Advancing Pediatric Oncology in India with Active Research Focus
- Dr. Sameer Bakhshi
Dr. Sameer Bakhshi studied medicine at the Jawaharlal Institute of Post Graduate Medicine and Research (JIPMER), Pondicherry, and undertook his specialist training in Pediatrics at the All India Institute of Medical Sciences (AIIMS), New Delhi, in 1996; both prestigious medical institutions in India. In 1997 he did his residency and fellowship in oncology at the Children’s Hospital of Michigan, Wayne State University. After a fiveyear stay in USA, he returned to India and became a faculty member at Dr. B. R. A. Institute Rotary Cancer Hospital (IRCH), AIIMS, in the Department of Medical Oncology. He has supervised theses for MD, DM (Medical Oncology) and PhD degrees and also coordinates the teaching program leading to a DM Medical Oncology degree at IRCH, AIIMS. He is a Special Invitee of the Medical Oncology Committee of the National Cancer Control Program of India and an expert for developing standard oncology treatment guidelines for the Ministry of Health & Family Welfare in India.
Dr. Bakhshi initiated and developed a Pediatric Oncology program in the in-patient department of Medical Oncology at IRCH, AIIMS, which, over a span of eight years, has become one of the largest referral centers for pediatric cancers in India, with more than 1000 new pediatric cancer cases being registered per year. However, he remains the only consultant in pediatric oncology at IRCH, AIIMS. His vision is to develop state-of-the-art care for this large patient population, as well as a research program which should be focused on local issues. In his words: “You cannot reduce the patient load in order to be able to provide state-of-the-art care. You have to adjust to the system and develop strategies within the system that provide the best possible patient services. Waiting for a perfect doctor-patient or bed-patient ratio may mean that state-of-the-art care may never come.” He has, therefore, formed a team with the pediatric surgeons, orthopedic surgeons, ophthalmologists and radiotherapists to administer care for his patients. He is assisted by DM Medical Oncology residents and research officers for patient care, and data managers for patient tracking. This has been possible because of the support provided by INCTR and the Jiv Daya Foundation.
Dr. Bakhshi paid special attention to the chemotherapy of bone and soft tissue sarcomas after joining IRCH and his group has been instrumental in defining the role of PET-CT and MRI for determining prognosis in osteosarcoma. Further, the group has also shown the utility of VEGF in assessing the persistence of osteosarcoma cells after neoadjuvant chemotherapy, and the utility of DCE-MRI as a surrogate marker for angiogenesis in osteosarcoma.
Dr. Bakhshi also initiated the Ophthalmic Tumor Clinic at IRCH and has registered more than 700 cases in the last seven years. He has published several research papers in retinoblastoma dealing with issues ranging from patient compliance, a major issue in retinoblastoma treatment in many south-east Asian countries, outcome in locally advanced retinoblastoma and defining the clinical predictors of highrisk histopathology. In view of the high prevalence of advanced retinoblastoma in India, the group has also focused on research pertaining to higher doses of carboplatin in retinoblastoma, and the significance of angiogenesis.
He has a special interest in hematological malignancies and collaborates with INCTR in projects on acute lymphoblastic leukemia aimed at improving long-term survival. He has also initiated laboratory projects in acute myeloid leukemia (AML) on proliferation, apoptosis and mutational analysis, and demonstrated the role of mitochondrial mutations as a prognostic marker in childhood AML, a breakthrough research finding. All this, while managing the enormous patient burden. The pressure on beds has been alleviated by successfully treating many patients with febrile neutropenia as outpatients; similarly, he has also developed consolidation chemotherapy in AML that can be managed in the clinic. Finally, he has performed more than 75 stem cell transplants for various childhood malignancies including autologous and allogenic transplants and has recently initiated cord blood stem cell transplantation at IRCH.
