My interests lie in clinical and translational research in advanced prostate cancer, including trial design, and development of novel agents. I piloted the early trials targeting the androgen receptor in advanced prostate cancer, developing ketoconazole and contributing to an understanding of its mechanisms of activity and resistance. I subsequently was centrally involved with the development of two novel androgen signaling inhibitors, abiraterone acetate and apalutamide, from first in human studies to FDA approval.
I have also been involved in the early application of immunotherapy to prostate cancer, developing sipuleucel T from first in human studies through FDA approval, and undertaking the first in human testing of ipilimumab, the first immune check point inhibitor to be clinically developed.
Understanding the mechanisms of resistance in advanced prostate cancer has been a research focus. I was principal investigator of a $10 million multi-center Stand Up to Cancer (SU2C)/Prostate Cancer Foundation Dream Team Award undertaking deep genomic characterization of prostate cancer metastases, in order to elucidate patterns of resistance in abiraterone and/or enzalutamide treated patients. Important observations from this, and subsequent work have included unexpectedly high prevalence rates of treatment associated small cell/neuroendocrine prostate cancer (t-SCNC), as well key structural variants which contribute to progression of castration-resistant disease, observed in the largest Whole Genome Sequencing series to date of metastatic advanced prostate cancer specimens.
I hold a number of leadership roles, serving as Co-Leader of the UCSF Prostate Cancer Program, and as Deputy Director of the UCSF Helen Diller Family Comprehensive Cancer Center. I previously served as Chief of the Division of Hematology and Oncology in the UCSF Department of Medicine for 10 years, and most recently have assumed the position of Chief Scientific Officer in the UCSF Helen Diller Family Comprehensive Cancer Center. Nationally, I serve on the ASCO Board of Directors, and chair 4 External Advisory Boards for other NCI-Designated Cancer Centers.