Keck Medicine of USC

Dr. David Tran, the Chief of Neuro-Oncology at Keck Medicine of USC, received his MD and PhD degrees from the Mayo Clinic College of Medicine in 2005 and completed his postgraduate training in Oncology and Neuro-Oncology at Washington University School of Medicine in St Louis in 2011. He is a leader in precision medicine and a NIH/NCI-funded investigator focusing on the cause of cancer progression and the development of novel precision cancer therapies in brain and breast cancers.

Tran has authored many seminal publications in cancer research and serves as the principal investigator of several national clinical trials in brain and breast tumors. Research in the Tran laboratory focuses on understanding the molecular mechanism of how cancer develops, progresses, and resists treatment through a vertically integrated approach, starting with clinical observations, guided by systems and computational analyses, validated experimentally, and translated into novel, safe and effective anti-cancer therapeutics.

In an exclusive interview with MedTech Outlook, Tran shares his valuable insights on the challenges, trends and best practices in the Oncology space.

Can you talk about your roles and responsibilities as the Chief of Neuro-Oncology and Co-Director of the USC Brain Tumor Center?

I oversee the clinical operation and clinical research enterprise of the brain tumor centers, including developing clinical trials that incorporate new technology from our institutions and with industry partners. I also direct the clinical workflow, overseeing patient access, ensuring clinical safety, managing treatment types, and coordinating separate services within the brain tumor centers. Collaborating with colleagues in various departments, including neurosurgery, radiation oncology, neuroradiology, neuropathology, social workers, and nursing staff, I ensure smooth transitions of patients between departments.

Improving access to patient care involves collaborating with marketing and development teams to reach out to local communities. This includes increasing educational activities for patients and promoting the training of future generations of physicians at both regional and national levels. The future generation includes graduate students, clinical trainees, residents, medical students, and fellows. Additionally, I promote new academic activities locally and attend conferences in the US or internationally.

Could you tell me about a recent project that you have been associated with and what are some of the elements that you had to take care of?

Our group focuses on developing new immunotherapy approaches for brain tumors using the tumor treating field as a vaccinating machine. At Keck Medicine, we have developed an in-situ vaccine approach, which involves bringing all the knowledge about the immune reaction to the tumor. This in-situ approach leverages the presence of the tumor and its accessibility, coaching the immune system to develop an immune reaction against the tumor from within. Demonstrated by our first-in-human clinical trial which is made of this approach, it has been quite successful.

“Collaborative work which is crucial for achieving change requires integrating allies and offering mutual benefits.”

In addition, our group has run a successful first-in-human clinical trial using this approach, which involved collaborations with surgeons, neuropathologists, and neuroradiologists. We sample the tumor before and after treatment, identifying changes that require surgical dissections. Following this, we work closely with neuropathologists to understand the changes in the tumor and how it can be detected on MRI scans.

The successful clinical trials led to the development of an international phase three trials based on this approach. The trial is expected to open in the next few months and will be supported by both the manufacturer of the technologies and the immunotherapy drugs from Merck. Due to the complexity of medicines, we also emphasize the importance of collaboration in developing new immunotherapy approaches targeting deadly cancers.

What would be your piece of advice for fellow peers and colleagues?

Collaborative work is crucial for making a difference, but many people fail to acknowledge its importance. To make these partnerships successful, it is essential to make allies an integral part of the project, giving them something in return. For example, academic institutions often use publications and grant money as currency for joint efforts. Assigning tasks to partners who own specific project aspects allows them to play a crucial role in publications and grant money, fostering a shared resource.

It is crucial to involve all allies in the process and offer something in return for their personal and career growth. This approach ensures that collaborations are not transactional and that everyone has an input into the process.

How do you envision the future and are there any new developments that are affecting your outlook in the next 18 months?

Our group is unique in its use of technology in developing new therapies for brain cancer, including immunotherapy and in-situ vaccines. We also heavily invest in developing AI technology for entire brain tumor centers to investigate complex and heterogeneous cancers.

We focus on the commonality of cancer rather than the heterogeneity of individual tumors. In addition, we identify common patient factors and view differences as modifying factors, improving our understanding of disease complexity and guiding more effective treatment strategies. This approach allow us to develop new gene therapy that targets the fundamental master regulator of brain or breast cancer, generating personalized treatment.

AI technology enables us to inquire about fundamental aspects of cancer, such as the core sets of master genes that contribute to its development and progression.. Understanding master regulators in GBM cancer can help modify its state to reduce malignancy or utilize it as a therapeutic approach.

Our group foresees adopting a comprehensive AI approach to comprehending cancer over the next two to three years. This approach will concentrate on the fundamental aspects of individual tumors or patients. We will be equipped to create therapies that can treat a large number of patients, rather than just a small group by defining GBM or breast cancer.