Latest / Becker’s Healthcare Podcast / Dhruv Bansal, MD, MBA, Director of Immunotherapy, Precision and Thoracic Oncology at Endeavor Health

Transcript

Dhruv Bansal, MD, MBA, Director of Immunotherapy, Precision and Thoracic Oncology at Endeavor Health · Becker’s Healthcare Podcast

• 0:02
  This is where health care leadership comes together.
• 0:04
  Becker's sixteenth annual meeting brings more than 3,500
• 0:07
  hospital and health system executives and nearly 800
• 0:11
  speakers to Chicago April.
• 0:14
  This year's event includes keynote conversations with Dallas
• 0:17
  Cowboys legend Troy Aikman and former president George
• 0:20
  w Bush. For the agenda and event details,
• 0:23
  visit beckershospitalreview.com
• 0:25
  and click on the events tab in the
• 0:27
  upper right. We're looking forward to hosting you
• 0:29
  in Chicago.
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  This is Laura Dirdo with the Becker's Healthcare
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  podcast. I'm thrilled today to be joined by
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  doctor Dhruv Bansal, who's the director of immunotherapy
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  precision and thoracic oncology at Endeavor Health. Doctor
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  Bansal, it's a pleasure to have you on
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  the podcast today.
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  Thank you, Laura. Thanks for having me.
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  Absolutely. Now I know we've got a lot
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  of ground to cover today. I'm really excited
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  for our conversation, especially looking into,
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  some of the cool things that are happening
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  in immunotherapy,
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  oncology, and more. But before we dive in,
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  can you tell us a little bit more
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  about your background or research? What are some
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  of the, questions that are at the heart
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  of your research right now, and what are
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  you most excited about investigating?
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  Yeah. So,
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  my role at Endeavor Health is,
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  I'm the director of immunotherapy as you just
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  said,
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  and I lead the precision and thoracic oncology
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  programs too.
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  So, it's a pretty broad role, but it,
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  my research currently is focused on
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  immunotherapeutics
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  and precision oncology,
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  which,
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  pretty much encompasses
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  all the
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  new,
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  new cancer treatments that we have recently.
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  And we are attempting to find biomarkers which
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  reveal
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  which patients do better with immunotherapy
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  versus not because that's one of the key
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  questions that everybody wants to answer right now.
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  Why is it that some patients with stage
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  four lung cancer, for an example,
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  live ten four ten plus years?
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  And and to give some background,
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  about,
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  even, like, ten years ago, patients with stage
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  four lung cancer were
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  the survival was less less than a year.
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  So now I commonly have a patient in
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  my clinic
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  who is five, ten years out from lung
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  cancer diagnosis.
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  Stage four lung cancer diagnosis is in remission.
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  So we are trying to find why are
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  some patients doing so much better than others
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  and what are the reasons behind it. So,
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  so that's like a big picture overview of
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  what my research focuses on.
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  Wow. That's fascinating to hear. You know, a
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  really important, thing to be thinking about and
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  figuring out, because I can imagine, you know,
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  it would really be impactful for patients and
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  so many families, if you're you have a
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  a long survival right there. Can you share
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  a moment when precision medicine has fundamentally changed
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  the course of care for patients or reshaped
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  how you your team thinks about cancer?
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  Yeah. So
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  so precision medicine has be become like a
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  foundational tool for oncology.
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  It all started in 2003
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  when the first,
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  precision met targeted treatment was approved, which is
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  jeffitinib for third line treatment of EGFR mutated
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  non small cell lung cancer.
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  And since then, there have been a number
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  of approvals since then. So on on an
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  average
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  day, like, we are using targeted treatments,
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  on most of the patients that I'm seeing
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  in the lung cancer clinic.
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  So
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  fundamentally, it's completely changed how we treat treat
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  these patients. In the past, we had only
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  chemotherapy. I think of chemotherapy
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  more like a sledgehammer. You kind of hit
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  the cancer hard, but it also affects in
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  normal organs.
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  Now we have these precise treatments that
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  target the cancer.
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  Mostly, the cancer have
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  much fewer side effects compared to chemotherapy for
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  the rest of the body, and they are
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  much more effective. So
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  you're getting the benefit of a more effective
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  treatment
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  with less side effects. So, I mean, that's
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  a win win. It's, like, way better than
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  chemotherapy.
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  Absolutely. That's amazing to hear. And, you know,
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  it's really cool that,
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  your research in the evolving space of of
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  therapy and cancer care has,
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  gotten us to a place where there are
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  opportunities
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  and other alternatives.
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  I'm curious, you know, when you talk about
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  your research and you look at,
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  how it translates into your day to day
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  practice,
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  how do you bridge that gap between some
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  of the genomic discoveries and then the real
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  world treatment decisions for patients?
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  The
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  that's a good question. So
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  the short answer is a lot of reading.
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  Like, I just have to constantly keep on
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  top of it. I have to read,
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  go to the important conferences.
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  There are plenty of good conferences and,
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  stay up to date on all the literature.
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  I have to make sure I read all
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  the important journals, interact with my peers who
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  are at the cutting edge of this, and
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  also conduct my own research, which also helps
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  me keep, stay up to date,
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  which is a challenge in, today's environment. At
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  the so the good thing is the pace
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  of discoveries is so fast that,
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  patients have new treatment options, like, nearly every
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  month now.
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  So
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  it just is involves, like, a lot of
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  work to go
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  to
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  go to the right meetings,
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  read the right material to stay on top
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  of all this.
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  Absolutely. That I can imagine it's, you know,
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  constantly
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  trying to catch up with everything in really
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  truly,
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  important
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  aspect of the things you're doing every single
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  day. Now I know data is a huge
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  part of precision medicine. Can you tell me
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  a little bit about what's the most exciting
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  part about what data capabilities you have today
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  and what promise do you see and how
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  it can be used to treat patients in
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  the future?
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  Yes.
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  So the data
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  so the health care systems are getting a
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  lot of data, and it's very,
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  important to know what to do with the
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  data. And we have a very, robust molecular
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  tumor board, once,
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  where we meet once a week,
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  and we go over all the important patient
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  data
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  and make sure that these patients are getting
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  the appropriate treatment recommendations. It's,
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  the molecular tumor board includes me and other
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  medical oncologists,
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  a molecular pathologist,
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  pharmacists,
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  and we work as a team to make
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  sure these treat patients
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  are based on the available data from the
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  genomic testing is are getting the right treatments.
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  Got it. That makes so much sense,
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  and really, really exciting to hear about. Now
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  can you talk about some of the collaboration
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  you've done between clinicians, data scientists, and researchers,
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  and how that's opened doors to new treatments
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  that didn't exist even a few years ago.
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  Yeah. So,
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  some of the projects I've done, we have
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  collaborated with, some other companies where
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  we use our clinical data and the genomic
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  data that's available.
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  And,
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  we
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  test out so
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  we have, we have the information on which
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  patients are doing better versus not.
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  And we try and, so
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  for for one of the projects, we ran,
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  some AI algorithms
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  to see,
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  what are the markers in the transcriptome
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  of those patients
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  to see why they are doing better. And
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  we were able to tell,
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  pretty much divide up the patients in four
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  different buckets
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  of roughly twenty five percent each where
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  the twenty five percent of the patients did
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  great on immunotherapies.
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  The then there was a bottom twenty five
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  percent that did not, and we were able
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  to tell from their genetic makeup of their
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  cancers
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  why that is.
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  So,
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  just to step back a bit, transcriptome analysis
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  is RNA sequencing,
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  and that's like,
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  about, a decade ago, we are focusing on
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  DNA sequencing, and now we are moving more
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  and more towards RNA sequencing and transcriptomic analysis.
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  And, my research the recent research that we
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  have published has focused more on that, and
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  this seems to be,
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  more accurate in predicting,
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  which patients tend to do better on immunotherapies.
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  That's fascinating to hear about and definitely,
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  helpful and cool to see behind the scenes
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  a little bit on some of the work
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  that you're doing and how it's evolved over
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  the last couple of years.
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  I'm curious, what are some of the breakthroughs
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  that you think will redefine cancer in the
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  next two to three years or even five
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  years out if you can look that far
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  out and and why?
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  Yeah. So, I mean, it's a very exciting
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  feeling,
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  honestly, now I
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  I can honestly look a a person in
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  the eye
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  and say, I do think in the next
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  ten years, a lot of the cancers would
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  be cured or curable.
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  So
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  the pace at which discovery is happening, this
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  seems,
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  like a reality now.
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  The treatments, I mean, there is stuff to
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  name, like, a few. There's so many exciting
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  discoveries. So,
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  cellular therapies are big, which is the next
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  step for immunotherapies
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  where,
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  we tie together body's infection fighting cells.
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  They are called T lymphocytes.
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  To
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  either we attach them to a a target
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  on the cancer cell. For example, in small
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  cell lung cancer,
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  there's a target called DLL three. And we
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  so we so this sounds like science fiction,
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  but it's happening everyday in clinic.
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  We give them a molecule where,
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  it targets the DLL three on the cancer
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  cell of which is on most small cell
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  lung cancers, and the other end binds to
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  the T lymphocytes in the patient.
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  And small cell lung cancer, which historically has
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  had a very poor prognosis,
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  Now a lot of patients are long term
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  survivors on this drug, and this treatment got
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  approved two years ago. So these treatments,
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  which would include antibody drug conjugates
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  by specific t cell engagers,
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  CAR t CAR t cells, they're they're broadly
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  called cellular therapies,
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  and I do believe they would be the
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  next frontier in the next two, three years.
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  A lot of treatments a lot of patients
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  would do great on these treatments.
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  So that's one. And then vaccines are the
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  other big thing. The,
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  since the COVID era, the vaccines are improve
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  have improved so much. The mRNA vaccines are
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  improving a lot, and we are seeing some
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  possible therapeutic implications in cancer where a patient
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  would come. They're all in clinical trials right
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  now. They're not approved yet, but we can
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  see in in the near future how,
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  vaccines would play a big role in cancer
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  treatment.
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  Maybe prevention, but I think that's a little
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  further out. Definitely in treat, treatment, it's, vaccines
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  are coming in a big way.
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  That's amazing to hear. And really, interesting stuff
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  and some cool things that are happening whether
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  through some of the technology, some of the
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  collaboration, artificial intelligence, and data management, and more.
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  Seems like a lot to be excited about
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  for the future of oncology immunology.
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  Thank you so much, doctor Bansal, for joining
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  us on the podcast today. This has been
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  a really fun and informative conversation, and I
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  look forward to connecting with you again soon.
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  Alright. Thank you.