Gastrointestinal Cancer Research Abounds in Washington, DC

George P. Kim, MD

Since relocating to Washington, DC, George P. Kim, MD has taken over the Gastrointestinal Cancer Group at George Washington University Cancer Center, within which active areas of investigation include genomic disparities between African Americans with hepatocellular carcinoma (HCC), the incidence of HIV-associated cancer, and chimeric antigen receptor (CAR) T-cell therapy in solid tumors.

For example, investigators are evaluating the clinical and molecular characteristics of African-American patients with HCC to determine whether core differences exist between ethnic groups that may require more individualized treatment approaches. For this opportunity for personalized medicine to become a reality would be very gratifying, explained Kim, especially now that there are 6 FDA-approved agents in the field.

Moreover, investigators are recommending more patients with HIV-associated cancers for clinical trials with immunotherapy combinations to assess the safety and curative potential of those strategies. Given the high incidence of HIV-associated cancers in Washington, DC, Kim also called for better screening standardization to better identify individuals who are at greatest risk.

Finally, research with CAR T cells designed to target solid tumors is beginning to gain traction in the field. Soon, George Washington University, in partnership with the Children’s National Main Hospital, will open its first clinical trial of CAR T-cell therapy for patients with solid tumors.

“Certainly, it would be tremendous if the work that's done here can go back and affect larger populations on a global scale,” said Kim. Although, much of this work is preliminary, he added.

OncLive^®: What research are you currently working on in the gastrointestinal (GI) cancers space?

In an interview during the 2019 OncLive^® State of the Science Summit™ on Gastrointestinal Cancers, Kim, director, Gastrointestinal Oncology Section, George Washington University Cancer Center, associate professor of medicine, George Washington University Medical Faculty Associates, discussed these areas of active investigation in the Washington, DC, area.Kim: I've recently relocated back to Washington, DC, which is my home, and I am heading the Gastrointestinal Cancer Group at George Washington University Cancer Center. Washington, DC, is a very unique area to practice. I'm learning a lot about the different patients that we have. One of the areas that we have excellent research in is HCC. There are certain populations here, in the city, [of people who come] from different parts of the world. This is a major center, so we see many African immigrants who develop cancer.

What other populations do you see here in Washington DC?

We are looking at those individuals and their cancers on a clinical and molecular level to try to understand how [their cancers may] differ or are similar to those that we see here in the United States. We are also looking at how that translates into treatment [approaches], especially with all of the new treatments that have emerged in HCC. That's very exciting.Unfortunately, we see a lot of patients with HIV disease here in Washington, DC. We treat a lot of those types of malignancies, certainly the hematologic malignancies. We're also seeing a lot of anal cancer. The good news is that we're seeing them early. We want to participate in trials that are using combined modality therapy that are adding on checkpoint inhibitors or immunotherapies to determine whether it's safe and whether it helps in curing more of these individuals. We also need to do a better job of screening and finding out who is at risk in this general population.

Are there notable differences in the genomics of African-American patients with HCC compared with those patients of another ethnicity?

As an attendee of the State of the Science Summit™, how can programs like this further research in the field?

The other area of research is with CAR T-cell therapy. We will have a trial open in the very near future that is targeting solid tumors. In particular, we're looking at this [approach] in [patients with] esophageal carcinoma, so that's very exciting. This research is being conducted in conjunction with individuals at the Children’s National Main Hospital here in Washington, DC. Finally, we are in the nation's capital. We are in a very political atmosphere, so we want to look at the health economics of what we're prescribing, especially in regard to molecular markers and how that may be a more cost-efficient way to define more tailored treatments for patients.It's a great question, and we are just in the beginning of that research. I would imagine there are, although the causality is still hepatitis B and C. It'll be interesting to see if there are other environmental factors in particular and whether we can target them.This event in Washington, DC is led by John Marshall, MD, out of Georgetown University. He's been very inclusive of inviting speakers from Johns Hopkins University, the University of Maryland, and Inova, which is in Northern Virginia. This allows us all to get together and talk about research being done in the Washington, DC. region. We see different populations of patients, and we want to complement one another in terms of the research that we do and the types of GI cancers that we see. OncLive does a wonderful job of getting that information out. We certainly want to educate ourselves, but also practicing oncologists who are so busy. This is a very good program with some great speakers from all the major cancer centers in this region. It’s a very good opportunity [to share our knowledge and our work].