PHLBI Annual Report 2019-2020

ANNUAL REPORT

2019 2020

2019 2020 ANNUAL REPORT CONTENTS THANK YOU

4

OUR TEAM

6

WHO WE ARE

8

SURVIVOR STORIES

18

OUR EVENTS

24

FINANCIALS

32

OUR SPONSORS

36

“I am so thankful I found Dr. Robert Cameron, head of the thoracic dept. at UCLA, who performed my surgery. He is an amazing doctor and surgeon with a heart of gold. I am also very appreciative for Lien Hua-Feng, Dr. Cameron’s nurse practitioner, who is always available to answer any questions and has given me great advice. Through them I met Clare Cameron, who always goes the extra mile and runs PHLBI, a non-profit organization. Clare works closely with Dr. Cameron and Lien to find a cure for cancer and mesothelioma. PHLBI also provides support for patients and caregivers by having monthly conference calls once a month, Lien and Christina McSherry facilitate the calls. I will always be grateful for Dr. Cameron and his amazing team! PHLBI is a fantastic non-profit organization that deserves more attention for all the great work and research they provide.”

3 2019 / 2020 ANNUAL REPORT

Deliver excellent research

education on treatment options

Support through patient & family outreach

Excellence in Research

re

Our dedication Our people are and integrity empowered, improves the skilled and way we work effective Our Culture is high performing and innovative n u

O

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Increase Stakeholder Satisfaction & Engagement

Or

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Expand Resources For Sustainable Funding

inancially Stron Be F g

Expand Patient & Family Outreach

th : G pport & education rese e n u a o s i rch s s i , M takeholder S & F oc nt us tie a Provide P

Be

ell Governed Be W

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es pi ra

Vi sio n:

Lung & Blood t r a He innovative ideas i Inst c itu nto ifi evelop effe c te cti ve Pa idly d enerate hope through

Be Responsible Stewards Of The Funds Received

a ti o n w We o pu ed w t q g We ua hin d per lity at the heart of evert ro u p f o e W e m We rm research of which we’r ers ities ak v a l ue oth un ea our relationships with omm m ea c our surabl e difference to

Our Values

PHLBI will continue to deliver excellence in research, provide education and support through our outreach programs, and be good stewards of the funds we receive.

Our vision mission, strategic aims and values are listed in this diagram.

THANK YOU

OUR TEAM

WHO WE ARE

SURVIVOR STORIES

As an organization, we measure our success through the impact of our work. The mission of The Pacific Heart, Lung & Blood Institute (PHLBI) is to generate hope through research, support and education. We remain committed to advancing medical research that may lead to new treatments for cancers of the chest; including mesothelioma, lung, thymus and esophageal. Over the past two years, our scientists have made great strides in developing research that could potentially lead to a higher success rate for immunotherapy treatments. In addition, we have provided guidance and support to patients through PHLBI’s unique programs: •

“First Mesothelioma Connection Program”

•

“Patient Support Group”, led by Nurse Practitioner: Lien Hua Feng, MSN, NP-C

Research accomplishments

OUR EVENTS

PHLBI remains unique as we operate our own dedicated research laboratory and International Tissue Bank. In addition to acquiring a patent for our mesenchymal stem cell research, PHLBI has submitted several government grant proposals on “Identification of Therapeutic and Diagnostic Targets by Analyzing B-Cell and T-Cell Receptors in Two Rare Cancers: Mesothelioma and Thymoma”.

This innovative research could lead to a higher success rate for immunotherapy treatments.

FINANCIALS

Each antibody therapy selectively targets a protein on a cancer cell; however, the challenge is that the protein disappears as the cancer stage advances. Therefore, it is crucial to identify proteins that are stable throughout all stages of cancer.

PHLBI’s novel research proposes a way to identify these stable proteins, which can then be used to develop new immunotherapy antibodies.

Education, Research and Funding

OUR SPONSORS

In alignment with our mission, we continue to educate thousands about mesothelioma. The Institute also recognizes the importance of education, support and research. Collectively, they serve as catalysts for increasing awareness, quality of life and overall outcomes. Throughout the year we host a myriad of events for

5 2019/2020 ANNUAL REPORT

these very implicit reasons. Such events include: •

The Walk/Hike for Mesothelioma

•

The Greatest Escape Motorcycle Ride

•

The International Symposium on Malignant Pleural Mesothelioma

For the first time, PHLBI also hosted our inaugural “unMASKing the Cure for Cancer Gala” on November 21st, 2019. This was held at the UCLA Luskin Conference Center.

The Gala paid tribute to the work of PHLBI’s Scientific Advisor: Dr. Robert B. Cameron.

Celebrities such as Sir Anthony Hopkins, Sugar Ray Leonard and Ringo Starr painted masks for auctioning. The Gala proved successful, raising $220,000 for mesothelioma research.

The global pandemic in 2020 prevented us from holding the majority of our events. As a result, PHLBI hosted its first “Virtual Walk for Mesothelioma” in October 2020. The international event attracted attendees from the United Kingdom, Northern Ireland, Portugal, Austria and Japan. The Institute was very proud and grateful to have received two matching donations of $150,000 from two noteworthy families with close mesothelioma ties. As a result, our virtual walk raised over $527,000 for mesothelioma research.

In the early fall of 2020, the family of Joanne

Anderson (a mesothelioma warrior who sadly lost her battle to mesothelioma) generously donated $1 million for mesothelioma research at PHLBI. We are so very grateful to the family for their incredible, generous support and belief in us.

We could not have achieved such success without each and every one of you (our stakeholders, supporters and PHLBI/PMC family). For this, I am sincerely appreciative and grateful to you.

Thank you for helping us advance our mission, while also making an impact in the lives of mesothelioma patients. There is still much work to be done. With your continued support, PHLBI remains committed to our innovative research, support and education. Bottom line, we are committed to you. Thank you for remaining part of our PHLBI family.

With gratitude,

Joseph Garland, MBA, FACHE PHLBI Chair, Board of Directors Board Certified Healthcare Executive

THANK YOU

BOARD OF DIRECTORS OUR TEAM

Joseph Garland, MBA, FACHE – Board Chair

Managing Partner and CEO of Centennial Harvest Group

Andre Perry, JD/MBA – Treasurer RCA Consulting

Michael Arlen, JD – Secretary Entrepreneur

WHO WE ARE

Douglas Gamble – Director

International Vice President of the Western States Conference Heat and Frost Insulators and Allied Workers

Matthew Kerbel, MBA – Director

SURVIVOR STORIES

MusclePharm

Rhonda Mayes, PhD – Director

Lisa Perry, MBA – Director Chief Marketing Officer Captivating Solution

Radha A. Savitala, Esq – Director Savitala Law

Brian Yeh, MBA – Director Strategy & LLC

Nationally Recognized Board Certified Professional Counselor

PATENT/GRANTS ADVISOR COMMITTEE OUR EVENTS

Walid Sabbagh, PhD Grant/Patent Advisor

PHLBI STAFF Dr. Robert B. Cameron, M.D. Scientific Advisor

FINANCIALS

OUR SPONSORS

Clare Cameron Executive Director

Lien Hua-Feng, RN, MSN, FNP-C Nurse Practitioner

Masahide Tone, Ph.D. Research Scientist

Christina McSherry Marketing & PR

Yukiko Tone, Ph.D. Research Scientist

Victoria Adams Consultant

Our staff functions in multiple capacities to maximize the use of our human and fiscal resources for administration, research and consumer health education.

7 2019/2020 ANNUAL REPORT

SCIENTIFIC ADVISORY BOARD HEART Peyman Benharash, M.D. UCLA

LUNG Robert B. Cameron, M.D. Cardiothoracic Surgery and Surgical Oncology Professor, David Geffen School of Medicine at UCLA Director, Comprehensive Mesothelioma Program & Chief of Thoracic Surgery, VA West Los Angeles Medical Center Diana Gage, M.D., Ph.D. Director, Stereotactic Radiosurgery Program Director, Radiation Oncology Wellness Program Department of Radiation Oncology, VA Greater Los Angeles Health Care System Dr. Jim teWaterNaude MBChB, MPhil (MCH), FCPHM Cape Town, South Africa Sherven Sharma, Ph.D. David Geffen School of Medicine at UCLA and VA West Los Angeles Medical Center Robert M. Strieter, M.D., FCCP, MACP Global Translational Medicine Head for Respiratory, Novartis Institutes for BioMedical Research, Inc.

Anne S. Tsao, M.D. Associate Professor, Director, Mesothelioma Program Director, Thoracic Chemo-Radiation Program University of Texas M.D. Anderson Cancer Center Olga M. Olevsky, M.D. Assistant Clinical Professor, David Geffen School of Medicine at UCLA

BLOOD Gary L. Schiller, M.D. Professor of Medicine, David Geffen School of Medicine at UCLA

THANK YOU

OUR TEAM

WHO WE ARE

SURVIVOR STORIES

WHO WE ARE ABOUT US Established in 2002, the Pacific Heart, Lung & Blood Institute (PHLBI) is a 501 (c)(3) non-profit, research institution that is committed to advancing medical research that may lead to new treatments, early detection and prevention programs for chronic disorders— including diseases of the heart, lung and blood.

Modeled on the National Heart, Lung & Blood Institutes of the NIH, PHLBI is divided into divisions and centers: • Pacific Heart • Pacific Lung • Pacific Mesothelioma Center • Pacific Thymus Center • Pacific Blood

OUR EVENTS

One of the divisions of the PHLBI is the Pacific Mesothelioma Center (PMC) whose focus is on finding better treatments for malignant pleural mesothelioma, an asbestos-related cancer affecting the lining of the chest the pleura.

PHLBI’S MISSION

FINANCIALS

Generate hope through research, support and education.

PHLBI’S VISION Rapidly develop innovative ideas into effective treatments.

OUR SPONSORS

9 2019 / 2020 ANNUAL REPORT

PA C I F I C H E A R T

PA C I F I C L U N G Pacific Mesothelioma Center • Pacific Thymus Center •

DIFFERENTIATORS What makes the Pacific Mesothelioma Center at The Pacific Heart Lung & Blood Institute different?

PA C I F I C B L O O D

reviews from the people that we serve, our volunteers and our donors. www.toprated.greatnonprofits.org

• We are the only nonprofit research institute that deals with cancers of the chest and that does in-house research (intramural).

• We have our own in-house labs – The Punch lab at UCLA and a newer lab on Santa Monica Boulevard.

• We have our own scientists.

• We have coordinated research.

• We have an in-house research portfolio.

• We are associated with a major university - UCLA.

GREAT NONPROFITS TOP-RATED AWARDS In 2019, PHLBI was recognized with the prestigious Great Nonprofits Top-Rated Award, a “people’s choice” award that is earned based on

GUIDESTAR EXCHANGE GOLD LEVEL In order to earn GuideStar’s Gold level designation, PHLBI provides additional transparency to financial statements and operational details. The PHLBI believes that sharing governance, leadership and financial impact information is vital for donors to understand and support our mission. www.guidestar.org

THANK YOU

SCIENTIFIC ADVISOR SPOTLIGHT

OUR TEAM

WHO WE ARE

SURVIVOR STORIES

OUR EVENTS

FINANCIALS

OUR SPONSORS

Dr. Robert B. Cameron, MD FACS, is one of the leading experts in North America on the treatment of pleural mesothelioma.

He has been treating mesothelioma patients for over 35 years and is an early innovator of the lung-sparing pleurectomy decortication surgical procedure for mesothelioma. He has authored or co-authored over 40 papers on oncology, thoracic surgery, and other topics. Dr. Cameron attended medical school at UCLA, where he obtained his medical degree. He completed three years of training as a clinical associate in surgical oncology at the National Cancer Institutes of Health in Bethesda, Maryland, a five-year residency in general surgery at UCLA, and a two-year fellowship in cardiothoracic surgery at Cornell-New York Hospital and Memorial Sloan-Kettering Cancer Center in New York City.

RESEARCHER SPOTLIGHT Masahide “Masa” Tone, PhD is the Director of Research at The Pacific Heart, Lung & Blood Institute. Masa has led research groups in molecular biology, immunology, immunotherapy, and cancer immunology at Hoechst (Japan), the Universities of Cambridge and Oxford (UK), the University of Pennsylvania, and Cedars Sinai Medical Center. His vast area of research expertise is in molecular and cellular immunology, CRISPR gene editing, gene regulation, antibody engineering, cytokines, macrophages, dendritic cells, T-cells and regulatory T-cells (Treg). In addition to his work as a researcher, Masahide has served as an associate editor for the Journal of Immunology and a review editor for Frontiers in Immunological Tolerance. Throughout his research career he has mentored many post-doctoral fellows, graduate and undergraduate students.

RESEARCHER SPOTLIGHT Yukiko “Yuki” Tone, PhD is the Senior Researcher at The Pacific, Heart, Lung & Blood Institute. Yuki is a molecular biologist whose skill set includes gene cloning, DNA/RNA/protein analysis, antibody engineering, BAC (Bacterial Artificial Chromosome) technology and CRISPR gene editing. After finishing her academic studies, Yukiko moved to Great Britain where she studied molecular mechanisms of the thyroid hormone receptor at the University of Cambridge. She then moved on to the University of Oxford where she worked on regulation of gene expression of cytokines. Later she worked at the University of Pennsylvania

11 2019/2020 ANNUAL REPORT

where she studied regulatory T-cell (Treg) mediated immune responses. After moving to Los Angeles, she worked as a project scientist where she continued her work studying Foxp3 gene expression in Treg.

She recently focused on gene regulation in cancer cells to overcome drug resistance and to reduce cancer cell survivability in tumor microenvironments.

RESEARCHER SPOTLIGHT Nurse Practitioner Lien Hua-Feng embodies PHLBI’s commitment to patient care and treatment in her work. Through our partnership with the Department of Veterans Affairs, Nurse Lien meets with veterans and their families to discuss clinical care options and treatment modalities. She is a vital resource to thousands of people, from all walks of life and all parts of the country, answering questions on available treatment and support.

Because mesothelioma is rare, there are very few experienced medical staff like Nurse Lien, and patient care resources are limited. PHLBI is working to expand our dedicated staff but we cannot do this without more sources of funding. Hiring experienced and dedicated nurses like Nurse Lien is something we are working towards!

RESEARCH UPDATE In developing our therapeutic strategies for mesothelioma and thymoma cancers, we are focusing on the immune responses in these isolated tumors at PHLBI. The immune system is not only an important defense system against foreign invaders including bacteria and viruses, but it also protects us from our own mutated cells even cancer cells. Our analysis of immune cell populations in mesothelioma and lung cancer tumors shows that immune cells, as expected, are activated and expanded to fight cancer cells in these tumors.

Thus, these cancer cells are evading the anti-tumor immunity by using the immunosuppressive cells/mechanisms by inactivating these immune cells.

in mesothelioma patients. In fact, Treg deficient patients (IPEX patients) induce aggressive autoimmune diseases and die from serious cases. For example, immunosuppressive immunity, including Treg is necessary to block over activation of immune responses and prevent development of autoimmune diseases. Our immune system attacks foreign invaders, such as COVID-19 virus, by activating immune cells and inducing inflammation in tissues, including lung tissues.

Typically, inflammation is reduced by Treg and other immunosuppressive mechanisms. However, if this immunosuppression fails, over activated immune responses induce severe inflammation and dysfunction of organs leading potentially to death.

To this end, our analysis suggests that an immunosuppressive regulatory T cells (Treg) strongly contributes to mesothelioma cancer development.

In healthy individuals, Treg plays an important role in preventing development of autoimmune diseases, but it also helps cancer development

These important immunosuppressive mechanisms that prevent auto immune dysfunction also aid in the ability of cancer cells survival by inhibiting the anti-tumor activity. However, this suggests that we can kill cancer cells by re-activating anti-tumor immunity through blocking these

THANK YOU

OUR TEAM

WHO WE ARE

SURVIVOR STORIES

OUR EVENTS

immunosuppressive mechanisms. A recently highlighted PD-1/PD-L1 therapy for mesothelioma has gained much attention, but our preliminary data of PD-1/ PD-L1 therapies show that they are also ineffective due to low expression levels of PD-L1 in almost all mesothelioma patients tested. Thus, we still need additional new therapeutic strategies for mesothelioma patients and targeting Treg may be another more effective strategy for these mesothelioma patients. As we have previously suggested, inducing GITR signaling may be a potential therapeutic strategy since the development and function of Treg are inhibited by the GITR signaling.

In order to develop effective additional strategies, including antibody-based therapeutics for mesothelioma and thymoma patients, we will continue our analysis of tumors from our International Tissue Bank in order to identify anti-tumor antigens. Recent vaccine technologies, including RNA and DNA vaccines, have been dramatically improved as evidenced against the battle with COVID-19 virus.

More importantly, these new vaccine technologies can also be applied to develop cancer vaccines for mesothelioma and thymoma. Thus, if we can identify these cancer specific antigens, we can then generate new RNA and/or DNA vaccines for these cancers as well. Even CAR-T immunotherapy also requires stable antibodies against tumor specific antigens. Therefore, while developing better mesothelioma and thymoma therapies, with these recently developed technologies, we will also be addressing a significant and unmet need of better antigen selection for the cancer immunotherapy field.

Even though the road is difficult, we are committed to accomplishing our mission, and we will continue to strive in our effort to advance rare cancer research, publish our new findings, and submit grants to the NIH, DOD and foundations to secure funding with our new findings.

FINANCIALS

OUR SPONSORS

“The entire staff at the Pacific Heart Lung &Blood Institute is caring and dedicated. They are like family. I am so grateful to be in their wonderful care. They go above and beyond and they care about every patient. They have all contributed tremendously to the fact that I am thriving. Being diagnosed with mesothelioma is challenging but they are my angels. I will forever be grateful to Dr. Cameron and the entire team.”

13 2019 / 2020 ANNUAL REPORT

A Selfreactive cells

B

Immunosuppressive cells (including Treg) /mechanisms Cancer cells

Bacteria Virus

Block

Autoimmune diseases

Kill

Block

over activation of Immune -responses

Immune responses

C targeting immunosuppressive cells/mechanisms

Block

Immunosuppressive cells/mechanisms

Cancer cells

Kill Immune responses

Cancer

Enhance cells

Block

Anti-tumor immunity

Immune responses

D Immunotherapy

Immunosuppressive cells (including Treg) /mechanisms

Immunotherapy

targeting cancer specific antigen

Immunosuppressive cells (including Treg) /mechanisms Enhance

Kill

Cancer cells Cancer

specific antigen

Block

Anti-tumor immunity

Immune responses Fig. 1. Immune regulations and potential Immunotherapeutic strategies. A. In healthy individuals, immune responses kill cancer cells and foreign invaders including bacteria and virus, and immunosuppressive cells/mechanisms including Treg prevent over activation of immune responses and development of autoimmune disease. B. Cancer cells evade the anti-tumor immunity by enhancing immunosuppressive mechanisms (e.g. by producing TGF-b). C. Immunotherapeutic strategy by targeting immunosuppressive cells/mechanisms. D. Antibody-based Immunotherapeutic strategy.

Cancer specific antigens will be identified and antibodies against these antigens will be generated. These antibodies may directly be used for cancer therapy (or used to generate CAR-T cells).

THANK YOU

OUR TEAM

WHO WE ARE

SURVIVOR STORIES

OUR EVENTS

FINANCIALS

OUR SPONSORS

STUDENT INTERNSHIP PHLBI provides undergraduate student interns from UCLA early career training and mentorship in medical research. Our interns are given hands-on educational opportunities that are difficult to obtain at their host universities as undergraduate students. University research labs are often constrained by limited budgets, where resources are typically prioritized for post-doctoral fellows and graduate students pursuing advanced degrees. At PHLBI, our interns have the unique opportunity to gain real-world experience and fill meaningful roles in medical research at a young age. In return, PHLBI’s core mission of conducting cancer immunotherapy research benefits from their involvement.

Notably, two of PHLBI’s interns were selected to participate in UCLA’s Student Research Day. Grace Lee and Michelle Nguyen presented their individual research projects on May 21st, 2019 at the Pauley Pavilion. Michelle spoke to individuals about “Immunological Environments of Mesothelioma and Lung Cancer Tumors’’ and Grace about “The Perioperative Surgical Microenvironment of Mesothelioma Patients: Analysis of Chest Tube Drainage Cytokine Levels’’ .

15 2019 / 2020 ANNUAL REPORT Perioperative Surgical Microenvironment of Mesothelioma Patients: Analysis of Chest Tube Drainage Cytokine Levels Grace Lee, Lien Hua-Feng, and Robert B. Cameron

David Geffen School of Medicine at UCLA; Pacific Heart, Lung & Blood Institute, Los Angeles, CA Introduction and Background

Results Fig. 3 (Right and Below) Tables display p-values for monotonic trend significance of each cytokine. Functional classes were adapted from Dinarello, Charles A. 2007. Historical Insights into Cytokines. European Journal of Immunology. 37(1):S34-S35

Stress Response

Surgical removal of tumor

Functional Cytokine Class General IL-1RA Antiinflammatory IFN-A2 IL13 IL-10

Pro-Inflammatory Response and/or Anti-Metastatic Functional Class

Cytokine P-Value

IL-1α General Pro-inflammatory

Angiogenic cytokines

0.09

IL-12 P70 0.61 1

IL-18 GRO-α MIP-1α MIP-1β

0.04 0.72

Clinical studies in MPM and other cancer patients undergoing major resection studies, however, such as that done by Gregoire (2009), suggests that MPM immunotherapies hold major potential for improving the natural immune response against new growth post-surgery. In Gregoire’s study, applying tumor-infiltrating lymphocytes in MPM patients in particular, was associated with an increased ability of the patient to fight off tumors.

IL-2

0.09

IL-4 IL-7

However, to further optimize immunotherapies in conjunction with resection surgeries, a better understanding of the cytokines implied in the stress response post-surgery is necessary. Recent immunological studies such as those by Chen (2017) show that certain cytokines are elevated post resection surgery such as transforming growth factor beta (TGF-B) and may be used as a possible biomarker of decreased survival in certain cancers post surgery. While studies have looked at particular cytokines as biomarkers for certain cancers, the present research focuses on a myriad of cytokines in attempt to isolate significant trends and reveal possible causal relationships between new growths post surgery and elevated cytokine levels.

0.22 0.46

IL-15 IL-17A

0.81 0.22

Th1 cytokines Th2 cytokines

IFN- γ IL-5

0.81 0.22

Hematopoietic progenitor activator

Flt3L

0.22

Lymphocyte growth factors

• Drainage fluid from standard chest tube drainages was collected 2, 4, 6, 8 and 10 days post operation from mesothelioma resection patients and patients who underwent cardiothoracic surgery.

Sample Analysis

• Cytokine levels were assessed using a biomarker assay via 42-plex array for 42 different known human cytokine and chemokines.

Statistical Analysis

Fig. 2. Standard chest tube drainage collection set-up

• Median cytokine levels in drainage collections across data collection time points were used for preliminary analysis and data summary.

• Monotonic trends in individual cytokine levels were tested for using the Mann-Kendall trend test package in R. • Differences in cytokine levels of pleural chest tube drainages two and ten days post surgery were compared in Mesothelioma resection surgery patients to those of patients who underwent a cardiothoracic non-pleural surgery were analyzed via the Wilcoxon rank sum test..

IL-8

1 0.81

2000 1500 1000 500 0

1

2

2

3

4

5

4 6 8 Days Post Operation

10

Other Related Function

Eosinophil attractant Cell Growth Activator

Cytokine

PValue 0.46

Legend

1 0.03 0.27

MDC Eotaxin

0.46 0.09

EGF

0.03

TGF-α IL-3

0.03 0.09

Mitogen

0.09

PDGF-AA PDGF-BB

0.09 1

VEGFA

TNF-α

MIP-1A

TGF-α

IL-18

EGF

Trend

Levels

Increasing Increases and/or peaks from 10-14 days Stable

Multifunctional Fractalkine 0.81 anti-apoptotic

Methods Sample Collection

0.61 1 0.73

Chemokine (cell MCP-1 activating) MCP-3 MIP-1A Rantes

0.09

Platelet activator sCD40L

2500

0.09

0.03

Functional Class

TNF- β

Fig. 1 (Above) Surgical resections may contribute to post-operative metastatic growths via stress response and accompanying immunosuppression.

P-Value

VEGF-A

Mesenchymal FGF2 Growth Factors

IL-1β 0.09 TNF-α 0.03 IL-12 P40 0.81

Local and systemic cytokine interactions leading to regrowth

Significant Upward Trends in Cytokine Levels of Mesothelioma Patient Pleural Drainages for 10 Days Post-Resection Surgery

Anti-Inflammatory and/or Pro-Metastatic

Amount (picograms/milliliter)

Multimodal strategies for cancer treatment combine surgery with chemotherapy and radiation to improve patient prognosis. However, recent studies have shown surgery to be a double edged sword when used as a cancer treatment modality.

Surgical trauma may induce local and even systemic inflammatory responses, which may contribute to future metastatic growths. This trade off between removing large amounts of cancerous tissue via surgery and resultant immunosuppression in the tumor neogenesis site is particularly important to consider in the case of cancers that require large surgical removals. For instance, in the case of malignant pleural mesothelioma (MPM) multimodal treatment courses, the goal of primary surgery is often to obtain a macroscopic complete resection (MCR). Even more strikingly, studies within the last year have shown that MCR procedures are not associated with improved survival of MPM patients.

Fig. 4 (Above) Graph displays upward trends for cytokines which had significant monotonic trends according to the MannKendall test.

Cytokines/Chemokines GRO-a/CXCL1, IL-1RA, MCP-3/CCL7, G-CSF, MIP1b/CCL4, MIP1-a/CCL3, MDC, IL18, IL10, IL-1b, Eotaxin-1, Flt-3, IL-5, TGF, IL-12p40, IFN-a, IL-4, IL9, IL-13, IL-2, IL-12p70 IL-8/CXCL8, IL-6, MCP-1/CCL2, VEGF-A, IL-1a, TNFa, FGF, GM-CSF, IL-17a, Fractalkine, IFN-g, IL-7, IL-3

Decreasing Decreases to IP-10/CXCL10, RANTES, PDGF-AA, PDGF-AB/BB, less than half sCD40L, EGF, TNF-b, IL-15 Fig. 5 (Above) Chart of general observed cytokine trends comparing the levels from the beginning to end of the sample collection period.

Discussion & Future Directions Creating a baseline control for our statistical tests proved difficult as drainage collection began only after chest tubes were inserted during resection surgeries. However, for our next step in analysis, we attempt to establish a control by analyzing the significance of cytokine levels two and ten days post surgery by comparing Mesothelioma resection surgery patients with patients who underwent a cardiothoracic non-pleural surgery via the non-parametric Wilcoxon rank sum test.

Future goals include both statistical tests on current data comparing cytokine levels and differential cancer types. In order to better gauge the significance of cytokine interactions in post-operative resection sites, tests comparing the significance of pro-inflammatory and anti-inflammatory cytokines will be run. By comparing trends in these different types of cytokines, future findings may build on our results and help find new biomarkers or targets for immunotherapies to be used as adjuvants in resection surgeries. Furthermore, comparisons of post-resection drainages across different cancer types may help reveal hypotheses about the cytokine interactions in less invasive resection surgeries.

Furthermore, after we establish significant immunological trends, we hope to deliver specific cytokines as resection surgery adjuvants to modulate the immune environment of surgery sites. Currently, one project we are working on is using genetically modified mesenchymal stem cells (MSCs) as a tumor homing vehicle for cytokines delivery.

Acknowledgements We would like to thank Yuki Tone, Masa Tone, Clare Cameron, Christina McSherry and Martha Martinez at the Pacific Heart, Lung & Blood Institute for their continued support of this project.

Immunological Environments of Mesothelioma and Lung Cancer Tumors Michelle Nguyen, Yukiko Tone, Lien Hua-Feng, Masahide Tone, Robert B. Cameron David Geffen School of Medicine at UCLA; Pacific Heart, Lung & Blood Institute, Los Angeles, CA Results

Objectives and Background

TIL and T cell populations: To understand the regulation of immune responses in mesothelioma and lung cancer, we first focused on T cell populations in tumors isolated from different stages of cancer patients. As shown in Fig. 1, tumor cells including TIL were analyzed by FACS. The dead cell population was identified by AnnexinV and 7AAD staining. In the live cell area in the SSC/FSC scatter, we identified P1 and P2 populations (Fig. 1). CD4+ and CD8+ T cells, B cells, NK cells were detected in P1, and macrophages, dendritic cells and cancer cells were detected in P2 (Fig. 1). However, we could not identify clear P1 populations in two lung cancer patients’ tumors and both CD4+ and CD8+ T cell populations in these tumors were very low. In these patients, T cells did not seem to properly proliferate, suggesting the absence of recognizable tumor antigens in these tumors. On the other hand, T cells were detected in the rest of the 30 tumors. This finding suggests that by analyzing T cell populations and their activation status in the 30 tumors, we can understand regulation of anti-tumor immune cell activity. Consequently, we analyzed percentage of CD4+ (helper) or CD8+ (cytotoxic) T cells in total tumor cells isolated from different stages of cancer patients (Fig. 2). In mesothelioma tumors, 6.1% to 9.0% of CD4+ and CD8+ T cells were detected in Stage1+2 and 3 tumors, but these populations declined at Stage4. However, in lung cancer, both CD4+ and CD8+ T cell populations increased from Stage1 to Stage 2+3. In other words, both T cell populations seem to have expanded during tumor progression in lung cancer. This T cell expansion between Stage1+2 and Stage3 was not detected in mesothelioma; T cell expansion in this cancer may have occurred at a much earlier stage of tumor progression. These findings suggest that T cells have been activated and have proliferated in these tumors. Next, we investigated whether these T cells function as effector or memory/exhausted T cells. T cells in tumor cells were further analyzed using an antibody against memory T cell marker CD45RO. Almost all of the CD4+ and CD8+ T cells (90.7% to 99.5%) in both tumors expressed CD45RO, indicating that these T cells have already reached memory and/or exhausted status. This suggests that these T cells cannot eliminate cancer cells in these tumors.

CD14 Dendritic Cells

CD19

CD56

B cell

CD3

CD11c

Fig. 1. Tumor infiltrating lymphocytes (TIL) in a mesothelioma tumor.

Dead cells were analyzed by FACS using anti-AnnexinV and 7AAD and indicated by red dots. TIL and cancer cell populations were analyzed by FACS within P1 (blue) and P2 (green) gates.

Stage 3

Mesothelioma

30 20 10

Lung Cancer

100

100

% of PD1+ T-cells

% of CD4+ or CD8+T-cells

% of CD4+ or CD8+T-cells

80

80

60

60 40

40 20

20

0

0

Stage 1

Stage 4

b.

Stage 2+3

20 10 0

*

Lung Cancer 60

*

50 40 30 20 10 0

b.

Mesothelioma 30 25 20 15 10 5 0

*

*

% of M2a and M2c Macrophages

30

*

% of M2a and M2c Macrophages

Mesothelioma 40

% of FOXP3+ Treg in CD4+ T cells

CD8 cd

NK cell

Mesothelin Macrophages

0

*

40

0

Stage 1+2

High

Stage 3

Stage 4

Low

Stage 1

Stage 2+3

Negative

PD-1 and PD-L1: We also assessed the potential of PD-1/PD-L1 immunotherapy in PD-L1 mesothelioma and lung cancers. To investigate this potential, we analyzed expression levels Mesothelioma 3 Mesothelioma 4 Mesothelioma 14 of PD1 on T cells and PD-L1 on cancer cells and antigen-presenting cells (APCs).

Lung Cancer 2 Lung Cancer 5 Lung Cancer 4 Approximately 80% of both CD4+ and CD8+ T cells expressed PD-1 receptors in tumors Fig. 3. Expression of PD-1 on CD4+ and CD8+ T cells and PD-L1 on cancer cells isolated from all mesothelioma and lung cancer patients tested (Fig. 3a). However, and APCs. a.

Percentage of PD-1+ cells in CD4+ (blue circle) and CD8+ (red circle) expression levels of its ligand, PD-L1, are low in these cancers. Certain levels of PD-L1 T cells were analyzed. Averages are indicated by black bars. b. PD-L1+ cells in 22 expression were detected in only five tumors (Fig. 3b, High). This suggests that PD-1/PD-L1 mesothelioma and 10 lung cancer tumors were classified based on expression levels therapy would not be effective for the other 27 patients due to their lack of PD-L1 ligand (PD(High, Low and Negative). Typical examples of PD-L1 expression levels are shown.

L1 low and negative).

Treg and M2 macrophage: Finally, we investigated suppression of anti-tumor immunity by the immunosuppressive lymphocytes, Treg and M2 macrophages. Usually, 5 to 10% of CD4+ T cells are FOXP3+ Treg. However, in Stage1+2 mesothelioma tumors, the percentage of FOXP3+ Treg cells was slightly higher than normal. Moreover, the Treg population significantly increased at Stage3, but did not change at Stage4 (Fig. 4a). Surprisingly, the Treg population in Stage1 lung cancer tumors was very high (about 50%), but then significantly decreased in Stage 2+3 tumors (Fig. 4a). These different patterns of Treg level fluctuation between mesothelioma and lung cancer may depend on the immunological environments of these two cancers (see background and discussion). The M2 macrophage population, another suppressive lymphocyte, also seems to be stage dependent (Fig. 4b).

In mesothelioma, M2 macrophage population at Stage1+2 was significantly increased at Stage3, but then decreased at Stage4. Similarly, this population at Stage1 was increased at Stage2+3 in lung cancer. These immunosuppressive lymphocytes perhaps differentiated or accumulated in a stage-dependent manner to inhibit anti-tumor immunity in these cancers.

% of FOXP3+ Treg in CD4+ T cells

SSC

Annexin V CD4

CD8+ T-cell

*

5

*

50

Fig. 2 CD4+ and CD8+ T cell populations in mesothelioma and lung cancer tumors isolated different stage cancer patients. Percentage of CD4+ (blue circle) and CD8+ (red circle) T cells in total tumor cells analyzed using tumor cells isolated from indicated cancer stage patients. Averages are indicated by black bars. * P<0.05

a.

P2 P1 FSC

CD4+ T-cell

15

Stage 1+2

Materials and Methods

7AAD

*

10

Lymphocytes and cancer cells were analyzed by FACS using antibodies against maker proteins CD3, CD4, CD8 PD-1 (T cells), CD19 (B cells), CD56 (natural killer cells), CD14 and CD163, (macrophages), CD11c (dendritic cells) and mesothelin, PD-L1 (cancer). Single cells were prepared from tumors (22 mesothelioma and 10 lung cancer) by digesting with DNase I and collagenase. Cells were first stained with anti-AnnexinV and 7AAD to identify the dead cell population. Then, live cell populations were gated and expression of the marker proteins were analyzed. We analyzed CD4+ and CD8+ T cells, PD-1+ T cells, Treg and M2 macrophage populations in tumors isolated from different cancer stage patients. We have more earlier stage tumors (Stage1: 4, Stage2: 3, and Stage3: 2) in lung cancer, and conversely more later stage tumors in mesothelioma (Stage1: 5, Stage2: 1, Stage3: 9, and Stage4: 7) presumably due to difficulties of diagnosis. Therefore, in this study, we compared different cell populations in Stage1+2, Stage3 and Stage4 in mesothelioma, and in Stage1, Stage2+3 in lung cancer.

Cancer

*

20

a.

Lung Cancer

Mesothelioma

25

% of PD1+ T-cells

Naturally, immune cells can recognize cancer cells as abnormal and can eliminate them. Indeed, we observed a diverse array of immune cells including dendritic cells, macrophages, natural killer (NK) cells, B-cells, and T-cells in tumors from a mesothelioma patient (Fig. 1).

However, some cancer cells are able to escape anti-tumor immunity, allowing them to survive and proliferate as malignant cancer. This project’s objectives are to understand how cancer cells are evading the immune system and to determine how we can re-activate and/or enhance anti-tumor immunity to develop Cancer Immunotherapy. In this project, we focused on mesothelioma, a rare, asbestos-related cancer, and lung cancer. Although both cancers develop in the chest area, their immunological environments seem to be distinct. Since lungs are constitutively exposed to microbes and carcinogens such as air pollution and smoke, immune cells are constantly responding to pathogens in this area. We will therefore compare tumor infiltrating lymphocyte (TIL) populations in these two cancers. First, to investigate anti-tumor immune responses, we analyzed T cell proliferations and their activation status. We also considered the potential of PD-1/PD-L1 immunotherapy to treat these cancers. PD-1 is an immunosuppressive receptor expressed on T cells, and T cell activity is inhibited by binding of its ligand PD-L1 on cancer cells. In this immunotherapy, PD-1 and PD-L1 interaction is blocked by antibodies against these molecules to maintain active T cells.

Therefore, this immunotherapy would only be effective for patients with PD-1 and PD-L1 positive tumors. Finally, we also focused on immunosuppressive lymphocytes, regulatory T cells (Treg) and M2 macrophages, in tumors. Normally, these lymphocytes play important roles in preventing development of autoimmune disease. However, cancer cells seem to escape anti-tumor immunity by using these cells’ immunosuppressive activity. We have therefore analyzed these cell populations by FACS using antibodies against FOXP3 (Treg) and CD163/CD14 (M2a and M2c macrophages) marker proteins.

Lung Cancer 30 25 20 15 10 5 0

FIG. 4. FOXP3+ Treg population and M2a/M2c Macrophage in mesothelioma and lung cancer tumors a.

Percentage of FOXP3+ T cells (Treg population) in CD4+ T cells were analyzed by FACS using tumor cells isolated from indicated cancer stage patients. b. Percentage of CD163+CD14+ macrophages (M2a and M2c macrophage populations) in P2 (cancer and APCs) were analyzed by FACS using tumor cells isolated indicated cancer stage patients. Averages are indicated by black bars. * P<0.05

Acknowledgements Special thanks to Clare Cameron, and Christina McSherry and Martha Martinez at the Pacific Heart, Lung & Blood Institute.

Discussion, Conclusion, and Future Directions Our data suggest that in 30 out of 32 (22 mesothelioma + 10 lung cancer) tumors, T cells responded to tumor antigens. However, almost all of the T cells had already reached memory/exhausted status. We also suggested that PD-1/PD-L1 immunotherapy would not be very effective for 27 of the patients. Alternative cancer immunotherapy strategies are needed for these patients. We also found that the Treg population is enriched in both tumors. However , the Treg population increased at later stages in mesothelioma but decreased in lung cancer.

Since lungs are always exposed to many pathogens, Treg differentiation may be enhanced under their immunostimulatory environment in early stage of tumors, but downmodulated by immunosuppressive molecules expressed in T cells and cancer cells in later stages. M2 macrophage population is increased at Stage3 (Stage2+3) in both tumors and then decreased at Stage4 in mesothelioma tumors. Activation of CD163+M2 macrophage (M2a and M2c) is regulated by IL-4, IL-13 and TGF-b.

Expression of these cytokines may be upregulated in Stage3 tumors.

Further experiments are required to understand Treg and M2 macrophage regulation in these tumors. In this study, we investigated immunological environments in mesothelioma and lung cancer tumors by analyzing FACS using antibodies against T cell and macrophage markers. We found that many T cells were exhausted in these tumors.

However, it is difficult to identify exhausted T cells by only FACS using TIL directly isolated from tumors. Therefore, we will perform functional assays using T cells from these tumors and PBMC. By analyzing activity of immune cells and expression of immunoregulatory molecules including cytokines in these tumors, we may be able to find strategies to re-activate anti-tumor immunity.

THANK YOU

OUR TEAM

WHO WE ARE

SURVIVOR STORIES INTERNATIONAL TISSUE BANK The PHLBI received Institutional Review Board (IRB) approval in 2016 for its international tissue bank.

OUR EVENTS

Diseases of the heart, lung and blood affect a large number of people in the U.S. and throughout the world each year. It is imperative that both personal health information and tissue samples are collected from as many patients as possible in order to understand: • The normal tissue biology • The natural history of the disease

FINANCIALS

• Outcomes from current treatments • The advantages and disadvantages of • potential future novel therapies PHLBI is soliciting tissue specimens and seeks study participants who wish to donate their tissue and personal health information for current and future research at the institute.

OUR SPONSORS

For further information on how you can get involved, please contact us at 310478-4678.

17 2019 / 2020 ANNUAL REPORT

SUPPORT GROUP PHLBI is proud to offer a support group for mesothelioma patients and their families. The support group meets monthly through a conference call run by PHLBI’s Nurse Lien. Patients have the ability to speak with other patients, asking each other questions, trading stories, and sharing difficulties with each other. In addition, Nurse Lien is available to answer any questions patients might have about their treatment or health.The support group serves as an invaluable resource for patients and is available to all mesothelioma warriors interested in joining.

THANK YOU

OUR TEAM

WHO WE ARE

SURVIVOR STORIES

Anna Schoefield MESO WARRIOR

SURVIVOR STORIES

OUR EVENTS

FINANCIALS

OUR SPONSORS

Anna Schofield grew up in idyllic Monterey, California close to one of her great loves in life, the ocean. Her deep desire to give back and make a difference led her to California Polytechnic Institute where she studied business. Realizing the greatest impact she could make would be in the classroom she embarked on a fulfilling career in teaching. Over the course of twenty five years Anna taught first through sixth grade. During that time she met her husband, Bryn, the ying to her yang.

Anna and Bryn enjoyed travelling together, going to plays, visiting museums, and attending concerts.

After twenty-two joyful years together Bryn passed away from liver cancer in 2017. That same year Anna went to see a doctor about a persistent recurrent respiratory infection. Her doctor ordered a CT scan and noticed a rapid growth in a lung nodule. She had the nodule biopsied and discovered that Anna had mesothelioma. Anna was immediately referred to Dr. Cameron who approved her for a pleurectomy decortication surgery. She had the surgery in October of 2017 and afterwards underwent radiation. In 2018 she entered a chemotherapy study with Dr. Olevsky at UCLA. After a year in the study the nodule started to grow again so she was put on immunotherapy in early 2020. Anna stopped treatment after developing a bad reaction. She is now discussing new possible treatment options with her doctors.

Anna brings positivity to every aspect of her life. She is an active member of PHLBI’s Patient Support Group and brings her upbeat, caring, and encouraging attitude to every meeting. An active, outdoor enthusiast Anna loves to hike and joined us for our annual Walk for Mesothelioma in 2019. She also keeps well informed about the latest mesothelioma treatments. Anna has attended PHLBI’s last two International Symposia on Malignant Pleural Mesothelioma. Her positivity puts everyone at ease around her and she loves to share her knowledge and insight with others.

19 2019 / 2020 ANNUAL REPORT

Joanne Anderson DONOR AND MESO WARRIOR

My grandmother Joanne Anderson still remains the most dedicated and hardworking woman that I have ever known. She was also an incredibly brave woman who unfortunately lost her battle to mesothelioma on March 22nd, 2019.

Joanne had many symptoms but due to being misdiagnosed, as she got into the later stages of this cancer, it made it difficult to get the treatment she should have had earlier on. The main cause of her cancer was her exposure to Johnson & Johnson’s baby powder that she used on her babies. She heard about PMC through her networking with several different foundations that supported and educated Meso patients and she called PHLBI to see if it was possible to donate her body to mesothelioma research. This led to her being introduced to patients through the First Mesothelioma Connection Program and creating important friendships, with those that understood her pain and suffering. One of those individuals was Tina Herford, a meso warrior, who developed a close relationship with the Anderson family and Tina’s “Team Pinky”,who later won the “Joanne Anderson Top Team Award” for the 9th annual Walk/Hike for Mesothelioma this past October.

In the early fall of 2020, my family generously donated $1 million to the Pacific Heart, Lung & Blood Institute’s research program. We believe

strongly in the work that their scientific advisor Dr. Robert B. Cameron is directing and we look forward to better treatments that will one day lead to a cure for this devastating disease.

To tell you a little about my grandmother, she was born in Phoenix, Arizona where she grew up with her three siblings before moving to California to start her life and where she would soon marry her husband Gary. Joanne and Gary Anderson were married for nearly 50 years and during that time they had two kids, two grandchildren, and 1 great-grandchild. They also bought some land in Oregon and built a lovely home together with their own designs and plans.

Her hobbies included camping, fishing, hiking, rockhounding, and spending as much time as possible with family. My favorite memory with my grandmother was when she was teaching me how to tumble rocks and create necklaces. We would spend hours out in that rock shed, tumbling away, laughing, and creating great memories.

To all of you Meso Warriors out there my grandma would tell you to keep up the good fight, and never give up! Always do your research and stay up to date with all treatments as early as possible and most importantly do not waste time and enjoy your life.

Joleen Anderson – granddaughter of Joanne Anderson

THANK YOU

OUR TEAM

“I candidly knew very little about mesothelioma before attending PMC’s annual Walk for Mesothelioma. While I was impressed with their mesothelioma research fundraising endeavors, I was even more impressed with how much I learned after attending the walk. They do an excellent job raising awareness about this very unknown disease. At the walk they had information all along the trail detailing how many people are diagnosed each year, the uses of asbestos (the cause of mesothelioma) in household products, and the fact that it is still not universally banned in the U.S. What they are doing is very important because the more people who learn this information and share it with others the more cautious one will be about potential exposure. Overall, a great cause run by people very passionate about helping mesothelioma patients.”

WHO WE ARE

SURVIVOR STORIES

Sam D. Schwartz

DONOR AND SURVIVOR

Sam D. Schwartz was born to a relatively poor family in Chicago and lived in Rockford Illinois. They did not have their own bathroom and he grew up never experiencing what it was like to have a hot shower while living in a cold water flat.

OUR EVENTS

FINANCIALS

OUR SPONSORS

Early on in life, Sam realized that this was not the life he wanted. It would mean he would have to work hard and smart. After High School, He got a scholarship and grants and graduated from New York University, Stern School of Business with Distinction, (BS), Columbia Pacific Business, (MA/MBA) and the New York Institute of Finance. He held different part time jobs while in college, including selling women’s shoes and doing bookkeeping for a garment manufacturer.

Sam started his professional career working as a management trainee for Chesbrough- Ponds, a Fortune 500 Company in New York City where in two years he became one of the youngest executive trainees to achieve management status. After serving in the U.S Army as a medic, he was stationed in San Antonio Texas and worked at Brooke Army Hospital.

Sam founded Kaliber Management Corporation (KMC) in 1970. KMC was organized as a 1940 Act SEC registered investment counseling firm. He also founded and managed an early-stage Venture Capital Group which was structured to invest and restructure, both capability and capital in emerging growth companies that had the potential to alter delivery systems of various digital deliverance systems. Mr. Schwartz was also portfolio manager for several very substantial entrepreneurs including an NFL team owner, the largest world-wide fast-food restaurant and others where preservation of capital is uppermost.

21 2017 ANNUAL REPORT

Among the many developmental accomplishments, was the establishment of converting a regional not for profit HMO to one of the most prominent and largest for-profit public companies in the world.

the pleural decortication (P/D) surgery on July 8th 2019, which lasted 11 hours. Dr. Cameron was there for him every step of the way, a strong advocate, every day, even visiting him on Sunday.

Mr. Schwartz was nominated as Entrepreneur of the Year in 1995 by Merrill Lynch and Ernst & Young.

After his P/D surgery and during his eight-day hospital stay, it was discovered that he has a rare heart condition called Hypertrophic Cardiomyopathy, an often-undiagnosed disease associated with heart failure. After completing five weeks of radiation therapy, Sam now has an Implantable Cardioverter Defibrillator (ICD) that will deliver an electric shock to restore a normal heartbeat. Fortunately, there have not been any incidents to trigger the device.

With his success behind him and Rita, his wife of 54 years, he was ready to sit back and enjoy life’s offerings and spend time with his family. He has a daughter who lives in Miami and has 3 grandchildren. His son lives in Los Angeles. Sam’s life changed irrevocably on an annual visit to Dr. Ed Hui, his East/West Internist at UCLA, through a routine blood test, when it was discovered that he had mesothelioma. He knew virtually nothing about mesothelioma, other than from the television commercials, advertising lawyers on television.

Sam does not know how he contracted mesothelioma but thinks that it may have come from the U.S Army barracks at Ft. Dix N.J which were constructed with asbestos. It also may have come from the talc that was distributed from the military and used for personal perspiration hygiene. And, it could have come from a house that he bought some fifty years ago that had popcorn blown ceilings that he had had removed.

Through his pulmonologist, Dr. Joanne Bando at UCLA, Sam was referred to Dr. Robert B. Cameron. He did his research and then when he met him, he knew that he had found the right doctor.

Dr. Cameron informed him that he was in the early stages of mesothelioma – stage one. As Sam had no symptoms, he asked him that if he decided to do nothing at all, how long would he survive. Dr. Cameron told him that it would be between 12-20 months. Sam also asked him how many people he had lost on the table. Dr. Cameron told him only one, and it was due to a heart attack. So, with the odds weighing heavily in his favor, he went with

He is so grateful to Dr. Cameron for saving his life that he promised to do whatever he could to help with mesothelioma research. He generously matched $150,000 in donations for the October 2020, 9th annual walk/hike for mesothelioma, which this year was virtual. His team, Fans of Sam also raised an additional $27,605. His leadership and guidance stimulated the most successful fundraiser in the history of the Institute raising in excess of $500,000.

He feels good. He told Dr Cameron that he will willingly assist in supporting the institute, and he has certainly done so. He lives a healthy lifestyle and has an upbeat, positive attitude on life. He is easy to like and easy to get to know. He is extremely thankful to Dr Cameron and his team for all that he has done for him. And he acknowledges how lucky we are to have access to the amazing medical professionals at UCLA. Sam is an avid sports fan and has season tickets to the Lakers, Clippers and Kings. He is looking forward to being able to attend the games again with his son.

THANK YOU

OUR TEAM

“Being diagnosed with Mesothelioma was like being hit by a bolt of lightning out of the blue. However, I have to count my blessings. First, for Dr. Cameron, head of the thoracic dept. at UCLA, who performed my surgery. Second, for Lein, Dr. Cameron’s nurse practitioner, who is always available to me to answer any questions as the months go by in my recovery. Third, is the PHLBI, the non-profit organization, working closely with Dr. Cameron and Lien to find a cure for this horrible cancer. PHLBI also provides support for patients and caregivers by having monthly conference calls once a month, Lein and Christina facilitate the calls. I have been able to talk to other survivors of Mesothelioma. Being able to talk to other people who have experienced exactly the same thing is invaluable. It’s so easy to feel you are alone in your fight for recovery. PHLBI has filled that hole for me, knowing we’re in this together as a team, Dr. Cameron, Lein, PHLBI, and the patient”.

WHO WE ARE

SURVIVOR STORIES

OUR EVENTS

FINANCIALS

OUR SPONSORS

Tina Herford There are the traditional fighters in the ring and then there are those that fight each day for their life. Each round brings another obstacle but they persevere in spite of it all. Tina Herford is the embodiment of that tenacious spirit. After battling breast cancer she was hit another blow when she was diagnosed with malignant pleural mesothelioma in 2016.

Upon meeting with PHLBI’s Scientific Advisor Dr. Robert B. Cameron Tina was approved for pleurectomy decortication surgery in the fall of 2016. Tina then completed an aggressive round of chemotherapy. A year later Tina discovered that she also had peritoneal mesothelioma, requiring her to undergo another surgery to remove the cancer around her abdomen. Throughout all of this Tina maintained her active lifestyle, playing golf, fishing, and visiting with her four children and six grandchildren. She also kept her deep faith, praying that she would win her latest fight with cancer so she could continue to be there for her family.

Determined to remain active so she could enjoy the quality of life she was used to, she went ahead with a hip replacement surgery in 2019.

As Tina states “I’m in a fight with mesothelioma, and there can only be one winner, and it’s going to be me”. She shares her spirit with her fellow mesothelioma warriors on PHLBI’s Patient Support Group call. And uses her story to inspire everyone around her, urging people to help raise awareness and support research.

This past year she participated in her fourth “Walk for Mesothelioma” and raised over $161,000 for mesothelioma research as captain of Team Pinky. Her success shows that mesothelioma has met its match with Tina Herford.

23 2019 / 2020 ANNUAL REPORT

James Winkle

MESO WARRIOR

James Winkle sought adventure from a young age.

Growing up in Fort Benton, Montana with his five siblings he was constantly outside, camping, snowboarding, fishing, and mountain biking. It was this curiosity and thrill for adventure that caused him to enter the Navy in 1982 and serve for six years. He arrived in the Philippines in 1983 after thirteen weeks of boot camp and six months of machinist school. The tropical, exotic environment was Winkle’s first introduction to life outside of the United States and where he first realized his love of traveling. While he was there for two and a half years he spent his free time traveling among the islands, conversing with the locals, and trying the new cuisine. Then in 1985, he was transferred to Yokosuka, Japan where he worked as an engineer on a Navy destroyer. His job entailed taking care of the equipment in the engine and boiler room. While on this destroyer, he traveled extensively throughout the South Pacific and the Persian Gulf in his role as small boat engineer patrolling the seas for Russian and North Korean submarines and acting as protection for other ships traveling in dangerous waters.

After his return to the U.S. in 1988 he joined the Navy Reserves and moved to Spokane, Washington where he met his wife Kimberly and got a job working for a trucking company. His life seemed to be falling perfectly into place, Winkle had met a woman he wanted to share his life with and start a family. Unfortunately, just when everything was falling into place, he was diagnosed with stage four Hodgkin’s disease in June 1991 and soon embarked on another fight, only this one was raging inside of him. He married his wife while undergoing chemotherapy that year and in 1995 when he relapsed, he decided to undergo a stem cell transplant. The surgery appeared to save him and in 1998 Winkle had his first child with his wife and a

second chance at life.

After getting a clean bill of health from his doctors Winkle joined the Montana Army National Guards in 2001 and was sent to Iraq in 2004 as an infantryman.

His role as team leader in the conflict-driven town of Hawija involved apprehending people, searching for suspects, and clearing buildings of any suspicious individuals. His experience and knowledge from his tours in the Navy served him and those around him well as he made it his responsibility to look after the younger men in his battalion who experienced culture shock and nerves during their first tour.

After his return from Iraq life returned to normal for Winkle and his family. He worked for the Army National Guard, met with his buddies one weekend a month for National Guard training, and he watched his daughter and now son grow up in front of him.

Then in 2013, he was diagnosed with colon cancer.

After having his colon removed and going into remission, his doctor found a spot on the outside of his lung and what was originally thought to be scar tissue, was in fact, malignant pleural mesothelioma.

Initially, Winkle did not know a great deal about mesothelioma. He had heard the familiar commercials at night from lawyers and had known a few friends who got it from working in mines in Montana, but he did not know much about the disease itself. He realized he was exposed to asbestos when he worked at a dry dock in the Philippines during his time in the Navy.

While researching mesothelioma he was referred to Pacific Mesothelioma Center Scientific Adviser Dr. Robert B. Cameron who subsequently performed his lung-sparing pleurectomy surgery on Winkle in June 2015. Five years later and Winkle is continuing his immunotherapy treatment and advocating for greater mesothelioma awareness and funding. On October 26th,2020 Winkle participated in our Virtual Walk for Mesothelioma, walking through the snow in Montana to help raise funds. He has shown that his determination and strength are no match for cancer.

THANK YOU

OUR TEAM

2019 EVENTS

WHO WE ARE

SURVIVOR STORIES

OUR EVENTS

FINANCIALS

OUR SPONSORS

THE GREATEST ESCAPE MOTORCYCLE RIDE 2019 “The Greatest Escape” Motorcycle Ride originated as a tribute to “The Great Escape’’ movie starring Steve McQueen, who died of mesothelioma. Since its inception, hundreds of riders have gathered each year to honor those who have lost the fight against mesothelioma and to raise money for research. This year riders gathered at Ventura Harley Davidson on Saturday, April 5th and rode ro The Elks Lodge in Simi Valley with Musician/Actor Sean McNab as the grand marshal.

The ride raised $45,000 for PMC’s research.

25 2019 / 2020 ANNUAL REPORT

THE WALK/HIKE FOR MESOTHELIOMA 2019 On October 26th hundreds of walkers joined The Pacific Mesothelioma Center for the annual Walk/ Hike for Mesothelioma. The 8th Annual Walk for Meso took place at The Will Rogers State Historic Park in the Pacific Palisades. The event had 28 walk teams hike up to Inspiration Point and back. After the hike, there was a delicious lunch by Lalo’s Catering and an exciting opportunity drawing with great prizes. In total, over $151,000 was raised for mesothelioma research.

THANK YOU

OUR TEAM

“Everyone at this organization collectively works so hard to help raise funding for mesothelioma. I have attended their annual “Walk for Mesothelioma”” for the last several years and each year I leave inspired by their dedication to their cause.

PMC’s unMASKing the Cure for Cancer Gala blew me away. I have never had so much fun and been a part of something so meaningful at the same time. Getting to hear patients share their stories and the impact that Dr. Cameron has had on extending their lives made such an impact on everyone. It shows just how important it is that we continue to support novel cancer research like the research conducted at The Pacific Mesothelioma Center. Thank you for all that you do!”

WHO WE ARE

SURVIVOR STORIES

OUR EVENTS

FINANCIALS

HAMBURGER MARY’S BINGO NIGHT 2019

OUR SPONSORS

It was great fun and a great turnout at Hamburger Mary’s Bingo in West Hollywood on March 14th. In addition to raising greater awareness for PMC and mesothelioma, we also raised $6,676 for research! A special thanks to friends, family, board members, and PMC supporters who came out to support our cause!

27 2019 / 2020 ANNUAL REPORT

THE “UNMASKING THE CURE FOR CANCER” GALA 2019 The Pacific Heart, Lung & Blood Institute held its inaugural gala “unMASKing the Cure for Cancer’’ on November 21st at the UCLA Luskin Conference Center. The event paid tribute to the work of PHLBI Scientific Advisor Dr. Robert B. Cameron. Celebrities such as Sir Anthony Hopkins, Mark Hammil, Gloria Gaynor, Sugar Ray Leonard and Ringo Starr, painted masks which

were auctioned at the event. Attendees dined, danced, and raised funds for PHLBI’s cancer research. In total, the gala raised over $242,000 for research at the Pacific Heart, Lung & Blood Institute. Thank you to everyone who attended the gala and contributed to PHLBI’s innovative cancer research.

THANK YOU

OUR TEAM

“PHLBI has a proven track record of excellence in: 1) conducting much-needed research into lung-sparing treatments, and someday a cure, for mesothelioma at its own laboratories under the direction of one of the nation’s top mesothelioma specialists, 2) educating doctors about best practices and latest innovations for treating mesothelioma through its annual symposium, 3) providing patient and caregiver support and resources through its nurse practitioner who is available one on one and via web support group meetings, and 4) raising public awareness about mesothelioma and the need for research through its website, social media, and fundraising events including the annual walk, motorcycle rally, casino night, art auctions, etc. which bring affected families and friends together with others to build enthusiasm and dedication to the cause. PHLBI has made a meaningful impact on the lives of many families who turn out to support the institute year after year. It is a truly unique non-profit whose work to benefit mesothelioma sufferers and the public at large has only started to hit its stride!!”

WHO WE ARE

SURVIVOR STORIES

OUR EVENTS

FINANCIALS

OUR SPONSORS

THE INTERNATIONAL SYMPOSIUM ON MALIGNANT PLEURAL MESOTHELIOMA 2019 The 9th International Symposium on Malignant Pleural Mesothelioma was held on September 21st at the UCLA Luskin Conference Center and chaired by Dr. Robert B. Cameron. This seminar was jointly hosted by UCLA and the Pacific Mesothelioma Center (PMC). The International speakers included doctors and professors from Italy, France, New York, and Maryland, as well as local experts.

The Symposium is geared towards physicians and offers continuing medical education (CME) credit. It also provides up-to-date information on mesothelioma for medical students, nurses and other healthcare professionals, as well as mesothelioma patients, their families, and other interested parties.

29 2019 / 2020 ANNUAL REPORT

2020 EVENTS Because of COVID-19 we had to cancel most of our events this year. That included our 7th annual motorcycle ride, 10th International Symposium and The Great Gatsby Casino evening. However we forged ahead with our virtual walk, and thanks to all of you who participated, had our best year ever.

Since its inception in 2012, PMC’s Walk/ Hike for Mesothelioma has generated over $1,423,000. Despite the pandemic, this year’s virtual walk shattered this record by raising $527,565. Special thanks are extended to Sam D. Schwartz, a mesothelioma survivor, who generously challenged donors by offer-

ing to match their contributions, resulting in a personal donation of $150,000.

We are also grateful for Judy Anderson who, on behalf of her mother Joanne Anderson, a meso warrior who sadly lost her battle to the illness, generously donated $150,000 as a member of Team Pinky. This donation secured Team Pinky, captained by mesothelioma survivor Tina Herford, the “Joanne Anderson top Fundraising team Award” raising $160,533.

VOLUNTEER SPOTLIGHT Since a young age charity work was woven into the fabric of Halle Hallal’s life. Following her grandmother’s example growing up, Halle volunteered at The Salvation Army and for veteran related causes. After moving to Los Angeles Halle took up motorcycle riding, introducing her to a community well known for its philanthropic work. Halle started to attend and volunteer for a number of charity rides including “The Women’s Breast Cancer Ride”, “The Ride for Kids’’, and “The Love Ride”. She was first introduced to PHLBI in 2015 through our charity motorcycle ride, “The Greatest Escape’’. When she heard the patient’s stories and saw the direct involvement of PHLBI supporters at the ride, in typical fashion she asked how she could help. In addition to her helping to grow “The Greatest Escape Motorcycle Ride’’ she also volunteers at other PHLBI events including “The Walk for Mesothelioma”, “Hamburger Mary’s Bingo” and our “unMASKing the Cure for Cancer Gala”. Halle’s approach to life is also what makes her an amazing volunteer; her fearless attitude to tackle whatever is in front of her; her eagerness to take initiative, and her desire to empower others.

When asked why she enjoys volunteering, Halle shared with us that it’s the joy of meeting many great people and knowing at the end of the day you did something productive for humanity.

THANK YOU

“What an amazing experience i have had volunteering for this organization over the last few years! Each year PHLBI hosts their annual “Walk for Mesothelioma” to raise money for mesothelioma research. I have helped organize and distribute walk t-shirts to participants. It is always a great deal of fun and I would encourage anyone to volunteer at one of their events!”

OUR TEAM

WHO WE ARE

SURVIVOR STORIES

OUR EVENTS

THE VIRTUAL WALK FOR MESOTHELIOMA 2020

The Pacific Mesothelioma Center (PMC) held it’s 9th annual Walk/Hike for Mesothelioma on Sunday, October 25th. Due to the pandemic, this year’s walk was *virtual*. Everywhere, teams walked together as one, in cities all over the USA, Southern Ireland, the United Kingdom, Portugal, Austria, and Japan. Together we raised $527,565 for mesothelioma research.

FINANCIALS

OUR SPONSORS

“I’ve volunteered at so many of their events, it’s always fun. The Greatest Escape Motorcycle Ride, their annual charity ride is probably my favorite. The ride brings a lot of bikers and members of the riding community together and educates them about mesothelioma, an audience their organization might not normally reach.

Overall, a great event and I enjoy helping out however I can!”

31 2019 / 2020 ANNUAL REPORT

THANK YOU

OUR TEAM

FINANCIALS PACIFIC HEART LUNG & BLOOD INSTITUTE

WHO WE ARE

Pacific Form Heart Lung and Blood Institute 990 - Financial Summary Financial Summary for the year ended December 31, 2019 2018

2019

Revenue

SURVIVOR STORIES

OUR EVENTS

Contributions and grants

(

666,349)

(

725,823)

Investment income

(

(6,078)

(

39,768)

(

660,271)

(

765,591)

Salaries, other compensation

(

637,260)

(

618,622)

Professional fundraising fees

(

)

(

30,630)

Other expenses

(

275,876)

(

207,097)

Total expenses

(

913,136)

(

856,349)

Revenue less expenses

(

(252,865)

(

(90,758)

Total Revenue Expenses

-

2018

2019

Net Assets of Fund Balances

FINANCIALS

Total assets

(

807,930)

(

717,281)

Total liabilities

(

11,329)

(

11,438)

(

796,601)

(

705,843)

Net assets or fund balances

PACIFIC HEART LUNG & BLOOD INSTITUTE 2019 Form 990 - Statement of Functional Expenses

OUR SPONSORS

Total expenses

Management Program and service expenses general expenses

Fundraising expenses

Compensation of officers, advisors(

260,329) (

216,703) (

43,626) (

- )

Other salaries and wages

(

290,895) (

271,208) (

19,687) (

- )

Other employee benefits

(

36,005) (

23,403) (

9,001) (

3,601)

Payroll taxes

(

31,393) (

20,405) (

7,849) (

3,139)

(

37,682) (

37,682) (

- ) (

- )

Fees for services (nonemployees): MSC Patent

33 2017 ANNUAL REPORT

Pacific Heart Lung and Blood Institute Functional Expenses for the year ending December 31, 2019 Total expenses

Compensation of officers, advisors Other salaries and wages Other employee benefits Payroll taxes Fees for services (nonemployees): MSC Patent Accounting Professional fundraising services Investment management fees Other Occupancy Travel Conferences, conventions, and meetings Depreciation, depletion, and amortization Insurance Other expenses Lab expenses Supplies All other expenses Total functional expenses

Program service expenses

Management and general expenses

Fundraising expenses

( ( ( (

260,329) 290,895) 36,005) 31,393)

( ( ( (

216,703) 271,208) 23,403) 20,405)

( ( ( (

43,626) 19,687) 9,001) 7,849)

( ( ( (

- ) - ) 3,601) 3,139)

( ( ( ( ( ( ( ( ( (

37,682) 1,975) 30,630) 3,675) 2,827) 69,236) 147) 10,129) 1,639) 9,669)

( ( ( ( ( ( ( ( ( (

37,682) - ) - ) - ) 1,838) 36,220) 96) - ) 1,065) 6,285)

( ( ( ( ( ( ( ( ( (

- ) 1,975) - ) 3,675) 706) 33,016) 36) - ) 410) 2,417)

( ( ( ( ( ( ( ( ( (

- ) - ) 30,630) - ) 283) - ) 15) 10,129) 164) 967)

( ( ( (

37,979) 4,366) 27,773) 856,349)

( ( ( (

37,979) 2,838) 17,607) 673,329)

( ( ( (

- ) 1,091) 7,459) 130,948)

( ( ( (

- ) 437) 2,707) 52,072)

Fundraising Expenses Management & General Expenses

Patient Support

Research Laboratories

THANK YOU

OUR TEAM

WHO WE ARE

FINANCIALS Pacific Heart Lung Blood Institute PACIFIC HEART LUNGand & BLOOD INSTITUTE Summary Financial SummaryForm for 990 the- Financial year ended December 31, 2020 2019

2020

Revenue

SURVIVOR STORIES

OUR EVENTS

Contributions and grants

(

725,823)

(

1,908,445)

Investment income

(

39,768)

(

28,712)

(

765,591)

(

1,937,157)

Salaries, other compensation

(

618,622)

(

593,482)

Professional fundraising fees

(

30,630)

(

8,742)

Other expenses

(

207,097)

(

195,424)

Total expenses

(

856,349)

(

797,648)

Revenue less expenses

(

(90,758)

(

1,139,509)

Total Revenue Expenses

2019 Total assets

(

Total liabilities Net assets or fund balances

FINANCIALS

OUR SPONSORS

2020

Net Assets of Fund Balances 717,281)

(

(

11,438)

(

152,256)

(

705,843)

(

1,845,304)

PACIFIC HEART LUNG & BLOOD INSTITUTE 2020 Form 990 - Statement of Functional Expenses

1,997,560)

35 2017 ANNUAL REPORT

Pacific Heart Lung and Blood Institute Functional Expenses for the year ending December 31, 2020 Total expenses

Program service expenses

Fundraising expenses

Management and general expenses

Compensation of officers, advisors(

347,764) (

312,987) (

34,777) (

- )

Other salaries and wages

(

213,815) (

192,433) (

21,382) (

- )

Other employee benefits

(

747) (

672) (

75) (

- )

Payroll taxes

(

31,156) (

28,040) (

3,116) (

- )

Legal

(

3,453) (

3,319) (

134) (

- )

Accounting

(

2,250) (

- ) (

2,250) (

- )

8,742) (

- ) (

- ) (

8,742)

383) (

- ) (

383) (

- )

Fees for services (nonemployees):

Professional fundraising services ( Investment management fees ( Advertising and promotion

(

5,369) (

3,489) (

1,343) (

537)

Office expenses

(

43,624) (

28,355) (

10,906) (

4,363)

Occupancy

(

78,564) (

39,282) (

39,282) (

- )

Travel

(

57) (

37) (

14) (

6)

552) (

358) (

139) (

55)

Depreciation, depletion, and amortization ( 597) (

388) (

149) (

60)

Conferences, conventions, and meetings ( Insurance

(

47,541) (

40,733) (

5,987) (

821)

Lab expenses

(

8,030) (

5,219) (

2,008) (

803)

Supplies

(

4,751) (

4,276) (

475) (

- )

All other expenses

(

253) (

165) (

63) (

25)

Total functional expenses

(

797,648) (

659,753) (

122,483) (

15,412)

Other expenses

100% Fundraising

83%

15%

Expenses

Management & General Expenses

Research Laboratories

2%

THANK YOU

OUR TEAM

WHO WE ARE

SURVIVOR STORIES

OUR SPONSORS DIAMOND SPONSOR

Ms. Judy Anderson

PLATINUM $20,000 - $1M

H.N. and Frances C. Berger Foundation Mr. Peter LaMonica Mr. Sam Schwartz Simon Greenstone Panatier The Auen Foundation Mr.John Winkel Mr. Roger Worthington Worthington & Caron PC

GOLD: $10,000 $19,999.99

OUR EVENTS

FINANCIALS

OUR SPONSORS

Mr. and Mrs. John and Suzanne Caron Mr. & Mrs.Nassen and Sena Farag Ms. Cathy Goodman

SILVER $1,000 - $9,999.99

Mr. Wayne Anderson Mr. Michael Arlen Mr. and Mrs. Daniel and Cendi Botti Mr. James Carden CD Medical Legal Consulting Mr. Armando Cignarale Ms. Maya Ezratti Mr. and Mrs. Sandra and Thomas Hazen Mr. and Mrs.. Bonnie Hewitt Frost Law Firm Insulators International Health Hazard Fund Mr. James Jarvis Ms. Sonia Jarvis Kazan McClain Partners Foundation Mr. James Kawolski and Ms. Hida Pirelli Ms. Judith Landau Ms. Janna Ponomarenko Ms. Elizabeth Resnick Mr. Jimmy Resnick Ms. Maria Rourke Ms. Radha Savitala Mr. David Schwartz Ms. Rita Z Schwartz

Sence Foundation Mr. and Mrs. Al and Joyce Sommer Mr. & Mrs. David & Rosemary Stirdivant The Johnny Carson Foundation The Joseph Drown Foundation The Kabor Family Foundation Mr. & Mrs. Robert & Therese Vitale Waters & Kraus, LLP

BRONZE $1 - $999

Amgen Classic Property Management Johnny’s Auto Mr. Simon Greenstone Panatier PC The Gori Law Firm The Legends Car Club The Paypal Giving Fund Ms. Donna Abdun-Nur Mr. Andre Aberu Ms. Cindy Adams Mr. Erik Adams Mr. Kenneth Adams Mr. Lukas Adams Mr. Matthew Adams Ms. Victoria Adams Ms. Christina Aegerter Ms. Lynn Alesso Mr. Aubrey Allenbrand Mr. Carlos Amiel Mr. Flynn Amiel Ms. Brooke and Ava Ms. Lisa Anderson Ms. Mary Antone Ms. Maribel Arias Ms. Emily Arlen Ms. Mary Arlen Ms. Phebe Arlen Mr. Robert Arlen Mr. Chris Armand Mr. Gregory Armand Mr. Jean-Louis Armand Ms. Susan Arnold Ms. Jennifer Awrey Ms. Julianne Awrey Mr. Paul Awrey Ms. Nicole Baeza Ms. Rebecca Baeza Mr. Ruben Baeza Ms. Vana Baeza

Ms. Rochelle Baker Ms. Patty Balcerzak Ms. Ellen Barros Mr. Elias Bates Martinez Ms. Joanne Bates Mr. Mark Bauserman Mr. Edward Bayek Ms. Sonia Bayek Mr. Daniel Bergin Ms. Eileen Bergin Mrs Margaret Bergin Ms. Jeanine Berner Ms. Marcia M. Bethencourt Ms. Sylvie Bidet Ms. Rena Beil Mr. &Mrs. Michael & Natalie Bittner Mr. Willie Bittner Ms. Barbara Black Ms. Janis Black-Warner Mr. Andrew Blinkinsop Mr. and Mrs. Bob and Karen Blinkinsop Ms. Christine Blinkinsop Mr. Doug Blinkinsop Mr. Jonathan Bobb Mr. Robert Bolton Mr. Charles Bonan Ms. Alexandria Borys Ms. Claire Bothwell Ms. Carla Boudreau Ms. Anna Boyle Mr. & Mrs Eugene Brink Ms. Linda Britt-Smith Ms. Randa Brooks Ms. Christy Brower Mr. Barry Brownstone Ms. Barbara Bryant Ms. Sherie Burton Ms. Robin Byrne Mrs. Irene Califano Mr. John Califano Ms. Rosary Califano Ms. Bonnie Cameron Mr. Brian Cameron Mr. Wlliam and Clare Cameron Dr.. Robert Cameron Mr. Scott Cameron Mr. Anthony Carden Ms. Winifred Carnegie Mr. Cal Caron Ms. Macey Caron Ms. Nancy Caron Mr. Steve Caron

37 2017 ANNUAL REPORT Ms. Marven Carr Mr. Scott Carruthers Ms. Kimberly Carvajal Ms. Jill Castellano Mr. and Mrs. Carlos and Rosa Ceja Mr. Andrew Chan Ms. Elizabeth Chrisman Ms. Margaret Chu-Moyer Mr. Sal Ciulla Ms. Lauren Ciuro The Clays Ms. Cathy Cocannouer Ms. Judy Coleman Mr. William Colosimo Mr. and Mrs. Mike and Theresa Colton Ms. Shirley Conway Mr. and Mrs. Jeff and Julie Conway Ms. Sherri Cook Mr. William Corcoran Mr. David Courson Ms. Jennipher Courson Mr. John Crandall Ms. Tia Crank Ms. Christina Cuddy Mr. Gary Cullins Mr. Michael Curran Ms. Sarah Cusimano Mr. and Mrs. Kit and Deb Dahl Ms. Paulette Dauber Ms. Candace Delbo Ms. Marilyn Dempsey-Cameron Mr. Lawrence Demster Ms. Marie Derks Ms. Betty DeSantis Ms. Katie DeSantis Mr. Paul DeSantis Mr. Steve DeSantis Ms. Rosa Di Bello Ms. Marilynn Diamond-Wexler Ms. Filomena Dileva Ms. Kim Dileva Mr. Johnny DiMeglio Ms. Kylee Dodd Dr. John Doley Mr. Anthony Dominguez Ms. Samantha Dorfman Ms. Terre Downey Mr. Chris Echavia Ms. Teresa Eckman Dr. Stephen & Linda Eckstone EGA Consultants Ms. Tissy Eggleston Mr. Tess Enyeart Ms. Penny Erhart Mr. and Mrs. Celia and Bob Erickson Ms. Courtney Erickson Mr. Mike Erickson Mr. Andrew Mumford Ms. Miriam Farag Ms. S. Farmer Ms. Julianna Farrell Ms. Sue-Ying Feng Ms. Patti Feuerstein Ms. Laura Finvarb Ms. Angela Fitts Ms. Louise Fletcher Ms. Leslie Folkes Ms. Solvejg Fong

Mr. James Francisco Ms. Susan Frantz Ms. Susan Frazier Ms. JoAnn Frederiksen Mr. & Mrs. Greg & Doris Freisen Ms. Courtney Frisch Ms. Susan Fukuda Mr. and Mrs. Barbara and Simon Gamer Ms. Rosemarie Ganoe Mr. Joseph Garland Ms. Vanessa Garland Ms. Erin Garman Ms. Carolyn Gates Mr. Dave Gentry George Lucas Foundation Ms. Maryam Ghavami Ghavami Family Mr. and Mrs. Justus and Jayn Ghormley Ms. Jane Gibson Mr. Matt Glaser Mr. Brian Glodowski Ms. Naomi Glugeth Ms. Linda Goodan Ms. Leann Gordon Ms. Marilyn Gordon Ms. Emily Gouveia Ms. Nalani Grace Mr. & Mrs. Patrick & Ellie Grayson Ms. Courtney Gresham Mr. and Mrs. Boryana and Jason Griffin Dr. William Grimm Mr. and Mrs. Bill and Jeanne Gundacker Mr. Michael Gutierrez Ms. Susan Hackett Ms. Halle Hallal Mr. Christian Hamlin Mr. WIlliam Hancock Ms. Mary Handfelt Mr. Don Hansen Ms. Belinda Hanson Mr. Shuko Harada Harbor Lites Seniors Ms. Anne Hawley Mr. Doug & Tina Herford Mr. and Mrs. Mike and Linda Hill Ms. Beth Hillebrand Mr. Timothy Hinz Kyle and Darren Hirabayashi Mr. & Mrs. Martin & Judy Holman Ms. Lien Hua-Feng Ms. Ida Huber Ms. Miranda Iglesias Ms. Christiane Irwin Mr. Marc Jacoby Ms. Jennifer Jarvis Mrs. Sonia Jarvis Mr. and Mrs. Kiela and Jesus Jimenez Ms. Katrina Johnson Ms. Sierra Johnston Ms. Lynn Joseph Mr. Colin Joy Ms. Katy Joy Ms. Lori Kagan Schwarz Mr. Bruce Kagan Mr. Leonard Kagan Ms. Bonnie Kalberer Ms. Anne Kalisek

Mr. Ferris Kaplan Ms. Joan Kasparian Sumi Kawaratani Mr. Brent Keeton Ms. Kathryn Keisling Ms. Nicole Keller Mr. Larry Kennebeck Mr. Brandon Kennington Mr. John Kennington Ms. Patricia Killan Mr. Robert Kirchberger E. Klausner Mr. and Mrs. Bruce and Eleanor Knowles Ms. Jamie Lynn Kovacs Mr. and Mrs. Anna and Kevin Kreager Ms. Michelle Kroakes Mr. and Mrs. Michael and Michelle Krokes Ms. Laura Krupp Ms. Tamara Kurth Ms. Roseann Lamendola Mr. and Mrs. Roxanne and Vince Lauro Ms. Pam Lazenby Ms. Candace LeBlanc Ms. Ilisa Lee Mr. Miles Lee Mr. Jerry Legaspi Ms. April Lentz Mr. Juan Leon Ms. Jackie Lepore Mr. Stuart Lerner Ms. Trina Lesnick Ms. Elaine LeTarte Mr. Michael Levy Lindquist LLP Ms. Marcia Long Ms. Shana Longo Los Angeles Airport Police Ms. Nicole Loseman Ms. Connie Lundby Tahne Lutz Ms. Karen Lyons Ms. Kim Madril Ms. Antoinette Mancini Ms. Barbara Mancini Ms. Lauren Mancini Mr. Tom Mancini Mr. Gregg A Mandinach Ms. Conniel Marangi Mr. Frank Marangi Ms. Joanne Marangi Ms. Stefanie Marangi Ms. Carolyn Marcial Ms. Martha Marinez Ms. Judy Martinez Ms. Diana Mascoli Mr. and Mrs. Eugene and Lucille Mascoli Mr. Michael Mascoli Mr. Stephen Mascoli Ms. Ronda Massey Ms. Cindy Mastro Ms. Mary Jane McCall Mass Mutual Mr. Kevin McCann Ms. Anne McClard Mr. John McDonough Mr. Thomas McGah Mr. Scott McKee

McMoegan and Company Ms. Carol McSherry Ms. Caroline McSherry Ms. Christina McSherry Ms. Tara McSherry Ms. Jeanette Mednicoff Ms. Erica Mendoza Ms. Rebecca Hendrickson + Michael Hammond Mr. and Mrs. Donald and Sheilah Miller Ms. Sally Miller Ms. Tammy Miller Ms. Michelle Mills Worthington Mr. Takashi Minowa Mr. Nicholas Monteer Ms. Joleen Montminy Mr. Mike Moore Ms. Eileen Morgan Mr. John Moses Mr. Dann Moss Mr. David Moss Mr. Michael Munoz Ms. Janeen Murray Ms. Anna Maria Muscarella Ms. Leeann Nabors Ms. Rebecca Nabors Ms. Cynthia Neff Ms. Linda Negrete Mr. John Nelson Mr. & Mrs. Mark & Lori Nichols Mrs. Sue Noble Ms. Joanne Norman Ms. Lisa Nunes Mr. & Mrs. Patrick & Georgene O’Shea Mr & Mrs. Eric & Jackie Oaks Ms. Lisa Oaks Ms. Lucille OConnor Odessey Wealth Ms. Barbara Oetting Ms. Olga Olevsky Ms. Robin Olin Xochitl Olivas Mr. & Mrs. Jeff & Suzi Oliver Ms. Anastacia Oliveras Ms. Delia Oliveri Mr. Don Omelas Ms. Christine Ortega Tori Oliver Mr. Jose Ortiz Ms. Brenda Ostroth Jamie Owen Mr. Tom Parmelee Mr. James Parnell Mr. Gary Paul Ms. Rachel Pauling Ms. Susan Payne Ms. Megan Perez Mr. Ali Petrichko Ms. Carol Peyton Mrs. Anne Pfeifer Ms. Ann Pillar Mr. Barry Plaga Mr. John Plaga Mr. Dahven Polakow Ms. Jenica Polakow Mr. Shaun Polakow Ms. Cynthia Popelka Mr. Phillip Prokop Ms. Marieluise Prouty Ms. Geneva Putman

THANK YOU

OUR TEAM

WHO WE ARE

SURVIVOR STORIES

OUR EVENTS

FINANCIALS

OUR SPONSORS

Ms. Lee Ann Quesada Ms. Lila A Quilici Mr. and Mrs. Robyn and Kirk Quinones Mr. Dennis Quint Mr. and Mrs. Wayne and Tammy Quint Ms. Lourdes Rada Ms. Jeana Radovcich Ms. Corinne Ramaley Mr. George Ramirez Mr. Rudy Ramirez Ms. Regina Rea Ms. Fern Resnick Ms. Alexa Reuling Ms. Marie Reynolds Ms. Andriana Ricchiuti Mr. Danny Robinson Ms. Sharyl Rodina Mr. and Mrs. Miguel and Marjore Rojas Ms. Elizabeth Roman Ms. Jenna Roman Ms. Stacy Roman Ms. Daniella Romanaggi Ms. Donna Rosen Syma Rosenfeld Ms. Alicia Rubio Mr. and Mrs. Giovanni and Mary Russo Ms. Julie Russo Ms. Barbara Sadicario Ms. Sharon Sager Mr. Steven Salak Ms. Greta Salmi Mr. Frank Sardegna Ms. Shannon Sarver Ms. Radha Savitala Mr. Nikhil Sawhney Ms. Jennifer Sazant Ms. Elizabeth Schafer Ms. Susan Schieferle Ms. Linda Schlampp Ms. Anna Schofield Ms. Sharalynn Schulner Ms. Monica Schwafaty Ms. Susan Schy Ms. Bianca Sementilli Mr. and Mrs. Martha and Michael Sementilli Ms. Cherri Senders Ms. Pamela Shortreed Ms. Natalie Shuck Mrs. Terri Siegfried Mr. Kenneth Simms Mr. Neil Sipos Ms. Caroline Sloniker Ms. Colleen Smith Ms. Jennifer Smith Mr. Kenny Smith Ms. Jeanelle Smith-Bauserman Ms. Sandra Snyder Ms. Margo Sommerfield Mr. Michael Spector Ms. Michelle Spitz Ms. Deborah St. John Ms. Michele St. John Mr. & Mrs. George& Jennifer Stapish Ms. Lily Stapish Ms. Sharon Starett Mr. Shawn Steen Mr. John Stephen Mr. Matthew Stevenson

Mr. Jonathan Stewart Mr. and Mrs. Mike and Marianne Stewart Ms. Virginia Sudol Mr. Norman Solomon Ms. Michele Supan Mr. Michael D. Sutherland Mrs. Suszi Sutherland Tosha Swan Ms. Erin Swanson Ms. Sandra Sykes Mr. John Talma Ms. Coral Taylor Ms. Becky Thom Mr. and Mrs. Teresa and Michael Tockstein Mr. & Mrs. Masa & Yuki Tone Ms. Toni Trenda Mr. and Mrs. Sheri and Larry Trudnich Mr. Hang Tsan Ms. Karen Tucker Mr. Martin Uribe Ms. Alica Vallejo Ashton Vian Ms. Barbara Vick Ms. Elena Villareal Mr. Logan Villareal Mr. Daniel Villeda Ms. Mary Vitale-Zarlin Mr. Gregory Vitale Ms. Jamie Vitale Mrs. Janet Voelker Mr. Joey Walker Ms. Kathryn Wallace Ms. Elaine Wassil Mr. Josh Weatherman Ms. Sheila Weinberg Ms. Heather Welles Ms. Lisa Welser Ms. Mary Wexler Mr. and Mrs. Carol and William White Mr. William White Mr. Bob Williamson Ms. Trish Wilson and Joy and Mr. Terry Joy Mr. Todd Wilson Mr. James Winkle Ms. Heather Wise Mr. and Mrs. Matthew and Heather Wise Mr. Matthew Wise Ms. Sydney Wise Zeelynn Wise Mr. Michael Wooden Mr. David Worthington Ms. Juniel Worthington Ms. Gloria Wright Mr. Connor Yardumian Ms. Isabelle Yardumian Mr. and Mrs. John and Christy Youk Mr. John Youk Mr. & Mrs. Bill & Linda Young Ms. Susie Zachik Ms. Christina Zboril

39 2017 ANNUAL REPORT

Pacific Heart, Lung and Blood Institute 10780 Santa Monica Blvd. Suite #101 Los Angeles, CA 90025 Call Us Free: 1-888-996-Meso (6376) Email: info@phlbi.org Phone: (310) 478-4678 Fax: (310) 474-6376

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