Three questions for radiation oncologist Ravi Chandra

Ravi Chandra, M.D., Ph.D., is an assistant professor of radiation medicine in the OHSU School of Medicine who has a special interest in serving as a bridge between scientists in the lab and the patients he treats in the clinic. We asked him three questions:

What’s been the most interesting development in your area in the last two years?

Two broad developments come to mind: First, there is increasing evidence for the safety and efficacy of cutting-edge treatments (like stereotactic body radiation therapy, or SBRT) in patients with advanced and recurrent cancers. As a result patients across the spectrum of cancer have more treatment options available to them than ever. In some cases patients with metastatic disease are being offered new, potentially curative treatments. The interplay of the immune system, novel systemic therapies, and the role with radiation is also being studied and may help such patients. Moreover, as all patients with cancer are living longer, some are experiencing new or recurrent cancers. It was once thought that radiation could only be given once to a site in the body, and there is mounting evidence that we can continue to devise treatment strategies even in prior radiated regions.

Learn more about Dr. Chandra and the Chandra Lab.The second development is in my primary area of clinical specialization: head and neck cancer. Radiation is an extremely effective weapon against cancers of the head and neck, but can leave patients with chronic side effects. The technologies for treatment have advanced markedly, but so too have studies on de-escalation of therapy in some favorable types of head and neck cancer and in the integration of robotic surgery to help decrease overall treatment intensity. New data are beginning to emerge and they are very promising. Similar to the above, I am very optimistic about how we can further improve care for head and neck cancer patients.

What projects are you currently working on and are there opportunities for fellow faculty to participate?

I am excited to develop and participate in collaborative projects across our institution, especially given the strengths we have in Otolaryngology-Head and Neck Surgery, advanced imaging, dentistry, and supportive care. Presently I am involved in outcomes studies in the head and neck space with Ryan Li, M.D., and Shannon Nugent, Ph.D. I also have interests in interprofessional education (collaboration with Kristi Tonning, M.S.), SBRT and immunotherapy in recurrent head and neck cancer (collaboration with Jon Schoenfeld, M.D., M.P.H. at Dana-Farber Cancer Institute), and even COVID-associated pneumonia (multi-institutional study on using radiation in such patients). I would love to collaborate with researchers hoping to translate their work to the clinic or are performing clinical sample and biomarker based studies and who are in need of a clinical, physician-scientist partner.

Going forward, I hope to build upon the success of our head and neck program in creating an even more vibrant multidisciplinary head and neck clinic. Conversations are just beginning. We hope to increase multidisciplinary collaboration and referrals, broaden our reach through a remote second opinion program, and enhance accrual to clinical trials through the program. I am excited to collaborate with stakeholders across the institution on this important endeavor.

A hypothetical: If you could have one tool that would solve a seemingly impenetrable problem in your work, what would it do? You have unlimited resources to design this tool, so think big. 

I’d love it if we could have sensitive means to assess how patients’ cancers are responding to treatment, during treatment. That way we could be even smarter about decreasing or increasing dose to different regions of the body and designing next generation clinical trials that are much more personalized. Right now, we have to wait until treatment is complete to “see how we did,” and in many cases treatment paradigms, which are derived from large clinical trials, are one size fits all. Advances in early detection and diagnostic imaging have been instrumental in helping drive better outcomes for our patients, both prior to and after treatment. I do hope one day we can readily assess patients as they are being treated, so we can tailor our treatments nimbly and improve outcomes.

About Three Questions

This Q&A series features OHSU School of Medicine faculty members, leaders, and staff talking about their work with the goal of getting to know them and different areas across the school. Are you interested in being featured? Want to nominate a colleague? Contact us at somdeansoffice@ohsu.edu

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