Piotr Rutkowski1, Jin Ye Yeo2
1Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw, Poland; 2TCR Editorial Office, AME Publishing Company
Correspondence to: Jin Ye Yeo. TCR Editorial Office, AME Publishing Company. Email: tcr@amepc.org.
This interview can be cited as: Rutkowski P, Yeo JY. Meeting the Editorial Board Member of TCR: Prof. Piotr Rutkowski. Transl Cancer Res. 2024. Available from: https://tcr.amegroups.org/post/view/meeting-the-editorial-board-member-of-tcr-prof-piotr-rutkowski.
Expert introduction
Prof. Piotr Rutkowski (Figure 1) is the Professor of Surgical Oncology at the Maria Sklodowska-Curie National Research Institute of Oncology in Warsaw, Poland. He is also the current Head of the Department of Soft Tissue/Bone Sarcoma and Melanoma and the Plenipotentiary of Head Director of Institute for National Oncological Strategy and Clinical Trials at the Maria Sklodowska-Curie National Research Institute of Oncology. He has participated in several investigator-driven trials in melanoma and sarcoma. He is a reviewer for several international scientific journals, as well as a member of the Editorial Board of Annals of Surgical Oncology and European Journal of Surgical Oncology.
Prof. Rutkowski is an active member of the EORTC Melanoma Group; EORTC Soft Tissue and Bone Sarcoma Group, where he chaired the Local Treatment Subcommittee and the Membership Committee of the EORTC Board. He is a member of several Polish and international scientific societies (President of Polish Oncological Society, Board member of Polish Society Surgical Oncology, ex-member of the Board of Directors of the Connective Tissue Oncology Society, member of International Affair Committee of ASCO, Global Curriculum Committee of ESMO). Prof. Rutkowski has authored or co-authored over 500 scientific papers in Polish and international journals (with an impact factor of above 4000, index-H:82, citation index >35000, rewarded Highly Cited Researcher in Clinical Medicine 2021, 2022 and 2023), and is co-author of national and international recommendations for sarcoma and melanoma. He is working very closely with national patient advocacy groups for GIST/sarcoma and melanoma, coordinating Polish Sarcoma Group and is Chairman of the Melanoma Academy in Poland. Member of Council of Agency of Medical Research. Chair of Task Group of Ministry of Health, Poland for National Oncological Strategy.
Figure 1 Prof. Piotr Rutkowski
Interview
TCR: What drove you to dedicate your research in the area of sarcoma and melanoma, and how do you stay inspired and focused on your goals?
Prof. Rutkowski: For me oncology is the most fascinating and challenging field of medicine. When I started my career as a surgical oncologist, I found the field of melanoma and sarcomas fascinating and realized how much the field has an unmet clinical need in cancer care. Moreover, sarcoma therapy is especially demanding and requires high levels of surgical skills while working in a multidisciplinary environment. These two entities are treated in one department in the Maria Skłodowska-Curie National Research Institute of Oncology in Warsaw, Poland. I was attracted to this field from the beginning as I wanted to work as a surgical oncologist and have finished two specialties: general surgery and subsequently oncological surgery.
TCR: You have participated in several investigator-driven trials in melanoma and sarcoma. Can you discuss some of the key findings or breakthroughs from your research in these areas?
Prof. Rutkowski: The investigator-initiated studies are excellent vehicles for pioneering independent research as they can focus on the unresolved questions beyond the interest of pharmaceutical companies and answer the questions that can change the current practice, especially in rare tumors. One recent great example is the AXAGIST trial, presented at the ESMO congress this year, which was designed from scratch by my team and is the largest prospective study evaluating the efficacy of the combination of an immune checkpoint inhibitor (avelumab) and a multikinase inhibitor (axitinib) in patients with advanced/metastatic gastrointestinal stromal tumor (GIST). Our study provides unique data on axitinib activity in GIST patients, which, combined with avelumab, resulted in long-term clinical benefits in a subset of patients pretreated with 2 or 3 lines of therapy. The treatment we designed had a favorable safety profile.
Another great example is the NADINA trial, which demonstrated that neoadjuvant immune checkpoint blockade with anti-PD-1 + anti-CTLA-4 improves event-free survival (EFS) as compared to adjuvant anti-PD-1 alone in resectable, macroscopic stage III melanoma. The NADINA trial demonstrated an estimated 12-month EFS of 83.7% with neoadjuvant nivolumab plus ipilimumab versus 57.2% with adjuvant nivolumab. Neoadjuvant ipilimumab + nivolumab also resulted in an improved distant metastases-free survival (DMFS) as compared to standard-of-care adjuvant PD-1 blockade (HR=0.37, p<0.001). The final major pathologic response (MPR) rate in NADINA is 60.8%. As neoadjuvant ipilimumab plus nivolumab is superior to adjuvant nivolumab, it should be considered a new standard of care treatment.
TCR: What are some major challenges you face in developing new treatments for melanoma and sarcoma? How do you address these challenges?
Prof. Rutkowski: The incidence of cutaneous melanoma across the world is still increasing. Although we have noted the dramatic improvement in survival of stage IV patients, there is still a significant percentage of patients who were initially diagnosed with stage I and IIA disease but ultimately die, so we need a better prognostication system to identify this small percentage of patients based on perhaps, molecular factors. Improving perioperative therapy and increasing access to preoperative systemic treatment are essential. There is high expectancy relating to personalized immunotherapy with mRNA vaccines. The challenges for treating sarcoma are even higher as sarcomas are very heterogeneous tumors with several different subtypes and as rare cancers are underfunded for clinical research. For the care of patients with these tumors, one of the major challenges is the effective panEuropean organization of proper diagnostic and therapeutic system as EURACAN network, which do not work as they should.
TCR: You work closely with national patient advocacy groups for GIST/sarcoma and melanoma. What are some gaps in GIST/sarcoma and melanoma that your team(s) have identified and requires more attention?
Prof. Rutkowski: Advances in adjuvant and palliative treatment are still unsatisfactory in patients with metastatic cutaneous melanoma, and, therefore, melanoma should be detected at the earliest possible stage of the disease. This is why we have introduced several awareness programs in our country and the joint efforts of several stakeholders have led to an unprecedented increase of survival due to cutaneous melanoma in Poland by about 25% during last 9 years from about 52% relative 5-year overall survival to almost 80%. This may be attributed to two factors: early detection of melanoma due to increased awareness of the disease and secondary prevention as well as full access to new systemic therapies in advanced and locoregional stages - which are available across Poland in 35 designated comprehensive cancer centers. Hence, awareness and education are major issues that require working with very active patient advocacy groups in the melanoma field. Next, as they are rare tumors, a multidisciplinary approach is mandatory in all cases. Management should be carried out in reference centers for sarcomas and/or within reference networks sharing multidisciplinary expertise to treat a high number of patients annually. In my country, we are currently developing such a network. Correct diagnosis and effective combination therapy of sarcomas depend on the multidisciplinary cooperation of radiologists, pathologists, surgical oncologists, orthopedic surgeons, medical oncologists, radiation oncologists, and physiotherapists. Multidisciplinary treatment should necessarily be carried out in the reference centers. Close cooperation with GIST/sarcoma patient advocacy groups helps to decrease these gaps and inequalities in access to correct diagnosis and treatment.
TCR: What emerging trends or future directions in melanoma and sarcoma research are you most excited about?
Prof. Rutkowski: In the melanoma field, I am very excited to work with a personalized approach to perioperative therapy, limiting the extent of surgery. In adjuvant and advanced settings, research on molecular profiling, personalized vaccines, and prognostic biomarkers for new drug activity and toxicity are on the way.
In the sarcoma field, more individual approaches to perioperative therapy and better research on the use of immunotherapy in selected sarcoma subtypes are the top emerging fields.
TCR: How has your experience been as a long-standing Editorial Board Member of TCR?
Prof. Rutkowski: TCR has provided several fascinating, good-quality research papers and gathered a great collective of editorial board members over the years, so I am very satisfied to be part of the board for such a long time. TCR covers and combines a great range of specialties, including molecular biology, pharmacology, genomics, and immunology, and emphasize on how these disciplines contribute to modern cancer treatment.
TCR: As a member of the Editorial Board, what are your aspirations for the future of TCR, and how do you see it evolving in the field of oncology?
Prof. Rutkowski: TCR should definitively focus on special issues that target hot topics in translational oncology and specific treatment targets as well as immunological aspects of selected tumor types. But generally, it is a well-developing journal and I am proud to be part of it.