Raymond Nagle, MD, PhD, involves himself within molecular pathology studies in prostate carcinogenesis. His research program has focused for the past several years on understanding the biological basis for the variability in the clinical evolution and spread of prostate cancer. In collaboration with Drs Anne Cress, Timothy Bowden, Ronald Heimark and many others, his group has worked to define molecular events during the progression of the disease that allow the cancer to migrate out of the site of origin in the prostate and thus metastasize to the bone and other sites. Such knowledge may provide the basis for predicting the probable outcome of an individual’s tumor as well as suggest approaches to block the evolution and dissemination of prostate cancer. Dr. Nagle received combined training in anatomic and clinical pathology at the University of Washington. Subsequently, he received an NIH post-doctoral fellowship in experimental pathology which led to a Ph.D. degree. He was an associate pathologist in the Department of Experimental Pathology at Walter Reed Army Institute of Research where he was involved in studies of pathogenesis of African Trypanosomiasis as well as acute renal failure. Following military service, he served on the faculty at the University of Maryland where his research primarily dealt with mechanisms of acute renal failure as well as models of experimental glomerulonephritis. In 1968 he joined the faculty at the University of Arizona College of Medicine. His work as a surgical pathologist led to a research program focusing on the role and identification of cytokeratins in the diagnosis of human neoplasms. Dr. Nagle has over 28 funded research grants, and has authored over 180 papers and abstracts in the area of solid tumor pathology and prostate cancer progression.
Phase Ii Study Of Erlotinib In Patients With Locally Advanced Or Metastatic Papillary Histology Renal Cell Cancer: Swog S0317. Source: Journal Of Clinical Oncology : Official Journal Of The American Society Of Clinical Oncology
PURPOSE:<br>Patients with advanced papillary renal cell cancer (pRCC) have poor survival after systemic therapy; the reported median survival time is 7 to 17 months. In this trial, we evaluated the efficacy of erlotinib, an oral epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor in patients with advanced pRCC, a tumor type associated with wild-type von Hippel Lindau gene.<br><br>PATIENTS AND METHODS:<br>Patients with histologically confirmed, advanced, or metastatic pRCC were treated with erlotinib 150 mg orally once daily. A RECIST (Response Evaluation Criteria in Solid Tumors) response rate (RR) of > or = 20% was considered a promising outcome. Secondary end points included overall survival and 6-month probability of treatment failure.<br><br>RESULTS:<br>Of 52 patients registered, 45 were evaluable. The overall RR was 11% (five of 45 patients; 95% CI, 3% to 24%), and the disease control rate was 64% (ie five partial response and 24 stable disease). The median overall survival time was 27 months (95% CI, 13 to 36 months). Probability of freedom from treatment failure at 6 months was 29% (95% CI, 17% to 42%). There was one grade 5 adverse event (AE) of pneumonitis, one grade 4 thrombosis, and nine other grade 3 AEs.<br><br>CONCLUSION:<br>Although the RECIST RR of 11% did not exceed prespecified estimates for additional study, single-agent erlotinib yielded disease control and survival outcomes of interest with an expected toxicity profile. The design of future trials of the EGFR axis in pRCC should be based on preclinical or molecular data that define appropriate patient subgroups, new drug combinations, or potentially more active alternative schedules.<br><br>