Cedars-Sinai Magazine
Biomedical Bonanza: Accelerated Understanding of Cancer Means More Treatments and Answers for Patients
Medical science is a meticulous, detailed and exacting process. Months, years and even lifetimes might be spent in the pursuit of a single question. Sometimes, Navid Hafez, MD, MPH, is struck by the breathtaking progress of just the past 15 years.
“The chemistry advanced, and then the computational methods and even the computer processor speeds jumped. Suddenly, we could model proteins and build small molecules that could lock on to cancer cells and stop them from growing,” said Hafez, who recently joined The Angeles Clinic and Research Institute, an affiliate of Cedars-Sinai Cancer, as director of Precision Medicine and Thoracic Oncology.
“We started seeing a big rush of new targeted therapies coming through. Then we had this breakthrough—a sea change in oncology—with the development of immunotherapy and medications that could harness the immune system to help fight cancer.”
This team has been on the forefront of drug development and immunotherapy development from the beginning. I am excited to be part of the advancement of that."
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Dr. Navid Hafez
Hafez joined The Angeles Clinic and Research Institute from Yale School of Medicine, where he served as a principal investigator in several national studies in the National Cancer Institute’s Experimental Therapeutics Cancer Trials Network.
“Part of the reason I joined The Angeles Clinic and Research Institute is that this team has been on the forefront of drug development and immunotherapy development from the beginning, and I was already doing collaborations with them a decade ago,” he said. “We are excited to continue this legacy as a leader in the development of immunotherapies and precision medicine therapies. I am excited to be part of the advancement of that.”
Hafez shared some of his thoughts on the promising developments in this important area of cancer research and care.
What developments are you most excited about in the field of thoracic oncology?
Navid Hafez: We’ve made great strides on many fronts in lung cancer. We’ve made improvements in preventing lung cancer through tobacco- and smoking-cessation programs and awareness. We now have screening available for people who are at high risk for lung cancer and have significant smoking histories, so we’re better at catching lung cancers at an early stage. Early detection enables us to cure patients with cancer.
We also have seen a seen a burst of drug development for how we treat lung cancers and, in particular, how we apply precision medicine treatments. These treatments can target lung cancers with specific gene variants.
In this past year, we have developed new drugs for cancers with a KRAS gene variant, which is the most common lung cancer gene variant. This has been a holy grail in the cancer world. After 40 years, we have two drugs that can target this variant, and they’re pills people can take at home.
We’re seeing major developments in prevention, screening and treatment. It’s an incredible time to be a lung cancer doctor.
What’s the DNA damage response, and how can that help you fight cancer?
NH: Our cells have a robust system to repair their own DNA damage so they can survive. They also detect damage and shut down if they cannot repair it. This whole process is important to our overall cellular health and critical to our understanding of how we fight cancer.
When I talk to my medical students about cancer that is resistant to treatment, I use the metaphor of a life vest. Cells are designed to kill themselves if they suffer too much damage. But first, cells try to repair DNA damage with proteins that act like a life vest that helps them stay afloat.
One of the ways that cancer cells become resistant to chemotherapies and other treatments is that they rely on and up-regulate, or boost, these proteins that repair DNA damage. These life vests help cancer cells survive the attack we’re unleashing on them with cancer treatment.
What we’ve been doing in some of my trials and investigations is to try to get rid of these support proteins—or remove that life vest—so that the cancer cell will drown in its own DNA damage. There’s a famous class of drugs called PARP inhibitors that target DNA repair in tumors. Since those were developed, we’re testing a whole slew of other drugs in this space to exploit the weaknesses in these cells.
Why are clinical trials that will determine the treatments of tomorrow important to people who have cancer today?
NH: The advancement in science is happening so fast. There’s currently an explosion in our understanding of cancer and how to target cancer, and therefore a surge in drug and treatment development. We’re rapidly learning how to precisely treat different malignancies.
Really the only way to have access to these new options with truly cutting-edge potential is to seek care at an institution that offers clinical trials. At The Angeles Clinic and Research Institute, you have the opportunity to participate in clinical trials—or at least seek out the opinion and expertise of people involved in these trials.
Sometimes, people are understandably anxious or skeptical of clinical trials because of the unknown. At the same time, I see patients who are extraordinarily optimistic and hopeful about clinical trials for the exact same reason—the unknown. You must be comfortable with both things at the same time: living with the unknown and living with hope, excitement and optimism. That’s the true picture of clinical trials and advancing the field forward.
