New Investigator Spotlight: Neil Desai, MD

March 18, 2025

Dr. Neil Desai is the Director of Clinical Research and an Associate Professor in the Department of Radiation Oncology at University of Texas Southwestern Medical Center in Dallas, Texas. He specializes in the management and radiation treatment of genitourinary cancers, with a specific focus on prostate and bladder cancers. He has extensive experience in radiation techniques including stereotactic body radiotherapy (SBRT), brachytherapy, and adaptive radiotherapy and has established himself as a leader in the clinical trial community. Dr. Desai is currently a co-Principal Investigator of the NRG-GU010 utilizing Decipher risk score to guide intensification or de-intensification of treatment to better match therapies to an individual patient’s cancer aggressiveness in prostate cancer.

Q1: What kind of research are you currently engaged with?

My work focuses on improving treatment selection and novel treatment combinations to improve the therapeutic ratio in genitourinary malignancies. At NRG Oncology, I co-lead NRG-GU010, which tests whether a tissue-based gene expression biomarker (Decipher Biopsy) can guide selection for de-intensification of treatment for better prognosis patients and intensification in those with worse outcomes with historical approaches. I also will aid the conduct of soon to launch bladder cancer trials via RT QA as a modality chair. At my institution, I am running trials investigating approaches to reduce toxicity with SBRT in localized prostate cancer, including with a randomized trial of neurovascular sparing for sexual function sparing and a PSMA PET-response based study in higher risk prostate cancer. Going forward, I am mentoring fellow investigators in a spectrum of response-adapted treatment trials in and outside of my disease site.

Q2: What is your proudest accomplishment so far in regard to your research/career?

I am most proud of the opportunity to be part of the NRG Genitourinary Cancer Committee’s work in bringing individualized treatment selection to localized prostate cancer, using biomarkers. This work was the vision of the late Dr Felix Feng and being a small part of its execution in near completed phase III trials is a cherished gift.

Q3: What are you most interested in achieving through your research/career?

I would like to build a clinical research program that not only investigates novel ideas but also acts as a mechanism for mentorship to fuel optimism, vision, and fulfillment in new investigators in our field. I have had the opportunity to lay out a plan for this at my home institution with generous departmental and Texas state funding support (CPRIT) and look forward to seeing this plan through over the next decade as pressures mount on new investigators.

Q4: What inspired you to become involved in cancer research and/or specifically your field?

I have benefited from wonderful mentors, spanning from college to residency. In each case, I was encouraged to check out something beyond my intended path and to find something that would fulfill me in an enduring way. Like many, this meant being humbled as a young student seeing the gravity of oncology clinics, the need for hope, the excitement with novel treatment successes and the reward even in ‘failure’ of being part of kind and earnest teams. When picking sub-specialties in cancer care, I finally was ‘sold’ on a characteristically generous and random outreach from Dr Seth Rosenthal who described a wonderfully balanced career of service to patients, clinical investigation, teamwork, and technology. I wanted to be a physician who could make a difference as a natural extension of clinic experiences, and in shoes like his and other mentors’, I could see it.

Q5: What has been your experience engaging in the Radiation Oncology community and with RTOGF?

I think we have all been told to “show up” as the first step in any passion. This has been very true for me at NRG/RTOGF. We have a small field, and many earnestly want to help grow the Team. This has been very true of the GU group, as credit to the longstanding open meeting approaches of Dr Sandler and Dr Feng. My colleagues and friends laugh at me for stumbling into interesting scenarios in life and work--there are few better places to stumble into fulfilling work than by keeping your hand raised and head up here.