Dr Razelle Kurzrock Of CureMatch On The 5 Things Everyone Needs To Know About Cancer

An Interview With Savio P. Clemente

Be proactive when supporting a friend, colleague or loved one who is going through cancer treatment, and be an advocate for them. Offer to take on tasks like grocery shopping or delivery, household chores, babysitting and other things that help keep their household running smoothly. Drive them to their appointments. One of the best things you can do, though, is to be an advocate for them, whether you’re their primary caregiver or simply accompanying them to a doctors’ appointment. A cancer diagnosis is overwhelming for anyone. However, it’s important to remember that patients and their caregivers have the right to ask questions about any treatments their doctors prescribe, including exactly what it entails and why they recommend it. Take notes for them, ask questions, and do research that they may not be able to do on their own. Cancer patients have options, and it’s important to stay engaged and know exactly why a treatment is being used, and ask if there are better treatment choices.

Cancer is a horrible and terrifying disease. There is so much great information out there, but sometimes it is very difficult to filter out the noise. What causes cancer? Can it be prevented? How do you detect it? What are the odds of survival today? What are the different forms of cancer? What are the best treatments? And what is the best way to support someone impacted by cancer?

In this interview series called, “5 Things Everyone Needs To Know About Cancer” we are talking to experts about cancer such as oncologists, researchers, and medical directors to address these questions. As a part of this interview series, I had the pleasure of interviewing oncologist, Dr. Razelle Kurzrock.

Dr. Razelle Kurzrock is a board-certified medical oncologist, practicing physician, researcher, and a co-Founder of CureMatch. With her clinical expertise, Dr. Kurzrock has led the evolution of the CureMatch Decision Support System for Precision Medicine that supports doctors with therapeutic options based on the molecular profile of the patient. She is also known for developing one of the largest and best-known Phase I clinical trial programs in the United States while at MD Anderson Cancer Center in Texas. Dr. Kurzrock is currently the Clinical Trials Committee Chair for the Worldwide Innovative Network (WIN) for Personalized Cancer Therapy, and most recently led University of California, San Diego’s Center for Personalized Cancer Therapy at the Moores Cancer Center. She also served as a Distinguished Professor of Medicine/Associate Director of Clinical Science at the UC San Diego School of Medicine. A renowned oncologist and expert speaker, Dr. Kurzrock has published nearly 900 scientific papers in peer-reviewed literature.

Thank you so much for joining us in this interview series! Before we dive into the main focus of our interview, our readers would love to “get to know you” a bit better. Can you tell us a bit about your childhood backstory?

I was born and raised in Toronto, Canada. I stayed there through medical school and then left for the United States because I felt there were better research opportunities there. My father had a third-grade education, but was the wisest man I ever knew — probably because he was the only member of his family (Jewish) who survived the Holocaust. He lived to age 100, fully healthy almost until the end. I still miss him.

What or who inspired you to pursue your career? We’d love to hear the story.

I was always interested in science. I knew I wanted to do scientific research when I was six years old. My nickname in grade school was “the scientist,” and it was not meant kindly. The field of medicine was solidified for me when my mother died, when I was 12 years old. She had had rheumatic fever as a child and developed mitral valve disease and heart failure. Valve replacements were being done in the U.S., but not yet in Canada. I wanted to speed the pace of medical research that would save lives.

This is not easy work. What is your primary motivation and drive behind the work that you do?

There have been major breakthroughs in genomics, immunotherapy, and precision medicine for cancer treatment, giving doctors the ability to tailor cancer treatments to their patient’s exact genomic profile, resulting in better outcomes. However, despite these advancements, only a fraction of cancer patients are having molecular profiling performed. And further, interpretation of these results has become enormously complex — really beyond human cognition.

Oncologists face barriers to using precision medicine methods to treat their patients. As mentioned, the amount of data related to personalized cancer treatment is daunting. There are millions of possible combinations of drugs that could be used to target any given tumor, and it is not humanly possible for an oncologist (or any human being) to evaluate every single treatment option.

The work we have done is to resolve the complexity problem with an AI framework that provides information about the combination of drugs that best matches the molecular abnormalities in the patient’s tumor.

What are some of the most interesting or exciting projects you are working on now? How do you think that might help people?

As an oncologist, there is nothing more exciting than helping to save and improve people’s lives. One of my most interesting projects has been developing the Decision Support System with CureMatch. With our team of experts, we’ve been able to help oncologists navigate the immense complexity behind genomics, so that they can use their expertise to match patients to therapy treatments that consider their individual molecular profile.

For the benefit of our readers, can you briefly let us know why you are an authority about the topic of Cancer?

In addition to being a practicing oncologist for over 25 years, I had the honor of developing one of the largest and best-known Phase I clinical trial programs in the United States while at MD Anderson Cancer Center in Texas (the #1 ranked cancer center in the U.S.). I also recently led University of California, San Diego’s Center for Personalized Cancer Therapy at the Moores Cancer Center — a center that I founded. I have served as a Distinguished Professor of Medicine/Associate Director of Clinical Science at the University of California School of Medicine, and through my work with clinicians and other experts, I have published almost 900 scientific papers in the peer-reviewed literature. For several years, I have been named to the list of most cited scientists worldwide.

Ok, thank you for all of that. Let’s now shift to the main focus of our interview. Let’s start with some basic definitions so that we are all on the same page. What exactly is cancer?

Cancer is a complex group of diseases with abnormal/uncontrolled growth of cells and many possible internal and external causes. No two patients’ cases are the same, even if they have the same type of cancer.

What causes cancer?

While every cancer case is different, the American Cancer Society sums up exactly what they all have in common:

“You are made up of trillions of cells that over your lifetime normally grow and divide as needed. When cells are abnormal or get old, they usually die. Cancer starts when something goes wrong in this process and your cells keep making new cells and the old or abnormal ones don’t die when they should. As the cancer cells grow out of control, they can crowd out normal cells. This makes it hard for your body to work the way it should.”

What is the difference between the different forms of cancer?

From a diagnostic perspective, there are two main types of cancer:

• Hematologic (blood) cancers are what happen when abnormalities occur in blood cells. Hematologic cancers include leukemia, lymphoma, and multiple myeloma.
• Solid tumor cancers are cancers of any of the other body organs or tissues, which occur when those organs or tissues start developing cells abnormally. The most common solid tumors are breast, prostate, lung, and colorectal cancers.

Because no two peoples’ cells are exactly the same, and cancer is caused by abnormalities in cells, it’s so important for each patient’s cancer treatment to be unique to their genetic makeup. The CureMatch Decision Support System uses AI to sort through a patients’ complex genomic/immune/RNA/protein sequencing report to match their individual cancer’s biological profile to drugs or therapies that may be the best match for the abnormalities.

I know that the next few questions are huge topics, but we’d love to hear your thoughts regardless. How can cancer be prevented?

About 1 in 3 people in the United States will be diagnosed with a form of cancer at some point in their lifetime, whether it’s a fairly common melanoma or a rarer form of brain cancer. Some of the factors leading to various cancers, such as genetics, are out of an individual’s control, but many other lifestyle and environmental factors are under individual control. These include smoking and tobacco use; diet and physical activity; and exposure to sun and other types of radiation. By avoiding tobacco, using alcohol in moderation, eating a healthy diet, engaging in regular physical activity, limiting sun and radiation exposure, reducing pollution in their environment and generally staying healthy, a person can help prevent some cancers.

How can one detect the main forms of cancer?

If you know you have a family history of a certain type of cancer, such as breast cancer, or you’re of a particular age that puts you at higher risk of a particular type of cancer such as colorectal cancer, we recommend being proactive and getting regular screenings.

If you have a symptom or screening result that suggests cancer, there are a number of things your doctor will do to figure out if you have cancer, and what type it is. They may order a number of lab tests, imaging tests (such as CT scans or MRIs), or other tests or procedures. You may also need a biopsy, a procedure in which a doctor removes a sample of tissue for testing. This is often the only way to tell for sure if you have cancer.

Cancer used to almost be a death sentence, but it seems that it has changed today. What are the odds of surviving cancer today?

You are right, we have made significant advances in cancer treatment and diagnosis over the past several decades, which has dramatically improved overall survival rates. However, the odds of progression-free survival (PFS) or disease-free survival (DFS) depends on the type of cancer a patient has developed, what stage it is diagnosed, how early they get treatment, and the country in which they live, as well as the patient’s individual genetic makeup. Earlier diagnosis and accurate treatment improves the odds of survival, no matter what type of cancer you have.

Can you share some of the new cutting-edge treatments for cancer that have recently emerged? What new cancer treatment innovations are you most excited to see come to fruition in the near future?

Groundbreaking work is being done now in the area of genomics and in immunotherapy. As clinicians know, genomics as well as the immune system are hugely complicated, and there are thousands of possible abnormal variants and immune reactions for cancer cells. Understanding genomics and the immune system yields a much better understanding of what is driving a cancer cell, but the complexity is beyond human cognition.

To harness the value and volume of data related to genomics and the immune system, the application of a complete knowledge base of AI is key. The CureMatch Decision Support System helps to decipher this complexity so that doctors have all the information they need on hand to select from a number of genomically targeted drugs, immunotherapy, hormonal therapy, and chemotherapy options to consider for their patient’s treatment plan. Integrating the patient’s tumor profile with an aggregation of all the latest research, as well as curated clinical and scientific knowledge, the doctor can then access a consolidated oncology report that summarizes which therapy combinations would best match the abnormalities in that particular patient’s tumor.

Overall, CureMatch empowers oncologists to unravel the immense complexity behind genomics and the immune system so that they can use their expertise to match patients to more effective treatments. A recent study published in Nature Medicine found that PFS was significantly improved in patients treated with combination therapies assessed by CureMatch to closely match their genetic profiles.

Healing usually takes place between doctor visits. What have you found to be most beneficial to assist a patient to heal?

I believe the most important aspect is a good family and/or friend support system

From your experience, what are a few of the best ways to support a loved one, friend, or colleague who is impacted by cancer?

Find a concrete way to support your friend or loved one. Sometimes it’s something as simple as helping them keep their household running: offer to cook, clean, babysit, do errands or even get their groceries delivered. Stop by for a visit, but just bear in mind that many cancer patients suffer from fatigue during treatment, so make sure to be there only as long as they need company, and try not to suggest any activity that is too physically demanding. Just sit with them and listen. Go with them to doctors’ appointments, take notes, and help them remember things like treatment options and medications, because chemotherapy and other cancer treatments can make it hard for a person to concentrate.

MD Anderson Cancer Center has a great, more comprehensive list of things you can do to support someone in your life who has cancer.

What are a few of the biggest misconceptions and myths out there about fighting cancer that you would like to dispel?

First and foremost, as you pointed out earlier, cancer is not a death sentence. There are so many advancements, including precision medicine treatments, that have helped doctors dramatically improve survival rates.

Secondly, even though a positive attitude will give you the motivation to do healthy things like maintain social connections and stay active, there is no convincing scientific evidence that links a person’s “attitude” to their chances of dying from cancer. In fact, it’s healthier to acknowledge every emotion that can come from a cancer diagnosis — sadness, anger, frustration, but also hope — and feel them fully in the present moment.

Finally, no two cancer diagnoses are the same. What works for one patient may not necessarily work for the other, and vice versa. My mission is to help doctors have as much data as possible so that they can give their patients the best treatment. This is why I am so passionate about the CureMatch Decision Support System and other technologies.

The American Cancer Society has a great article that debunks some of the most common myths about fighting cancer, I’d recommend giving it a read.

Thank you so much for all of that. Here is the main question of our interview. Based on your experiences and knowledge, what are your “5 Things Everyone Needs To Know About Cancer? Please share a story or example for each.

1. No two cancer cases are exactly alike. No two people are the same, and neither are their cancers. Even two cases of the same type of cancer have different biological characteristics. These differences, which can be very subtle, may be extremely complex.
2. Earlier diagnosis and treatment improves many patient outcomes. Getting the best treatment for a patient as early as possible is crucial.
3. An individual’s genetic profile and lifestyle factors can influence their likelihood of developing or dying of cancer. Leading a healthy lifestyle can help prevent certain types of cancers, so I highly recommend giving up smoking or tobacco use, drinking alcohol in moderation, eating a healthy diet, engaging in regular physical activity, spending time away from polluted environments and protecting yourself from sun exposure. However, many other factors, particularly a person’s genes, are out of their control, and it’s important to remember this fact.
4. Advances in genomics and precision medicine and immunotherapy, which treat an individual cancer patient based on their genetic and immune makeup, are leading to better outcomes. There are millions of possible combinations of drugs or therapies, including chemotherapy and immunotherapy, that could treat any given patient’s cancer. The complexity problem is a big one, and that is why we have created a system that can CureMatch a patient’s tumor, meaning the system is set up to resolve the complexity with the best known information and indicate which drugs best match the abnormalities that drive a patient’s cancer .
5. Be proactive when supporting a friend, colleague or loved one who is going through cancer treatment, and be an advocate for them. Offer to take on tasks like grocery shopping or delivery, household chores, babysitting and other things that help keep their household running smoothly. Drive them to their appointments. One of the best things you can do, though, is to be an advocate for them, whether you’re their primary caregiver or simply accompanying them to a doctors’ appointment. A cancer diagnosis is overwhelming for anyone. However, it’s important to remember that patients and their caregivers have the right to ask questions about any treatments their doctors prescribe, including exactly what it entails and why they recommend it. Take notes for them, ask questions, and do research that they may not be able to do on their own. Cancer patients have options, and it’s important to stay engaged and know exactly why a treatment is being used, and ask if there are better treatment choices.

You are a person of great influence. If you could start a movement that would bring the most amount of good to the most amount of people, what would that be? You never know what your idea can trigger. :-)

I’m doing that work right now with CureMatch: harnessing the power of AI and huge knowledge databases to help doctors sort through the mountains of data in each patient’s profile. Cancer is a complex problem, but we are harnessing the power of the computer to resolve that complexity with the best science available.

How can our readers further follow your work online?

A great deal of my work can be found on PubMed.gov. A couple of relevant publications are:

• Real-world data from a molecular tumor board demonstrates improved outcomes with a precision N-of-One strategy (Nature Communications, 2020)
• The Crossroads of Precision Medicine and Therapeutic Decision-Making: Use of an Analytical Computational Platform to Predict Response to Cancer Treatments (Cancers, 2020)
• Molecular profiling of cancer patients enables personalized combination therapy: the I-PREDICT study (Nature Medicine, 2019)

You can also learn more about my work on AI-powered recommendations for precision medicine treatments at www.CureMatch.com

Thank you so much for these insights! This was very inspirational and we wish you continued success in your great work.