Latest / Becker’s Healthcare - Clinical Leadership Podcast / Where cancer treatment is headed, with Karmanos Institute CEO Dr. Boris Pasche

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Where cancer treatment is headed, with Karmanos Institute CEO Dr. Boris Pasche · Becker’s Healthcare - Clinical Leadership Podcast

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  Thanks for listening. Now here's the episode.
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  - This is Chris Doso with the Becker's Healthcare Podcast.
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  I'm thrilled today to be joined by Dr.
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  Boris pch, president
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  and CEO of the Karmanos Cancer Institute in Detroit,
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  an internationally round cancer researcher.
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  He's also chair of the Department
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  of Oncology at Wayne State University School of Medicine.
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  Dr. Pass, thank you so much for joining us today.
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  - Thank you for the opportunity to speak with you.
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  - Certainly, uh, understandably you've had an extensive
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  career, but Dr.
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  Pass, would you mind telling us a little
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  bit more about your background?
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  - Happy to. Yes. I grew up in the French speaking part
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  of Switzerland and, uh, went to medical,
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  started medical school in, in Switzerland, uh,
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  and then, um, moved to Sweden, uh, at
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  to Stockholm more precisely at the Carolines Care Institute
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  where I received my MD and my PhD degrees.
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  Um, thereafter I moved to the US
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  and I was a postdoctoral fellow at, uh, the Brigham
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  and Women Hospital at Harvard Medical School
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  for three years prior to moving to New York,
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  where I trained in internal medicine at Cornell, uh,
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  and then in, uh, hematology
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  and oncology at Memorial Sloan Kettering Cancer Center.
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  That's where I continued my work
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  and research, um, at the Howard Hugs Medical Institutes
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  and the lab of Dr.
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  Joan Maga.
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  That's where I discovered the first mutation of the type one
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  TGF beta receptor, which really propelled my academic,
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  uh, research career.
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  I then moved to, um, uh, Northwestern
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  where I started my own lab,
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  and I was also the founder
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  of the Northwestern Cancer Genetics Program working on tumor
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  susceptibility genes.
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  Um, in 2008, I was offered the position of director
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  of the division of Hematology oncology at the University
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  of Alabama in Birmingham.
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  Um, and, uh, I was there until 2014, um,
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  and also served there as
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  Deputy director of the Cancer Center.
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  In 2014, I became the, uh, director
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  of the Wake Forest Baptist Comprehensive Cancer Center
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  and the chair of the Department of Cancer Biology, uh,
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  position I held until, uh, 2022.
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  And in 2023, I moved to, um, Karmanos to become the new, uh,
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  president and CEO as you indicated.
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  So my background is both, uh, as a physician scientist.
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  I'm trained as a, an oncologist in hematology
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  and medical oncology,
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  and I see mostly patient with gastrointestinal malignancies.
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  I'm also, uh, the inventor
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  and developer of a novel technology for the treatment of,
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  uh, cancer, which recently received FDA approval
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  for its first indication.
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  Uh, so I think that sums up my, uh, background.
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  - Thank you so much, doctor.
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  I'm glad you mentioned, uh, the device that you mentioned.
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  I do wanna get to that a little bit later,
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  but off the top here,
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  I understand you feel strongly about cancer screening
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  guidelines, uh, to what do you
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  or your passion regarding the subject
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  and how should the healthcare industry adjust course?
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  - So I think cancer screening is one
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  of the most successful achievement
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  of cancer research in the past few decades.
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  Um, I think, uh, in my area of expertise, colorectal cancer,
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  the, um, um, the IM implementation of any form of screening,
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  but preferably colonoscopy decreases the risk of dying from
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  that deadly disease by about 40%.
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  And that's, uh, uh, quite dramatic.
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  And, uh, it is also a disease that is very common.
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  It is the second most common tumor type in non-smoker
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  and the third in non-smokers.
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  Um, so I think I've seen the benefits, the value,
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  uh, of, uh, screening in multiple instances,
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  and especially when you're interested in inherited form
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  of cancer in patient who have a family history
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  of colorectal cancer screening plays an even a more
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  important role because you really save lives early on, uh,
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  just by screening
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  and removing early polyps
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  that could develop into deadly cancers.
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  - Certainly it's beneficial to everyone that this type
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  of advancement has been made over the course
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  of, uh, decades.
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  Uh, what I did want to ask you also in relation to that, um,
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  what are the keys to reducing racial
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  and ethnic disparities in cancer treatment,
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  and how can other hospitals and health systems follow suit?
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  - So I think this is a very important issue.
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  The, um, you, you see that, um, um, racial
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  and ethnic disparities in in the United States are quite
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  prominent, uh,
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  and in certain region, the, uh, the rate of screening is,
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  is very low, uh, which certainly, uh, decreases the,
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  the ability to impact cancer before it occurs or,
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  or develop, uh, some example in the Detroit area
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  with a very low rate of HPV vaccination
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  and a low rate of HPV vaccination,
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  especially in ethnic minorities, results in a higher rate
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  of, uh, cervical cancer, but also of head and neck cancer.
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  And these two tumors that are easily screened for or,
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  or treated, uh, it can be prevented with these, um,
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  with vaccination.
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  So when you have, you have a very low rate of vaccination
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  in, uh, younger individual
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  because this is when, uh, vaccination should occur.
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  Uh, it's will lead to a higher rate of tumors.
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  So one of our faculty, Dr.
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  Ariel Washington, is focusing on
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  that at Car Cancer Institute on how to impact
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  or change the, uh, acceptance of, uh, of,
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  um, HPV vaccination
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  and has developed strategies to, uh, enhance the rate
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  of vaccination and
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  therefore prevent cancer, um, in, uh, large proportion
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  of the Detroits and Detroit area population.
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  - Uh, on those, on that note, rather, Dr.
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  Pash, how does the Karmanos Institute work with its partners
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  to advance treatments for cancer?
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  And how would you advise others in your position who want
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  to achieve similar goals and results?
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  - So Karmanos has been very successful in expanding the
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  depths and breadth of its reach within the state of Michigan
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  and northern Ohio by establishing 16, uh,
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  different centers that provide patients
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  screening treatments according to guidelines
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  that are the same as at the, uh, Maine, uh,
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  Caros Cancer Institute in downtown Detroit.
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  So that has allowed patient to have access
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  to state-of-the-art treatment, uh,
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  state-of-the-art clinical trial novel technologies, uh,
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  to treat their cancer close to their home.
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  Just this morning I was in Roseville, uh, in Macomb County,
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  uh, to, for the inauguration of the renovated Roseville, uh,
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  Kaus Cancer Institute, which is very impressive,
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  and provide state-of-the-art, uh, cancer treatment
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  for the large, um, McComb County
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  and Roseville community, which doesn't have, uh, many, many,
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  uh, options to access, uh, high quality cancer care, uh,
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  without traveling quite far away.
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  And the, uh, mayor of Roseville was expressing his, uh, his,
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  uh, pleasure and,
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  and, uh, a satisfaction about the fact that
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  for many elderly patient
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  or patient with, uh, disability difficulty with transport,
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  that they now will be able to get, uh, cancer care close
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  to their home and especially high quality cancer care.
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  So I think that's a good example of how Carmano is impacting
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  a large fraction of the Michigan population, uh,
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  treating more than 14,000, uh, new patients
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  with cancer per year, more than one third of the entire, uh,
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  population of patient with cancer in the state of Michigan.
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  - Certainly efforts like that are,
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  are very heart heartwarming and worthwhile after.
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  I'm so glad that analysis has been able
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  to make those inroads
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  and certainly access to most kinds
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  of healthcare has been on the minds
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  of leaders such as yourself.
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  So thank you for outlining all of that.
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  Uh, did I also want to circle back
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  to the treatment that you mentioned?
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  I would say before, recently, I had no idea that a spoon
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  such as it is in this case, could be used
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  to help treat cancer that is just mind boggling
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  and wonderfully exciting.
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  So I wanted to ask you about the bionic
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  and how it came to be.
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  In addition to that, what excites you about
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  other emerging cancer treatments?
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  - So, with respect to Theo Bio,
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  it has been a very long term project
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  that started more than 20 years ago, uh, where, um,
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  with my scientific partner, Alexon Baa Frenchman, uh,
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  who lives in Kmar, France, we started working on, um,
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  using a hypothesis that tumors might be sensitive
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  to certain, um, frequencies, radio frequencies,
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  and to, uh, test these hypothesis.
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  We examined a large number of patients with cancer
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  and identified changes in pulse pressure in layman's
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  language would be change in the intensity of the pulse
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  that you could measure with your finger,
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  but better with a detector that measures changes in,
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  in, in pulse intensity.
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  And what we found is that, um, uh, looking at a large number
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  of patient with different type of tumors,
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  we found some consistent changes in pulse pressure at
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  certain frequencies in patient that had the same tumor type.
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  So let's say you had 20 patient with, uh, breast cancer,
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  uh, some had early stage, some had advanced stage,
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  we found similar frequencies, um,
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  eliciting these changes in pulse pressure.
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  So having, um, identified that within a few years,
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  we tested the hypothesis that sending these frequencies
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  to the patient could have, um, therapeutic effects.
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  So we launched a feasibility study back in 2003,
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  and, uh, within a few years had evidence
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  that we could have an impact on cancer.
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  All these patients had advanced cancer without curative
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  uh, opportunities.
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  And in the first, uh, study that was published in 2009, we
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  reported a complete response, which mean total disappearance
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  of disease in a patient with breast cancer was metastasis
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  to the left femur and the right adrenal glands.
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  So two location that were, uh, clearly seen on,
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  on imaging studies, more specifically pet ct.
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  And within just a few months
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  of only receiving this treatment, uh,
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  that patient had a total disappearance of the tumor,
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  which lasted 11 months.
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  We had another patient was, uh, stage four breast cancer
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  that also had metastasis to the bones
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  and to the liver that had a partial response,
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  which mean a tumor shrinkage, uh, not total disappearance,
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  but tumor shrinkage that lasted 13 months.
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  That led us to expand this work into, um, a tumor type
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  for which there was very few, uh, treatments, if any at
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  that time, um, advanced liver cancer,
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  also called hepatocellular carcinoma.
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  So together with a former colleague of Sloan Kettering
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  who had moved to, um, Sao Paulo Brazil,
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  we conducted a study on 40, uh, two patients with, um,
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  advanced hepatocellular carcinoma
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  and we're able to demonstrate that using the same approach,
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  using a portable device that emitted this low
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  and fairly safe level
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  of radiofrequency electromagnetic fields three times a day
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  for one hour, uh, by means
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  of a spoon placed in the patient's mouth, uh,
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  we had about 10% of patient that had significant shrinkage
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  of the tumor, and another 40% of patients, uh,
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  in the tumor stopped growing for at least six months.
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  So with this data in mind, we, um, developed a,
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  uh, more commercial version of the device, which
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  took into account all the comments we had received from the
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  physician they wanted, in particular, to be able
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  to control the number of treatments they wanted to be able
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  to monitor whether the treatment was delivered or not.
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  Uh, and they also wanted a device that would be, uh,
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  very easy to transport so that the patient could, uh,
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  take the treatment home.
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  So in 2013, we established a company in Germany with a goal
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  of developing a device
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  that would become commercially available.
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  And in 2018, we received European approval
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  for this indication, um, in 2019,
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  the FDA granted breakthrough designation to this device
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  for the treatment of liver cancer.
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  And fast forward on December 11th, 2023,
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  so less than a month ago, um, we received FDA approval
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  for the treatment of patient with advanced, uh,
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  liver cancer hepatocellular carcinoma who failed first line
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  and second line therapy.
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  So we're very excited to see these very long-term, uh,
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  projects, uh, based on the discovery
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  of frequencies in patient with cancer, um, bear fruit,
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  and now becoming available for patient with liver cancer
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  where carano will be the first in the world
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  to offer these treatments, um, with FDA approval.
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  - Congratulations again on that accomplishment, Dr. Pass.
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  That's just incredible.
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  Uh, were there other treatments that you wanted
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  to mention that you're excited about?
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  - Yes, I think, you know, the world of, uh,
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  oncology has seen some very exciting
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  development in the past decade.
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  I would say checkpoint inhibitor immunotherapy has, uh,
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  really offered a, uh, a, a novel option for treatment
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  for about 15% of patient of cancer.
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  But when patient have, um, a tumor that responds
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  to checkpoint inhibitor, it is a therapy
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  that is very well tolerated, that has some side effects,
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  but, uh, in the majority of cases well tolerated
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  and can provide long-term survival in, in,
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  in these patients that do response.
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  I think CAR T-cell is another, uh, very exciting development
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  that is expanding, that has started
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  for hematologic malignancies, so blood cancer,
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  but is now moving into, uh, the arena of solid tumor.
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  And Caros has been at the forefront of offering, uh, such,
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  uh, clinical trials to patient with, uh, advanced form
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  of solid tumor that have no other options.
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  So that has been also a very exciting development.
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  Theranostic is probably another, um, development
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  that has recently received FDA approval.
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  Uh, theranostics is the use of, uh, antibodies or
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  or tag, if you wish, that will find, uh,
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  tumor cells throughout the body, both primary tumor
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  and metastasis, and get stuck to these tumors
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  with a irradiating components or a local radiation.
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  So it's, it allows to deliver radiation
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  to the tumor only with minimal adverse events
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  to the rest of the body.
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  And in 2018, the first, um, indication
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  for neuroendocrine tumor received FDA approval.
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  And in 2022, uh, another indication
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  for metastatic prostate cancer received FDA approval.
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  So I think it's a field where we're gonna see, uh,
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  additional indication for other tumor types
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  or earlier stage of the disease.
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  And, uh, Carmano sees that the leading edge
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  of developing this novel technology
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  and, um, um, offering clinical trial to patient
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  with various form of tumors, uh,
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  that will benefit from this, uh,
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  therapeutic, um, innovation.
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  - Excellent. Thank you so much, doctor.
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  Lastly, I simply wanted to ask you, what's one goal
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  in particular that Karmanos has for 2024
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  that you're looking forward to achieving?
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  - I would say two goals, growth and expansion.
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  We are on, we're recruiting new investigators,
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  we're expanding our, uh, clinical basic
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  and translational research,
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  and we want to become the leader in healthcare disparities.
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  Uh, Dr. Haley Thompson has run a, uh,
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  fantastic community outreach
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  and engagement program, uh, in Detroit
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  and throughout the state of Michigan
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  with already sh showing already impact on, um,
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  healthcare disparities that are noted nationwide.
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  And I think this is one of the key priorities we want
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  to further expand.
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  - Dr. Pash, thank you so much for being so generous
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  with your time and insights today.
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  We can't wait to share them with our audience,
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  and we look forward to connecting with you soon.
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  - Thank you very much, grace.
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  It was a pleasure speaking with you.
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  Looking forward to speaking with you in the future. Bye-Bye.
• 18:07
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