Researcher seeks to defy odds in taking on pancreatic cancer
Dr. David Dawson has never been intimidated by the odds.
An assistant professor of pathology and laboratory medicine and a researcher at UCLA’s Jonsson Comprehensive Cancer Center, Dawson is tackling one of medicine’s fiercest enemies, pancreatic cancer. Dismal survival rates and limited treatment options have left many with little hope of conquering the disease — a view that Dawson is committed to changing.
"The perception among many is that there is little that can be done for patients with pancreatic cancer," said Dawson. "I think this defeatist attitude is unfortunate and ignores the potential benefits patients may obtain from existing and evolving treatment options."
Pancreatic cancer is a particularly challenging disease. The National Cancer Institute estimates that of the more than 43,000 new cases that were diagnosed in 2010, 36,000 lives were lost—about 84 percent of those diagnosed—and overall five-year survival rates hover around five percent.
Because there are few early symptoms and no effective screening tests for pancreatic cancer, a diagnosis usually is not made until the cancer is advanced and no longer able to be surgically removed. Existing medical therapies also provide only modest survival benefit for most patients.
As both a researcher and a physician, Dawson is interested in moving towards personalized therapy for pancreatic cancer.
"We need to move beyond the approach where all pancreatic cancer patients are treated uniformly, because it is clear that not every patient gains the same benefit from the existing standard of care," he said. "We need to have strategies and markers that indicate how individual patient tumors differ so we can predict their behavior and response to a variety of treatment options, and allow that to guide more informed therapeutic decision-making."
Dawson was raised in a suburb of Dayton, Ohio, and always knew he wanted to be in medicine. Naturally drawn to intellectual challenges, he completed both his medical degree and doctoral graduate work at Northwestern University in Chicago as a trainee in the Medical Scientist Training Program. Despite a high level of early success, Dawson initially wavered about his choice of career path. Believing he had to "do something different" to stand out in the highly competitive field of medicine, it took some soul-searching to discover his true calling.
"I had a really productive graduate experience. Every project I pursued seemed to turn to gold, such that at one point I almost decided not to finish medical school," Dawson recalled. "But I have a real passion for cancer biology and knew that as a fully-trained physician, I would be better equipped to translate ideas and discoveries between the bench and the clinic and thus have a greater impact on cancer research and patient care."
After graduating from Northwestern, Dawson came to UCLA in 1999 to pursue residency training in anatomic pathology and fellowship training in gastrointestinal pathology. He then pursued postdoctoral research training in the laboratory of Dr. Michael Teitell, also a member of UCLA’s Jonsson Cancer Center and leader in lymphoma research.
In Dr. Teitell’s lab, Dawson pursued research in the burgeoning field of cancer epigenetics, the study of heritable changes other than that directly encoded by DNA. It was an exciting time for the upstart researcher, putting him on the ground floor of a cutting-edge field and illuminating a critical mechanism through which cancer evolves.
After finishing in Teitell’s laboratory, Dawson was promoted to a UCLA faculty position as assistant professor. Given his clinical expertise in gastrointestinal pathology and cancer research background, Dawson focused his laboratory work on pancreatic cancer, first asking how epigenetic changes might be used as prognostic and predictive markers in pancreatic cancer, as well as potential targets for therapy.
“While a few key molecular events occur in most pancreatic cancers, each tumor has a much larger number of lower frequency molecular changes that occur and vary widely from one patient to the next,” Dawson said. “I believe major improvements in the treatment of pancreatic cancer will occur when we better understand the complexity of this disease and account for these various molecular alterations and their relation to tumor behavior and response to therapy."
Spurred by his epigenetic investigations, Dawson and his research team are now studying pancreatic cancer stem cells. Representing a very small percentage of cells that make up a tumor, cancer stem cells are thought to have an unlimited lifespan and be largely, if not solely, responsible for the initial development of a tumor and its spread to other organs. They also are thought to play key roles in cancer recurrence and resistance to radiation and chemotherapy.
“One key to understanding the biology of pancreatic cancer lies in determining how these rare pancreatic cancer stem cells differ genetically and epigenetically from the remaining cancer cells that make up the majority of the tumor,” Dawson explained. "While there is still some disagreement as to the precise identity of these cancer stem cells, it seems likely that the ability to therapeutically target them represents the most promising means to cure pancreatic cancer.”
When not in his lab, Dawson is devoted to his family. He and his wife Nicole, also a pathologist at UCLA, enjoy spending time with their 6-year-old son Jack and their German shepherd, Lizzie. An avid outdoorsman, Dawson can often be found on weekends running or biking on the beach, or hiking or skiing in the local mountains with his family.
Although content both professionally and personally, Dawson continues to dream big. In 2008, he received the Seena Magowitz Pancreatic Cancer Action Network-AACR Career Development Award, given annually by the Pancreatic Cancer Action Network and the American Association for Cancer Research.
He continues to pursue research with the ultimate hope of bridging scientific discovery into clinical applications and treatments that will bring meaningful benefit to pancreatic cancer patients.
“In addition to my own research, I am particularly proud of my role as a facilitator of translational pancreatic cancer research with multiple investigators here at UCLA and elsewhere,” Dawson said. “I cherish those moments when important new discoveries are made in this challenging field, and I believe that great things are yet to come.”