Robert Flavell, MD, PhD

Principal Investigator, Associate Professor Division Chief, Molecular Imaging & Therapeutics
(415) 353-3638
[email protected]
Profiles

Robert Flavell, MD, PhD, is the Chief of Molecular Imaging and Therapeutics Clinical Section in the Department of Radiology and Biomedical Imaging at the University of California, San Francisco. He received his medical degree from Weill Cornell Medical College, and his PhD from the Rockefeller University as part of the Tri-Institutional MD PhD program. He completed his one-year internship at the Memorial Sloan­Kettering Cancer Center in New York. Dr. Flavell completed his radiology residency at UCSF, including an NIH T32 funded research fellowship, and subsequently completed a one-year fellowship in nuclear medicine. In June 2016. he joined the faculty as an Assistant Professor in Residence.

Dr. Flavell’s laboratory, the Molecular Imaging Lab, focuses on the development of new molecular imaging tools for better understanding of disease progression in patients with prostate and other cancers. One area of interest is the relationship between acidic interstitial pH and disease progression. Solid tumors are poorly perfused and secrete acids into the adjacent interstitium, resulting in a pH which is mildly acidic, typically ranging from 6.5 – 7.0. This property has been associated with high-grade malignancy, local invasion, and metastasis in animal models. Therefore, it would be desirable to have a method which could be used in patients for monitoring tissue pH. Therefore, one focus of Dr. Flavell’s research is developing methods of imaging acidic interstitial pH with potential for clinical translation. Specifically, two methods are being developed, one of which permits whole body evaluation of areas of acidic pH using positron emission tomography (PET) imaging, and one method which permits quantitative, local determination of interstitial pH based on hyperpolarized 13C magnetic resonance spectroscopy (HP-MRS). The PET method is based on pro-drug glycosylamine derivatives of the commonly used oncologic tracer, [18F]FDG, termed [18F]FDG amines, which are blocked with an acid-labile protecting group. When exposed to the mildly acidic pH present in the interstitium of a solid tumor, the caging group decomposes, liberating native [18F]FDG, which is subsequently absorbed by the adjacent cancer cell (Flavell R.R. et al., Bioconjugate Chem., 2016). The HP-MRS method is based on the administration of a 13C labeled probe which has a predictable change in its chemical shift based on pH. By comparison to a standard curve, quantitative pH measurements can be obtained (Flavell R.R. et al. Chem. Comm. 2015). These techniques are being optimized and ongoing directions include application in animal models, with the long term goal of clinical translation. Other areas of developing interest in the laboratory include techniques for imaging of metals in the microenvironment, and imaging of a metabolic signature associated with immune activation.

Expertise:
Nuclear Medicine and Molecular Imaging and Therapeutics

Specialty:
Novel radiotracer development, oncologic imaging, PET imaging, hyperpolarized 13C magnetic resonance imaging

Professional Interests:
Radiology, molecular imaging, PET imaging, prostate cancer, nuclear medicine, radiochemistry, hyperpolarized 13C magnetic resonance imaging

Education and Training:
• Medical School: Weill Cornell Medical College, New York
• PhD: The Rockefeller University, New York
• Internship: Memorial Sloan­-Kettering Cancer Center, New York
• Residency: University of California, San Francisco
• Fellowship: University of California, San Francisco – Nuclear Medicine

Honors and Awards
David Blitzer Young Investigator Award, Prostate Cancer Foundation, 2017-2020
Howard S. Stern Research Award, Society of Abdominal Radiology, 2017-2019
New Directions in Prostate Cancer Research Award, University of California, San Francisco, 2017
Research Program Physician Research Training Grant, Department of Defense Prostate Cancer, 2016
Runner up, Surbeck Scholar Award, University of California, San Francisco, 2016
Research Scholar Program, Association of University Radiologists / American College of Radiology, 2015
Certificate of Merit, Radiology Society of North America (RSNA), 2015
T32 Training Grant, National Institute of Biomedical Imaging and Bioengineering (NIBIB), 2014
Certificate of Merit, Radiology Society of North America (RSNA), 2014
Catalyst Consultation Award, University of California, San Francisco Catalyst Program, 2014
Introduction to Academic Radiology Program, American Roentgen Ray Society, 2013

Publications

Effective Treatment of Disseminated Prostate Cancer Using CD46-Targeted 225Ac Therapy.

Clinical cancer research : an official journal of the American Association for Cancer Research

Bidkar AP, Peter R, Wadhwa A, Bobba KN, Bidlingmaier S, Meher N, Chou J, Greenland N, Dasari C, Naik S, Raveendran A, Basak M, Camara Serrano JA, Steri V, Kogan S, Oskowitz A, He J, Wilson DM, Aggarwal R, Sriram R, VanBrocklin HF, Seo Y, Liu B, Flavell RR

Tissue-based T cell activation and viral RNA persist for up to 2 years after SARS-CoV-2 infection.

Science translational medicine

Peluso MJ, Ryder D, Flavell RR, Wang Y, Levi J, LaFranchi BH, Deveau TM, Buck AM, Munter SE, Asare KA, Aslam M, Koch W, Szabo G, Hoh R, Deswal M, Rodriguez AE, Buitrago M, Tai V, Shrestha U, Lu S, Goldberg SA, Dalhuisen T, Vasquez JJ, Durstenfeld MS, Hsue PY, Kelly JD, Kumar N, Martin JN, Gambhir A, Somsouk M, Seo Y, Deeks SG, Laszik ZG, VanBrocklin HF, Henrich TJ

A phase 1b dose escalation study of FOR46, a novel antibody-drug conjugate targeting a tumor-specific epitope of CD46, in combination with enzalutamide (Enza) in patients with metastatic castration resistant prostate cancer (mCRPC).

Journal of Clinical Oncology

Nonna Shakhnazaryan, Nathan Curry, Medini Rastogi, Daniel Avins, Shrina Pandey, Ivan de Kouchkovsky, Daniel Kwon, Arpita Desai, Kelly N. Fitzgerald, Rohit Bose, Jonathan Chou, Terence W. Friedlander, Vadim S Koshkin, Lawrence Fong, Maya Aslam, Khadija Siddiqua, Eric J. Small, Bin Liu, Robert R. Flavell, Rahul Raj Aggarwal

Multimodal Molecular Imaging Reveals Tissue-Based T Cell Activation and Viral RNA Persistence for Up to 2 Years Following COVID-19.

medRxiv : the preprint server for health sciences

Peluso MJ, Ryder D, Flavell R, Wang Y, Levi J, LaFranchi BH, Deveau TM, Buck AM, Munter SE, Asare KA, Aslam M, Koch W, Szabo G, Hoh R, Deswal M, Rodriguez A, Buitrago M, Tai V, Shrestha U, Lu S, Goldberg SA, Dalhuisen T, Durstenfeld MS, Hsue PY, Kelly JD, Kumar N, Martin JN, Gambir A, Somsouk M, Seo Y, Deeks SG, Laszik ZG, VanBrocklin HF, Henrich TJ

177Lu-PSMA Therapy.

Journal of nuclear medicine technology

Parent EE, Savir-Baruch B, Gayed IW, Almaguel F, Chin BB, Pantel AR, Armstrong E, Morley A, Ippisch RC, Flavell RR

Imaging of solid tumors using 68Ga-FAP-2286.

Journal of Clinical Oncology

Thomas A. Hope, Rahul Raj Aggarwal, Mallika Sachdev Dhawan, Robin Kate Kelley, Robert R. Flavell, Courtney Lawhn Heath, Yan Li, Sima P. Porten, Hope S. Rugo, Sue S. Yom, Robin Ippisch, Vadim S Koshkin

Molecular Imaging of Prostate Cancer Targeting CD46 Using ImmunoPET.

Clinical cancer research : an official journal of the American Association for Cancer Research

Wang S, Li J, Hua J, Su Y, Beckford-Vera DR, Zhao W, Jayaraman M, Huynh TL, Zhao N, Wang YH, Huang Y, Qin F, Shen S, Gioeli D, Dreicer R, Sriram R, Egusa EA, Chou J, Feng FY, Aggarwal R, Evans MJ, Seo Y, Liu B, Flavell RR, He J