On Friday I received a message I had been dreading. My friend and colleague, Lou Houston, had died, peacefully and surrounded by his family at his home near Seattle.
Lou was about 70, and had battled his cancer, a mucinous adenocarcinoma of the peritoneal cavity, for nearly a decade. He had undergone several aggressive surgeries, with various forms of intraperitoneal chemotherapy, and had also received several different forms of systemic chemotherapy during the course of his illness. At the end, he was on total parenteral nutrition (iv feeding) because his gut no longer worked. His type of cancer is fairly unusual; when oncologists counsel patients with this disease, we may reassure them that this is one of the “good” cancers to get, as patients tend to do well and may survive for years. Tell that to Lou’s family now…
This unusual malignancy has no identified molecular signature and as a result, it is hard to do anything that is not basically empiric in nature. And, because of its relative rarity, it is hard to obtain solid evidence from randomized clinical trials to guide the choice of empiric therapies. Finally, because it is rare and molecularly mysterious, it’s hard to know how to assess risk for the development of the cancer, or how to prevent it. This perplexing set of factors characterizes many of the cancers we see and treat; clearly the answer lies in the systematic implementation of molecular analysis to uncover the causes and potential targets for all cancers.
Ironically, Lou would agree with me wholeheartedly. He was a biochemist who had trained at the University of Kansas (and knew everything worth knowing about their basketball team). I first met him a little more than 20 years ago. Those of you who read last week’s blog may recall that I recently saw Ed Bradley, whom I first met when I collaborated with Cetus Corporation to develop a bispecific antibody. Well, Ed connected me with Lou, who was pioneering recombinant immunotoxins that used an antibody fragment to deliver recombinant ricin A chain to breast cancers at Cetus. Lou was organizing a group of collaborators to develop this concept with the support of a National Cooperative Drug Discovery Group (NCDDG) grant. I got involved, we got the grant, and I began a series of collaborations with Lou, and with other outstanding scientists such as Jim Huston (who initially described single-chain Fv antibodies) and Jim Marks (who worked with Greg Winter to develop antibody phage display, and affinity maturation techniques), among others.
Lou was the consummate leader, scientist and friend. He was open, interested, generous and incredibly insightful. The NCDDG created novel molecules, spawned the careers of numerous investigators, and certainly made major contributions to the field of antibody engineering. Lou eventually moved on to other scientific ventures, always looking for cancer-related molecular signatures, and for ways to develop novel therapeutics directed against important targets.
I should add that he was a marvelous host; I had several meals at his home, graciously presided over by Lou, his wife Terri and by a fabulous piece of salmon courtesy of his son Scott, who is a Seattle-based salmon broker. Over the past five years or so, his energy and focus had necessarily waned as he fought his illness, but until recently he was always looking for the next big opportunity to make a difference.
Nearly 500,000 Americans will die of cancer this year. Not everyone will have had the impact that Lou had in his life, but each of them will have his or her own unique and important story. The same is true of the cancers that took their lives. I am glad that we have the privilege and opportunity to do something to change the plots.