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- This is Chris Doso with the Becker's Healthcare Podcast.
I'm thrilled today to be joined by Dr.
Boris pch, president
and CEO of the Karmanos Cancer Institute in Detroit,
an internationally round cancer researcher.
He's also chair of the Department
of Oncology at Wayne State University School of Medicine.
Dr. Pass, thank you so much for joining us today.
- Thank you for the opportunity to speak with you.
- Certainly, uh, understandably you've had an extensive
career, but Dr.
Pass, would you mind telling us a little
bit more about your background?
- Happy to. Yes. I grew up in the French speaking part
of Switzerland and, uh, went to medical,
started medical school in, in Switzerland, uh,
and then, um, moved to Sweden, uh, at
to Stockholm more precisely at the Carolines Care Institute
where I received my MD and my PhD degrees.
Um, thereafter I moved to the US
and I was a postdoctoral fellow at, uh, the Brigham
and Women Hospital at Harvard Medical School
for three years prior to moving to New York,
where I trained in internal medicine at Cornell, uh,
and then in, uh, hematology
and oncology at Memorial Sloan Kettering Cancer Center.
That's where I continued my work
and research, um, at the Howard Hugs Medical Institutes
and the lab of Dr.
Joan Maga.
That's where I discovered the first mutation of the type one
TGF beta receptor, which really propelled my academic,
uh, research career.
I then moved to, um, uh, Northwestern
where I started my own lab,
and I was also the founder
of the Northwestern Cancer Genetics Program working on tumor
susceptibility genes.
Um, in 2008, I was offered the position of director
of the division of Hematology oncology at the University
of Alabama in Birmingham.
Um, and, uh, I was there until 2014, um,
and also served there as
Deputy director of the Cancer Center.
In 2014, I became the, uh, director
of the Wake Forest Baptist Comprehensive Cancer Center
and the chair of the Department of Cancer Biology, uh,
position I held until, uh, 2022.
And in 2023, I moved to, um, Karmanos to become the new, uh,
president and CEO as you indicated.
So my background is both, uh, as a physician scientist.
I'm trained as a, an oncologist in hematology
and medical oncology,
and I see mostly patient with gastrointestinal malignancies.
I'm also, uh, the inventor
and developer of a novel technology for the treatment of,
uh, cancer, which recently received FDA approval
for its first indication.
Uh, so I think that sums up my, uh, background.
- Thank you so much, doctor.
I'm glad you mentioned, uh, the device that you mentioned.
I do wanna get to that a little bit later,
but off the top here,
I understand you feel strongly about cancer screening
guidelines, uh, to what do you
or your passion regarding the subject
and how should the healthcare industry adjust course?
- So I think cancer screening is one
of the most successful achievement
of cancer research in the past few decades.
Um, I think, uh, in my area of expertise, colorectal cancer,
the, um, um, the IM implementation of any form of screening,
but preferably colonoscopy decreases the risk of dying from
that deadly disease by about 40%.
And that's, uh, uh, quite dramatic.
And, uh, it is also a disease that is very common.
It is the second most common tumor type in non-smoker
and the third in non-smokers.
Um, so I think I've seen the benefits, the value,
uh, of, uh, screening in multiple instances,
and especially when you're interested in inherited form
of cancer in patient who have a family history
of colorectal cancer screening plays an even a more
important role because you really save lives early on, uh,
just by screening
and removing early polyps
that could develop into deadly cancers.
- Certainly it's beneficial to everyone that this type
of advancement has been made over the course
of, uh, decades.
Uh, what I did want to ask you also in relation to that, um,
what are the keys to reducing racial
and ethnic disparities in cancer treatment,
and how can other hospitals and health systems follow suit?
- So I think this is a very important issue.
The, um, you, you see that, um, um, racial
and ethnic disparities in in the United States are quite
prominent, uh,
and in certain region, the, uh, the rate of screening is,
is very low, uh, which certainly, uh, decreases the,
the ability to impact cancer before it occurs or,
or develop, uh, some example in the Detroit area
with a very low rate of HPV vaccination
and a low rate of HPV vaccination,
especially in ethnic minorities, results in a higher rate
of, uh, cervical cancer, but also of head and neck cancer.
And these two tumors that are easily screened for or,
or treated, uh, it can be prevented with these, um,
with vaccination.
So when you have, you have a very low rate of vaccination
in, uh, younger individual
because this is when, uh, vaccination should occur.
Uh, it's will lead to a higher rate of tumors.
So one of our faculty, Dr.
Ariel Washington, is focusing on
that at Car Cancer Institute on how to impact
or change the, uh, acceptance of, uh, of,
um, HPV vaccination
and has developed strategies to, uh, enhance the rate
of vaccination and
therefore prevent cancer, um, in, uh, large proportion
of the Detroits and Detroit area population.
- Uh, on those, on that note, rather, Dr.
Pash, how does the Karmanos Institute work with its partners
to advance treatments for cancer?
And how would you advise others in your position who want
to achieve similar goals and results?
- So Karmanos has been very successful in expanding the
depths and breadth of its reach within the state of Michigan
and northern Ohio by establishing 16, uh,
different centers that provide patients
screening treatments according to guidelines
that are the same as at the, uh, Maine, uh,
Caros Cancer Institute in downtown Detroit.
So that has allowed patient to have access
to state-of-the-art treatment, uh,
state-of-the-art clinical trial novel technologies, uh,
to treat their cancer close to their home.
Just this morning I was in Roseville, uh, in Macomb County,
uh, to, for the inauguration of the renovated Roseville, uh,
Kaus Cancer Institute, which is very impressive,
and provide state-of-the-art, uh, cancer treatment
for the large, um, McComb County
and Roseville community, which doesn't have, uh, many, many,
uh, options to access, uh, high quality cancer care, uh,
without traveling quite far away.
And the, uh, mayor of Roseville was expressing his, uh, his,
uh, pleasure and,
and, uh, a satisfaction about the fact that
for many elderly patient
or patient with, uh, disability difficulty with transport,
that they now will be able to get, uh, cancer care close
to their home and especially high quality cancer care.
So I think that's a good example of how Carmano is impacting
a large fraction of the Michigan population, uh,
treating more than 14,000, uh, new patients
with cancer per year, more than one third of the entire, uh,
population of patient with cancer in the state of Michigan.
- Certainly efforts like that are,
are very heart heartwarming and worthwhile after.
I'm so glad that analysis has been able
to make those inroads
and certainly access to most kinds
of healthcare has been on the minds
of leaders such as yourself.
So thank you for outlining all of that.
Uh, did I also want to circle back
to the treatment that you mentioned?
I would say before, recently, I had no idea that a spoon
such as it is in this case, could be used
to help treat cancer that is just mind boggling
and wonderfully exciting.
So I wanted to ask you about the bionic
and how it came to be.
In addition to that, what excites you about
other emerging cancer treatments?
- So, with respect to Theo Bio,
it has been a very long term project
that started more than 20 years ago, uh, where, um,
with my scientific partner, Alexon Baa Frenchman, uh,
who lives in Kmar, France, we started working on, um,
using a hypothesis that tumors might be sensitive
to certain, um, frequencies, radio frequencies,
and to, uh, test these hypothesis.
We examined a large number of patients with cancer
and identified changes in pulse pressure in layman's
language would be change in the intensity of the pulse
that you could measure with your finger,
but better with a detector that measures changes in,
in, in pulse intensity.
And what we found is that, um, uh, looking at a large number
of patient with different type of tumors,
we found some consistent changes in pulse pressure at
certain frequencies in patient that had the same tumor type.
So let's say you had 20 patient with, uh, breast cancer,
uh, some had early stage, some had advanced stage,
we found similar frequencies, um,
eliciting these changes in pulse pressure.
So having, um, identified that within a few years,
we tested the hypothesis that sending these frequencies
to the patient could have, um, therapeutic effects.
So we launched a feasibility study back in 2003,
and, uh, within a few years had evidence
that we could have an impact on cancer.
All these patients had advanced cancer without curative
uh, opportunities.
And in the first, uh, study that was published in 2009, we
reported a complete response, which mean total disappearance
of disease in a patient with breast cancer was metastasis
to the left femur and the right adrenal glands.
So two location that were, uh, clearly seen on,
on imaging studies, more specifically pet ct.
And within just a few months
of only receiving this treatment, uh,
that patient had a total disappearance of the tumor,
which lasted 11 months.
We had another patient was, uh, stage four breast cancer
that also had metastasis to the bones
and to the liver that had a partial response,
which mean a tumor shrinkage, uh, not total disappearance,
but tumor shrinkage that lasted 13 months.
That led us to expand this work into, um, a tumor type
for which there was very few, uh, treatments, if any at
that time, um, advanced liver cancer,
also called hepatocellular carcinoma.
So together with a former colleague of Sloan Kettering
who had moved to, um, Sao Paulo Brazil,
we conducted a study on 40, uh, two patients with, um,
advanced hepatocellular carcinoma
and we're able to demonstrate that using the same approach,
using a portable device that emitted this low
and fairly safe level
of radiofrequency electromagnetic fields three times a day
for one hour, uh, by means
of a spoon placed in the patient's mouth, uh,
we had about 10% of patient that had significant shrinkage
of the tumor, and another 40% of patients, uh,
in the tumor stopped growing for at least six months.
So with this data in mind, we, um, developed a,
uh, more commercial version of the device, which
took into account all the comments we had received from the
physician they wanted, in particular, to be able
to control the number of treatments they wanted to be able
to monitor whether the treatment was delivered or not.
Uh, and they also wanted a device that would be, uh,
very easy to transport so that the patient could, uh,
take the treatment home.
So in 2013, we established a company in Germany with a goal
of developing a device
that would become commercially available.
And in 2018, we received European approval
for this indication, um, in 2019,
the FDA granted breakthrough designation to this device
for the treatment of liver cancer.
And fast forward on December 11th, 2023,
so less than a month ago, um, we received FDA approval
for the treatment of patient with advanced, uh,
liver cancer hepatocellular carcinoma who failed first line
and second line therapy.
So we're very excited to see these very long-term, uh,
projects, uh, based on the discovery
of frequencies in patient with cancer, um, bear fruit,
and now becoming available for patient with liver cancer
where carano will be the first in the world
to offer these treatments, um, with FDA approval.
- Congratulations again on that accomplishment, Dr. Pass.
That's just incredible.
Uh, were there other treatments that you wanted
to mention that you're excited about?
- Yes, I think, you know, the world of, uh,
oncology has seen some very exciting
development in the past decade.
I would say checkpoint inhibitor immunotherapy has, uh,
really offered a, uh, a, a novel option for treatment
for about 15% of patient of cancer.
But when patient have, um, a tumor that responds
to checkpoint inhibitor, it is a therapy
that is very well tolerated, that has some side effects,
but, uh, in the majority of cases well tolerated
and can provide long-term survival in, in,
in these patients that do response.
I think CAR T-cell is another, uh, very exciting development
that is expanding, that has started
for hematologic malignancies, so blood cancer,
but is now moving into, uh, the arena of solid tumor.
And Caros has been at the forefront of offering, uh, such,
uh, clinical trials to patient with, uh, advanced form
of solid tumor that have no other options.
So that has been also a very exciting development.
Theranostic is probably another, um, development
that has recently received FDA approval.
Uh, theranostics is the use of, uh, antibodies or
or tag, if you wish, that will find, uh,
tumor cells throughout the body, both primary tumor
and metastasis, and get stuck to these tumors
with a irradiating components or a local radiation.
So it's, it allows to deliver radiation
to the tumor only with minimal adverse events
to the rest of the body.
And in 2018, the first, um, indication
for neuroendocrine tumor received FDA approval.
And in 2022, uh, another indication
for metastatic prostate cancer received FDA approval.
So I think it's a field where we're gonna see, uh,
additional indication for other tumor types
or earlier stage of the disease.
And, uh, Carmano sees that the leading edge
of developing this novel technology
and, um, um, offering clinical trial to patient
with various form of tumors, uh,
that will benefit from this, uh,
therapeutic, um, innovation.
- Excellent. Thank you so much, doctor.
Lastly, I simply wanted to ask you, what's one goal
in particular that Karmanos has for 2024
that you're looking forward to achieving?
- I would say two goals, growth and expansion.
We are on, we're recruiting new investigators,
we're expanding our, uh, clinical basic
and translational research,
and we want to become the leader in healthcare disparities.
Uh, Dr. Haley Thompson has run a, uh,
fantastic community outreach
and engagement program, uh, in Detroit
and throughout the state of Michigan
with already sh showing already impact on, um,
healthcare disparities that are noted nationwide.
And I think this is one of the key priorities we want
to further expand.
- Dr. Pash, thank you so much for being so generous
with your time and insights today.
We can't wait to share them with our audience,
and we look forward to connecting with you soon.
- Thank you very much, grace.
It was a pleasure speaking with you.
Looking forward to speaking with you in the future. Bye-Bye.
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