Tuesday, February 22, 2022
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David Cachia, MD, still remembers the way his childhood doctor could so readily put him at ease. His doctor had earned his trust—and it felt good. Realizing that a career in medicine would enable him to emulate these actions and help patients of his own, he set out to become a doctor.
But his aspirations didn’t stop there.
His training in neurology impressed on him the need to better understand brain tumors and sparked his ambition to bring more effective treatments to patients. A fellowship in neuro-oncology provided additional training, and he came to UMass Chan in September 2021 as a seasoned physician-scientist. Here, he will establish a neuro-oncology translational research program, collaborating with bench scientists and bridging the gap between the lab and the clinic.
In your short time here, what steps have you taken toward integrating clinical care with research?
I've begun working with industry and consortia across the country to prepare for opening clinical trials [for brain tumor patients] at UMass Chan. The therapeutic options for patients with brain tumors are very limited, and we need to find better ways to treat them. Until I got here, there hadn’t been a dedicated neuro-oncologist at UMass Chan in a while, but now the program is expanding and I'm hopeful that over the next few months, these new clinical trials for brain tumor patients will open at UMass Chan [and I can enroll patients who are eligible.]
What kind of team must be in place to set up neuro-oncology clinical trials here at UMass Chan?
Preparing for a clinical trial is not something anyone can do alone. I am getting help from the Cancer Research Office (CRO). This office is responsible for the everyday management of the clinical trials, helping to plan and execute the trials and analyze the data. Through the CRO, we have access to clinical trial managers and dedicated nurses to help set up and run the trials as well as specialists like neurosurgeons, neuropathologists, and radiation oncologists that can offer specialized care for these patients. All these components are needed for the project to succeed. So far, everyone has been very supportive in helping this project move forward. It’s exciting to see something build up from scratch.
What do you see as your niche within translational research?
Before I joined UMass Chan, I offered a clinical perspective to my preclinical research colleagues, giving them my insight about what [investigative] drugs I think have the most hope of getting into the clinic. I hope to build similar collaborations here, so I can provide the same perspective. By collaborating with preclinical researchers, the goal is to eventually get new drugs to the clinic and enroll patients into clinical trials.
You’ve emphasized the need for better brain tumor treatments. What do you see as the most promising approach in neuro-oncology right now?
Immunotherapy has revolutionized oncology care in certain tumor types—like melanoma and lung cancer—but we don’t yet have evidence to support the use of immunotherapy for primary brain tumors. There are clinical trials going on right now looking at whether there’s a role for immunotherapy in these brain tumors. That’s why having these clinical trials open here at UMass is vital for our patients—they can get access to the latest treatments that are only available to patients taking part in clinical trials. The hope is that some of these treatments will change the trajectory of these tumors.
In your view, how has the field progressed over time?
We now have a much better molecular understanding of these tumors. Up until a few years ago, we didn't really understand their underlying biology or that there could be differences in behavior between tumors of the same type. Over the last few years, with better technology, we gained a more complete understanding of the underlying mutations and the underlying forces driving these tumors. We can hopefully use this information to come up with better treatments.
What would you say is the most satisfying part of your job as a clinical researcher?
It is rewarding to see patients that are grateful for what we do as a team. It isn’t just me alone, but a whole team, including the patient and their relatives. It is satisfying to see them feeling comfortable in my care. That’s something I don't ever take for granted and that I work on every day to make sure that I’m giving my best to my patients.
What is your message to potential donors?
Treatment options for patients with brain tumors are quite limited. We need better treatments, novel ideas and new studies. Any development we think might possibly be useful for patients, we need to investigate. But conducting the necessary clinical studies requires substantial financial support. Therefore, any contribution offered by donors can have a substantial impact, potentially improving overall survival for brain tumor patients.
About David Cachia, MD
David Cachia, MD, is an associate professor in the Department of Medicine/ Hematology-Oncology at the University of Massachusetts Chan Medical School and is affiliated with UMass Memorial Health. Dr. Cachia earned an MD from the University of Malta Medical School and received residency training in neurology at the University of Massachusetts. He completed two fellowships, one in Clinical Neurophysiology at the University of Massachusetts and the other in Neuro-Oncology at MD Anderson Cancer. He is board certified in both neurology and neuro-oncology.
