The university asked me to develop this Phase I program, the first [step] in human clinical trials, as part of UC’s cancer institute. There are few Phase I centers in the United States, maybe 10 to 15. We have new drugs, new strategies [researchers] want to investigate, and I am here to run the trials and to translate this knowledge from bench to bedside.
Most patients in the trials failed other therapies—chemo, radiation. They are resistant to most of them. We see patients very, very, very motivated. It’s the last opportunity to get treatment and hopefully to have some benefit.
Currently we are developing Antibody Drug Conjugates. It’s a very specific way to deliver anti-cancer agents. We identified some very specific protein targets [that appear in] cancer cells; we designed antibodies to recognize those targets, and they are loaded with some bombs—toxins. When we inject those toxins, we deliver [them] directly to the cancer cells. So we move from a nonspecific treatment, chemotherapy, to a very specific targeted molecular therapy. We are at the very initial step. This is one of the most promising avenues of the future. Only two centers in the U.S. are doing this trial—one in San Antonio and the other, here.
Soon we will develop this fascinating approach for treatment of primary brain tumors, called gliomas. And we have a drug coming from [UC’s research that] is a kind of nanotechnology: We can deliver a very toxic drug for the cancer cells to the primary brain tumors in a very specific way and induce “cell deaths.” The results are very impressive in animals. We are waiting for FDA approval to move to Phase I. This is going to be a UC story, from basic research to general hospital to clinical development.
It’s fascinating to work with the cancer cells. Those cells are so small, they can develop resistance. They can adjust, adapt to our strategies. So who is going to be the smartest? We don’t know, but those drugs are very smart, so we’ll see. As an oncologist I must be an optimist. There is no alternative.
What is extremely emotional is sometimes you see some positive effects. You are the first to see some shrinkage, the strategy seems to be promising, and then you say: “OK, I think I found the dose and we are ready to move to Phase II and Phase III, and maybe one day to get the drug approved.” It’s amazing to bring something new and to see the drug having its own life.
I have just one real enemy: cancer. That’s why we are here.
Illustration by Grady McFerrinOriginally published in the January 2011 issue.
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