Heinz-Josef Lenz, MD: New Treatment Options in Colon Cancer at ASCO 2011
Heinz-Josef Lenz, M.D., FACP, is the Associate Director for Clinical Research and Co-Leader of the Gastrointestinal Cancers Program at the USC Norris Comprehensive Cancer Center. He sat with The Group Room at ASCO 2011 to discuss new treatment options in colon cancer.
The Group Room at the 2011 American Association For Cancer Research Annual Meeting was made possible, in part, by:
VIDEO TRANSCRIPT
Selma R. Schimmel, Founder & CEO, Vital Options International:
This is Selma Schimmel at ASCO 2011 in Chicago where our discussion continues with some of the most noted oncologists and key opinion leaders reporting on different areas of cancer – all cancer types here at the ASCO meeting. And now we’re with one of our Group Room regulars and favorites, in fact he is our GI cancer key opinion leader, Doctor-Professor Heinz-Josef Lenz, Associate Director for Clinical Research and co-leader of the Gastrointestinal Cancers Program at the USC Norris Comprehensive Care Center, Professor of Medicine and Preventive Medicine at the Keck School of Medicine at the University of Southern California in Los Angeles. Hello Heinz-Josef Lenz.
Heinz-Josef Lenz, MD, Scientific Director, USC/Norris Cancer Genetics Unit:
Hello. I’m always happy to see you, and this is a very exciting time for development of new drugs and the theme of ASCO this year is personalized medicine, and we have a lot of reasons to believe that it will become reality in the not-so-far future.
Selma R. Schimmel:
One of the reasons I love talking with you and being able to bring you directly to our viewing audience is that not only are you a medical oncologist, but you have your own lab, and now must be the most exciting time to have your own laboratory.
Heinz-Josef Lenz:
Yes, I think it’s an incredible time to be a witness the changes – what’s going on with the opportunities of treatment options for our patients. From five, six years ago with one or two drugs, we have five drugs and we are on the verge to really crack down the code of different cancers, how we can attack. And we see again at this meeting, we are getting closer and closer. There may not be one miracle drug, changing everything and curing colon cancer or lung cancer, and breast cancer with same treatment. But we understand more and more the key players in these cancers and have developed now drugs to interfere with these players and see dramatic, clinical changes.
Selma R. Schimmel:
Dr. Lenz, one of the things we keep hearing about are the identification of these new pathways. With all kinds of acronyms and letters that identify these pathways, the problem is it’s very complex for the general consumer and patient to understand. What I would love to have you do is try to in simple English, explain this mechanism and how these pathways actually lead to the development of targeted therapies that attack these different pathways and proteins and enzymes and things like that.
Heinz-Josef Lenz:
You know, it’s not complicated only for patients. It’s the same complexity for the practicing oncologist at community. The news are travelling so fast, it’s not easy to really understand all the interactions of the genetic changes. But in order to simplify it it’s very easy, actually. You visualize a highway-free map of Los Angeles, or New York, or Chicago. You have a map, all these freeways are connected. We all know, living in Los Angeles, where the key intersections are in the city, where there is always a traffic jam. We know that other freeways are less frequently used and you have less intersection problems. But this connection of different freeways is the network information of a cancer cell. And you know if you develop one drug which may be interferes with one intersection, or one major exit. We know how to detour it. We know if we get off Ave 53 and go on at Ave 72, and the cancer cell can do that too. So it is very important not to know only what the most important intersection is, we need to know all the intersections – how they communicate with each other, and the level of traffic. If there is no traffic on this freeway inhibiting this freeway, it doesn’t make any sense. In order to be successful, when you live in LA, you have to shut down the 10 freeway, or the 490 in Chicago. And if you’re able to do that, then you see the progress and the success in the tumor.
Selma R. Schimmel:
My cancer manifests differently, even though it may be the same diagnosis in the general sense as the person next to me, but our pathways, we may have the same pathways but they manifest differently? Or they jam up differently like one’s on the 405 and one’s on the 134?
Heinz-Josef Lenz:
Yes, so I think you’re hitting a very important point. To identify one of this genetic alterations is not giving us the answers. They may meet differently in breast cancers versus colon cancer, and why would that be? Because the interaction of this molecular change, or this intersection of freeway, means completely something different when you change the environment. Now we have learned over years that every tumor has about six to eight major intersections, not more. But this intersections are not the same from one colon cancer to the other. Here is the challenge in the future of drug development. We need to identify these, what we call ‘driving mutations’. The ones who make the tumor grow and metastasize, and we are getting close to do that. If we know the variations of these six to eight driving mutations we will be able to really personalize treatment. So what does it take? It takes the drug developed and it takes the selection of the patients. A target drug without selection of the patient will not work. We need to understand the molecular make-up, we need to know what major intersections drive the tumor, we test for this, we need to know where the traffic and intersections are. And then pick the medications which interfere with this special network of mutations.
Selma R. Schimmel:
So while we understand this network, or this highway, different pathways equivalent to the highways, one’s personal genomic profiling will then influence the direction that they need to take to get home.
Heinz-Josef Lenz:
Yes, you know I think there is a lot of progress because we were so optimistic with the targeted drug with one specific target, or two, each have receptors. But these are one major exit. To be successful you have to shut down the freeway, and not one exit alone. And we have learned to see that how to do that because all these freeways communicate. But the variations from one cancer to this other cancer in another patient, even if it’s still colon cancer, can be traumatic. So we need to know what drives an individual tumor to do the individual treatment. We are getting closer and closer. We can now do under $1000, whole genome sequencing. The challenges are not that we cannot find it. We still don’t know all the individual traffics and how they are connected and what that means to specific treatments. But we are getting close so fast that the data we are generating is almost too much to consume and understand in the same time frame.
Selma R. Schimmel:
Are you still doing your blog?
Heinz-Josef Lenz:
I’m still on C3 Coalition. I’m trying to update that when there’s a new gene, a new treatment, new concepts in order to really communicate that with patients because I think going on websites is very confusing. And I think to give some guidance is very, very critical.
Selma R. Schimmel:
Thank you Dr. Lenz, really for being a forerunner in this area of research and for sharing your time with us. Associate Director for Clinical Research, Co-leader of the Gastrointestinal Cancer’s Program, USC’s Norris Comprehensive Cancer Center, and Professor of Medicine and Preventive Medicine at the Keck School of Medicine at the University of Southern California.
Heinz-Josef Lenz:
And Selma I couldn’t thank you much because I think it’s so critical for your viewers to see what’s going on and maybe feel a little bit of the excitement that there is so much to come which all changes the lives of our patients.
Selma R. Schimmel:
Thank you.
END OF VIDEO