Dr. Karen Antman: A Force Behind Columbia Cancer's Clinical Expansion
Former director paved the way for clinical growth at the HICCC, led major breakthroughs in combination therapies.
A friend’s cancer journey set Dr. Karen Antman on a career path in search of a cure.
Years before becoming director of the Herbert Irving Comprehensive Cancer Center (HICCC), Dr. Antman’s personal connection with cancer drove her decision to pursue oncology. While a student at Columbia University’s College of Physicians and Surgeons (P&S), a friend of Dr. Antman’s was diagnosed with late-stage Hodgkin’s lymphoma. People in her medical school circle, including herself, presumed the friend would not live past a year.
“It was the late 1970s, and at the time, there were limited options and the standard treatment typically resulted in relapse and death,” says Dr. Antman. Luckily, Dr. Antman’s friend was one of the first patients to enroll in an NCI clinical trial testing a novel combination drug therapy for advanced Hodgkin’s, known as the MOPP Trial. This landmark trial provided the first long-term survivors for a once-fatal disease.
“This was really exciting. You can take an invariably fatal disease, carefully put together a combination of drugs and cure the disease,” says Dr. Antman. “This [strategy] was still very new at the time, and we needed to do more work on how to put together these new drug combinations, but it got me excited for what the future could be for cancer treatment.”
After graduating from P&S (now VP&S, the Vagelos College of Physicians and Surgeons) in 1974 and then completing her residency, also at Columbia, in 1977, Dr. Antman served as a clinical fellow at Dana Farber Institute and Harvard Medical School. For 10 years, she was on faculty at Harvard before returning to Columbia in 1993 as director of the Herbert Irving Comprehensive Cancer Center, professor of medicine and chief of medical oncology at NewYork-Presbyterian/Columbia University Irving Medical Center, known then as Columbia-Presbyterian.
Dr. Antman is credited for designing and leading clinical trials that tested breakthrough combination therapies for metastatic breast cancer and metastatic soft-tissue sarcomas. She developed the MAID regimen, a combination of the chemotherapy drugs mesna, ifosfamide, doxorubicin and dacarbazine in the 1980s, which became a standard treatment for advanced sarcoma patients and laid the foundation for combination treatments to follow. She also developed a high dose regimen in combination with autologous bone marrow treatment, widely prescribed for advanced breast cancer and other solid tumors.
Strengthening the clinical arm of the cancer center
When Dr. Antman took the helm at the HICCC in 1993, she was tasked to increase the center’s clinical trials portfolio and raise its clinical performance overall. “We were known for being strong in cancer research but not for our clinical work,” says Dr. Antman, the current dean of the School of Medicine at Boston University and provost of Boston University Medical Center, positions she has held since 2005. “We started out with one nurse and one data manager in the HICCC’s Clinical Protocol and Data Management (CPDM) office. We kept growing, and by the time I left [in 2004], we had a dedicated clinical trials office with a staff of 14, and also a fellowship program in medical oncology to train the next generation of oncologists.”
The CPDM now operates with 114 employees, comprising 26 research nurses, 36 clinical research coordinators, 11 regulatory coordinators and 9 data coordinators and is actively enrolling patients in 326 clinical trials.
Under her directorship, Dr. Antman served as principal investigator of a vital project grant by the Avon Foundation that provided $12 million in support for breast cancer research and care, outreach and education, an Avon professorship, 5,000 square feet of laboratory space and pilot research grant funding. It established multi-disciplinary breast cancer treatment at NewYork-Presbyterian/Columbia and the Avon Foundation Breast Imaging Center, still open and seeing patients on the ground floor of the HICCC.
“We designed the breast floor of the hospital to have surgery, radiology, medical oncology and psychiatry, all on the same floor, with a library for the patients as well,” Dr. Antman says. “The goal was to build infrastructure that gave patients total multi-disciplinary care.”
Dr. Antman divided her time between teaching, research, treating patients and fundraising for the HICCC. She recalls spending many lunch meetings with then-dean, Herb Pardes, MD, and longtime Columbia benefactor, the late Herbert Irving himself, to lay out the construction for the Irving Cancer Research Center, which houses the HICCC’s main administrative offices and floors dedicated to cancer research and shared resources.
Cancer research, discovery and public health
Twenty years ago, right before her departure from Columbia to join the NCI as deputy director for translational and clinical sciences, Dr. Antman put together a pioneering national meeting on health disparities. “Reducing Disparities in Breast Cancer Survival: A Columbia University and Avon Breast Cancer Research and Care Network Symposium” was one of the first organized symposia that addressed and spotlighted the great need to improve racial and economic disparities in cancer research and care.
“This was before addressing diversity was generally recognized as an important goal,” says Dr. Antman. “Because of Columbia’s diverse patient population, we became aware of cancer health disparities in our patient populations and were trying to address them.“
Dr. Antman is a strong advocate for public funding for research and improving diversity and access in clinical trials. She has held several key leadership roles, including president of the American Society of Clinical Oncology, the American Association for Cancer Research and the American Society for Blood and Marrow Transplantation. She also served as the chair of the American Association of Medical Colleges council of deans. In 2011, she was elected to the National Academy of Medicine, and just two years ago, Columbia University VP&S Alumni Association honored her with a gold medal for outstanding achievements in clinical medicine.
With a career more than four decades long initially focused on cancer, but expanding to include medical and research administration, and education, Dr. Antman sees an exciting future ahead, making targeted treatments even more targeted and continuing advancements at the intersection of basic science, clinical care and public health.
“What truly makes a difference in patient diagnosis and survival is based a lot on public health,” she says. “It’s research and discovery and it’s getting that to the patients, every patient.”