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FEATURES (This article, reprinted with permission, featuring Judah Folkman, class of 1950, appeared in The Columbus Dispatch on February 8, 2004) 04/11/04
Anti-angiogenesis, which target’s blood-vessel growth in tumors, is becoming the fourth treatment for cancer (behind surgery, chemotherapy, and radiation), Folkman said. His nights are spent answering phone calls from frantic cancer patients. His days are spent in labs at Harvard University and Children’s Hospital in Boston, where he is pursuing research for the anti-angiogenesis concept he fathered. Angiogenesis, the growth of new blood vessels, is a natural reaction to pregnancy and wounds. Yet the process runs out of control in tumors. The goal of anti-angiogenesis is to turn off the process and rob a tumor of its blood supply. Folkman’s work was brought to the world’s attention in 1998. Yet the drug that Folkman was studying, Endostatin, initially had poor results in human clinical trials. Last year, the pendulum swung toward renewed interest when a colon-cancer drug, Avastin, which inhibits the growth of blood vessels to the tumor, showed promise. It allowed for prolonged survival with fewer side effects than traditional treatments. Many researchers say that angiogenesis inhibitors are not a cure and that many such drugs must be taken indefinitely to get tumors to shrink. “I think it’s fair to say that all novel approaches to cancer treatment, including anti-angiogenesis, are turning out to be as complicated to develop as we expected,” Dr. Louise Grochow of the National Cancer Institute told the Los Angeles Times. “This research is very appealing,” said Dr. Miguel Villalona, an associate professor of medicine at Ohio State University. OSU is testing Avastin for use in fighting lung cancer. Folkman is optimistic about the future of cancer treatments. “In the 1930s, medical books were full of instructions to locate infections and remove all the pus,” Folkman said. “If a little bit of pus was missed, the patient could die. Could it be that cancer therapy could replicate the whole history of infection?” he asked. His hope is this: Anti-angiogenesis inhibitors will be taken to fight off cancer in much the same way as antibiotics are used today for infections. “We’re farther ahead than the Wright brothers but not as far as Lindbergh,” he said. Within five to ten years, Folkman predicts, such drugs will be added to traditional treatments, including some chemotherapies, as first-line treatments for many cancers. At a health meeting in Washington last month, the chief medical officer of Genentech, which makes Avastin, put up a slide: “Can we eliminate chemo?” Folkman has learned from past criticism. But he enthusiastically applauds the question being asked. Because most anti-angiogenesis drugs carry fewer side effects than chemotherapy, Folkman says anti-angiogenesis is among new treatments that show promise to meet the National Cancer Institute’s goal of treating cancer as a chronic disease. So far, two anti-angiogenesis-type drugs have been approved for use in the United States: Iressa, a lung-cancer drug, and Velcade for multiple myeloma. Not all anti-angiogenesis drugs work alike. Some directly cut off the blood supply of tumors; others disrupt either the signal that tells the cancer cells to divide and multiply or the signal that allows the cancer to repair itself. Folkman is the son of the late Jerome Folkman, who was a rabbi at Temple Israel on the east side from 1947 to 1973. The physician’s longtime conviction about anti-angiogenesis came more from his background as a surgeon than from religion. “As a surgeon, you hold tumors in your hand and see how hot they feel before they bleed. As early as my surgeon’s training in 1957 at Massachusetts General, I knew the prevailing view that cancer tumors didn’t attract new blood vessels was wrong.” My wife, Paula, has always said, “If you are right about your idea, why would you give it up?” |
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