The last 43 years of my life have been spent in five areas of endeavor.
First, I have studied the evolution of malignant melanoma and was involved in the first classification of the tumor into subtypes in 1969 with Dr. Wallace Clark. This work then led to identifying early signs of melanoma and to receipt of the first and only NIH grant to study the biology of this often deadly cancer. This work also led me to study not only the fields of Internal Medicine and Dermatology but also Pathology, in order to understand better the biology and pathophysiology of human tumors.
This work also led to my second great interest: diagnostic dermatopathology. From this work, I went on to found, at the Massachusetts General Hospital, one of the first five institutions in the United States establishing a fellowship program in Dermatopathology, thereafter recognized as an official subspecialty in Medicine.
My third great interest was to understand the evolution of the human immune response. Beginning in 1969 and extending into the early 1980s, I worked with Dr. Harold Dvorak to study and define the human delayed hypersensitivity as presented in experimental contact dermatitis. We also studied human allograft rejection and published one of the first descriptions of the blood vessels as the target in this process. This work served as a segue into a further elaboration of my interest in melanoma with studies of the immune response or TIL’s in primary and metastatic melanoma. This work has continued to the present with members of the WHO melanoma program for which I co-directed the pathology panel and currently, with the melanoma pathology group of the EORTC. I also co-direct this endeavor.
Some of the most ground-breaking studies of the host response in mice and man have been carried out with Dr. Glenn Dranoff and his associates as we have studies the importance TILs in patients vaccinated with viral vectors containing DNA that results in autologous tumor cells producing GMCSF with remarkable responses in Stage IV melanoma patients. This work continues with now also Dr. George Murphy, Margaret Shipp, and F. Steven Hodi. These collaborations have blended my interest in melanoma and human delayed response, resulting in highly significant studies in human tumoral immunologic response.
Recent studies in the interest in the glycobiology of melanomas have brought new insights into the potential mediators of T cell infiltration and potential mechanisms of T cell fate within melanomas. I am currently studying the role of galectin-1 (Gal-1) and its ligands in melanoma growth and progression. My interest in prognostication is intrinsically bound to understanding progression. This area should prove to be fertile ground for very meaningful research in understanding melanoma and creating new therapies.
My fifth area is the study of vascular anomalies in collaboration with Drs. Paula North, Milton Waner, Robert Rosen, Stuart Nelson, and Wenbin Tan. We have made seminal observations concerning the importance GLUT1 in the diagnosis and biology of infantile hemangiomas. We also have made other seminal observations in the pathophysiology and pathology of Port Wine stains. I continue to work with all of these physicians in this important area. My prior work qualifies me to be a meaningful collaborator in further vascular studies.