Linda Garland, M.D., knows all about the steep challenge that mesothelioma still presents to medical providers, but she also sees the future opportunities it brings.
Garland serves as director of the clinical lung cancer program and associate professor of clinical medicine at the University of Arizona Cancer Center. Hailing the recent advances in genetic tumor profiling, she contributed to an article entitled “Individualizing Mesothelioma Treatment: Small Steps into a Brighter Future.”
Fast Fact: In 2008, Dr. Garland was named as the principal investigator for a clinical trial of trimodal therapy as an intervention for mesothelioma patients and patients with other solid tumors.
The article, co-authored by highly-regarded surgeon Raja Flores (Mount Sinai Medical Center, New York) and oncologist Anne Tsao (MD Anderson Cancer Center, Houston), calls for increasingly personalized treatments for mesothelioma patients based on those advances being made.
“[Mesothelioma’s] relative rarity, biologic heterogeneity and inherent chemotherapy- and radiation-resistance continue to challenge efforts to discover and develop novel therapeutic strategies,” she wrote. “However, the availability of pleural tumor from diagnostic pleural biopsies and pleurectomy specimens provides a distinct opportunity for molecular/genetic studies that can yield prognostic and predictive biomarkers, upon which individualized therapy can be designed.”
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Garland, who specializes in medical oncology, has research interests in several malignant chest diseases and the use of experimental therapeutics. Diseases of particular interest to her include lung cancer, mesothelioma and other rare mediastinal tumors. She has a special interest in designing “finely-tuned” therapies.
Her clinical focus centers on mesothelioma, small-cell lung cancer, non-small cell lung cancer, head and neck cancer and thyroid cancer. While the prevalence of lung cancer has helped medical researchers make rapid advances in treatment, the rarity of mesothelioma (only 3,000 new cases annually in the United States) and previous lack of research money has produced slower growth. But the potential for dramatic, future progress exists.
We predict that over the next 5 to 10 years, we will have a small but expanding set of validated predictive and prognostic molecular/genetic biomarkers that can be used in the clinic to personalize the treatment of mesothelioma. Central to this framework is the rigorous harvesting and optimal processing of tumor and other relevant tissues for molecular/genetic analysis, now considered de rigueur for other tumor types such as NSCLC.
She cites the personalization of chemotherapy as one strategy that may lead to improved clinical outcomes.
“There is new data suggesting that this will be possible for mesothelioma,” she explains. “Two studies have reported on predictive biomarker analysis for pemetrexed-based therapy.”
Her quest for more personalized medicine isn’t limited to mesothelioma, which is caused by exposure to asbestos. She has done similar research with thyroid cancer, along with head and neck cancer and different types of lung cancer.
“My clinical and research interests are in experimental therapeutics, with focus on malignant diseases of the chest,” she wrote as a summary of her research activity on the Arizona Cancer Center website. “Novel targets for therapeutic design, including targets in signal transduction pathways conferring drug resistance, are being identified. We are designing trials … thus providing more potent anti-cancer activity.”
In 2011, Garland authored “Chemotherapy for Malignant Mesothelioma,” which discussed the history and future of chemotherapeutics for mesothelioma patients. This article appeared in Current Treatment Options of Oncology, and her other articles have appeared in the Journal of Thoracic Oncology, Clinical Lung Cancer and the Journal of Clinical Oncology.
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