9th Annual Surgery, Intervention, and Engineering Symposium
Keynote: Stephen B. Solomon, MD
Enid A. Haupt Chair in Clinical Investigation
Chief of Interventional Radiology
Memorial Sloan Kettering Cancer Center
Professor of Radiology
Weill Cornell Medical College
Innovations in Interventional Oncology: From Bench to Clinic
Stephen Solomon is a physician and scientist driven by innovation, strategic vision, and successful translation to improve clinical care. As Chief of Interventional Radiology over the last 12 years, he has transformed Memorial Sloan Kettering Cancer Center’s (MSKCC’s) Interventional Radiology (IR) Service from 6 faculty and 5,000 annual procedures to over 25 faculty performing 22,000 annual procedures. He has developed an internationally acclaimed Service by recruiting talented and diverse faculty to meet the Center’s academic mission of delivering innovation to the clinical practice, research enterprise, and educational portfolio.
Dr. Solomon himself is regarded as a renowned innovator who holds many patents and has invented and developed several technologies that are being applied in clinical medicine today throughout the world. He has a creative mind that identifies solutions to unmet needs in medicine. He has done this through his own efforts and has instilled this same curiosity and creativity on his team in Interventional Radiology at Memorial Sloan Kettering.
One of his most important contributions to Medicine has been the development of a navigational bronchoscope that has helped spawn the field of Interventional Pulmonary Medicine. Before this invention, bronchoscopy could only visualize structures within the airway. Dr. Solomon developed an electromagnetic position (“GPS”) sensor that tracked the location of the bronchoscope as it moved in the airway. Marrying this location to a CT scan enabled visualization of structures in and out of the airway. This allowed biopsy and other interventions to be performed on structures outside of the airway and allowed guidance to abnormalities seen on a CT scan. This innovation was developed in the laboratory, evaluated in animal models, was translated into clinical trials, and is now a standard tool throughout the world.
Dr. Solomon similarly used this electromagnetic position sensor to track other devices in the body. Another significant success was applying this sensor to catheters in the heart that would track and treat electrical rhythm abnormalities. By combining CT and MR imaging of the heart to the electrical and temporal rhythm of the heart beat, Dr. Solomon helped improve the ability to guide therapy in heart beat dysfunction such as atrial fibrillation. This is also a system that is a standard across the world.
Dr. Solomon’s clinical expertise is image-guided interventions and specifically destroying (i.e. ablating) cancers with heat or cold. He is one of the foremost experts in this field and has developed and translated many of these tools into daily clinical practice at MSKCC and around the world. This has enabled destroying cancer with a simple needle rather than having to undergo a major surgical resection. This technology is routinely applied in lung cancers, liver cancers, bone cancers, kidney cancers, and others.
Dr. Solomon has worked with Nobel Laureate Jim Allison to demonstrate how using thermal ablation in mice can create an immune response to the dead ablated tissue and how this immune response can be trained to fight cancer in other parts of the body, creating a “personalized cancer vaccine.” Dr. Solomon has helped translate this work into ongoing clinical studies.
Dr. Solomon’s laboratory has also experimented with a variety of energy sources to destroy cancer. One of the most interesting has been the application of electrical fields on cancer cells. The field of electroporation has been around for a while and has allowed a cell’s membrane to be temporarily permeable. Dr. Solomon has experimented with irreversible electroporation which permanently destroys cells by irreversibly destroying their cell membranes. This has benefits of destroying cells but not the proteins that create the structure of an organ. This may allow preservation of the organ’s function (e.g. bile ducts or bronchi) while still killing the cancer cells. With his engineering partner he developed a new method of killing cancer cells called “e-stress” which through continued cell membrane depolarizations, that the cell must use energy to correct, “exhausts” the cells of its energy supply and leads to cell death.
While CAR T-cells have made a significant impact on “liquid tumors” such as lymphoma, it still has not been very successful in solid tumors. Dr. Solomon has teamed up with colleagues at MSKCC to improve CAR T-cell delivery with image-guidance and to apply electrical fields to enhance CAR T-Cell delivery to solid tumors. This has led to receipt of an NIH R01 grant.
As Precision Medicine has become central to cancer care, so too has the image-guided biopsy to collect the tissue necessary for genetic analysis. One of the challenges of image-guided biopsy is knowing while the patient is in the biopsy suite that the appropriate amount of tissue has been collected. Without knowing this a patient may return for treatment 3 weeks later to be told that insufficient tissue was collected to perform molecular analysis. Dr. Solomon has led development of an optical spectroscopy device that analyzes the tissue at the time of biopsy to determine sufficient quantity for molecular studies.
Dr. Solomon has been instrumental in a number of additional advances in cancer care ranging from molecular-guided PET interventions to protective displacement of organs undergoing radiation therapy to intra-arterial delivery of chemotherapy for lung metastases. He has encouraged his team to think creatively and apply the tools of imaging to solve the unmet challenges in medicine. This has led the MSKCC IR team to be one of the most academically prolific and well-funded worldwide with research across multiple DMT disease states.
Dr. Solomon has over 250 peer-reviewed publications, chapters, and reviews. He is a graduate of Harvard College and Yale School of Medicine. He completed his radiology residency at Johns Hopkins and his fellowship at New York Presbyterian Hospital/Weill Cornell Medical Center. He was a faculty member at Johns Hopkins for 7 years before joining MSKCC as the Director of The Center for Image Guided Intervention and then Chief of Service. He has recently been granted the Enid A. Haupt Endowed Chair in Clinical Investigation at Memorial Sloan Kettering.