Bassel El-Rayes, MD

GI Oncology Now

Bassel El-Rayes, MD, is a distinguished leader in gastrointestinal (GI) oncology, currently serving as the deputy director of the UAB O&rsquo;Neal Comprehensive Cancer Center, director of the Division of Hematology &amp; Oncology, Albert F. LoBuglio Endowed Chair for Translational Cancer Research, and professor of medicine at the University of Alabama at Birmingham (UAB). Dr. El-Rayes has held significant roles at the Barbara Ann Karmanos Cancer Institute and later at Emory University&rsquo;s Winship Cancer Institute, where he led the GI oncology program and served as associate director for clinical research. His research focuses on pancreatobiliary and neuroendocrine cancers, with more than 250 peer-reviewed publications and leadership in multiple National Cancer Institute (NCI)&ndash;funded trials.In an exclusive interview with GI Oncology Now, Dr. El-Rayes reflects on his career in translational research, emphasizing his efforts to expand clinical trial infrastructure, investigate the tumor microenvironment, and foster collaboration, while offering advice to aspiring oncologists to pursue their passions in the field.&mdash;What inspired you to pursue a specialization in GI oncology, particularly in pancreatic and neuroendocrine tumors or cancers? Were there any mentors along the way who significantly influenced you?Dr. El-Rayes: I completed medical school at the American University of Beirut, then moved to Detroit, where I did my residency and fellowship at Wayne State University. I was drawn to oncology because it is a field that strongly integrates biology with treatment and is constantly evolving. That dynamic nature is what initially attracted me.During my fellowship, I had several excellent mentors who guided me toward a focus on pancreatic cancer. One of the most influential was Dr. Philip Philip, who still practices at Wayne State University and Henry Ford Hospital. He was a key mentor throughout my fellowship and played a major role in shaping my interest in pancreatic cancer.During that time, I also spent a year in the lab. Working in the lab helped me see the potential of a translational research career&mdash;bringing new ideas from the lab, testing them in cell lines and animal models, and then designing clinical trials that parallel those experiments. That process deepens our understanding of cancer biology while simultaneously contributing to the development of new treatments. This translational approach became the foundation of my career, and it was something I was specifically trained to do during my fellowship under Dr. Philip&rsquo;s mentorship.After finishing my training, I spent a few years at Wayne State, where I developed several research projects. Eventually, I began exploring opportunities beyond the institution where I had trained. Emory University in Atlanta felt like a great fit, so I transitioned there.At Emory, my career evolved along 2 parallel paths. On the one hand, I continued my translational research work&mdash;running a lab and designing clinical trials based on the concepts we were testing. On the other hand, I took on a number of administrative roles, the most prominent of which was serving as the associate director for clinical research at Winship Cancer Institute and Vice Chair for Clinical Research in the Department of Hematology Oncology. In that role, I had the privilege of building and overseeing the infrastructure to support clinical research across the institution. Over the course of about 7 to 8 years, we increased the number of patients enrolled in treatment trials from around 300 to nearly 1,000&mdash;a major accomplishment&mdash;all while I maintained my own research and lab.Another important part of my time at Emory was mentoring junior faculty. I was fortunate to mentor several individuals who have gone on to lead in their own right. One example is Dr. Olatunji, who now leads the GI program at Emory. Another is Dr. Akce, who is currently with me at the University of Alabama at Birmingham (UAB) and leads a successful phase I clinical research program and has an interest in liver cancer.After about 9 years at Emory, an opportunity arose to join UAB as division director of Hematology and Oncology and deputy director of the Cancer Center. This was a significant step forward in my administrative career, and it also brought me to an institution with a strong reputation for research and cancer care. At UAB, I have continued along the same trajectory. I maintain a lab focused on pancreatic cancer and neuroendocrine tumors, I run clinical trials inspired by our lab research, and I also oversee the division and help lead the cancer center. That is the big picture of my career path so far.During your tenure at Emory University&rsquo;s Winship Cancer Institute, you significantly increased patient accruals to therapeutic trials. What strategies did you implement to achieve this growth, and how do you apply similar approaches at UAB?Dr. El-Rayes: The strategy rests on 3 main pillars. First, it is essential to build a robust infrastructure that supports clinicians in conducting trials. Physicians and advanced practice providers (APPs) are extremely busy and face many demands on their time. You need an infrastructure&mdash;often called the Clinical Trials Office&mdash;that is functional and reliable, so that investigators feel confident in investing their time and effort into clinical research.Second, you must actively engage and inspire physicians and APPs to participate in clinical trials. This means making clinical research an important and meaningful part of their work. They should feel that contributing to trials is not an extra burden, but a core aspect of their mission.Third, you need to make clinical trials visible and accessible to patients. Patients coming to Emory&mdash;or now to UAB&mdash;should see trials as a legitimate and valuable option. When they meet with their physicians, clinical trials should be part of the conversation. You also need to prepare patients and families to be open to those discussions when they arise.Underneath these 3 broad strategies&mdash;infrastructure, clinician engagement, and patient awareness&mdash;are countless smaller tactics and initiatives. But those are the key pillars that helped us grow patient accruals to trials so significantly.Your research emphasizes translational studies and drug development in gastrointestinal cancers. Could you elaborate on some key advancements you have contributed to in pancreatobiliary and neuroendocrine cancer treatments?Dr. El-Rayes: My contributions can be divided into 2 broad categories. The first includes clinical trials I participated in that may not have originated in my lab but in which I was actively involved. For example, I participated in trials testing immunotherapies in liver cancer and microsatellite unstable colorectal cancer. These studies led to important FDA approvals for immune-based therapies in those diseases.The second category encompasses work from my own lab, where we focus on the biology of cancer-associated fibroblasts (CAFs). These cells play a supportive role for pancreatic cancer cells by modifying the tumor microenvironment, making it more conducive to cancer growth. CAFs also affect how the immune system interacts with the tumor, often promoting tolerance instead of attack&mdash;which is counterproductive.In the lab, we study how to alter the biology of CAFs to improve immune system engagement and enhance the effectiveness of treatments. This area of focus has been central to my lab&rsquo;s work for many years.Your work involves studying the tumor microenvironment in pancreatic cancer. How has this research enhanced our understanding of the disease and influenced the development of novel therapeutic strategies?Dr. El-Rayes: I would highlight a few important developments. Last year, for instance, we published a pivotal paper that examined how the tumor microenvironment differs between primary pancreatic tumors and their metastases in the liver. Rather than focusing solely on cancer cells, we analyzed the surrounding microenvironment in both locations. What we discovered is that although the cancer cells are essentially the same, their interaction with the local environment&mdash;whether in the pancreas or the liver&mdash;leads to very different biological behaviors.That study, conducted in collaboration with the University of Indiana, was published in Nature Genetics, a high-impact journal. The findings help explain why some treatments may work well for primary tumors but fail in metastatic disease.Another paper we published last year in Cell Reports Medicine examined how vitamin D and hydroxychloroquine&mdash;both of which impact a process called autophagy&mdash;affect the tumor microenvironment in pancreatic cancer. We studied these agents in both preclinical models and patients enrolled in clinical trials. Our findings showed that these drugs could modify the tumor microenvironment in a way that makes it more receptive to the immune system.While it remains to be seen whether vitamin D and hydroxychloroquine will become mainstream treatments, our research adds important insights into how these agents function and how they could be leveraged in combination with other therapies.Serving on national committees like the NCI Neuroendocrine Tumor Task Force and contributing to ASCO [American Society of Clinical Oncology] guidelines demonstrates your commitment to shaping oncology practices. How have these experiences informed your clinical and research perspectives?Dr. El-Rayes: To truly make progress against cancer, we must work together as a unified community. Unfortunately, the system often puts us in silos. I am at UAB, someone else is at MD Anderson, another at Memorial Sloan Kettering. While institutional pride is important, cancer care and research should not be competitive endeavors.Serving on national committees, such as the NCI Task Force or ASCO guideline panels, provides a platform for collaboration across institutions. These opportunities allow us to learn from one another, share best practices, and develop concepts that are synergistic. They also facilitate collaborative clinical trials that benefit from broader patient populations and shared expertise.Ultimately, these collaborations are not about making one institution more successful than another. They are about helping the field move forward collectively&mdash;whether that means improving treatment for pancreatic cancer, neuroendocrine tumors, or any other malignancy.With the evolving landscape of GI cancer treatments, what emerging trends or innovations do you foresee playing a pivotal role in the next 5 to 10 years?Dr. El-Rayes: One major area of advancement is immune therapy, which includes cancer vaccines, immune checkpoint inhibitors, and cell-based therapies. Immunotherapy has already transformed treatment for several GI cancers, such as liver, certain colorectal cancers, and gastric cancer. However, we have yet to fully unlock its potential.As we deepen our understanding of tumor biology, particularly how cancer cells interact with their microenvironment, we will be better equipped to harness the immune system effectively.Another rapidly advancing area is targeted therapy. These are drugs that act on specific genetic or molecular abnormalities within cancer cells. One class of targeted agents that is particularly promising involves drugs that act on the RAS pathway&mdash;a common driver of many cancers, including pancreatic and colorectal. For a long time, RAS was considered &ldquo;undruggable,&rdquo; but that is changing.The real power, however, will come from intelligently combining these strategies&mdash;pairing immune therapies with targeted therapies or using different immunotherapies together&mdash;to break through the defenses of the tumor and meaningfully change its biology. That is where the field is heading: deeper biological understanding that leads to more precise, personalized, and effective treatment combinations.The last question harkens back to something you said at the beginning: your deep involvement in mentorship. What advice would you give to incoming trainees, fellows, and the next generation of doctors entering the GI oncology field?Dr. El-Rayes: It is important to recognize that there are many different ways to make an impact in this field. Success does not look the same for everyone. Some individuals may excel in mentoring others. Some may discover new treatments. Others may work on improving access to care or advancing prevention and early detection. Every one of these avenues is valuable.For new trainees and junior faculty, the key is to discover what resonates with them personally. Which area excites them the most? Which path inspires them to give their best every day?This is not just another job: it is the job. Caring for cancer patients and advancing the science that supports them is a privilege. Find the path that lights a fire in you, the one that makes you look forward to going to work. That is where you will make the most meaningful impact.

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Dr. El-Rayes reflects on his career in translational research, emphasizing his efforts to expand trial infrastructure.