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Q&A: New UMGCC Associate Director of Clinical Research Discusses New Cancer Drug Development and More

Edward A. Sausville, M.D., Ph.D.

Edward Sausville, M.D., Ph.D., who has led the National Cancer Institute's (NCI) new drug development program since 1994, will become associate director of clinical research at the University of Maryland Greenebaum Cancer Center. Dr. Sausville is currently the associate director on the NCI's Developmental Therapeutics Program, which has played a key role in developing many of the new cancer drugs in use today. He is expected to assume his new position in May.

Dr. Sausville talks about his goals at UMGCC, his experience in and approach to new drug development, the importance of translational research, future advances in cancer research and much more.

What attracted you to the UM Greenebaum Cancer Center?

What's very special about the University of Maryland is its long-standing track record as both a clinically oriented cancer center that provides really excellent care for very ill patients with cancer, and as a place that has helped set the standard by which patients of certain types of cancer are managed around the world. It's pretty clear here at Maryland that you have excellence on the part of the staff and the participation of patients in clinical research. So the fact that there was an opening in this type of an environment attracted me. The diverse segments of society that are served by the University, both locally and nationally, points to a real wealth of potential activity in what interests me, which is clinical research devoted to cancer treatment.

Another feature I found very attractive about Maryland are the links of the cancer center to one of the best public universities in the world. And that would include both the scientists in the local environment as well as throughout the larger University of Maryland system. Catalyzing the interaction between their scientific skills and interests and the clinical research efforts of the cancer center will be an important focus of mine.

A third attraction was the state of Maryland's support for cancer research through the Cigarette Restitution Fund Program. The allocation of significant funds from this program to the cancer center creates special opportunities for the advancement of basic and ultimately translational research and to accelerate the application of discoveries to the clinic for the benefit of patients. The provision of these funds by the state for cancer research, treatment, screening and outreach is quite remarkable, and provides opportunities for me and the cancer center to pursue leads that we uncover at the bench and bedside. Ultimately, these investments will lead to clinical applications that will have major benefits for Marylanders. The degree to which the state of Maryland has provided these funds to cancer research appears unparalleled, and figured in my decision to join the faculty at the University of Maryland.

Talk about your scientific experience as it relates to new drug development.

My scientific background is really focused on two aspects: What is the mechanism at the molecular/cellular level by which useful cancer drugs work? And then parallel to that, how do we optimally begin the initial study of those medicines in patients?

My recent work at NCI has focused on advancing drugs that are recognized in the early stage of the development cycle as potential candidates and trying to discern what the best opportunities for rapid development might be.

On a clinical side, I've maintained clinical activity in early phase clinical trials with new agents in people in a clinical center at NIH. And for a long time I've had an interest in clinical trials in patients with lymphomas. I plan to see patients and be involved in that work at the University of Maryland as well.

How will your experience at NCI help you in this position?

The NCI is really a crossroads for people who have good ideas, so I think having been aware of many different opportunities that are actually available, and what some of the strong points and not so strong points of certain others gives me a lot of experience in how new therapeutic agents are approached. At NCI I've developed an understanding of how consensus is built and how excellent programs are put together, skills that should help me in my role at the University of Maryland.

What are some of your goals at the University of Maryland?

My top priority is to bring new treatments and new good ideas to clinical research, and to work with the many disease oriented clinics and physicians here to really facilitate their ability to bring new agents that would be able to address a large number of cancer patients to the bedside. That would involve everything from making sure the support apparatus assists in the execution and planning of the clinical trials, to facilitating liaisons with academic, government or corporate sources on new agents. And then depending on the sort of project, helping with the structural planning that would allow that to happen.

I also want to further develop areas of noteworthy strength in the cancer center, such as cancer imaging and surgical oncology. With our advances in imaging, there's going to be large number of opportunities to tell in real time whether our treatments are getting to where they need to be, which is a critical part of the equation.

From a surgical standpoint, we need to make sure that the surgical oncologists and surgeons are full partners in the clinical research enterprise of the UM Greenebaum Cancer Center. In particular, one can imagine clinical trials where patients receive a new treatment before and after a previously planned and otherwise necessary surgical procedure. Teamwork in acquiring and processing the tumor specimen, along with patient support and consent, could be key in advancing our understanding of the treatment's action.

UMGCC Director Dr. Kevin Cullen has talked a lot about the plans for growing the cancer center. Was this a factor in your decision to come here?

The plans for growth have not escaped my notice (laughs). To me, it's not only a question of growing research, but it's growing it in a way that it becomes a cohesive endeavor across the many different disciplines who are interested in cancer care. And also cohesive from addressing the range of patients that actually are coming to us. So part of the challenge is to make sure the growth is done in a balanced, inclusive way to take advantage of input from a variety of experts in the cancer center and also addresses the needs of the patients coming to us. I would say it's not only growth, it's doing it smartly, taking advantage of the resources we have and making it a sustainable enterprise as time goes on.

What is translational research, and how do you see it impacting patient care?

I think it will help by explaining what translational research is. To summarize very simply, translational research is taking discoveries from the laboratory and ultimately shaping these into clinical applications. Also, observations in the clinical setting may lead us to more laboratory research, again with the ultimate aim towards new clinical applications. This is the oft-quoted "bench to bedside and back again" to continuously refine process of discovery that circles back and forth between the laboratory and the clinic.

In a more scientific sense, translational research is where a knowledge of the biology of the disease in a patient informs the science that comes to that patient. Conversely, a knowledge of the science influences how the clinical aspects are approached. So it's a real interplay. And although it may seem strange, that's not the way it always was in cancer research. Until the mid 80s, it was largely empirical oriented. For example, we'd find a treatment that helped mice, and we'd try to find a way to resemble how we did it in mice and give it to humans.

In the last 25 years, there's been a remarkable increase in our knowledge of how cells work in general, and how cancer cells depart from this state of normalcy. And we can use this information to actually inform what treatments are being used at the bedside. We can actually use our knowledge of biology to give patients the most appropriate new treatment, while at the same time minimizing patients' exposure to agents that have a low probability of working for them. All these are a new set of opportunities, and that translation back and forth, from the patient to the lab and back to the patient, is something that really successful medical research scenarios are seeking to access. Clinical research is translation of that knowledge from one sector to another.

How important is the pharmacological component to developing new cancer drugs?

My own belief is that the relationship between people who are knowledgeable on tumor models in animals, and the scientists or pharmacologists who actually study how the drug is handled by the animals, is vital. If you have a pretty good idea of what the relationships are between concentrations of drugs used in animals, that is, whether the targets are being achieved and whether there's any adverse affects, you can be pretty informed in your decision about how to move to the next step.

So many of the less than successful outcomes that have occurred over the past few years have been because there hasn't been a good understanding of the pharmacological and pharmaceutical aspects. The fact that the University of Maryland has a very active pharmacy school -- both in terms of training pharmacists and in drug discoveries and new approaches to developing medicines -- gives us a lot of potential to bring new therapies to patients with cancer.

What sort of advances in cancer research do you see on the horizon?

I think this notion of individualizing or personalizing treatment is something that we'll see remarkable advances in in the near term. Another is the various efforts to incorporate genomics and proteonomics into routine care of patients. At Maryland we have a proteonomics support facility, so we're certainly well positioned to participate in clinical trials that would bring that to fruition. Real-time imaging is another major advance, as it will help with the selection of patients for a certain drug and help us to track the efficacy of those treatments. The cancer center is well positioned here because of the experts we have in the area of radiation oncology and the state-of-the-art imaging equipment at the Medical Center.

Is it rewarding to you to help develop new drugs for, and to work with, cancer patients, many of whom are seriously ill?

Personally, I feel a tremendous amount of responsibility and I might say almost a degree of awe at the willingness of people who are in desperate straits to volunteer their lives, time and effort to help advance the field. It astonishes me, the overwhelming generosity of spirit that patients in advanced stages of disease bring to us, the doctors and scientists who are studying this problem. So I think we have a very special responsibility to make sure that the people who place themselves in our care at that time in their lives are receiving the very best that we can offer as physicians and researchers.

This page was last updated on: January 25, 2007.