The saying goes that curiosity killed the cat, but in the case of Chris Flowers, MD, that trait has been crucial to his success.
Like many oncologists, Dr. Flowers, division head ad interim of cancer medicine at Houston-based MD Anderson Cancer Center, was drawn to the field because of the opportunity to help patients. His desire to help patients mingled with his curious nature, shaped the path for Dr. Flowers to reach his leadership position, and it has helped the hospital innovate during difficult times.
Here, Dr. Flowers discusses the innovations he is looking forward to and how his team hopes to accelerate innovations for patients.
Editor's note: Responses have been lightly edited for clarity.
Question: What drew you to oncology?
Dr. Chris Flowers: I saw oncology as an opportunity to help patients and their families at a time when they need you most. I discovered that opportunity when I was an intern while rotating in internal medicine. It was one of the things that really attracted me to oncology. I also had been very involved throughout my research career starting back in medical school in clinical pharmacology and immunology. Over my career I have been really excited about the opportunities to be able to apply those directed areas of research to cancer patients. To be able to perform basic, translational, and clinical research in ways that can help to develop new therapies for patients has been a gift.
Q: What cancer study, technology or innovation are you most excited about right now?
CF: Biologic therapies for cancer are extraordinarily exciting. There are two particular areas in immunotherapy: bispecific antibody therapies and cellular therapies that bring components of the immune system to target the cancer and attack it. In my own area of the lymphomas, we've seen both cellular therapies. Historically, autologous stem cell transplantation and allogeneic autologous stem cell transplantation — and now more recently in car-T cell therapy — have had a major impact on outcomes for patients with lymphomas and other blood cancers. I think in the decades ahead, we'll see that cellular therapies and antibody approaches will have an impact not only in the hematologic malignancies, but in solid tumors and a number of cancers across the board.
Q: What aspect of your work or the field keeps you up at night?
CF: I think that we are at a place in cancer care where we're going to need to innovate more rapidly. I think there are a fair number of things that we do in drug development or therapy development for cancer that are not using the most modern technologies and data that we have available to us in terms of innovating. This would be similar to taking a road trip and pulling out a paper map to plan how you will get there. There are opportunities in designing and performing clinical trials that use existing and available data from prior patients that can help us to innovate more rapidly.
The other component of that is ensuring that all patients that have cancers of various subtypes have access to cancer therapies and access clinical trials. This is not only good for the patients who were able to go on the clinical trial, but it's also good for the clinical trials to reflect the population of patients who will need the therapy for over the long run. It's going to be a challenge to develop clinical trials and execute clinical trials in ways that really address both of those issues. One of the things that we are focusing on at MD Anderson are ways to stand up to this challenge.
Q: What's one thing your hospital or health system is doing in cancer care that you are most proud of?
CF: I'm extraordinarily proud of the work we've done around delivering goal concordant care. This work is centered on trying to make sure that we meet patients and families where they are and deliver care that matches their goals and the realities of the cancer that they are facing. This has been something that was very critical during the COVID-19 pandemic, and we have instituted processes both within our ICUs and system to make sure that those goals of care are being addressed during parts of the care delivery process.
A researcher studied our goal concordant care program, comparing about 5,000 patients who received care before implementation and about 5,000 after implementation, and found that this program decreased the ICU length of stay and decreased our hospital length of stay and actually had an impact on the system as a whole.
The other steps that we've taken even beyond those efforts are to make sure that all of our physicians and teams are trained in the process of having these difficult conversations that are necessary to be able to institute care. The majority of our clinicians inside of my division of cancer medicine have been trained in the serious illness conversation guide. This is also occurring in our nursing division. The training gives our providers the tool sets for having these crucial conversations and helps patients and their families achieve their goals of care.
Q: What advice would you give to someone who wants to have your job title one day?
CF: Be curious. That is one of the things that has really helped me throughout my career: I have been quite curious about things that we can do better in a number of situations. It helped us be able to innovate through the COVID-19 pandemic, both in terms of helping address some of the staffing challenges that many hospitals faced, as well as quickly being able to handle remote work and hybrid work environments. Curiosity has been a key component to what I've done in performing research that impacts patient outcomes. My advice in the educational arena is to focus on mentorship and stay curious about the goals your mentees have in pursuing their own career objectives. Curiosity really has been key to my success in a number of arenas.