The Cancer Questions Project, Part 24: Antonio “Tito” Fojo

Dr. Antonio “Tito” Fojo specializes in the management of patients with adrenocortical cancer, malignant pheochromocytoma, neuroendocrine malignancies, and thyroid cancer; his current laboratory efforts are focused on developing therapies to treat such patients. Dr. Fojo has worked to understand the molecular basis of drug resistance, he was involved in the original work relating to several ABC transporters and identified rearrangements involving the MDR-1 gene as a novel mechanism of drug resistance in several cancers. He has also been very involved in research on microtubule-targeting agents. In addition to his clinical expertise Dr. Fojo is involved in the design, conduct and interpretation of oncology clinical trials and his collaboration have helped to pioneer a novel method of analysis that dissects rates of tumor growth and regression as concurrent events.

Azra Raza, author of 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?