January 25, 2012
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Brian I. Rini, MD: Wine enthusiast, musician, triathlete and leader in genitourinary cancer care

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Brian I. Rini, MD, is an associate professor of medicine at the Cleveland Clinic Lerner College of Medicine of Case Western Reserve University and a staff member in the department of solid tumor oncology.

Rini also is a member of the HemOnc Today Editorial Board.

His work focuses on genitourinary malignancies. His primary research areas have been renal cell carcinoma (RCC) and prostate cancer, with a focus on immunotherapy and antiangioneic therapy.

What inspired you to pursue a career in medicine?

I was always interested in math and science, and in college, I decided that medicine was a good fit. My mother was a nurse, and I was always drawn to that field. I felt it would be challenging and also allow me to interact with people.

What is your greatest professional reward?

Brian I. Rini, MD
Brian I. Rini

When patients say after a visit how grateful they are for the information and hope that I have given them.

What is your biggest professional challenge?

Ultimately, most of my patients will succumb to their disease. One has to take solace in helping them live better and longer, even if cure is not currently attainable. I’ve been out of medical school for 15 years and have developed more of a comfort level when dealing with it, but it never gets easier. You also understand how to help people in different ways. You understand that people need different things from their physician. Not everyone needs the same approach or the same attitude.

What do you consider your biggest success in your specialty?

My biggest success has been contributions to the clinical development of targeted therapy in RCC and ongoing efforts to develop biomarkers. These agents — sorafenib (Nexavar, Bayer), sunitinib (Sutent, Pfizer) and, most recently, axitinib (Pfizer) — have drastically changed the way we treat RCC. The way we approach the disease is totally different, and patients are living longer on these drugs.

What do you think will be the biggest breakthrough in your specialty in the next decade?

We will see specific biomarkers developed that allow us to tailor therapy to individual patients. I’m hopeful that we will develop biomarkers that will help us understand treatment-induced hypertension. There appears to be a strong signal there, but it’s a matter of understanding the biologic basis of that and capitalizing on that. I also see promise in single nucleotide polymorphisms and their role in drug metabolism, drug response and drug toxicity. A number of groups are looking at the role of SNPs in kidney cancer and other cancers.

Who is your mentor?

My initial mentor was Nicholas J. Vogelzang, MD, at The University of Chicago. He remains a friend and mentor to this day. He is why I went into genitourinary oncology, as he has great passion for clinical research and is a staunch patient advocate. Eric J. Small, MD, was then my mentor for my first faculty job at the University of California, San Francisco, and provided tremendous guidance to developing a clinical research career.

What advice would you offer to someone who wants to enter your specialty?

Make sure you are passionate about doing it. Patient care is both difficult and rewarding. As with any profession, you need to love it.

If you hadn’t become a physician, what career path would you have chosen?

Robert Smith, PhD, a cancer epidemiologist and director of
Brian I. Rini, MD, crosses the finish line of a recent triathlon. He is accompanied by his sons, Jackson and Will.

Photo courtesy of B. Rini, MD.

I’m not sure. The rest of my family is in advertising, so perhaps that. I also was interested in computer science in high school. My retirement plan is to move to Sonoma and be in the wine industry somehow. I’m a wine enthusiast. I lived in northern California for 4 years, where I was introduced to wine and developed that interest. It’s a hobby that I enjoy.

What do you enjoy doing when you aren’t at work?

I have competed in two half ironman triathlons and ran a marathon in the last couple years. After I passed 40, I had to convince myself I wasn’t that old, so I began to take fitness more seriously. I also take piano and guitar lessons with my two sons, Jackson and Will. Part of the reason my wife and I require them to take lessons is that it is best to develop the skill at an early age.

Which instrument do you prefer?

The guitar and the piano are totally different instruments, both in the physical and musical skills required. I don’t know which one I like better. I love them both and wish I had more time to practice them.

What is the last good book you read?

I just finished The Girl with the Dragon Tattoo series. I don’t do as much pleasure reading as I should, but I enjoy the page-turner suspense novels.

What is your ‘can’t miss’ TV show?

Phil Dunphy of Modern Family is my personal hero. That show is hilarious, and any middle-aged, married man can identify with him.

What music is on your iPod right now?

I have more than 7,000 songs. I have gotten into music much more over the last 5 years and my taste varies. My current favorites are John Mayer, David Gray and Keith Urban. I have always been a huge James Taylor fan, also.

What is your favorite travel destination and why?

Probably Barcelona, as it is a unique and fun and vibrant city. It’s a little South Beach, a little Vegas, a little New York and others rolled into one. There is a lot of stuff to do, and there are friendly, interesting people. My job affords me opportunities to travel internationally, and I look forward to seeing many places I’ve not yet been.