In the operating room and the research lab, Christopher Collier, MD, is focused on improving patient outcomes where orthopedics and cancer intersect. A fellowship-trained orthopedic surgeon with Riley Children’s Health, he specializes in the management of bone and soft tissue tumors in children and adults. He also leads a basic science research laboratory dedicated to the study of primary bone tumors, metastatic bone disease and muscle loss, and body composition changes in patients undergoing cancer treatment.
Exploring new treatment options for metastatic osteosarcoma
Collaborating with Ed Greenfield, PhD, and his laboratory at the Indiana Center for Musculoskeletal Health at Indiana University School of Medicine, Dr. Collier’s lab developed a three-dimensional in vitro osteosarcoma drug-screening platform that provides highly uniform sarcospheres to mimic metastatic disease. The team used the sarcospheres, generated from three metastatic human cell lines, to screen the National Cancer Institute’s panel of 114 FDA-approved oncology drugs. Two of the 15 most effective drugs uncovered in the study were histone deacetylases inhibitors romidepsin and vorinostat—the only two epigenetic therapies included in the panel. The findings are consistent with growing interest in epigenetic therapies for treating osteosarcoma.
“Survival rates for osteosarcoma have hovered around 70% for the last 40 years primarily because we’re still using chemotherapies that were developed in the 1970s,” explained Dr. Collier, one of the few orthopedic surgeons in the Midwest specializing solely in orthopedic oncology. “While these therapies were a major breakthrough, there is an urgent need to find new treatments for children who develop metastatic disease.”
In addition to identifying drugs to treat recurring metastatic osteosarcoma, Dr. Collier is part of a team of researchers at IU School of Medicine working to develop and use patient-derived xenograft models for pediatric sarcoma. The research, which aims to find effective therapies for both current and future patients, is conducted using tissue donated by cancer patients through the Indiana Pediatric Biobank, one of the most robust pediatric tissue biobanks in the nation.
Investigating cachexia in metastatic cancer
Using novel models of renal cell carcinoma metastasizing to bone, Dr. Collier aims to uncover surgical and medical therapies targeting cachexia-related muscle and bone dysfunction. Experienced by 80% of patients with advanced cancer, cachexia is responsible for 20 to 40% of cancer-related deaths. The Collier lab is exploring direct links between cachexia and metastatic bone disease that result in muscle weakness and wasting.
“With immunotherapy and other targeted advancements, we’re getting much better at controlling cancer long term,” Dr. Collier said. “As the treatment paradigm shifts to managing cancer as we would a chronic disease, addressing cancer’s repercussions, which include muscle loss, becomes an important part of restoring quality of life for individuals living with cancer.”
Related to muscle loss in cancer patients, Dr. Collier is also studying body composition changes in people undergoing cancer treatment. Using artificial intelligence and mapping of CT scans, he is quantifying the amount of muscle, fat and bone mass in cancer patients as they progress through treatment, and investigating the changes that occur.
“Taking excellent care of patients always comes first,” Dr. Collier said. “As an orthopedic oncologist and through what I learn as a researcher, I strive to improve outcomes for my patients—I believe that blending the two worlds together makes me better at both.”
Dr. Collier has applied for a National Institutes of Health K08 award to expand his research programs.
Pediatric Orthopedic Oncology Program at Riley Children’s Health
Two fellowship-trained orthopedic oncologists at Riley Children’s diagnose and treat benign and malignant musculoskeletal tumors. They are among the few specialists in the Midwest dedicated exclusively to treating bone and soft tissue tumors.