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Annual Philip A Salem M.D. Oncology Lecture - December 20, 2023

Lecture underscores bench-to-bedside value of the comprehensive cancer center.

Recently presented at Baylor St. Luke's Medical Center (BSLMC) by Pavan Reddy, M.D., director of the Dan L Duncan Comprehensive Cancer Center at Baylor College of Medicine.

Focus of the Lecture

The focus of Dr. Reddy’s talk was the vital role of comprehensive cancer centers in translating cancer research from the laboratory to patient care. The comprehensive cancer designation is given by the National Cancer Institute and, to receive the designation, a center must meet NCI’s rigorous criteria for laboratory research, clinical research, and population-based research. The centers must also demonstrate the ability to conduct transdisciplinary research that bridges scientific areas.

Noting that Houston is fortunate to have two comprehensive cancer centers, the Dan L. Duncan Comprehensive Cancer Center and the M. D. Anderson Cancer Center, Dr. Reddy explained that these two leading institutions are among a total of 55 comprehensive cancer centers in the United States.

In explaining the designation, he said: “The idea is to provide sub-specialized, multidisciplinary and comprehensive care in general oncology, but also include cutting-edge care in clinical research, all in a very personalized and efficient manner.”

Importance of Comprehensive Cancer Centers

Addressing why this designation is important to patients and their families, Dr. Reddy pointed out that research shows a patient’s survival chances statistically improve when treated at a comprehensive cancer center. “There is actually a 10% lower chance of dying in the first year if you are treated at a comprehensive cancer center,” he said. “This is across the board, all cancers put together…based on research-driven data that was put together a few years ago.” He added that, for patients and their families, “it matters for life.”

Cancer Discoveries

Highlighting a variety of important cancer discoveries made at the Dan L. Duncan Comprehensive Cancer Center in the last 20 years, Dr. Reddy spoke about the organization’s research contributions to CAR T-cell therapy for life-threatening blood cancer. The treatment, which was FDA approved in 2017, has saved thousands of lives.

Dr. Reddy then discussed his own journey as a physician scientist engaged in both patient care and research. In the laboratory, he focuses on the immunobiology of graft-versus-host disease (GVHD), a devastating immune response that can occur following a stem cell or bone marrow transplant in which the newly transplanted donor cells attack the transplant recipient’s body.

He explained that, in noting that GVHD mainly presented with harmful effects to the patient’s liver and skin, his research has focused on the GI tract as the largest driver of mortality in most cases. Noting that patients had significant losses of histone proteins, this ultimately led Dr. Reddy and his team to look at the role of the microbiome and, more specifically, the metabolite butyrate. Recently published research involved their prebiotic approach, giving patients resistant potato starch as a medication to increase the microbes that make butyrate, seeking to fortify those levels before treatment and promote the cellular processes that are inhibited when butyrate levels are low.

Dr. Reddy said that the results so far, noting the work is in its early stages, show that the resistant potato starch does alter the microbiome in humans in the right direction and, similarly, changes the metabolites in the right direction.

He also touched on other promising research involving iron chelation and its use to mitigate harmful oxygen levels in the microbiome that disrupt the bacteria in the intestinal lumen. He believes that the road ahead for his research will lead to more opportunities for translation at the intersection of diet, iron chelation, and epigenetic operation.

“In patient care, translation is how you get real advances in cancer,” said Dr. Reddy. In summary, he added that he hoped his examples helped to illustrate the strengths of a comprehensive cancer center in making those advances possible.

Annual Lecture Series

This annual lecture series was established in 2017 by St. Luke’s Hospital to recognize Dr. Salem’s contributions to cancer medicine. In 2010, St. Luke’s Hospital established a cancer research chair in Dr. Salem’s name.

“I’ve been in cancer medicine and research for 55 years,” said Dr. Salem. “My eyes were always on the ball, and the ball was not a Nobel prize, it was saving human lives.”

Dr. Salem, who continues to practice oncology medicine at the Salem Oncology Center in the Texas Medical Center, served as director of cancer research at St. Luke’s for 20 years and is currently director emeritus of cancer research at Baylor St. Luke’s Medical Center. He has been practicing cancer treatment in this center for 32 years and most recently developed a strategy for the treatment of advanced cancer.

Dr. Salem’s strategy uses a combination of immunotherapy, chemotherapy, and targeted treatment. It has shown promising success in patients with advanced diseases who have exhausted standard therapy and in patients who have diseases of no known standard treatment.