Dr. Allan Pantuck: Taking Cancer Research from Bench to Bedside

Allan Pantuck always knew he wanted to be a physician. His father was an anesthesiologist, his mother a chemist. Together they did research for Columbia University on how diet and nutrition impacted drug metabolism. In Pantuck’s case, the apple didn't fall far from the tree.

Pantuck also is a doctor and researcher. One of his focuses has been to study how natural products such as green tea and pomegranate juice can prevent the onset or recurrence of prostate cancer by stabilizing the levels of prostate specific antigen or PSA, a biomarker that indicates the presence of cancer.

“I grew up in a house where the topic of dinner conversation was how Brussels sprouts, cabbage and charcoal-broiled beef affected the activity of certain enzymes in the body,” said Pantuck, director of the Genitourinary Oncology Program Area at UCLA’s Jonsson Comprehensive Cancer Center and an associate professor of urology.

“Since then, we have learned there are foods that can affect the way these same enzymes metabolize potential cancer causing substances, such as the chemicals in cigarette smoke,” he added. “Some foods activate them and some cause them to be excreted without causing any harm. In a way, what I’m doing is an extension of what my parents were doing.”

The pomegranate study, which showed that an eight-ounce glass of juice daily kept levels of PSA stable in men with prostate cancer, garnered international coverage, which wasn’t surprising. A glass of juice keeping cancer at bay is big news.

Published in Clinical Cancer Research, the study found that drinking the juice increased by nearly four-fold the length of time that PSA levels in prostate cancer patients remained stable. The study involved 50 men who had undergone surgery or radiation, but who quickly experienced increases in PSA. Pantuck and his team measured “doubling time,” how long it takes for PSA levels to double, a signal that the cancer is progressing. They observed an average increase in doubling times from 15 months to 54 months.

But what Pantuck likes to point out about the study is its truly “translational” nature, a hallmark of research at the Jonsson Comprehensive Cancer Center. Pantuck is the only urologist in the country to hold a master’s degree in clinical research, and he bridges the gap between the basic research in the laboratories and the clinical research that involves patients.

“To improve human health, basic scientific discoveries must be translated into everyday applications,” Pantuck said. “Such discoveries begin at ‘the bench’ with laboratory research—in which scientists study disease at a molecular or cellular level—then progress to the clinical level, or the patient's ‘bedside.’”

Researchers are increasingly aware that this bench-to-bedside approach is really a two-way street. Basic scientists provide clinicians with promising new tools that need to be tested in patients, and clinical researchers make novel observations about the nature and progression of disease that can stimulate new ideas for basic investigations. Pantuck sought a master’s degree because he recognized that the increasing complexities of clinical research make it more difficult to translate new knowledge to the clinic and back again.

“I think clinical trial design is something you need advanced training to do well,” he said.

The pomegranate study, beginning with a novel observation about the effects of the juice on prostate cancer in the laboratory, is a good example. Pantuck and his team took findings from the lab into the clinic to test in patients. Pantuck collected urine and blood samples from study volunteers and took them back into the lab to see if he could discover how the juice keeps PSA levels stable.

“We want to understand what is happening on a molecular level,” he said. “We need to understand what the pomegranate juice is doing to the prostate cancer, not just to the patient’s PSA measurement.”

In addition, Pantuck was involved in a study that tested green tea extract and the drug Tarceva to determine if either prevented bladder cancer. The study, also based on research conducted in cancer center labs, was part of a first-of-its-kind program to prevent the recurrence and progression of smoking-related bladder cancer, which accounts for about half of all bladder cancers.

Pantuck attended Columbia University before going to Robert Wood Johnson Medical School. After his urology residency in New Jersey, Pantuck arrived at UCLA in 1999. He was attracted to the Westwood campus because of its renowned kidney cancer program.

“Cancer is a great challenge in terms of curing people,” Pantuck said. “And for people we can’t currently cure, I think it’s important to improve their quality of life while seeking to discover the cures of the future.”

By Kim Irwin, 2007