Enhancing immunotherapies in prostate cancer: A Q&A with Dr. Akash Patnaik

Akash Patnaik

Akash Patnaik, MD, PhD, assistant professor of medicine, joined the University of Chicago Medicine a year ago as a medical oncologist specializing in genitourinary cancers, including prostate, bladder, kidney, and testicular cancers. Also an accomplished researcher, Patnaik translates novel therapies developed in the lab into early-phase clinical trials.

He was recently awarded a Young Investigator Award from the Cancer Research Foundation, Career Development Award from the National Cancer Institute-funded SPORE to Northwestern University/University of Chicago, the Bristol-Myers Squibb/International ImmunoOncology Award, and a pilot project grant from UChicago Institutional Research Grant from the American Cancer Society to study how to enhance response to immunotherapies — treatments that uses the body's immune system to fight cancer — in patients with prostate cancer.

Patnaik was also recently awarded a $1 million Challenge Award from the Prostate Cancer Foundation for a translational team science project with co-investigators Walter Stadler, MD, Fred C. Buffet Professor of Medicine and Surgery, and Thomas Gajewski, MD, PhD, professor of pathology and medicine. We spoke to him recently about his work.

What is the focus of your research?

While there have been incremental advancements in therapies for prostate cancer over the past decade, the field is faced with several challenges as we navigate the exciting and complex era of personalized medicine and cancer immunotherapy. The goal of my interdisciplinary research program, that spans both laboratory-based and early-phase clinical trial investigations, is to develop targeted therapeutic strategies to improve the responsiveness of prostate cancer to immunotherapy.

What is the impact of your research?

We anticipate that our parallel efforts in the laboratory and clinical trials will result in the development of new immune-based combination therapies to alleviate suffering from advanced prostate cancer within the next five years.

What do you hope to accomplish during your career?

The realization of a career as a physician-scientist has been a gradual process, spanning years of life experience and training to acquire the relevant knowledge, clinical experience, and scientific maturity. I aspire to leverage the breadth of my parallel endeavors as a translational scientist, physician, and educator, to end suffering for patients with advanced prostate cancer.

How has your field of study changed since you began your career? Where do you think it is heading?

As an MD/PhD student, I discovered the molecular mechanism for how retroviruses (including HIV) bud from infected cells, a step in the replication cycle that is poorly understood for any enveloped virus. My PhD work led to the identification of a novel function for cellular housekeeping protein called ubiquitin in the context of virus budding. This process can be targeted by proteasome inhibitors, which are a class of drugs used to treat multiple myeloma, a hematological cancer.

All existing antiretroviral drugs target the virus, which is capable of rapid resistance via mutations, making therapies ineffective over the long-term. In contrast, proteasome inhibitors target the "protein garbage disposal" machinery within the infected cell and not the virus directly, thereby allowing the virus minimal opportunity to develop resistance to the drug. Not surprisingly, a growing number of virus families have since been shown to require the ubiquitin system for virus budding.

My PhD work led to the exciting possibility that a single antiviral medication can target all viruses, analogous to the concept of penicillins to treat bacterial infections. My current efforts as an independent investigator blend a unique combination of expertise in medical oncology, cancer biology, and early-phase clinical trial investigation. Several drugs targeting dysregulated signaling pathways in tumor cells have been deployed in cancer therapy. However, their impact on immune responses within the tumor microenvironment is poorly understood. My laboratory is now actively investigating how interference with cell survival signaling and DNA repair pathways can enhance the effectiveness of immunotherapy in prostate cancer.

How did you get interested in studying cancer and/or treating cancer patients?

At age 7, I had the misfortune of witnessing the progressive downhill course of my maternal grandfather, who was diagnosed with an aggressive form of brain cancer and died within a few months after diagnosis. It was the beginning of an endless journey of asking more questions than there were answers available.

As a medical intern and resident in Internal Medicine, it was deeply inspirational and uplifting to care for cancer patients in the hospital, who transmitted an aura of hope and optimism in the face of terminal illness. I had an inner realization that the care of cancer patients provides a unique opportunity for humanism in medicine. During my clinical fellowship in Medical Oncology at Harvard, I lost a close maternal uncle to metastatic prostate cancer. At that time, I was emotionally humbled and intellectually challenged by the limited treatment options for patients with this disease, and so I dedicated my career to translating the most effective therapeutic approaches from the bench to the bedside to combat this disease.

What is the most rewarding part of your job?

As a physician-scientist, I wear multiple "hats" as a medical oncologist caring for cancer patients, laboratory/clinical trials investigator translating scientific discoveries into the clinic, and educator/mentor training the next generation of physicians and scientists. While challenging to maintain balance between these seemingly disparate responsibilities, it is truly a privilege to contribute to the collective breadth of activities within academic medicine. The cancer problem is global, with an increasing need for international teams to come together to find creative solutions with a broader public health impact. It is an honor to be part of this international effort to end suffering from cancer.

Who inspires you?

I am continually inspired by our patients, who fight cancer with courage, optimism, and grace. I am grateful to my colleagues and team members, whose tireless efforts motivate me on a daily basis. I am deeply indebted to my family for their loving support, which serves as an inspiration for my efforts as a physician-scientist, even during the most challenging phases of this journey.

Why did you come to the University of Chicago? What do you love about working at this institution?

After completing my clinical and research training and joining the faculty at Harvard, I was well-poised to lead an independent translational research program in prostate cancer. During the recruitment process, I was impressed with the scientific depth and intellectual rigor at the University of Chicago, with unique opportunities for interdisciplinary collaborations within the institution. I particularly resonate with the culture of collegiality and team spirit at the institution. I am thankful for the invaluable commitment and support for translational research provided by the Section of Hematology/Oncology, Department of Medicine and Comprehensive Cancer Center.

What are your favorite hobbies outside of work?

I enjoy international traveling, tennis, and learning to play the sitar.

What is one thing on your bucket list?

As a young boy growing up in India, I developed a love for science and a career in medicine/biomedical research, which remains with me today. I hope to come back full circle and collaborate with institutions in India, to advance infrastructure for translational cancer research and clinical trials in areas with the greatest unmet need.

Akash Patnaik, MD, PhD, MMSc

Akash Patnaik, MD, PhD, MMSc

Akash Patnaik, MD, PhD, MMSc, is a medical oncologist specializing in the care of patients with genitourinary cancers, including prostate, bladder, kidney and testicular cancers. He also has a strong interest in the development of novel therapeutics for treatment of advanced solid tumors.

Read Dr. Patnaik's physician bio