Exposing Cancer’s Weakness
Through his work with genetic mutations, Daniel Haber has discovered that cancer is sometimes more vulnerable than once imagined.
Denise Bosco for Proto
Daniel Haber is an oncologist and geneticist with a long-standing interest in genes implicated in breast cancer and Wilms’ tumor, a pediatric kidney cancer. But shortly after he became director of the MGH Cancer Center in 2003, he made a discovery that linked a genetic mutation to drug sensitivity in lung cancer, propelling the Cancer Center into the forefront of targeted therapies that exploit a cancer’s genetic vulnerabilities.
Q: How have targeted therapies changed the way you see cancer?
A: We all used to think most cancers were so complicated you couldn’t unravel their genetic programs. All you could do was poison them, irradiate them or cut them out. But now we know that some cancers are in fact dependent on just one overactive gene, an oncogene. We call this oncogene addiction. And you can sometimes send cancer into withdrawal by shutting down that gene. It’s a new paradigm.
Q: What’s the current standard for cancer care at MGH?
A: We screen each patient’s tumors for genetic markers that may tell us if the cancer will respond better to one drug than to another. If a cancer has a vulnerable mutation, we see if there’s a targeted therapy that matches that mutation. When there is a match, you can really stop cancer in its tracks.
Q: What will the future of cancer care be?
A: It will be crucial to monitor a patient throughout treatment much more actively. We will use noninvasive liquid biopsies—screening blood for tumor cells—at frequent intervals to verify whether treatment is working and to check for early warning signs that the cancer is mutating or turning on resistance genes. The minute we see that happening, we’ll use another drug to cut cancer off at the pass.
Q: What about surgery and radiation?
A: Let’s take breast cancer. Our surgeons are developing much less disfiguring techniques that also cause fewer complications, and our radiologists are pioneering shorter, more localized radiation treatments that are less harmful and a lot more convenient, because they don’t require patients to come back every day for weeks.
Q: It sounds like the Cancer Center is focusing on quality-of-life issues.
A: We’re keenly aware of the lifelong consequences of some treatments. We can save lives but leave patients with constant, sometimes painful reminders of their cancers. We’re making a lot of progress toward solutions.
Q: It’s still a reality that not every cancer is treatable.
A: We’re all working to change it, believe me. In the meantime, we provide palliative care in tandem with other treatments rather than instead of them. We’ve shown that earlier is better. Not only does early integration of palliative care improve quality of life, but it also helps patients live longer. That surprised even us, but it points to the importance of well-balanced care that is targeted to each patient.