Dr. Judah Folkman, Anti-angiogenesis Pioneer

[Lolly]

Dr. Folkman died Monday January 17, apparently of a heart attack. He was a medical pioneer; his concept of angiogenesis 30 years ago, and subsequent research to develop means to block this process resulted in the anti-angiogenesis drugs such as Avastin.
I didn't see this in the news this week, and just came across it while researching Avastin on-line, so thought I would let you all know.

Dr. Judah Folkman
http://www.cancer.org/aspx/blog/Comments.aspx?id=189

[Lani]

He was inspirational.

I asked three questions during one lecture and one question after a lecture and he was incredibly thoughtful in his answers.

When I last heard him speak last year, he was still operating as a pediatric surgeon, even at his age. Few knew he was a surgeon, but he said it was because of being a surgeon that he stuck to his guns when everyone poo-pooed his research, ridiculed him and refused to fund grants and publish papers. He KNEW from experience how much cancers would bleed when he tried to remove them and that gave him the wherewithall to stick it out--all the medical oncologists, radiation therapists, PhDs and especially pathologists had no clue about that very important feature of cancer because they didn't approach it in the same way and come in direct contact with it in its native state on a daily basis.

At his last lecture I got to meet his daughter and granddaughter who were in the audience. It was evident that his pride in them knew no bounds. His demeanor at all times was full of kindness and humanity.

I considered myself lucky to have seen this aspect of this absolutely remarkable human being and stubborn fighter against cancer on multiple fronts (in the operating room and the research lab).

His early death is a tragedy for us all.

[Lani]

He was truly inspirational.

I asked three questions during one lecture and one question after a lecture and he was incredibly thoughtful in his answers.

When I last heard him speak last year, he was still operating as a pediatric surgeon, even at his age. Few knew he was a surgeon, but he said it was because of being a surgeon that he stuck to his guns when everyone poo-pooed his research, ridiculed him and refused to fund grants and publish papers. He KNEW from experience how much cancers would bleed when he tried to remove them and that gave him the wherewithall to stick it out--all the medical oncologists, radiation therapists, PhDs and especially pathologists had no clue about that very important feature of cancer because they didn't approach it in the same way and come in direct contact with it in its native state on a daily basis.

At his last lecture I got to meet his daughter and granddaughter who were in the audience. It was evident that his pride in them knew no bounds. His demeanor at all times was full of kindness and humanity.

I considered myself lucky to have seen this aspect of this absolutely remarkable human being and stubborn fighter against cancer on multiple fronts (in the operating room and the research lab).

His early death is a tragedy for us all.

[Jean]

http://www.latimes.com/features/health/la-me-folkman18jan18,1,220964.story?coll=la-headlines-health&track=crosspromo

The above link is only 2 hrs. old...news re: his passing.

Jean

[Barbara H.]

His death is a huge loss to the field of cancer. A friend of mine had him for dinner a few weeks ago. He was driven in his research and as a physician. He would practice medicine and then do research well into the night. I was really saddened when I heard this news.
Thank you for posting this news.
Barbara H.

[gdpawel]

Truly sad news for a great researcher, scientist and physician. Nobody believed Folkman that the growth of cancers could be stopped, even reversed, by blocking the tiny vessels that feed them blood. Over the years, however, he had survived peer rejection of his theory and gone on to develop drugs that did what he predicted they would do. His ideas will be greatly missed.

There are some scientists that believe the realization of Dr. Folkman's brilliant dream of inhibition of angiogenesis is not sufficient to consistently control cancer. There are multiple ways by which tumors can evolve that are independent of angiogenesis. Tumors can acquire a blood supply by angiogenesis, but some say also by co-option of existing blood vessels, and vasculogenic mimicry. All must be inhibited to consistently starve tumors of oxygen.

Vascular co-option is the invasion of malignant cells along blood vessels. Instead of growing new blood vessels, tumor cells can just grow along existing blood vessels. This process cannot be stopped with drugs that inhibit new blood vessel formation. Vasculogeneic mimicry is where some types of cancers form channels that carry blood, but are not actual blood vessels. Drugs that target new blood vessel formation also cannot stop this process.

All three of these processes involve the use of normal cellular machinery to carry out proliferation and invasiveness. The consistent and specific control of cancer requires therapy that can target the set of all malignant cells that could evolve. It is critical that each drug be given at a dose sufficient to kill all cells that express the pattern targeted by the individual drug. That requires that all three mechanisms be addressed.

Folkman had stated that angiogenesis inhibitors will not be the cure for cancer but that they will make cancer more survivable and controllable, especially in conjunction with other treatments. These new targeted drugs mostly need to be combined with active chemotherapy to provide any benefit and the need for predictive tests allowing for a rational and economical use of them for individualized therapy selection has increased.

Look at what researchers did with Folkman's discovery of endostatin. When is was first discovered, doctors hoped its tumor-fighting properties would lead to a cure for cancer. But clinical trials had been disappointing, possibly because most clinicans had injected the hormone directly into patients, where the hormone broke down in the body before it had a chance to slow the spread of cancer.

I can understand the disbelief that endostatin clinical trials had been disappointing. But researchers like Dr. Veena Antony, at the University of Florida, rethought the situation by understanding that talc had the ability to stunt cancer growth by cutting the flow of blood to metastatic lung tumors. Her study, published in the Europen Respiratory Journal, reveals that by allowing talc in the chest cavity, it causes normal cell to produce 10-fold higher levels of endostatin, a hormone released by healthy lung cells, and inhibiting the growth of tumors.

Thanks to scientists like Folkman and Antony, who took the time to think through "whiz bang" science that often gets a pass without much thought. The problem is that few scientific discoveries work the way we think and few physicians/scientists take the time to think through what it is they've discovered.

Dr. Antony is still having a hard time getting funding for the research. It is hard to get the NCI to think outside the box. However, here and there around the world, there are decisions still being made by folks who aren't in the pockets of American Big Business. Individual intelligence, integrity and curiosity.