September 21, 2019
Acid Test: Cancer tumors and acidity research

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Dr. Robert J. Gillies focuses on the environments surrounding tumors. "A tumor has an ecology of its own," he says.

Cancer Care

Acid Test: Cancer tumors and acidity research

Art Levy | 1/25/2019

Twenty years ago, when Robert J. Gillies first received funding from the National Institutes of Health to study whether cancer tumors thrive in highacid environments, such research was generally, he says, pooh-poohed by mainstream scientists. Now, however, the cancer-acid relationship has become one of the hottest and most promising topics in cancer research.

Gillies, chairman of the Department of Cancer Physiology and vice chairman of Radiology Research at Tampa’s Moffitt Cancer Center, spoke to FLORIDA TREND about his work — which won a gold medal last year from the World Molecular Imaging Society — and his thoughts on the future of cancer research.

  • Tumor habitats: “What is foremost in our lab right now is a type of imaging called habitat imaging. Habitat imagining is a way to characterize the tumors as complex and heterogeneous systems. A tumor has an ecology of its own. We oftentimes refer to tumors as entire continents, where you have different ecosystems, and within tumors you have these distinct areas. And we can image that, and we can also monitor how these habitats change during the course of therapy, telling us whether the patient is responding or not.”
  • Oxygen-poor tumors: “One habitat that we’re looking at is a tumor that’s oxygen-poor. This is important for a number of reasons. Oxygen-poor environments have a much worse prognosis for the patient. They’re resistant to most therapies — radiation therapy, chemotherapy, immunotherapy — but we have a drug that targets oxygen-poor areas specifically. So, if I can define an imaging test to predict and say this patient has an oxygen-poor tumor then before you treat it with anything else, you should treat it with this drug to target that region — and then treat it with something else.”
  • The role of acid: “I spent my career studying environments that exist in tumors: Oxygen-poor environments, very acidic environments. As acid is measured with the pH scale, somebody has called me the ‘Pope of pH.’ I was the first to show that tumors are acidic and that has spawned an entire industry of people who are making drugs to target the acidity. We have a trial starting in pancreatic cancer next month where we have a drug that targets acidity along with a chemotherapy agent at the same time. People refer to my work all the time when they want to promote an alkaline diet. I don’t participate in that because it’s not necessarily scientifically sound. But there seems to be evidence that a less acidic diet is conducive to better health — not just cancer, but across the board.”
  • Using data: “I see mathematical oncology as having a big impact — and also computational oncology, which is different. Computational oncology is a way to mine the data that exists now. And it’s a way to consolidate the data. Some people look for interactions. They look for signs of ‘this being related to this, so therefore we think this might be happening.’ Mathematical oncology starts with first principles and says ‘cancer should behave this way, so let’s go look for evidence of that.’ So, I see those two things coming together, and I think that’s going to have a tremendous impact on our understanding of cancer going forward.”

Read more in our February issue.

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