Cancer researcher Piet Borst receives ‘American Nobel Prize’: ‘Afraid?  For cancer?  No.  You have to die of something

Cancer researcher Piet Borst receives ‘American Nobel Prize’: ‘Afraid? For cancer? No. You have to die of something

News in brief

  • Dutch cancer researcher Piet Borst (89) receives a Lasker Award, the most important American prize for biomedical research. Borst, previously scientific director of the Netherlands Cancer Institute and the Antoni van Leeuwenhoek Hospital in Amsterdam, will receive the prize (250,000 dollars) for his discoveries in the field of parasitology and oncology.
  • He is also honored for his social achievements. According to the jury, it is thanks to him that the Netherlands Cancer Institute has developed into an internationally leading center where excellent researchers are trained. Borst, emeritus professor of clinical biochemistry and molecular biology at the University of Amsterdam, wrote columns for NRC for twenty-three years.
  • The Lasker Award is seen in the scientific world as the American equivalent of the Nobel Prize. One in four laureates also receives a Nobel Prize after a Lasker Award, sometimes in the same year.

Piet Borst sits unfazed, Tuesday at his home in Bussum, with a cup of tea and a biscuit, two days before the news about the Lasker Award is announced. But of course, he says, he finds it “great fun” and “a great honor”, especially for the Cancer Institute. No, he hadn’t counted on it. “I didn’t even know that the prize is also awarded to people outside America.” So yes, he was surprised when he found a letter in the mail two months ago in which the chairman of the jury, the biochemist and Nobel Prize winner Joseph Goldstein, invited him to New York in September to receive the prize. “He had it in hand terrific credited.”

You received your PhD in 1961 for research into disrupted energy management in cells, which is said to cause cancer.

“An idea from the German biochemist Otto Warburg, who received the Nobel Prize in 1931. So everyone believed in it. It turned out to be nonsense.”

Another idea at the time was that all cancer was caused by viruses. The American pathologist Francis Rous received a Nobel Prize for this in 1966.

“And that has not proven to be true. It is at most 20 percent and then you have to think of the human papilloma virus, which is sexually transmitted and can cause cancer in the cervix, throat and anus. Young people are now being vaccinated against this. When I started, the big problem was: what is cancer? We wandered in the mist. Only in the 1970s, twenty years after the discovery of the structure of DNA, did it become completely clear what the cause of cancer is: derailed gene expression. My luck is that I experienced all that.”

Your mother died of cancer at fifty-seven.

“Metastatic colon cancer. She had a very rotten tumor, the first symptom was a liver full of metastases. It is still not curable, but chemotherapy does cause remissions. Then there was nothing at all, zero. A very unpleasant death, extremely painful. That was in 1963. In my family, despite a healthy lifestyle, not smoking and so on, we all die of cancer. My father” – professor of internal medicine in Amsterdam – “had prostate cancer. He was 75 when he died. My eldest brother” – doctor and husband of Els Borst – “had Kahler’s disease and one of my younger brothers also had prostate cancer. They lived with it for about ten years due to treatment with cytostatics and radiotherapy.”

You have discovered how tumor cells become resistant to cytotoxic drugs.

“Tumor cells are extremely good at this, due to the principle of mutation and selection that has driven evolution. First, errors occur in DNA repair, causing more mutations to accumulate than in normal cells, and this creates all kinds of variants that manage to avoid chemotherapy.”

Which means that an idea from the 1970s, that chemotherapy would solve everything, also turned out to be untrue.

“Twenty years ago we thought we would be about there by now, and that was a huge disappointment. But the prognosis for cancer, including metastatic cancer, has greatly improved. The DNA sequence of each tumor can now be determined and then you can see where things are going wrong. This offers opportunities for new chemotherapy. And immunotherapy, still in its early stages, has opened up completely new possibilities. After long-term fundamental research, we know how a tumor is able to shut down the host’s immune system and with that knowledge we can tackle cancer. Young people with metastatic melanoma, very malignant, can sometimes be cured with immunotherapy.”

And pancreatic cancer?

“One of the ugliest tumors you can get, with a 5 percent survival rate after five years. Yet there was recently an encouraging article about it Nature. In a small trial, with a control group, researchers have mapped all the changed proteins and made a vaccine against them using RNA technology, which stimulates the natural defenses. The results are spectacular. They still need to be confirmed in new and independent research, but a significant proportion of patients achieved a long-term remission, up to a year and a half, which was previously completely unthinkable. I have high expectations for it.”

And the side effects?

“There is no free ride in oncology and it is a risky approach. With immunotherapy you remove a number of brakes from the immune system, so that it can suddenly attack the thyroid gland, or the adrenal gland, or the pituitary gland, or the cells that make insulin in the pancreas.”

When do you think all cancer can be cured?

“In 2013, when the Cancer Institute was a hundred years old, it was said that in twenty-five years 90 percent would be curable, or so treatable that it would become a chronic disease with a good quality of life. It was laughed at at the time, but I think we have come a long way.”

Are you afraid that you may get cancer yourself?

“Anxious? For cancer? No. You have to die of something and I’m lucky to be quite healthy. Last winter I did have a streptococcal infection on my face. My granddaughter noticed how ill I was, and I thought it wasn’t too bad. I was almost there then.”

His wife, who was listening, says she also thought it wasn’t too bad. “Piet was in bed with the blanket over his head. It would go away when he slept.”

Piet Borst: “My son came and found that I had a fever of 41 degrees. He took me to the AMC and there they treated me with penicillin, the antibiotic that was first successfully used for a bacterial infection in 1944. Streptococci are still not resistant to it.” Now he goes back to the Cancer Institute two or three times a week. But not all day long anymore, like until a few years ago. And not every day either.