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David Sugarbaker, M.D.

Chief, Division of Thoracic Surgery
Chief, Department of Surgical Services-Dana Farber Cancer Institute

David Sugarbaker

Assistant Professor of Surgery, Harvard Medical School - 1988-1993

Associate Professor of Surgery, Harvard Medical School - 1993-1999

Professor of Surgery, Harvard Medical School - 1999-

Dr. Sugarbaker is board certified in Thoracic Surgery and Surgery. He attended Wheaton College and Cornell University Medical School. He completed his Surgery residency at Brigham and Women's Hospital and Cardiothoracic training at the Toronto General Hospital as Chief Resident in Thoracic Surgery and Chief Resident in Cardiac Surgery. His specific interests are in general thoracic surgery, minimally invasive surgery, lung volume reduction surgery, esophageal cancer, mesothelioma, non-small cell lung cancer, and video-assisted thoracic surgery(VATS).

Dr. Sugarbaker has been actively involved in the development of several programs. These include : The Division of Thoracic Surgery 1988-present, the Brigham Lung Transplant Program, The Thoracic Oncology Program at the DFCI/BWH 1995-present, Surgical Services at the DFCI 1996-present, the Lung Volume Reduction Program at BWH 1996-present. In addition he has been active in the development of new minimally invasive surgical procedures and actively involved in the areas of therapy of thoracic malignancy.

Malignant pleural mesothelioma has been a central focus of Dr. Sugarbaker's clinical and laboratory research. A trimodality therapeutic approach based on extrapleural pneumonectomy and adjuvant chemotherapy and radiation was developed and examined in a consecutive series of patients. Analysis of this series has revealed improved overall survival with acceptable morbidity and operative mortality, and has elucidated new prognostic variables in this disease. These include cell type, nodal status and resectablity, which have formed the foundation of a new staging system currently in use, which was presented to the American Surgical Association in 1996.

Laboratory investigation in mesothelioma has entailed the banking of frozen samples of more than 100 mesotheliomas that are currently the focus of research examining molecular markers in this disease. One important project seeks a definitive answer as to the potential role of Simian Virus 40 exposure(e.g. via contaminated polio vaccine) in mesothelioma through collaborative involvement with the NIH SV-40 working group.

As Chair of the Surgery Committee of the Cancer and Leukemia Group B (CALGB), it has been possible for Dr. Sugarbaker to play a leadership role in developing the clinical investigation of the role of surgery in cancer therapy trials, with the support of NCI U10 funding. This effort has supported the clinical investigation of new therapies in thoracic, GI and breast malignancies. These prospective clinical investigations have led to further NCI U10 support to examine the efficacy of new innovative minimally invasive thoracic surgery techniques in the staging and treatment of thoracic malignancy.

Concurrent laboratory work has focused on prognostic factors in stage I non-small cell lung cancer. Although surgery alone is standard therapy in this group of patients, 30-40% of them will succumb to recurrent disease. Identification of molecular and pathologic prognostic markers indicating metastatic potential in resected stage I tumors will facilitate selection of patients for adjuvant therapy. The evaluation of markers in our laboratory has led to the publication of a molecular substaging system for stage I non-small cell lung cancer. The prognostic significance of markers currently under study utilizes specimens from our respiratory tissue bank.

The establishment of the respiratory tissue bank in 1991 has led to the development of new methodologies for tissue processing and storage. This activity has led to extremely fruitful collaborative research projects. Prominent among these is "A gene expression approach to Adenocarcinoma classification", a funded response to the NCI Director's Challenge involving investigators at the Whitehead Institute, DFCI, MGH and BWH. Others have focused on the role of cell cycle regulatory pathways (Rb, cyclin D1, p16), matrix metalloproteinases (stromelysin-3), adhesion/motility proteins (paxillin, gelsolin), retinoid receptors and macrophage stimulating protein in the pathogenesis and metastasis of lung cancer. The bank has also supported large-scale gene discovery and expression profiling work in malignant pleural mesothelioma. "Evaluation of assays for detection of Simian Virus 40 DNA in Mesotheliomas", a multicenter study by the International SV40 Working Group organized by the Viral Epidemiology Branch of the NCI, utilized specimens from the bank in a careful investigation of this sensitive public health issue.

Recently the scope of the bank has been expanded as the BWH Tissue and Blood Repository to serve as an institutional core facility for specimen procurement and distribution in a wide array of malignancies as well as benign and neo-plastic tissues, blood, cells and nucleic acids. Dr. Sugarbaker serves as co-director and operations chair.

Dr. Sugarbaker is the Chief of Surgical Services at the Dana-Farber Cancer Institute, Executive Vice-Chair, Dept. of Surgery, Brigham and Women's Hospital, Chief of Thoracic Surgery at Brigham and Women's Hospital and Professor of Surgery at Harvard Medical School.