December 2016: Guido Tricot, MD, PhD

Dr. Guido Tricot likes to see his discoveries in action, which is why a mix of research and clinical work is so important to him. It’s hard, he says, to see the connection between real life and what happens in the lab without seeing patients, too. “I would lose touch with what is really important. In translational research,” he says, “you can see the benefits within three to five years, but in basic research, you might have to wait twenty, thirty years.”

Born in Belgium, Dr. Tricot completed his M.D. and his Ph.D. at the University of Leuven followed by a residency and fellowships in Hematology in the Netherlands. While on faculty at the University of Leuven, he also did postgraduate work at M.D. Anderson in Texas, the Royal Marsden Hospital in London, and Roswell Park Memorial and Memorial Sloan Kettering Cancer Center in New York. After about five years at Leuven, Dr. Tricot says he heard from a former Leiden colleague who had been working at Indiana University. “He called me on a weekly basis and said ‘I have too much work here, you need to come and help me.’” Dr. Tricot demurred, but the colleague was persistent. After a year, Dr. Tricot agreed to a visit and then to stay, in part because many countries throughout Europe were preparing for the formation of the European Union. “This meant,” Dr. Tricot says, “that every government had to cut back on their expenses to meet certain criteria. And one of the first victims, as often is the case, was research.”

That same colleague that lured Dr. Tricot to Indiana? He left the next year. But Dr. Tricot stayed for six more years before following the cutting-edge research from Indiana to the University of Arkansas. “Arkansas is the Mecca for multiple myeloma. While in Arkansas, around 2007, it became clear that the next breakthrough in therapy would come through a better understanding of genes.” Through gene expression profiling, it could be determined whether particular chemotherapies could increase or decrease certain genomic activity in cancer cells. “But then it also slowly but surely became clear that focusing on a single gene in a disease as complex as cancer was not going to give us an answer to therapy.”

Dr. Tricot’s search for that answer next led him to the University of Utah, which had a broader research portfolio than Arkansas’s singular focus on myeloma. And although Utah was supportive of his work and he appreciated working “where it was easy for patients to go,” Dr. Tricot “decided to look for a place (that was) willing to reinvest part of the money that we generated” back into the research. Only two universities that he investigated seemed willing to entertain that idea, and one of them was the University of Iowa. Dr. Tricot is now the Director of the Adult Hematopoietic Stem Cell Transplant & Multiple Myeloma Program in the Holden Comprehensive Cancer Center (HCCC), as well as the Gary D. Arthur Professor of Adult Bone Marrow Transplantation.

“The main attraction of Iowa was that there was a very good group of people who were not necessarily interested in myeloma but in B-cell malignancies. One of the best researchers in this area is here.” And although focus in research has turned away from the search for a single gene, a “silver bullet” in cancer treatment, gene expression profiling has still proven useful, revealing the behavior of those cells that remain after chemotherapy. Even though 99 percent of the cancer cells have been eradicated, remaining mature cancer cells can “de-differentiate and become cancer stem cells again.” It therefore becomes important “to understand what the expression profile looks like in those cells that are surviving even the most intensive chemotherapy.” This has led to another main focus of Dr. Tricot’s research, a gene important in drug-resistant cells called NEK2. Overexpression and knock-down of this gene correlates with drug resistance and sensitivity in more than 50 different types of cancers. Finding effective NEK2-inhibitors may allow oncologists to take out the chemotherapy-resistant cancer cells after the initial bulk of cancer cells has been decimated. This two-pronged attack could be successful in increasing remission durations and rates.

“I have rarely seen a physician more devoted to their patients than Dr. Tricot,” says Dr. Steve Lentz, Director of the Division of Hematology, Oncology, and Blood & Marrow Transplantation. Dr. George Weiner, Director of the HCCC concurs, citing his dedication and “to doing everything he can to assure each patient gets the treatment he believes is best for their long-term outcome.” Dr. Umar Farooq, Clinical Assistant Professor, praises Dr. Tricot’s international reputation and the “tremendous contribution to our understanding of this disease.” Administrative Services Coordinator Jillna Patel says that Dr. Tricot makes her job “enjoyable,” and marvels at his work ethic: “I don’t think I’ve ever met any individual who is more focused and passionate about what he does for a living.”

Dr. Tricot is just as thoughtful about how he spends his free time, preferring movies and “whatever is available on Netflix or Amazon” over books, which he saves for vacations and longer uninterrupted periods of concentration. But when the vacations do happen, Dr. Tricot travels to Arkansas to see one of his two daughters and his new grandchild. He also travels to Belgium to see his 91-year-old mother, who more than 20 years ago received a terminal diagnosis of cancer but was saved when her son arranged for her care in the United States. “It is hard to argue,” Dr. Tricot says, “with the idea that everything happens for a reason.”