Dr. Manish A. Shah: New Recruit From MSKCC
A New Era in GI Cancers
Sept. 22, 2011
Perhaps not widely known, GI malignancies are the most common cancers in the U.S. and the world, including colon, esophagus, gastric, pancreas, and liver. Combined, they are double the incidence of lung, breast and prostate. “We are at the tip of the iceberg in terms of a new personalized approach to patient care,” says Dr. Shah.
Spurred by a new era in gene sequencing during the early 1990s, as well as “realizing the power of molecular biology” while in medical school, Dr. Shah has pursued a career in Medical Oncology with a primary focus on clinical translational medicine in GI Oncology that melds his research experience at the bench with patient care. “We're entering a new era of personalized medicine where individuals will have very specific mutations identified which may direct our treatment approach for that particular individual. However, we're only at the tip of the iceberg. This is where the future of GI is going,” explains Dr. Shah. In a recent paper published in Clinical Cancer Research, Dr. Shah and colleague(s) proposed a new concept to individualize stomach cancer. “We proposed the concept that stomach cancer is not just one cancer, but actually three different types of cancer.” (Shah et al, Clin Cancer Research 2011;17(9):2693-701).
Regarding different types of stomach cancer, Dr Shah explains that “If you look under the microscope, you will see that some cancers have a very unique growth pattern. Some may grow as a diffuse sheet of cells. Some may grow as a tumor mass.” In the Clinical Cancer Research paper, Dr. Shah demonstrated in a test set that the molecular profiles of different types of stomach cancer were also different, supporting his clinical observations. Dr. Shah continues, “Stomach cancer is a very heterogeneous disease, and the same can be said for colon cancer, especially when examining colon cancer metastases. Some people will have these cancers limited to one organ, while some will spread beyond a single organ. We need to understand these differences better.”
Using a molecular analysis based on their own understanding of the epidemiological process, Dr. Shah believes the concept—that stomach cancer is “not just one cancer”—will ultimately be proven. This innovative work is leading to more than targeting drugs, he explains. “Understanding the epidemiology and biology of GI cancers will allow us to design how aggressive we can be with treatment. We can weigh chemotherapy versus surgery and be able to tailor treatment to the individual patient. It will be much more than drugs, but involving an individualized treatment algorithm.”
Newly recruited to the Division of Gastroenterology and Hepatology, Dr. Shah serves as Director of the Gastrointestinal Oncology Program. Working on a multidisciplinary basis with other divisions and departments, he is set to fully realize “the concept of personalized medicine in GI cancers on both the personal level and from a programmatic standpoint for the treatment of patients.”
Dr. Manish A. Shah is a graduate of biomedical engineering, Johns Hopkins University, and received his M.D. from Harvard Medical School, Health Sciences and Technology.
For Dr. Shah's biography and more information please click here.