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Improving the Human Condition

Improving the Human Condition

Bruce Minsky ’77

 

Each year colorectal cancer strikes 150,000 people in the United States. Until very recently, the standard of care for those patients was surgery to remove the tumor, followed by chemotherapy and radiation to kill any lingering cancer cells.

That approach has saved many lives, but also has left many people with permanent colostomies and the impact on their lifestyle that entails. In 2004, however, the standard of care changed, because of research led by Bruce Minsky ’77.

"Our first principle in medicine is to do no harm. So when something is working, people are rightly apprehensive about introducing a new therapy," Minsky says. "But over the course of many years treating patients and studying new therapies, we believed that we could do better."

After earning his BS in biology at WPI, Minksy went on to the University of Massachusetts Medical School. He then trained in Boston at New England Deaconess Hospital and the Joint Center for Radiation Therapy, an affiliate of Harvard Medical School, where he specialized in radiation oncology and gastrointestinal cancers.

In 1986 he moved to New York to take a position at the Memorial Sloan-Kettering Cancer Center, where he’d stay for 20 years, treating patients and directing clinical trials. "The type of chemotherapy and radiation we used 20 years ago was much less sophisticated than it is today," Minsky says. "Part of my work at Sloan-Kettering was to run clinical trials to evaluate new therapies and new combinations of therapies."

In the course of that research, Minsky developed a hypothesis— would patients with colorectal cancers, particularly rectal cancers, do better by reversing the standard of care? Instead of surgery first, what if patients were treated with radiation and chemotherapy before the surgeon removed the tumor?

"This took a considerable amount of convincing and required a change in thinking among surgeons, because they believed reversing the treatment would make the surgery more difficult,” Minsky says. “In fact, it turned out to be the opposite."

Surgeons weren’t the only ones wary of changing the standard of care. Patients facing life-and-death decisions would almost always opt for the proven therapy, even if the side effects were severe. "We had trouble randomizing patients into clinical trials for the new therapy, which is understandable," Minsky says.

In time, however, with evidence mounting from Minsky’s research, a large-scale randomized clinical trial was launched in Germany, testing the standard of care against the new approach. The results were conclusive. The combination of radiation and chemotherapy before surgery significantly reduced tumor sizes, so when the surgeons went in, they had to remove less tissue, thereby preserving a functional organ in many more patients. "The new standard reduced the number of colostomies by half," Minsky says. "That has a dramatic impact on the quality of life for those patients."

In 2004, Minsky’s approach became the recognized standard of care, worldwide, for treating colorectal cancer. That same year, Minsky received an honorary doctorate from Friedrich-Alexander University in Erlangen, Germany, in recognition of his contributions to the field, documented in his over 300 published medical journal articles about the treatment of gastrointestinal cancers. "I didn’t know when I started this line of research that it would ultimately result in these advances," Minsky says. "It was really just about asking a simple question—can we do better?"

It’s a question that continues to drive Minsky’s passion in health care today, only now on an even larger scale. Last January, he was appointed chief quality officer for the University of Chicago Medical Center. (He was also named associate dean for clinical quality in the Biological Sciences Division and professor of radiation and cellular oncology.)

In his new role, Minsky is charged with nothing less than improving every aspect of patient care at the hospital and its associated medical offices and clinics. "I’m very excited about this new challenge," he says. "I hope to have a positive impact on an even wider range of medicine and patients."

Susan Moser Roberts ’92

As the founding director of the Institute for Cellular Engineering at the University of Massachusetts Amherst, Susan Moser Roberts ’92 is both a scientist and a teacher.

In her lab, she’s engineering plant cells to produce lifesaving drugs. At the university, she’s launched a new program to train graduate students in the rapidly expanding field of cellular engineering. Her goal is simple: to improve people’s health and quality of life. "Our approach is the integration of life sciences and engineering at the cellular and molecular levels," Roberts says. "We want to understand how cells function so we can engineer them, from the inside out, to produce a desired output."

Roberts focuses much of her own research on the drug paclitaxel, commonly known by the brand name Taxol, which is one of the most potent anti-cancer drugs in use today. Taxol kills cancer cells and shrinks tumors by blocking the malignant cells’ ability to reproduce. The drug is also being explored as a possible treatment for Alzheimer’s disease and is used in coating heart stents.

While the demand for Taxol is very high, the supply is limited. In fact, when Taxol was first discovered in the bark of the Pacific Yew tree in the 1960s, the species was at risk of being clear-cut into extinction because it takes three 100- year-old yews, on average, to make enough Taxol to treat just one cancer patient. Since then, Taxol has been synthesized from yew cell cultures grown in laboratories, but that process still does not yield enough material to satisfy all the research and clinical needs. Roberts hopes to overcome that problem by engineering yew cells to produce more Taxol. "We work with cell cultures generated from yew tree embryos," she says. "The cells we utilize in our processes are undifferentiated and can be considered stem cells of the plant world."

Roberts has developed new methods for growing yew cells in culture and for identifying the cells that are overachievers, producing much more Taxol than other cells. Roberts has also identified several genes that appear to regulate the cellular machinery that produces Taxol. "If we can understand how the biosynthetic pathway in the cell works, we can engineer it effectively so that cells produce higher levels of Taxol," Roberts says. "We’ve honed in on two steps in the Taxol biosynthetic pathway that we think are particularly important and are working on developing engineered cells through targeting those steps."

Roberts is also developing a new technology that helps mammalian cells live and grow in culture and in the body by encapsulating them in materials that improve oxygen delivery to those cells. The novel process, for example, may help keep insulin-producing islet cells viable for extended time periods, which would enable implantation into patients with diabetes, potentially reducing the need for glucose monitoring and insulin injections for these patients. "Diabetes has touched my family, so it’s always been an interest of mine," she says. "But what really drives me is to work on projects that are relevant to improving human health for all."

At WPI, Roberts majored in chemical engineering with a minor in biomedical engineering. She went on to earn a PhD in chemical engineering at Cornell and then joined the faculty at UMass Amherst, where she is now an associate professor of chemical engineering.

While at UMass, Roberts saw the need for an enhanced educational experience for graduate students interested in the interface of engineering and life sciences. She also wanted to encourage her colleagues to do more interdisciplinary, project-based research initiatives— the model that she’d thrived on at WPI.

In 2005 Roberts launched the Institute for Cellular Engineering, which has grown to include faculty from 10 academic departments and research programs at UMass, working together on cellular engineering projects with applications in clean energy, pharmaceuticals, and the environment. In September 2007, the institute received a $3 million grant from the National Science Foundation to establish a graduate education program in cellular engineering.

"The institute has been an incredible spark for initiating new collaborations among faculty," Roberts says. "And to see the graduate students working in the labs, doing great things, is so rewarding. It’s really all coming together."

Paul Amazeen ’64, ’71

When researchers from the famed Institute of Applied Physics at the Russian Academy of Sciences came to the United States in the mid 1990s to commercialize their new medical imaging technology, they turned to Paul Amazeen ’64 (MS), ’71 (PhD) for help.

This was no surprise. By that time, Amazeen was a wellknown leader, innovator, and entrepreneur in the medical device and imaging fields. For more than two decades he’d led research and development efforts and built new business models around several medical technologies at companies both large and small.

Trained as an electrical engineer, Amazeen’s graduate work at WPI was the basis for a product developed to analyze cardiac arrhythmias and identify patients at high risk for a heart attack. He helped engineer Raytheon’s early program in nuclear medicine. He crafted the business plan and launched General Electric’s first three ultrasound imaging systems. So when the Russian technology came to the Cleveland Clinic for evaluation, Amazeen was asked to review it and advise on its technical capabilities and its potential commercial viability. He ended up founding a company to bring the new technology to market.

"I tested their prototype and I could see pretty quickly that this was for real,” Amazeen says. “It was an important new technology and I wanted to help develop it into a product that could fill a clinical need.”

Amazeen partnered with Felix I. Feldchtein, PhD, one of the Russian scientists who’d invented the new imaging technology, and became the founding president of the company now called Imalux. The company’s lead product is called Niris—a system that uses optical coherence tomography (OCT), which, simply put, bounces light off tissues to create detailed images of very small elements of those tissues.

The Niris system works in real time, scanning tissue and instantly displaying images on a bedside monitor, allowing a physician to see the telltale signs of cancer, or guiding a surgeon’s scalpel to make sure the parts of diseased tissues are removed, while leaving healthy tissue in place. “This is not just a better version of an existing technology or product,” Amazeen says. “OCT is something completely new. We see things that no other imaging technology in clinical use today can see.”

At first glance the Niris system is reminiscent of an ultrasound machine that uses sound waves, emitted from a probe at the end of a flexible cord, to image parts of the body. Niris also has a probe at the end of a cord, but instead of sound waves it emits a pulsating beam of near-infrared light from a tiny diode. As the light is scattered and reflected back off the tissue, it is collected by the probe and processed by the system’s software to generate detailed images of very small sections of tissue.

The scale and resolution of the images produced by OCT is much finer than ultrasound. Using Niris, physicians can see the microscopic abnormalities that indicate cancerous or pre-cancerous tissues. And while ultrasound is typically used externally, with the probe moved over a person’s skin, the Niris system is used internally. Its probe is small enough to be sent through an endoscope’s tube, to look at internal structures like the bladder, esophagus, or cervix.

“We see tissue structures that can’t be seen with the naked eye,” Amazeen says. “Without this new imaging modality, the only way to test for these abnormalities is to biopsy the tissue and look at it under a microscope. That can take days, even weeks, all the while with the patient worried that he or she may have cancer. With our system, in about half a second, the image is on the screen. It’s an optical biopsy.”

The Niris system is now being used in clinical trials at the Cleveland Clinic, Johns Hopkins Hospital, Massachusetts General Hospital, and other leading research centers. “Our clinical data is looking extremely good. We’re able to find the boundaries of cancer, guide the surgery, then evaluate after recovery,” Amazeen says. “We’re about a year away from a full-scale launch, with significant publications showing the effectiveness of this system.”

Romiya Glover Barry ’04

It is a cruel irony in the battle against HIV/AIDS that state-of-the-art therapies known to be effective are often not available, or are difficult to administer, in the areas of the world hit hardest by the disease.

After earning her BS in biotechnology, Romiya Glover Barry ’04 joined a team working to overcome an important element of that treatment gap. She accepted a position in the research and development laboratory at PointCare Technologies, the Marlborough, Mass., company where she interned during her senior year at WPI.

PointCare developed a portable blood analysis system designed for use in rural clinics treating AIDS patients. Barry’s job was to help optimize and expand the functionality of that system. “The challenge is to have a self-contained product that will work under conditions you’ll find in remote areas, and that will provide results right away, while the patient is still in the clinic,” Barry says.

To treat people infected with HIV, the virus that leads to AIDS, physicians must closely monitor the number of CD4 immune-system cells in the bloodstream. Based on that cell count, the clinician can safely start and manage the cocktail of drugs that suppress the virus and delay the onset of AIDS.

For most people in developed countries, waiting a few days for lab results before starting treatment is not a big issue. “In remote areas of Africa, Asia, and other parts of the developing world, it’s a problem,” Barry says. “Patients will often walk for many hours to get to a clinic. So to tell people that they have to come back in a day or in a week for their test results before treatment can start is not realistic.”

To remedy that problem, PointCare’s technology can measure CD4 cells in a blood sample in minutes, giving the clinic staff results while the patient is still present. It’s an automated system, with everything needed for the analysis built into one console that sits on a tabletop. “It’s a very different approach to medical technology. It’s not about frills, or putting in all the bells and whistles. You have to design it so that it is affordable and has what it needs to be effective in these remote areas,” Barry says. “The system can even be powered by a solar panel, or a car battery, if necessary.”

At PointCare, Barry worked as a chemist to improve the reagents and processes used in the diagnostic system. She helped develop additional capabilities for the system—new blood tests beyond the CD4 assay that would give medical teams a more complete picture of a patient’s condition. Barry also traveled to AIDS clinics in Trinidad and Barbados to set up the PointCare system and train the local staff. “It was a great experience to get into the field, and to work with the patients and the physicians to get this technology into action,” she says.

During her time at PointCare, Barry continued her education and in 2007 she earned an MS in clinical investigation at the MGH Institute of Health Professions in Boston. She’s now applying that training, and her experience, to her current position as an in-vitro diagnostics clinical monitor specialist at Instrumentation Laboratory in Lexington, Mass. “I work with physicians in the United States and in Europe to identify clinical needs,” she says, “then try to bring new products to market to meet those needs in the area of blood clotting disorders.”

On any given week Barry may be working at a hospital site monitoring a clinical trial of a new diagnostic test, and then analyzing the data from that trial. Or, she may be back at the lab in Lexington working with the scientific team to refine their product development or to prepare for a submission to the FDA for approval of a new device. Other days, she’ll brainstorm with the company’s marketing team on how best to inform and educate the clinicians and technicians who will use the new products Instrumentation Laboratory is about to launch. “I like being one step from the lab bench, and one step from the patient,” Barry says, “managing projects so we can get them approved and into the clinic to help people.”

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Last modified: April 01, 2009 08:25:47