Caroline Hastings, MD

Dr. Caroline Hastings is a senior clinician-scientist and educator. She is one of the leaders of the Hematology/Oncology Division. She is the Director of the Pediatric Hematology/Oncology Fellowship Program and the Chair of the hospital-wide fellowship education program. On a national level, she is a leader in the specialty’s society, the American Board of Pediatric Hematology Oncology (ASPHO) and serves as the Treasurer/Secretary, and an elected trustee to the board. She is actively involved in career and practice development.

Dr. Hastings is the Director of our Outreach Program, including Shadelands-Walnut Creek and Reno, Nevada. Dr. Hastings was the co-founder of our multidisciplinary Pediatric Neuro-Oncology Program in 2004. Her skill set in program building has led to her selection in 2015 as the Associate Medical Director for the pediatric network development for both UCSF Benioff Children’s Hospitals.

Dr. Hastings has several academic interests, including high risk and relapsed extramedullary acute lymphoblastic leukemia, and a rare metabolic storage disease, Niemann-Pick Type C disease. She has been an active member of many Children’s Oncology Group (COG) committees, co-chair of an extramedullary relapse study, and was the principal author for two recent reports from the Children’s Oncology Group:

Hastings C, et al.  Increased post induction intensification improves outcome in children and adolescents with a markedly elevated white blood cell count (>200 x 109/L) with T cell Acute Lymphoblastic Leukaemia but not B cell disease:  A report from the Children’s Oncology Group.  Brit J Haematol, 2015

Barredo J*, Hastings C, et al.  Isolated late testicular relapse of B-cell Acute Lymphoblastic Leukemia treated with intensive systemic chemotherapy and response-based testicular radiation:  A Children’s Cancer Group Study. (*authors contributed equally to this work )  Pediatr Blood Cancer. 2017

In 2008 Dr. Hastings met the Hempel twins and diagnosed them with a rare metabolic condition called Niemann Pick Type C (NPC) disease, for which there was no known cure or intervention.  Together with the family, she developed a compassionate use experimental protocol of hydroxyl-propyl-beta-cyclodextrin (HPβCD) based on promising outcomes in mouse research.  She has shared her protocol internationally and continues to treat more patients with promising outcomes and developed a research program for this disease. This amazing story of a partnership between a family and a physician in search of a real-time treatment for a lethal disease has been featured in a Wall Street Journal series as well as CNN programs.

• TRIALS: A Fight for Children with Niemann-Pick Type C, a Fatal Genetic Disease, Wall Street Journal
  
  
• Hempel twins with Niemann Pick find a treatment, CNN, part 1
  
  
• Hempel twins with Niemann Pick find a treatment, CNN, part 2
  
  
• Hempel twins with Niemann Pick find a treatment, CNN, part 3
  
  

The family has chronicled their journey in connecting physicians and researchers internationally at AddiandCassi.com. Dr. Hastings has collected and reported on the data on compassionate use of HPβCD in NPC patients internationally. Dr. Hastings is now the principal investigator for a Phase I clinical trial (Clinical trials.gov:  NCT02939547), currently open at UCSF Benioff Children’s Hospital Oakland (only US site).  In addition, she serves as the senior medical advisor for a Phase I/II international trial (Clinical trials.gov:  NCT02912793) in 5 countries.  Dr. Hastings has been involved with a number of basic science and clinical investigators studying new treatments for Niemann-Pick Type C, as well as studying amyloid-beta metabolism, iron hemostasis and biomarkers for this disease.

After developing a clinical program for Niemann-Pick Type C Disease, she developed a research program for this disease. She is the principal investigator for FDA-approved new treatment for Niemann-Pick Type C, and has with colleagues been studying amyloid-beta metabolism, iron hemostasis and biomarkers in Niemann-Pick. She serves as the international PI in a Phase I/II trial opened the summer of 2016.

Dr. Hastings is a tireless volunteer with many national organizations advocating for children with cancer, including the St. Baldrick’s Foundation for which she has raised over $2 million for childhood/adolescent cancer research by hosting a head shaving venue annually since 2008; the American Cancer Society's childhood cancer survivors college scholarship (served as the chair for 12 years); and several non-profits aimed at improving quality of life for cancer patients and their families. She is also involved with philanthropic programs to raise awareness and funds to support research and care in childhood cancer.

Selected books and publications:

1. Barredo J*, Hastings C*, Lu X, Armstrong D, Devidas M, Chen Y, Winick N, Wood BL, Yanofsky R, Loh M, Gastier-Foster JM, Jorstad DT, Marcus R, Ritchey K, Carrol WL, Hunger, SP.  Isolated late testicular relapse of B-cell Acute Lymphoblastic Leukemia treated with intensive systemic chemotherapy and response-based testicular radiation:  A Children’s Cancer Group Study.  *authors contributed equally to this work.  Pediatr Blood Cancer. 2017 Dec 29. Doi. 1002/pbc.26928. [Epub ahead of print]

2. Feusner JH, Hastings CA, Agrawal AK, eds. Supportive Care in Pediatric Oncology: A Practical Evidence-Based Approach. Berlin Springer; 2015.
3. Hastings C, Torkildson J, Anurag A. Handbook of Pediatric Hematology Oncology: The Children’s Hospital & Research Center Oakland, 2nd edition, Wiley-Blackwell, 2012.
   
4. Hastings C, Gaynon PS, Nachman JB, Sather HN, Lu X, Devidas M, Seibel N.  Increased post induction intensification improves outcome in children and adolescents with a markedly elevated white blood cell count (>200 x 109/L) with T cell Acute Lymphoblastic Leukaemia but not B cell disease:  A report from the Children’s Oncology Group.  Brit J Haematol, 2015 Feb; 168 (4):533-46. Doi:10.1111/bjh.13160 [Epub 2014 Oct 13]  PMID:25308804
5. Te Vruchte D, Speak AO, Wallom KL, Al Eisa N, Smith DA, Hendriksz CJ, Simmons L, Lachmann RH, Cousins A, Hartung R, Mengel E, Runz H, Beck M, Amraoui Y, Imrie J, Jacklin E, Riddick K, Yanjanin NM, Wassif CA, Rolfs A, Rimmele F, Wright N, Taylor C, Ramaswami U, Cox TM, Hastings C, Jiang X, Sidhu R, Ory DS, Arias B, Jeyakumar M, Sillence DJ, Wraith JE, Porter FD, Cortina-Borja M, Platt FM. Relative acidic compartment volume as a lysosomal storage disorder-associated biomarker. J Clin Invest 2014.
6. Zweideler-McKay P, Hogan MJ, Jubran RF, Black V, Casillas J, Harper J, Malempati S, Margolin J, Felgenhauer J, Sakamoto K, Franklin J, Shah M, Seibel N, Buchanan G, Vaiselbuh S, Hastings C, Hilden J, Stork L. Navigating your career path in pediatric hematology/oncology (PHO): On and off the beaten path. Pediatr Blood Cancer 2016;00:1-10.
7. Hung YH, Faux NG, Killilea DW, Yanjanin N, Firnkes S, Volitakis I, Ganio G, Walterfang M, Hastings C, Porter FD, Ory DS, Bush AI. Altered transition metal homeostasis in Niemann-Pick disease, type C1. Metallomics, 2013. DOI:10.1039/c3mt00308f. PMID: 24343124
8. Mattson N, Olsson M, Gustavsson MK, Kosicek M, Malnar M, Månsson, JE, Blomqvist M, Gobom J, Andreasson U, Brinkmalm G, Vite C, Hecimovic S, Hastings C, Blennow K, Zetterberg H, Portelius E. Amyloid-β metabolism in Niemann-Pick C disease models and patients. Metabolic Brain Disease, e-pub Sept 1, 2012. PMID: 22935999
9. Hastings C, Torkildson J, Raphael R. Intrathecal Hydroxy-Propyl-Beta-Cyclodextrin Reverses Hearing Loss in Identical Twin Girls with Niemann-Pick Type C Disease. Mol Gen Metabolism. 2012;105(2):S34.
10. Nachman JB, La MK, Hunger SP, Heerema NA, Gaynon PS, Hastings C, Mattano LA, Sather H, Devidas M, Fryer DR, Steinhertz PG, Seibel NL. Young adults with acute lymphoblastic leukemia have an excellent outcome with chemotherapy alone and benefit from intensive postinduction treatment: A report from the Children’s Oncology Group. J Clin Oncol. 2009 Nov 1;27(31):5189-94. Epub 2009 Oct 5.
11. Seibel NL, Steinhertz PG, Sather HN, Nachman JB, DeLaat C, Ettinger LJ, Freyer DR, Mattano LA, Hastings C, Rubin CM, Bertolone K, Franklin JL, Heerema NA, Mitchell TL, Pyesmany AF, La, MK, Edens C, Gaynon PS. Early post-intensification therapy improves survival for children and adolescents with high-risk acute lymphoblastic leukemia: A report from the Children’s Oncology Group. Blood. 2008;111(5):2548.
12. Hastings C, Wechsler DS, Stine KC, Graham DK, Abshire T. Consensus on a core curriculum in American training programs in Pediatric hematology-oncology: A report from the ASPHO training committee. Pediatric Hematology and Oncology, 24:503-512, 2007.