Ritsuko Komaki, MD, Program Co-Leader
Dr. Komaki (Professor and Gloria Lupton Tennison Distinguished Professorship for the Lung
Cancer Research, Department of Radiation Oncology at UTMDACC) occupies a key position and
exerts considerable authority at UTMDACC as Co-Director with Dr. Roy Herbst of the UTMDACC
Multidisciplinary Lung Cancer Program.
Dr. Komaki is a clinician and translational researcher who has been active in clinical and
translational research in radiation oncology for thirty years. She worked at the Radiation Effect
Research Foundation as a Postgraduate Fellow in the Department of Internal Medicine affiliated
with Hiroshima University Atomic Bomb Research Institute, Hiroshima, Japan from 1969 to 1970.
She worked for people who were exposed to Atomic Bomb and their incidence of malignancy
correlated with chromosome abnormality. She worked as a Post-doctoral Research Fellow at the
Hematology Oncology at the VA Hospital Milwaukee Wisconsin from 1972 to1973. Then she took
her Radiation Oncology Residency program at the Medical College of Wisconsin (MCW) between
1974 and 1977. She took a fellowship at the MCW including elective time spent at the M. D.
Anderson Cancer Center (MDACC) in 1979. She received ABR board certification in 1977 and
recertification in 2001. She served the associate professor and clinical chief at the Department of
Radiation Oncology in Columbia-Presbyterian Medical Center in New York City from 1985
till1988. She served as the director of Clinical Research Program, Department of Radiation
Oncology, Division of Radiation Oncology of Columbia-Presbyterian Medical Center, New York,
New York from 1/1986 to1/1988. In Aug.1988, she was recruited to be the associate professor
and section chief of Radiation Oncology at UTMDACC. She has been the tenured professor of
Radiation Oncology at the UTMDACC from 1997 to present. She is the Primary Investigator of
Radiation Therapy and Oncology Group (RTOG) for the UTMDACC from1997 till present. She is
the Associate Medical Director, of the Thoracic Center UTMDACC from 1997 till present. She
holds the Program Director of Thoracic Radiation Oncology, Department of Radiation Oncology,
Division of Radiation Oncology, The University of Texas M. D. Anderson Cancer Center from
1/2004 till present.
Dr. Komaki is an ABR Oral Board Examiner. Dr. Komaki is a member of twenty-four medical
societies, including American Medical Association, American Association for Cancer Research,
American Society Therapeutic Radiation Oncology (ASTRO), American Radium Society, (ARS)
American College of Radiology, American Society of Clinical Oncology, American Association of
Women Radiologists (AAWR), International Association for the Study of Lung Cancer (IASLC), a
member of the National Council Radiation Protection (NCRP), Radiological Society of North
America(RSNA). Women Against Lung Cancer (WALC), a member of National Comprehensive
Cancer Network (NCCN) for the Lung Cancer, Chair of American College of Radiology (ACR)
appropriateness of management of Lung Cancer, and past Chair of Radiation Oncology for the
Texas Radiological Society.
Dr. Komaki served as the president of AAWR in 2000- 2001. She was a chair of Education
Committee of ASTRO in 2002-2006. She was the vice-president of RSNA in 2005. She has been
the Board of Director of the IASLC in 2003-2007. She is the president of the ARS in 2007-2008.
Dr. Komaki is an advisory member of NCCN PET committee in 2006-present.
In 2005, she has received award of Business and Professional Women in Texas. NY Times,
People Magazine and USA have interviewed her today because of her scientific commitment for
Radiation Oncology and patient care. She has published that 260 papers in peer reviewed
journals including The New England Journal of Medicine; Seminars in Radiation Oncology;
International Journal of Radiation Oncology, Biology and Physics; Radiotherapy and Oncology;
Radiology; Journal of Clinical Oncology; Journal of National Cancer Institute; Cancer; and Clinical
Cancer Research.
Dr. Komaki is the editor of the Image Guided of Radiation Oncology for the Lung Cancer. She
serves six national or international editorial boards.
Dr. Komaki has extensive experience in clinical thoracic oncology research and in clinical trials
design and management.
Dr. Komaki is the PI of the Radiation Therapy Oncology Group (RTOG) from UTMDACC and CoChair of the Lung Committee of RTOG. She is PI of NCI approved RTOG- 0239 (a phase II trial of
limited small cell lung cancer). RTOG 0239 will be one of three arms on Randomized
prospective intergroup study approved by NCI-CTEP. She is the Co - PI of NCI approved RTOG
0324 which was a phase II trial of Radiotherapy with concurrent Cetuximab and
Carboplatin/Paclitaxel RTOG 0324 has been waiting longer follow-up to see median survival
(MS) will exceed 22 months ( Blumenshine, G, ASCO 2007). If MS will be better than 22 months,
a randomized study will be initiated though RTOG and intergroup. These RTOG studies have
been done with collaborations of Medical Oncologists, Diagnostic Imaging, Pulmonary Medicine
and Thoracic Surgical Oncologists at the UTMDACC.
RTOG 0324 has a translational component to analyze EGFR over expression from the biopsy
specimens. The IHC analysis has been done at the ERO at MDACC and will be presented at the
ASTRO 2007 by Dr. Komaki. The FISH study of RTOG 0324 has been done by Dr. Fred Hirsh at
the University of Colorado, which will be submitted to AACR next year.
Dr. Komaki has been focusing translational research especially in EGFR and VEGF-R of the lung
cancer. RTOG 324 was based on preclinical data which was tested at the Experimental Radiation
Oncology (ERO), interim chair, Dr. Ray Meyn. In the ERO laboratory, extensive studies were
done using Head/Neck and Lung Cancer cell lines treated by EGFR inhibitors as radiosensitizers
with or without chemotherapy. There have been numerous publications on this aspect ( Milas,L ,
Ang,K, Meyn,R, in CR,CCR ).
Dr.Komaki has been working with Dr. Michael O’Reily and Dr.Roy Herbst regarding antiangiogenesis for the lung cancer and pre-clinical study has been published( Itasaka S, Komaki R,
Herbst RS, Shibuya K, Shintani T, Hunter NR, Onn A, Bucana CD, Milas L, Ang KK, O’Reily MS.
Endostatin improves radio- response and blocks tumor revascularization after radiation therapy
for A431 xenografts in mice. Int J Radiat Oncol Biol Phys 67:870-8, 3/2007).
Dr. Komaki has been interested in the biomarkers to predict the outcome of the Lung Cancer
especially biomarkers to predict brain metastasis (Bubb RS, Komaki R, Hachiya T, Milas I, Ro JY,
Langford L, Sawaya R, Putnam JB, Allen P, Cox JD, McDonnell TJ, Brock W, Hong WK, Roth JA,
Milas L. Association of Ki-67, p53, and bcl-2 expression of the primary non-small-cell lung cancer
lesion with brain metastatic lesion. Int J Radiat Oncol Biol Phys 53:1216-24, 8/2002),( Milas I,
Komaki R, Hachiya T, Bubb RS, Ro JY, Langford L, Sawaya R, Putnam JB, Allen P, Cox JD,
McDonnell TJ, Brock W, Hong WK, Roth JA, Milas L. Epidermal growth factor receptor,
cyclooxygenase-2, and BAX expression in the primary non-small cell lung cancer and brain
metastases. Clin Cancer Res 9:1070-6, 3/2003.)
She has conducted a prospective randomized study to have shown that WR -2721 would protect
acute normal tissue toxicities such as esophagitis and pneumonitis when patients with locally
advanced NSCLC treated by concurrent chemoradiotherapy(Komaki R, Lee JS, Milas L, Lee HK,
Fossella FV, Herbst RS, Allen PK, Liao Z, Stevens CW, Lu C, Zinner RG, Papadimitrakopoulou
VA, Kies MS, Blumenschein GR, Jr, Pisters KM, Glisson BS, Kurie J, Kaplan B, Garza VP,
Mooring D, Tucker SL, Cox JD. Effects of amifostine on acute toxicity from concurrent
chemotherapy and radiotherapy for inoperable non-small-cell lung cancer: report of a randomized
comparative trial. Int J Radiat Oncol Biol Phys 58:1369-77, 4/2004).
Dr.Komaki was co-PI of institutional multidisciplinary protocols in thoracic oncology and was the
principal investigator of the first randomized trial showing survival benefit with neoadjuvant
chemotherapy in stage IIIA resectable lung cancer (Roth,J et al in NCI 1999).
Dr. Komaki was a collaborator of the study conducted by Dr. Roth showing that the synergistic
interaction of over expression of wild type p53 and external beam ionizing radiation in mediating
apoptosis and tumor regression. With Drs. Roth, Swisher and others, the use of an adenovirus
vector to restore p53 function in patients with lung cancer has been reported.
Dr. Komaki has been interested in functional imaging as a predictor of outcome of patients with
NSCLC and reported higher standard uptake value (SUV) in the pre-treatment [18F]FDG-PET
findings correlated with poor outcome (Sasaki R, Komaki R, Macapinlac H, Erasmus J, Allen P,
Forster K, Putnam JB, Herbst RS, Moran CA, Podoloff DA, Roth JA, Cox JD.
[18F]fluorodeoxyglucose uptake by positron emission tomography predicts outcome of non-smallcell lung cancer. J Clin Oncol 23:1136-43, 2/2005.)
Dr. Komaki has been interested in cognitive function for patients with limited small cell lung
cancer and has been collaborating with Drs. Christina Meyers and Jack Lee to predict which
patients need prophylactic brain irradiation after complete remission to the concurrent
chemoradiotherapy for their limited stage small cell lung cancer(Lee JJ, Bekele BN, Zhou X,
Cantor SB, Komaki R, Lee JS. Decision analysis for prophylactic cranial irradiation for patients
with small-cell lung cancer. J Clin Oncol 24:3597-603, 8/2006). This study might have implication
of early detection of small cell lung cancer by serum immunoglobulin or other markers.
Dr. Komaki has been interested in improving therapeutic ratio by enhancing efficacy of malignant
cells without killing surrounding normal tissue. Therefore, she has tested WR-2712 to reduce
severe acute esophagitis and pneumonitis and molecular targeted agents such as cetuximab or
Cox-2 inhibitor with chemoradiotherapy . Now radiotherapy technique has been image guided
and highly technically oriented by 3 dimentional radiotherapy, intensity modulated radiotherapy
and proton treatment to enhance therapeutic ratio, which will allow more combined treatment
fesible without damaging or mutating surrounding normal cells but induce more apotosis and
prevent DNA repair of the malignant cells.
Dr. Komaki has organized multiple international conferences including early lung cancer
management which has been published with Dr. Roth . We are trying to activate international
prospective randomized trial to find out the survival benefit by surgery vs. stereotactic body
radiotherapy (Komaki R,& Roth J. ed. Stereotactic Body Radiotherapy vs. Surgery for stage I
NSCLC . J Thor Oncol. 2(7) Supplement 3 , 1-136 ,7/2007).There will be translational research
associated with this trial.