaller fraction will fund research aimed at understanding the basic biological effects chemotherapy and radiation have on normal tissues. The unparalleled success of the previous 60 years of pediatric oncology research has ushered in a new era. We must begin to understand the cellular and molecular mechanisms leading to severe late effects. In this current era of rapidly advancing biomedical research technology, focusing some of our resources on the problem of late effects has the potential to fundamentally transform the practice of pediatric oncology over the coming decades. Successful endeavors will lead to novel therapies, decreased morbidity in survivors, and the creation of formal institutional programs aimed at expanding efforts to understand the basic science of late effects. With this in mind, the mission of the Aune laboratory is as follows:
The mission of the Aune Laboratory is composed of three core goals
- Conducting high quality basic science that increases our knowledge of how chemotherapy and radiation affect normal tissues and lead to late health effects in long-term pediatric cancer survivors
- Translating laboratory findings into the clinic to allow pediatric oncologists to identify high risk patients and to lay a foundation for the development of novel strategies to prevent normal tissue damage occurring during exposure to standard chemotherapy regimens
- Educate patients and our local community about the growing public health problem of late effects in pediatric cancer survivors. Via these efforts, we will raise awareness and promote fundraising to establish Greehey CCRI as a national leader in the effort to solve the problem of pediatric cancer late effects
Community Awareness & Fundraising
There are upwards of 30,000 long-term survivors of pediatric cancer that reside in the State of Texas. By using the 2010 census data, it is estimated that as many as 3,000 citizens in the South Texas region are survivors of pediatric cancer. Currently, the South Texas Cancer Survivorship Program actively follows approximately 400 patients. Furthermore, surveys of adult medical practitioners indicate a fundamental lack of knowledge regarding the severity of late effects in pediatric cancer survivors and therefore there is a large population of patients at high-risk for life-threatening health effects that are not receiving the expert comprehensive care their medical condition requires. To improve the lives of these patients we must educate survivors, medical providers, and our surrounding community. We must improve our medical systems to provide consistent and cutting edge long-term care. In order to accomplish these tasks, community awareness and fundraising are a top-priority of the Aune laboratory.
In 2010, Dr. Aune became a health science center faculty advisor for a student-led community awareness and fundraising effort at the University of Texas San Antonio (UTSA) whose primary goals are focused on childhood cancer. For The Kids (FTK) Dance Marathon at UTSA is modeled after a program at Penn State University that raises approximately $9 million annually for pediatric cancer programs at Hershey Children’s Hospital in Hershey, Pennsylvania. Dr. Robert Lengel created FTK-UTSA to serve as the featured community service project linked to his yearlong leadership challenge class within the UTSA Center for Professional Excellence and College of Business. The culmination of their yearlong efforts is a high-energy dance marathon each spring that honors childhood cancer patients and their families.
The goals of FTK are three-fold
- Establish a grassroots childhood cancer awareness and fundraising effort on the UTSA campus and throughout the San Antonio community
- Provide emotional, spiritual, and monetary support to children and families battling childhood cancer
- Create a new generation of leaders with a sense of community service and the passion to provide support to the most vulnerable members of our society
In the near term, FTK-UTSA is providing countless hours of volunteer service for our cancer programs in San Antonio. This includes volunteer events with patients at Christus Santa Rosa Children’s Hospital, participation in local outreach and awareness events, and creating a local fundraising infrastructure. The Aune Laboratory fully supports these efforts and is positioned as the integral component to facilitate collaboration among UTSA, FTK, Christus Santa Rosa, Greehey CCRI, and UT Health San Antonio. In the long-term FTK-UTSA will become a critical component in our efforts to educate childhood cancer survivors and to galvanize our community to financially support efforts to expand our academic pediatric oncology programs serving South Texas children.
Donate to FTK-UTSA or contact the Donor Relations Team at