Passion for patient care promotes rigor in research

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The summer of 2008, the first in Birmingham for Boris Pasche, M.D., Ph.D., was relatively mild for the region. Still, it was a good 20 degrees warmer than Chicago, where he had been an associate professor at Northwestern University, and about 40 degrees warmer than his native Switzerland. In this climate he is a research physician — the director of Hematology & Oncology for the UAB Comprehensive Cancer Center and associate director for Translational Research.

Boris Pasche is the director of Hematology & Oncology for the UAB Comprehensive Cancer Center and associate director for Translational Research.
Born and raised in Lausanne, the southwestern, French-speaking area of Switzerland, Dr. Pasche entered medical school in the shadow of the Savoy Alps. An exchange program brought him to the Karolinska Institute in Stockholm, Sweden, where he earned his doctorate degrees and discovered a passion for research.

However, Pasche says, the European medical system is not designed to accommodate doctors who aspire to be both physicians and researchers. “What attracted me to the United States was that I could be a clinician-scientist. This path not only is encouraged but really is considered to be the golden path.”

That desire led him to postdoctoral training at Harvard University, a residency at Cornell Medical Center and a fellowship at New York’s Memorial Sloan-Kettering Cancer Center. “I wanted to see patients and be able to translate discovery into intervention that would ultimately benefit those patients,” he says.

Tailored Therapies
During his fellowship, Pasche began exploring cancer genetics and discovered a mutation that was a tumor-susceptibility gene. He realized that if genes involved in cancers can be identified, then early detection and treatment could be improved.

Pasche says that genetic components can be found in every kind of tumor, which means cancer genetics research has applications throughout the field of oncology. He predicts that those genetic components will lead to the advent of personalized medicine — gene-specific treatments that target cancer with the greatest possible accuracy.

“With the dramatically improved techniques we have to look at genes,” he says, “it is likely that you’ll be able to sequence the entire genome for an individual for less than $1,000 within the foreseeable future.”

Oncologists already know that some features of a breast or colon tumor may predict how well a patient will react to various types of chemotherapy or biological therapy. “We’re probably going to move from a standard therapy for all breast or colon or gastric cancers to individualized therapies, which probably will be less toxic and more specifically targeted to patients with a specific type of tumor,” Pasche says. He adds that developments and discoveries in diagnosis and treatment will be led by centers with a tradition of Phase I and Phase II clinical trials, high patient volume and teams of physician-scientists such as UAB.

Finding Inspiration
Pasche says a combination of factors brought him to UAB. “First, UAB has a very strong reputation in the field of oncology. I was moving to a place that I knew had the necessary infrastructure to be among the top centers.

“Second, UAB has a very strong research environment, offering an opportunity to really expand any medical discovery at both the basic science and clinical levels,” he says. “UAB is strong in both.”
Pasche derives motivation and insight for his research from treating patients. “For me it is an inspiration that is renewed when I go into the clinic and see patients,” he says. “Medicine, and oncology in particular, is my passion.”

Reprinted from Crossroads, a publication of the UAB Comprehensive Cancer Center that offers news, features and profiles highlighting current cancer-related news of prevention, treatment and research.