Dr. Humberto M. Guiot: Targeting Pancreatic Cancer in a Community-Based Clinical Trial
Dr. Humberto M. Guiot, a distinguished 46-year-old infectious disease physician and professor of medicine at the University of Puerto Rico, was at the pinnacle of his career. With roles as an educator, clinical researcher, President of the Infectious Diseases Society of Puerto Rico, and Dean of the School of Medicine, as well as an active clinical practitioner, his work life was full. In addition, he and his husband were moving Humberto’s mother, who was being treated for breast cancer, in with them. Then, in the winter of 2022, everything changed.
It began with a persistent pain in his flank and back that gnawed at him through the holidays, making sleep elusive and daily activities burdensome. As a doctor, Humberto initially assumed he was suffering from a musculoskeletal issue, perhaps the result of his demanding workload. But when the pain refused to subside and his weight began to drop, he realized it might be something more serious.
After weeks of tests and consultations, a large mass was discovered near his left kidney. The news was devastating. What initially appeared to be a kidney tumor turned out to be an adenocarcinoma of pancreatic origin—pancreatic cancer. The diagnosis in March 2023 left him reeling. As a physician, he knew the grim prognosis associated with pancreatic cancer. He understood the aggressiveness of the disease and the limited effectiveness of available treatments. “I was devastated because I knew it was a very hard road for me,” Humberto said.
He had always been the one providing care, offering hope to his patients, but now, as he grappled with his own diagnosis, Humberto was overwhelmed. The cancer was advanced, involving several organs, and surgery was not initially an option. He wanted a second opinion and traveled to a cancer center in New York. He was advised to start with conventional chemotherapy, locally in Puerto Rico, with the hope that the tumor would shrink enough to make surgery a viable option.
Chemotherapy was grueling. The side effects were severe: weight loss, hair loss, bleeding, anemia, superimposed infections, and relentless fatigue. Humberto found himself in and out of the hospital, struggling with complications and the emotional toll of his condition. “I was very weak. I required admission to the hospital several times for transfusions or because of fever and for different complications,” he said. However, amid all the adversities and suffering, there was a glimmer of hope—the tumor was shrinking.
By July 2023, the tumor had reduced in size, and surgery was finally an option. Humberto traveled back to New York for the surgery. The operation was extensive, requiring the removal of several organs. The recovery was difficult. “But I was happy that I was recovering well. In the back of my mind, I knew that I had to go back to chemo, which was very hard the first time. I didn’t know what to expect after having several organs removed and after losing so much weight.”
In August 2023, Humberto was back in Puerto Rico to complete the courses of chemotherapy. However, as the year drew to a close, his treatment became more difficult. By December 2023, Humberto was practically bedridden, losing more weight, and barely able to perform basic tasks. The holidays were a blur of pain and exhaustion. Then, in early January 2024, he received more grim news: The cancer had progressed, spreading to distant organs.
A ray of hope emerged through genetic testing, which revealed a mutation in the KRAS gene that made him eligible for a clinical trial involving a new molecularly targeted treatment, adagrasib (Krazati). Though skeptical, Humberto, bolstered by the optimism of his husband and medical team, decided to pursue this opportunity.
The first infusion was incredibly challenging, but within days, Humberto began to feel better. His symptoms improved rapidly, and by the time of his second infusion, he was able to walk unaided and even stopped taking pain medication. His lab results improved, and by April 2024, he was in complete remission—a stunning turnaround from the dire prognosis just a few months earlier.
Today, Humberto has regained much of the life he thought he had lost. He is back at work, not only as a physician but also as the interim executive director of the University of Puerto Rico Comprehensive Cancer Center. His personal battle with cancer has given him a renewed purpose, to help other patients navigate their own journeys. He is committed to ensuring that other patients have the same opportunities for recovery and quality of life that he was fortunate to experience.
Humberto’s story is a testament to the power of medical research. “My life is an example of how much clinical trials can help patients to go back to their life and to serving their community. A few months ago, I thought that everything was over when conventional therapies had failed me. And if it were not because of clinical trials, I would not be here right now. Since my treatment, I have visited Europe twice, taken a cruise, and am back to work. And everything has been possible because of clinical trials.”