Chapter 04: A Fellow at MD Anderson: A View of Developmental Therapeutics in the Early Seventies

Chapter 04: A Fellow at MD Anderson: A View of Developmental Therapeutics in the Early Seventies

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In this chapter, Dr. Keating gives an overview of the state of research into blood malignancies in the early seventies and the exciting environment for research he discovered when he came to MD Anderson in 1974 as a fellow in the Department of Developmental Therapeutics. He then tells an anecdote about Dr. Emil J Freireich (interviewed for project, 2012), notes his charisma, then explains that he created the first “translational scenario” in the Department of Developmental Therapeutics. He explains that because there was no established treatment for most diseases at the time, the Department often used an “n of 1” study, “making it up from first principles,” an approach that was very exciting to him. He notes that the NCI controlled the direction of research at the time, as it controlled the drugs.

Identifier

KeatingM_01_20140513_C04

Publication Date

5-13-2014

City

Houston, Texas

Topics Covered

The University of Texas MD Anderson Cancer Center - MD Anderson History; Joining MD Anderson; MD Anderson History; The Researcher; Portraits; Understanding Cancer, the History of Science, Cancer Research; Research, Care, and Education; Discovery, Creativity and Innovation

Creative Commons License

Creative Commons Attribution-Noncommercial-No Derivative Works 3.0 License
This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 3.0 License.

Disciplines

History of Science, Technology, and Medicine | Oncology | Oral History

Transcript

Michael Keating, MD:

But there was tremendous camaraderie in the Department of Developmental Therapeutics, and Freireich [Oral History Interview] had, and still has, great charisma, and he was the first person really to set up a translational research program with Dr. Emil Frei, who’d left the year before I arrived. So Frei and Freireich had set up this department where you had chemotherapists and immunologists and pharmacologists and infectious disease people all in the same department, so that this was, again, this cross-fertilization, learning the language of the people.

Tacey Ann Rosolowski, PhD:

And directed at clinical problems.

Michael Keating, MD:

Yeah, very much so, so that they would have N-equals-1 studies, that you would have something that you would try in one patient and—

Tacey Ann Rosolowski, PhD:

Now, I missed the descriptor that you used for that.

Michael Keating, MD:

“N,” number, “equals 1,” instead of having clinical trials now that have hundreds in each arm of the study. For example, there was a patient who had malignant melanoma, and the melanomas used to metastasize, had spread to the liver, and so the patients would often have massive livers and not very much anywhere else. So that the pharmacologist, Dr. TiLi Loo, T-i-Li L-o-o, said, “Well, when you get this drug, there’s a first-pass effect that has to be neutralized, etc., and activated.” And he said, “What we need to do is to figure out a way to deliver the drug directly into the liver.” And we had some wonderful interventional radiologists, even back then, that had figured out what you could pass catheters into the arterial system. Dr. Sid Wallace [Oral History Interview] was the leader of those concepts.

Tacey Ann Rosolowski, PhD:

Yeah, I interviewed him.

Michael Keating, MD:

So that they decided in this patient they would cannulate the liver artery and deliver the drug directly into the liver. I don’t think it did very much, but they also figured that another patient came along and it had spread just to the brain, and so they figured out they could deliver it through the carotid artery to go to the brain. And in those days, there was no established treatment for most things, so that you were just making things up that might work from first principles, and that was an exciting concept for me, that you didn’t have to have the recipe. You just had to have some thoughts as to what you knew, and you’d find out that there was a lot of missing information back in those days about the drugs, because there wasn’t a lot of research being done on them. The interesting thing back then was that the National Cancer Institute was really the director of research, because they would have the drugs that would be developed by the National Cancer Institute, and it was only beginning to happen that the pharmaceutical companies would be developing cancer drugs. The National Cancer Institute, or the NCI, would be begging people to, “Please do some research on cancer, and we’ll give you this drug,” and they gave patients grants for outpatient treatment and grants for inpatient treatment, so that they were really directing traffic.

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Chapter 04: A Fellow at MD Anderson: A View of Developmental Therapeutics in the Early Seventies

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