“Her name was Melissa,” Dr. Bert Vogelstein recounts to the packed auditorium. He’s talking about his first patient as a pediatric resident at Johns Hopkins nearly 40 years ago. “I still remember to this day her parents asking me why this happened to their daughter.”

Melissa was a young child who was diagnosed with acute lymphoblastic leukemia (ALL), a cancer of the blood and bone marrow. Fresh into his training, Dr. Vogelstein was tasked to treat an enduring disease. “We had no idea back in 1975 what caused leukemia; it was a black box.”

woman holding her child and his toy, while he kisses her on the cheak.

Image courtesy of Ark Media

In truth, patients such as Melissa are just one of hundreds of thousands over the world fighting cancer. And it’s these patients that are the focus of the upcoming documentary presented by renowned Emmy award-winning director Ken Burns, Cancer: The Emperor of All Maladies.

The six-part documentary series is based on the Pulitzer Prize-winning book, The Emperor of All Maladies: A Biography of Cancer, by Siddharta Mukherjee, M.D., Ph.D, an oncologist at Columbia University. The documentary was filmed primarily at the Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins Medicine in Baltimore, Md., and follows the lives of real patients and their individual battles against cancer. The film also chronicles the history of cancer, current treatments and the future of conquering the disease.

In preparation for its release, patients, doctors and researchers at the Johns Hopkins Hospital were treated to a sneak preview of the film on Tuesday, March 23. The preview was followed by a panel of acclaimed members, including author Dr. Mukherjee; Oscar-nominated director Barak Goodman; Margaret Foti, Ph.D., M.D. (hc), CEO of the American Association of Cancer Research; Lori Wilson of Howard University, a cancer survivor and surgical oncologist whose story is featured in the film; and Bert Vogelstein, M.D., and Kenneth Kinzler, Ph.D., co-directors of the Ludwig Center at the Kimmel Cancer Center.

The panel, which was moderated by Kimmel Cancer Center director William Nelson, M.D., Ph.D., highlighted the challenge of making the film, portraying patients on screen and the personal struggles of the doctors and patients fighting cancer.

Public reception of the screening has been nothing short of enthusiastic. Ken Burns, who lost his own mother to cancer when he was 11 years old, took care to include the stories of real cancer patients, focusing on their experiences over time as they progressed through treatments — and in the best cases — healing processes. The documentary serves to bring many of the negative stigmas associated with “our malevolent, contemporary doppleganger,” as Dr. Mukherjee puts it, into the public.

In commenting on one of the closing panel questions, Dr. Vogelstein ended on a positive note. He spoke about how much we have learned about cancer since he was a young resident: “Once you understand a disease, it’s only a matter a time before that disease is conquered. We don’t know exactly how the disease will be conquered, but we understand it, it’s outlined and that conquering is just a matter of time.”

 

Cancer: The Emperor of All Maladies, a film by Barak Goodman, airs on WETA public broadcasting on March 30 and 31 and April 1 at 9 p.m.

About the Author

Paul Sirajuddin

Paul Sirajuddin is a postdoctoral fellow in radiation oncology, a writer and a photographer. When he isn’t zapping cells or shooting photos, he’s writing about science.

Does anyone remember being asked if they were left-brained or right-brained? That’s how I recall my friends and I attempting to find our academic niche. We had two choices: We were either good at solving equations or writing essays.

That may have seemed true when we were young, but as professionals we now know that science, technology, engineering and math (STEM), and communication skills are essential partners. As Ph.D. candidates, we must survive an oral candidacy exam, publish papers, defended our thesis and continue discussing our work in whatever forms our future career requires. All these milestones necessitate developed communication skills.

microphoneBut while some people have a natural ability, most require practice to develop these skills. So, how do doctoral programs help us avoid becoming noncommunicative scientists?

Here at Johns Hopkins, the short answer is repetition. There is no single way this training is carried out, but I would argue the general philosophy is the same: Learn by trying it again and again.

As a fourth-year student in the Program in Molecular Biophysics and working in a lab in the Department of Pharmacology and Molecular Sciences, I have firsthand experience with the scientific communication training in both programs.

For over 15 years, the pharmacology department has offered a weekly seminar series called “Research in Progress,” in which trainees present their current research and are provided constructive feedback. According to, Philip Cole, the director of the program, two objectives of this forum are for trainees to “get experience giving oral presentations and answering questions in a public forum, and to gain confidence in their communication skills.”

This requirement is extended to all trainees working for pharmacology faculty, regardless of their program of origin, which presents an interesting consequence for me: Once a year, I give a talk on biophysical research to a pharmacology community. Because this audience has a different level of knowledge about my research, the seminar I give during “Research in Progress” is not the same talk I give to my own department. Though difficult at first, this endeavor has taught me to extract and present the most relevant components of my research based on my audience.

Conversely, the Department of Biophysics and Biophysical Chemistry takes a different approach. Second-year students give a seminar on a topic unrelated to their thesis project, forcing them to digest and distill research so it can be understood by any audience. I chose to discuss a protein implicated in Parkinson’s disease, and so, as you can imagine, the audience was filled with neuroscientists!

Additional training involves voluntary participation in the monthly “Student Evening Series,” in which two students present their work to the other biophysics graduate students. Jeremy Anderson, a fourth-year biophysics student, described the feedback from these sessions as beneficial, given that it “pulls from the diverse background of those involved.”

Regardless of the flavor of training we receive, our time at Johns Hopkins prepares us to speak effectively about our work. Jeremy’s experience in biophysics enabled him to deliver a successful talk at the Biophysical Society Meeting recently held in Baltimore, while my own expertise in biophysics and pharmacology allowed me to navigate the challenges of a poster presentation at the same conference.

So, the next time we think to complain about preparing for a required talk, we should stop to remember the undeniable benefits it adds to our communications skill set.

About the Author

Shannen Cravens

Shannen Cravens is a Ph.D. student in molecular biophysics with a passion for teaching who enjoys weaving art into her lab life.

While most graduate students are worried about their next exam or an upcoming experiment, Carmen Kut, an M.D./Ph.D. student in the Biomedical Engineering Department at Johns Hopkins School of Medicine, is quietly immersed in her latest endeavors to create meaningful medical products for those in need. Since her time as an undergraduate at Johns Hopkins University, Kut has been a standout success; she was chosen as a member of the All-Star Academic First Team in 2008, and was awarded the prestigious National Institute of Health F30 fellowship, as well as the Siebel Scholarship during her graduate degree.

Looking to enrich her experience, Kut attempted to find an outreach program allowing her to travel overseas. Frustrated with the lack of options, Kut started her own program, Medical and Educational Perspectives (MEP), to better advance global health education.

Carmen Kut sitting on a desk in front of a group of students

Image courtesy of Freddy Espinoza

After initially receiving resistance, she persevered and initiated the program using a network of contacts from her hometown in Hong Kong, while also recruiting colleagues throughout the US. In their first excursion, a small group of MEP volunteers traveled to a rural school in China and taught health care classes to high school students. Over the next few years, the program grew to 10 chapters in over three continents, serving schools in China, India and Tanzania. Kut transitioned the student program into a Maryland-based nonprofit organization by her senior year, while managing to graduate at the top of her class.

After Kut was accepted to the Johns Hopkins School of Medicine, she took her first two years as a medical student to reinvent MEP, with a new mission statement switching the focus from education to the production of simple medical innovations for use in less medically equipped areas.

Kut applied for and was awarded a $125,000 grant from the PhD Innovation Initiative from Hopkins. Kut and her team used the money to develop two courses for MEP volunteers to learn the clinical and business acumen necessary to bring inventive ideas to commercialization and placement in global clinics. Using multiple connections to help drive her cause, she reached out to professors, physicians, CEOs and regulatory staff to teach these courses. The program has now blossomed into two full semester courses.

MEP volunteers also visited clinics and hospitals in India to speak with clinicians and patients to discuss their needs. Using this information, teams of inventors designed items and presented to business CEOs and Hopkins physicians to gain insight and feedback about their products.

Through the combination of education, innovation and the goal of implementing meaningful changes in less fortunate communities, MEP has become a success story for both Kut, her team and the Hopkins community. After running the program for 10 years and supporting close to 600 volunteers, Kut remains focused on what’s to come. When asked about the future of her program, she emphasized a desire to expand the program to include outreach in the local Baltimore community, while maintaining a steady presence in overseas chapters, as well as to return in some capacity to its roots in education.

Clearly, Kut is prepared to take on the many challenges currently facing global healthcare, and Hopkins should be proud to call her one of their own.

If you want to get involved in MEP, please contact MEPJHU@gmail.com or visit their blog at http://mepjhu.tumblr.com.

 

 

About the Author

Kirstie Keller

Kirstie Keller is a classically trained ballerina-turned-scientist with a penchant for 90s music. She enjoys piecing together the details of a discovery into the larger puzzle of life.

In January, a week prior to the holiday celebrating the birthday of Martin Luther King Jr., the Johns Hopkins community gathered to celebrate the life of Idoreyin P. Montague, an accomplished second-year combined internal medicine and pediatrics resident physician.

Montague, who was 30 years old, was killed in a car accident on Dec. 24.

Hundreds of physicians, nurses, students and other hospital employees, many who worked directly with Montague during her brief tenure at Johns Hopkins, crowded the historic Hurd Hall to pay final respects to “a star” who was training toward a career in primary care specifically for marginalized populations. Also present were her parents, three siblings, and other close family and friends, including her boyfriend, who was with her shortly before her passing.

A common thread among the many who spoke was Montague’s unwavering dedication to her patients. Trainees who worked with her shared their memories of her and how she inspired them to be better advocates for their own patients. A supervising physician spoke of her untiring commitment to ensure that a cancer patient she had admitted to the hospital, who was also struggling with drug addiction, received substance abuse counseling so he/she could receive the necessary cancer treatment. That patient is still alive several months later because of Montague’s efforts.

Her impact was felt among even the most senior physicians, including a former director of the department of medicine, who was moved to tears as he spoke of her. Her program director spoke of the young physician’s numerous attributes that had endeared her to so many at the hospital and in the community. Her Baltimore church pastor said her life had even strengthened his own spiritual walk.

Shortly before the program’s conclusion, a video played of Montague alone in her car, wearing her white lab coat, singing verses of Charles Tindley’s hymn “Beams of Heaven” as she recorded herself.

“I do not know how long ’twill be, nor what the future holds for me. But this I know, if Jesus leads me, I shall get home someday.”

Montague’s legacy will live on with an eponymous scholarship and an annual Urban Health Grand Rounds in her honor, which will bring together the departments of Medicine and Pediatrics at The Johns Hopkins Hospital. She was a graduate of Shaw University in Raleigh, North Carolina, and Meharry Medical College in Nashville, Tennessee.

About the Author

Ryan Lang

Ryan Lang is a physician and writer with a passion for the underserved and a desire to bring the medical issues of this population to light.

An earthquake shook Baltimore our first day of anatomy.

Days later, a hurricane moved through. That was our first week of medical school, and Mother Nature welcomed us in perfect allegory. Almost four years later, we’ve arrived at the 2015 Match Day.

Friday, more than 26,000 medical students learn where they will be training for the next three to seven years. They have interviewed all over the country and ranked their preferences, and Friday at noon, they are given the name of a single residency program: their match.

To date, over one-third of the medical school class of 2015, myself included, have taken additional time to conduct research, obtain another degree and more. Luckily, Johns Hopkins is so supportive of our varied interests, and we have such incredible resources for all kinds of inquiry. But despite the fact that we will not all be graduating together, the class’ bond has withheld, and this day arrives with an incredible amount of excitement and emotion. We’ve become a family over these past four years, and Match Day is the ultimate celebration and send-off.

Students and their significant others pose in the Bahamas during their last trip together.

Students and their significant others pose in the Bahamas during their last trip together.

We learned to do physical exams on each other, and we struggled through the rigors of our first two years. During our big meeting before transitioning into the hospital in our third year, we packed into the lecture hall and played with our newly obtained pagers, which periodically — and loudly — beeped in the middle of the talk. I worried that being split up in the hospital setting would loosen our bond, but if anything, sharing a collective experience brought us even closer.

Baltimore has served as our home, regardless of wherever we left to come here. Our patients are incredible, and they teach us not just the clinical components of medicine but also the profound impact of environment and culture. As Johns Hopkins students, we’ve been threaded into that world, which has shaped our experience as we’ve progressed.

The learning experience of medical school is not unlike a comedy of errors. The safety net of a medical team is there to catch your mistakes before they reach the patient. But you learn from those mistakes, and your pride survives through sharing your experiences. As such, a common third-year bonding activity is sharing stories of learning through folly, each one of us trying to outdo the other in the hilarity of our own realized inadequacies in the hospital.

Of course, amid that humor, there were struggles. Working in the hospital makes you part of the defining moments in the lives of others. As a class, we have been there for each other through these struggles too. And, at least for me, that has been an invaluable component of defining both the physician and the overall person I want to be.

quote: Regardless of the elements you face, your classmates are your environment, and they are your drive to be better

We also have had incredible adventures together outside of the hospital. Johns Hopkins’ 2015 school of medicine class travels en masse, and we could write books about our adventures to Mexico, Brazil, Turkey, Panama, Nicaragua and, most recently, a trip that almost one-third of our class took to the Bahamas this past week before Match Day.

Now, realizing over one-half of my class is about to move on to their lives as doctors, I see how far we have come. Discussions no longer center on mistakes but rather visions of the road ahead. The student white coat is clearly now too short on my friends; they are ready to exchange it for the long coats of the doctors.

Without a doubt, the men and women of the 2015 school of medicine class here at Johns Hopkins have made my world a better place and made me a better person, all before officially receiving their M.D.s. I can only imagine the good they will do for their patients.

Lighting struck in a big way when the class of 2015 came to Johns Hopkins. Well … rain, wind, lightning and a shifting of the tectonic plates. But regardless of the elements you face, your classmates are your environment, and they are your drive to be better. I am so honored to call them peers, and I cannot wait to see the impact they have on the world. If it is even a fraction of the impact they have had on me, the world is about to become a much brighter place.

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About the Author

Arielle Medford

Arielle Medford is a fourth-year medical student who spent this past year doing cancer research. She is also a dancer and a writer, and she loves everything science.

Troubling tales of race, poverty and violence seem to span the contours of today’s media. However, University of Pennsylvania criminologist Sara Heller’s research1, published last month in Science, contributes a hopeful voice to the dialogue. In a randomized controlled trial of disadvantaged youth in Chicago, her study shows a significant link between joblessness and youth violence — and proposes a low-cost solution.

Poverty scholars have long argued that unemployment is a risk factor for violent behaviors: Joblessness leads to weaker social bonds and psychic strain, and it reduces the perceived cost of punishment. But until Heller’s study, practical applications of this concept have been lacking, and job assistance programs have largely failed to produce a reduction in youth delinquency.

word cloud hand articulating to stop violence and crueltyWhile most previous studies involved individuals already out of the school system, Heller focused on those still in high school. They were C students on average, one-fifth of whom had been arrested previously, and over 90 percent of whom were eligible for free or reduced-cost lunch. She randomized over 1,600 youths to one of two arms: Some were entered into a job assistance program, while the others were not asked to change their daily lives.

Those entered in the program were offered eight weeks of summer employment for 25 hours per week and were provided with job counselors. They worked as camp counselors and office assistants, among other positions. Some worked for only 15 hours weekly but spent 10 hours engaged in “social emotional learning,” based on the principles of cognitive behavioral therapy, and focused on learning to manage emotions and behaviors in various workplaces.

In a partnership with the City of Chicago, Heller followed these individuals for 16 months. Violent crime arrests among those in the intervention arm were reduced by 43 percent when compared to those in the control group. There were no differences, however, in the two groups when it came to other outcomes, like drug or property arrests.

Interestingly, her data suggested that most of the benefit to the youth who had summer jobs occurred not during their period of work but in the several months after. The delay implies that summer work doesn’t merely keep kids out of trouble by keeping them busy; it has a lasting effect. Perhaps such programs give them skills they can build upon for future employment, or maybe they teach them that work is a more attractive option than crime. Further research is necessary to tell the full story of how jobs reduce violence.

Regardless, Heller’s data is a scientific, data-driven argument for what she calls “shifting from remediation to prevention.” The program in her study, which cost around $3,000 per student — $1,400 for wages and $1,600 for administrative costs — may very well be cost-effective when compared to the societal costs of punishment involving prison or parole.

“Well-targeted, low-cost employment policies can make a substantial difference,” she says, “even for a problem as destructive and complex as youth violence.”

 

1. Heller, SB. “Summer jobs reduce violence among disadvantaged youth.” Science 2014 Dec 5;346(6214):1219-23.

About the Author

Benjamin Oldfield

Benjamin Oldfield is an Internal Medicine-Pediatrics Urban Health resident interested in the intersection of health care and social justice.

Since their discovery in the early 1990s and 2000s, microRNAs have been implicated in a variety of human conditions. Most recently, however, microRNAs are being scrutinized under a different light: not as causative agents in human diseases, but rather as potential guides for cancer detection.

The microRNA is a short nucleotide sequence, usually 21 to 23 bases long, that acts to silence gene expression. There are currently hundreds of known microRNAs, and most exist in unique locations inside the human body.

Micro RNA (miRNA, hsa-miR-133a) structure, computer modelWe now know that certain tumors actually produce unique microRNAs that are then circulated in the bloodstream of patients. This characteristic has lead researchers in Germany to test whether these circulating microRNAs can be a viable option for early detection of cancers.

Together with her team at the National Center for Tumor Diseases in Germany, Nina Habermann assembled a group of patients diagnosed with colorectal cancer at stages 1 to 4.

The goal of the study1 was simple: to look for microRNA profiles in these patients versus healthy controls to determine if certain microRNAs discriminate differently between the two groups.

They also looked at whether these tumor-specific microRNA profiles changed at various time points with the surgical removal of the cancerous tumors. Because the tumor microRNAs are secreted into the bloodstream, the team was able to easily quantify the levels of circulating microRNAs with standard techniques. They collected blood from patients at three different time points: one day presurgery, within one week postsurgery and six months postsurgery.

The blood was then profiled against a panel of 16 microRNAs preselected to be high potential candidates for colorectal cancer. The findings show that one microRNA in particular, miR-92a, was distinct between the control group and the patient group, a result that agrees with previous hypotheses.

In addition, they documented changes in microRNA profiles within the patient group at the different times pre- and postsurgery. A total of nine of the profiled microRNAs had lower levels just days after surgical removal of the tumor. The fact that microRNA profiles can change so significantly in a matter of days postsurgery has never been illustrated before, and it highlights the complex underpinnings of microRNAs in our biological systems and, importantly, in cancerous processes.

The implications from this pilot study are tremendous not only to colorectal cancer, but also, potentially, to a whole host of other conditions. The ability to identify a unique microRNA that can discriminate cancer patients from healthy controls opens a great avenue for early cancer detection. While the specificity of the screening procedure needs to be optimized, using microRNAs as a biomarker for colorectal cancer has great potential because of the ease of sample collection, ability for early detection and potential as a postsurgery monitoring method.

 

1. Ristau, J. et al. Suitability of Circulating miRNAs as Potential Prognostic Markers in Colorectal Cancer. Cancer Epidemiol Biomarkers Prev; 23(12), 2014. 

About the Author

Xuan Pham

Xuan Pham is a human geneticist graduate student who enjoys telling stories about genetics with a creative twist.

Imagine you are a pediatrician working in an emergency department when a young female patient who was recently diagnosed as bipolar is brought in by her mother. She is visibly angry upon arrival, and her mother looks tired and distressed. When you enter the room, the young girl begins the interaction with foul language. She not only threatens to hit you and the hospital staff but actually succeeds. Her mother sits quietly in the back of the room and does not say a word. Security is called into the room for the safety of the patient and the health staff. She begins to yell, kick and spit as security places her in restraints. Soon, she is given a shot of haloperidal, a powerful antipsychotic medication. In a few short minutes, she zones out. She is only 9 years old.

white profile of a child with a red heart over the headAcross the hall is a young teenager who wants to take his own life. Although he is a straight-A, honor roll student at a prestigious school and a skilled athlete who helped his team to the lacrosse state championship, he is overwhelmed by sadness and feels as if he is drowning. He has already come up with a plan for how to end his life. His parents are visibly distraught, tears welling up in their eyes.

These are two very real types of encounters I have had with children and their families when they came to the emergency department for care. Unfortunately in both cases, because there were no local psychiatric beds available within the region, they were forced to remain in the emergency department for days on end without access to the specialized mental health services each of them required.

As a pediatric emergency doctor in Maryland, this is an all too common occurrence when trying to give the best possible care to patients. As such, it’s an issue that warrants urgent attention in our state.

Emergency department overcrowding threatens access to medical services for patients who need care the most. Patients who need mental health services usually require a significant amount of resources and stretch our capacity to accommodate their unique needs while balancing the flow of new patients coming in. The high-stimulation environment of the emergency department is also not conducive to healing or calming patients in mental duress.

So what can we do to fix this problem and ensure timely and age-appropriate access to mental health services for patients in our state? One place to start is to establish more pediatric psychiatric inpatient beds within the Baltimore metro region.

Children with mental illness eventually become adults with mental illness. The costs of leaving their mental health needs unaddressed in childhood have dire ripple effects on society, the health care system and their own potential to live long, healthy and fulfilling lives. If we address mental illness early in life by strengthening the pediatric workforce and providing more resources to emergency departments through inpatient units specialized for children, we will start to take meaningful action to improve the lives of children in our state. This, in turn, will help improve the health of our community and our children.

About the Author

Sylvia Owusu-Ansah

Sylvia Owusu-Ansah is a pediatrician who emergently takes care of pediatric patients and would like to be a philanthropist when she grows up.

On the afternoon of May 12, 2008, a magnitude-8 earthquake hit Sichuan province, a mountainous region in western China. Official figures stated that 69,197 were confirmed dead, including 68,636 in Sichuan province, and 374,176 injured, with 18,222 listed as missing.

The earthquake left about 4.8 million people homeless,though the number could have been as high as 11 million. Although this disaster itself was so devastating, many inspiring stories still managed to surface during that time.

a graphic of a heart with bandages over itIt’s amazing that it is within this horrific tragedy that I find one of the most moving stories I’ve ever heard. On May 13, the day after this earthquake, rescuers saw a woman lying motionless in the ruins of Beichuan County.

Through a pile of reinforced concrete space, people could see the position of her body. She was kneeling down, prostrated, as if worshipping the ancients. Her upper body was creeping forward, and her hands were on the ground for support. Her body was so disfigured from the disaster that no one could bear to look at her.

After the rescuers confirmed her death, the leader of the rescue team found a living child under her. This 3- or 4-month-old baby was wrapped with a small, red, flowered quilt. Because of his mother’s protection, he was not injured at all and was still peacefully asleep.

When the accompanying doctor untied the small quilt for physical examination, he found a mobile phone with a message written on the screen that said: “Dear baby, if you can live, please always remember that I love you!”

I cannot say how shocked I was the first time I heard this story. The only thought I have is that it’s never been clearer to me that love is the most amazing and powerful thing in the world. I hope we all can learn from the unconditional love epitomized in this story and give our love to the people around us to make our world a better place.

About the Author

Xin Liu

Xin Liu is a postdoctoral fellow in biological chemistry. She loves her research, writing, singing and is really happy to make new friends here.

What do faulty brakes on a car and cancer cells have in common? For one, cancer cells have found ways to evade checkpoints that the body’s cells use as brakes to stop them from dividing out of control. By this same analogy, the accelerator in a cancer cell is always pushed to the floor, and the brakes are ineffective, causing cancer cells to multiply uncontrollably.

Though chemotherapy and surgery have been treatment staples for decades, they are not without unwanted side effects, expenses and resistances, in which the cancer cells find ways to circumvent the treatments. Therefore, instead of using exhaustive and expensive chemotherapies, what if doctors could use the patients’ own immune systems to fight cancer?

boxing glove punching a cancer virusDubbed Science magazine’s Breakthrough of the Year1 in 2013, cancer immunotherapy offers new hope for combating difficult-to-treat cancers by invoking the power of the patients’ own T cells and B cells: the body’s natural immune defense mechanisms.

As early as the 1990s, biologists in Japan found that T cells have a brakelike mechanism that prevents their aberrant activation. This molecule, known as programmed cell death protein 1, or PD-1, is a protein expressed on the surface of both T cells and naive B cells. Along with that, other reports published around the same time showed that drugs inhibiting PD-1 released this brake on T cell function and subsequently overcharged the immune system.

However, the potential power of these immune checkpoint mechanisms wasn’t recognized until Drew Pardoll, M.D., Ph.D., of The Johns Hopkins University began using PD-1 inhibitors in the clinical setting. Specifically, in a clinical trial he pushed for, cancer patients with refractory disease treated with PD-1 inhibitors saw their tumors shrink.

A year after immunotherapy gained its Breakthrough of the Year moniker, Suzanne Topalian, M.D., director of the Melanoma Program and professor of surgery and oncology at Johns Hopkins, helped pioneer and solidify the field of immunotherapy in cancer treatment. Recently listed as one of Nature’s Top 10 people of 2014, Dr. Topalian is paving the way to make these treatments a reality through clinical trials she initiated at Johns Hopkins using the PD-1 inhibitor nivolumab in partnership with Bristol-Myers Squibb. Having completed a promising trial of nearly 300 patients that was published in the New England Journal of Medicine, Topalian found that nivolumab was effective in combating treatment-refractory lung cancer, melanoma and kidney cancers.

Most recently, a follow-up phase 3 clinical trial demonstrated that the PD-1 inhibitor is superior to chemotherapy, with significant improvements in overall survival and progression-free survival in melanoma patients. This is particularly encouraging given that lung cancer and melanoma remain some of the most deadly cancers to treat today.

Doctors and researchers have barely scratched the surface of immunotherapy’s potential, and more trials and research are currently being conducted on advanced cancers that were previously thought to be untreatable. Nevertheless, researchers such as Pardoll and Topalian are proceeding cautiously yet optimistically as the landscape of treatment options broadens for cancer patients with advanced disease.

1. Science 20 December 2013: Vol. 342 no. 6165 pp. 1432-1433 DOI: 10.1126/science.342.6165.1432

About the Author

Paul Sirajuddin

Paul Sirajuddin is a postdoctoral fellow in radiation oncology, a writer and a photographer. When he isn’t zapping cells or shooting photos, he’s writing about science.