Profiles in Innovation: Dr. Ross Cagan
If you were to pass Dr. Ross Cagan on the street, you would peg him as a sophisticated lead guitarist in an underground band before you pegged him as one of the world’s foremost cancer researchers. Maybe that has something to do with his past life as a rockstar in Chicago’s vibrant music scene. As a musician, Dr. Cagan learned how to break down paradigms and take creative risks; crucial skills that would serve him later in life as a biology PhD and research scientist.
He is the founder of the Center for Personalized Cancer therapeutics, an institute that uses Fruit Flies (Drosophila Melanogaster) to create a unique model of the patient’s cancer in a fruit fly avatar. As an innovator in the field of cancer research, he was invited by President Aoun to speak about his research as part of the Profiles in Innovation: Presidential Speaker Series.
According to Dr. Cagan, cancer treatment has undergone four major revolutions. Prior to the 17th century, cancer was thought to be an untreatable disease. This changed in 1689, when surgery was used to remove a malignant tumor from the neck of a Dutch woman. Surgery was a turning point in the history of cancer because there was a treatment for a disease that was previously untreatable.
The next revolution came in the form of chemotherapy; using cytotoxic medicines to eradicate cancer (and the surrounding cells) before the disease could spread. At first, chemotherapy affected a large area until the invention of targeted care — the third revolution. Now, cancer treatment targets a more specific area but still relies on blanket medications and broad-area radiation therapies.
What Dr. Cagan works tirelessly to bring to reality is the fourth revolution: personalized cancer treatment. Since each type of cancer is unique to every individual. Dr. Cagan envisions a world where a patient can have their genome sequenced and be treated with therapies that target the cancer on the cellular level. As it stands, cancer treatment has stalled just before the fourth revolution. Even though the cause can be pinpointed at a genetic level, it is still treated using the same ineffective targeted therapies from the third revolution.
The Center for Personalized Cancer therapeutics are actively striving for the Fourth Revolution by mimicking human cancer in fruit flies and using fruit fly avatars to develop optimal drug cocktails and treatments to use in human patients. Fruit flies are an excellent organism to study cancer with because they are the simplest lab animal that tumors can be produced and they have a short lifespan/generation time.
An example of this is Dr. Cagan’s research on medullary thyroid carcinoma (thyroid cancer). Dr. Cagan disrupted the Ret Oncogene, which is disrupted in thyroid cancer, in the eye of the fly to create thyroid cancer in the fly. Using hundreds of fruit flies, Dr. Cagan was able to test the effectiveness of hundreds of drug therapies. Eventually, he arrived at ZP6474, a drug originally developed for breast cancer that never made it through clinical trials. With a little refinement in dosing, ZP6474 became the standard of care for thyroid cancer.
Currently, the Center for Personalized Cancer Therapeutics has its sights set on developing and improving therapies for colorectal cancer and triple negative breast cancer. To treat individual cases, a small tissue sample is taken from the tumor and cancer-associated proteins are grafted into a fruit fly. Often, more than one mutation is causing the cancer. Treating just one mutated protein is usually not treating the full complexity of the disease.
Once the full human cancer is modeled on the fly, drug therapies are tailored to the specific cancer. The fly can even model other diseases present in the patient, and experiment with the way treatment for that disease affects the cancer treatment. For example, diabetic patients can have their fly put on a high sugar diet to see the effects of the diabetes on the cancer.
Dr. Cagan’s fruit flies are not the only thing that makes him an innovator. The ethos of the Center for Personalized Cancer Therapeutics involves treating patients with respect and allowing them to take an active role in shaping their own treatment by walking through experimental data with Dr. Cagan and his colleagues. He firmly believes that involving patients allows them to manage their treatment expectations and build trust with their care provider.
In the future, Dr. Cagan hopes that his approach to personalized cancer treatment will be expand ed and industrialized, provided that genome sequencing continues to get faster and cheaper. Since the Center for Personalized Cancer Therapeutics opened September 1st, the future is still unclear, but looks bright for Dr. Ross Cagan and his fruit flies.