For Dr. Walter J. Urba, his mother’s cancer diagnosis set in motion profound changes to both his personal life and career goals that finally led him to Providence Portland Medical Center.
Key takeaways:
- Immuno-oncology is driving breakthroughs for targeted therapies to treat cancer
- Genomics gives doctors deep insights into individual patients' immune system
- Providence has a deep bench of disease-specific experts focused on patient-centered care
[4 MIN READ]
Melding immunology with oncology
Dr. Walter J. Urba, M.D., Ph.D. didn’t take a conventional approach to his immunology career at Providence. His path travels from his start in academics all the way to a position running Earle A. Chiles Research Institute and Robert W. Franz Cancer Center for Providence in Portland.
We caught up with Dr. Urba while he was taking a break from entertaining his grandson. Whether he needed a break or not, the fact that he took time to talk to us hints at the giving person behind an outstanding set of accomplishments in the fields of oncology and immunology.
Cancer immunotherapy is a specialized field of study focused on harnessing the power of the immune system to cure cancer. While Dr. Urba began his interest in immunology during his earliest college days, his interest shifted to oncology when his mother was diagnosed with breast cancer. The reality of this emotionally charged, life-changing event prompted him to return home to New Jersey to take care of his family. By his mother’s side, he was exposed to oncologists that inspired and called him to the field of oncology. According to Dr. Urba:
“There was just an amazing opportunity at that time to combine my science background in immunology with my clinical interest, which was how to take care of and improve the therapy of patients who have cancer.”
Immunotherapy and personalized care
The field of immuno-oncology is still relatively new and evolving, and breakthroughs continue to be discovered—often in conjunction with other areas of research. In the area of genomics, researchers and scientists have found ways to identify and eliminate altered or mutated cells. Broken down, genomics enables clinicians to:
- Identify changes in a cancer cell caused by a virus or mutations to the DNA that make the cancer cell look “foreign” to the body mutated proteins
- The immune system can then detect and eliminate the “foreign” cancer cells
When the immune system sees the cells as a foreign object, the body reacts by producing T cells and antibodies to attack them. Dr. Urba noted his appreciation for how this genomics research enhances his team’s work in immunotherapy:
“I'm a strong proponent of targeted therapy and personalized genomic medicine. Of course, I argue that immunotherapy was the first targeted therapy and it is very personalized. And I think our institute [at Providence] is an example of where genomics and immunotherapy have come together to improve therapy for patients with cancer.”
“Because of our clinical trials program, Providence patients often get access to drugs that end up being FDA approved because of their efficacy: and they get access to them years before FDA approval.”
The future of targeted medicine
Despite the varied successes that have occurred in the field of immune-oncology, there is still much to do…and learn. Naturally, we had to ask Dr. Urba to pull out his crystal ball to share his vision for the future of this ever-changing field of medicine. In his words:
“If we can understand the tumor better and the immune system better at the time a patient is diagnosed, maybe based on what particular deficiencies we find in that patient's immune system, we can then predict exactly what combination of drugs will give them the best chance of cure. I think that's the future.”
A major goal for the team at Providence is a therapy called Adoptive Cellular Therapy. While some patients respond well to the emerging therapies and medications designed to prompt an immune system response, others have not. Dr. Urba refers to someone whose immune system can’t fight their tumors as “having the brakes turned on.” But certain drugs can free these impediments and re-activate a patient’s immune response to fight the cancer. In many cases, the tumors can go away altogether.
Not every patient’s genetic makeup allows for existing drugs to kickstart an immune response. Through ongoing research and clinical trials Providence is exploring ways to develop personalized therapies designed to trigger an immune response. In labs across the Providence system, cells are engineered to recognize tumor characteristics at an individual level. These personalized “soldier” cells are then injected back into the patient to fight (and ideally eliminate) cancerous tumors.
Providence leadership in clinical excellence
Like most every endeavor, enlisting exceptionally qualified doctors, scientists and researchers often leads to the best results. Dr. Urba explicitly noted his gratitude for the Portland community whose support allowed Providence to recruit the “best and brightest.”
“Providence has many clinical trials across the system and is building a centralized research network that will allow us to scale access to personalized treatments to all patients over time. Our integrated approach to clinical excellence is what sets Providence apart.”
At Providence, doctors and researchers are at the forefront of helping to develop innovative therapies, and patients often get early access to drugs years before FDA approval. Unfortunately, with a disease like cancer, almost half of typical patients still die because the right drug hasn’t been discovered and tested to address their unique situation.
Per Dr. Urba: “For Providence to have a clinical trial research program in Oregon or elsewhere, patients benefit by being able to get treatments close to home.”
Dr. Urba credits Providence leadership for having the foresight to evolve from cancer programs that depended on a range of generally trained medical, radiation and surgical oncologists to building a program of highly trained disease-specific practitioners.
“Our leadership saw the value in having…experts in certain diseases. Over the years we’ve been able to change to address our patients needs, which have gone from - ‘Who is your best surgeon’ to “Who is your best breast surgeon?” “Who is your best hepatobiliary surgeon?” That…helped us then recruit some of the smartest people around…the innovative thinkers pursuing certain diseases and new approaches to care.”
Patient-focused care
For Dr. Urba and the entire team at Providence, they will continue to practice medicine from a patient-first lens. Patients are not just patients—they are people with a zest for life. Providence clinical experts are motivated and passionate about helping people live their happiest and healthiest lives.
Dr. Urba: “To have somebody whose x-rays are clear, whose life returns to normal and they're probably going to live a normal existence, really sharing in the joy of the patients—even seeing them come back year after year as grateful patients…it keeps you going.”
As breakthroughs continue in the treatment of cancer, having compassionate people like Dr. Urba at Providence can only bode well for the future. In his typically optimistic words: “If we just hang in there and keep at it, we're going to figure this thing out.”
Somewhere out there, one particular doctor’s mother is smiling.
Learn more about the Earl A. Chiles Research Institute.
Related resources
Providence cross-state efforts to #FinishCancer
Phase II study of neoadjuvant combination therapy for ovarian cancer
Colorectal cancer increase in younger populations, emphasizing importance of screenings
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