Archive for June, 2022

 

Jun 26 2022

Progress

by at 11:42 pm

We live in a politically aware town, and as a result, the news is never boring around here. However, the pace of news — be it from the Supreme Court, primary elections, overseas wars or other global activities — has left my head spinning. But here in our very important corner of the universe, the news is good.

Putting aside the exciting news that came out of the ASCO meeting earlier this month, the progress we are making at Georgetown Lombardi is very gratifying. The ways in which we organize cancer center activities has never been better. Our seminars have never been more interesting. We have been invigorated by the addition of many new colleagues, who bring fresh perspectives and expertise to the work we do. Our clinical research infrastructure has been strengthened, and we are poised to offer important clinical trial options to more people than ever before. Our consortium partners in New Jersey have done a fabulous job to increase scientific depth there, and are poised to meet and exceed the expectations of NCI in that regard.

Our Cancer Cell Biology CCSG research program held a really interesting hybrid retreat last week, revealing numerous opportunities for new collaborations. The Cancer Host Interactions (CHI) program is preparing for its own retreat. Our Community Outreach and Engagement efforts have been bolstered by the recent gift from the Ralph Lauren Foundation that I wrote about in May. Cancer research training and education efforts have gained traction. There’s lots of good stuff all around.

Including the grants of new recruits that are in the process of being transferred, Georgetown Lombardi has increased its cancer-focused peer reviewed funding by more than 50% since 2018. This is perhaps the best marker of funding depth, though we all should be very proud that 25% of the more than 1,100 publications we’ve had since 2018 have had impact factors of at least 10.

This very real progress reminds us that, even in these most uncertain times, we have made and will continue to make progress against cancer, the Emperor of All Maladies. We are making a difference. I could not be prouder to represent this cancer center and all the wonderful work we all do, together.

I’ll be taking a blog break next week, so have a wonderful July 4 holiday, and remember to stay safe and be well.

Lou

 


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Jun 19 2022

Juneteenth

by at 6:08 pm

I write today’s blog on Juneteenth. On this long weekend I have had time to think about something other than work. So, I will dispense with work-related news quickly.

So far this month, I have submitted a new R01 and have nearly finished preparing two DOD pre-applications. All that’s left is to polish the pre-applications and do my SITEL modules (required yearly training for physicians at MedStar Health). Then it is on to reviewing CCSG write-ups and thinking about how I will modify my Director’s Overview to reflect the many wonderful developments we’ve had at the cancer center over the past eight months or so. Our EAC will be meeting after the summer, and we have to gear up for our May 2023 competitive renewal application.

Juneteenth honors emancipation and the end of slavery in this country, only 159 years ago. Think of this, if you will. Peter Mills, born a slave in 1861 in Prince George’s County, died in 1972, the last surviving American born into involuntary human bondage — only 50 years ago. How can that be? How could so many in this country have embraced such a barbaric practice so recently, defended it in the bloodiest war in our country’s history, and then continued to celebrate so many of the customs and beliefs associated with what is essentially a crime against humanity? Can anybody with a heart and a head truly believe that slavery is a good idea, or that other, less extreme yet still abhorrent forms of human subjugation are somehow acceptable?

Today’s blog by Heather Cox Richardson (“Letters from an American”) shared the following tidbit that delegates to a convention of the Texas Republican Party approved platform planks that reflect the extraordinarily Luddite perspectives of a Republican Party that would be unrecognizable to Ronald Reagan, Dwight Eisenhower and George Bush, let alone Abraham Lincoln and Theodore Roosevelt. The platform includes protecting Confederate monuments, withdrawing from the United Nations and the World Health Organization, and — wait for it — “calling for a vote for the people of Texas to determine whether or not the State of Texas should reassert its status as an independent nation.” In other words, the Republican Party of Texas would like to consider secession from the United States. Everything old is new again. I doubt this craziness will gain real traction, and actually wonder if such an act would trigger another Civil War or a collective shrug of the shoulders.

Of course, the real question is why this madness resonates with so many people. I have no special insights, but it seems to me that this is more than the expression of frustration over a lack of full control by previously advantaged people in the economic and cultural life of our society. I heard an analysis the other day that makes sense. As our communities have lost their gravitational force, with an accompanying decline in attendance in religious worship services, Americans, both on the left and the right, have turned to political identification as a ferocious surrogate. Religious fervor accepts no compromise, and in its extremes, prizes identification and conformity — sometimes with disastrous consequences. Good people get led astray. I doubt that people will turn back to organized religion in droves, but perhaps can be persuaded somehow to readopt the secular religion of belief in a common vision for the United States that is reinforced by our mainstream religions.

Maybe I am right; maybe not. I certainly have no easy solutions. But, this I know: Human enslavement is abhorrent and immoral, as are all the trappings that surround it and celebrate the society that created and sustained it. Juneteenth reminds us of that, and should be a call to action for all of us. Today, we remember all those who suffered and died, and those whose lives continue to be affected by the echoes of enslavement.

It’s easy to mouth the words “never again,” but this can only come to pass if we make it so, working together to create a better future for all. In these times, that seems like a tall order, and I don’t know how we might heal. But we can and must do it.

Stay safe, be well, and be the change.

Lou

 


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Jun 12 2022

Enemy On The Run?

by at 3:11 pm

Greetings on a very rainy Sunday morning in the Philadelphia suburbs. We are at the new home of our son Ken and his wife, Sarah, ready to attend their daughters’ ballet recital at around noon. There is something very peaceful about being in a cozy home with lots of windows, watching it pour outside. Hopefully the rain will subside when we are ready to go to the recital, and from there, drive back to DC. This week’s blog is not about politics, insurrections or shooting wars. They are important, but today I want to write about progress that transcends conflicts.

I am still thinking about ASCO. By now, I can say comfortably that I avoided getting COVID-19, and it was a truly remarkable meeting. Last week, I described the game-changing findings regarding the use of a new HER2-targeted antibody-drug conjugate for women with HER2-low breast cancer. Upon further reflection, there was another, potentially even more revolutionary presentation.

A small study showed that treatment with an anti-PD1 antibody caused complete remissions of early stage mismatch repair-deficient rectal cancers in every treated patient. I repeat — every treated patient. This has profound implications, if verified in follow-up studies. The first implication is that immunotherapy with checkpoint antibodies can be applied to early stage rectal cancers with incredible efficacy, perhaps more so than in patients with more advanced disease. Conceivably, this could eliminate the need for surgery, radiation and chemotherapy one day, with immune memory preventing future metastases. Many of you know that the current rectal cancer standard of care requires surgery; if the cancer is too close to the anus, patients need AP resections that require a colostomy bag for waste elimination. The implications for both improved treatment outcomes and quality of life are no less than colossal. While I am hearing thunder from this morning’s rainstorm, perhaps it is an apt metaphor for the earth-shattering implications of this work.

A few words of caution: These are very preliminary data, and any changes to existing approaches that can be curative must be undertaken with the greatest of care, and only after rigorous clinical trials have been conducted and evaluated fully. Patients with mismatch repair-deficient rectal cancers are rare, and immunotherapy works well in such patients when their cancers have metastasized. This approach likely will not be as effective in cancers that are less sensitive to immune checkpoint inhibition. But now we have a blueprint. These findings provide an additional spark (as if one was needed) for a revolution in how we approach the therapy of rectal cancer, and down the road, who knows how many other types of malignancies.

How cool is it that we get a chance to contribute to a genuine revolution in cancer therapy? It does not always feel that way, but in the war on cancer, we are winning more battles, winning them decisively, and the enemy is on the run. ’Bout time…

Stay safe and be well.

Lou

 

 


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Jun 05 2022

Progress

by at 10:14 pm

Greetings from Chicago! I am at the annual ASCO meeting; the first full-on in-person ASCO meeting since 2019. The energy is high, and some of the progress is simply jaw-dropping. You would not be able to tell by looking at me, because I am wearing my mask; but I am in a distinct minority. Let’s hope COVID decided to take the weekend off…

I spent Sunday afternoon at the Plenary Session, which had at least 10,000 attendees. Frequently, the plenaries are, shall we say, somewhat pedestrian. But not this time. The first presentation pointed the way to the use of molecular markers to guide the therapy of colon cancer — with practice changing implications. The key drug used in the study was panitumumab, an anti-EGF receptor antibody. I led the initial Phase I clinical trial of that antibody, starting in 2001. I felt like a proud papa, grateful to have had a chance to start a chain of events that led to this day.

The next abstract used a clever basket trial design to explore combination therapies for Ewing Sarcoma. As if on cue, the presenter responded to a question by touting the potential and exciting early results with TK216. Early laboratory research by Jeff Toretsky, Aykut Üren and colleagues led to the development of TK216. Jeff got a personal shout out from the presenter. Congratulations, Jeff!

Then, there was a presentation about an antibody drug conjugate (ADC; trade name is Enhertu) containing trastuzumab (i.e., Herceptin) and a topoisomerase inhibitor. The Destiny-04 breast cancer clinical trial demonstrated that this drug can be highly effective in women with breast cancers having low levels of expression of Her2. This is an absolute game changer for many women with breast cancer and offers new hope for women with types of triple-negative breast cancer for whom effective therapies have been lacking. At the end of the presentation, there was a prolonged standing ovation — only the second one I have ever seen at an ASCO plenary. The first was for Bernie Fisher when he gave a Plenary discussion shortly after being removed (unfairly, in the view of many) as chair of the NSABP clinical trials group by the NCI. This time, people stood not in appreciation for the life’s work of a giant, but rather because of the progress this trial represents.

For me, it was so satisfying to see antibody therapy continue to come of age. I was involved in early ADC clinical trials nearly 30 years ago and had the privilege of speaking at the 2012 ASCO Plenary Session about the first truly effective Her2-targeted ADC. This drug, and this general concept, are going to infiltrate throughout oncology, and it will be a good thing for our patients. Thrilling.

In another Georgetown Lombardi-connected moment, Claudine Isaacs was a discussant on a breast cancer study in another session. Former ASCO President George Sledge tweeted out a lovely appreciation of her outstanding commentary. Well done, Claudine!

I came away from Sunday filled with optimism for the power of cancer research to translate into more effective treatments for people with dreaded diseases. In this crazy time, with news cycles dominated by senseless hatred and violence that have somehow pushed a remorseless pandemic into the background, it is deeply reassuring and life-affirming to know that the arc of progress has held true in the face of these challenges. It’s up to us to maintain this momentum.

And ASCO is only half-over!

Stay safe, be well and be the change.

Lou

 

 


The views, thoughts, and opinions expressed in the text belong solely to the author, and not necessarily to the author’s employer, organization, committee or other group or individual.

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