An NCI-designated Comprehensive Cancer Center
By Maxine Nunes | September 19, 2019
Ajay Goel Ajay Goel, Ph.D., M.S.
Dynamic and passionate — with a formidable track record of innovations in cancer care — Ajay Goel , Ph.D., M.S., has recently joined the staff at City of Hope, and he’s hit the ground running.
 
He is founding chair of the new department of Molecular Diagnostics and Experimental Therapeutics and founding director of Biotech Innovations at Beckman Research Institute of City of Hope.
 
Goel’s research is currently focused on the early detection of colon, pancreatic, ovarian and digestive tract cancers, as well as on precision cancer therapy — and there are some exciting breakthroughs on the horizon.

A BLOOD TEST FOR COLON CANCER

One of Goel’s top research projects is a blood test for colon cancer funded by the National Cancer Institute, and it’s well on its way to becoming a reality.
 
We lose a lot of people to colon cancer, mostly because the disease is diagnosed late,” he said. “But if you can detect high-risk polyps or an early-stage cancer and remove it, then you have virtually a 100% chance to cure that cancer.”
 
The blood test he is developing will revolutionize the way patients are currently screened. Its biomarkers are genetic regulators known as small RNAs, and the test can become a simple and affordable part of everyone’s annual health physical.
 
“Just as we go to a doctor each year to check for diabetes or cholesterol, we'll be able to look at markers for colon cancer,” he said. “And that will be beautiful because not only can we do it affordably, but we can save a lot of lives without exposing people to invasive colonoscopy and all that it involves.”
 
An initial agreement has already been reached with a biotech company, which will independently confirm the test’s efficacy. The process is expected to take about two years.

Finding PANCREATIC, OVARIAN CANCER Early

Research into a blood test for pancreatic cancer is also underway. The study is a cooperative effort involving City of Hope, its affiliate TGen and their physician-in-chief Daniel von Hoff, M.D., along with six other major research institutions in the U.S., Japan and South Korea. It is one of eight projects funded by the NCI’s distinguished Pancreatic Cancer Detection Consortium.
 
“This is a very aggressive cancer and absolutely notorious when it comes to survival,” Goel said. “With current methods of detection, by the time a patient is diagnosed with pancreatic cancer, they generally don’t live more than a few months or a year or two — but if we can find it early on, these people can live a much longer time.”
 
The other challenge, he added, is that in more than 80% of patients diagnosed with pancreatic cancer, the disease is so advanced it is inoperable. Earlier detection could make surgery, and better outcomes, possible.
 
The blood test will be based on biomarkers that use extracellular vesicles (EVs). These are microscopic organelles that are released into the bloodstream by tumors and carry the tumor’s signature. EVs may help us detect cancer as much as seven years earlier than is now possible.
 
“It’s very exciting, because what has made detection difficult with imaging-based methods, such as CT and MRI, is that the pancreas is a very small organ tucked deep inside the abdomen,” he said. “But these tiny vesicles are constantly being released by pancreatic cells, so as we continue to refine these markers, we can hopefully develop a blood test for the early detection of pancreatic cancer.”
 
These markers will be studied in approximately 500 patients over the next three to four years.
 
Research on a similar blood-based test using EVs to screen for ovarian cancer has progressed even further, and the test is currently in the validation phase.
 
“Just like pancreatic cancer, ovarian cancer is diagnosed at late stages,” he said. “Now we have a panel of markers, and I’ll be working with our City of Hope investigators to complete the investigation.”

PERSONALIZED THERAPEUTICS

One of the more frustrating aspects of cancer therapy is that treatments, especially targeted therapies, don’t work for many patients — and the reasons are often unclear. To find answers to this problem, Goel is using leading-edge technologies to provide deeper insight into each individual case.
 
“I do a lot of work on precision oncology, where we can look at the complete genomic sequencing of a patient’s tumor tissues,” he said. “This profile can help their oncologist understand what kind of targeted treatment or what kind of chemotherapy will work best, based upon each person’s unique genetic makeup — a significant step forward in personalized therapeutics.”

TECHNOLOGY AND … TURMERIC?

Goel was born in India, received his Ph.D. in biophysics from Punjab University and completed his postgraduate work at University of California San Diego.
 
“Growing up in India, you look at the U.S. as the poster child of perfection — the best minds, the best health care, the best technology,” he said. “But it was always baffling to me that this country also has a huge epidemic of many diseases, including cancer.”
 
India, he explained, has eight to 10 times less colon cancer, several times less breast cancer and Alzheimer’s disease is almost unheard of.
 
“I realized very early on that it’s not about genetics, it’s about diet and lifestyle,” he said. “And as crucial as early detection is, it’s secondary to prevention.”
 
The Indian diet is rich in herbs and spices that have been known for their medical benefits for thousands of years, he said. They’re part of a wellness system called ayurveda, one of the oldest in the world, and recent scientific evidence is demonstrating its validity. Goel mentioned one of those spices in particular, turmeric. It contains the active principle curcumin, a proven anti-inflammatory that may be useful in preventing cancer and several other diseases.
 
Breakthrough medical technologies, however, remain his primary interest. He has authored more than 300 articles published in peer-reviewed international journals and holds more than 30 advanced genomic and transcriptomic international patents. He comes to City of Hope after a noteworthy 16-year career at Baylor Scott & White Research Institute in Texas.
 
“City of Hope has a wonderful track record of moving discoveries from bench to clinic. There’s probably nowhere else on the planet that can do it faster,” he said. “And by founding this new department, which will add a layer of earlier noninvasive diagnostics, we will hopefully make a difference in this war on cancer.”
 
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