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Pediatric Oncology

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Thoughts From Our Childhood Cancer Experts

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Photo of Dr. Christine Anne Pratilas, M.D.

Pratilas, Christine Anne, M.D.

Associate Professor of Oncology
Associate Professor of Pediatrics
 

Assistant Professor of Oncology

The in-depth clinical management required of oncologists, says Dr. Christine Anne Pratilas, “Really gets you thinking.”

It was this complexity involved in oncology, in addition to the opportunity to work with pediatric patients, which drew Dr. Pratilas to a career in pediatric oncology.

Spending the first twelve years of her medical career at the Memorial Sloan Kettering Cancer Center, initially as a clinical and research fellow, then as Assistant Member in Pediatric Oncology, Dr. Pratilas honed her scientific interest studying the signaling pathways of mutated proteins that are aberrantly activated in cancers. She brought her enthusiasm and specialized research focus to Hopkins, where she is currently building a laboratory.

While Dr. Pratilas possesses clinical expertise in pediatric sarcoma and melanoma, she emphasizes that her laboratory will remain intentionally “cancer-type independent.” Instead, she says, the research conducted in it will be “signaling-pathway specific”.

By conducting her research with an eye towards mitogenic signaling pathways, Dr. Pratilas hopes to make a broader impact on multiple types of cancer, especially those that are particularly aggressive and develop resistance to therapies. 

It’s possible, explains Dr. Pratilas, that several types of pediatric cancers may contain a particular mutation in their signaling pathways. “The goal is to identify cancers that depend on this pathway,” she says.

Finding mutations is one thing. But, says Dr. Pratilas, it’s not enough. It’s also critical to understand the interplay between these mutations and other proteins, she explains. These relationships may hold the key to understanding why certain cancers are resistant to targeted therapies, and why they progress.

“My hope is that the more we use information from the gene/protein level and signaling interactions within the cell, the better able we will be to predict the response to targeted therapy,” Dr. Pratilas says.

While there is still much to learn, Dr. Pratilas acknowledges that the scientific community’s knowledge of these signaling pathways has increased substantially in the past ten to 15 years. “There was a general awareness of the role of the ERK pathway in cancer cell proliferation, but not to where it is today,” she says.

She describes the first clinical trials to target the ERK pathway as disappointing. “The investigators didn’t have the genomic information at the time. No one knew how to accurately predict if the pathway was activated,” she says. Since then, however, researchers have gleaned far more information on how signaling is turned on in cancers with BRAF and RAS mutations; subsequently, the first small molecule inhibitor of MEK was approved in 2013.

“Cancer cells are still smarter than us. We’re always chipping away at it,” Dr. Pratilas says.

In their quest to outsmart cancer cells, Hopkins physician-scientists such as Dr. Pratilas have the benefit of being surrounded by a strong cohort of multi-disciplinary medical professionals. “It takes all these disciplines working together. And at Hopkins, you don’t have to reinvent the wheel every time you confront a complex problem. There’s plenty of opportunity for collaboration, for putting multiple heads together,” she says.