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Memorial Hermann Recruits Dr. Ernest Conrad to Launch Musculoskeletal Oncology Service

Chappie ConradErnest “Chappie” Conrad, M.D., has a well-established international reputation for the surgical treatment of sarcomas. At the University of Washington in Seattle, he paved the way and helped set standards for the world in assessing risk and response in sarcoma patients, using PET imaging, as well as in limb-salvage surgery for adults and children. His goal at Memorial Hermann-Texas Medical Center and McGovern Medical School at UTHealth is to establish a strong Musculoskeletal Oncology Service that combines surgery with medical oncology, radiation oncology, pathology and radiology to provide comprehensive, collaborative care to patients.

When Dr. Conrad relocated to Seattle in the 1980s, little was known about sarcoma. By 1996, the malignancy was the second most common reason after breast cancer for admission of patients to the University of Washington Medical Center for chemotherapy.

“Chemotherapy for sarcoma was a very new idea in the early eighties,” says Dr. Conrad, a professor in the department of Orthopedic Surgery at McGovern Medical School. “At that time, it was a novel therapy used primarily in children. I believed it could be applied to young adults and adults successfully.”

At the University of Washington he assisted in launching clinical trials for sarcoma in adults, and by 2000 he had created a model that included aggressive early imaging with PET scans to determine the likelihood of positive response to chemotherapy in adults. “We could image a patient after the first two months of therapy and tell if the tumor was responding, which at the time was novel,” he says. “The work we did has been repeated in trials around the world, and today evaluating patients quickly and effectively with PET is the standard of care in good, aggressive academic medical programs.”

FibulaThe surgical treatment of pediatric tumors represented a third of Dr. Conrad’s practice at the University of Washington, where he provided care annually for 50 to 100 pediatric patients with sarcoma – an uncommon malignancy in children – and between 200 and 300 adults with the malignancy a year. “Treatment results with pediatric sarcoma patients are more dramatic because of their greater ability to respond to chemotherapy, which allows for a smaller surgery and helps avoid amputation,” he says.

In his first few months at Memorial Hermann and UTHealth, Dr. Conrad and his team have provided surgical treatment to 60 patients at Memorial Hermann-TMC and Memorial Hermann Orthopedic & Spine Hospital – a number he considers a surprisingly busy start for any tumor type.

“The Memorial Hermann Red Duke Trauma Institute is one of the busiest Level I trauma centers in the nation, and the Memorial Hermann Health System one of the largest in the country,” he says. “With the large base of primary care physicians and specialists, we expect to see many new patients as our service grows.”

Dr. Conrad’s current interests include finding new drugs for sarcoma treatment. His research projects include multiple clinical studies in pediatric and adult tumors with a special interest in pediatric limb-sparing procedures, benign pediatric tumors and soft-tissue sarcomas in adults. His research interests include the metabolic imaging of sarcomas, the clinical and biologic description of hereditary multiple exostoses and the response associated with musculoskeletal transplantation. He is site principal investigator of a Phase 2/3 randomized, double-blind, placebo-controlled efficacy and safety study of oral palovarotene in patients with multiple osteochondroma. An investigational retinoic acid receptor gamma (RARy) agonist, palovarotene has the potential to slow disease progression. Approximately 150 participants will be enrolled at 20 international sites.

“I have a great sense of urgency to further knowledge of sarcoma and other musculoskeletal malignancies through clinical research,” Dr. Conrad says. “The natural history of sarcoma is the same as that for most high-grade tumors – the chance of survival is 50 percent. More than half a million new patients are diagnosed with musculoskeletal malignancies every year in the United States. With the high incidence of both benign and malignant musculoskeletal tumors and the high incidence of other new malignant diagnoses – breast, prostate, lung and colon cancer that involve the musculoskeletal system – we expect to be able to help many patients. Our research is still in its infancy, and the treatment potential is enormous.”