The Cancer Questions Project, Part 5: Mohandas Narla

Mohandas Narla, D.Sc. is Vice President for Research of New York Blood Center and has authored 340 peer-reviewed publications and 100 review articles and book chapters. His research focuses on red cell physiology and pathology; helping improve understanding of the molecular and structural basis for red cell membrane disorders, developing mechanistic insights into pathophysiology of thalassemias and sickle cell anemia, characterizing structural and functional changes induced in red cells by the malarial parasite, plasmodium falciparum and understanding of erythropoiesis particularly on disordered erythropoiesis in Diamond-Blackfan Anemia and Myelodysplasia. Dr. Narla has been a member of numerous NIH review and advisory panels for the last 30 years and is currently on the editorial boards of numerous journals including Journal of Biological Chemistry, Biochemistry, and Current Opinion in Hematology.

Azra Raza, author of the forthcoming book The First Cell: And the Human Costs of Pursuing Cancer to the Last, oncologist and professor of medicine at Columbia University, and 3QD editor, decided to speak to more than 20 leading cancer investigators and ask each of them the same five questions listed below. She videotaped the interviews and over the next months we will be posting them here one at a time each Monday. Please keep in mind that Azra and the rest of us at 3QD neither endorse nor oppose any of the answers given by the researchers as part of this project. Their views are their own. One can browse all previous interviews here.

1. We were treating acute myeloid leukemia (AML) with 7+3 (7 days of the drug cytosine arabinoside and 3 days of daunomycin) in 1977. We are still doing the same in 2019. What is the best way forward to change it by 2028?

2. There are 3.5 million papers on cancer, 135,000 in 2017 alone. There is a staggering disconnect between great scientific insights and translation to improved therapy. What are we doing wrong?

3. The fact that children respond to the same treatment better than adults seems to suggest that the cancer biology is different and also that the host is different. Since most cancers increase with age, even having good therapy may not matter as the host is decrepit. Solution?

4. You have great knowledge and experience in the field. If you were given limitless resources to plan a cure for cancer, what will you do?

5. Offering patients with advanced stage non-curable cancer, palliative but toxic treatments is a service or disservice in the current therapeutic landscape?