Duke oncologist Neil Spector, MD, is co-director of the Experimental Therapeutics Program at the Duke Cancer Institute (DCI).

Neil Spector, MDHe is recognized internationally for his leadership in the development of cancer drugs such as Tykerb. Spector came to Duke in 2006 from GlaxoSmithKline to direct the DCI’s efforts to translate basic science discoveries in the laboratory into advanced care for our cancer patients.

What is translational research?

Spector: Translational research is taking knowledge developed and insight gained in the laboratory, and applying it in the clinic in order to enhance detection, treatment, prediction of outcomes, and prevention of disease in people.

Essentially, it is bridging the gap between the science being done in the lab, and the clinic where patients are treated.

We often hear in the media about great scientific discoveries, like a new gene identified in fruit flies, for instance. And the researchers always say, “At some point, we hope this will help people with cancer.”

Since most of us will be touched by disease at some point in our lives, we all want to see those great discoveries applied to advancing treatment and outcomes. That’s what translational research is all about.

Who does this type of research, and why is
 it important?


Spector: You never know where the next big advances in cancer treatment are going to come from. The key is to have people who are thinking: “How does that discovery potentially apply to patient care?”

Traditionally there have been excellent basic scientists hard at work in university and corporate laboratories, and then there have been excellent physicians working in hospitals and clinics, but it was difficult to bridge that gap.

It’s essential that we can think in both worlds -- so we can understand the science and say, “Well, maybe that discovery in Alzheimer’s disease has some bearing on bladder cancer,” or vice versa.

And increasingly, through physician-scientist training programs and through the addition of translational research training in medical schools and doctoral programs, we are gaining more people from both the medical and science worlds who have that mindset and that ability to bridge the divide.

How is the Duke Cancer Institute involved 
in translational research?


Spector: To continue to be a world-class center for cancer care and research, the DCI must have a world-class program in translational research. Building that program here is a top priority.

We have brilliant investigators working in cancer genetics, biology, pharmacology, and other disciplines and making important discoveries.

The Duke Cancer Institute is committed to making it easier for our basic scientists and clinicians to collaborate in order to translate these discoveries into advanced care for our patients through new medications, imaging technologies, diagnostic tools, and other advances.

Translating our home-grown research is a big challenge, since academic medical centers have not historically been geared toward doing that -- a role traditionally filled by pharmaceutical and biotechnology companies.

Because industry now considers discovery research too high a risk for their business models, the responsibility for drug and device development has been shifting from industry to academia. More and more, institutions like Duke are being called upon to lead the way.

At the DCI, our goal is to build our capacity to help our scientists and clinicians move their research from the laboratory to the clinic as efficiently and effectively as possible.

One way we are doing that is through our Experimental Therapeutics Program, which interfaces with basic and clinical investigators, providing the expertise to help Duke investigators move their projects forward, whether through internal resources or through strategic alliances with partners beyond Duke.

One of our biggest projects is to build a tissue database of every cancer biopsied at Duke, so that we can track the molecular pathology of cancers and correlate the molecular profile of cancers with clinical outcomes.

Having a database of this caliber is a critical aspect of translational research, because we need these tissue samples to help us understand the clinical relevance and potential diagnostic and therapeutic application of discoveries made in the laboratory. Duke is one of only a handful of institutions in the world with the capability to build a database of this magnitude.

The more patients we care for, the larger the database will be, and the greater the value and impact it will have on the future of cancer research and patient care.

What are some other examples of translational research taking place at Duke?


Spector: An exciting example of translational research at Duke is the work of Dr. Mark Dewhirst, who studies the effects of heat treatment on tumors.

In the lab, Dr. Dewhirst developed heat-sensitive “nanoparticles” that can carry chemotherapy drugs to a tumor when injected into the bloodstream. Then, when the tumor is heated, the nanoparticles release the drug directly into the tumor.

This technology is now being used in a clinical trial to treat recurrence of breast cancer. It also could be used to treat other cancers.

In another Duke laboratory, physician-scientist Dr. John Sampson has developed a vaccine that has shown encouraging preliminary results in clinical trials for treating some glioblastomas, the most aggressive type of brain tumor.

And Dr. Donald McDonnell, chair of Duke’s Department of Pharmacology and Cancer Biology, has developed anti-estrogen approaches that are being tested in women who have estrogen receptor-positive breast cancer that has become resistant to standard therapies.

How does the Duke Cancer Institute impact translational research?


Spector: The vision of the DCI for Dr. Victor Dzau, Duke chancellor for health affairs, is to bring together clinicians and basic science researchers who are now spread across the Duke campus, so that they can regularly meet, exchange ideas, brainstorm, and problem-solve.

This type of interaction is critical to our ability to translate research effectively from the lab to the patient. That has begun to happen more and more at Duke.

And the new Cancer Center will only enhance our ability for collaboration among physicians and scientists and to inform and educate our patients about new and innovative treatment options.

All in all, this building represents an important step forward for the DCI in our commitment to push the boundaries to improve outcomes for our patients.