Dr. Raphael Bueno
Executive Summary
Dr. Raphael Bueno serves as Chief of Thoracic Surgery at Brigham and Women's Hospital and leads the International Mesothelioma Program (IMP), the world's largest mesothelioma research and treatment initiative.[1] Following Dr. David Sugarbaker's death in 2018, Dr. Bueno assumed leadership of the program and has pioneered research into the genomic and molecular basis of mesothelioma.[2] His research team conducted groundbreaking whole-genome sequencing studies that identified critical gene mutations affecting disease progression and treatment response, including BAP1, CDKN2A, MYH9, and RHOA.[3] These discoveries have opened pathways for developing targeted therapies that address specific genetic abnormalities in mesothelioma cells.[4] Under Dr. Bueno's direction, the IMP continues advancing personalized medicine approaches, utilizing tumor tissue banks and genomic profiling to match patients with optimal treatment strategies.[5]
The genomic discoveries emerging from Dr. Bueno's laboratory have transformed understanding of why mesothelioma responds differently in different patients. The BAP1 gene, mutated in 44-60% of mesotheliomas, plays a critical role in DNA repair and cell cycle regulation; patients with BAP1 mutations often have better prognoses than those without.[6] Conversely, CDKN2A deletions—more common in male patients—correlate with shorter survival times. These insights enable oncologists to better predict outcomes and select appropriate treatment intensities.[7]
Beyond research, Dr. Bueno maintains an active surgical practice, performing complex mesothelioma operations while training the next generation of thoracic surgeons.[8] The IMP's tumor tissue bank, built over decades of surgical cases, provides an invaluable resource for ongoing research into mesothelioma biology. His team is currently investigating combinations of immunotherapy with targeted agents, seeking to build on the success of the CheckMate 743 trial while addressing the specific genetic vulnerabilities identified through genomic profiling.[9]
Key Facts
| Key Facts: Dr. Raphael Bueno's Research and Leadership |
|---|
|
Who Is Dr. Raphael Bueno and How Did He Assume Leadership of the IMP?
Dr. Raphael Bueno is a thoracic surgeon and researcher who has dedicated his career to understanding the molecular underpinnings of thoracic malignancies, particularly mesothelioma.[10] When Dr. David Sugarbaker passed away in August 2018, Dr. Bueno was the natural successor to lead the International Mesothelioma Program—the world's preeminent mesothelioma research center that Sugarbaker had founded in 2002.[11]
Dr. Bueno's transition to program leadership represented both continuity and evolution. While maintaining the IMP's commitment to aggressive multimodal treatment for appropriate patients, he expanded the program's focus on genomic research and personalized medicine approaches.[12]
| "Dr. Bueno represents the next generation of mesothelioma research—building on Dr. Sugarbaker's surgical legacy while adding the genomic understanding that will drive future breakthroughs. His work identifying specific gene mutations is already helping match patients with the treatments most likely to work for their particular cancer." |
| — Paul Danziger, Founding Partner, Danziger & De Llano |
What Genomic Discoveries Has Dr. Bueno Made?
Dr. Bueno's research team conducted groundbreaking whole-genome sequencing studies on mesothelioma tumors, identifying critical gene mutations that affect disease progression and treatment response.[13]
BAP1 Mutations
BAP1 (BRCA1-associated protein 1) is a tumor suppressor gene mutated in approximately 44-60% of mesotheliomas. Dr. Bueno's research has revealed:[14]
- BAP1 loss impairs DNA repair mechanisms
- BAP1-mutated tumors may be more sensitive to certain treatments
- Germline BAP1 mutations indicate hereditary cancer susceptibility
- BAP1 status serves as both a prognostic and potential therapeutic marker
| Info: BAP1 Cancer Syndrome: Some families carry inherited BAP1 mutations that increase risk for mesothelioma and other cancers. Dr. Bueno's research has contributed to understanding this syndrome and developing guidelines for genetic counseling. |
CDKN2A Deletions
Dr. Bueno's work revealed that men with mesothelioma are more likely to experience CDKN2A gene deletions, which correlate with lower survival rates.[15] This finding has important implications:
- CDKN2A deletions indicate more aggressive disease
- Patients with this deletion may need more intensive treatment
- Testing for CDKN2A status helps predict prognosis
- CDK4/6 inhibitors may potentially restore normal cell cycle control
MYH9 and RHOA Mutations
The research team also identified mutations in MYH9 and RHOA genes that reduce survival regardless of gender.[16] These discoveries have:
- Expanded understanding of mesothelioma biology
- Identified potential new therapeutic targets
- Improved prognostic accuracy
- Opened pathways for developing targeted therapies
| Gene | Mutation Frequency | Clinical Impact |
|---|---|---|
| BAP1 | 44-60% | May predict sensitivity to platinum chemotherapy, PARP inhibitors |
| CDKN2A | Variable (higher in men) | Associated with worse prognosis, potential CDK inhibitor target |
| MYH9 | Present in subset | Reduces survival, emerging therapeutic target |
| RHOA | Present in subset | Reduces survival, emerging therapeutic target |
How Is Dr. Bueno Advancing Personalized Medicine?
Under Dr. Bueno's direction, the IMP continues to advance personalized medicine approaches that match individual patients with their optimal treatment strategies.[17]
Tumor Tissue Banks
The IMP maintains extensive tumor tissue banks collected over decades. These samples enable:[18]
- Genomic sequencing of historical and current tumors
- Comparison of genetic profiles with treatment outcomes
- Identification of mutations that predict treatment response
- Development of new therapeutic targets
Genomic Profiling
Every patient at the IMP receives comprehensive genomic profiling, including:[19]
- Whole-genome or targeted sequencing
- Analysis of known mesothelioma mutations
- Identification of potential therapeutic targets
- Assessment of prognosis based on genetic markers
| "Personalized medicine is the future of mesothelioma treatment. Dr. Bueno's work means that treatment decisions are increasingly based on what's happening in each patient's specific tumor—not just what works for mesothelioma in general. That's how we'll continue improving outcomes." |
| — Rod De Llano, Founding Partner, Danziger & De Llano |
What Clinical Trials Is the IMP Conducting Under Dr. Bueno?
Dr. Bueno's research group participates in numerous clinical trials exploring novel combinations of immunotherapy, targeted agents, and traditional treatments.[20]
Areas of Active Research:
- Immunotherapy Combinations: Testing checkpoint inhibitors with other agents
- Targeted Therapies: Drugs designed for specific genetic mutations
- Biomarker Development: Identifying predictors of treatment response
- Surgical Timing: Optimal sequencing of surgery with systemic therapy
- Perioperative Immunotherapy: Immunotherapy before and after surgery
| Clinical Trial Access: Patients treated at the IMP have access to clinical trials testing cutting-edge treatments not available elsewhere. This includes trials specifically designed for patients with certain genetic mutations identified through genomic profiling. |
How Does the International Mesothelioma Program Continue Sugarbaker's Legacy?
Under Dr. Bueno's leadership, the IMP maintains its position as the world's largest and most comprehensive mesothelioma research and treatment initiative:[21]
Continuing Traditions:
- Multidisciplinary collaboration across five Boston institutions
- Commitment to aggressive treatment for appropriate candidates
- Comprehensive surgical expertise (both P/D and EPP)
- Training the next generation of mesothelioma specialists
New Directions Under Bueno:
- Enhanced focus on genomic research
- Personalized medicine approaches
- Integration of immunotherapy with traditional treatments
- Liquid biopsy and ctDNA monitoring
The IMP continues to collaborate with Brigham and Women's Hospital, Dana-Farber Cancer Institute, Massachusetts General Hospital, Boston VA Health Care System, and Harvard School of Public Health.[22]
What Is the Future of Mesothelioma Research Under Dr. Bueno?
Dr. Bueno's research agenda points toward several frontiers in mesothelioma treatment:[23]
Near-Term Goals:
- Validate genomic biomarkers for treatment selection
- Identify patients who will respond to immunotherapy
- Develop targeted therapies for specific mutations
- Optimize combination treatment sequences
Long-Term Vision:
- Cure some patients with early-stage disease
- Convert mesothelioma to a chronic, manageable condition
- Prevent mesothelioma in high-risk individuals
- Eliminate asbestos-related disease through prevention and treatment
| "The genomic research Dr. Bueno is leading will fundamentally change how we treat mesothelioma. When we can look at a patient's tumor and know which treatment will work best for their specific cancer, outcomes will improve dramatically. That's the promise of personalized medicine." |
| — David Foster, Client Advocate, Danziger & De Llano |
Get Help Today
If you or a loved one has been diagnosed with mesothelioma, accessing the latest treatment approaches—including the personalized medicine pioneered by Dr. Bueno at the International Mesothelioma Program—can significantly impact outcomes. You may also be entitled to compensation from the companies responsible for your asbestos exposure.[24]
The experienced mesothelioma attorneys at Danziger & De Llano have helped thousands of families navigate both the medical and legal challenges of this diagnosis.[25]
For veterans with mesothelioma, the VA provides specialized benefits and healthcare services.[26]
Call (866) 222-9990 or request a free case review online.
See Also
- History of Mesothelioma Research
- Dr. David Sugarbaker (IMP Founder)
- Dr. Paul Baas
- Brigham and Women's Hospital
- Clinical Trials
- Treatment Options
- Mesothelioma Treatment Centers
References
- ↑ International Mesothelioma Program, Brigham and Women's Hospital
- ↑ Malignant Mesothelioma Lawyers, Danziger & De Llano
- ↑ Mesothelioma Treatment (PDQ), National Cancer Institute
- ↑ New Mesothelioma Treatments and Research, Mesothelioma.net
- ↑ Mesothelioma: Diagnosis, Treatment & Legal Help, Mesothelioma Lawyer Center
- ↑ PubMed: BAP1 Mesothelioma Research, National Library of Medicine
- ↑ Mesothelioma Diagnosis Guide, Danziger & De Llano
- ↑ Surgery to Treat Cancer, National Cancer Institute
- ↑ Brigham Mesothelioma Clinical Trials, ClinicalTrials.gov
- ↑ Mesothelioma, National Cancer Institute
- ↑ Mesothelioma Diagnosis Guide, Danziger & De Llano
- ↑ Mesothelioma Treatment Centers, Mesothelioma.net
- ↑ Genetics and Cancer, National Cancer Institute
- ↑ PubMed: BAP1 Tumor Suppressor Mesothelioma, National Library of Medicine
- ↑ Tumor Suppressor Gene Definition, NCI Dictionary of Cancer Terms
- ↑ Malignant Mesothelioma Lawyers, Danziger & De Llano
- ↑ Precision Medicine in Cancer Treatment, National Cancer Institute
- ↑ Mesothelioma Treatment, Mesothelioma.net
- ↑ Mesothelioma Diagnosis Guide, Danziger & De Llano
- ↑ Mesothelioma Genomic Clinical Trials, ClinicalTrials.gov
- ↑ Thoracic Surgery, Brigham and Women's Hospital
- ↑ NCI-Designated Cancer Centers, National Cancer Institute
- ↑ New Mesothelioma Treatments and Research, Mesothelioma.net
- ↑ What's Your Mesothelioma Case Worth?, Danziger & De Llano
- ↑ Mesothelioma Compensation, Danziger & De Llano
- ↑ VA Asbestos Exposure, U.S. Department of Veterans Affairs