By David Kirsch, MD, PhD

Sarcomas are tumors of the soft tissue and bones. These cancers afflict men, women, and children. Decades ago, most patients with soft-tissue sarcomas of the arms and legs had amputations. Today, most patients receive radiation therapy in addition to limb-sparing surgery. Because sarcomas can occur almost anywhere in the body, each tumor presents different treatment challenges. That’s why I became a sarcoma radiation oncologist. I wanted to help patients, each of whom need radiation therapy tailored to treat cancer in a variety of different sites in the body.

Sarcomas are rare. Primary care physicians may only see one or two cases over their entire career. Oncologists may only see a few patients with a sarcoma each year. Last year, Duke opened a clinic dedicated specifically to the treatment of patients with sarcoma. In our multi-disciplinary sarcoma center, a patient will see an orthopedic oncologist, radiation oncologist, and medical oncologist to determine the best treatment plan. Because Dukehas a team of doctors with expertise in the care of patients with sarcomas, many of our patients travel a long way for treatment.

In my laboratory, we have developed a mouse model of soft-tissue sarcomas. These mice develop their own cancers that are similar to my patients’ tumors. We are using this model to learn how sarcomas develop, why they spread, and to test novel therapies. Our ultimate goal is to translate our discoveries in the lab into better treatments for patients with sarcomas. From our recent studies, we are now developing clinical trials of new therapies for our sarcoma patients.

The funds I received as the recipient of the Damon Runyon-Rachleff Innovation Award are being used to develop a hand-held device that can be used in the operating room for sarcoma patients. The device will utilize molecular imaging to scan tumor sites after Kirsc h is one of the first scientists to receive the Damon Runyon-Rachleff Innovation Award, which is funded by venture capitalist Andy Rachleff. The award supports young researchers who may find it difficult to obtain funding from the National Institutes of Health for their innovative projects. the surgeon has removed a cancer to detect residual cancer. Residual cancer is the microscopic amount of a patient’s tumor that may be left in the body after the surgeon removes a tumor during surgery. If left unchecked, residual cancer can cause a local recurrence that may spread to other areas of the body.

The device we are developing may allow surgeons to identify patients who have no residual cancer after surgery. These patients may be spared unnecessary radiation therapy. The device may also allow surgeons to identify patients with residual cancer so that the remaining cancer cells could be removed at the time of the initial surgery.

The next step is to test this device in animals, and then we hope to open a clinical trial for humans with sarcomas and other cancers. I believe that this imaging approach may change the way we care for our patients—those with sarcomas and also those patients with other types of cancers.

Kirsch is one of the first scientists to receive the Damon Runyon-Rachleff Innovation Award, which is funded by venture capitalist Andy Rachleff. The award supports young researchers who may find it difficult to obtain funding from the National Institutes of Health for their innovative projects.