ELAINE LAM, MD, ISN’T WASTING TIME WAITING FOR THE RIGHT DRUGS FOR HER PATIENTS. INSTEAD, SHE’S EXPANDING PRECISION MEDICINE, MATCHING INDIVIDUAL GENES TO TARGETED THERAPIES.
University of Colorado Cancer Center investigator Elaine Lam, MD, is on a mission to make personalized medicine a reality. Though Lam realizes there are still many advances to be made, she works toward finding the mechanisms that drive cancer and matching them to targeted drugs.
Colorado has been home to Lam for much of her life. Growing up in Littleton, she attended Heritage High School and then went on to receive a bachelor of arts in biochemistry at the University of Colorado Boulder and a bachelor of science in pharmacy at the University of Colorado Health Sciences Center, as it was then known. Fresh out of school, Lam became a clinical pharmacist but quickly realized she longed for patient interaction.
“I loved my work as a clinical pharmacist, but always felt that something was missing. I wanted to have more patient contact and be directly involved in the care of patients,” Lam says. “I decided that going back to [medical] school was the way to make that happen.”
Her Colorado roots continued. Lam landed at the CU School of Medicine for medical school and completed her residency in internal medi¬cine, serving as chief medical resident. During her residency, she became interested in treating patients with cancer and developing new cancer drugs while working under S. Gail Eckhardt, MD, CU Cancer Center investigator and director of the Phase I Clinical Trial Program. Lam later went on to complete a fellowship in hematology and medical oncology at The Ohio State University, but in 2010 decided Colorado was truly home.
“I received excellent training at OSU, but wanted to return to Colorado after fellowship,” Lam says. “When an opportunity arose to return to the University of Colorado to become a part of the Phase I and Urologic Oncology teams, I jumped at the chance to work with Gail again and become a part of our growing Cancer Center.”
Medical oncologists at academic institutions like the University of Colorado often choose only one type of cancer to treat and research. Lam chose genitourinary oncology so she could treat a variety of cancers, including prostate, bladder, testes and kidney. Additionally, drug development for these cancers has rapidly expanded in the past decade, which perfectly matched her background in pharmacy.
Traditionally, chemotherapy treatment options depend mainly on a patient’s cancer type. But that’s not good enough. Lam believestreatment types need to depend on the genetic mutation each patient has—the basis of precision medicine.
“We can do better and need to do better,” says Lam. “The examples of erlotinib and crizotinib in lung cancer and vemurafenib for melanoma have taught us that certain genetic changes and muta-tions in cancer cells may be predictive of whether a specific treatment will work. By targeting the genetic drivers within a patient’s cancer cells, we could potentially treat the cancer more effectively with fewer side effects.”
Recently Lam launched a new clinical trial at CU Cancer Center in which patients with very advanced cancer may undergo a biopsy to determine the genetic characteristics of their tumors using a panel of 200 cancer genes. While this will provide a plethora of information, Lam says the questions will become more complex from there.
Which gene is the main driver of the cancer? Can they reliably validate the findings? If a mutation is identified, are there drugs available to the patients either through clinical trials or through drugs already approved for other cancer conditions? Will insurance companies pay for these drugs? Will our hypothesis of one gene, one drug pan out across a variety of cancers?
While the questions are indeed complex, Lam works tirelessly to discover the answers. But she has help.
In collaboration with colleagues in the CU School of Medicine and Cancer Center, Lam is able to gain valuable expertise in molecular pathology, bioinformatics, genomic sequencing, interventional radiology and clinical investigations. And donors like Cancer League of Colorado and Mr. and Mrs. Monty Rifkin are generously supporting the effort to move this research forward.
“There is a great urgency for cancer researchers to find more personalized approaches to treat¬ing cancer so that patients don’t waste time and resources on therapies that aren’t likely to work,” Lam says. “Now more than ever, we have a chance to make precision medicine a reality.”