George Named a Fellow of ASCO

Daniel George, MD, is one of two DCI faculty to be named a Fellow of ASCO this year

Daniel George, MD, Duke Cancer Institute professor and director of DCI’s Genitourinary Cancer program, has been named a Fellow of the American Society of Clinical Oncology (FASCO), ASCO announced last week in a press release introducing the 2021 FASCO class and presenting other special awards. Thomas Leblanc, MD, MA, MHS, FAAHPM, DCI clinical hematologic malignancies specialist and palliative care physician, was also named a Fellow of ASCO (READ).

The FASCO distinction recognizes ASCO members for their extraordinary volunteer service, dedication, and commitment to ASCO.

George, who co-leads the DCI Center for Prostate and Urologic Cancers and the Patierno/George/Freedman Lab for Cancer Research, is an internationally recognized clinical oncologist, researcher and thought leader in genitourinary malignancies — specializing in kidney cancer and prostate cancer. His areas of research include improved treatment modalities, the development of new drugs, and the identification of biomarkers in GU cancers with an emphasis on the biological drivers of cancer disparities. He’s the author of more than 200 peer-reviewed publications, including several reviews and position papers on GU cancer disparities.

George is a tenured professor (since 2015) in the Department of Medicine, Division of Medical Oncology, with a secondary appointment in the Department of Surgery, Division of Urology, at the Duke University School of Medicine. He received both his BS (1988) and his MD (1992) at Duke and did his residency and fellowship at Johns Hopkins Hospital. George joined the DCI faculty in 2003 from Harvard University Medical School's Dana-Farber Cancer Institute, where he was an assistant professor in the Department of Medicine.

George has been a member of ASCO since 2003. His roles with ASCO have included serving on the Scientific Committee for the Genitourinary Cancer Symposium for three years; serving twice on the ASCO Scientific Program Committee (two three-year terms); serving one three-year term as leader of the Scientific Program Committee GU (Non-prostate) Cancer Track; and serving two three-year terms on the Conquer Cancer Foundation grants review committee, including one as chair. He has also, as a volunteer, led GU fellows on poster walks and has volunteered at mentorship luncheons.

Most recently (since 2019), George has been serving as a member of the ASCO Research Priorities Decision Group.

In addition to ASCO, George has served in a leadership or membership capacity in various other cancer-focused national committees and organizations, including serving on the NCI (National Cancer Institute) Renal Task Force (2012) and the NCI Genitourinary Cancers Steering Committee (2014).

George is currently the scientific leader for kidney cancer in the Alliance Cooperative Group (since 2011) and serves on Alliance’s GU scientific committee. He’s been a member of the Advisory Board of the Kidney Cancer Association since 2005, a member of the Scientific Oversight Committee of the Prostate Cancer Clinical Consortium since 2007, a member of the Society for Immunotherapy of Cancer Program RCC Cancer Immunotherapy Guideline Committee (SITC RCC CIG) since 2018, and a member of the American Association for Cancer Research (AACR) Cancer Health Disparities Research Scientific Review Committee since 2019.

In addition, he currently serves as senior editor for AACR’s journal, Clinical Cancer Research, and as co-editor in chief of Clinical Advances in Hematology and Oncology.

Key Studies, New Paradigms

George is principal investigator of a forthcoming $10 million nationwide, prospective observational Phase IV study called — ODYSSEY (Outcomes Database to prospectivelY aSSEss changing therapY landscape in Renal Cell Carcinoma)  — to describe the patterns of care and outcomes of metastatic renal cell carcinoma (mRCC) patients in the U.S.

“We hope the data will give us an insight into how novel immunotherapies are being applied in real world settings,” said George.  

Findings from a previous prospective observational study of around 450 mRCC patients across the U.S. were published just last month in the American Cancer Society journal Cancer — with George, co-PI of the study, as senior author, and Michael Harrison, MD, as first author. They concluded that active surveillance appears to be a safe and appropriate alternative to immediate systemic therapy in patients who have mRCC with slow‐growing metastases.

George is co-principal investigator with two other PIs (Lorelei Mucci, PhD, from Harvard School of Public Health and Phil Kantoff, MD, from Memorial Sloan Kettering Cancer Center) of the IRONMAN  study — the International Registry to Improve Outcomes in Men with Advanced Prostate Cancer. 

Since launching in 2017 the study has recruited approximately 2000 patients at 87 sites; across academic and community practices in Australia, Brazil, Canada, Ireland, Sweden, Switzerland, Spain, the UK and the US, and is still recruiting. Sites in Africa (including Nigeria, Kenya and South Africa) as well as the Caribbean (including Jamaica and the Bahamas) are opening and will increase the racial diversity of this study. By collecting clinical outcomes, patient-reported outcomes, epidemiological data, and bio-specimens, the research team hopes to expand global knowledge of how and why prostate cancer outcomes differ by race and ethnicity. [See the latest related publication in the April 2021 issue of JCO Global Oncology: Tackling Diversity in Prostate Cancer Clinical Trials: A Report From the Diversity Working Group of the IRONMAN Registry]

George is the first author of several important papers to be published this year on cancer disparities.

His forthcoming paper in Cancer (in press) reports out some new results of his investigator-initiated race-stratified multi-center prospective ABI-RACE trial (A Phase II Open Label, Parallel group study of Abiraterone Acetate in African American and Caucasian Men with Metastatic Castrate Resistant Prostate Cancer). George is first author and Andrew Armstrong, MD, MSc, is senior author.

The ABI-RACE trial, completed in 2019, involved the enrollment of equal numbers of Black and White men with metastatic, castrate resistant prostate cancer who were treated with the anti-hormone therapy, abiraterone, and the steroid, prednisone.

The data, presented at the 2018 ASCO Annual Meeting, revealed that Black men in the study had a greater response to therapy, characterized by more dramatic declines in a tumor blood marker called prostate-serum antigen (PSA) and had a longer median time to PSA progression than White men (16.6 vs 11.5 months). In other words, they lived longer.

“In this setting we demonstrated that Black men may be more responsive to this specific hormonal intervention,” said George in an interview at the time. “There is an urgent need explore the underlying genetic differences associated with treatment response.”

That same study also appeared to suggest that Black men in the study had higher rates of hypertension and hypokalemia — treatment related toxicities (side-effects).

George said the study sent a clear message that race-based trials are justified.

He and his DCI team subsequently received a $1.6 million grant in 2019 (ends 2022) from the Department of Defense Prostate Cancer Research Program that supports further research to confirm whether biological differences contribute to African-American patients responding better to secondary hormonal therapy in metastatic castration-resistant prostate cancer.

George has a forthcoming paper in Prostate Cancer and Prostatic Diseases — Nature (under review) on the topic of overall survival, by race, of patients with metastatic castration-resistant prostate cancer treated with the novel hormonal therapies — chemotherapy-naïve enzalutamide or abiraterone.

In addition, George (senior author) and Duke GU Oncology Fellow Matthew Labriola, MD (first author) have recently written an educational paper that reveals new data on treatment toxicities in Black and White patients who were enrolled in ABI-RACE. This particular topic, in George’s words, “has generated great interest.” This paper will be published in the ASCO Educational Book, an NLM-indexed, peer-reviewed collection of articles written by ASCO Annual Meeting Education Program faculty.

Recognition for Life

George and LeBlanc were two of 34 individuals nationwide to earn the FASCO designation this year.

Once conferred, the recognition is for life. The two are in good company at DCI — joining Kevin Oeffinger, MD, FASCO (2020); Yousuf Zafar, MD, MHS, FASCO (2019); Arif Kamal, MD, MBA, MHS, FAAHPM, FASCO (2019); Susan Halabi, PhD, FASCO (2018); Christopher Willett, MD, FASCO (2011); and James L. Abbruzzese, MD, FASCO, BA (2008).

The FASCO recognition, which originated in 2007 as the ASCO Statesman Award, has been conferred on 399 individuals to date. Founded in 1964, ASCO has 45,000 members — oncology professionals who care for people living with cancer.