Ronald D. Alvarez, MD
Whether it involves the minutiae of preclinical studies or the broad perspective of group leadership, if the work concerns gynecologic oncology, Ronald D. Alvarez, MD, has likely tried it.
As a translational researcher and senior scientist at the University of Alabama at Birmingham (UAB) Comprehensive Cancer Center, Alvarez spends half of each week treating patients with gynecologic cancers in the clinic and operating room, and much of the rest of his time conducting preclinical and clinical research aimed at developing gene therapies and vaccines for diseases, including ovarian and cervical cancers.
As a professor at UAB, the Ellen Gregg Shook Culverhouse Chair of Gynecologic Oncology, and director of the Division of Gynecologic Oncology, Alvarez also juggles administrative duties with the time he spends teaching residents and fellows.
Outside the school, he’s helped shepherd his field through changes in the healthcare and cooperativegroup systems by holding high-profile leadership posts, including last year’s stint as president of the Society of Gynecologic Oncology (SGO).
His latest achievement is earning a master’s degree in business administration from Auburn University, with the idea that he might eventually turn even more toward the administrative side of medicine.
The variety isn’t something Alvarez planned, but it has defined the 56-year-old’s journey thus far.
“When I started my residency, I really intended to be delivering babies, but then I was exposed to the specialty of gynecologic oncology and was immediately enamored by it,” Alvarez recalled. “I consider myself sort of an accidental academician, because I really thought I’d go into private practice. That ended up not being the chosen path for me and, as a result, I have ended up doing a lot of different things. I still consider myself a grand experiment, a work in progress.”
Developing New Treatments
To conduct his research, Alvarez collaborates with basic bench scientists, seeking to move the gene therapies they create for the treatment of gynecologic cancers out of the laboratory and into the clinic.
Such therapies, Alvarez said, are designed to provide a number of different ways by which cell death can be caused selectively in tumor cells. A subject of oncologic research mainly since the 1990s, gene therapy has been tested only on a small scale, so far, in humans. While his collaborators have continued to work at the bench to tweak viral-based gene therapies so they are better able to target and kill gynecologic cancers, Alvarez has been at the forefront of conducting clinical trials of such treatments in patients.
In 2010, he conducted the first study ever to evaluate an infectivityenhanced conditionally replicative adenovirus (CRAd) in patients with malignant gynecologic diseases.1
The phase I study of the tropismmodified CRAd known as Ad5-Δ24- RGD showed “the feasibility, safety, potential antitumor response, and biological activity of this approach in ovarian cancer,” Alvarez and coauthors wrote. “Further evaluation of infectivity enhanced virotherapy approaches for malignant gynecologic diseases is warranted.” Since then, Alvarez has completed two phase I trials of other adenoviruses in this population with promispromising results, one of them this year.2
Another area of keen interest for Alvarez has been the development of vaccines against the human papillomavirus (HPV), a condition the doctor said is a prerequisite to the development of cervical cancer, and is implicated in most cases of other genital-tract malignancies including vulvar and vaginal cancers.
Although preventive HPV vaccines Gardasil and Cervarix are already on the market, Alvarez hopes to address gaps in what those vaccines can accomplish. He’s working toward that goal as co-principal investigator of a $2.6 million cervical neoplasm vaccine project that is part of a Cervical Specialized Program of Research Excellence (SPORE). SPORE is funded by the National Cancer Institute and includes collaborators at UAB, Johns Hopkins University, and the University of Colorado at Boulder.
“We’re looking at lower-cost vaccines that don’t need to be refrigerated, that cover a number of different HPV types, not just 16 and 18, and, instead of being strictly preventive, will be more therapeutic for patients who have cervical dysplasia and cancer,” he said.
Alvarez, who has also written a number of papers that shed light on how best to apply and combine current treatment strategies for gynecological cancers, has participated in trials looking at new applications for medications approved in other tumor types—including imatinib, cetuximab, lapatinib, and ixabepilone—in the treatment of gynecologic cancers.