ESMO 2024 Highlights: OncoDaily Updates with Chandler Park on Cancer Breakthroughs

In episode three of OncoDaily, host Chandler Park welcomes Dr. Petros Grivas, a global leader in GU oncology and professor at the University of Washington. Dr. Grivas shares his inspiring journey from Athens, Greece, to becoming a prominent figure in cancer research, reflecting on his early fascination with oncology shaped by the mysteries surrounding cancer in the ’80s. He emphasizes the importance of mentorship and his commitment to research and clinical excellence, discussing advancements in bladder cancer treatments, his move to Seattle, and the critical role of individualized patient care in oncology’s “golden age.”

Chandler Park MD, FACP is an haematologist oncologist, medical journalist, and clinical researcher. He is the Advisory Dean and Clinical Professor at University of Louisville School of Medicine. He is the Kentucky Physician Representative of the ASCO State Executive Council. He is also the Medical Oncology Board Examiner at  American Board of Internal Medicine.

Petros Grivas, a board-certified medical oncologist, serves as Clinical Director of the Genitourinary Cancers Program at the University of Washington and Seattle Cancer Care Alliance. He’s an Associate Professor at the Dept. of Medicine and Associate Member at Fred Hutchinson Cancer Research Center since January 2018. With extensive training and experience, he’s led clinical trials, contributing to FDA approvals for bladder/urothelial cancer treatments. 

Chandler Park: We’re very happy here with episode three. You know, episode one, we were very happy to have Giuseppe Curliano. Love his discussion on TDXD and it kind of talked about how he started in, you know, Milan and it kind of ended up as a global leader in oncology.

And then in episode two, we talked about Dr. Joshua Brody at Mount Sinai. He kind of followed his dad when he was 14 years old and started going into the lab and just developed this passion for oncology. And now he’s doing CAR T-cells and we’re talking about bi-specific T-cell engagers that are moving into the solid tumor.

And so today we have episode three and we’re very happy to have a global leader and also a great friend, Dr. Petros Grivas. He’s a full professor at the University of Washington, director of the GU clinical trials, and also just a great person in general. So Petros, great to see you, man.

How you been?

Petros Grivas: Great to see you, Chandler. Thank you for having me. Such a great pleasure to be here with you discussing as always what a great experience we had, you know, in the last several years, seeing the field moving forward across tumor types, oncology is marching along and helping patients living longer and better.
So it’s great to see that transformation happening. We still have a lot of work to do, but always great to see you and discuss with you. Absolutely.

Chandler Park: And, you know, it’s all about patient care. And I tell you, like in the 2010s, we had like very little data. And then like we were using, you know, neoadjuvant chemotherapy, but now there’s an explosion of new data.
And we’re going to be talking about the Niagara. The Niagara answers questions, but it also raises more questions. And so I think this is where the field is moving forward.

It’s the golden age of oncology. But, you know, for me, I want to kind of share with the audience, you know, Dr. Petros Grivas, you know, tell us a little about yourself, Petros. I know for me, getting to know you, like you’re from Greece, can you give us a little background on, you know, what it was like growing up and what caught you into going into oncology?

Petros Grivas: Absolutely. Thanks for asking this. You know, it’s always interesting to go back in time, right?
And try to reinvent ourselves, understanding the why, right? This is a very important point in life, understanding the why. I always talk to my mentees and trainees and say, you have to know the why, why you do something and why you make a decision.

So going back in time, as you mentioned, I’m from Athens, Greece. I was born and I was raised in Athens. And my parents always had this, you know, intellect and curiosity about things in life.

And I was definitely very positively influenced by them. And they always try to support this notion of seeking knowledge and try also to self-improve. You know, this continuous self-improvement process.

These are the characteristics that I definitely owe to my parents, among many other things. And, you know, back in the day, back in the 80s, Chandler in Greece, you know, cancer was kind of a mystery, was kind of an enigma, a riddle. And, you know, people did not talk about it much.

You know, I was remembering I was a kid and someone, you know, maybe in the neighborhood or some family friends, someone died of cancer and people did not talk much about it. It was kind of a, you know, a forbidden word, you know, kind of a unknown entity. And to me, it was very intriguing.

You know, why someone died of this cancer, mysterious disease? Why this is happening? We have to do something about it.
We have to change this. We have to save people’s lives. And I always wanted to pursue medicine as a career.
And through that process, oncology became really, really a very interesting focus for me early on. And, of course, this was even enhanced more in medical school. And, of course, the very, very positive impact and influence from mentors definitely steered me in the direction of oncology.

And I’m very, very delighted and excited that I was lucky enough to know early on what I want to do. And with the support of many other people, I was able to pursue that very, very exciting career.

Chandler Park: Yeah, I think it’s great, Petros. I mean, just listening to you, like one of the things about us is just, you know, the mystery. We’re like detectives.

We like puzzles. And, you know, that’s what oncology is. Like, it’s very intellectually stimulating.
I mean, you know, the patients are the forefront, but everybody deserves individualized care, not just for the best treatment in terms of the science, but the emotional and the mental aspects of it. And just hearing your story about like how it’s a mystery, right? When you first noticed it in the 80s, when you were maybe younger, and you’re like, what’s going on here?

So that developed like a knowledge, a spark of curiosity. I think it’s amazing. And so now tell us about, you know, after, you know, you started working very closely with different mentors and becoming like, you know, the GU director and professor at the University of Washington.
Tell us a little about that as well.

Petros Grivas: You know, one of my favorite poems, Chandler, you know, is Ithaca by a Greek poet. The name is Constantine Cavafy. And this poem was really, really about the journey in life.
And of course, a story in that poem was the odyssey, right? That Ulysses left Troy and, you know, was trying to get back home. It took him about 10 years or so to reach a destination.

But the poem is about the adventures and the occurrences unexpected or expected in life. And what really matters is a journey. What really matters is that continuous journey in life that you start, you know, from somewhere, from your origin, and you try to go to the destination.

The destination is only the reason why, you know, you go through the journey, but the journey matters. So I think extrapolating from that poem, that story, same thing, you know, with many other people in life and including myself, you know, started in a country which I love, as everybody knows. I mention Greece very frequently when I talk about something.

And those experiences early life, of course, give you direction, give you a passion, give you, let’s say, your North Star. And for me, North Star and the why was to help other people, was to be of support, add some value, provide some comfort. And this was really, really motivating for me.

And medicine was definitely the perfect conduit to do that. And I was very honored to enter medical school when I was 17 years old. And you have to take exams in Greece, you know, when you finish high school, graduate, you go to university.

There’s no college like we have in the US, which is like, you know, college acts as a buffer, right? You try to figure out yourself what you want to do. In Greece, it’s in many other systems, in other countries, it’s a direct transition from high school to the university and medical school in my situation.

And I was remembering very vividly, I was 17 years old, I had to move to a different city called Patras, different than my name. Many patients ask me, Petros, your University of Patras, what’s going on? I said, it’s just a different name, P-A-T-R-A, it’s a beautiful city in Greece, it’s the third biggest city after Athens at Thessaloniki.

And in Patras, I had the opportunity and honor to interact with great mentors, who definitely influenced my direction towards oncology and Hans, as I mentioned before, this passion, and many of them had studied or had practiced or done research in the United States. So definitely there was a positive influence in that direction. They instilled, you know, this thought in my head, you know, they planted the seed that I had to look in the United States as a environment, as a place, as a country where I can thrive even more and learn and do my training.

So after I graduated from medical school, I decided to pursue my PhD sequentially after MD. And many people ask me, Petros, why you did your PhD after your MD? It’s not the classical, you know, it’s not like the conventional pathway.

And I always joke, I said, you know, guys, in Greece, the last names are very long, right? Very, very many syllables, right? And for me, it’s only two syllables like Grivas.

So I had to add letters. Grivas MD PhD, right? That’s my joke about it.
But the real reason it was my passion to learn about research even more, I want to go to the lab, understand the, you know, all the methodologies of research, you know, biostatistics, bioinformatics, learn about work in the lab and techniques and have a more, let’s say, balanced approach when it comes to research and learn more about it and think about how to ask a relevant question and how to try to answer that relevant question. So it was very helpful to me to have this great training.

And at the same time, Chandler, I decided to go to the United States and come in this country to pursue my clinical and further research training. So while I was doing my PhD and work in the lab and, you know, try to develop those skills and complement, you know, the clinical skills with lab-based skills, I was taking the USMLE exams. And I was honored to be able to come to the United States and do my residency in Philadelphia, a fantastic environment at Hahnemann Hospital, Drexel University.

Three years there, learned a lot about clinical medicine. Every patient, of course, is an opportunity to learn more, more about the patient and the human being behind, you know, a particular illness, but also learn about clinical skills and develop important clinical questions. From there, I went to Ann Arbor, Michigan, University of Michigan, fantastic environment, my fellowship there in hematology, oncology, great environment, great mentors.

You know, within a month, you know, after I started my fellowship, Chandler, I committed to do research in GU oncology. And I saw the light, sort of speaking, and specifically, particularly in bladder cancer. And we’ll talk more about it if you want.
It was just a need, right? We had to move the field forward. You know, it was a stagnant, I would say, disease for many years because of challenges, understanding that this is biology, lack of funding, lack of visibility.

And of course, it was a perfect storm in a way when in the decade that followed that, we had a lot of great people working in that disease, and we had made huge strides forward helping our patients. From there, I finished my fellowship in 2013. I stayed an extra year as a junior faculty at the University of Michigan, wonderful, again, supportive environment, great mentors.
And then I moved to Cleveland Clinic.

This was, I think, July 2014, a fantastic place working with great people there. I learned a lot.
Again, learning is a continuous process. I stayed in Cleveland for about three and a half years, a wonderful experience. We definitely, you know, had a huge development of the bladder cancer program with the help of colleagues, and of course, research staff, research nurses, and a wonderful environment, and of course, multidisciplinary collaborations.

And I moved to Seattle. Literally, I started here. It was January 2, 2018, almost seven years ago, and I love it.
It’s a great environment. I learn every day, and it’s a fantastic team, you know, helping our patients, multidisciplinary clinic, research, education, outreach, a fantastic place to be in the great city.

Chandler Park: Very similar to Athens. I mean, I know you mentioned that before. Like, if you think about it, like, especially when you’re flying in, or just the water’s there, you know, you got the beautiful blue water, and then you got the, you know, the views.
And what are your thoughts about that, Petros? Wouldn’t you say it’s very similar to Athens in a way?

Petros Grivas: You know, I was actually interviewing candidates for the fellowship program the other day, and we had this, you know, Zoom call with all the people in the Zoom, and of course, I had to comment, and the truth, and say, you know what? Seattle is my favorite city outside Greece. It’s the most beautiful city I have been outside Greece, and I believe it.

It’s a great place, full of nature. The natural landscape is fantastic. You know, it’s such a great environment to be in, natural environment, mountains all over you, surrounding the city.
Of course, the water, you pointed out, you know, you have the Puget Sound, you know, you have the Pacific Ocean on the west, you have an unbelievable number of lakes, rivers, and, you know, little fjords, and other, you know, natural elements, parks, nature. Of course, it’s raining, and, you know, people tell me, Petros, can you survive this continuous drizzling in Seattle? And I say, you know what?

We carry the Greek sun sign everywhere we go. It’s, you know, we work hard, and, you know, we have great team, and colleagues, and friends, and Seattle overall is a beautiful place to be. And I remember, I first came here, Chandler, I don’t know if I ever told you, in 2009, to interview for fellowship.

And I remember it was a beautiful city, but when I moved here, I realized even more, you know, the breadth of the options, and all the amazing things you can do in this city. Of course, we all work very hard, so the major limitation is time, right? To find enough time to enjoy this wonderful landscape.

Chandler Park: I mean, you think about, like, the mountains, you know, whether if you like to go hiking, or if you like to go boating, or, you know, Vancouver’s not too far away either. And so, Portland, I mean, there’s just so many beautiful places, especially if you like the outdoors, kind of, because we all need balance, you know? We have a very tough situation, where we want to help the sickest of the sickest.

But sometimes, for you, me, and our mentees, and all of our mentors, like, we need to recharge. I think that’s one of the things that I learned from Dr. Jamie Abraham, who’s my mentor, is just to, kind of, like, you have to recharge your own battery. And it sounds like you’re doing a great job there, Petros.

Petros Grivas: You know, you mentioned Jamie, such a great person. I worked closely with Dr. Abraham when I was in Cleveland Clinic. We worked together in efforts to engage the community, and do community outreach in underserved populations.

And one of the things I’m really proud of was a study we did together with Dr. Abraham, trying to work together with local leaders in a very underserved area, very close to Cleveland, Ohio. And we tried to do educational initiatives, and do, you know, an immense health day, talking about the importance of primary care, but also prostate cancer screening. And we did an interventional study, actually, with a very interesting, you know, a way to try to improve upon education in that community, and help them do informed and shared decision making about prostate cancer screening.

Many lessons learned, we learned a lot from that exercise and process. We actually published this together with Jamie and others, and one of our mentees there. And it was so important, you know, it opens your eyes about the disparities that exist in health care.
And they’re all, we all have to try to address those disparities, and work towards, you know, inclusion, equity, and diversity in all we do. And definitely, definitely have a very, very fond memories working with Jamie.

Chandler Park: Absolutely. And you know, you really touched on like, you know, one person can make a difference. That’s one of the things that I learned from Dr. Abraham. You know, yes, we see patients and provide the best care that we can try to give. But also, from a global scale, like we do all of these different meetings, advocacies, because the advocacy groups, and the people and the patients and the families, they’re also lifting a lot for the just global care of bladder cancer. And then also the mentees.

I mean, we have so many touch points that we have every single day, whether it be the medical students, the residents or the fellows and, and guiding them, helping them because we’re all at the end of the day, we’re all learning. And just to kind of help out all the different people around us and also be helped. What do you think about the various touch points that we have Petros, to try to make a difference on people around us?

Petros Grivas: You said perfectly Chandler, you know, the life is a totality of those moments, right? Those touch points, those interactions is human beings to human being interactions. This is so refreshing.

And I think during the pandemic, we all got reminded that human interactions are so important. And I agree with you those touch points, you know, these relationships we form over time, their lessons with our mentors, our teachers, our professors, with our peers, our colleagues, our friends, our mentees and trainees. These are amazing, very sacred relationships, right?

Very important. And I think we all get better. We all learn through these experiences and these interactions.
You know, mentorship is such an important concept. I think I have shared with you in the past that, you know, my father was a teacher and, you know, his life was dedicated. He was committed to support younger students, trainees, mentees.

And the concept of teaching education and mentorship was ingrained, you know, in my mindset early on, you know, by seeing him doing that. And my mother was also, you know, active in the Ministry of Health in Greece at the time. And she was doing the same thing, helping younger folks get into their careers.

And I think it’s so important, you know, what you’re doing, what many colleagues are doing around the world, you know, investing time, effort and energy to stimulate and cultivate talent, right? It’s very important to nurture talent. And I think our relationship with mentees, it’s so important.

I think it’s so refreshing and makes us better. I personally feel that I learned every time I interact with mentees. They teach me a lot.

I try to support them in every way. My father was telling me, you know, it will be sometimes in your life that you will have no time, you will be so busy, but you have to create time for things that matter. And he was right.
And mentorship is definitely one of those things that matters so much. And we always create time. And you’re doing the same thing yourself.

You got to make time.

Chandler Park: I mean, we have to prioritize, you know, kind of crystallizes all the things that we can do. There’s more time than we even think about. It’s just that we just have to kind of think about it, you know.