By Vikas Natesh
Scheie Vision Spring 2015
Dr. Daniel Gombos is a Professor and Chief of Ophthalmology at MD Anderson Cancer Center, with joint appointments at Baylor College of Medicine and the University of Texas Medical Branch, Galveston. After completing fellowships at University of California San Francisco (with Dr. Joan O’Brien) and St. Bartholomew’s Hospital in London, Dr. Gombos was recruited by MD Anderson as an ocular oncologist.
At MD Anderson, Dr. Gombos focuses on retinoblastoma and uveal melanoma. He helped to create the Retinoblastoma Center of Houston, a center wide program that brings in resources of major healthcare institutions in Houston. As the clinical co-director for this center, Dr. Gombos has collaborated on several children’s oncology group protocols.
Dr. Gombos also built the uveal melanoma program at MD Anderson and brought in new technologies, such as Ruthenium Plaques, for treatment. Plaques are radioactive implants sewn onto the surface of the eye, used to destroy uveal melanoma cancer cells.
“These plaques were very successful in Europe and allowed for salvage of the eye with less ocular toxicity,” he explained.
In addition to working on surgical techniques for ocular cancer management, Dr. Gombos conducts prognostic testing for uveal melanoma using genetic expression profiling. Researchers have identified specific genetic profiles that are associated with a higher risk of uveal melanoma. These genetics tests have become commercially acceptable. Additionally, research has identified specific genetic profiles that are associated with a higher risk for metastatic disease. These patients need long-term surveillance. This discovery led to the initiation of new trials to identify novel drugs for patients with overt metastatic disease.
Although genetic tests can identify whether a patient is at high risk for a disease, we do not have a standard treatment that affords these patients a reduction in risk. Nevertheless, the identification of patient specific mutations and markers suggests that cancer is moving in the new and exciting direction of personalized and precision medicine.
“Ocular oncology is increasingly becoming an environment where you have to work collaboratively with ocular oncologists, radiation oncologists, and geneticists.” Dr. Gombos said. “Patients come in for fresh tissue harvesting and genetic testing, but also for genetic counseling and family planning. The big hurdle will be the cost and access to care since we need the ability to assess something right away.”
We at Scheie are extremely proud of researchers such as Dr. Gombos who move our field into new frontiers!