From the Desk of Dr. Louis M. Weiner

I hope everyone is enjoying their long weekend and the wonderful weather we are having for Memorial Day.

See you next week!

I hope you had a good weekend.

We stayed in town this weekend (giving both I-95 and Amtrak a break!). On Friday night we attended a wonderful GU event at the Law Center honoring the Commencement awardees. On Saturday we also attended a wonderful evening event celebrating the CBCC Lombardi Avon Walk for Breast Cancer team’s accomplishments. We had a wonderful time; one of the key events of the evening was an appreciation of Jeanne Mandelblatt’s leadership of the team. Note that the team decided to create a marvelously humorous effigy of her – her likeness is on a toilet (which she urged the team members to use frequently as a tool to assure they were hydrated during practice walks). The only thing missing was a set of knitting needles and yarn!

Aside from a few errands, I have spent the rest of the weekend working on a new grant – no, not the CCSG, which was formally submitted early in the week. This is a U01 supplement to the U54 Center for Cancer Systems Biology, where we will examine the really interesting (to me, at least!) proposition that the evolution of drug resistance occurs due to two types of broad mechanisms. The first, which I term “clonal adaptation”, can be viewed as genetic, epigenetic and related modifications of an existing clone that allow those cells to survive assault by the immune system, drugs or radiation. The other mechanism can be termed “clonal heterogeneity”, where resistance is not really acquired, but results from the selection of clones that are well adapted to survive in a particular selection pressure. We will use a variety of tools, including conditional cellular reprogramming, reverse phase protein microarrays, siRNA library screening (of course!), and others.

Of course, there is still the CCSG, with the site visit looming on October 3. Carolyn Hurley has already sent me the template for my slide presentations! We have much work to do to assure that our site visit is up to the standards of our application. But we will get there.

Last week was typically busy, highlighted by the dedication of the renovated chemotherapy unit on 5 Main in the hospital; the unit was renovated due to the support of Neil Kishter, who dedicated this in memory of his late wife, and in honor of her doctor, Craig Kessler. Craig gave a marvelous talk at the dedication in the Lombardi atrium, which has really become a real gathering place for celebrations. You should take advantage of the opportunity to celebrate yet again in the atrium this Wednesday, when we celebrate the Hackensack affiliation with our new colleagues. Please join us at the event! And make sure to take note of the atrium since it seems likely to undergo another round of renovations in the near future. A DC advisory committee has recommended that the proposed proton therapy unit, to be housed in the Lombardi clinic building, should be approved. This clears the way for new construction that could begin as early as this coming autumn – so the current repaved driveway is likely to be only a temporary respite before the fun resumes, albeit without water damage. But the end result will be more high technology options for our patients and some very nice remodeling of the atrium and related spaces.

Finally, it’s been a busy week for Beth Peshkin as well — she has had multiple media interviews as a results of the news regarding Angelina Jolie’s preventative double mastectomy, including a truly great interview on PBS News Hour. She has really been a terrific voice of reason amidst this media blitz. Check out some links to these news stories in the “In the News” section of Lombardi Next Week.

Have a wonderful week.

On Friday I received this message from Michael Vander Hoek, entitled “Congratulations, It’s a CCSG!.” The text continued, “Even Phyllis was awestruck when the 200 pounds of the CCSG application were received back from the printer a few minutes ago. What a delivery!”  The application will most likely go to the NCI today.

Speaking of deliveries, I left on Thursday night for a long weekend to be be with Harriet, Ella, Ken and Sarah. We celebrated Mother’s Day, which was also Sarah’s birthday, and were joined by our other kids and Isaac. It’s hard to believe Ella is already one month old and that she has changed so much so quickly. It’s even harder to believe that Ken is 32, since a part of my mind’s eye still sees him as a toddler, depending on his parents for guidance, approval and knowledge. Of course I know better, but anyone with a grown child knows exactly what I mean. It was a particularly poignant thought for me this weekend as I helped Ken demolish a wall in his new house, install a new window in the newly enlarged room and get the room ready for some serious renovation. I know how to do none of those things. I am best kept away from tools, which only cause unwanted destruction, personal injury and large repair bills. However, Ken is remarkably adept, and patiently steered me through the process, at the cost of a single splinter and a torn pair of jeans. A once dark room now has light streaming in and will be a wonderful space for Ken’s growing family.Sometimes the child indeed is father to the man. For years Ken has wanted to share with me those things he does so well that I do not do; I successfully avoided mountain climbing (to my relief) and we have never gotten around to wilderness camping (which I think I would like). At least we’ll always have a shared demolition. And, we will have the memory of devouring some Philly delicacies – a cheesesteak from Chubby’s in Roxborough, a hoagie from Lee’s and an unexpectedly fantastic barbecue from a new place called Barbacoa in Ardmore.

While driving home on Sunday night I reflected on how I had learned some new skills from Ken, and considered other ways that old dogs like me can learn new tricks. I thought about my students and other folks in my lab and how my research has grown and developed as they have brought new skills and perspectives to my work. When I came to Georgetown five years ago my career had focused on antibody engineering, and I was beginning to get involved in functional genomics. Now our entire lab is deeply engaged in functional genomics, signaling networks, basic mechanisms underlying cytotoxicity of immune effectors and evolutionary biology. I am proud of how our lab has developed, and am deeply grateful to everybody who has helped me learn what I need to know to ask research questions that are important, impactful and cutting-edge. Like Ken, they have been patient mentors who have broken down walls of ignorance and misunderstanding and have illuminated my current and future research as we tear apart genes in search of new cancer cures. Thanks to all of you! And Happy Mothers Day to everybody who qualifies!

The CCSG competitive renewal is all but done, and I must say that I am more than a bit pleased and relieved to be able to write that phrase! It has been an extraordinarily intense time, made easier by several factors. Firstly, the wonderful work of the Center has provided us with many wonderful accomplishments to share; I have highlighted some of them in recent blogs. Despite being in the midst of a historically challenging external funding environment, and with new rules and regulations that limit what we can claim as funding, our “Summary 2” funding has remained stable since 2009. Few cancer centers can claim such stability, and for this I am grateful for all of the wonderful work you do. Secondly, that funding has supported some truly outstanding science. And we have enjoyed remarkable support from Georgetown University that permitted us to continue to build the Lombardi of today. I am particularly grateful to Howard Federoff for his consistent support of our mission. Our partnership with MedStar Health has deepened, with simply outstanding support by Joy Drass and her colleagues for recruitments, facilities and expansion throughout the MedStar Washington region. And our External Advisory Commitee, chaired by Stan Gerson from Case Western Reserve, has been a source of wisdom and support throughout this whole process.

But at the end of the day, all organizations (and CCSGs) rise and fall on the strength of their people. And I am humbled by the hard work of Lombardi’s senior leadership, and in particular the tireless efforts of Carolyn Hurley, Ellen McLaughlin, Michael Vander Hoek, Mike Atkins and a host of stellar internal reviewers who have really held us all to the highest possible standards of description, messaging and accuracy. My particular thanks go out to Anna Riegel and Jeanne Mandelblatt for their remarkably perceptive and helpful reviews.

When I look back at the last four years I am struck by how much has changed at Lombardi, and how we have genuinely progressed in our sense of who we are, what we do and what we aim to accomplish. We now have four tightly constructed and coherent research programs, and support these programs with nine outstanding shared resources. We engage our community in new ways that reflect our genuine commitment to our catchment area. Our leadership structure has been refined and strengthened,  and we have benefited from a large number of stellar senior and junior recruits who have enhanced existing strengths and allow us to expand into new areas where we can have high impact. We even can extend our impact beyond DC, as evidenced by HackensackUMC’s affiliation with us and its support of a reincarnated hematopoietic stem cell transplant program.

In a very real way, we are on the way to becoming the regional resource that we should be. The events that led to and then followed the acquisition of Georgetown University’s medical enterprise in 2000 had profound impacts on all aspects of health care and research on this campus. Lombardi was affected as well, as the insufficient alignment of research and clinical missions made it difficult for the Cancer Center to synthesize those missions in the manner expected by the NCI and by our community. Accordingly, the Lombardi I joined in late 2007 was more of a research institute with a connected but unintegrated clinical enterprise characterized by parallel rather than intersecting and mutually reinforcing activities. The recent creation of the MedStar Georgetown Cancer Network was accompanied by an emphasis on service to the broader catchment area with research-inspired clinical care and a very substantial investment of resources by MedStar Health to accomplish these goals. Our aspirations can now be accompanied by a certitude that the vision of what a comprehensive cancer center can be in our region is shared by Lombardi, GUMC and MedStar Health. The opportunities to transform the impact of cancer on our region and throughout the world have never been greater, and I am certain that we are up to the challenge.

I took a day off on Friday so I could spend the weekend with Harriet, our new granddaughter and her parents. I plan to do the same this coming Friday too. I don’t know that this qualifies as a true vacation but I can think of no better way to celebrate the end of a long march than to hold Ella in my arms. Speaking of long marches, I very much regretted that the trip required that I miss the Avon Walk for Breast Cancer, which concluded today. Avon presented our team with a check for $250,000 to support the work of CBCC — and Wanda Lucas was there to accept it. Our Lombardi / CBCC team raised more than $145,000 — a new record — and magnificently represented our mission and values. Thanks again to Jeanne Mandelblatt for her leadership and inspiration.  And thanks to MedStar Health for supporting our team with a $10,000 donation. A few photos are below.

The season of walks is not over, however. This Saturday, May 11 we still have the Komen Walk — our CBCC-led team is growing by the day. Check out our team page here.