publication date: May. 12, 2017

Obituary

Robert Comis, piano man, clinical trials impresario, and ECOG-ACRIN co-chair, dies unexpectedly at 71

By Paul Goldberg

It’s possible that there were pianos that Bob Comis didn’t like.

The luminary of clinical trials commandeered pianos wherever he found them—at hotel lounges and at the American Society of Clinical Oncology president’s receptions, where, year after year, he blasted his way through My Way.

Whether he was writing protocols for landmark clinical trials, banging on the keyboards of out-of-tune pianos, homing in on Comis-worthy Italian food in any city on the planet, or letting priceless zingers fly as he took on NCI and FDA over matters big and small, Comis didn’t do lukewarm. Couldn’t, probably.

Comis, who died suddenly May 10, went full-blast all the time. He was 71.

The word “luminary,” would surely have made Comis cringe. But he would have had to accept “visionary.” Science, funding, politics, policy—all of it changed in the 22 years during which he led Eastern Cooperative Oncology Group. After the 2012 merger with American College of Radiology Imaging Network, he co-chaired the resulting entity—ECOG-ACRIN Cancer Research Group.

“The borders between the humanities and the sciences didn’t exist for Bob,” said Peter O’Dwyer, who was expected to succeed Comis on March 1, 2019, and who appears to have gotten a battlefield promotion.

“His right and his left brain—they were firing on all cylinders all the time,” said O’Dwyer, director of the Developmental Therapeutics Program at the Abramson Cancer Center and professor of medicine at the University of Pennsylvania and co-chair of the NCI-Match trial. “There was no cultural incoherence of having an artistic side and a scientific side. And, actually, they informed each other.”

Comis was incapable of having hobbies. Instead, he had obsessions, and his latest obsession was with painting. “About four years ago, he started with a teacher. A lot of the initial work he did was with charcoal, but the direction was going to be clearly toward painting,” O’Dwyer said. “He would send me his paintings on the phone, and you could just see the evolution—they were getting more and more complex, they were just becoming so sophisticated, it was fantastic.”

On May 10, Comis took a day off to paint. Sometime during the day, he experienced cardiac symptoms and called 911, but apparently went into cardiac arrest after the ambulance arrived.

“He is just a guy with a passion for life,” said Walter Curran, director of Winship Cancer Institute of Emory University, co-chair, and principal investigator of NRG Oncology, a clinical trials network. ”He also had a real sense of what’s right and what’s wrong, and if he felt that someone was doing something that wasn’t right, he would feel that passionately as well.”

Comis died at the time when ECOG-ACRIN’s work was rising to a new level as a result of his scientific vision.
In 2012, when NCI announced that it would support no more than four adult cooperative groups, Comis saw a scientific opportunity to incorporate imaging studies into ECOG. His plan was to merge with ACRIN.

The result is a clinical trials group that is able to answer unique questions in clinical trials. “We use imaging studies, radiographic studies to inform (1) how drugs are working, (2) which patients might be appropriate for a particular drug, so we are not treating the wrong patients, (3) getting an early readout on whether or not there is a benefit,” said O’Dwyer.

Mitchell Schnall, who is now the ECOG-ACRIN group co-chair representing the diagnostic imaging-based disciplines, said the vision was largely Comis’s.

“I would say it was 60:40, tilted toward him,” said Schnall, the Eugene P. Pendergrass Professor of Radiology and chair of the Radiology Department at the University of Pennsylvania Perelman School of Medicine. “He really saw this from a greater height than I did.”

ECOG-ACRIN is conducting a phase III trial using breast MRI and genomics for treatment decision-making in ductal carcinoma in situ. It addresses questions about the overtreatment of DCIS in direct response to recommendations made by a NIH scientific consensus panel. Using personalized diagnostic tools may prevent unnecessary mastectomies and/or radiation for some women.

“That’s the kind of a unique study that can be only done by us,” Schnall said.

“When we committed to work together, Bob took me in as a real partner and taught me a lot about oncology as a practice and a discipline, taught me a ton about the culture of the group system and how to be successful in it,” Schnall said. “He just loved helping anyone—and in that case it was me—to develop their goals and careers.

“We just had our group meeting last week. Toward the end of the group meeting, we had a reception, and Bob and I were talking, and he was just so excited about the direction of where the group went, and the kinds of innovative studies and science we are doing,” Schnall said. “That was the last time I saw him.”

Comis is also credited with leading the design and implementation of the NCI-MATCH (EAY131) trial, a precision medicine trial, which has completed the enrollment of 6,000 patients in 15 months.

“His leadership was responsible for getting that trial done for NCI’s National Clinical Trials Network,” said Jeff Abrams, acting director for clinical research at the NCI Division of Cancer Treatment and Diagnosis and associate director of the Cancer Therapy Evaluation Program at the Division of Cancer Treatment and Diagnosis. “I know that he wanted to live to see the results of that trial, but I think it never could have happened without him. It was logistically a very complex trial, one that really brought us into precision medicine oncology age, where we were characterizing patients’ tumors from fresh biopsies, turning that around in real time, so that the results could be used to treat patients, putting it through a sophisticated, computer-generated algorithm to enable that treatment decision to be made quickly for the patients, and that required a lot of coordination between the NCI, between ECOG-ACRIN, between pathology banks at MD Anderson and at Frederick National Laboratory. Bob was the key individual in the midst of all that.

“He showed great leadership, he showed vision, and even though he was in the job for a long time, he showed the ability to change and evolve his leadership with the science, and I think that’s what made him a special, unique individual,” said Abrams. “What I liked about Bob was we had our disagreements over the years, but he always gave things a fair hearing. He didn’t rush to judgment or refuse to listen to another point of view. Nowadays individuals like that are very much appreciated.

“When you were with him and the leadership of his group, you sensed that they were particularly fond of him, not just as the head of ECOG-ACRIN, but as a leader—they appreciated all the effort and heart he put into making a strong clinical trials group.”

Comis believed in ECOG-ACRIN’s mission to educate young investigators.

“I think the MATCH trial is a testament to that,” said Joseph Sparano, vice chair of ECOG-ACRIN, professor of medicine and women’s health at the Albert Einstein College of Medicine, associate chairman for clinical research in the Department of Oncology at Montefiore Medical Center, and associate director for clinical research at the Albert Einstein Cancer Center. “If you look at the people who serve as the study chairs of the different studies, they are generally junior or first-time investigators, assistant professor level people, who are getting the first opportunity to participate in cooperative group research. And it spans all the groups, not just ECOG-ACRIN, all the groups.

“That was another legacy that he left behind.”

Comis is survived by his wife, five children and four grandchildren.

Funeral arrangements and other information can be found here.

Copyright (c) 2017 The Cancer Letter Inc.