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33
TEAM SCIENCE
BY JENNY HAZAN
A
ccording to the latest estimates from the Prostate Cancer Foundation, more than 218,000 men in the United States
alone will be diagnosed with prostate cancer this year. The disease strikes one in six men. If detected early enough,
there is a high success rate with traditional treatments such as radiation, chemotherapy, surgery (prostatectomy), hor-
mone therapy, cryotherapy, and high-frequency radiotherapy (Hi-Fu). But the side effects of such treatments can be severe,
requiring patients to undergo long and painful recoveries and in the long-term, causing impotency or incontinency. What’s
more, in all cases the collateral damage caused by one treatment closes the door to subsequent therapies, so healing is hope-
less in cases where the cancer is not cured in one shot or metastasizes to other parts of the body.
At least that was the prostate cancer treatment landscape until the beginning of 2000, when the research outcome of a
unique team of scientists at the Weizmann Institute of Science in Rehovot, Israel, had appeared to enable a better remedy. Nine
years earlier, the director of the Weizmann Institute’s Avron-Wilstatter Minerva Center for Research in Photosynthesis, Dr. Avigdor
Scherz, and the head of the Institute’s Department of Biological Services, Dr. Yoram Salomon, helmed jointly the basic idea. By
1995, they had already gathered a relatively small group of chemists, biologists, pharmacologists, physicians, and physicists who
had proven their novel concept. At the end of 1996, industry joined in to boost up the pharmaceutical development. Three
years later, following an extensive basic and pre-clinical research, a new compound and tailored technology emerged.
cooperating
for a cure
DR. AVIGDOR SCHERZ, DR. YORAM SALOMON,
DR. ALEXANDER BRANDIS, EFRAT RUBENSTEIN,
DR. NATALIA KOUDINOVA
& DR. SMADAR SCHREIBER PhotocourtesyofWeizmannInstituteofScience
The treatment is nontoxic and
there are no long-term side effects. It
takes only 10 minutes and is a non-
invasive, potentially outpatient proce-
dure. Best of all, the remedy doesn’t
cut patients off from subsequent
treatments. In clinical trials, 50% of
patients have been cured with a
single treatment and possibly
70–80% may be cured after two. It is
called Vascular Targeted
Photodynamic Therapy (VTP), and it
may revolutionize the way science
approaches cancer treatment.
How did this small team come so
far so quickly? What is the secret to
their solution? How did they manage
to succeed where other major univer-
sities and research institutes have failed?
According to Salomon, it is all a
matter of opening the lines of commu-
nication between disciplines. Whereas
classical formats of multidisciplinary sci-
entific research consist of interactions
between whole departments at dif-
ferent institutes around the globe, the
Weizmann Institute team gathered rep-
resentatives from each discipline and
put them shoulder-to-shoulder in the
same lab—an innovative new approach
to scientific collaboration.
“Wherever you have contact
between disciplines, that’s where new
ideas form because you are inspired by
your environment and you can some-
times bridge concepts that you other-
wise wouldn’t be able to bridge,” says
Salomon. “The idea for VTP never
would have come up if we hadn’t sat
together and bridged the different disci-
plines we’re in.”
DR. AVIGDOR SCHERZ
The story of bacteriochlorophyll (Bchl)-
VTP begins in 1990 in a hallway of the
Ullmann Building at the Weizmann
Institute, where Dr. Yoram Salomon,
who at the time was conducting
research on the role of hormones in
tumor biology as a professor in the
Department of Biological Services, ran
into his younger brother’s former high
school classmate, Dr. Avigdor Scherz,
then an associate professor in the
Institute’s Department of Biological
Chemistry.
Driven to cure the cancer of a
recently diagnosed member of his own
family, Scherz had switched the focus
of his lab from plant photosynthesis to
chlorophyll-based cancer drugs. At this
chance meeting in the corridor, he
asked Salomon whether he had any
cancer cells on which to test his new
development. Salomon offered Scherz
melanoma cells. “Our collaboration
began at that moment,” recalls Scherz.
By 1991, the two professors had
co-opted their labs and gathered
together a team of some eight scientists
representing different disciplines and
varying developmental stages in the life
of a new treatment—from basic
research to the pharmaceutical industry
to clinical application.
“What we developed is a kind of
closed circle, wherein there was a very
intimate level of interaction between all
the branches,” explains Scherz. Their
idea was to create the ideal feedback
mechanism, whereby expertise from all
areas could inform each other, creating
the most efficient route to test new
ideas and discover solutions. “We didn’t
just want the group to be multidiscipli-
nary in the sense of having different
people from different disciplines com-
municate together; we had our sights
set on developing in all scientists
involved a multidisciplinary way of
thinking. Later on this was accom-
plished by a daily and completely
transparent communication with the
industrial partner’s experts. This model
for collaboration represents an entirely
new scientific approach.”
The concept of the unique new
lab’s development, however, was not
entirely new. VTP takes its basic idea
from its predecessor, Photodynamic
Therapy (PDT). In classical PDT, a
cancer patient is injected with a light-
sensitive pigment-based chemical
(“sensitizer”) that when exposed to
light forms radicals that in turn excite
oxygen molecules to oxidize, thus cre-
ating a toxic internal environment that
kills tumor cells.
While it is an effective technique,
the problem with classical PDT is that
the sensitizers used show no tissue or
organ selectivity, need hours to days to
absorb into the tumor cells before treat-
ment, and slowly exit the body after-
ward. The result is that patients con-
tinue to be sensitive to regular light and
cannot go outside for several weeks or
months after the treatment, since they
are at risk of being burned by the light
of the sun. Moreover, current sensitizers
enable treatment of shallow tumors
because of their limited physico-chem-
ical properties.
Until Scherz and Salomon’s lab,
scientists had not figured out a way to
harness effectively the photosensitiza-
tion capabilities of chlorophyll in the
photodynamic treatment, since in
their native form these molecules pre-
sent extremely low solubility disabling
their use as vascular photosensitizers.
Scherz’s lab discovered ways to modify
the hydrophobicity of the chlorophylls.
But there was still work to be done.
Although the chlorophyll-based drug
was a big improvement over existing
sensitizers, the type of light (i.e., sun-
light) required to excite it could only
penetrate into tissue at relatively
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34
TEAM SCIENCE
PhotocourtesyofWeizmannInstituteofScience
shallow depths. Hence, Scherz pro-
posed the use of a different kind of
chlorophyll, namely, a type of Bchl
that exists in the depths of the ocean
and relies on infrared light (which can
penetrate more deeply into human
tissue) to photosynthesize. It turned
out, in experiments conducted in the
two labs, that this discovery enabled
the first successful treatments of
melanoma tumors and consequently,
patent application in 1993 for non-
toxic chlorophyll-based sensitizers to
be used in PDT.
“It had a lot of advantages over
the pigments that were used at the
time,” says Scherz. “Namely, chloro-
phyll doesn’t stay in the system very
long. After all, it’s in every piece of let-
tuce we eat.”
In 1995, Scherz and Salomon’s
lab patented the first PDT containing
Bchl-based sensitizer, and in 1999 a
more water-soluble version of it:
Tookad. This name, which is the
Hebrew wording for “the center or
warmth of light,” was coined after a
passage in the Bible, that deals with a
cure delivered by God to humans. The
birth of Tookad marked the dawn of
Bchl-VTP and a possible new age of
cancer management.
DR. YORAM SALOMON
According to Dr. Salomon, who did
his B.Sc., M.Sc., and Ph.D. in bio-
chemistry at the Hebrew University in
Jerusalem before becoming a pro-
fessor at the Weizmann Institute, the
unique kind of collaboration that gave
rise to Tookad would not likely take
place outside of the Weizmann
Institute or outside of Israel, for that
matter. “I have to give the Institute
itself credit because they made our
collaboration very easy,” he says.
“There are no barriers there. It’s a very
cooperative environment.”
As for Israeli science in general,
Salomon says that the Institute’s
approval of the lab’s avant-garde
approach is indicative of a general
trend in the country’s scientific cul-
ture. “Rather than conduct years and
years of testing on chlorophyll, for
instance, we just jumped to the end
and said, ‘Does it work? Good. Now,
let’s see how it works,’” he explains.
“We use our knowledge and intuition
to find solutions that work, then go
backward to understand in greater
detail why they worked. Most scien-
tists around the world function in the
opposite way, so we really operate
against the dogma.”
It’s for that reason the lab’s initial
findings, while extremely impressive,
were rejected out-of-hand by the scien-
tific community at large and why it took
so long—nearly five years—to get their
methodology tested in clinical trials.
“Initially, we had lots of problems;
much of what we did was not accepted
by colleagues in the field. Our papers
were refused by labs around the world;
they wouldn’t even test it before they
rejected it,” says Salomon.
For instance, because classical PDT
required a lag time of 24 hours or
more between injection of the sensi-
tizer and illumination of the infected
tissues (in order for the drug to pene-
trate into the cells), the scientific com-
munity was apt to reject VTP’s bio-
chemical mechanism, which required
immediate or simultaneous illumina-
tion in order to be effective. “We had
to work very hard to change the scien-
tific community’s status quo,” he says.
It wasn’t until Scherz and
Salomon convinced Dutch pharma-
ceutical company Steba Beheer NV to
come on board in 1996 that other
institutes agreed to start testing
Tookad in pre-clinical trials. Says
Salomon, “Slowly, but surely, our
methodology was taken seriously.”
Rather than classical PDT, which
targets the tumor cells themselves,
VTP targets the blood vessels that
supply the tumors. According to
Salomon, the idea to cut off blood
flow to the tumor was also not a new
one. But the problem with the chemi-
cals used in anti-angiogenic therapies
(i.e., therapies that inhibit the growth
of blood vessels) is that the drugs used
only antagonize the creation of the ves-
sels, but don’t end their construction
completely. When the treatment stops,
the blood vessels begin to grow again.
In conjunction, there is the issue of
drug resistance.
By contrast, VTP completely
destroys the blood vessels that feed
the tumor; the tumor becomes
schemic, necrotic, and is finally eradi-
cated and carried out of the body by
the immune system.
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35
TEAM SCIENCE
“We use our knowledge and intuition to
find solutions that work, then go back-
ward to understand in greater detail why
they worked. Most scientists around the
world function in the opposite way....”
PhotocourtesyofWeizmannInstituteofScience
With VTP, doctors first conduct an
MRI and ultrasound to map out the
tumor and establish a plan of attack.
The drug is infused into the blood-
stream via an IV, and while it is continu-
ally distributed throughout the body,
the tumor area is illuminated with a
series of carefully placed fiber optic
lasers (so as to confine the illumination
as close as possible to the treated
zone). Within approximately 10 min-
utes, the illuminated tumor blood ves-
sels narrow and fill with clots. Blood
flow to the tumor stops. Five minutes
later, more than 90% of the drug is
cleared from the bloodstream.
The best part is that there are no
side effects to VTP. There is absolutely
no damage to tissue or cells that are
not illuminated, and none of the
three elements that comprise VTP—
Bchl, oxygen, and infrared light—are
toxic in and of themselves. But
together, they’re a lethal combina-
tion—for tumors.
Currently, Tookad is being tested
in advanced Phase 2 clinical trials in
France (for a degenerative eye dis-
ease called macular degeneration); in
the UK, on prostate cancer patients
with no previous treatment history
who chose VTP as their first therapy;
and in Canada, at Princess Margaret
Hospital in Toronto and Royal Victoria
Hospital in Montreal, where they are
conducting “salvage therapy” aimed at
curing patients with a recurrence of
prostate cancer after first treatment
radiation. Phase 3 testing is scheduled
to take place this summer.
DR. ALEXANDER BRANDIS
While those clinical trials are taking
place, the Weizmann Institute group
continues to develop an arsenal of
new compounds, aimed at different
types of cancer, regimes of treatment,
and diagnostics.
The chief molecular engineer who
is enabling the synthesis of the new
compounds is Dr. Alexander Brandis, a
Ph.D. in chemistry and technology of
natural products from the Lomonosov
Institute of Fine Chemical Technology in
Moscow, Russia, and a double postdoc-
torate in biochemical studies on chloro-
phyll and bacteriochlorophyll from the
Weizmann Institute in Scherz’s lab.
For Brandis, working on the VTP
project came as a welcome surprise. It
was merely by chance that he had
heard of the Weizmann Institute team
and their work at one of the first meet-
ings that was allowed to take place of
the USSR’s Society of Jewish Scientists
and Engineers in Moscow in 1991.
“When Gorbachev came into power,
there were a lot of new things in the
air, and a lot of Jewish societies started
in Moscow. This was one of them,”
explains Brandis. “I participated in the
Societies’ Israel Science Day, and just
happened to pass my CV to one of the
representatives from the Weizmann
Institute who was there.”
Brandis had been working on com-
pounds for PDT for several years and, in
fact, engineered one of the first sensi-
tizers for use in PDT. “Photodynamic
therapy was extremely interesting to
me because it was a new area with so
many potential applications,” he says.
On the afternoon of Israel Science
Day, Brandis received a call from the
Weizmann Institute representative
encouraging him to apply to do his
postdoc in Rehovot. “It was Israel’s
Independence Day, and my father’s
birthday,” recalls Brandis. “I will never
forget that day.”
Brandis moved to Israel from
Moscow in 1992 to join the fledgling
team. “From the moment I met Scherz,
we started coordinating,” he says. “It
was an ideal adoption. I found exactly
the place where I had to be to continue
my career.”
The Israeli approach to scientific
research was a shock to Brandis’s
system. “Although our lab in Moscow
was a very well-established alma mater,
we had very little direct contact with
labs around the world,” explains
Brandis. During that time in the USSR,
scientists had access to research papers
from around the globe but did not
conduct many cooperative efforts with
scientists abroad. “For me, working in
Israel opened up this whole new world
of international collaboration. After 15
years, this global approach is still
extremely exciting to me.”
The VTP team took that collabora-
tion to a whole different level for
Brandis. “In Moscow, my lab used to
synthesize a compound, then test it,
then send the sample to another insti-
tute, then wait for their reply,” he
explains. “The first time I came to the
lab at Weizmann, it was so strange to
see all the scientists multitasking. Here,
you don’t have a department where
everyone does his own work, individu-
ally; you have a few people who do a
lot of different things.
“In our group now, the close
proximity between disciplines not
only makes the process much faster,
but the collaborative work sharpens
your intuition. Getting feedback every
day and discussing problems in real
time makes a huge difference to one’s
state of alertness.”
That’s not to say that the experi-
ence hasn’t had its challenges. While he
loves the multidisciplinary structure of
the group, it also makes creating com-
pounds more difficult, since there are
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36
TEAM SCIENCE
PhotocourtesyofWeizmannInstituteofScience
more factors to consider. “Rather than
just synthesize new compounds that
will be effective from a physical stand-
point, we have to think ahead about
whether they will be viable from a clin-
ical and pharmaceutical perspective,”
explains Brandis. “The compound may
be effective, but what’s it worth if it
causes bad side effects, or if it’s too
expensive to be mass produced?”
Since so many cures have been
serendipitously discovered (i.e., while
searching for a cure to one affliction, a
researcher stumbles upon a cure for a
totally unrelated problem), Brandis says
the group’s new approach to contex-
tual thinking is extremely challenging,
since his natural inclination is to follow
his molecules to see where they lead.
“Participating in the group has
required a real switch from question-
oriented research to objective-oriented
research.”
On a personal note, adjusting to
Israel has also been a big challenge for
Brandis, who although Jewish, had
never been to Israel until he came to
the Weizmann Institute. “Coming to
Israel was itself an adventure. It was
very strange for me to go from living
in Moscow, with 15 million people, to
living in Rehovot,” says Brandis. “But,
I met my wife here and now we have
two daughters. I am very happy.”
EFRAT RUBINSTEIN, M.Sc.
One of the most intriguing new com-
pounds the team is working on is a
more sophisticated version of Bchl, one
that exclusively targets tumor blood ves-
sels so that the drug does not have the
potential to affect all tissues that are
subjected to light subsequent to infu-
sion. Instead, it only affects tumor ves-
sels, so it’s possible to hone in even
closer on the targeted tissues.
The woman behind this new
innovation-in-progress is Efrat
Rubenstein, one of 14 Ph.D. students
hailing from disciplines including
computational chemistry, chemistry,
biology, and pharmacology. These
students comprise the basic research
arm of the group and whom Scherz
dubs “the team’s lifeline.”
“My new development capitalizes
on the fact that some tumor blood
vessels—including those that feed
brain tumors, metastatic breast,
melanoma, and lung tumors—have
special receptors,” explains
Rubinstein, a student of both the
Institute’s Departments of Plant
Sciences and Biological Regulation. “I
am adding a sort of ‘homing device’
to the sensitizer in order to target
these specific receptors.
“The benefit of this new drug is
that because it’s more directed, there
can be no accidental peripheral
damage to ‘good vessels’ and tissues
surrounding the tumor vessels, and it
will spare as much as possible the col-
lagen supporting matrix, which plays
a big role in the body’s natural
healing process.”
Since commencing her Ph.D. in
2001, Rubinstein has synthesized,
developed, and tested in vitro a large
number of VTP agents.
“Before you can check the agents
on animals (in vivo) you have to test
them extensively on cell cultures (in
vitro),” explains Rubinstein. “But there
is a problem in the correlation: The cell
environment is very different from the
animal environment and oftentimes
what responds in vitro does not
respond or work in vivo.”
According to Rubinstein, the
process of in vitro testing can be
extremely taxing. “It’s very hard men-
tally because you experience so many
disappointments along the way.” She
says that there is often no correlation
between what should work theoreti-
cally and what does work in practical
application. “You have to be very
strong to continue.”
“This sort of frustration is the real
test of one student or one scientist
versus another,” comments Scherz.
“Either you take it in stride and learn
to benefit from it, or it breaks you
down.”
It’s precisely because there are so
many disappointments that the
moments of accomplishment are so
exhilarating. For instance, Rubinstein
says she will never forget the moment
that one of her sensitizers elicited a
positive response to a cancer sample.
“I was at the special lab in Jerusalem,
about halfway through testing some
250 samples, all of which had pro-
duced a flat line,” she recalls. “Then I
put this cancer tumor sample into the
machine and the line started to peak,
indicating that a reaction was indeed
taking place.
“At first, I thought the machine
was broken,” she says. “Then I tested
and retested and retested again, and I
realized it wasn’t broken at all. I was
onto something! As long as I live, I will
never forget that moment. It was
August 23, 2004. We submitted the
patent one year later.”
Rubinstein, a new mother of two,
completed her B.Pharm. at Hebrew
University in Jerusalem in 1995. Straight
out of school, she began to work at
Super-Pharm Pharmacy in Rishon
LeZion, a position she kept throughout
the duration of her M.Sc. in pharma-
cology at Tel Aviv University, and right
up until she started her Ph.D. “I wasn’t
happy just to work in a pharmacy,” she
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PhotocourtesyofWeizmannInstituteofScience
says. “Something was always missing.
After my master’s, I understood that I
had to do research full-time, but it had
to be in a field with clinical applications.”
That’s when she discovered the
group at the Weizmann Institute. “I
can’t think of any other place where I
would be able to be involved, step-by-
step, from the very beginning of sepa-
rating molecules and synthesizing
them in vitro to seeing my agents
being used in pre-clinical and clinical
applications,” she says. “It is impos-
sible to describe the joy of nurturing
this little molecule into something
that really works. Being part of this
group has been a dream come true.”
According to Rubinstein, who will
submit her Ph.D. thesis on April 30,
2007, being part of the group has been
a very special experience for other rea-
sons, too. “When I look at the papers
and abstracts from the big conferences
and see how many authors and univer-
sity departments and research institutes
are involved, and how much support
projects receive from big companies, it
makes me very proud,” she says. “We are
only a little group, a few people, and we
are not accomplishing less than them.
“When it comes to finding a cure
for cancer, there is still a long way to
go,” she says. “But we have already
made a contribution that has been way
beyond our expectations.”
DR. NATALIA KOUDINOVA
As Rubinstein says, there is a big differ-
ence between in vitro and in vivo
testing. That’s where Dr. Natalia
Koudinova comes in. As head of Steba
Israel’s Biological Unit, Koudinova
serves as an essential conduit between
the lab at Weizmann and the pharma-
ceutical company.
Since she assumed the position
three years ago, Koudinova has
screened dozens of compounds in
vivo, between those produced by
Steba’s R&D Department and those
produced by the lab at the Weizmann
Institute. Altogether, she has recom-
mended only six for pre-clinical or
Phase 1 clinical trials.
According to Scherz, Koudinova is
an essential member of the Weizmann
team, since she is in a very unique
position to diffuse the tension inherent
between the lab and the pharmaceu-
tical company, or between research
and industry related primarily to issues
of intellectual property (IP). “Dr.
Koudinova and the rest of the Steba
team bridge a very important gap and
replace natural hostility with construc-
tive cooperation,” says Scherz.
“Without this collaboration, several of
our compounds might never have
made it into circulation and the devel-
opment of others would take forever.”
Like Brandis, Koudinova came to
the Weizmann Institute group quite
by accident. Her husband, a neurosci-
entist from Moscow, was invited to
participate in a project at the
Department of Brain Research at the
Weizmann Institute in 1997. She fol-
lowed him to Israel. After working for
two years on her postdoc on
Alzheimer’s disease at the Institute’s
Department of Neurobiology,
Koudinova, a medical doctor who
completed her Ph.D. on lipid metabo-
lism in Alzheimer’s at the Peoples’
Friendship University in Moscow, met
Dr. Salomon.
“I never anticipated I would end
up in the field of PDT,” says
Koudinova. “But before I knew it, I was
developing the animal prostate cancer
and bone metastases models.”
It was Koudinova who conducted
the first study that showed that
Tookad was a successful treatment
for human prostate carcinoma and
bone metastases. More than 80% of
the animals used in preliminary tests
were completely cured of large
tumors via VTP.
It was these tests that became the
backbone of Koudinova’s second post-
doc, which she completed in 2004.
Just after she finished her degree,
her Israeli visa expired. “All of a sudden,
it looked as though I would have to
leave Israel, which was such a pity
because I loved Israel and the group
and I didn’t want to go anywhere else,”
recalls Koudinova, the team’s only non-
Jewish member. “Although science is a
very international thing, when you are
working in a lab, you are not just doing
science; you are working with people,”
she says. “The lab environment at the
Weizmann Institute was unlike any
other lab I had worked in before. It was
an open, communicative, social envi-
ronment. I really enjoyed it.”
Salomon and Scherz took action
on Koudinova’s behalf and wrote let-
ters to the Ministry of the Interior
appealing to the authorities to grant
Koudinova an extension. “She was a
key member of our team,” comments
Scherz. “The amount of knowledge
and skills that she had acquired over
the years was essential for the fast
development of new products. It was
really in the best interests of the State
of Israel to let her stay.”
Koudinova was awarded tempo-
rary residency (giving her three more
years) in 2004. “Finally, I could
breathe a sigh of relief,” she says. “I
was very lucky.”
Around the same time, Steba
decided to establish an independent
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39
affiliate lab in Israel almost exclusively
geared to supporting new research
and development in the field of VTP.
“The timing couldn’t have been
more perfect,” says Koudinova.
Then three years later, at the
start of 2007, Koudinova found her-
self in a similar pickle. “Again, we
applied to the Ministry of the
Interior,” she says. “Only this time, I
got extra lucky and they awarded
me permanent residency. So, now I
can live the rest of my years in
Israel worry-free.
“It’s been strange to have my
professional scientific life tied in so
closely to my personal life,” she
notes. “But in the end, I love my work, I
love this country, and I know that this is
where my family belongs.”
DR. SMADAR SCHREIBER
According to Salomon, the sort of ten-
sion that exists between the research
and pharmaceutical fields of medical
development tends to exist similarly
between the research and clinical
fields. In the case of VTP, which
requires far fewer human and hospital
resources—and, ultimately, less
expense than traditional cancer thera-
pies—this tension is particularly pro-
nounced. “In medicine, there is usually
opposition to new approaches,” says
Salomon, who explains that there is
also the issue of having to train in
order to learn how to implement the
new technique.
Dr. Smadar Schreiber is a clear
exception. The practicing doctor in the
PDT Unit at the Assaf Harofe Medical
Center near Tel Aviv, Schreiber’s pri-
mary contribution to the team is her
firsthand experience.
“I am actually putting current pho-
todynamic technology into practice,”
says Schreiber, who uses PDT to treat
dermatological ailments such as skin
lesions, viral warts and other viral
lesions, psoriasis, acne, and of course,
cancer. “The patients react very well to
the treatment. Side effects are local and
transient, and although there is usually
an inflammatory reaction for a few days
following the treatment, it only takes
three or four weeks after one treatment
for the lesions to disappear completely
and to be replaced with healthy,
younger-looking skin.”
In addition to bringing firsthand
PDT experience to the group, Schreiber
was the first to test Tookad-VTP in pre-
clinical trials. “I was the first to test the
mode of application and successfully
demonstrate that it worked against
tumors in animal models,” explains
Schreiber. “I think this was a very
important contribution to the group.”
It’s worth noting that Schreiber
did not get her start in PDT. Since she
graduated from medical school at the
Technion Institute of Technology in
Haifa in 1986, she worked first as a
physician in the IDF, then as a
researcher at a manufacturer of light-
based devices for medical and cos-
metic purposes, and finally as a devel-
oper of clinical protocols for doctoral
students around the world. It wasn’t
until she began her residency in plastic
surgery at the Weizmann Institute in
1997 that all of her myriad work expe-
rience seemed to come together.
Before she knew it, she had extended
her basic science requirement into a
Ph.D. project on the effects of bacteri-
ochlorophylls on tumors and became
a vital member of the VTP team. “I
never thought I would end up in this
field,” she says. “But what I am doing
now really is a combination of every-
thing I have learned.”
According to Schreiber, this flexi-
bility to combine the various ele-
ments of her knowledge base into
one useful application is unique to
Israeli science. “The standards of sci-
ence and technology are very high in
Israel,” says Schreiber. “At the same
time, there is always a place for inno-
vation and the opportunity to pursue
radically new ideas.”
VTP is one such pursuit.
“Photodynamic treatments have such
great potential. What is being done
now is only the beginning; it is going
to evolve to apply to many medical
specialties and many different usages,”
says the mother of three from Gan
Hatikvah, who names gastric cancers,
internal infections, restenosis, hema-
tology, and melanoma among the likely
future applications.
To date, VTP has been tested on
colon carcinomas, prostate cancers, sar-
comas, liver cancers, breast tumors,
brain tumors, pancreatic cancers, and
various metastases. According to
Scherz, the group’s immediate objec-
tive over the next two years is to cover
the entire field of prostate ailments,
from cancer and metastases to
enlarged prostate and benign prostate
treatment at various stages. After that,
the team intends to tackle nonlocalized
cancers such as leukemia. “Right now,
we can only use this method to treat
cancers wherein we know their loca-
tion,” explains Salomon. “Cancers
without specific locations are on our list
of upcoming challenges.”
“But,” says Scherz with a hopeful
smile, “the more we advance, the more
the possibility for future developments
and future applications opens up.”
“In the end, one thing is cer-
tain,” adds Salomon. “The more we
collaborate, the greater our chances
of success.” lifestyles
TEAM SCIENCE
PhotocourtesyofWeizmannInstituteofScience

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  • 1. www.lifestylesmagazine.com 33 TEAM SCIENCE BY JENNY HAZAN A ccording to the latest estimates from the Prostate Cancer Foundation, more than 218,000 men in the United States alone will be diagnosed with prostate cancer this year. The disease strikes one in six men. If detected early enough, there is a high success rate with traditional treatments such as radiation, chemotherapy, surgery (prostatectomy), hor- mone therapy, cryotherapy, and high-frequency radiotherapy (Hi-Fu). But the side effects of such treatments can be severe, requiring patients to undergo long and painful recoveries and in the long-term, causing impotency or incontinency. What’s more, in all cases the collateral damage caused by one treatment closes the door to subsequent therapies, so healing is hope- less in cases where the cancer is not cured in one shot or metastasizes to other parts of the body. At least that was the prostate cancer treatment landscape until the beginning of 2000, when the research outcome of a unique team of scientists at the Weizmann Institute of Science in Rehovot, Israel, had appeared to enable a better remedy. Nine years earlier, the director of the Weizmann Institute’s Avron-Wilstatter Minerva Center for Research in Photosynthesis, Dr. Avigdor Scherz, and the head of the Institute’s Department of Biological Services, Dr. Yoram Salomon, helmed jointly the basic idea. By 1995, they had already gathered a relatively small group of chemists, biologists, pharmacologists, physicians, and physicists who had proven their novel concept. At the end of 1996, industry joined in to boost up the pharmaceutical development. Three years later, following an extensive basic and pre-clinical research, a new compound and tailored technology emerged. cooperating for a cure DR. AVIGDOR SCHERZ, DR. YORAM SALOMON, DR. ALEXANDER BRANDIS, EFRAT RUBENSTEIN, DR. NATALIA KOUDINOVA & DR. SMADAR SCHREIBER PhotocourtesyofWeizmannInstituteofScience
  • 2. The treatment is nontoxic and there are no long-term side effects. It takes only 10 minutes and is a non- invasive, potentially outpatient proce- dure. Best of all, the remedy doesn’t cut patients off from subsequent treatments. In clinical trials, 50% of patients have been cured with a single treatment and possibly 70–80% may be cured after two. It is called Vascular Targeted Photodynamic Therapy (VTP), and it may revolutionize the way science approaches cancer treatment. How did this small team come so far so quickly? What is the secret to their solution? How did they manage to succeed where other major univer- sities and research institutes have failed? According to Salomon, it is all a matter of opening the lines of commu- nication between disciplines. Whereas classical formats of multidisciplinary sci- entific research consist of interactions between whole departments at dif- ferent institutes around the globe, the Weizmann Institute team gathered rep- resentatives from each discipline and put them shoulder-to-shoulder in the same lab—an innovative new approach to scientific collaboration. “Wherever you have contact between disciplines, that’s where new ideas form because you are inspired by your environment and you can some- times bridge concepts that you other- wise wouldn’t be able to bridge,” says Salomon. “The idea for VTP never would have come up if we hadn’t sat together and bridged the different disci- plines we’re in.” DR. AVIGDOR SCHERZ The story of bacteriochlorophyll (Bchl)- VTP begins in 1990 in a hallway of the Ullmann Building at the Weizmann Institute, where Dr. Yoram Salomon, who at the time was conducting research on the role of hormones in tumor biology as a professor in the Department of Biological Services, ran into his younger brother’s former high school classmate, Dr. Avigdor Scherz, then an associate professor in the Institute’s Department of Biological Chemistry. Driven to cure the cancer of a recently diagnosed member of his own family, Scherz had switched the focus of his lab from plant photosynthesis to chlorophyll-based cancer drugs. At this chance meeting in the corridor, he asked Salomon whether he had any cancer cells on which to test his new development. Salomon offered Scherz melanoma cells. “Our collaboration began at that moment,” recalls Scherz. By 1991, the two professors had co-opted their labs and gathered together a team of some eight scientists representing different disciplines and varying developmental stages in the life of a new treatment—from basic research to the pharmaceutical industry to clinical application. “What we developed is a kind of closed circle, wherein there was a very intimate level of interaction between all the branches,” explains Scherz. Their idea was to create the ideal feedback mechanism, whereby expertise from all areas could inform each other, creating the most efficient route to test new ideas and discover solutions. “We didn’t just want the group to be multidiscipli- nary in the sense of having different people from different disciplines com- municate together; we had our sights set on developing in all scientists involved a multidisciplinary way of thinking. Later on this was accom- plished by a daily and completely transparent communication with the industrial partner’s experts. This model for collaboration represents an entirely new scientific approach.” The concept of the unique new lab’s development, however, was not entirely new. VTP takes its basic idea from its predecessor, Photodynamic Therapy (PDT). In classical PDT, a cancer patient is injected with a light- sensitive pigment-based chemical (“sensitizer”) that when exposed to light forms radicals that in turn excite oxygen molecules to oxidize, thus cre- ating a toxic internal environment that kills tumor cells. While it is an effective technique, the problem with classical PDT is that the sensitizers used show no tissue or organ selectivity, need hours to days to absorb into the tumor cells before treat- ment, and slowly exit the body after- ward. The result is that patients con- tinue to be sensitive to regular light and cannot go outside for several weeks or months after the treatment, since they are at risk of being burned by the light of the sun. Moreover, current sensitizers enable treatment of shallow tumors because of their limited physico-chem- ical properties. Until Scherz and Salomon’s lab, scientists had not figured out a way to harness effectively the photosensitiza- tion capabilities of chlorophyll in the photodynamic treatment, since in their native form these molecules pre- sent extremely low solubility disabling their use as vascular photosensitizers. Scherz’s lab discovered ways to modify the hydrophobicity of the chlorophylls. But there was still work to be done. Although the chlorophyll-based drug was a big improvement over existing sensitizers, the type of light (i.e., sun- light) required to excite it could only penetrate into tissue at relatively www.lifestylesmagazine.com 34 TEAM SCIENCE PhotocourtesyofWeizmannInstituteofScience
  • 3. shallow depths. Hence, Scherz pro- posed the use of a different kind of chlorophyll, namely, a type of Bchl that exists in the depths of the ocean and relies on infrared light (which can penetrate more deeply into human tissue) to photosynthesize. It turned out, in experiments conducted in the two labs, that this discovery enabled the first successful treatments of melanoma tumors and consequently, patent application in 1993 for non- toxic chlorophyll-based sensitizers to be used in PDT. “It had a lot of advantages over the pigments that were used at the time,” says Scherz. “Namely, chloro- phyll doesn’t stay in the system very long. After all, it’s in every piece of let- tuce we eat.” In 1995, Scherz and Salomon’s lab patented the first PDT containing Bchl-based sensitizer, and in 1999 a more water-soluble version of it: Tookad. This name, which is the Hebrew wording for “the center or warmth of light,” was coined after a passage in the Bible, that deals with a cure delivered by God to humans. The birth of Tookad marked the dawn of Bchl-VTP and a possible new age of cancer management. DR. YORAM SALOMON According to Dr. Salomon, who did his B.Sc., M.Sc., and Ph.D. in bio- chemistry at the Hebrew University in Jerusalem before becoming a pro- fessor at the Weizmann Institute, the unique kind of collaboration that gave rise to Tookad would not likely take place outside of the Weizmann Institute or outside of Israel, for that matter. “I have to give the Institute itself credit because they made our collaboration very easy,” he says. “There are no barriers there. It’s a very cooperative environment.” As for Israeli science in general, Salomon says that the Institute’s approval of the lab’s avant-garde approach is indicative of a general trend in the country’s scientific cul- ture. “Rather than conduct years and years of testing on chlorophyll, for instance, we just jumped to the end and said, ‘Does it work? Good. Now, let’s see how it works,’” he explains. “We use our knowledge and intuition to find solutions that work, then go backward to understand in greater detail why they worked. Most scien- tists around the world function in the opposite way, so we really operate against the dogma.” It’s for that reason the lab’s initial findings, while extremely impressive, were rejected out-of-hand by the scien- tific community at large and why it took so long—nearly five years—to get their methodology tested in clinical trials. “Initially, we had lots of problems; much of what we did was not accepted by colleagues in the field. Our papers were refused by labs around the world; they wouldn’t even test it before they rejected it,” says Salomon. For instance, because classical PDT required a lag time of 24 hours or more between injection of the sensi- tizer and illumination of the infected tissues (in order for the drug to pene- trate into the cells), the scientific com- munity was apt to reject VTP’s bio- chemical mechanism, which required immediate or simultaneous illumina- tion in order to be effective. “We had to work very hard to change the scien- tific community’s status quo,” he says. It wasn’t until Scherz and Salomon convinced Dutch pharma- ceutical company Steba Beheer NV to come on board in 1996 that other institutes agreed to start testing Tookad in pre-clinical trials. Says Salomon, “Slowly, but surely, our methodology was taken seriously.” Rather than classical PDT, which targets the tumor cells themselves, VTP targets the blood vessels that supply the tumors. According to Salomon, the idea to cut off blood flow to the tumor was also not a new one. But the problem with the chemi- cals used in anti-angiogenic therapies (i.e., therapies that inhibit the growth of blood vessels) is that the drugs used only antagonize the creation of the ves- sels, but don’t end their construction completely. When the treatment stops, the blood vessels begin to grow again. In conjunction, there is the issue of drug resistance. By contrast, VTP completely destroys the blood vessels that feed the tumor; the tumor becomes schemic, necrotic, and is finally eradi- cated and carried out of the body by the immune system. www.lifestylesmagazine.com 35 TEAM SCIENCE “We use our knowledge and intuition to find solutions that work, then go back- ward to understand in greater detail why they worked. Most scientists around the world function in the opposite way....” PhotocourtesyofWeizmannInstituteofScience
  • 4. With VTP, doctors first conduct an MRI and ultrasound to map out the tumor and establish a plan of attack. The drug is infused into the blood- stream via an IV, and while it is continu- ally distributed throughout the body, the tumor area is illuminated with a series of carefully placed fiber optic lasers (so as to confine the illumination as close as possible to the treated zone). Within approximately 10 min- utes, the illuminated tumor blood ves- sels narrow and fill with clots. Blood flow to the tumor stops. Five minutes later, more than 90% of the drug is cleared from the bloodstream. The best part is that there are no side effects to VTP. There is absolutely no damage to tissue or cells that are not illuminated, and none of the three elements that comprise VTP— Bchl, oxygen, and infrared light—are toxic in and of themselves. But together, they’re a lethal combina- tion—for tumors. Currently, Tookad is being tested in advanced Phase 2 clinical trials in France (for a degenerative eye dis- ease called macular degeneration); in the UK, on prostate cancer patients with no previous treatment history who chose VTP as their first therapy; and in Canada, at Princess Margaret Hospital in Toronto and Royal Victoria Hospital in Montreal, where they are conducting “salvage therapy” aimed at curing patients with a recurrence of prostate cancer after first treatment radiation. Phase 3 testing is scheduled to take place this summer. DR. ALEXANDER BRANDIS While those clinical trials are taking place, the Weizmann Institute group continues to develop an arsenal of new compounds, aimed at different types of cancer, regimes of treatment, and diagnostics. The chief molecular engineer who is enabling the synthesis of the new compounds is Dr. Alexander Brandis, a Ph.D. in chemistry and technology of natural products from the Lomonosov Institute of Fine Chemical Technology in Moscow, Russia, and a double postdoc- torate in biochemical studies on chloro- phyll and bacteriochlorophyll from the Weizmann Institute in Scherz’s lab. For Brandis, working on the VTP project came as a welcome surprise. It was merely by chance that he had heard of the Weizmann Institute team and their work at one of the first meet- ings that was allowed to take place of the USSR’s Society of Jewish Scientists and Engineers in Moscow in 1991. “When Gorbachev came into power, there were a lot of new things in the air, and a lot of Jewish societies started in Moscow. This was one of them,” explains Brandis. “I participated in the Societies’ Israel Science Day, and just happened to pass my CV to one of the representatives from the Weizmann Institute who was there.” Brandis had been working on com- pounds for PDT for several years and, in fact, engineered one of the first sensi- tizers for use in PDT. “Photodynamic therapy was extremely interesting to me because it was a new area with so many potential applications,” he says. On the afternoon of Israel Science Day, Brandis received a call from the Weizmann Institute representative encouraging him to apply to do his postdoc in Rehovot. “It was Israel’s Independence Day, and my father’s birthday,” recalls Brandis. “I will never forget that day.” Brandis moved to Israel from Moscow in 1992 to join the fledgling team. “From the moment I met Scherz, we started coordinating,” he says. “It was an ideal adoption. I found exactly the place where I had to be to continue my career.” The Israeli approach to scientific research was a shock to Brandis’s system. “Although our lab in Moscow was a very well-established alma mater, we had very little direct contact with labs around the world,” explains Brandis. During that time in the USSR, scientists had access to research papers from around the globe but did not conduct many cooperative efforts with scientists abroad. “For me, working in Israel opened up this whole new world of international collaboration. After 15 years, this global approach is still extremely exciting to me.” The VTP team took that collabora- tion to a whole different level for Brandis. “In Moscow, my lab used to synthesize a compound, then test it, then send the sample to another insti- tute, then wait for their reply,” he explains. “The first time I came to the lab at Weizmann, it was so strange to see all the scientists multitasking. Here, you don’t have a department where everyone does his own work, individu- ally; you have a few people who do a lot of different things. “In our group now, the close proximity between disciplines not only makes the process much faster, but the collaborative work sharpens your intuition. Getting feedback every day and discussing problems in real time makes a huge difference to one’s state of alertness.” That’s not to say that the experi- ence hasn’t had its challenges. While he loves the multidisciplinary structure of the group, it also makes creating com- pounds more difficult, since there are www.lifestylesmagazine.com 36 TEAM SCIENCE PhotocourtesyofWeizmannInstituteofScience
  • 5. more factors to consider. “Rather than just synthesize new compounds that will be effective from a physical stand- point, we have to think ahead about whether they will be viable from a clin- ical and pharmaceutical perspective,” explains Brandis. “The compound may be effective, but what’s it worth if it causes bad side effects, or if it’s too expensive to be mass produced?” Since so many cures have been serendipitously discovered (i.e., while searching for a cure to one affliction, a researcher stumbles upon a cure for a totally unrelated problem), Brandis says the group’s new approach to contex- tual thinking is extremely challenging, since his natural inclination is to follow his molecules to see where they lead. “Participating in the group has required a real switch from question- oriented research to objective-oriented research.” On a personal note, adjusting to Israel has also been a big challenge for Brandis, who although Jewish, had never been to Israel until he came to the Weizmann Institute. “Coming to Israel was itself an adventure. It was very strange for me to go from living in Moscow, with 15 million people, to living in Rehovot,” says Brandis. “But, I met my wife here and now we have two daughters. I am very happy.” EFRAT RUBINSTEIN, M.Sc. One of the most intriguing new com- pounds the team is working on is a more sophisticated version of Bchl, one that exclusively targets tumor blood ves- sels so that the drug does not have the potential to affect all tissues that are subjected to light subsequent to infu- sion. Instead, it only affects tumor ves- sels, so it’s possible to hone in even closer on the targeted tissues. The woman behind this new innovation-in-progress is Efrat Rubenstein, one of 14 Ph.D. students hailing from disciplines including computational chemistry, chemistry, biology, and pharmacology. These students comprise the basic research arm of the group and whom Scherz dubs “the team’s lifeline.” “My new development capitalizes on the fact that some tumor blood vessels—including those that feed brain tumors, metastatic breast, melanoma, and lung tumors—have special receptors,” explains Rubinstein, a student of both the Institute’s Departments of Plant Sciences and Biological Regulation. “I am adding a sort of ‘homing device’ to the sensitizer in order to target these specific receptors. “The benefit of this new drug is that because it’s more directed, there can be no accidental peripheral damage to ‘good vessels’ and tissues surrounding the tumor vessels, and it will spare as much as possible the col- lagen supporting matrix, which plays a big role in the body’s natural healing process.” Since commencing her Ph.D. in 2001, Rubinstein has synthesized, developed, and tested in vitro a large number of VTP agents. “Before you can check the agents on animals (in vivo) you have to test them extensively on cell cultures (in vitro),” explains Rubinstein. “But there is a problem in the correlation: The cell environment is very different from the animal environment and oftentimes what responds in vitro does not respond or work in vivo.” According to Rubinstein, the process of in vitro testing can be extremely taxing. “It’s very hard men- tally because you experience so many disappointments along the way.” She says that there is often no correlation between what should work theoreti- cally and what does work in practical application. “You have to be very strong to continue.” “This sort of frustration is the real test of one student or one scientist versus another,” comments Scherz. “Either you take it in stride and learn to benefit from it, or it breaks you down.” It’s precisely because there are so many disappointments that the moments of accomplishment are so exhilarating. For instance, Rubinstein says she will never forget the moment that one of her sensitizers elicited a positive response to a cancer sample. “I was at the special lab in Jerusalem, about halfway through testing some 250 samples, all of which had pro- duced a flat line,” she recalls. “Then I put this cancer tumor sample into the machine and the line started to peak, indicating that a reaction was indeed taking place. “At first, I thought the machine was broken,” she says. “Then I tested and retested and retested again, and I realized it wasn’t broken at all. I was onto something! As long as I live, I will never forget that moment. It was August 23, 2004. We submitted the patent one year later.” Rubinstein, a new mother of two, completed her B.Pharm. at Hebrew University in Jerusalem in 1995. Straight out of school, she began to work at Super-Pharm Pharmacy in Rishon LeZion, a position she kept throughout the duration of her M.Sc. in pharma- cology at Tel Aviv University, and right up until she started her Ph.D. “I wasn’t happy just to work in a pharmacy,” she PUBLISHINGTEAM SCIENCE www.lifestylesmagazine.com 37 PhotocourtesyofWeizmannInstituteofScience
  • 6. says. “Something was always missing. After my master’s, I understood that I had to do research full-time, but it had to be in a field with clinical applications.” That’s when she discovered the group at the Weizmann Institute. “I can’t think of any other place where I would be able to be involved, step-by- step, from the very beginning of sepa- rating molecules and synthesizing them in vitro to seeing my agents being used in pre-clinical and clinical applications,” she says. “It is impos- sible to describe the joy of nurturing this little molecule into something that really works. Being part of this group has been a dream come true.” According to Rubinstein, who will submit her Ph.D. thesis on April 30, 2007, being part of the group has been a very special experience for other rea- sons, too. “When I look at the papers and abstracts from the big conferences and see how many authors and univer- sity departments and research institutes are involved, and how much support projects receive from big companies, it makes me very proud,” she says. “We are only a little group, a few people, and we are not accomplishing less than them. “When it comes to finding a cure for cancer, there is still a long way to go,” she says. “But we have already made a contribution that has been way beyond our expectations.” DR. NATALIA KOUDINOVA As Rubinstein says, there is a big differ- ence between in vitro and in vivo testing. That’s where Dr. Natalia Koudinova comes in. As head of Steba Israel’s Biological Unit, Koudinova serves as an essential conduit between the lab at Weizmann and the pharma- ceutical company. Since she assumed the position three years ago, Koudinova has screened dozens of compounds in vivo, between those produced by Steba’s R&D Department and those produced by the lab at the Weizmann Institute. Altogether, she has recom- mended only six for pre-clinical or Phase 1 clinical trials. According to Scherz, Koudinova is an essential member of the Weizmann team, since she is in a very unique position to diffuse the tension inherent between the lab and the pharmaceu- tical company, or between research and industry related primarily to issues of intellectual property (IP). “Dr. Koudinova and the rest of the Steba team bridge a very important gap and replace natural hostility with construc- tive cooperation,” says Scherz. “Without this collaboration, several of our compounds might never have made it into circulation and the devel- opment of others would take forever.” Like Brandis, Koudinova came to the Weizmann Institute group quite by accident. Her husband, a neurosci- entist from Moscow, was invited to participate in a project at the Department of Brain Research at the Weizmann Institute in 1997. She fol- lowed him to Israel. After working for two years on her postdoc on Alzheimer’s disease at the Institute’s Department of Neurobiology, Koudinova, a medical doctor who completed her Ph.D. on lipid metabo- lism in Alzheimer’s at the Peoples’ Friendship University in Moscow, met Dr. Salomon. “I never anticipated I would end up in the field of PDT,” says Koudinova. “But before I knew it, I was developing the animal prostate cancer and bone metastases models.” It was Koudinova who conducted the first study that showed that Tookad was a successful treatment for human prostate carcinoma and bone metastases. More than 80% of the animals used in preliminary tests were completely cured of large tumors via VTP. It was these tests that became the backbone of Koudinova’s second post- doc, which she completed in 2004. Just after she finished her degree, her Israeli visa expired. “All of a sudden, it looked as though I would have to leave Israel, which was such a pity because I loved Israel and the group and I didn’t want to go anywhere else,” recalls Koudinova, the team’s only non- Jewish member. “Although science is a very international thing, when you are working in a lab, you are not just doing science; you are working with people,” she says. “The lab environment at the Weizmann Institute was unlike any other lab I had worked in before. It was an open, communicative, social envi- ronment. I really enjoyed it.” Salomon and Scherz took action on Koudinova’s behalf and wrote let- ters to the Ministry of the Interior appealing to the authorities to grant Koudinova an extension. “She was a key member of our team,” comments Scherz. “The amount of knowledge and skills that she had acquired over the years was essential for the fast development of new products. It was really in the best interests of the State of Israel to let her stay.” Koudinova was awarded tempo- rary residency (giving her three more years) in 2004. “Finally, I could breathe a sigh of relief,” she says. “I was very lucky.” Around the same time, Steba decided to establish an independent TEAM SCIENCE www.lifestylesmagazine.com 38 PhotocourtesyofWeizmannInstituteofScience
  • 7. www.lifestylesmagazine.com 39 affiliate lab in Israel almost exclusively geared to supporting new research and development in the field of VTP. “The timing couldn’t have been more perfect,” says Koudinova. Then three years later, at the start of 2007, Koudinova found her- self in a similar pickle. “Again, we applied to the Ministry of the Interior,” she says. “Only this time, I got extra lucky and they awarded me permanent residency. So, now I can live the rest of my years in Israel worry-free. “It’s been strange to have my professional scientific life tied in so closely to my personal life,” she notes. “But in the end, I love my work, I love this country, and I know that this is where my family belongs.” DR. SMADAR SCHREIBER According to Salomon, the sort of ten- sion that exists between the research and pharmaceutical fields of medical development tends to exist similarly between the research and clinical fields. In the case of VTP, which requires far fewer human and hospital resources—and, ultimately, less expense than traditional cancer thera- pies—this tension is particularly pro- nounced. “In medicine, there is usually opposition to new approaches,” says Salomon, who explains that there is also the issue of having to train in order to learn how to implement the new technique. Dr. Smadar Schreiber is a clear exception. The practicing doctor in the PDT Unit at the Assaf Harofe Medical Center near Tel Aviv, Schreiber’s pri- mary contribution to the team is her firsthand experience. “I am actually putting current pho- todynamic technology into practice,” says Schreiber, who uses PDT to treat dermatological ailments such as skin lesions, viral warts and other viral lesions, psoriasis, acne, and of course, cancer. “The patients react very well to the treatment. Side effects are local and transient, and although there is usually an inflammatory reaction for a few days following the treatment, it only takes three or four weeks after one treatment for the lesions to disappear completely and to be replaced with healthy, younger-looking skin.” In addition to bringing firsthand PDT experience to the group, Schreiber was the first to test Tookad-VTP in pre- clinical trials. “I was the first to test the mode of application and successfully demonstrate that it worked against tumors in animal models,” explains Schreiber. “I think this was a very important contribution to the group.” It’s worth noting that Schreiber did not get her start in PDT. Since she graduated from medical school at the Technion Institute of Technology in Haifa in 1986, she worked first as a physician in the IDF, then as a researcher at a manufacturer of light- based devices for medical and cos- metic purposes, and finally as a devel- oper of clinical protocols for doctoral students around the world. It wasn’t until she began her residency in plastic surgery at the Weizmann Institute in 1997 that all of her myriad work expe- rience seemed to come together. Before she knew it, she had extended her basic science requirement into a Ph.D. project on the effects of bacteri- ochlorophylls on tumors and became a vital member of the VTP team. “I never thought I would end up in this field,” she says. “But what I am doing now really is a combination of every- thing I have learned.” According to Schreiber, this flexi- bility to combine the various ele- ments of her knowledge base into one useful application is unique to Israeli science. “The standards of sci- ence and technology are very high in Israel,” says Schreiber. “At the same time, there is always a place for inno- vation and the opportunity to pursue radically new ideas.” VTP is one such pursuit. “Photodynamic treatments have such great potential. What is being done now is only the beginning; it is going to evolve to apply to many medical specialties and many different usages,” says the mother of three from Gan Hatikvah, who names gastric cancers, internal infections, restenosis, hema- tology, and melanoma among the likely future applications. To date, VTP has been tested on colon carcinomas, prostate cancers, sar- comas, liver cancers, breast tumors, brain tumors, pancreatic cancers, and various metastases. According to Scherz, the group’s immediate objec- tive over the next two years is to cover the entire field of prostate ailments, from cancer and metastases to enlarged prostate and benign prostate treatment at various stages. After that, the team intends to tackle nonlocalized cancers such as leukemia. “Right now, we can only use this method to treat cancers wherein we know their loca- tion,” explains Salomon. “Cancers without specific locations are on our list of upcoming challenges.” “But,” says Scherz with a hopeful smile, “the more we advance, the more the possibility for future developments and future applications opens up.” “In the end, one thing is cer- tain,” adds Salomon. “The more we collaborate, the greater our chances of success.” lifestyles TEAM SCIENCE PhotocourtesyofWeizmannInstituteofScience