The State of Yale Cancer Center and Smilow Cancer Hospital

February 16, 2021

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Yale Cancer Center Grand Rounds | February 16, 2021

Charles Fuchs, MD, MPH

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00:00Available online and looking
00:03forward to today's discussion.
00:06Today I've I've taken the opportunity
00:08to to offer up grand rounds on my own.
00:11That is, you know, typically would be
00:14customary for me to give a state of
00:17the Cancer Center talk in September,
00:19but with my my departure,
00:21my time is can send director and
00:23physician in Chief coming to a close soon.
00:26I wanted to take this opportunity
00:28to review with all of you where we
00:31stand across the broad range of our
00:34endeavors in the cancer enterprise.
00:36Including our missions in clinical care,
00:39research, education, outreach.
00:41We have one thing I think we should
00:45never lose sight of and I hope you're
00:48all aware is that today we stand as
00:51one of the elite cancer centers and
00:53cancer hospitals in the United States,
00:56if not the world.
00:57Our success in clinical care research,
00:59discovery, innovation, education,
01:01outreach is renowned and our
01:03programs are expanding.
01:04With an ever greater rate,
01:06reach across an enlarging community.
01:09You know, in the next 40 minutes,
01:11I'd like to cover a lot,
01:13but to be candid,
01:15time prohibits me from covering all
01:17the initiatives that have we've done in
01:20the past several years and were ongoing now.
01:23And frankly,
01:24at the same time,
01:25there's so many people that I want to
01:29thank as I sort of plan my own departure,
01:32and time prohibits me from really recognizing
01:35so many people who have done so much.
01:38You know,
01:39that includes our Associate Cancer
01:41Center directors and and leaders in
01:44the in the Cancer Center or research
01:46program leaders or disease center
01:48leaders or division Chiefs or leaders
01:51across my lower nursing pharmacy
01:53clinical operations Administration.
01:55Chief medical officers are,
01:56I know this services.
01:58You know a couple of individuals
02:00that I want I sort of recognizes
02:03the onset one being Lori Pickens,
02:05who is really been my partner.
02:08In much of this and frankly,
02:10all of it as our Senior Vice President,
02:13Executive Director,
02:14who I think is been tireless advocate
02:17for the mission of Smilow in the
02:19Cancer Center and has been somebody
02:22I've thoroughly enjoyed working with
02:24and at the same time, Dan Demeo.
02:27Who has been an extraordinary deputy
02:30director for the Cancer Center and
02:32continues to put his all into?
02:35What is the rich history and legacy
02:38and the continued success of our
02:41research enterprise and in other
02:44aspects of our Cancer Center.
02:47You know we are marking now a
02:49year into this pandemic.
02:52And it's obviously been a
02:54challenge and at times exhausting.
02:56But the sacrifice you've all put
02:58in over the past year and your
03:01commitment to remaining steadfast to
03:03all the missions has really paid off.
03:06You know you have found new ways to
03:09provide care to conduct clinical basic
03:12translation and population research.
03:14Anne, frankly.
03:17That is made an extraordinary difference,
03:20and that has only been successful,
03:22not because just the leaders
03:24bought into that,
03:25but everyone throughout the
03:26organization has stepped up and that
03:29volunteerism has been recognized
03:30on so many countless fronts.
03:32I cannot tell you how many times I
03:35speak in events about the success of our
03:38enterprise in the midst of this pandemic,
03:41and I think we have the
03:43admiration of so many centers.
03:46So if I may let me sort of review.
03:49Where we're at and make sure that we
03:52have time for questions and let me make
03:55sure hopefully my slides are showing up.
03:58You know, I'll start with the slide that I I.
04:01I can't help it show because it was
04:04something that we launched with my
04:06start which is our vision statement,
04:08which I frankly think is so important.
04:10It may may benefit from modification
04:12in the years ahead,
04:13but I think it speaks volumes
04:15about who we are as a leader in
04:18cancer care research and education.
04:20That our institution delivers the
04:22transformative scientific discoveries and
04:24care innovations of both our University,
04:26their health system,
04:27to bring us closer to a world free of cancer.
04:31One patient at a time because
04:32we are a cancer enterprise that
04:35leverages our diverse communities.
04:37All the individuals committed to
04:39this mission and ultimately focused
04:41on the individual patient who in
04:43each case we provide the very best.
04:45You know,
04:46I'm proud of the fact that
04:48I think we are the model.
04:50In the system in the cancer world,
04:53for not sort of looking at it.
04:56In which side of the street you reside,
04:59I think we really do wear a model of
05:02being a single enterprise working
05:04together and to do so across the pillars
05:08of clinical care and innovation,
05:10research and discovery
05:11outreach sustainability.
05:12That is, I think, our success,
05:14both in terms of our operations and
05:17our finances, is really enabled.
05:19Lots of great things.
05:21Across the biomedical enterprise
05:22for Yale and Yale,
05:24New Haven Health and no less importantly,
05:26one thing we always have to
05:28keep our eye on or the people.
05:31Because it's never bricks and mortar,
05:33it's it's actually the people doing the
05:35work of which we have so many talented
05:38and dedicated individuals and that we
05:40have to continue to invest in our people.
05:43We have to engage our people and
05:45we have to expand our ability to
05:48embrace diversity and inclusion.
05:50Our clinical enterprise has thrived
05:52over the years and prior to the
05:55pandemic we once again had a record
05:57year of just routine enm visits
06:00in across the small enterprise.
06:02Obviously the pandemic was earth
06:05shattering for all of us and
06:08obviously there was a lot of loss
06:10and a lot of challenge.
06:13But I'm just so proud of our leaders,
06:16Kim Slusser and Kevin Billingsley.
06:18And really,
06:18the entire entire workforce in
06:20responding to the pandemic.
06:22You know the story,
06:23moving multiple floors sometimes in 23
06:26hours and throughout keeping patients safe,
06:28ensuring their care,
06:30and continuing to advance
06:32the mission of the center.
06:34Those types of events can
06:36sometimes be an opportunity,
06:38an opportunity to look at
06:40the way we do business
06:42to innovate, and I think would emerge
06:45to follow where these transformation
06:47groups which continue to meet regularly
06:49in terms of innovating the way we
06:52do inpatient care, outpatient care,
06:54supportive care and clinical research.
06:56Ongoing work which I'll touch upon.
06:59Over the next 30 to 40 minutes in
07:02terms of the volume in this year,
07:05well we did have a dip in April,
07:08but that candidly was by design.
07:10We needed to keep our waiting rooms
07:13somewhat sparse and so a lot of
07:15efforts in terms of telemedicine
07:17in terms of reducing the need for
07:20infusion to reduce the frequency by
07:22which patients needed to get infusion
07:24care while maintaining their care.
07:26But ultimately we resumed and
07:28resume robustly beyond what was
07:30only a modest decline or volume.
07:32And even through the year,
07:34I think a reasonably steady
07:37pace of providing patients care
07:39across our entire region.
07:41Concurrently was an effort to ensure
07:44scientific engagement despite the
07:46challenges we were dealing with
07:48with the pandemic in terms of
07:51the work on clinical research,
07:53expanding our translational science,
07:54which I'll touch upon the research
07:57programs developing their own
07:59strategies to work to enhance research
08:01program and art interactions,
08:03to promote team science,
08:05and to focus on our trainees
08:08and junior faculty.
08:10You know,
08:11as I mentioned,
08:12it's all about the people and we had
08:14a banner year of of recruitment Pam
08:17Koons who was recruited to lead.
08:19You are in college which I'll talk about.
08:22Mira,
08:22Gulshan recruited as our Deputy Chief
08:24Medical Officer for surgical Services,
08:26but at the same time serving
08:28us are acting director for the
08:30breast program Marcus Musician,
08:31our inaugural leader for the Center
08:33for Molecular and Cellular Oncology
08:35and a variety of other folks that I
08:38won't I'll talk about during the talk, but.
08:41Really, a new set of leaders,
08:44individuals who bring.
08:46Great talent in terms of science,
08:49innovation, clinical care among others,
08:51and this is really just three slides
08:53for those I neglected to include.
08:55My apologies because I think we really.
08:58Despite a pandemic,
08:59we can take great pride in beyond
09:02the extraordinary people we
09:03already have on the ground.
09:05Here, the individuals we brought on since.
09:08You know,
09:09in terms of how we think about
09:11advancing the clinical enterprise,
09:13for me it sometimes it's I
09:16keep it relatively simple,
09:17which is beyond everything else we do.
09:20We have to make sure that we are the
09:23provider of choice for patients,
09:26families, referring providers,
09:27and that involves sort of making
09:30sure that people aware of the great
09:32services opportunities we have for
09:34cancer patients and families to make
09:36sure that the interface when people call.
09:39Is as easy as possible.
09:41Being a patient,
09:42a family member,
09:43referring doctor,
09:43those are challenging times for
09:45people with the new diagnosis and
09:47whether it be through our next day
09:49access programs or other interfaces.
09:51This is something we always have to
09:53keep our eye on and then finally
09:55making sure that as always,
09:56the care here is excellent that
09:58the experience for patients
10:00and. Families is exceptional so that you
10:03know they really feel comfortable and
10:05assured that they are in the right place.
10:09In terms of those principles
10:11and all of our efforts,
10:12I'll highlight a few which is 1 I'm
10:15really proud of is the work of our teams
10:18to look at the way we're delivering
10:20in patient care in the inpatient redesign,
10:23a process that Roy Herbs and Karen
10:25Adelson Anchang Tracy Caraffi know,
10:27and a litany of other folks have been
10:29advancing with the launch of what
10:31will soon to be the smilow inpatient
10:33medicine service or hospitalist service,
10:36to improve the way we deliver.
10:38Care free up a lot of our services.
10:41To focus on other things,
10:42to the efforts to move more of our
10:44care to ambulatory namely things like
10:47stem cell transplant and cell therapy.
10:49To improve the kind of things we
10:51can do at home in post acute care to
10:54help patients get home to expand,
10:57palliative care,
10:57to reduce the need for people to be admitted.
11:01And the things we have to deliver on
11:04giving the investment for this hospitals
11:06service that the health system is putting in,
11:09we obviously need to reduce
11:10our length of stay.
11:12It's candidly too long.
11:13We have to reduce re admissions,
11:15preventable admissions,
11:16expand bed capacity.
11:17And these are the right things for our
11:19patients beyond obviously important
11:20for our sustainability as a system.
11:22And then other measures is we have
11:25to look at the way we're managing.
11:27End of life care in the experience of
11:30our patients and as well for our workforce.
11:33Making sure that those people who
11:35work on the inpatient service that
11:37they're feeling fulfilled that they
11:39have the resources they need and
11:41they feel that they are able to
11:43provide the best care possible in
11:45terms of our ambulatory operations.
11:47The Ambulatory Transformation
11:48Group has involved a lot of people.
11:51I frankly have the short list here
11:53and there's many others forgive
11:55me for not including,
11:57but I think you're doing great work.
11:59They have interviewed hundreds I believe
12:01up to 700 individuals in various manner.
12:04To find out how we could do it better
12:06looking at our workflow looking
12:08at the roles and staffing models
12:10actually getting piloting in various
12:12forums across our network next day
12:14access which is so important for
12:17patients and families to know that
12:19when they are strict with it,
12:20this sort of kick in the teeth
12:23of a diagnosis of cancer that if
12:25they want to be seen right away,
12:27we're here for them to develop new
12:29efficiencies within our infusion
12:31space with lean tops to expand our
12:33multidisciplinary care in multiple
12:35and coordinated care things that
12:36will meaningfully.
12:37Improve our ability to provide
12:39care and hopefully make it easier
12:42for us to do our jobs.
12:44Kevin investors,
12:44you know,
12:45took on a new role as Vice President
12:48for disease centers where we really
12:51look at our disease focused care,
12:54research, education, outreach.
12:55These often referred to as our darts.
12:59We want to further enable in them,
13:02invest in them, empower them to really
13:04come up with full measure strategic
13:07plans across the entire enterprise,
13:09clinical research, outreach,
13:11education, and to do so.
13:13Kevin, an others.
13:14Have sort of built a model by which we
13:18have enhanced leadership structures.
13:20A director or research director,
13:22clinical director.
13:23Additional support to to enable
13:26operations in strategic planning
13:28as well as forums for each of the
13:31members of these teams to work and
13:33to ultimately expand our ability
13:35to do disease focus work in in.
13:38Really a powerful way beyond what
13:41we've done that is to be Centers
13:44for Disease focused innovation.
13:46To be a strategic in terms of
13:48how they do the work to leverage
13:51all disciplines to be inclusive.
13:53That is a big tent across the
13:56entire enterprise,
13:57across communities and across
13:58disciplines to span the entire
14:01health system and to ultimately
14:03execute on our signature of
14:05care which we are so proud of.
14:07You know one example was I mentioned
14:10we may was recruited as our Deputy
14:13CMO for surgical services and at the
14:15same time took on the opportunity
14:18to be serve as our interim
14:20leader for the breast program,
14:22and I think he has done a phenomenal job,
14:25most notably some really
14:27high profile recruitments.
14:28Rachel Greenup,
14:28who is now starting as the
14:30Chief of Breast Surgery.
14:32Melanie Lynch,
14:33who's leading breast or breast surgery
14:35program at Bridgeport Hospital who
14:37just recently joined us and you may
14:40have noticed in your email today.
14:42The announcement that Miriam Lossberg
14:44really an international leader in this space,
14:47will be joining us soon as our
14:49permanent director of the Breast
14:51program with Mayor now becoming our
14:54clinical director and a lot of exciting
14:56work that the breast program is doing.
14:59Realizing that again that big tent
15:01property that to get it all done,
15:04research,
15:04education,
15:04clinical outreach that you really have
15:07to embrace all members of the team,
15:09each of whom contribute to the mission of.
15:12Ultimately,
15:13eliminating breast cancer in our time.
15:17Pam Koons I mentioned,
15:18recruited in GI and this past week.
15:21Pam Ann,
15:22really the entire GI team have built
15:24in a multidisciplinary organization
15:26that I think is really going to fire in
15:30all cylinders within all the domains
15:32of GI cancer and really expand us
15:35across all elements of the mission.
15:38You know our network continues
15:40to grow and I will tell you.
15:43I think it is a model for any
15:46NCI comprehensive Cancer Center
15:4815 sites across Connecticut,
15:50Rhode Island with the potential then
15:53move into Massachusetts an I think
15:55you know in terms of the measures
15:58of of engagement across the disease
16:00programs in terms of 25% recruitment,
16:03two of our clinical trial enrollments in
16:06terms of the talent across our network,
16:08it's really quite extraordinary and,
16:10frankly, unprecedented.
16:11There's always opportunities.
16:13I think the work to continue to
16:15integrate our network within the
16:17disease centers across our research
16:19mission to expand multidisciplinary
16:21care in each of these sites
16:23to expand our
16:25ability to conduct clinical trials and
16:27to ensure that they have the resources,
16:30including research labs
16:31and these sites important.
16:32And we're always going to look at
16:35new opportunities to create new
16:37partnerships and to further invest in
16:39our current centers which were doing.
16:42As we speak. A key element of our
16:46success has to be engagement.
16:48I think we've learned a lot about how
16:51we can communicate in innovative ways.
16:54In the midst of this pandemic.
16:56But communication, transparency,
16:58sharing our strategy,
16:59and ensuring that we invest in
17:01our people towards a culture of
17:03excellence and innovation is critical.
17:06As we move in the years ahead.
17:09You know, terror staff was last year.
17:14Became our inaugural Chief Experience
17:16Officer and working with Kim Slusser
17:19is RVP for patient services.
17:20They really are looking at all aspects
17:23of our enterprise in terms of communication,
17:26culture and engagement in terror.
17:28Has led a faculty committee in this
17:30space that I think is doing great work.
17:33We've expanded our forums for communication.
17:36Roy Decker enjoy stall, launched,
17:37the clinical Trial Advisory Committee
17:40to engage our all of our staff
17:42and how we can best improve.
17:45Our clinical research opportunities
17:46we've looked at were looking
17:48broadly about how we engage people
17:50and understanding compensation,
17:51professional development an
17:52and to recognize our staff.
17:54Lots of forums that have been created,
17:57like our Luminary awards across
17:58the entire enterprise,
18:00Kim had a an event last month where we
18:02had a record number of educational grants
18:05for our nursing and nursing allied staff,
18:08and these are the kind of investments
18:11we need to continue to make.
18:14You know our center has been at the
18:16forefront of research innovation,
18:18most notably in immuno oncology and
18:20targeted therapies and biology.
18:22No one never knows where the
18:24next advances will come,
18:25but we obviously have to make
18:27sure that we position ourselves.
18:29And this is work.
18:30I think we've done over the years
18:33in terms recruitment,
18:34retention,
18:34promotion of outstanding talent to
18:36ensure that we have a state of the
18:39art clinical operation to continuously
18:41look at our clinical research
18:42operations to ensure that it can
18:44enable moving the science into the clinic.
18:47To expand our translation
18:49research infrastructure,
18:50which I'll touch upon to expand our
18:54cores and centers.
18:55To enhance, enable innovation,
18:57and then just to continuously promote
19:00innovation across population.
19:02Basic, translational and clinical science.
19:06Our seven research programs are
19:08really the organization framework for
19:10advancing science in our Cancer Center.
19:13In each is led by talented Co leaders.
19:16As you may know,
19:18Michaela Diant dining joined us in
19:20January as our new leader for CPC,
19:23and we're glad to have Michaela,
19:26but we have such great leaders
19:28across the realm who are really
19:31advancing the mission.
19:32One note that you may have seen
19:35this past week was on the advice of
19:39our external Scientific Advisory
19:41Board we elected to.
19:43To move our cancer microbiology.
19:47Program off the roster and to move
19:50the membership into other programs.
19:53Candidly, that was a difficult
19:56decision because our Cancer Center
19:58has an extraordinary legacy.
20:00Of great work of really
20:03phenomenal work in this space,
20:05and we continue to have outstanding
20:08investigators in cancer microbiology
20:11virology, the microbium.
20:12But the challenges in terms of
20:14funding in terms of the rules for
20:17the NCIII think Walther, Amy,
20:19Dan Demeo and I and others came to
20:21the conclusion that it was best given
20:24the feedback we were getting to move
20:27those members into other programs.
20:29Let me just say we will always
20:31celebrate the work that these people
20:33have been doing and are doing and this
20:36will be a great opportunity to expand
20:39the reach of our other six programs.
20:42Over the past years I've we've celebrated
20:45our growth in direct research funding,
20:48and last year we talked about how
20:51we were so close to the three
20:54digit mark for the first time.
20:56Well, in 2020 we hit $107,000,000
20:59in total direct research funding,
21:01which is a really important mark,
21:04and again emphasizes the elite
21:06status of our Cancer Center.
21:09We've had an incredible clinical trial
21:12program which has continued to grow,
21:14but over the past few years has
21:17plateaued and the challenges of kovid,
21:20and last year certainly saw a
21:23noticeable drop on our Roman's
21:25noticeable drop in our activities.
21:28Some of that was covid,
21:30some of that candidly was a recognition
21:33that the rapid growth that occurs over
21:36the past decade created some inefficiencies.
21:40And issues in terms of the way
21:42we were doing business,
21:44most notably regulatory.
21:45It's been a challenging year in
21:47terms of our clinical trial,
21:49and I will tell you as I leave,
21:52this is 1 issue that I I wish we I want
21:56to make sure we resolve as soon as possible.
22:00Namely, we have to expand and
22:02reorganize our regulatory processes.
22:04We've had about 105 audits
22:06conducted by external consultants.
22:07You're on opportunities to fix things,
22:10nothing that was.
22:11Serious in nature,
22:12but clearly an important need
22:14to look at our workflow.
22:16We've been approved to hire
22:18a number of regulatory staff,
22:20and I want to applaud the work of
22:23Roy Decker joist all in their teams
22:25in moving that forward and we are
22:28looking forward for support from
22:30the University to advance those
22:32recruitments rapidly so that we can
22:35activate trials and then work with our.
22:37Our disease center leaders to
22:39expand the portfolio.
22:40Something we have to do imminently.
22:43And we are committed to doing imminently now,
22:46this is really important.
22:47There have been some really positive things.
22:50The work that Joyce is done on
22:53our clinical operations side,
22:54has converted what historically
22:56has been a 25 to 30% vacancy rate
22:58on clinical operations to a rate
23:01that's now under 5%,
23:02and I want to thank the people working in
23:05the CTO for their Esprit decor in that,
23:08and as we now rebuild our
23:11regulatory services,
23:11I'm looking forward to seeing.
23:13Even greater output from our
23:15clinical trial program,
23:16the impact of our clinical
23:18trials this past year,
23:20you know, has been nothing short
23:22of extraordinary or herbs actually
23:25let it a number of pivotal studies,
23:27probably most prominently,
23:28was the study VO Symerton IB in
23:31agement therapy lung cancer with
23:33what amounts to about an 80%
23:36improvement in disease free survival,
23:38something that you just don't
23:41see in oncology research.
23:43Craig Crews launched a series of
23:45programs, a Protex.
23:47Anne frankly launched our Venice
23:49working with Dan Petra lack.
23:51They made their lead program targeting
23:53the Angie receptor and presented at
23:56ASCO with really promising proof
23:58of concept that this idea out of
24:01the laboratory it out of Yale,
24:03actually can degrade and receptors
24:05for the benefit of patients with
24:07castrate resistant prostate cancer.
24:09And this is, I think,
24:11an important new therapeutic.
24:13Domain that is coming out of
24:16our Cancer Center.
24:17The sort of litany of studies that came
24:20out this past year are really Legion Anas.
24:23I love to quote.
24:24I think what we can say with great
24:27pride is that over the past year,
24:29our Cancer Center has led to four
24:32FDA approvals in the oncology space.
24:34I've said it before.
24:35I'll say it again when I go to site visits.
24:39A Cancer Center may mention that in
24:41the past year they had one or two of these,
24:45having four in one year is truly
24:47extraordinary and reflective.
24:48Of just how exceptional our center is.
24:52I mentioned how grateful I am and
24:54we should all be to work the Joycon
24:56warrior doing and there's opportunities.
24:58I think there's a lot of work
25:00going on in our staffing models.
25:02We've gotta work on regulatory
25:04and trial activation.
25:05We need to figure out how to
25:07better leverage IT to improve
25:08efficiencies and tracking,
25:09and they have a number of great ideas
25:12working with your on to advance.
25:14We've got to look at our portfolios
25:16in clinical research and to make
25:18sure that we maximize enrollments.
25:20I think we've actually done a great job.
25:22Andrea Silber and others of.
25:24Expanding our enrollment minorities,
25:25which is at a new high,
25:28but that's something we always
25:30have to keep an eye on.
25:32We're expanding genomic annotation.
25:34How can we leverage that towards
25:36advancing novel clinical trials
25:38and to continuously look at
25:40biospecimen collections so we can
25:42understand both our successes and
25:44our failures in clinical research?
25:48We've talked for the past several years
25:50on expanding translation research,
25:52and I think the past year,
25:54despite the pandemic has been
25:56one where where there's a
25:57number of exciting initiatives.
25:59We've been very grateful to Roy Herbs
26:01and his team in using the T Terra
26:04money to support translational research,
26:06new clinical trial spores,
26:08and other things which really have
26:10paid off beginning before the pandemic.
26:12We launched the Universal consent
26:14where every new patient is asked to
26:16consent to have their clinical data.
26:19Their specimens,
26:19all of it put into a database
26:22available for clinical research
26:24that is up and running.
26:26We were slowed by the pandemic,
26:29but we look forward to
26:31resuming that this year or
26:33pilot work says that 85% of new patients
26:36will agree to participate this month,
26:39February and March.
26:40We will be launching whole XM
26:43sequencing on all new patients,
26:45initially with human logical indices,
26:47but then two solid tumors were a
26:50clinical report of roughly 500 events.
26:52Of mutations, translocations,
26:54rearrangements will be put into the
26:57clinical record and the all the data
26:59of roughly 24,000 genes from whole
27:01exomes we put into a research database
27:04for all of us to benefit from.
27:07Mike Murray has been moving forward
27:09on the Generations project in
27:11terms of germline characterization,
27:13characterization,
27:13and I encourage everyone to think
27:15about that as an opportunity to
27:18expand their own research portfolios.
27:20Ed captain has been working ****
27:22** Biospecimen collection and Wade
27:24Schultz and Alan Chow have launched
27:26the Comprehensive Health platform
27:28where all of these data get put into
27:31a data link where we can leverage and
27:33this was used to a great extent and
27:36in the publications that we put out.
27:39About through covid.
27:40This will be a data warehouse that
27:42we will leverage for all of these
27:45translational research initiatives,
27:46and I congratulate all the people
27:48on this slide and others for the
27:51work they've done.
27:52Our sport program continues to
27:54enlarge beyond our skin lung scores.
27:57As you know, last fall,
27:59Barbara Burtness and team were
28:00successful in getting ahead and
28:02export where now with three spores.
28:05Only six cancer centers in the United
28:07States have more spore grants than us,
28:10again putting us in that elite category.
28:14Marat in Antonio or work still
28:16working **** ** the brains.
28:18Poor that will probably require
28:19a recent mission,
28:20but we know under their leadership,
28:22good things are going to happen and
28:25we look forward to other spores that
28:27will be launched in the years ahead.
28:30We've launched a number of centers.
28:32One particularly proud of building on the
28:35extremely rich legacy of meaning biology.
28:38Our successes in immuno oncology is
28:40our Yale Center for Immuno Oncology,
28:43a partnership between the Cancer
28:45Center in Immunobiology,
28:46Marcus Bosenberg and before him
28:48Roy Herbs have done great work
28:51as interim director's I think
28:53launching a annual symposium Marcus
28:56was successful in getting a number
28:58of new grants in the IO space.
29:00And a lot of exciting new collaborations
29:03and efforts as we continue to watch
29:06the success of this new center,
29:08some great studies that come out
29:11of the individuals working in
29:13this space just in the past year.
29:15A team led by Aaron Ring and others,
29:19characterized ILT L,
29:2018,
29:21which enhances you know antitumor immunity.
29:24What Aaron and others discovered
29:26was that the problem was IL 18
29:30binding protein which essentially
29:32nullified the ability of D R18
29:35to stimulate an immune response.
29:37But Aaron ultimately engineered
29:39a decoy resistant ILT nor D R18,
29:42which dramatically improves survival
29:44in mouse models, and ultimately,
29:47I think is now providing a very
29:51promising IO IO therapy that is now.
29:54Planned for an intended clinical
29:57trial through a startup that
29:59Aaron and others have law.
30:02At the same time,
30:04a team led by Akiko Osaki, Nana Pile,
30:07and others have been focusing
30:09on the innate immune system,
30:12leveraging nucleic acid sensing
30:14pathways where they have shown
30:16that rig one agonist can documents
30:19significant antitumor efficacy.
30:21Anna robust response in terms of T
30:24cell and NK cell infusion the tumors,
30:27suggesting that you can
30:29leverage Nate immunity.
30:31In a way to further advance immuno
30:34oncology and both of these as I mentioned
30:37or now startups that will further
30:39move Yale science into the clinic.
30:42For a number of years,
30:44we've been working hard to expand
30:46our cadre of physician scientists
30:48who really do bridge the basic
30:51and clinical individuals who not
30:54only are outstanding physicians,
30:56but outstanding scientists who
30:57each would merit appointments in
30:59a basic scientific Department.
31:01We were very fortunate last year
31:04to recruit Marcus Musician,
31:06really an international leader,
31:07physician scientists,
31:08B cell biologists,
31:10cancer biologists,
31:11immunologists to lead being Orgel director.
31:13Of the Center for Molecular and
31:16Cellular Oncology to be housed
31:18at 300 George Street and Marcus.
31:20Since historic beyond the great
31:22recruitments we've done in this
31:24space before Marcus is arrival,
31:26Marcus is now bringing in a
31:28number of outstanding recruits,
31:30really exceptional people, and looking.
31:32We're looking forward to that
31:34program continuing to grow.
31:36We look at other ways to advance
31:39innovation in terms of new cores.
31:41Are functional genomics core,
31:42which I think is going to be a
31:45powerful tool for all of us in terms
31:47of crisper and related technologies.
31:49Marcus,
31:50Bosenberg and others have launched
31:52the Precision Modeling Cancer
31:53modeling core to really use novel in
31:55vivo models to test our protheses,
31:57we continue to invest in metabolism,
31:59metabolomics and obviously rely
32:01increasingly on a growing number
32:02of collaborations with industry,
32:04which I think is a really powerful tool.
32:07To expand our reach.
32:10I've mentioned before that beyond
32:12our extraordinary success as an R1
32:14funded shop with very talented individuals,
32:17we need to expand our team
32:19science where we need more.
32:22P grants you grants.
32:23We invited.
32:24Ned Sharpless,
32:25the NCI director,
32:26to do a town Hall with us last fall,
32:30and we asked,
32:31Ned, you know,
32:33what is the take of the NCI
32:36on program project grants?
32:38And Ned admitted that the reputation?
32:40Was that the NCI was not
32:42supportive of these grants,
32:44but he he disabused us of that notion.
32:47Said in fact they are looking to expand
32:50program project grants and so we've launched.
32:53As you know,
32:54the team Science awards the Team
32:56Challenge Awards to build new teams
32:58focused on a research a pivotal research
33:00priority beyond providing funding
33:02with Don Wynn and Gary Hunnicutt,
33:04we want to provide the expertise
33:07and staffing to help these teams.
33:09These teams totally work
33:11to a tangible outcome.
33:12Of a successful P grant you Grant last year,
33:16we funded five teams focused on
33:18these five very important domains.
33:20Shortly we will be announcing a series
33:23of foreign war new grants that we
33:25are in the process of supporting,
33:28and I think this will continue
33:30to advance our efforts to expand
33:33the important element of team
33:35science in our Cancer Center.
33:37One team that isn't necessary part
33:40of the current funding portfolio,
33:42it's doing great work focused on
33:44this sort of extremely challenging
33:46disease of pancreatic cancer.
33:48Mandar Muzumdar Luis Escobar.
33:50Hoyo Spam Koons in her role as
33:53the new GI leader and many others
33:55are now pulling together a group
33:58focused on pancreatic cancer.
34:00The group,
34:00in a recent cell publication developed
34:03a novel mouse model of obesity,
34:05which drives pancreatic cancer development.
34:07In these care ask mutated mass who are also.
34:11Mutated or developing mutation to
34:14increase caloric intake with the
34:18development of profound development of.
34:21Pancreatic cancers in these
34:23rats mutated bottles.
34:24They also discovered that
34:26with caloric restriction,
34:27the tumor burden is dramatically reduced,
34:29suggesting the importance of of
34:31calorie restriction at the same time,
34:34Mandar and his team have shown that it is the
34:37expression of colas assignment cholecyst,
34:40a kind, and in response to obesity
34:42that seems to be driving.
34:44This are really important area
34:46of not only of understanding
34:48pancreatic cancer biology,
34:49but understanding how will be.
34:51Listening drives tumorigenesis
34:53Louisa and her work in her lab
34:57have identified that a P53 hotspot
35:00mutation drive splicing events in
35:03RNA binding proteins such that it
35:06actually maximizes TERAS activation.
35:08Suggesting that efforts looking at
35:10RNA splicing in these tumors may
35:13actually fundamentally improve the
35:15therapeutic landscape of pancreatic cancer.
35:17Two really important efforts,
35:19and it's really with great pride that
35:22we recognize that both Mandar and
35:24Louisa were just recently awarded.
35:26Damon Runyon innovator awards.
35:28The other aspect of this is that
35:31on the obesity side,
35:32it really reflects the work that
35:35Melinda Irwin and our teams and
35:37population science are doing.
35:39With the obesity working Group,
35:41bringing together individuals really
35:43across various research domains to
35:45look at this fundamental problem in
35:48cancer biology and cancer prevention.
35:50We're obviously keyed in on the
35:52importance of education on supporting our
35:55trainees and junior faculty and staff.
35:58We have an expanded number of T32
36:00grants training grants that hairy
36:02cougar David Stern and others
36:04have been moving forward,
36:06including a new T32 and him on
36:08a T32 in cancer prevention that
36:11Melinda Irwin launched.
36:13We're so proud of the work that
36:15offered Lee is doing as our new heme
36:19ONC Fellowship director, succeeding.
36:20Joe Lacey and her great work,
36:23and we're continuing to advance
36:25and expand those efforts with new
36:27gifts to support training programs
36:29beyond the work that the De Luca
36:32Foundation is providing are nursing
36:34and other services to expand
36:36education in those domains.
36:39Prior to the pandemic,
36:40we recognize the importance of
36:42community outreach that is ensuring
36:44HealthEquity across the domain that
36:46we care for the regions are catchment
36:49area across Connecticut and beyond,
36:51and we were very fortunate to recruit
36:53Marcella Nunez Smith to be our
36:56inaugural director for the Center for
36:58Community Engagement and HealthEquity,
37:00as well as our Chief Health
37:02HealthEquity Officer for Smilow
37:04Cancer hospitals.
37:05Marcel, as you know,
37:06has had an extraordinary
37:08history in this space.
37:10Being equity HealthEquity Research,
37:11Ann is doing an extraordinary
37:13job as our inaugural edaran.
37:15Simultaneously as you all know,
37:17Marcela is splitting her time 50%
37:19with us in the Cancer Center and 50%
37:22as the leader for the White House
37:24Task Force and HealthEquity and I
37:26think in terms of our ability to
37:29not impact not only impact the care
37:31of patients in our Cancer Center,
37:33but to impact policy nationally and globally.
37:36This is truly powerful,
37:37and we're so proud of the work
37:40and grateful for the work.
37:42That Marcella is doing that Marcella
37:45and the team are really doing really
37:48advancing this cause dramatically a
37:51number of individuals as you see here,
37:54focused on informatics,
37:56community engagement,
37:57screening, prevention,
37:58clinical trial participation.
38:00To really have the full spectrum
38:03of what we need to do in community
38:06engagement at the same time,
38:07we're making sure that every disease
38:10center in every research program has
38:12a representative so that we really
38:14are always thinking about our advances
38:17in community engagement and and outreach.
38:19We also recognize
38:20particularly this past year,
38:22the importance of diversity,
38:23equity and inclusion,
38:25and I want to thank hairy Cougar,
38:27Kevin Billingsley and Aaron
38:29Lattimore for their work,
38:30which started before the pandemic on
38:33the diversity and Inclusion Task Force.
38:35They identified very appropriately the
38:37need for a new associate can center
38:40director for diversity equity inclusion,
38:42and I'm very optimistic that in
38:44the coming days, if not weeks,
38:46we will be announcing our in Oracle director.
38:49And the launch of this expanded program
38:52to build in greater diversity equity
38:55inclusion across our entire workforce.
38:58Beyond everything else,
38:59it's important that we do this in a
39:02way that is financially sustainable,
39:04and I think this has been a
39:07challenging year with finances,
39:08but we have continued to invest in our
39:11programs beyond pursuing new grants,
39:13doing our best to monitor our our efforts.
39:16We have to always think about
39:18how do we expand philanthropy.
39:20And we've had a number of successes here,
39:23most notably the DeLuca gift,
39:25Liz De Luca, and the De Luca Foundation.
39:29Launching the Delucas Center for Innovation,
39:31Haematological research.
39:32Stephanie Allyne,
39:33who was recently appointed as
39:35our Chief of Hematology and Art
39:37Director for the Center,
39:38is working with our all of our
39:40investigators to advance innovation
39:42through the support of the center
39:44to expand the reach of people
39:46working in this space,
39:48to support trainees and junior faculty
39:50with the number of training grants
39:52and to build an infrastructure to how
39:54we collect samples in this space.
39:57And Moreover, how do we innovate in terms of.
40:00Sam And molecular annotation.
40:03I'm pleased to announce a very recent gift,
40:06which is Louis Shanavia or the
40:08chair of our Cancer Center Advisory
40:10Board and his family.
40:12Louis and Debbie have recently enabled
40:14the chandelier family Brain Tumor Center.
40:16Given Louise longstanding commitment to
40:18our Cancer Center are really exciting
40:20program that will innovate in clinical care,
40:22scientific research, clinical trials,
40:24and new therapies for it really
40:26important area, namely brain tumors.
40:28And these and other gifts as they
40:31come in is going to be critical
40:33for us to advance the mission.
40:36When we started 2020,
40:38just prior to the pandemic,
40:40you all know we were about to start
40:43our first enterprise wide Yale
40:46Smilow strategic plan that was sadly
40:49derailed because of the pandemic,
40:51but in fact we will pick it up and in
40:55the meantime our transformation efforts.
40:59A lot of really important near term
41:02efforts to improve clinical care,
41:04research, education, outreach.
41:06And diversity, inclusion,
41:07and all of these things ongoing continuing,
41:10and to really making a difference.
41:13You know, so in some,
41:14I think that we've had an amazing year
41:17and we have so much to be proud of.
41:19Certainly opportunities and challenges ahead.
41:21This is what we know in a career
41:23in Cancer Research and cancer care,
41:25but one that we're always ready to meet.
41:28Our clinical enterprise continues
41:30to grow despite the pandemic an
41:32we're launching a new disease center
41:34model that will enable even greater
41:37opportunities or research funding,
41:38hit a new record.
41:40Our publications are at the highest
41:42they've been in terms of high profile
41:44journals where it continuing to redouble
41:47our investment in team science.
41:49Four FDA approvals again,
41:51unprecedented a number of new centers
41:54that I think are really going to
41:56enable great work and more to come,
41:58and ultimately, paradigm shifting.
42:00Practice changing and policy influencing
42:03accomplishments across the entire continuum,
42:05and this again an extraordinary year 2020.
42:08How did we get here?
42:10Well, as I said,
42:12we got here because of the people.
42:15And I can tell you I am just so proud
42:18of everything that everyone has done here.
42:21It has been my profound privilege
42:23to be part of this community.
42:26I'm I'm so grateful for what you've
42:28done and what you continue to do
42:31and whether I'm here or elsewhere.
42:33I will always feel a part of this community.
42:36It will always be part of my heart
42:39and and I'm just thank you for
42:42for all of this and more,
42:44let me stop here and.
42:47And open it up to any questions.
43:01So I see one question, which is,
43:03what are the metrics that need to
43:06be met in order to bring covid units
43:08back to their original occasions.
43:11So I, Kathleen, I think that's
43:13a really good question. Namely,
43:15you know we are optimistic that we will.
43:18We've gotten back to most of our floors,
43:21although we still need to regain.
43:23NP1 and NP15, and I think, as we see,
43:27light at the end of this tunnel,
43:29with the vaccine and other things,
43:31I think we can anticipate as this
43:34year goes on to get that space back.
43:37There obviously, still using the 15th floor,
43:39but we are committed to getting our
43:42space back and at the same time,
43:44using this as an opportunity to.
43:47Figure out how we can do it better,
43:50but we appreciate Kathleen you and
43:52everyone in your team doing to enable
43:54our ability to provide all this care
43:56in the midst of this challenge.
44:00You know one other aspect.
44:02I well you know in case others have questions
44:04that I want to mention is, you know.
44:06You know, and I know how
44:09exceptional this Cancer Center is,
44:11and we want the world to know Renee Gaudet,
44:14who is our director, me communications
44:17and her team are always doing a really
44:20extraordinary job getting that message out.
44:23In the coming weeks again, there will be
44:26a poll for US news and World reports.
44:29Anobii it really don't want that
44:31publication to be the arbiter of
44:34what is a great Cancer Center.
44:36It is what patients and families look at,
44:39and so you'll probably be seeing
44:42in the next week or two or three.
44:46For those people eligible to vote
44:48is to log on to doximity and vote.
44:52Please do so.
44:53Because let me tell you,
44:55there's things we have to workout in
44:57terms of the mechanics of our ranking.
45:00But if we are ranked just on reputation
45:02score, where in the 25th of cancer
45:05centers we need to maintain that?
45:07To do that, we need people to vote.
45:10So when you get that email,
45:12look for it.
45:13It looks like our voting could be
45:15more robust in terms of internal
45:17people eligible to vote.
45:19So please look for that email
45:21and please vote.
45:27Well, it looks like we're we're.
45:30I don't see any more questions.
45:33I just want to again.
45:35It's will give people back
45:3710 minutes before I close.
45:39I just want to say.
45:43You guys are amazing.
45:44This is a phenomenal Cancer Center.
45:47I'm really thankful for what you do.
45:51Be aware how special this place is
45:54and how unique and successful you are
45:58an keep up this great work because.
46:02I'm looking forward to seeing great
46:03things at the Yale Cancer Center and
46:06Smilow Cancer Hospital in the years ahead.
46:08I do want to thank need Ahuja for her
46:11stepping in to be interim director and
46:13I want to thank Rick Edelson who will
46:16be leading the search for the new director.
46:18I know Rick is committed to engaging with
46:21people to hear what your perspectives
46:23are and to keep that search transparent,
46:25and I'm sure we'll get
46:27a great person as well.
46:28I want to thank Nida who is committed to
46:31engaging with all of you and keeping.
46:34Forward this great trajectory.
46:35So in some thank you all and
46:38I please don't be a stranger.
46:40Reach out to me and I look
46:42forward to seeing great things.
46:44Enjoy the rest of the day and
46:47thank you all for this great
46:49opportunity that you provided me.
46:52Take care.