Merck Serono Has Named Dr. John Orloff as Head of Global Clinical Development

 

Our friend and colleague Dr. John Orloff has joined Merck Serono as Head of Global Clinical Development. We wish him success in his new position.

 

At Merck Serono, Dr. Orloff will lead the design and execution of global clinical development programs and projects, driving quality execution of the projects after proof-of-concept (POC). John will also oversee pipeline management and development, working collaboratively with the research teams, commercial partners and Medical Affairs to drive the efficient development of Merck’s portfolio.

 

Dr. Orloff comes from Novartis Pharma AG, where he was Senior Vice President and Chief Medical Officer, responsible for leading all processes within Global Development as well as ensuring quality control and regulatory compliance, and driving innovative solutions to support business needs. Previous to that position at Novartis, Dr. Orloff was Senior Vice President and Head, US Medical & Regulatory Affairs, serving on the executive leadership front across Clinical Development, Medical Affairs, and Evidence-based Medicine (Health Economics and Outcomes Research) for the US organization, as well as Regulatory Affairs for North America. Prior to Novartis, Dr. Orloff was Senior Director of the Bone Group, Endocrinology & Metabolism at Merck Research Labs, supporting clinical development of products for bone related disorders including osteoporosis and arthritis.

 

Dr. Orloff received his undergraduate degree from Dartmouth College, and his MD from the University Of Vermont College Of Medicine. He completed his residency at the University of Pittsburgh, and started his career in academic medicine at Yale University as a Fellow in Endocrinology & Metabolism.

 

ON TARGET is the newsletter of Target Health Inc., a NYC-based contract research organization (CRO), providing strategic planning, regulatory affairs, clinical research, data management, biostatistics, medical writing and software services, including the paperless clinical trial, to the pharmaceutical and device industries.

 

For more information about Target Health contact Warren Pearlson (212-681-2100 ext. 104). For additional information about software tools for paperless clinical trials, please also feel free to contact Dr. Jules T. Mitchel or Ms. Joyce Hays. The Target Health software tools are designed to partner with both CROs and Sponsors. Please visit the Target Health Website.

 

Joyce Hays, Founder and Chief Editor of On Target

Jules Mitchel, Editor

Vanessa Hays, Editorial Contributor

Deep Sequencing of Breast Cancer Tumors Predict Outcomes After Single Dose of Therapy

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High-tech glasses developed at the School of Medicine help breast surgeon Julie Margenthaler, MD, visualize cancer cells in a patient. Inset: Still image from a video of the lymph node removal, as seen by Margenthaler as she wore the eyewear. A florescent marker injected into the patient and special lighting made cancer cells glow blue when viewed with the technology. The lighter the shade of blue, the more concentrated the cancer cells are. Credit: Photo by Robert Boston / Image courtesy of Washington University School of Medicine

 

New research from University Hospitals (UH) Case Medical Center Seidman Cancer Center and Case Comprehensive Cancer Center at Case Western Reserve University examined how changes in the genetic composition of breast cancer 1) ___ after brief exposure to either biologic therapy or chemotherapy can predict future clinical outcomes in patients. Results showed that through deep genome sequencing, a reduction in the most commonly mutated genes in breast cancer could be observed after just one dose of preoperative therapy. Deep sequencing is a process that involves sequencing the same region multiple times to identify mutations within tumors that have an importance in 2) ___ evolution. These new findings were presented during the December 2013 San Antonio Breast Cancer Symposium.

 

“Genomics is the new frontier of cancer research, and this study shows that we may be able to accurately determine what treatment methods will and will not be effective for individual patients after just one dose of3) ___,“ said Lyndsay Harris, MD, study investigator and Director, Breast Cancer Program, UH Seidman Cancer Center and Professor of Medicine at Case Western Reserve University School of Medicine. “The ability to understand potential clinical outcomes for patients earlier in the treatment process would provide physicians with better opportunity to personalize patients’ medicines according to their own tumor responses.“

 

More than 209,000 patients in the U.S. are diagnosed with breast cancer each year. The anticipated outcome of studying the genetic makeup of breast cancer patients is to determine who will benefit most from certain drug therapies and to use that information to create a personalized treatment plan for each 4) ___ involved. Dr. Harris and team are currently integrating whole genome profiles with deep sequencing data as they spearhead a new study at UH Seidman Cancer Center to validate these initial findings presented in San Antonio.

 

By studying the genetic makeup of breast cancer patients, doctors are taking the next steps forward in delivering more personalized care to patients. Whole genome sequencing from cancers is not a new concept, but recently researchers have delved more deeply into the evolution of breast cancers identifying that it comes in four distinct types. Breaking down how the 5) ___ of each sub-type of the disease function is allowing for doctors to customize treatments for improved outcomes. Even more promising, clinical research trials at a few select institutions around the country, including Cleveland’s University Hospitals Case Medical Center Seidman Cancer Center, are part of a development in a rising trend toward targeted treatments as a result of 6) ___ profiling of tumors.

 

“The knowledge of the molecular underpinnings of a particular kind of breast cancer can improve the cure rates and even in the advanced disease setting improve quality of life and length of life,“ says Lyndsay Harris, MD. “The cure of the disease is really our goal, and we are moving quickly toward a time when we can expect to cure the vast majority of 7) ___ who are diagnosed with breast cancer at the earliest stages.“ Source: University Hospitals Case Medical Center, Cleveland, OH and San Antonio, TX; ScienceDaily.com

 

ANSWERS: 1) tumors; 2) cancer; 3) medicine; 4) patient; 5) cells; 6) genomic; 7) women

King Richard III (1452-1485) Sequencing His Genome in 2014

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Now is the winter of our discontent
Made glorious summer by this sun of York;
And all the clouds that lour’d upon our house
In the deep bosom of the ocean buried“
—–William Shakespeare, written around 1592

 

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The earliest surviving portrait of Richard III (c. 1520, after a lost original), formerly belonging to the Paston family. Society of Antiquaries, London)

 

Richard III was King of England for two years, from 1483 until his death in 1485 in the Battle of Bosworth Field. He was the last king of the House of York and the last of the Plantagenet dynasty. His defeat at Bosworth Field, the last decisive battle of the Wars of the Roses, symbolizes the end of the Middle Ages in England. He is the subject of the play Richard III by William Shakespeare. At the time of the death of his father and older brother, at the Battle of Wakefield in 1460, Richard, who was eight years old, was sent by his mother, the Duchess of York, to the Low Countries, accompanied by his elder brother George. At this time Richard was named Duke of Gloucester as well as being made a Knight of the Garter and a Knight of the Bath. Richard was then sent to Warwick’s estate at Middleham for his knightly training. Richard stayed at Middleham until early 1465, when he was twelve. During his adolescence, he developed idiopathic scoliosis.

 

Richard became involved in the rough politics of the Wars of the Roses at an early age. His brother, Edward appointed him the sole Commissioner of Array for the Western Counties in 1464, when he was 11. By the age of 17, he had an independent command. At 18 years, Richard played crucial roles in battles that resulted in Edward’s restoration to the throne in spring 1471.

 

Polydore Vergil and Thomas More write about King Richard, emphasizing Richard’s outward physical deformities as a sign of his inwardly twisted mind. More describes him as “little of stature, ill-featured of limbs, crook-backed and hard-favored of visage“. Vergil also says he was “deformed of body with one shoulder higher than the right“. Both emphasize that Richard was devious and flattering, while planning the downfall of both his enemies and supposed friends. Richard’s good qualities were his cleverness and bravery. All these characteristics are repeated by Shakespeare, who portrays him as having a hunch, a limp and a withered arm.

 

During Richard’s reign, the historian John Rous praised him as a “good lord“ who punished “oppressors of the commons“, adding that he had “a great heart“. After his death, Richard’s image was tarnished by propaganda fostered by his Tudor successors (who sought to legitimize their claim to the throne). Richard’s reputation as a promoter of legal fairness persisted, however. William Camden in his Remains Concerning Britain (1605) states that Richard, “albeit he lived wickedly, made good laws“. Francis Bacon also states that he was “a good lawmaker for the ease and solace of the common people“. Despite this, the image of Richard as a ruthless power-grabber remained dominant in the 18th and 19th centuries.

 

Richard’s Council of the North, greatly improved conditions for Northern England, as commoners of that region were formerly without any substantial economic activity independent of London. Its descendant position was Secretary of State for the Northern Department. In December 1483, Richard instituted what later became known as the Court of Requests, a court to which poor people who could not afford legal representation could apply for their grievances to be heard. He also introduced bail in January 1484, to protect suspected felons from imprisonment before trial and to protect their property from seizure during that time. He founded the College of Arms in 1484, he banned restrictions on the printing and sale of books, and he ordered the translation of the written Laws and Statutes from the traditional French into English.

 

Richard III’s remains received burial without pomp, but the original tomb is believed to have been destroyed during the Reformation, and the remains were lost for more than five centuries. In 2012, an archaeological excavation was conducted on a city council car park using ground-penetrating radar on the site once occupied by Greyfriars, Leicester. The University of Leicester confirmed on 4 February 2013 that a skeleton found in the excavation was, beyond reasonable doubt, that of Richard III. This conclusion was based on a combination of evidence from radiocarbon dating, comparison with contemporary reports of his appearance, and a comparison of his mitochondrial DNA with that of two matrilineal descendants of Richard III’s eldest sister, Anne of York. The genomes of King Richard III and one of his family’s direct living descendants are to be sequenced in a project funded by the Wellcome Trust, the Leverhulme Trust and Professor Sir Alec Jeffreys. The project will be led by Dr Turi King of the Department of Genetics at the University of Leicester. The aim is to shed new light on the ancestry and health of the last king of England to die in battle, and provide a complete archive of information that historians, scientists and the public will be able to access and use. His remains and any samples taken from them are scheduled to be reinterred and for this reason, Dr Turi King and colleagues plan to sequence his genome and make it freely accessible as a resource to researchers wishing to analyze and interrogate its genetic information.

 

Richard III will be one of only a small number of ancient individuals to have had their genomes sequenced. Others include Otzi the Iceman, Neanderthal specimens, a Denisovan and a Greenlandic Inuit and a hunter gatherer from Spain. Richard III will be the first ancient individual of known identity to have his genome sequenced. This will be carried out in collaboration with Professor Michael Hofreiter at the University of Potsdam.

 

Analysis of Richard III’s genome will allow insight into his genetic make-up, including susceptibility to certain diseases, hair and eye color, and as the genetic basis of other diseases becomes known, these too can be examined for. It is also expected to shed light on his genetic ancestry and relationship to modern human populations. In addition, next generation sequencing technologies will allow the researchers to detect DNA from other organisms such as pathogens. Whole genome sequencing from Otzi the Iceman found the first known human infection with Lyme disease, for example.

 

Dr King says: “It is an extremely rare occurrence that archaeologists are involved in the excavation of a known individual, let alone a king of England. At the same time we are in the midst of a new age of genetic research, with the ability to sequence entire genomes from ancient individuals and with them, those of pathogens that may have caused infectious disease. Sequencing the genome of Richard III is a hugely important project that will help to teach us not only about him, but foment discussion about how our DNA informs our sense of identity, our past and our future.“ In addition to sequencing the remains of Richard III, Dr King and colleagues will also sequence one of his living relatives, Michael Ibsen. An initial analysis of the DNA of his mitochondria — the batteries that power the cells in our bodies — which is passed down the maternal line, confirmed the genealogical evidence that Ibsen and Richard III shared the same lineage. A more detailed analysis is due to be published shortly. This new project will allow researchers to look for any other segments of DNA that these distant relatives share.

 

Researchers based at the University of Cambridge and the University of Leicester have also uncovered evidence that Richard III suffered from a roundworm (Ascaris lumbricoides) infection, according to a Clinical Picture published in The Lancet. A team of researchers led by Dr Piers Mitchell, of the Department of Archaeology and Anthropology at the University of Cambridge, UK, used a powerful microscope to examine soil samples taken from the skeleton’s pelvis and skull, as well as from the soil surrounding the grave. The microscope revealed multiple roundworm eggs in the soil sample taken from the pelvis, where the intestines would have been situated in life. However, there was no sign of eggs in soil from the skull, and very few eggs in the soil that surrounded the grave, suggesting that the eggs found in the pelvis area resulted from a genuine roundworm infection during his life, rather than from external contamination by the later dumping of human waste in the area.

 

Roundworms are parasitic nematodes, which infect humans when people ingest their eggs via contaminated food, water, or soil. Once eaten, the eggs hatch into larvae, which migrate through the tissues of the body to the lungs where they mature. They then crawl up the airways to the throat to be swallowed back into the intestines, where they can grow into adults around a foot long. Roundworm infection is thought to be one of the commonest health conditions in the world, affecting up to a quarter of all people globally, although it is rare in the UK today.

 

According to Dr Mitchell, “Our results show that Richard was infected with roundworms in his intestines, although no other species of intestinal parasite were present in the samples we studied. We would expect nobles of this period to have eaten meats such as beef, pork and fish regularly, but there was no evidence for the eggs of the beef, pork or fish tapeworm. This may suggest that his food was cooked thoroughly, which would have prevented the transmission of these parasites.“ Dr Jo Appleby, Lecturer in Human Bioarchaeology at the University of Leicester, UK, said: “Despite Richard’s noble background, it appears that his lifestyle did not completely protect him from intestinal parasite infection, which would have been very common at the time.“

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In addition to abdominal infection, Richard III may have undergone painful medical treatments for his spinal curvature, according to research from a University of Leicester researcher. The remains of Richard III discovered by University of Leicester archaeologists revealed that the King suffered from severe scoliosis, which he probably developed in early adolescence. Scoliosis — a lateral or side-to-side curvature of the spine — can be a very painful condition to live with. Dr Mary Ann Lund, of the University’s School of English, has carried out research into the kinds of scoliosis treatments available at the time Richard III was alive. But some of the treatments practiced in the late medieval period would have themselves caused sufferers a lot of anguish. Among the “cures“ practiced was traction — the same principle on which “the Rack“ worked as an instrument of torture. The patient would be tied under the armpits and round the legs. The ropes were then pulled at either end, often on a wooden roller, to stretch the patient’s spine. This treatment would probably have only been available to those who could afford it. Richard III would certainly have been able to afford the highest levels of medical care available — and his physicians would have been well aware of the standard “traction“ methods for treating the condition.

 

Dr Lund charted the influence of Greek philosopher Hippocrates — who developed early prototype methods of dealing with spinal disorders — to the 11th century Persian polymath Avicenna, who utilized handed down treatments from the Greeks. These treatises on medicine and philosophy were well regarded in Medieval Europe. Avicenna’s documents on using traction in scoliosis treatment would have been widely read and practiced by doctors in Richard III’s lifetime. Avicenna also advocated the massage techniques practiced in Turkish baths, and herbal applications, as treatments for back disorders. In the longer term, patients might wear a long piece of wood or metal in an attempt to straighten their back. Dr Lund said: “Scoliosis is a painful illness, and Richard would have been in quite a lot of pain on a daily basis. These methods could also have been very painful — but people would have expected treatments to be unpleasant. Medical practices could exacerbate conditions rather than improving them. These treatments would have only been open to people in the upper echelons. Richard would have probably received these treatments because he was a member of the nobility.

 

Later methods of treatment for scoliosis included the orthosis, which was developed by French physician Ambroise Pare in the late 16th century. This was a tightly fitting metal corset for treating scoliosis made by an armourer, which would have been worn by patients to brace the skeleton in an attempt to correct the curvature of the spine. Source: The University of Leicester; ScienceDaily.com


Journal Reference: Piers D Mitchell, Hui-Yuan Yeh, Jo Appleby, Richard Buckley. The intestinal parasites of King Richard III. The Lancet, 2013; DOI: 10.1016/S0140-6736(13)61757-2

 

Miscellaneous

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English actor David Garrick as Richard III just before the battle of Bosworth Field. His sleep having been haunted by the ghosts of those he has murdered, he wakes to the realization that he is alone in the world and death is imminent. The painting, David Garrick as Richard III (1745), is by William Hogarth. Richard III is a historical play by William Shakespeare, believed to have been written in approximately 1592. It depicts the Machiavellian rise to power and subsequent short reign of Richard III of England.

 

At the battle of Bosworth Field, Lord Stanley (who is also Richmond’s stepfather) and his followers desert Richard’s side, whereupon Richard calls for the execution of George Stanley, Lord Stanley’s son. This does not happen, as the battle is in full swing, and Richard is left at a disadvantage. Richard is soon unhorsed on the field at the climax of the battle, and cries out, “A horse, a horse, my kingdom for a horse!“ Richmond kills Richard in the final duel. Subsequently, Richmond succeeds to the throne as Henry VII, and marries Princess Elizabeth from the House of York.

ONCOLOGY

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Regular Aspirin Use May Reduce Ovarian Cancer Risk

 

It is estimated that over 20,000 women in the US will be diagnosed with ovarian cancer in 2014, and more than 14,000 will die from the disease. Early stage ovarian cancer may be successfully treated. However, symptoms associated with this disease can mimic more common conditions, such as digestive and bladder disorders, so for this reason and others, it is often not diagnosed until it has reached advanced stages. Late stage ovarian cancer leaves women with limited treatment options and poor prognoses, making preventive strategies potentially important for controlling this disease.

 

According to an article published online (6 February 2014) in the Journal of the National Cancer Institute, women who take aspirin daily may reduce their risk of ovarian cancer by 20%. However, according to the authors, further research is needed before clinical recommendations can be made.

 

It has been reported that chronic or persistent inflammation has been shown to increase the risk of cancer and other diseases. Previous studies have suggested that the anti-inflammatory properties of aspirin and non-aspirin NSAIDs (non-steroidal anti-inflammatory drugs), may reduce cancer risk overall. However, studies examining whether use of these agents may influence ovarian cancer risk have been largely inconclusive. This is the largest study to date to assess the relationship between these drugs and ovarian cancer risk.

 

For the study, the authors analyzed data pooled from 12 large epidemiological studies to investigate whether women who used aspirin, non-aspirin NSAIDs, or acetaminophen have a lower risk of ovarian cancer. These 12 studies (9 from the US) were part of the Ovarian Cancer Association Consortium. The scientists evaluated the benefit of these drugs in nearly 8,000 women with ovarian cancer and close to 12,000 women who did not have the disease.

 

Results showed that among study participants who reported whether or not they used aspirin regularly: 18% used aspirin, 24% used non-aspirin NSAIDs, and 16% used acetaminophen. Results of the analysis showed that participants who reported daily aspirin use had a 20% lower risk of ovarian cancer than those who used aspirin less than once per week. For non-aspirin NSAIDs, which include a wide variety of drugs, the picture was less clear: a 10% lower ovarian cancer risk among women who used NSAIDs at least once per week was observed compared with those who used NSAIDs less frequently. However, this finding did not fall in a range that was significant statistically. In contrast to the findings for aspirin and NSAIDs, use of acetaminophen, which is not an anti-inflammatory agent, was not associated with reduced ovarian cancer risk.

 

This study adds to a growing list of malignancies, such as colorectal and other cancers, that appear to be potentially preventable by aspirin usage.

 

Adverse side effects of daily aspirin use include upper gastrointestinal bleeding and hemorrhagic stroke. Therefore, a daily aspirin regimen should only be undertaken with a doctor’s approval, caution the scientists.

GENETICS

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NCI Launches Trial to Assess the Utility of Genetic Sequencing to Improve Patient Outcomes

 

A pilot trial to assess whether assigning treatment based on specific gene mutations can provide benefit to patients with metastatic solid tumors has been launched by the National Cancer Institute (NCI). The Molecular Profiling based Assignment of Cancer Therapeutics, or M-PACT, trial is one of the first to use a randomized trial design to assess if assigning treatment based on genetic screening can improve the rate and duration of response in patients with advanced solid tumors. A trial in which patients are randomly assigned to various treatment options is the gold-standard method for determining which treatment option is best.

 

It is hoped that in addition to the knowledge gained from the trial about assigning therapy based on results of genetic sequencing of tumors, this trial could identify patient sub-groups that are likely to benefit from certain treatments and result in new treatments being developed quickly for some cancers. This could ultimately lead to smaller, more definitive clinical trials, which would be helpful to clinicians and patients in terms of cost and time.

 

Very few types of tumors have just one mutated gene that triggers cancer progression. Once a gene is mutated, it can lead to the activation of multiple pathways, resulting in disease progression and potentially requiring multiple interventions. Therefore, NCI’s M-PACT trial is designed to determine whether people with specific mutations that have been demonstrated in laboratory systems to affect drug effectiveness will benefit from a specifically chosen targeted intervention and if these interventions lead to better outcomes.

 

For NCI’s M-PACT study, after screening hundreds of people, 180 patients with advanced refractory solid tumors (those resistant to standard therapy) will be enrolled based on their genetic profile. During the screening process, samples of the tumors will be genetically sequenced to look for a total of 391 different mutations in 20 genes that are known to affect the utility of targeted therapies. If mutations of interest are detected, using a molecular sequencing protocol for tumor biopsy samples evaluated by the U.S. FDA, those patients will be enrolled in the trial and randomly assigned to one of two treatment arms to receive one of the four treatment regimens that are part of this study.

 

To ensure that patients receive the best treatment already known to provide benefit, patients with specific tumor types should have received certain therapies prior to being enrolled in NCI’s M-PACT. For instance:

 

1. Patients with melanoma whose tumors have mutations in the V600E region of the BRAF gene should have received and progressed on a specific BRAF inhibitor therapy to be eligible for NCI’s M-PACT trial.

2. Patients with lung cancer should have had their tumors tested for the presence of EGFR and ALK gene mutations, and, if mutations were detected, they should have received and progressed on therapies targeting EGFR or ALK, respectively.

 

Patients with all types of solid tumors will be considered for trial eligibility. For the randomization, patients will be assigned to Arm A (they will receive a treatment regimen prospectively identified to target their specific mutation or relevant pathway) or Arm B (they will receive a treatment regimen not prospectively identified to target their specific mutation or relevant pathway). Patients in Arm B will have the option to cross over to Arm A to receive therapy identified to target their specific mutation or relevant pathway if their disease progresses on their initial study treatment. As of January 2014, the study is open for patient accrual. The clinicians hope that they can rapidly enroll patients and report results of their findings by 2017.

TARGET HEALTH excels in Regulatory Affairs. Each week we highlight new information in this challenging area.

 

Imbruvica Approved to Treat Chronic Lymphocytic Leukemia

 

Chronic lymphocytic leukemia (CLL) is a rare blood and bone marrow disease that usually gets worse slowly over time, causing a gradual increase in white blood cells called B lymphocytes, or B cells. The National Cancer Institute estimates that 15,680 Americans were diagnosed and 4,580 died from the disease in 2013.

 

The U.S. FDA has expanded the approved use of Imbruvica (ibrutinib) for CLL patients who have received at least one previous therapy. Imbruvica works by blocking the enzyme that allows cancer cells to grow and divide. In November 2013, the FDA granted Imbruvica accelerated approval to treat patients with mantle cell lymphoma, a rare and aggressive type of blood cancer, if those patients received at least one prior therapy.

 

The FDA completed its review of Imbruvica’s new indication under the agency’s accelerated approval process, which played a vital role in rapidly making this new therapy available to those who need it most. Under the agency’s accelerated approval process, the FDA may approve a drug based on a surrogate or intermediate endpoint that is reasonably likely to predict clinical benefit. Drugs receiving accelerated approval are usually subject to an agreement to conduct confirmatory trials verifying and describing clinical benefit. Imbruvica for CLL also received priority review and orphan-product designation because the drug demonstrated the potential to be a significant improvement in safety or effectiveness in the treatment of a serious condition and is intended to treat a rare disease, respectively.

 

The FDA’s accelerated approval of Imbruvica for CLL is based on a clinical study of 48 previously treated participants. On average, participants were diagnosed with CLL 6.7 years prior to the study and had received four previous therapies. All study participants received a 420 milligram orally administered dose of Imbruvica until the treatment reached unacceptable toxicity or the disease progressed. Results showed nearly 58% of participants had their cancer shrink after treatment (overall response rate). At the time of the study, the duration of response ranged from 5.6 to 24.2 months. An improvement in survival or disease-related symptoms has not been established.

 

The most common side effects observed in the clinical study include low levels of platelets in the blood (thrombocytopenia), diarrhea, bruising, a decrease in infection-fighting white blood cells (neutropenia), low red blood cells (anemia), upper respiratory tract infection, fatigue, pain in the muscles and bones (musculoskeletal pain), rash, fever (pyrexia), constipation, swelling of tissues (peripheral edema), joint pain (arthralgia), nausea, mouth sores (stomatitis), sinus infection (sinusitis) and dizziness.

 

Imbruvica is manufactured by Pharmacyclics (Sunnyvale, CA.)

Moroccan Stew with Butternut Squash, Cauliflower, Lentils and Tomatoes

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Veggie Stew with Moroccan Spices — ©Joyce Hays, Target Health Inc

 

Ingredients

 

1/2 cauliflower, roasted
2 Tablespoons olive oil
1 yellow onion, chopped
4 cloves garlic, minced
1/2-1 teaspoon ground cumin (to your taste)
1/2-1 teaspoon coriander (to your taste)
1 cup pistachio nuts, chopped
2/3 cup fresh cilantro, chopped
1 teaspoon sweet paprika
Pinch cayenne pepper (or to your taste)
1 teaspoon turmeric
1 (3-inch) cinnamon stick (use the stick and not powdered form)
Salt and freshly ground black pepper
1 pound butternut squash, large dice
1 large red potato, washed and diced with skin left on
2 cups low-sodium chicken stock or broth
1 cup cooked chickpeas, drained
1 cup golden raisins
1 cup cooked lentils
1 (14-ounce) can diced tomatoes, with juices
Pinch saffron threads
1/2 lemon, juiced, and zest of ? lemon
1 cup brined green olives (Italian Cerignola)
Jasmine rice, cooked

 

Garnish: toasted marcona almonds, chopped cilantro (or parsley), pomegranate arils

 

Optional on the table: Plain yogurt, or sour cream, mango chutney

 

Directions

 

Heat olive oil in a 3- to 4-quart heavy saucepan with a tight fitting lid over medium heat. When oil shimmers, add onion, garlic, cumin, and cinnamon, turmeric, coriander, cayenne, and season with salt and freshly ground black pepper. Cook, stirring occasionally, until spices are aromatic and onions are soft and translucent, about 5 minutes.

Add squash and potatoes, season with salt and freshly ground black pepper, stir to coat, and cook until just tender, about 3 minutes. Add broth, chickpeas, tomatoes and their juices, cilantro, raisins, pistachios, olives and saffron. Bring mixture to a boil then reduce heat to low. Cover and simmer until squash is fork tender, about 10 minutes.

Remove from heat and stir in lemon. Serve over couscous or jasmine rice, garnished with cilantro, nuts, arils and yogurt or sour cream.

 

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Baked lamb patties — ©Joyce Hays, Target Health Inc.

 

We decided to stay home for dinner on Valentine’s Day and were we glad we did! This recipe turned out to be absolutely delicious. We’re not used to lots of spices, but I’m experimenting with them, anyway, so we’re having a real adventure trying them out. Jules suggested we start with some hummus and pita (one of our favorite things to eat), and opened a bottle of red velvet, a lovely Merlot. We find that a full-bodied red is the best accompaniment for spices.

 

I kept my fingers crossed and brought out the Moroccan dish with jasmine rice and all the garnishes. I also served lamb patties just in case the spicy veggies disappointed. But everything

was perfect! With gusto we devoured the Moroccan stew on jasmine rice, and came back for seconds.

 

The spices in this recipe were just the right amount and blend, for our palate. Important to get the green Italian cerignola olives, which have a unique taste and to use a fresh cinnamon stick which gives off just the right amount of light sweet flavor. Using cilantro rather than parsley, is the better choice. We found that adding a dollop of sour cream was a great addition, as well as lots of pomegranate arils. Usually the lamb patties are the star of a meal, but this time they took second place.

 

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©Joyce Hays, Target Health Inc.

 

Hope Your Valentine’s Day Went Well!

Cheers!