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Flores finds oncology a bridge between basic and clinical research

“For a long time, I think we’ve tended to treat these two spaces separately, the basic science space and then the clinical space,” said John Paul Flores, MD, fellow at the Tufts University School of Medicine. Keenly aware of the relationship between patient care and basic science, Flores found in oncology a profound union of these two disciplines; a union that drew him to the field and informs his innovative work.

“I went into medical school, I started treating patients, and I realized I liked more of the patient-treating aspects than the basic science aspects. I also realized that, in lots of medicine, we didn’t really use any of that basic science that I had learned and that had attracted me to the field in the first place. But then, through internal medicine, I realized that oncology is actually a good combination of all of those interests. Part of it is patient care, and there is a huge responsibility when it comes to treating cancer patients; it is something that changes a patient’s life entirely. And at the same time, there is constant research and innovation going on. Any understanding of that requires a good appreciation of the basic sciences. So, it was a good mix of my two interests: basic science and treating patients.”

This past December, Flores was honored as a recipient of the Danny Danielson Translational Innovation Award. In 2013, Donald C. “Danny” Danielson established the award, granted by the Walther Cancer Foundation.

The award is given twice each year to investigators working in partnership with Hoosier Cancer Research Network to support the correlative components of clinical trial protocols when financial support is not otherwise available. The correlatives under investigation must have a future clinical application, such as development of new treatment strategies or identification of patient subsets for specific treatment therapies, and/or provide hypotheses for future clinical trials.

“It is an incredible honor, and it was something that took me totally by surprise,” Flores said of the award. “I think it’s going to be greatly helpful in doing exactly what the award was designed to do.”

Currently, Flores is seeking to learn what effect adding a poly (ADP-ribose) polymerase (PARP) inhibitor will have when combined with standard anti-androgen therapy in the treatment of metastatic castrate-resistant prostate cancer. The study, known as GU14-202, is designed to assess the safety and toxicity of an investigational drug called niraparib when given in combination with the FDA-approved anti-androgen drug called enzalutamide. “We had a concept about targeting the androgen receptor with the two drugs in the trial, and we had everything basically designed on that.”

However, when new developments arose during trial design, Flores seized the opportunity to leverage the new information. “Towards the end of the design of the trial, some data came out about a different inhibitor and how you could potentially predict response based on some tumor DNA repair characteristics. This was exciting because we had a similar drug dose being used in this trial in a similar population, and what we didn’t quite have was a means of testing this DNA repair phenotype. So, we’re going to bank some of the blood samples from patients, and as more data comes out and we know what exactly to target, we’re hoping to use this funding to help test the banked samples that we have for this DNA repair phenotype and come up with a predictive or at least prognostic biomarker that would be useful for patients.”

The GU14-202 study recently opened to accrual at Tufts Medical Center.

Flores notes the advantages of innovating in collaboration with HCRN. “The HCRN research team has been excellent in helping with the design of the trial as well as figuring out logistics. It is not just different universities and different sites; with a trial like this, it is the drug companies, the pharmaceutical companies, and then we have several collaborative lab vendors that are working with us as well,” Flores said. “Being able to coordinate, not just different sites, but also different companies with different roles, is something that HCRN has been immensely helpful with through this whole process.”

About Hoosier Cancer Research Network:

Hoosier Cancer Research Network (formerly known as Hoosier Oncology Group) conducts innovative cancer research in collaboration with academic and community physicians and scientists across the United States. The organization provides comprehensive clinical trial management and support, from conception through publication. Created in 1984 as a program of the Walther Cancer Institute, Hoosier Cancer Research Network became an independent nonprofit clinical research organization in 2007. Since its founding, Hoosier Cancer Research Network has initiated more than 150 trials in a variety of cancer types and supportive care, resulting in more than 300 publications. More than 4,600 subjects have participated in Hoosier Cancer Research Network clinical trials.