|«I try to transfer my research findings and knowledge to patients». Josep Maria Llovet describes his job in these words. He is one of the main world experts in liver cancer. «I have one foot on each side», as the different jobs he carries out prove: ICREA (Catalan Institution for Research and Advanced Studies) research professor in the August Pi i Sunyer Biomedical Research Institute (IDIBAPS), which is part of the Clinical Hospital of Barcelona, full professor of Medicine and director of the Liver Cancer Program in the Mount Sinai School of Medicine in New York, and president of the International Liver Cancer Association (ILCA).
We met at the CCCB (Centre for Contemporary Culture of Barcelona), where professor Llovet is the first guest of a conference cycle to raise awareness on ICREA grants research. Llovet uses knowledge coming from molecular biology in his descent into the hell that is cancer. Carcinogenic cells have lost track of the baton that guided their harmonic dance of birth, growth and death. Mutations that alter this regulation –such as the ones related to apoptosis or cell suicide– relate to a wide variety of cancers. Identifying these mutations and turning them into therapeutic targets is one of the goals of his research. In his conference, Llovet highlights the variety of molecular alterations that are being identified, and how it inevitably boosts development of customized treatment for every cancer sub-type. Each new drug focuses in a very particular type of cancer affecting a small percentage of cases. Effectiveness depends precisely on achieving, slowly but surely, this degree of definition towards the disease.
Should cancer be understood as one illness, or more as an umbrella term encompassing a great range of illnesses?
And thanks to that classification we can think of more specific and effective treatment?
Which were your main contributions to liver cancer research up until now?
Your active collaboration with the pharmaceutical industry in the creation of drugs is also noteworthy.
How is a new drug developed?
«The way it is, the industry is absolutely necessary for the discovery, development and approval of new drugs»
«I try to transfer my research findings and knowledge to patients»
|And how is this process financed?
In the clinical stage, there are the first phases –1 and 2– and phase 3 –the main study it needs to be approved– and between 700 and 1,500 patients are included in it. There is no public institution able to fund that. Trials done in North-American public networks are loss making, and it is very difficult for them to fulfil the task. Only the industry has the capacity and resources to carry out phase 3. Many study centres can design new drugs, and make pre-clinical studies or the early phases. There are also small industries called biotech that, after discovering a new drug, can carry out phases 1 and 2. When we get to the advanced phases of clinical studies the cost is so high that the inventors of the molecule have to sell the patent. The industry is interested in buying and developing it themselves. The way it is, the industry is absolutely necessary for the discovery, development and approval of new drugs.
You explained in your conference that liver cancer is a poor country disease. Does that affect research?
Many alternative therapies appeared around cancer. What is your opinion on them?
You explain in your talks how genetic incidence of cancer is very low, around 5%, and the fact that the illness is more related to lifestyle.
You also talked about virus and bacteria causing cancer.
There are opportunists such as the nun and doctor Teresa Forcades, very publicised in the Catalan television channel TV3, who became very famous, among other things, for not getting the vaccine for the human papilloma virus.
1. First and –up until now– only drug to treat liver cancer. A great investment–made by Bayer– and more than five years of research led by Josep Maria Llovet and Jordi Broix from the Clinical Hospital in Barcelona, in collaboration with Mount Sinai School and more than 120 centres around the world, were necessary. Sorafenib acts blocking the proliferation of tumour cells and prevents new blood vessels from being formed. (Go back)
«Liver cancer is a poor country disease, like China, Mongolia, Central African Republic, Uganda and South Africa. Prevalence there is astonishing»
© Mètode 2013 - 79. Online only. Pathfinders in Science - Autumn 2013