April 1, 2016:
A conversation with Theodore Lawrence, MD, PhD, director of the University of Michigan Comprehensive Cancer Center, professor and chair of the Department of Radiation Oncology, and a member of the Big Ten Cancer Research Consortium.
Q: How do you think cancer research will change in the next 10 to 20 years?
There has never been a more exciting time to do cancer research.
Over the next 10-20 years, I expect that immunotherapy will continue to advance. We’ll start to see greater clarity in patient selection and in combining immunotherapies with other therapies.
Metabolomics is another exciting area of research, and I anticipate that the biological discoveries in this area will begin to be translated into new treatments. Likewise, our growing understanding of the interaction of the microbiome with the causes and treatment of cancer will produce new ways of decreasing the toxicity and increasing the efficacy of cancer treatments.
Biostatistics and bioinformatics are already central to much of our research, and the contributions of these fields will continue to grow. We’ll see a greater emphasis and opportunity to use mobile technologies to record patient reported outcomes.
There will be challenges as well. Our increasing understanding of tumor heterogeneity means that almost all diseases are becoming “orphan” diseases. When I was a medical oncology fellow and a radiation oncology resident, lung cancer was either “small cell” or “non-small cell.” Therefore, you could design a single trial that would apply to large group of patients. Now our protocols are, for example, “erlotinib-resistant EGFR mutated lung adenocarcinoma.” That’s so much more specific of a patient population, and we expect to accrue only a few patients a year. But it’s the same effort in protocol writing and start-up. While I am excited that our outcomes continue to improve, it is certainly a challenge to our clinical trial implementation. Read More
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