Interview with Dr. Puig-Domingo (MAB)

Dr. Manuel Puig-Domingo has been working in thyroid cancer research for more than 25 years, at first as a clinical investigator and currently with a team of basic researchers aimed at generating translational research.

Dr. Puig worked as a staff endocrinologist at the Hospital Clínic de Barcelona from 2003 to 2010 and, during this time and in collaboration with the Endocrine Unit staff, they tried to promote research in the area of thyroid cancer, offering different training courses regarding thyroid ultrasonography for primary care physicians. During this time, they introduced the clinical use of ultrasonography by attending endocrinologists and also promoted it at a national level through the Spanish Society of Endocrinology and Nutrition, of which Dr. Puig is the current president. Thereafter, he was contacted by LUCA project researchers, by Dr. Mireia Mora and Dr. Mattia Squarcia, who invited him to become a member of the Advisory Board.

How will LUCA’s technology benefit patients and thyroid cancer screening?

“Currently, the most important issues in the field of thyroid cancer concern the optimization of biomarkers to allow the identification of those cases that will have a negative clinical-biological evolution, and require a more aggressive therapeutic approach after diagnosis. In the last decade we have refined the treatment of those cases with low risk of malignant evolution, through less aggressive treatment modalities, but on the other hand, those cases with poor prognosis are waiting for more effective therapies. In these latter cases, recent new biological therapies have not proved to be as successful as desired and moreover, the safety profile is far from being acceptable. Moreover, the LUCA project will throw a lot more light onto thyroid cancer management by means of incorporating predictive bio-imaging markers that will be able to identify the biological nature of thyroid nodules that are currently ticketed as being of indeterminate nature, namely those cases with grade 3 Bethesda classification”.

What will you bring to the project in terms of expertise?

“I am a member of the Medical Advisory Board; thus, in my current professional position as Director of the Germans Trias i Pujol Research Institute and Head of Endocrinology at Germans Trias i Pujol University Hospital, I have been invited to give support to the strategic evaluation of the LUCA Project, its feasibility and its implementation.”

How does this technology differ from any other that you are currently using for end-user patients that suffer from this illness?

“This project is developing the use of an innovative optical technology to measure oxygen saturation, volume and blood flow, collagen and lipids at thyroid tissue level. The fact that this technology is combined with ultrasound, the most sensitive tool that we currently have to evaluate thyroid nodules, means that if it is as successful as we expect it will be, it will represent a very remarkable advance in the field of endocrinology. In my opinion, it could give additional, complementary and very relevant information to ultrasound data, thus potentially avoiding unnecessary biopsies, as well as avoiding unnecessary thyroidectomies and associated comorbidities in the cases where the biopsy is inconclusive”.

Do you see this device fulfilling the needs of your sector?

“As a physician, I need to be able to use new biomarkers for my patients in order to facilitate the decision-making process for the evaluation of thyroid nodules so we can better identify those of malignant origin. These new biomarkers should be of a bio-imaging nature that would be detectable in real-time at the bed-side, this would clearly accelerate the diagnostic procedure.”

LUCA project is constituted by a multidisciplinary group. What advantages does it have?

“A multidisciplinary approach, in every way, is the only way to make good science and thus to go further in order to reach new solutions for the patients and their unresolved needs. The clinicians have the patients’ problems and the questions; the scientists, and especially the basic scientists and engineers, have the answers but do not know the questions. Thus putting them together to work in a multidisciplinary team is the way to find solutions.”

As a doctor, could you comment on the challenges this project could face, if any?

“The technology being developed by the LUCA Project has to demonstrate its clinical applicability in the fields of radiology and endocrinology, mostly but not only, for the diagnosis of nodular thyroid disease for the differentiation between malignant and benign pathology. The technology to be applied in humans has to be very robust, sensitive and specific in the discrimination of malignant and benign tissue; if this is reached, it would be useful also in other organ tissues. From the scientific point of view, I trust that the results of this project will be very relevant and will have an international impact.”

Posted on Tuesday 21 February 2017