How do you collaborate with the other members of the Liver Cancer Program in the care of patients with liver cancer?
The best approach patient care is multi-disciplinary and requires collaboration between hepatologists, radiologists, oncologists, surgeons, molecular pathologists, geneticists, and pathologists, amongst others. This interaction is critical for patient care and at Yale, it happens at many forums, especially at multidisciplinary tumor boards. Precision tumor boards, in addition, also allow application of cutting-edge technology and personalized care to our patients. Having top-notch clinicians in each field makes this collaboration not only ideal for the patients, but also a great experience for the providers. Patients who are seen by the Liver Cancer Program at Smilow Cancer Hospital, have their pathology material routinely reviewed by our expert pathologists to ensure diagnostic accuracy and other required pathologic and molecular data. All our pathologists are sub-specialized and fellowship-trained, and well-known experts in the field of liver cancer.
How has your research been translated into clinical practice to help patients?
Yale promotes all forms of “bench to bedside” translational research and our research has helped advance medicine and improve patient care. The research from our group in pathology has over the years helped to improve the diagnosis of liver tumors, identify clinically important sub-types, provide prognostic biomarkers, and understand cancer biology. In this regard, our pathology group has published over 100 publications related to liver tumors. The ongoing collaborative research with the division of biomedical imaging is going to advance the application of artificial research and machine learning in the diagnosis of liver cancer on imaging. In the area of early diagnosis and treatment, our ongoing research will help identify patients with liver cancer before it develops and change how we identify and treat such patients. Many such exciting projects in liver cancer are ongoing that we anticipate will significantly change how we diagnose and treat these patients.
Mentorship is an important part of any research—how do you encourage collaboration and keep your team engaged and learning from one another?
Like top notch patient care, translational research is also often multi-disciplinary. High-quality translational research these days typically involves participation from various specialties, but also requires excellent support from bioinformatics, biostatistics, and genomics. In such collaborations often trainees and junior faculty are included, which provides great experience and a future path for them to not only grow in the field, but also leadership. We have a strong tradition of building great clinical and research programs and have many faculty who have gone on to receive national and international recognition.
As medicine, technology, and pathology continue to evolve, where do you see the future of liver cancer and the role of pathology?
Technology continues to evolve on a daily basis and transform our clinical practice. We are in the digital era where application of technology has allowed data to be seamlessly transferred to and easily retrieved from electronic medical records for patient care and research. Pathology glass slides now can be “digitized” which allows easy access from anywhere in the world, indefinite storage of patient material, application of artificial intelligence and machine learning, amongst many other advantages. This also opens the doors for exploring new cancer biomarkers, prognostic factors, diagnostic tools and sharing of information. I anticipate that pathologists will soon be using the digitized whole slide images to not only make the diagnosis, but also apply quantitative imaging tools to better assess histologic features, prognostic factors, and cancer biomarkers. We frequently employ genomic profiling of tumors to refine cancer diagnosis, better guide patient management, allow entry into clinical trials and provide prognostic data, and I anticipate that this is only going to increase in the future. Access to high quality tumor profiling lab and bioinformatics makes this possible.