Musings: Investigators versus Discovers

English: Albert Einstein Français : Portrait d...
English: Albert Einstein Français : Portrait d’Albert Einstein (Photo credit: Wikipedia)

Emil “Tom” Frei III, MD died recently and my mind wends back to a speech he gave at the American Association for Cancer Research (AACR)/American Society of Clinical Oncology (ASCO) meeting. In his keynote address, Dr. Frei describes two types of clinical cancer researchers: “Investigators” and “Discoverers.” Investigators proceed in a very orderly fashion, are esteemed by their peers, typically succeed (at least in answering the often rather ordinary question being addressed by their work), but produce, at most, single-step advances and don’t create new paradigms. In contradistinction, discoverers follow a path of inquiry that often seems disordered, tend not to be esteemed by their peers, often fail, but on occasions where they do succeed, produce multistep advances and create new paradigms. Dr. Frei’s point was that we would be better off being more supportive of the work of discoverers. What say you?

In the medical arena, discoverers have linked bacterial infection (Helicobactor pylori) to peptic ulcer disease. In breast cancer, few believed  that a drug targeting an antibody would revolutionize how we treat (with the targeted agent trastazumab (Herceptin)) some aggressive cancers. With respect to the latter, even the drug company that developed the drug was not particularly supportive of the concept and its stubborn progenitor (Dr. Denny Slamon). Of course, it was especially enjoyable to see Herceptin take the world by storm and for others to jump on board to claim partial credit for developing it!

I thank Larry Weisenthal, MD, PhD for reminding me of Frei’s observations. I’m Dr. Michael Hunter.

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Harvard AB Yale MD UPenn Radiation Oncology Radiation Oncologist, Seattle area

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