Primary Appointment

Radiation therapy has traditionally been the treatment of choice for locally advanced disease but has provided limited benefits both in terms of local tumor control and patient survival. Adding cytotoxic drugs to radiotherapy considerably improved treatment outcome, primarily when drugs were given concurrently with radiotherapy. This was achieved at the expense of increased normal tissue toxicity and morbidity. Further improvements in radiotherapy are needed, and recent emphasis is on molecular targeting, i.e. adding agents that counteract molecular processes dysregulated in cancer cells, which may be responsible for tumor radio-or chemoresistance. Many potential targets for augmentation of radio (or chemo) response have been identified including epidermal growth factor receptor (EGFR), cyclooxygenase-2 (COX-2) enzyme, mutated and angiogenic molecules, and inhibitors of DNA damage repair among many others. Agents that selectively inhibit these molecules are becoming available at a rapid rate, and many of them have been shown in our preclinical testing program to be highly effective in improving tumor radioresponse or chemoresponse, without significantly affecting normal tissues. The interaction of EGFR and COX-2 inhibitors with radiation has recently attracted the most investigational interest. Both EGFR and COX-2 inhibitors have entered clinical testing at MDACC and elsewhere in combination with radiotherapy or radiochemotherapy with results that have significantly changed the standard of care for patients with tumors of the upper aerodigestive tract.

Academic Appointments

Last updated: 3/13/2013