← Becker’s Healthcare Podcast
Becker’s Healthcare Podcast
Dhruv Bansal, MD, MBA, Director of Immunotherapy, Precision and Thoracic Oncology at Endeavor Health
00:11:59
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- [00:02]
A
This is where healthcare leadership comes together. Becker's 16th annual meeting brings more than 3,500 hospital and health system executives and nearly 800 speakers to Chicago, April 13th through the 16th. This year's event includes keynote conversations with Dallas Cowboys legend Troy Aikman and former President George W. Bush. For the agenda and event details, visit Beckershospitalreview.com and click on the Events tab in the upper right. We're looking forward to hosting you in Chicago.
- [00:33]
B
This is Laura Dardo with the Beckers Healthcare Podcast. I'm thrilled today to be joined by Dr. Drew Bansal, who's the director of immunotherapy, precision and Thoracic Oncology at Endeavor Health. Dr. Bansle, it's a pleasure to have you on the podcast today.
- [00:45]
C
Thank you, Laura. Thanks for having me.
- [00:47]
B
Absolutely. Now, I know we've got a lot of ground to cover today. I'm really excited for our conversation, especially looking into some of the cool things that are happening in immunotherapy, oncology, and more. But before we dive in, can you tell us a little bit more about your back background of research? What are some of the questions that are at the heart of your research right now, and what are you most excited about investigating?
- [01:08]
C
Yeah, so my role at Endeavor Health is I'm the director of immunotherapy, as you just said, and I lead the precision and thoracic oncology programs too. So it's a pretty broad role, but my research currently is focused on immunotherapeutics and precision oncology, which pretty much encompasses all the new cancer treatments that we have recently. And we are attempting to find biomarkers which reveal which patients do better with immunotherapy versus not. Because that's one of the key questions that everybody wants to answer right now. Why is it that some patients with stage 4 lung cancer, for an example, live 10, 4, 10 plus years? And to give some background about even like 10 years ago, patients with stage 4 lung cancer were the survival was less, less than a year. So now I commonly have a patient in my clinic who is 5, 10 years out from lung cancer diagnosis. Stage 4 lung cancer diagnosis is in remission. So we are trying to find why are some patients doing so much better than others and what are the reasons behind it. So that's like a big picture overview of what my research focuses on.
- [02:33]
B
Wow, that's fascinating to hear. A really important thing to be thinking about and figuring out because I can imagine it would really be impactful for patients and so many families if you have a longer survival right there. Can you share a moment when precision medicine has fundamentally changed the course of care for patients or reshaped how your team thinks about cancer?
- [02:54]
C
Yeah, precision medicine has become like a foundational tool for oncology. It all started in 2003 when the first precision targeted treatment was approved, which is Gefitinib for third line treatment of EGFR mutated non small cell lung cancer. And since then there have been a number of approvals since then. So on, on an average day, like we are using targeted treatments on most of the patients that I'm seeing in the lung cancer clinic. So fundamentally it's completely changed how we treat these patients. In the past we had only chemotherapy. I think of chemotherapy more like a sledgehammer. You kind of hit the cancer hard, but it also affects the normal organs. Now we have these precise treatments that target the cancer. Mostly the cancer have much fewer side effects compared to chemotherapy for the rest of the body and they are much more effective. So you're getting the benefit of a more effective treatment with less side effects. So I mean, that's a win win. It's like way better than chemotherapy.
- [04:08]
B
Absolutely. That's amazing to hear and it's really cool that your research in the evolving space of therapy and cancer care has gotten us to a place where there are opportunities and other altern alternatives. I'm curious, you know, when you talk about your research and you look at how it translates into your day to day practice, how do you bridge that gap between some of the genomic discoveries and then the real world treatment decisions for patients?
- [04:39]
C
That's a good question. So the short answer is a lot of reading. Like I just have to constantly keep on top of it. I have to read, go to the important conferences, there are plenty of good conferences. And stay up to date on all the literature. I have to make sure I read all the important journals, interact with my peers who are at the cutting edge of this, and also conduct my own research, which also helps me stay up to date, which is a challenge in today's environment. So the good thing is the pace of discoveries is so fast that patients have new treatment options like nearly every month now. So it just involves like a lot of work to go to the right meetings, read the right material, to stay on top of all this.
- [05:33]
B
Absolutely. I can imagine it's constantly trying to catch up with everything in really truly important aspect of the things you're doing every single day. Now I know data is a huge part of precision medicine. Can you tell me a little Bit about what's the most exciting part, about what data capabilities you have today and what promise you see and how it can be used to treat patients in the future?
- [05:56]
C
Yes. So the data. So the healthcare systems are getting a lot of data and it's very important to know what to do with the data. And we have a very robust molecular tumor board once, where we meet once a week and we go over all the important patient data and make sure that these patients are getting the appropriate treatment recommendations. The molecular tumor board includes me, another medical oncologist, a molecular pathologist, pharmacists, and we work as a team to make sure these patients are based on the available data from the genomic testing, are getting the right treatments.
- [06:41]
B
Got it. That makes so much sense and really, really exciting to hear about. Now, can you talk about some of the collaboration you've done between clinicians, data scientists and researchers, and how that's opened doors to new treatments that didn't exist even a few years ago?
- [06:57]
C
Yeah, so some of the projects I've done, we have collaborated with some other companies where we use our clinical data and the genomic data that's available and we test out. So we have, we have the information on which patients are doing better versus not. And we try. And so for one of the projects, we ran some AI algorithms to see what are the markers in the transcriptome of those patients to see why they are doing better. And we were able to tell, pretty much divide up the patients in four different buckets, roughly 25% each, where the 25% of the patients did great on immunotherapies. Then there was a bottom 25% that did not. And we were able to tell from their genetic makeup of their cancers why that is. So just to step back a bit, transcriptome analysis is RNA sequencing. And that's like, about a decade ago, we were focusing on DNA sequencing, and now we are moving more and more towards RNA sequencing and transcriptomic analysis. And my research, the recent research that we have published has focused more on that and which seems to be more accurate in predicting which patients tend to do better on immunotherapies.
- [08:28]
B
That's fascinating to hear about and definitely helpful and cool to see behind the scenes a little bit on some of the work that you're doing and how it's evolved over the last couple of years. I'm curious, what are some of the breakthroughs that you think will redefine cancer in the next two to three years or even five years out, if you can look that far out, and why.
- [08:47]
C
Yeah, so I mean, it's a very exciting field. And honestly, now I can honestly look a person in the eye and say, I do think in the next 10 years, a lot of the cancers would be cured or curable. The pace at which discovery is happening, this seems like a reality now. The treatments, it's tough to name a few. There's so many exciting discoveries. Cellular therapies are big, which is the next step for immune therapies where we tie together body's infection fighting cells, they are called T lymphocytes. To either we attach them to a target on the cancer cell. For example, in small cell lung cancer, there's a target called DLL3. And we. So we. So this sounds like science fiction, but it's happening every day in clinic. We give them a molecule where it targets the DLL3 on the cancer cell of which is on most small cell lung cancers. And the other end binds to the T lymphocytes in the patient. Small cell lung cancer, which historically has had a very poor prognosis, now a lot of patients are long term survivors on this drug and this treatment got approved two years ago. These treatments, which would include antibody drug conjugates, bispecific T cell engagers, CAR T cells, they're broadly called cellular therapies and I do believe they would be the next frontier in the next two, three years. A lot of treatments, a lot of patients would do great on these treatments. So that's one. And then vaccines are the other big thing. Since the COVID era, the vaccines have improved so much. The MRNA vaccines are improving a lot. And we are seeing some possible therapeutic implications in cancer where a patient would come. They are all in clinical trials right now. They're not approved yet. But we can see in the near future how vaccines would play a big role in cancer treatment, maybe prevention. But I think that's a little further out, definitely in treatment that vaccines are coming in a big way.
- [11:03]
B
That's amazing here and really interesting stuff and some cool things that are happening, whether through some of the technology, some of the collaboration, artificial intelligence in data management and more. Seems like a lot to be excited about for the future of oncology immunology. Thank you so much, Dr. Banzel, for joining us on the podcast today. This has been a really fun and informative conversation and I look forward to connecting with you again soon.
- [11:24]
C
All right, thank you.