Archive for July, 2014

 

Jul 27 2014

No lazy, hazy days of Summer

by at 9:54 am

There is an old song that contains the lyrics, “Bring on the lazy, hazy, crazy days of Summer!” Well, I am still waiting for those days. It has been a busy time. Seeing patients is at the core of my identity as a physician scientist and although it is never a burden to me, my patients’ needs certainly affect me and remind me of the human toll of cancer. For example, several of my patients, including my young patient with colon cancer, were hospitalized and needed extra time from me. He required surgery to stabilize one of his vertebrae that had been infiltrated by bone metastases. Thankfully, his pain has improved but it has been a difficult time for him and his family. Another of my patients, with metastatic pancreatic cancer, was discharged and placed on home hospice.

On the research front, we have submitted two papers (one a revision), and another is being readied for submission. But the most important research activity has been related to the Lombardi budget for the current fiscal year. In order to balance our budget it was necessary to institute significant reductions in the amount of institutional support we are able to provide our investigators. This has been a very challenging and painstaking process, and at every turn we have endeavored to prioritize and preserve Lombardi’s research mission with sensitivity to the people who are at the core of this mission. This is an ongoing process, and I can assure everybody that we are doing everything possible to identify additional revenue streams that allow us to invest in our future while remaining fiscally responsible.

We are not alone in dealing with this challenge, which is related to historically low funding paylines from the NIH, with no end in sight. Institutions around the country are struggling with reduced funding, and there are no magical solutions. However, by working together (e.g., combining to conquer) I firmly believe we can remain competitive and thrive in this peculiar new order.

I will be working with Michael Vander Hoek and all affected investigators to implement the new budget. The lazy, hazy days will have to wait.

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Jul 20 2014

Greetings from Canada!

by at 10:02 am

Greetings from Canada! Harriet and I were invited to an old friend’s wedding anniversary party on Saturday in Rhinebeck, New York and decided to just keep driving up North to visit Niagara Falls, which Harriet has never seen. The drive was made more pleasurable by listening to the book, “Orphan Train”, while we drove. It describes an aspect of American History that I did not really know, and the story is gripping, if a bit formulaic. We’ll visit the Falls (Canadian side) on Monday, and are really enjoying Niagara-by-the-Lake, a beautiful village on the shore of Lake Ontario. I don’t have much more to talk about on this blog, so if it’s OK with you I think I’ll just go back to deciding which show we’ll see tomorrow night at the Shaw Festival, and then take a crack at revising a manuscript related to our work on the Estrogen Network. I’ll be back on Wednesday. See you then.

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Jul 13 2014

A Sense of Urgency

by at 7:58 pm

Last week was highlighted by my trip to Houston to give an Experimental Therapeutics seminar at MD Anderson. The scope of Anderson is breathtaking-building after building and a seeming endless stream of patients. I met with a number of people including Ethan Dmitrovsky (Provost) Jim Allison and Cassian Yee. It was exciting to talk about science and to compare notes with so many excellent colleagues. I got back in time for my Thursday clinic and was brought back to earth when I saw my young patient with colon cancer who has been the subject of previous blogs. Despite many different treatments his cancer has worsened and he was in terrible pain when I saw him. I admitted him to the hospital to optimize his pain control.

It is a terrible privilege to care for people with cancer, but the future will be brighter only if we can come up with better treatments. This is happening for some other diseases like lymphoma and melanoma, but too many other diseases await the key that unlocks their secrets. So, as Harriet and I drive back from the joyous occasion of our niece’s wedding to a wonderful young man who is only a few years younger than my patient I find my thoughts turning to a heightened sense of urgency to work harder, smarter and faster.

Have a good week.

 

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Jul 06 2014

Back to work

by at 10:51 am

Happy Independence Day! This has been a glorious holiday weekend. Harriet and I hung around DC; on Saturday we took our grandson Isaac and his parents to see Lion King at the Kennedy Center. It is such a treat to see the world through the eyes of a 3-year old, and to introduce him to a larger world.

The preceding week was actually quiet, as many people in DC used the Friday holiday as an excuse to take a few extra days off. At least traffic in town was pretty easy. I used the time to finalize a supplement application to my R01, in response to an RFA looking to connect the immune response with the cancer metabolome. I am lucky to be at Lombardi, where we have such strong efforts in this area. The new aim on my grant addresses three linked questions: 1) How does metabolism-targeted therapy modify the tumor metabolome and the immune response? 2) How does immunotherapy affect the pancreatic cancer metabolome? 3) How does manipulation of the pancreatic cancer metabolome affect immunotherapy efficacy?

We are doing this work with two existing collaborators–Subha Madhavan (with her new colleague Simina Boca), and Chip Petricoin (from George Mason)–and new co-investigators Amrita Cheema and Jill Smith. Amrita needs no introduction, and her metabolomics expertise is critical to the success of the proposed work. But Jill is new to Georgetown. She is a gastroenterologist with genuine expertise in using pancreatic cancer models to explore the role of cholectystokinin in cancer development and the potential value of CCK receptor antagonists for treatment. In this supplement we will define how CCK receptor antagonists alter the pancreatic cancer metabolome and immune milieu, and how to use such antagonists in conjunction with antibodies targeting PD-1, CTLA-4 or both immune checkpoints. It has been a real pleasure to work with her, and I look forward to a fruitful collaboration.

The coming week will be a bit busier for me. Monday will be highlighted by a Lombardi Strategic Planning meeting. On Tuesday I head off to Houston to give a lecture on Wednesday morning at MD Anderson on my group’s systems biology work, and I look forward to meeting with many colleagues and learning more about their work. Friday will be a busy day, as I meet with the new cancer center director, Albert Aboulafia, from MedStar Franklin Square Hospital in Baltimore. Franklin Square is an active member of the MedStar Georgetown Cancer Network, and Dr. Aboulafia, a sarcoma surgeon, is interested in strengthening ties with Georgetown. After a meeting with MedStar marketing to discuss how to better advertise the Network, I then will be giving a talk to the Georgetown Romeos (a group of retired GUMC faculty members) at DeCarlo’s restaurant on Immunity, Evolution and Cancer. Harriet and I have eaten at DeCarlo’s and I am interested to see how they manage the audiovisual setup for my slides in their space. I don’t know how good my lecture will be, but I am sure that the pasta will be excellent! I then close out the week by interviewing a candidate for a leader of the Hackensack-Georgetown Bone Marrow Transplant effort here in DC, followed by a thesis committee meeting for a new Ph.D. candidate from the NCI/Georgetown program. All in all, it will be a busy end to a busy and potentially very interesting week.

And now, back to a final read-through of my grant proposal. Have a great week.

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