Chapter 36: An Interest in Biomarkers Spurs the Creation of the Early Detection Research Network and Its Services
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Description
Dr. Levin begins this Chapter by noting that his interest in biomarkers began when he worked on a Johns Hopkins University study of oncogenes in stools. As further background, he notes that in the eighties he worked with a Philadelphia-based company studying the elevated levels of CA 19-9 in patients with pancreatic cancer. Through this work he attempted to establish a group of individuals around the country interested in biomarkers. He explains why interest waned and why interest in CA 19-9 also diminished. He notes that the ability to find genetic markers and identify cellular and biochemical mechanisms of cancer has come of age and that this has revived interest in early detection, prognosis and therapy. He recalls that when the Early Detection Research Network was established, it was viewed skeptically and funding waxed and waned, depending on the leadership of the NCI and its Division of Cancer Prevention. He also notes that, today, all component of the NCI are suffering financially. Nevertheless, there are more investigations into early detection and the EDRN continues to grow intellectually. He also says that the EDRN has created an “elegant infrastructure” of relationships with other organizations. It continues to amass samples and analyze them using statistical techniques developed by NASA’s Jet Propulsion Laboratories.
Dr. Levin then talks about the Gordon Conferences, created through the EDRN, explaining that it is a forum for scientists to gather and share research ideas in a very relaxed forum. He describes his own experience at the Gordon Conference as a graduate student.
Identifier
LevinB_06_20130828_C36
Publication Date
8-28-2013
City
Houston, Texas
Interview Session
Topics Covered
The Interview Subject's Story - The Researcher The Value of the Oral History Project The Researcher Understanding Cancer, the History of Science, Cancer Research Business of Research Healing, Hope, and the Promise of Research Evolution of Career
Creative Commons 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
Tacey Ann Rosolowski, PhD:
Okay. We are recording. It is about four minutes after ten, and today is the 28th of August 2013. This is Tacey Ann Rosolowski, and today I am conducting the final phone interview with Dr. Bernard Levin, who is located right now in New York City. I’m in the Historical Resources Center Reading Room, MD Anderson. And I want to thank you, Dr. Levin, for agreeing to do all of these interviews via phone, etc. We appreciate your patience with our challenges with the recording equipment.
Bernard Levin, MD:
Let me express my appreciation to you personally and also to MD Anderson Historical Resources Center for the interest in actually recording some of this. So I appreciate the opportunity to share a few thoughts.
Tacey Ann Rosolowski, PhD:
Oh, well, it’s so important, and one of the great things that we’re discovering is that there’s a whole lot of interest and people are really planning on using this material, so I appreciate you taking the time. It’s going to be valuable to lots of different audiences. Well, yesterday we ended up our interview session with a conversation about the Early Detection Research Network, and I know you had some additional comments that you wanted to make about that group, so I wondered if you would continue with your thoughts on the subject.
Bernard Levin, MD:
Yes. Well, I should digress for a moment and say that my interest in finding biomarkers took expression through several different ways. I had been, as I had mentioned previously, privileged to participate in an early study on identification of the [unclear] oncogene in the stools of people with colorectal cancer. This study was primarily conducted from Johns Hopkins University by Burt Vogelstein and David Sidransky, using at that time extremely primitive methodology by today’s standards, but, nevertheless, it established perhaps for the first time that one could find these abnormal genetic signatures in the stool of people with colon cancer, but, of course, opened the way to doing this in other situations, other body fluids. So there was perhaps some background to this interest of mine, which also at in about the late 1980s, I worked with a company whose name I do not remember at the moment, based in Philadelphia, to try and establish the role more clearly of the serum marker CA 19-9, which circulates in everybody but is elevated in people with pancreatic cancer. And this effort actually took a fair amount of work to enroll centers and to establish a group of individuals around the country who might be interested in participating. And as I recall, while there was a lot of initial enthusiasm, after a few months it became obvious that the enrollment was very poor, and at some point—and I forget exactly when—the decision was made to shut this down, and nothing ever happened.
Tacey Ann Rosolowski, PhD:
Now, just so I’m clear, was this the study that was shut down or a group of people that was interested that was shut down?
Bernard Levin, MD:
The study and the group kind of fizzled out. Tracey Ann Rosolowski, PhD Why do you think that happened?
Bernard Levin, MD:
Well, I think that the estimate of the number of patients being seen or being screened at that time for suspicion of pancreatic cancer was perhaps lower than we expected, but I also think that the particular set of investigators whom we had enrolled just weren’t that involved or committed. So this attempt to answer the question or to find a role for CA 19-9 was not successful. It’s a substance that’s still used and measured, but it’s not as specific as we would like, nor is it as sensitive as we would like, but it is used as an adjunct.
Tacey Ann Rosolowski, PhD:
I was actually going to save this question for the end, but we’re kind of on the verge of talking about it right now. This is the second time that you’ve mentioned that kind of interest in early detection kind of fizzled out in the seventies and eighties, and I’m wondering if there’s a difference between the attitude or interest levels in those kinds of issues at that time and now. How have there been changes?
Bernard Levin, MD:
Yeah, I think that the coming-of-age of very sophisticated genetic technology to identify markers has made a huge impact and also much better knowledge of how cellular metabolism and cellular biochemistry goes or goes awry in the process of carcinogenesis has yielded such great insights into potential markers that there is now definitely a revival of interest, not only for early detection but for determining prognosis and, of course, response to therapy, taking us more or less towards a “personalized medicine,” in quotations. So this is, I think, a direct effect of the advancement of science.
Tacey Ann Rosolowski, PhD:
Mm-hmm. And you’ve noticed also that there are changes in the way funding is allocated? I mean, are there differences in funding support for those kind of initiatives now?
Bernard Levin, MD:
Well, EDRN is perhaps the example I know best. Initially, the establishment of the Network was viewed somewhat skeptically, and Dr. Barry Kramer and I and others fought for its establishment. That was in 1999, 2000. And subsequently, funding for it waxed and waned as various factors came into play. The leadership of the Division of Cancer Prevention of the National Cancer Institute, the relationship of that individual to the director of the National Cancer Institute itself, and the level of interest of the senior management of the NCI, all of these played a role in the waning and waxing fortunes of the EDRN. I think it’s fair to say that at the moment, because of sequestration and because of cuts in the NCI budget, all components of NCI or NCI-supported research are probably suffering, and that includes work on biomarkers.
Tacey Ann Rosolowski, PhD:
] But not because there’s any lessening of interest? I mean, as you said, the science has kind of come of age, so—
Bernard Levin, MD:
No, I think one can see that there are substantially more investigators now working in this field, and the EDRN has continued to grow intellectually and has continued to amass a very important repository of samples, created a very elegant infrastructure. It has worked out relationships with a variety of other organizations. For example, its statistical center was based at the Fred Hutchinson Cancer Center. It’s used advanced statistical technology developed by the Jet Propulsion Laboratory. So it’s had an interesting and illustrious life, actually, and is still alive today.
Tacey Ann Rosolowski, PhD:
Are you still involved with it?
Bernard Levin, MD:
No. After I served as founding co-chair, I was asked to sit on an evaluation committee that would determine if progress was being made, and then with some political shifts at the NCI, it was decided that this committee couldn’t actually provide any substantial advice. It would be relegated to what was called a network advisory panel. I think that was the word used. And its influence was substantially reduced by the nomenclature. So at that point, I actually lost interest in serving on what seemed to me a committee without any teeth.
Tacey Ann Rosolowski, PhD:
Mm-hmm. Mm-hmm.
Bernard Levin, MD:
I helped with several of the Gordon Conferences that were organized while I was in the Advisory Committee stage, and I believe those to be quite successful. As is common with Gordon Research Conference, we started out in a somewhat unpopular site, and because of the attendance and enthusiasm, we were upgraded to meeting in more popular sites.
Tacey Ann Rosolowski, PhD:
I’d actually not heard of the Gordon Conferences. What’s the significance of them?
Bernard Levin, MD:
Well, they’re usually held in the summer or some are held at other times of the year. Most are held in the United States. Some are held in other countries. They have been a venue for scientists to gather for approximately five to seven days, usually in very relaxed circumstances, often in New England or California, to interchange science, scientific ideas, and to do this in an informal way. Often dormitories are used. Often families are not included. The interchanges are not recorded, so individuals can report findings that may be quite preliminary or float ideas that may be premature, even. And it’s usually done in a good spirit of scientific exchange and camaraderie.
Tacey Ann Rosolowski, PhD:
Hmm. It sounds like it would be a real fertile ground for developing ideas and making connections.
Bernard Levin, MD:
Absolutely, and it’s great not only for senior people, it’s great for junior faculty and even for graduate students. So, having attended Gordon Conferences over many years, not that many but having attended them over the years, I can attest to the value.
Tacey Ann Rosolowski, PhD:
Hmm. What were some specific things you got from them?
Bernard Levin, MD:
Well, certainly the thrill of my very first Gordon Conference when I was a graduate student at the University of Chicago, actually going to Gordon Conference with my mentor and seeing his interchanges with other leaders, seeing the personalities of people who worked in the field of—at that time I was interested in lipid metabolism. And, of course, being exposed to new ideas and also the opportunity to visit a small village in New England and talk informally with people who had come from all over the country.
Tacey Ann Rosolowski, PhD:
Sounds like a great way to launch yourself into professional life in a new way.
Bernard Levin, MD:
Yeah.
Tacey Ann Rosolowski, PhD:
Yeah. Is there anything else that you’d like to share about the Early Detection Research Network?
Bernard Levin, MD:
Not really, no. I think I’ve probably covered everything I can.
Recommended Citation
Levin, Bernard MD and Rosolowski, Tacey A. PhD, "Chapter 36: An Interest in Biomarkers Spurs the Creation of the Early Detection Research Network and Its Services" (2013). Interview Chapters. 1372.
https://openworks.mdanderson.org/mchv_interviewchapters/1372
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