Question and Answer Interview
Medicine | Published: 25 September 2018
Q&A: New Kid on the Block
Elizabeth Ojo
Douglas B. Johnson is the Assistant Professor of Medicine for the Melanoma Research Program at Vanderbilt Medical Center. He focuses on clinical and translational studies. Dr. Johnson’s primary interests are developing and understanding biological indicators for immune diseases and researching targeted methods of treatment for patients. With a schedule filled with patient visits and department talks, he is currently developing clinical trials for melanoma patients to create profiles for cancers and predict which patients will benefit from immune therapies.
How did you get involved in this line of medicine?
I had a friend, during residency, who had melanoma and that got me somewhat interested. There was one of the senior… researchers who … became my mentor. [He] was doing really interesting [high impact] work in melanoma. It was more of [a combination of] … a friend being affected and, it being a really fascinating field.
What have you found surprising in your research on melanoma?
Essentially, in 2011, there were no really effective drugs. We’ve now had … 11 drugs FDA approved over just the last 6 years. [It] has been sort of remarkable and fast paced and pretty amazing. I think the biggest thing… is that you can go from a disease that was really sort of the worst cancer to get to something that we can actually cure [or at least slow down]. I think half the patients … are able to see improvements over the last few years.
Could you expand on the results of the 2016 research study that your department did on myocarditis, a condition when the heart is inflamed?
[An] impactful treatment for melanoma … has been immunotherapy. These drugs activate the body’s own immune system against cancer but occasionally can also activate against our own tissue[s]. [That can] be really dangerous. [We] published, in a systematic way, molecular testing on the tissue [and learned that the] T-cells were actually causing the tumors around the [patients’] hearts. …The [T-cells] may have been recognizing the same proteins in the tumor and the heart, which is causing the problem. One thing we are trying to study now is the long term outcomes of patients who are responding [to immunotherapy].
Your patients are amazed by your ability to explain their situations and scenarios to them. Why do you make it a priority to maintain that patient relationship?
One good thing about oncology is that you … develop good longitudinal long term patient relationships because people are coming every week so you really get to know people. … Explaining in a lot of detail up front is not only better for the patient, which is obviously the biggest goal, but is better for you as a provider too. You can really make sure they know what the plan is going forward to minimize confusion [and] complications. …If the patients in a really challenging situation, … knowing what they are up against really helps them … [and helps doctors] raise the bar as far as trying to get more people to respond to treatment.
What do people misunderstand about your work on immunotherapy?
[I think] the biggest two misunderstandings [are] the opposite of each other. Immunotherapies are sort of the new kid on the block, as far as cancer treatments go, that were only approved about three or four years ago. There is a group of people who don’t even … know about immunotherapy, [and others who think it is] the cure all, magic bullet. [They can work] so well that some patients think that they’re gonna work for every patient or work for every cancer. It’s sort of the … not knowing anything at all about it; all the way to thinking it’s the greatest thing in the world. The truth is really somewhere there in the middle.
Ojo- Final QandA-cancer doctor