Ruth O'Regan, MD
Targeted therapies have shown significant promise in oncology, improving survival and becoming the standard of care across multiple cancer types. But striving for true precision medicine in oncology by focusing on smaller and smaller tumor subtypes comes with its own set of challenges, according to Ruth O’Regan, MD.
O’Regan, formally a professor of Hematology and Medical Oncology at Emory University, was recently appointed the division head of Hematology, Medical Oncology, and Palliative Care in the Department of Medicine at the University of Wisconsin School of Medicine and Public Health.
In an interview with Oncology & Biotech News, O’Regan discussed the many advantages and challenges of molecular subtyping as they related to her new position at the University of Wisconsin.OBTN: What do you hope to achieve in your new role?Dr O’Regan:
The good news for me is that the faculty here is very strong and very productive, so that is positive. I think there are some areas in which we can improve, particularly in expanding our research. My biggest goal is to improve our clinical trials and expand the number that we do. I want to work with other institutions to further our clinical research.Are there particular areas in which you want to expand clinical research/trials?
My focus is on breast cancer, but I think overall we’d like to focus on therapeutic trials across all cancers and try and work with other institutions. We already have a trial network here called the Wisconsin Oncology Network (WON) and I think we’d like to work to increase the number of trials being done through that group because it really spans throughout the whole state. It is a unique resource that we’d like to take advantage of more.Your new role encompasses solid tumors as well as blood cancers. Do you see any overarching challenges across the board regarding the treatment of both?
I think for everyone globally one of the things we struggle with is that we’ve become so complex in our understanding of different cancers. Nothing is just one cancer type; there are multiple subtypes of each cancer. And the problem with that is when clinical trials become available they are so specific to different subtypes, only a small group of people qualifies and you only see a group of patients occasionally. I think we all struggle with the cost of opening a trial and then not being able to accrue many patients on the trials we would like. That is the cost of molecular subtyping.Is there a way to solve that?
The only way you can do it is by collaboration with other institutions, both nationally and internationally. We are very interested in working with other institutions across the country to accrue these more specific trials. It is a complex issue, but by working with others we can address these questions.
We do need to hone in on the specific subtypes of cancers so that we are only giving an individual patient what they need for the cancer that they have instead of giving them something that isn’t going to work. It is all about tailoring treatment. The challenge is figuring out which patients with which cancers really benefit the most from that approach. I think across the board—from targeted agents, chemotherapy agents, immunotherapies—we just have to really do a better job of working out who is going to benefit.
We need to do the right preclinical studies before we bring new drugs to patients so that we have some idea of who is going to benefit from those drugs.What research at the University of Wisconsin School of Medicine are you particularly excited about?
We have a very active phase I program, which has been around for a long time. Even in phase I programs, we are looking at very specific patients. There is a lot of strength in a number of areas here. We have a very active imaging program for preclinical work, and there is a lot happening in the liquid biopsy space. We are looking at circulating tumor cells and using them to be able to predict why a patient would respond to one treatment versus another. I am still learning everything that is going on here, but what I have seen so far has been really interesting and very impressive.Are you going to be continuing your own research at this new institution?
Yes, the plan is to continue my focus on breast can- cers that are resistant to current therapies and I will probably retain the focus that I had on triple-negative breast cancer at Emory. I am excited to work with some of the breast cancer researchers who are here to expand that. I am trying to bring some of the trials I was doing at Emory to the University of Wisconsin.So, do you have time in your life for anything other than your work?