UCI Magazine Winter 2020 -- Conquering Cancer by UCI Magazine

Winter 2020

MAGAZINE

Conquering Cancer

Middle Earth Rising Two new residential towers welcomed students on move-in day this fall. The $130 million expansion of the housing complex named for J.R.R. Tolkienâ&#x20AC;&#x2122;s fictional realm includes beds for 490 students, a dining hall, community rooms and office space for Housing Administration Services. Here, one gleaming structure reflects the other as they stretch up into the sky.

Fall2020 2017 Winter

Steve SteveChang Zylius / UCI

Contents

Winter 2020 Vol. 5, No. 1

Conquering Cancer

Beating Cancer – One Patient at a Time: At UCI, the

combination of research, evidence-based treatment and ongoing training results in state-of-the-art care

Battling Brain Cancer on All Fronts: Neuro-oncologist Daniela Bota’s pioneering work is improving outcomes for patients with the most aggressive form of the disease

D E P A R T M E N T S FLAS H BACK

PRISM

SPOT L IGHT

S PEC T RUM

On the Cover: Claudia Benavente (standing), assistant professor of pharmaceutical sciences and developmental & cell biology, observes Aditi Mehta, a pediatric hematology/oncology fellow from the UCI-CHOC Children’s Hospital program, in her lab. Benavente was awarded a $2.1 million grant in June from the National Cancer Institute to develop a novel therapeutic intervention for osteosarcoma, a childhood bone cancer. Photo by Steve Zylius / UCI

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30 Gut Feelings: Tackling cancer with innovation and compassion at UCI’s H.H. Chao Comprehensive Digestive Disease Center

34 Saving Mother and Child: Multidisciplinary teams of UCI

oncologists and maternal-fetal specialists utilize scientific advances to treat patients with high-risk pregnancies

P E R S PE CT I V E

R E FLECTIONS

A NT OURAGE

The Speed King: Professor Greg Weiss and collaborators have developed a method of detecting cancer molecules within minutes, a breakthrough that could save lives

PA RT ING ZOT !

About This Issue: This edition of UCI Magazine highlights myriad efforts by campus researchers and UCI Health physicians in “Conquering Cancer,” a

disease that sees about 1.7 million newly diagnosed cases in the U.S. each year. Our cover story, “Beating Cancer – One Patient at a Time” (page 14), illustrates how clinicians at the UCI Chao Family Comprehensive Cancer Center are making strides ranging from earlier detection using AI to translating lab discoveries into promising new trials and therapies. “Battling Brain Cancer on All Fronts” (page 26) profiles neuro-oncologist Daniela Bota and her groundbreaking work with aggressive glioblastoma. “Gut Feelings” (page 30) takes an in-depth look at how UCI’s H.H. Chao Comprehensive Digestive Disease Center has adapted an endoscopic technique from Japan to treat esophageal cancer, and “Saving Mother and Child” (page 34) tells the poignant stories of how multidisciplinary teams came together to help two pregnant women diagnosed with cancer. Finally, “The Speed King” (page 38) chronicles how chemistry professor Greg Weiss, motivated by personal loss and a desire to be quick, developed a way to detect cancer on the molecular level – in mere minutes.

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Letters to the Editor Fall 2019: “Brilliant Future” During my first week on campus in the early 1980s, I was extremely fortunate to have been invited to dine with other incoming freshmen at the home of UCI’s first chancellor, Dan Aldrich. From that moment on, I was hooked by the lure of the “Anteater experience” and became as active on campus as I could. Over the last several decades, my alumni involvement has ebbed and flowed as circumstances allowed. Reading the most recent edition of UCI Magazine, about the launch of the Brilliant Future campaign, has brought back fond memories of my years at UCI. The excitement of what is to come and UCI’s incredible commitment to excellence have inspired me – and should inspire us all – to re-engage with the school and fellow alumni. UCI is no longer Orange County’s best-kept secret! Zot! Zot! Zot! Michael O’Heany ’86 Treasurer, UCI Alumni Association board of directors

.................................. Reading through the “Brilliant Future” edition of UCI Magazine filled me with joy. To learn about the engaging work our students and faculty are doing – from researching ways to cure Alzheimer’s to having our community engaged in philanthropy against cancer – really goes to show how active my alma mater is in Orange County. Having professors, students, faculty and staff tell their stories is heartwarming. I know my experience at UCI was life-changing, so to see amazing stories of groundbreaking research and engagement, and the support Chancellor Gillman provides, makes me proud to be an alumnus.

What I loved about the “Brilliant Future” issue are the stories of Anteaters changing lives for the better through partnerships and support. It was beautiful and inspiring to read stories of turning grief into action; giving a gift to accelerate research after the loss of a loved one; and creating a storytelling center to foster understanding and connection. As LaVonne Smith wrote in “Do Tell” (page 38): “Everyone has a story to tell … and it’s always possible that their story can begin to change the world.” As a graduate in global cultures, I am proud to be part of a university that is so passionate about changing the world. Andi Long ’12 Irvine

.................................. Spring 2019: “Together We Zot!” As a longtime UCI enthusiast, I was thrilled to see the issue celebrating UCI Athletics. My husband and I are ardent supporters of both the men’s and women’s basketball programs, so it was delightful to read about all of those exciting moments we shared with the teams. But more importantly, it reminded us of why we have such a deep sense of pride in the university. Congratulations to UCI Athletics. (I also know that with Paula Smith as the new athletics director, there will be many more successes to celebrate in the future.) Go ’Eaters! Holly Ackman Irvine

UCI Magazine Vol. 5, No. 1 Produced by the University of California, Irvine Office of Strategic Communications & Public Affairs Chancellor Howard Gillman Associate Chancellor, Strategic Communications & Public Affairs Ria Carlson Assistant Vice Chancellor, Public Affairs Sherry Main Managing Editor Marina Dundjerski Design Vince Rini Design Visuals Steve Chang and Steve Zylius Copy Editor Kymberly Doucette Editorial Advisory Committee Jennie Brewton, Mandi Gonzales, Stacey King (athletics), John Murray (health), Will Nagel, Brian O’Dea (health), Janna Parris (advancement), Albert Recinos, Mara Schteinschraber and Lisa Zwick (alumni) Contributing Writers Christine Byrd, Greg Hardesty, Rosemary McClure, Kristin Baird Rattini, Roy Rivenburg, Shari Roan and Jim Washburn Contact Have a comment or suggestion? Address correspondence to: UCI Magazine UCI Office of Strategic Communications & Public Affairs 120 Theory, Ste. 100 Irvine, CA 92697-5615 949-824-6922 • ucimagazine@uci.edu communications.uci.edu/magazine UCI Magazine is a publication for faculty, staff, alumni, students, parents, community members and UCI supporters. Issues are published in winter, spring and fall. To change your address or receive the electronic version of UCI Magazine, email a request to campusupdates@uci.edu. UCI Magazine is printed with soy-based inks on a recycled paper stock certified by the Forest Stewardship Council. Please recycle.

Alberto Vargas ’19 Washington, D.C.

We Want to Hear From You When submitting a letter to the editor, please include your full name, UCI graduation year or affiliation (if applicable), mailing address, city of residence, phone number and email address. Submissions that do not include this information cannot be published. Contact information is for verification purposes only – not for publication or commercial use. Letters should be 150 words or less and may be edited. They become the property of UCI/the UC Board of Regents and may be republished in any format.

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F L A S H B A C K

CoCo Goodson ’11

Jane Chin ’09

Jerry Green ’02

Photos: UCI Ath letics

Mike Evans ’83

Kris Roberts ’88

Jayson Jablonsky ’07

Rod Spen ce

’75

Vince O’Boyle

Anteater Legends

fter a 12-year hiatus, UCI Athletics has brought back its hall of fame, honoring some of the most accomplished athletes in program history. Eight new inductees were recognized Feb. 1 at a luncheon and, that night, at the men’s basketball game versus Cal State Fullerton. They are: Jane Chin ’09 (women’s golf), Mike Evans ’83 (men’s water polo), CoCo Goodson ’11 (women’s soccer), Jerry Green ’02 (men’s basketball), Jayson Jablonsky ’07 (men’s volleyball), Vince O’Boyle (coach of men’s and women’s cross country and track & field from 1982 to 2013), Kris Roberts ’88 (women’s volleyball) and Rod Spence ’75 (baseball). “We are honored to include these eight individuals in our hall of fame,” says athletics director Paula Smith. “This group shows the diversity and success of our programs, and we are excited to celebrate their legacy and the tradition of UCI.” The 2020 class, which encompasses national champions, All-Americans and an Olympian, brings the number of hall of fame inductees to 77 in 17 different sports.

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News

P R I S M

Putting Cancer on Ice Breast cancer survivor Michelle Clark-Salib (center left) – with her husband, Fady (in snow hat), and sons, Caleb (in her arms) and Elijah – drops the ceremonial puck during Hockey Fights Cancer Night, on Nov. 25, at the Honda Center in Anaheim. Henry and Susan Samueli, honorary chairs for UCI Health in the campus’s Brilliant Future campaign, and NHL players Ryan Getzlaf (Anaheim Ducks) and Anders Lee (New York Islanders) also get in on the action, which was presented by UCI Health. For more on Clark-Salib’s remarkable journey, see “Saving Mother and Child,” on page 34.

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Mastering Entrepreneurship UCI’s Paul Merage School of Business has launched a Master of Innovation and Entrepreneurship program, the first of its kind in the University of California system. The 42 students in the inaugural class, which began Sept. 26, are matched with mentors and participate in a variety of co-curricular

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activities – such as workshops, speaker series and site visits – that complement classroom instruction. This combination of academics and experiential learning will provide graduates with the entrepreneurial tools and connections necessary to launch a business or grow an established company. The nine-month, full-time, accelerated degree program is the result of a collaboration among Imran Currim, UCI Distinguished Professor of business and director of the campus’s Beall Center for Innovation and Entrepreneurship; Christopher Bauman, UCI associate professor of organization and management and MIE faculty director; and Ken Beall, managing member of Dartbrook Partners LLC and chairman of UCI Beall Applied Innovation. Their goal was to institute a unique program that adds value to what students learn in the classroom by leveraging the entrepreneurial expertise of the local business community. “So many entrepreneurs are deeply knowledgeable about the science, engineering or technology behind their ideas but have blind spots when it comes to the business issues,” Currim said. “By the time they graduate, our students will be able to strategically build teams, foster collaboration, create new markets, redefine existing ones, and finance and grow a business.”

A Tribute to No. 12 UCI Athletics retired former Anteaters star Scott Brooks’ No. 12 jersey at the Bren Events Center during the Nov. 30 game against Eastern Michigan. It’s only the second jersey hung from the rafters in men’s basketball history; Kevin Magee’s No. 44 was retired in 1995. And it’s just the third one retired across all UCI athletic programs, joining former baseball head coach Mike Gillespie’s No. 19, which was retired in 2018. Currently head coach of the Washington Wizards, Brooks also led the Oklahoma City Thunder from 2008 to 2015. “I’m humbled by this recognition,” he said. “UCI holds a special place in my heart. I’m grateful to [former] coach Bill Mulligan and my teammates, who I share this honor with.”

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“What makes these prosecutions so deeply problematic is that coinciding with these women’s poverty and also their drug use and addiction happen to be the situations in which they live. This is an area where there’s so much ambiguity.” Michele Goodwin, UCI Chancellor’s Professor of law and author of the forthcoming book Policing the Womb, on the prosecution of women in connection with the drug-related deaths of their stillborn children Los Angeles Times Nov. 26, 2019

On Your Mark … Karen Isble, campaign director and associate vice chancellor for university advancement, adds a flourish to the “surge” mark for UCI’s $2 billion Brilliant Future fundraising endeavor at an Oct. 4 launch festival in Aldrich Park for faculty, staff and students.

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Health

Arming Tomorrow’s Doctors With Today’s Technology

Greg and Sally Palmer

The students of the UCI School of Medicine Class of 2023 received more than a white coat and a handshake at their induction ceremony in August. Dean Michael J. Stamos also presented each with a sleek, hand-held ultrasound device called a Butterfly iQ. Stamos’ announcement of the gift was met by a moment of stunned silence before the students leaped to their feet and began cheering. It’s the first medical school class in the nation to receive hand-held ultrasound devices to augment their four-year education. In 2010, UCI became the first school in the country to present each student with a curriculum-loaded iPad. Equipping every class member with a Butterfly is the latest manifestation of UCI’s 10-year-old iMedEd Initiative, which emphasizes digital and cutting-edge instruction, Stamos says.

The Butterfly gift was made possible by Sally and Greg Palmer. In January 2019, Sally Palmer was treated for breast cancer at UCI Medical Center; her husband serves on the UCI Health Advisory Board. The portable machine, which costs $2,000, can scan a person’s entire body and display the results on a smartphone. Doctors of tomorrow recognize the impact of being able to reach into their pocket and take a peek into their patients’ bodies, Stamos notes. “They were really, truly excited,” he says of the incoming class. “I was warmed by their emotions. They immediately got it and understood the advantage it gave them and how it would propel their careers.” Says first-year student Leonardo Alaniz: “I’m ready to start rocking this Butterfly ultrasound device and go save some lives.”

Dr. Chris Fox, chair of UCI’s Department of Emergency Medicine, demonstrates the Butterfly iQ, a hand-held ultrasound device, at the 2019 White Coat Ceremony.

What Not to Do When Mass Tragedy Strikes A shooter kills dozens of people. We turn to the television for the news – horrified, transfixed and, says a UCI social scientist, putting ourselves at risk of psychological harm. Roxane Cohen Silver, professor of psychological science, has spent her career analyzing the impact of tragedy on mental health and recently uncovered some fascinating information about the role of media in natural and manmade disasters. In a longitudinal survey of more than 4,000 U.S. residents conducted after the 2013 Boston Marathon bombings and the 2016 massacre at the Pulse nightclub in Orlando, Florida, Silver and her colleagues found that extensive media exposure can result in increased anxiety as well as persistent worry about future disasters. The study, published in the journal Science Advances, strongly suggests that repeated viewing of tragic, even gruesome, videos and photos doesn’t help people cope, as many might instinctively think. Instead, the media bombardment can exacerbate stress, sadness, worry

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and fear and coax people into habitual consumption of mass tragedy coverage, especially those already prone to anxiety or stress disorders. “We see a large range of psychological consequences for individuals who are exposed to these kinds of videos,” Silver says. “It’s a cycle. It would be helpful to circumvent that cycle.” The lesson for media companies is to avoid sensationalizing an already fraught moment, she says. But viewers need to shield themselves from the heart-wrenching fallout. It begins by recognizing that immersing oneself in the news coverage may contribute to depression and anxiety, Silver explains. “I, personally, don’t engage in any social media. I don’t watch TV,” she says. “I think we can be informed without repeatedly being exposed to sensational images or stories or videos that loop over and over again. We argue that people should be mindful of the number of hours they’re spending attending to these tragedies. Turn off the TV and put the phone down.”

S P O T L I G H T

Steve Zylius / UCI

A Frankenstein for Our Times

rtificial intelligence, genetic engineering and eerie dreams converge in “Reading Frankenstein,” a multimedia swirl of sight and sound staged last fall at UCI’s Experimental Media Performance Lab. Above, the Creature (played by Abel Garcia, a second-year M.F.A. drama student) has evolved into a living entity that attempts to prevent scientist Mary Shelley (Kaden Kearney, M.F.A. drama ’19) from annihilating him (thereby thwarting his plans to take control of her lab and, eventually, all organisms on Earth). Informed by “the autonomy of AI and the accelerating scientific possibilities of CRISPR,” the show raises questions about “ethics and evolution in an era of genetic possibility,” says director Annie Loui, a Claire Trevor School of the Arts professor who created the work with fellow faculty members Antoinette LaFarge and Lonnie Rafael Alcaraz, in collaboration with neurobiologist and School of Medicine Professor Emeritus Jim Fallon. The performance was sponsored by UCI Illuminations, the UCI Center for Medical Humanities and UCI’s Institute for 21st Century Creativity.

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S P E C T R U M

Thailand Bangkok

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Curbing Pandemics International threats of infectious diseases demand a new generation of health professionals across the globe. To that end, UC Presidential Chair Oladele “Dele” Ogunseitan, who founded UCI’s Department of Population Health & Disease Prevention, recently joined the executive team of the One Health Workforce–Next Generation project. Supported by an $85 million grant from the U.S. Agency for International Development and based at UC Davis, the project provides multidisciplinary training for health workers to preclude public health crises – such as pandemic influenzas or the spread of incurable diseases – by recognizing the interconnection among people, animals, plants and their shared surroundings. “If we want to prevent and stop diseases like Ebola, we have to understand these intersections,” Ogunseitan says. In November, he traveled to Bangkok to meet with representatives from the South East Asia One Health University Network. The visit coincided with a rabies outbreak in the northwest part of the city. Says Ogunseitan: “The SEAOHUN had an important role, as Indonesia was able to share its expertise with Thailand, having suffered a similar outbreak in the recent past.”

Oladele Ogunseitan

UCI Magazine

Winter 2020

Q&A

P E R S P E C T I V E Allen Chao CEO, Tanvex BioPharma Inc. Philanthropist

The Chao siblings and their spouses are (front row, from left) June Chao, Agnes Kung, Lee Chao and Phylis Hsia and (back row, from left) Richard Chao, J.K. Kung, Allen Chao and David Hsia.

Cancer Crusaders Over the last two decades, one local family has quietly transformed cancer care in Orange County, impacting thousands of lives. Siblings Allen Chao, Agnes Kung, Phylis Hsia and Richard Chao, together with their spouses, have strategically invested nearly $30 million toward cancer research and patient care at UCI. Today, the Chao Family Comprehensive Cancer Center is Orange County’s only National Cancer Institutedesignated comprehensive cancer center – one of just 51 across the country. The Chaos’ generosity helped complete the laboratory space for groundbreaking cancer research and renovations at UCI’s H.H. Chao Comprehensive Digestive Disease Center. Most recently, they created two endowed chairs at the university: the Chao Family Endowed Director’s Chair in Cancer Research and Treatment, held by Dr. Richard Van Etten; and the Chao Family Endowed Chair

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for Cancer Clinical Science, held by Dr. Susan M. O’Brien – like Van Etten a renowned leukemia researcher. Allen Chao (top row, third from left), CEO of Tanvex BioPharma, took a moment to discuss his family’s ongoing efforts to improve the affordability and accessibility of high-quality healthcare.

What made you decide to fund cancer research? Three generations of our family have been involved in the medical and pharmaceutical industries, and we always knew that cancer was a debilitating disease and that we should support cancer research. So we did. But then I had my own stomach cancer scare, and I was so thankful to Dr. Kenneth Chang at UCI for curing me. After that, we felt it was even more important to support better education and research that would lead to earlier

diagnosis and better treatment. With UCI, we believe we can achieve these goals and provide better cancer care to our community, and that’s motivated us to keep giving. There are plenty of hospitals in Southern California, so why did you choose UCI? We live in Orange County. We want to ensure that our friends, family and community have access to the best possible physicians, patient care, treatments and research. From personal experience, I know that it’s much better for both treatment and post-treatment to be near family and friends and not have to drive for hours to receive care. Over time, what do you hope your gifts will accomplish? We hope that our past and current donations will stimulate more research and attract more grants, as well as provide better care for the community and patients. Where did your family’s commitment to philanthropy come from? My parents started pharmaceutical companies in Taiwan, and then I continued that tradition with my own companies in the U.S. But my parents were always teaching and preaching that we need to remember where we come from, who made us successful and what community we serve. Therefore, we wholeheartedly believe in paying back both the institutions and the community that made us who we are. My father just wanted to see us be good citizens and help the people around us. You founded two pharmaceutical companies, Watson Pharmaceuticals in 1984 and Tanvex BioPharma in 2013. What was the motivation behind each of them, and how are they different? The name Watson honors my mother, Hwa, so the name comes from “Hwa’s son.” The vision when we founded Watson Pharmaceuticals was to create high-quality, lowcost generic pharmaceuticals. Our portfolio grew from one generic drug to two to a dozen, and then we started developing new drugs and eventually added a distribution company. In 2008, the company was worth about $3 billion, and we had created a lot of jobs. So I retired and started another small company. I really enjoy starting companies and helping people. I founded Tanvex BioPharma to focus on developing, manufacturing and distributing a new generation of drugs called biologics. These are often very expensive drugs for cancer, arthritis and allergies, and we want to make them more affordable. I feel it’s my new mission to help with the biologic field. That’s the next horizon.

Many pharmaceutical companies today are under scrutiny for their business practices and soaring drug prices. What’s your perspective? When I was young, I was taught that the purpose of drugs is to help the patients. As a pharmaceutical researcher and a businessman, I believe what’s most important is to create high-quality, affordable medicine. Yes, you need to recoup your investment in order to put more money into the research and jobs, and that’s a positive cycle. There’s a proper way to make a profit with pharmaceuticals, but more importantly, there’s a mission to help people.

“Three generations of our family have been involved in the medical and pharmaceutical industries, and we always knew that cancer was a debilitating disease and that we should support cancer research.”

You’ve donated to other educational institutions besides UCI. What’s the appeal of higher education for you? I earned my Ph.D. at Purdue University, so I set up an endowment there. Before that, I graduated from pharmacy school at Taipei Medical University, and so I serve on its board of trustees and support education and research. Even after 50 years in this country, I still believe that the United States is a land of opportunities. That’s part of the grand mission of the university. I see students who come to the U.S. to go to college and learn and grow, and they go on to contribute to our workforce and creativity. This country has been very tolerant as I’ve learned my way – and I’m learning all the time. It’s a great thing that this country accepts new people and trusts that we will adjust and contribute too. So we try to create a snowball effect that, hopefully, is regenerating.

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UCI Magazine

Beating Cancer – One Patient at a Time At UCI, the combination of research, evidence-based treatment and ongoing training results in state-of-the-art care By Shari Roan

Photos by Steve Zylius

ike most people, John Gifford wasn’t looking forward to a colonoscopy when he arrived on the UCI Medical Center campus in Orange in 2018. The Riverside man, 65, was concerned about his family history of colorectal cancer and had dutifully scheduled an appointment with UCI Health gastroenterologist William Karnes. The exam turned out to be intriguing and enlightening – a far cry from what one expects during a colonoscopy, Gifford recalls with a laugh. While the day-before prep had been the same annoying process, the test itself featured new technology – pioneered by Karnes, associate clinical professor in UCI’s School of Medicine – that uses artificial intelligence to make screening easier and more accurate. Running the AI program in real time during the exam, Karnes discovered two small precancerous polyps that might have been missed without the technology. He removed them, reducing the risk that his patient will develop colorectal cancer anytime soon. “It’s terrific to find these polyps so early,” Gifford says. “AI enhances your comfort level, and it helps reassure you that you’re getting the best care possible.” The colonoscopy even seemed easier than the one he had undergone 10 years earlier, he says. “It was pretty much painless,” says Gifford, who opted not to receive any anesthesia or moderate sedation and chatted with Karnes as both watched the computer screen. “Normally, you wake up and get a report that’s written for your doctor. But when you’re going through this, you’re seeing the same thing the doctor is seeing. That enhanced the experience for me.”

UCI gastroenterologist William Karnes (right) has developed an AI colonoscopy program that catches smaller precancerous growths sooner, as happened during patient John Gifford’s procedure.

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At a Glance

Removing some of the mystery associated with the development of cancer – its randomness and complexity – is foremost on the minds of doctors and researchers on the UCI campus and at the Chao Family Comprehensive Cancer Center in Orange. It’s one of only 51 National Cancer Institute-designated comprehensive cancer centers in the nation. That means patients can expect to receive the most advanced cancer care bolstered by a commitment to novel research – such as Karnes’ pursuit of AI colonoscopy – says Dr. Susan O’Brien, associate director for clinical science at the Chao Center and medical director of the Sue & Ralph Stern Center for Cancer Clinical Trials & Research. “What we have here is a continuum from basic science research to being able to translate those discoveries in the lab to clinical trials,” she says. “That’s the benefit academic medical centers have that other hospitals don’t.”

UCI Chao Family Comprehensive Cancer Center • • • •

Brings together clinicians and researchers from more than 32 departments across six schools at UCI Is one of 51 National Cancer Institute-designated comprehensive cancer centers in the country Has treatment specialties and subspecialties in 23 types of cancer At any given time, offers more than 150 clinical trials testing new cancer treatments, many of them developed by Chao Family Comprehensive Cancer Center members

What is an NCI-designated comprehensive cancer center? The 51 NCI-designated comprehensive cancer centers in the U.S. must: • Meet rigorous standards for transdisciplinary, state-of-the-art research focused on developing new and better approaches to preventing, diagnosing and treating cancer • Demonstrate excellence in laboratory, clinical and population-based research • Train and educate biomedical researchers and healthcare professionals • Take steps to alleviate the specific burden of cancer on the population served by the center Source: UCI Chao Family Comprehensive Cancer Center and National Cancer Institute

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Stopping Cancer Before It Starts The NCI designation also means that doctors are focused not only on treating and curing cancer but on cancer prevention and early detection, notes Dr. Richard Van Etten, director of the Chao Center and a professor of medicine in the Division of Hematology/Oncology. “Most cancers are diagnosed too late,” he says. “For a lot of cancers, the major route to a cure is surgery, and that will only work if you catch them early. Among the things that will transform oncology in the future are ways to detect cancer early.” UCI has made tremendous strides in the prevention and early detection of gastrointestinal cancers, says Dr. Kenneth Chang, executive director of the H.H. Chao Comprehensive Digestive Disease Center in Orange. The center has the only endowed chair in the country devoted to treating cancer with endoscopy – a minimally invasive procedure that spares patients open surgery. “We know that cancer has a timeline,” says Chang, who holds the Vincent and Anna Kong Chair in Gastrointestinal Endoscopic Oncology. “The very first cancer cell that appears in the patient’s body is the earliest stage. Then it continues to grow and metastasize until it gets to an advanced stage. But almost all cancers have a precancerous stage when the cells are not normal.” He continues: “There is also what I call a pre-precancer state in which the patient is genetically and environmentally set up for cancer or is at high risk for getting on the cancer spectrum. We’re doing a lot of work on early detection, getting rid of precancers and addressing pre-precancers.”

“Cancer is not one disease; it’s about 150 different diseases – and we have national experts in all of them. That allows our doctors to be the most up to date on the latest treatments and clinical trials. Many cancer patients will ultimately relapse after initial treatment and will no longer have standard treatment options. That’s where we come in with our clinical trials.” Dr. Richard Van Etten Director, Chao Family Comprehensive Cancer Center

An Easier Examination Researchers at UCI’s H.H. Chao Comprehensive Digestive Disease Center are part of a multi-institutional team testing a new way to check for precancerous lesions in the esophagus that may lead to cancer. Instead of inserting an endoscope through the mouth and into the esophagus, the new technique relies on little more than a patient’s ability to swallow. The Cytosponge is a piece of mesh sponge contained in a gelatin capsule. After the patient ingests the capsule, it dissolves, and the sponge absorbs cells from the esophagus as it’s withdrawn from the patient via an attached string. The cells are examined for changes that may indicate cancer or a condition called Barrett’s esophagus, a precursor to esophageal cancer. Once diagnosed, Barrett’s esophagus can be treated to reduce the risk of cancer. A similar technology, called EsoCheck, is also being evaluated at UCI. “We are one of the first institutions in the country to have this technology,” says Dr. Kenneth Chang, executive director of the CDDC. “These are point-of-service exams: The patient walks into their primary care doctor’s office, and they get the Cytosponge or EsoCheck. They allow us to significantly move the dial on cancer prevention and early detection.”

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For example, Chang says, one strategy begins with acknowledging that obesity is a major risk factor for many forms of cancer, especially digestive tract cancers. “We’re tackling obesity as a pre-precancer,” he says. “There are a lot of studies looking at how obesity will overtake smoking as the most detrimental risk factor in cancer incidence and cancer deaths. In practically all of the digestive cancers, obesity is a risk factor.” To address that, UCI has founded a comprehensive, state-of-the-art weight control center offering nutritional counseling, psychological and behavioral programs, integrative health services, weight loss medications, and endoscopic and laparoscopic procedures. “This is about moving from disease to health,” Chang says. “This is the future of medicine. We can genetically profile people, alter their environments and risk factors, and do proper cancer screening.” Advances in screening are leading to better detection of precancerous lesions. UCI has been at the forefront of efforts to identify precancers that can develop into

stomach, pancreatic, esophageal and colon cancer, as illustrated by Karnes’ AI colonoscopy program. “The work of Dr. Karnes with AI is super exciting,” Chang says. “It’s a game-changer.” UCI researchers also are pioneering imaging technologies, such as optical coherence tomography, that utilize an endoscopic device to map the esophagus and examine individual cell clusters that indicate Barrett’s esophagus, a condition that can evolve into esophageal cancer. “We’ve got an amazing technical ability to detect and stage esophageal precancers as well as get rid of them,” Chang says. “That’s huge, because if you stop Barrett’s, your risk of cancer goes back to that of your neighbor.” Barrett’s esophagus can be treated in several ways, including radiofrequency ablation – a procedure that Chang helped develop in which an electrical conduction system heats and destroys abnormal cells. “UCI has become a breeding ground of innovation,” he says.

“This is about moving from disease to health. This is the future of medicine. We can genetically profile people, alter their environments and risk factors, and do proper cancer screening.” Dr. Kenneth Chang Executive director, H.H. Chao Comprehensive Digestive Disease Center

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“What we have here is a continuum from basic science research to being able to translate those discoveries in the lab to clinical trials. That’s the benefit academic medical centers have that other hospitals don’t.” Dr. Susan O’Brien Associate director for clinical science, Chao Family Comprehensive Cancer Center Medical director, Sue & Ralph Stern Center for Cancer Clinical Trials & Research

Matching Treatments to Patients On the opposite end of the cancer spectrum, UCI’s clinicians have access to the latest methods to cure many cancer patients, especially those with early-stage disease, and extend the lives of people with the most challenging and advanced cancers, O’Brien says. In the last decade, cancer treatment has been transformed by immunotherapy – designed to prod the immune system to fight cancer – as well as targeted

therapies, which address the molecular and genetic underpinnings of the disease. “Historically, our treatment for cancer was basically chemotherapy,” O’Brien says. “Chemotherapy can still be quite effective, but it’s not very specific, which is why you often have a broad array of side effects. Nowadays, we have more targeted therapies. The side effects are much more tolerable than with chemo. With targeted therapies, we’ve developed personalized care for patients, so not everyone gets treated the same way.”

Fixing a Deadly Gene Mutation UCI’s Chao Family Comprehensive Cancer Center is one of three sites worldwide participating in the first human study of a drug called MRTX849 that could have a revolutionary impact. The drug targets a gene mutation found in 22 percent of all cancers, including half of all colon cancers and one-quarter of lung adenocarcinomas. The KRAS mutation affects how cancer cells grow and divide. The study, led at UCI by oncologist Sai-Hong Ignatius Ou, a clinical professor in UCI’s School of Medicine, will explore the drug’s safety and whether it can block the mutation’s effects. Study participants are people with KRAS gene mutations who have an advanced cancer that has progressed despite conventional treatment. “If the drug works, it’s going to be almost like a miracle,” says Viola W. Zhu, a UCI Health oncologist who works closely with Ou on targeted-therapy trials. “We know this mutation, KRAS, but until now it has not shown itself to be targetable.”

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UCI’s doctors make use of targeted therapies and immunotherapy whenever possible while continuing to look for ways to enhance those methods as well as the traditional cancer treatments of surgery, chemotherapy and radiation. A discovery by Krishnansu S. Tewari, a UCI gynecological oncologist, for example, showed that the drug Avastin could be combined with chemotherapy to extend the lives of women with advanced cervical cancer. His findings were published in February 2014 in The New England Journal of Medicine. “That led to Food and Drug Administration approval of Avastin for advanced cervical cancer and changed practice in the United States and around the world,” Van Etten says. Rita S. Mehta, a UCI oncologist/hematologist also changed cancer practice globally when she directed a team of researchers who demonstrated that pairing the drugs Faslodex and Arimidex improves survival in women with advanced hormone receptor-positive breast cancer. Her study was published in The New England Journal of Medicine in March 2019. In addition, Mehta was one of the first physicians in the world to use chemotherapy combined with the drug Herceptin on women with breast cancer before – rather than after – surgery. The work by Tewari and Mehta underscores the innovation practiced at UCI on a daily basis, Van Etten says. Recent studies show that cancer patients who seek care or consultations at academic medical centers tend

to have better outcomes. Area residents with the most complex cancer cases should be referred to UCI for a consultation or second opinion, he adds. “Cancer is not one disease; it’s about 150 different diseases – and we have national experts in all of them,” Van Etten says. “That allows our doctors to be the most up to date on the latest treatments and clinical trials. Many cancer patients will ultimately relapse after initial treatment and will no longer have standard treatment options. That’s where we come in with our clinical trials.”

Joining Forces in Research UCI is home to more than 150 cancer clinical trials at any one time, O’Brien says. Some of them are part of large national or international studies. Others are unique to UCI or have emerged from basic research in campus labs. Recently, a nationwide clinical trial led by UCI was launched in which doctors will explore whether the nonsteroidal anti-inflammatory drug sulindac and the drug eflornithine, used to treat a parasitic disease called African trypanosomiasis, can prevent recurrence of colon cancer or adenomas, lesions that can develop into cancer. The idea was first proposed by Dr. Jason Zell, a UCI associate professor of hematology/oncology, and Dr. Frank Meyskens, director emeritus of the Chao Center, who shepherded the work from early lab studies to overseeing the trial, dubbed PACES.

Pushing the Pace of Immunotherapy Immunotherapy, which spurs the body’s immune system to recognize and fight cancer, has revolutionized some cancer treatments in recent years and has the potential to help many more patients. Now a UCI researcher is creating a lab-on-a-chip device to speed up the development of immunotherapy medications. In the human immune system, T-cells have molecules on their surface that bind to antigens on the surface of foreign or cancer cells. To treat a tumor with T-cell therapy, researchers must first identify exactly which receptor molecules work against a specific tumor’s antigens. UCI’s Weian Zhao, associate professor of pharmaceutical sciences, and his colleagues at Caltech, including Nobel laureate David Baltimore, have accelerated that identification process with a prototype technology called droplet microfluidics screening. The device, which is being created by UCI startup Amberstone Biosciences, identifies T-cell receptors for individual tumors within days. Conventional identification techniques can take months or years – time cancer patients often don’t have.

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“There hasn’t been a lot of work looking at how mechanical processes within solid tumors influence properties of cancer stem cells, which likely play a big role in fueling cancer aggressiveness. We’re proposing to build molecular tools that can be delivered inside cancer cells to correct epigenetic modifications that we know are driving the disease.” Tim Downing Assistant professor of biomedical engineering and microbiology & molecular genetics

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“Cancer is going to overtake heart disease as the No. 1 cause of death in the U.S. Our education and training mission is one of the most important things we do. We’re training the next generation of doctors. They will go out in the community and, I hope, become doctors who are on the leading edge of cancer treatment.” Dr. Michael J. Stamos Dean, UCI School of Medicine

“Many clinical trials are on very cutting-edge technologies where the only way a patient would have access to the treatment is to participate in the trial,” O’Brien says. “One of the big advantages of participating in a clinical trial is that if an agent turns out to be effective, which many of them do, patients get access well before – sometimes years before – that drug is commercially available.” Improvements in cancer cure rates also will depend on contributions from experts in computational science,

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mathematics and bioengineering, she notes. With an emphasis on multidisciplinary research, UCI is fertile ground for collaborations that will advance the field, says Tim Downing, an assistant professor of biomedical engineering as well as microbiology & molecular genetics. “These days, it’s less common that going into the lab, closing the door and working by yourself will be fruitful when it comes to understanding and treating highly complex diseases like cancer,” he says. “Being at a place like UCI, where the faculty are very collegial and really

good at working together, greatly increases the potential for finding real clinical solutions.” On the Irvine campus, Downing’s lab is flush with cash after the young professor earned the 2019 Director’s New Innovator Award from the National Institutes of Health – one of three early-career UCI researchers to garner the prize last year. The $2.3 million grant will help fund Downing as he uses the tools of mechanobiology to search for new therapeutic approaches to colon cancer and other solid tumors. Mechanobiology focuses on how physical alterations to cells and the substances that support them – such as collagen and other proteins – can lead to alterations in cellular and genetic functions and, ultimately, to disease. Downing employs next-generation genetic sequencing to explore those cellular differences. “There hasn’t been a lot of work looking at how mechanical processes within solid tumors influence properties of cancer stem cells, which likely play a big role in fueling cancer aggressiveness,” he says. “We’re proposing to build molecular tools that can be delivered inside cancer cells to correct epigenetic modifications that we know are driving the disease.”

Shaping Future Oncologists Physicians at academic medical centers are required to stay current with the rapid developments in cancer care for the sake of both their patients and students learning the craft. The UCI School of Medicine places a premium on creating “lifelong learners,” says its dean, Dr. Michael J. Stamos.

“What you learn now will be passé in 10 to 20 years,” he says. “It’s a matter of active learning. That has much more staying power than lecture-style learning.” Moreover, medical students, fellows, residents and interns benefit from exposure to laboratory research and clinical trials, Stamos says. “When students see us doing clinical trials, they see that things evolve very rapidly,” he says. “That has an undeniable impact.” But the doctors and cancer researchers of tomorrow also learn to see their patients as complex people whose health depends on lifestyle, psychosocial and environmental factors, Stamos says. In 2017, a $200 million gift from Orange County philanthropists Susan and Henry Samueli created a new template for applying

“Most cancers are diagnosed too late. For a lot of cancers, the major route to a cure is surgery, and that will only work if you catch them early. Among the things that will transform oncology in the future are ways to detect cancer early.”

Reducing the Side Effects of Radiation Dr. Charles Limoli, a professor of radiation oncology in UCI’s School of Medicine, is looking for ways to reduce the cognitive side effects of radiation treatment for brain cancer. Patients who undergo chemotherapy and radiation often complain of mental fatigue and fogginess, commonly referred to as “chemobrain.” Limoli has spent his career trying to preserve brain health during cancer treatment. He’s currently analyzing a quick-burst technique called “flash” radiotherapy in which a high dose of radiation is administered in a millisecond – delivering the traditional dose but faster. So far, studies in mice have shown that it reduces side effects related to learning, memory and mood. Limoli and his colleagues are the first to demonstrate that “the flash effect” can diminish long-term cognitive consequences. “Although more research needs to be done,” he says, “this has the potential to revolutionize cancer care worldwide.”

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science-based approaches to integrative medicine research, education and patient services. The gift will fund the construction of the Susan and Henry Samueli College of Health Sciences on the UCI campus, establish 15 Samueli research chairs across integrative medicine, and support undergraduate and graduate students who plan careers in the field. UCI is fast emerging as a national leader in integrative medicine, which appeals to many cancer patients, Stamos notes. A new mission-based UCI program called HEAL-IM gives medical students the opportunity to learn more about integrative medicine, with an IM focus woven into the entire curriculum. Stamos planned for 18 students in the first class. When 50 applied, he expanded the class to 24 students. “They clearly have an interest in and are attracted to UCI because of our focus on integrative medicine,” he says. Those doctors are likely to be in high demand. As the huge baby-boom generation ages, cancer incidence rates are projected to rise. UCI intends to be ready for that shift, Van Etten says. “Cancer is going to overtake heart disease as the No. 1 cause of death in the U.S.,” he explains. “Our education and training mission is one of the most important things we do. We’re training the next generation of doctors. They will go out in the community and, I hope, become doctors who are on the leading edge of cancer treatment.”

Building a New Hospital in Irvine Residents of Irvine and communities to the south may soon have the added convenience of receiving top-flight cancer treatment, and other medical care, in Irvine. The planned UCI Campus Medical Complex is expected to include a hospital, outpatient medical and surgical facilities, and emergency care. It will augment UCI’s 417-bed acute care hospital in Orange. The same cancer programs that are part of the Chao Family Comprehensive Cancer Center in Orange will be available in Irvine. The estimated completion date for the ambulatory portion is 2024, with the hospital completion in 2026. “The complex will be designed with an eye toward education and clinical research to make sure the cutting-edge advantage we bring to our patients by having residents and fellows and students in our midst continues into the future,” says Dr. Michael J. Stamos, dean of the UCI School of Medicine. “Having learners in our environment keeps us all on our toes.”

Targeting Liver Cancer UCI is undertaking research on one of the most novel and personalized approaches to immunotherapy, called chimeric antigen receptor T-cell therapy. It involves taking a patient’s own immune cells from blood, re-engineering them, then infusing them back into the patient to prompt his or her immune system to attack cancer cells. Two CAR-T therapies have already been approved by the Food and Drug Administration for blood cancers. So far, there are no approved CAR-T therapies for patients with solid tumors – such as cancers of the liver, pancreas, lung, colon or ovary. However, a similar type of immunotherapy research is underway at UCI in which a patient’s T-cells are modified to fight advanced hepatocellular carcinoma, an aggressive type of liver cancer. This clinical trial emphasizes UCI’s commitment to meeting the specific needs of the region’s residents, as required of a comprehensive cancer center, says Dr. Susan O’Brien, associate director for clinical science at the Chao Family Comprehensive Cancer Center and medical director of the Sue & Ralph Stern Center for Cancer Clinical Trials & Research at UCI. “Hepatocellular cancer is highly prevalent in Asians, and we have a very big Asian population in Orange County,” she says. “One of the problems with this cancer is that it’s often not detected until it’s very far along.”

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Battling Brain Cancer on All Fronts Neuro-oncologist Daniela Bota’s pioneering work is improving outcomes for patients with the most aggressive form of the disease By Kristin Baird Rattini

hen you’re facing a cancer diagnosis with an average survival span of 12 to 18 months, every milestone is a victory. That makes each wedding invitation, graduation announcement and birthday photo that UCI neuro-oncologist Daniela Bota receives from her patients a cherished validation of her 12 years of groundbreaking research on glioblastoma multiforme, the most aggressive form of brain cancer. “Because of our work, these people have been able to move on with their lives,” she says. Bota has pushed the boundaries of innovation in her quest to increase the survival rates of individuals with brain tumors, especially glioblastomas. The esteemed physician-scientist has taken a truly comprehensive approach to battling this rare disease, which has a fiveyear survival rate of only 10 percent and claimed the lives of U.S. Sens. Ted Kennedy and John McCain. Bota has conducted clinical trials of multiple cutting-edge treatments that are improving the quantity as well as the quality of life for glioblastoma patients at UCI and beyond.

‘So Much Potential, So Much Growth’ Bota grew up in Romania, in a family of engineers. It was assumed she’d follow them into the profession – she was a national mathematics champion in her youth –

but Bota had another path in mind. “I wanted to make a more significant contribution,” she says. “I wanted to combine my analytical side with a place where I could help others. I ended up becoming an M.D.-Ph.D. to blend both.” At USC, Bota earned a doctorate in molecular biology, focusing on neural degeneration. She then went to the University of Kansas for medical school and a residency in neurology. During her shifts, Bota found herself caring for people with brain tumors – and discovered a new direction for her medical career. “The generosity and gratitude of brain tumor patients make it so rewarding to care for them,” she says. “I see it again and again at UCI. Many of these patients have a terminal diagnosis, but they’re volunteering their time and energy to participate in our clinical trials to help us build a better treatment and, hopefully, in the future, a cure.” After a neuro-oncology fellowship at Duke University, Bota joined the faculty of UCI’s School of Medicine and the Chao Family Comprehensive Cancer Center in November 2007. “Both my career and UCI in general have grown so tremendously over the dozen years since,” says Bota, who’s now co-director of the UCI Health Comprehensive Brain Tumor Program. “There has been so much potential, so much growth, so many changes and so much scientific revolution helping us move forward in so many different directions. It’s a very exciting time.”

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A Comprehensive Approach The word “comprehensive” carries significant weight in the realm of cancer care centers. The “comprehensive” designation from the National Cancer Institute recognizes an added depth and breadth of research that bridges multiple scientific areas. Just 51 cancer centers in the U.S. carry the designation; the Chao Family Comprehensive Cancer Center is the only one in Orange County. “We offer one of the most innovative and complex portfolios of clinical trials anywhere in the world,” Bota says. Her own multipronged attack against glioblastoma multiforme reflects the center’s comprehensive approach. Bota’s work on the experimental drug marizomib has generated significant attention and hope. Unlike traditional chemotherapy drugs, marizomib can penetrate the blood-brain barrier – the filtering mechanism that prevents many blood-borne substances from passing into brain tissues – and inhibit cancer growth without causing damage to other parts of the brain. Over the past 12 years, Bota has shepherded marizomib from preclinical development all the way through a 700-person international phase III clinical trial now underway. “We have a number of patients from our clinical trials who are surviving this tumor for longer periods of time than usually expected,” she says. Amanda Johnson, a 32-year-old freelance writer in Mission Viejo, has been receiving marizomib for two years under Bota’s care. Her large glioblastoma tumor – which straddled both sides of her brain – has shrunk so much that it’s no longer measurable. She has returned to work on her novel and even joined a gym. “I feel so happy just to be alive,” Johnson says. Larry Johnson, her father, told Fox News, “I don’t think [Amanda] has come to realize how important her survival is to other people and families who are going to find themselves in a similar situation.” Bota strives to reach a point where such cases will be so commonplace that they don’t make the news. “That’s

what success looks like – not having a prominent publication or being part of a game-changing discovery,” she says. “It’s having patients like Amanda still be here and doing well.”

Vaccine Trials and Right to Try To achieve that goal, Bota tenaciously pursues multiple avenues of treatment. She has been a leader in the use of Optune, a device worn on the head that generates an electrical field that disrupts the growth of cancer cells. “We were among the first in the country to explore and use this technology,” Bota says. “Now we’re working with physicians from other countries to help them adopt it in their practices.” She is also spearheading two clinical trials on cancer vaccines. “Brain tumors hide behind the blood-brain barrier, so the body doesn’t recognize them as not being a normal part of the body,” Bota explains. “With our vaccines, we extract cellular markers from the patient’s tumor and inject them back into the patient to stimulate the immune system to recognize those tumors, attack them and, if possible, eliminate them.” She adds: “Both studies have been well-received in our neuro-oncological community, which is highly promising. And a significant benefit is that the vaccines function with minimal or no toxicity.” In January 2019, one of Bota’s patients who was ineligible for both clinical trials was able to access one of the vaccines through the first successful application of the national Right to Try Act. Passed in May 2018, it allows people with terminal illnesses, in consultation with their doctors, to seek treatment with experimental drugs not yet approved by the Food and Drug Administration directly from pharmaceutical companies. “The law puts patients in charge of their care; they initiate contact with the manufacturer and request therapy,” Bota says. “It gives patients who don’t qualify for clinical trials another option.”

“We offer one of the most innovative and complex portfolios of clinical trials anywhere in the world.”

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Dr. Daniela Bota shares a joyous moment with 32-year-old Amanda Johnson. After two years in a clinical trial, Johnson’s large glioblastoma shrank so much that it’s no longer measurable.

Sharing Her Expertise Bota eagerly offers her knowledge beyond the doors of the Chao Family Comprehensive Cancer Center. Whenever she and her husband, Robert, a local psychiatrist, travel back to their home country of Romania, she consults with medical colleagues there, as there are no certified neuro-oncologists in the nation. On days when the couple work on their farm in the Transylvanian Alps, locals come to them – often on foot – for medical advice. The two hope to eventually establish a clinic in the area. “I want to make sure that Romania also benefits from my medical expertise,” Bota says.

Back on campus, in her capacity as senior associate dean for clinical research, she uses her vast clinical trial experience to help colleagues in UCI’s School of Medicine advance their own research projects into the clinical arena. “I’m excited by the ability to impact the lives of so many people through this role,” Bota says. “Whether it’s for burns or vascular disorders or other conditions, people come to UCI for the same reason: We can offer what community hospitals cannot. Being able to make that happen, to create new options for our patients, is what wakes me up in the morning.”

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Esophageal cancer survivor Alwyn Kong, pictured here with his friend Shaggy, says the endoscopic submucosal dissection he received not only removed the tumor but quickly restored him to his normal life.

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Gut Feelings Tackling cancer with innovation and compassion at UCI’s H.H. Chao Comprehensive Digestive Disease Center By Jim Washburn

he long, winding river that is the human digestive tract is prone to all manner of diseases, from the merely irritable to the decidedly deadly. All fall under the purview of the H.H. Chao Comprehensive Digestive Disease Center, an internationally lauded assemblage of doctors, pooled knowledge and technology devoted to gastrointestinal health gathered under one roof at the UCI Medical Center campus, in Orange. According to executive director Dr. Kenneth Chang, who holds the Vincent and Anna Kong Chair in Gastrointestinal Endoscopic Oncology – the nation’s only such endowed chair – the ethos that permeates the CDDC is “innovation fueled by compassion.” Both qualities contribute to the center’s often-pioneering approach to curing cancers and improving patient outcomes. Some of the most common, potentially deadly and hard-to-treat cancers are in the digestive system, in parts of the body generally ignored unless a tumor lodges there – such as the esophagus. In an understatement, Jason Samarasena, CDDC gastroenterologist and associate clinical professor of medicine, notes that “removing your esophagus is sort of a really big deal.” The tube connecting the throat and stomach really doesn’t look its best on a stainless steel tray. That’s where it’s removed to, however, in the standard surgical procedure for esophageal tumors. The cancerous sections are excised, and when the shortened esophagus is reinstalled, the stomach typically is relocated into the rib cage to be attached to it.

“Even our esophageal surgeons tell me the only thing worse than getting esophageal cancer is getting surgery for esophageal cancer,” Samarasena says. A successful surgery means one gets to live and return to a relatively normal life. But that’s not what Samarasena’s surgery-bound patients are focused upon, he says: “They’re worried about being cut open, feeding tubes, the risks and the monthslong recovery.” That was the case with Alwyn Kong (no relation to Vincent and Anna Kong) when a tumor was found in his esophagus in 2018. He was referred to UCI Health and put on the list for surgery. Kong looked into what that entailed and, he says, “went from shock to disbelief to freaking out, imagining every worst possible outcome.” What he didn’t imagine was waking up from an exploratory endoscopic ultrasound to have Samarasena tell him he was a likely candidate for an outpatient procedure called endoscopic submucosal dissection, which involves no external surgery, organ relocation or long recovery. “This was all an unknown to me, but Dr. Sam was so enthusiastic about it that I decided it was the way to go,” recalls Kong, now 59. With ESD, the patient is sedated and an endoscope accesses the esophagus via the mouth. The tumor is injected with a fluid to lift it and define its borders. In a successful operation, the growth is endoscopically excised and the area is tested for clean margins. Kong was back home within 12 hours of the ESD and says that within a week, he was fully recovered “and eating tostada salads again.”

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Adapting Procedures for Success It was fortuitous for Kong that he wound up at the CDDC, one of the first, foremost and most experienced facilities in the U.S. performing ESDs. The ESD procedure was developed in Japan and has been adopted in other East Asian countries, where a high incidence of stomach cancer dovetails with endoscopy’s efficacy at removing gastric tumors. Chang became interested in the procedure in the late 1990s and sent one of his fellows to Japan to study it. Along with wanting to provide an alternative for U.S. stomach cancer patients, he saw the potential for treating other cancers. In the years since, Chang has overseen the expansion of ESD to treat Barrett’s esophagus (a cancer precursor), as well as early esophageal and colon cancers. To date, the CDDC has performed more than 100 such procedures, and it’s a major teaching facility for spreading the technique. While Chang believes the word “pioneer” should be reserved for the physicians in Asia who developed the process, “we have been deeply involved in how these technologies are being refined and iterated. We assess various devices and ask ‘Why can’t we do this with it, or combine this with that? How can we make this better, faster, easier?’” He’s taken an endoscope to new areas as well. “I developed the ability to examine the liver by an endoscopic ultrasound,” Chang says. “From inside the stomach, I can do a liver biopsy that’s less invasive than coming from the outside, and I can directly measure the pressure on the key vessels going into and leaving the liver to determine if it’s progressing toward cirrhosis. That’s a UCI first.”

Early Detection Is Essential While Chang and the CDDC are expanding the endoscope’s utility into other regions, there is one limiting caveat for its use in removing esophageal cancer: The tumor has to be caught in its early stages, as was the case with Kong. If

it has spread more than 500 microns (about the thickness of two standard playing cards) into the esophageal wall, the invasive chest-opening surgery is likely needed. Chang was especially pleased when early detection allowed him to help a 68-year-old patient, Rubin Molina, who had come to the CDDC with a recurrence of esophageal cancer, after undergoing a surgical excision at another facility two years earlier. “Surgery the second time wasn’t an option. There wasn’t enough left of his esophagus to cut it safely, and he’d already maxed out on radiation,” Chang says. “I did the ESD on him, and even though the tumor was down to the muscle, we were able to get it all. Three years later, he’s still cancer-free and living a normal life.” While they’re seeking endoscopic solutions for removing deeper tumors, CDDC experts are also working to boost early detection of esophageal cancer. They’re currently testing a device called a Cytosponge, developed at the University of Cambridge, that enables a 10-minute screening in a doctor’s office. “I’m really excited about it,” Samarasena says. “Right now, the only way to test for esophageal cancer is to put an endoscope down your throat while you’re sedated, which takes up your whole day. The Cytosponge is a capsule with a sponge in it attached to a string. You swallow it, the capsule dissolves in your stomach, and when the sponge is pulled out, it collects about 500,000 cells that are sent to a lab. If the sample is positive, then you have an endoscopy done.”

Constructed for Collaboration Along with such advances, Chang and Samarasena credit the collaborative nature of the CDDC for their patient successes, noting that there are few such facilities in which all the disciplines dealing with gastrointestinal disease are together. “A cancer patient is a team effort,” Samarasena says. “With all of us being in the same location, there’s a constant communication between us. I travel to places

“A cancer patient is a team effort. With all of us being in the same location, there’s a constant communication between us. I travel to places where the surgeons and GI doctors are not even on the same campus, let alone the same floor.”

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UCI gastroenterologist Jason Samarasena describes cancer treatment options, including the leading-edge ESD procedure, using a model of the human esophagus.

where the surgeons and GI doctors are not even on the same campus, let alone the same floor.” Chang says that even the look of their building – which was redesigned and expanded by 24,000 square feet two years ago – has a purpose. “It was built with training in mind,” he says. “Everywhere you look there’s glass. We wanted it to be a window for the world to see in: What’s new? What are the cuttingedge, breakthrough technologies? We have teaching workshops nearly every week. We want to serve our community, the nation and the world by being a place where physicians can come and be exposed to the newest ways to help others.” Kong has remained cancer-free since his surgery in 2018. His work – as a vice president of human resources in the resort industry – has since taken him to Boca Raton, Florida. “But there is no way I’m going to change my doctors,” Kong says. “When I have an appointment, I fly back for it. I couldn’t be more delighted with the care I’ve received.” Molina, who’d had a recurrence of esophageal cancer, is similarly appreciative. “The [first] surgery left me feeling

like I’d been through my own autopsy. I was hospitalized for almost a month. It took three months to start feeling even a little bit like myself,” he says. “When the cancer came back, I couldn’t have faced that again. So you can’t imagine how grateful I am for the ease of the ESD and Dr. Chang’s care. My daughter was so impressed with their compassion that she’s studying to become a nurse.” Patients aren’t the only parties who are pleased. Says Samarasena: “ESD is by far the most rewarding procedure I’ve learned in my life. It’s very mentally and technically taxing, taking hours longer than a standard endoscopic procedure. But when a patient comes out of it and I get to say ‘Hey, we got it all,’ you just can’t imagine how gratifying that is.” Chang concurs: “I’m blessed to have the experience and the technology and to be in this environment where innovation is supported. Being able to offer what we do and make a difference in people’s lives? I get crazy satisfaction from that.”

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“I don’t know what I would have done without UCI,” says Karalayne Maglinte, sporting hair in solidarity with PurpleStride (which raises pancreatic cancer awareness), here with her husband, Dennis, and their children (from left) Ian, 12, Emlee, 5, and Isaac, 7.

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Saving Mother and Child Multidisciplinary teams of UCI oncologists and maternal-fetal specialists utilize scientific advances to treat patients with high-risk pregnancies By Rosemary McClure

ive-year-old Emlee jumps high, runs fast and likes to pirouette around the living room in her white ballet slippers. Her mom, Karalayne Maglinte, calls her a miracle. Indeed, Emlee is the embodiment of the word: She’s one of the reasons Maglinte is alive today. Another reason: High-risk pregnancy physicians and cancer specialists at UCI Health were able to help the Fontana woman when no one else could. Cancer during pregnancy is a rare event, occurring approximately once per 1,000 pregnancies annually, according to the National Institutes of Health’s World Journal of Oncology. Fortunately, “we have plenty of experience treating patients who need a multidisciplinary approach,” says Rita Mehta, a UCI Health oncologist. Mehta has cared for several pregnant women with cancer, including Michelle Clark-Salib, who was just 28 when diagnosed with breast cancer. Her son Caleb is now 7, and Clark-Salib is cancer-free. But the situation was touch-and-go for a long time, just as it was for Karalayne and Emlee Maglinte. Their poignant story began to unfold in 2013 when Maglinte was 15 weeks pregnant. She was 36 years old and had two boys at home: Ian, 6, and Isaac, 18 months. “Because I was pregnant, I was much more aware of my body’s cues that something wasn’t right, and I was quicker to react than I might have been otherwise,” Maglinte says. “My hands and feet were itchy,” she says, “so itchy I

wanted to tear them off.” She consulted “Dr. Google” and read that it might be a liver issue. “At first I thought perhaps it was because I was pregnant with a girl, and the other two were boys,” Maglinte recalls. “But it got so intense that I began to worry. I didn’t want to endanger her.” The itchiness began on a Friday. By Monday, she was convinced she needed to call her doctor.

A Challenging Diagnosis An arduous round of tests, physician appointments and hospitalizations ensued as several Inland Empire doctors tried unsuccessfully to diagnose and treat Maglinte. In addition to the itchiness, she developed jaundice. After four days at a community hospital, she was taken by ambulance in the middle of the night to UC Irvine Douglas Hospital, in Orange. A team quickly assembled, including high-risk maternalfetal expert Julianne Toohey, gastrointestinal endoscopy specialist John Lee, and pancreatic cancer surgeons Aram Demirjian and David Imagawa. Lee – an authority in diseases of the liver, pancreas, bile ducts and gallbladder – examined Maglinte using endoscopic ultrasound. His findings led to a biopsy of her pancreas. He also implanted a bile duct stent to alleviate her jaundice. Although complex, each procedure was minimally invasive and safe for the baby. But the diagnosis was daunting: Maglinte had an

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aggressive form of pancreatic cancer. “It’s strange that she would have had cancer at that age,” Lee notes. Statistically, almost all pancreatic cancer patients are older than 45, with the average age at the time of diagnosis being 70. Maglinte was only about half that. She was devastated. “I kept walking around the halls of the maternity ward saying: ‘How the heck did I get here? This is crazy.’” There weren’t many options. Early delivery “meant the baby would not have survived, as I was only 19 weeks pregnant,” Maglinte explains. But she also had two children at home to consider. She and her husband, Dennis, discussed it. “He said it was my choice,” Maglinte relates. “I wanted to fight for her, but I also needed to fight for myself.” The physicians worked together to save both mother and child. “Taking care of a high-risk patient with cancer involves careful communication with the whole team and, of course, the patient,” Toohey says. “Karalayne was very involved in decision-making.” A week after the diagnosis, Demirjian operated, performing a seven-hour Whipple procedure, or pancreaticoduodenectomy, to remove the tumor. But Maglinte didn’t have chemotherapy, which would have jeopardized Emlee’s survival. “We watched the baby’s growth and ended up with a planned delivery at 39 weeks,” Toohey recalls. “This is rather unusual with cancer patients – we usually deliver several weeks earlier in order for chemo or other treatment to begin as soon as possible.” Happily, 7-pound, 1-ounce Emlee was born without complications. Her mom says she’s a “little lifesaver” because only 20 percent of pancreatic cancers are diagnosed early, mainly because symptoms – abdominal or mid-back pain, jaundice, weight loss and indigestion – can overlap with those of other conditions. “Without Emlee, I probably wouldn’t have reacted to my symptoms the way I did,” Maglinte says. She and Emlee received the kind of advanced care that’s usually only available at an academic medical center like UCI.

Applying the Research Oncologist Mehta, who joined the faculty in 2001 as a clinical professor of medicine, lauds the university, saying, “One of the great things is that not only can you do research here, but you can apply what you learn from that research to treat high-risk pregnancies with cuttingedge techniques. That’s not possible in a community hospital setting.” That distinction was as important to Michelle Clark-Salib as it was to Maglinte. In 2012, at age 28, she was diagnosed with an aggressive 8-centimeter breast tumor. After undergoing nearly three months of chemotherapy with a community oncologist in Riverside, Clark-Salib found out that she was 23 weeks pregnant with her son Caleb. The North Fontana woman consulted with an obstetrician, who discovered that her amniotic sac contained almost no fluid, a side effect of one of her chemo drugs that posed a serious threat to the developing fetus. The doctor sent Clark-Salib to the high-risk maternalfetal physicians at UCI Health, where he had trained as a resident. Mehta, an international expert in metastatic breast cancer, eventually took over the case. “Michelle is an amazing young woman,” Mehta says. “She was at a very critical stage when she came to us but wanted to save her baby’s life and her own life. Abortion wasn’t an option for her.” The drug that was causing the amniotic fluid problem was discontinued, and Mehta devised a modified cancer treatment plan that avoided the more toxic drug Herceptin until the infant arrived. “As soon as the baby was delivered, we put her back on a chemotherapy regimen, and her cancer went into complete remission,” Mehta recalls. Caleb was born healthy at 37 weeks’ gestation.

“Survival rates are so much improved since I began working in oncology. Sometimes the steps are small; sometimes they’re bigger. But overall, each step adds to the next, and rates keep improving.”

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Steve Zylius / UCI

Oncologist Rita Mehta, whose research over the past 15 years has led to many advances in treating some of the most aggressive forms of breast cancer – with lifesaving results – stands in front of an inspirational quilt that hangs on display at the UCI Breast Health Center, in Orange.

Promising Scientific Advances Mehta finds this an exciting time in her field: “Survival rates are so much improved since I began working in oncology. Sometimes the steps are small; sometimes they’re bigger. But overall, each step adds to the next, and rates keep improving.” Over the last 15 years, her research has led to many advances in treating the most aggressive breast cancers. In a groundbreaking study published in 2012, Mehta showed that a combination of the drugs anastrozole and fulvestrant was superior in controlling cancer and improving patient survival to anastrozole alone or anastrozole followed by fulvestrant in treating hormone receptor-positive metastatic breast cancer in

postmenopausal women. A long-term update of the study, published in March 2019 in The New England Journal of Medicine, confirmed the increase in five-year survival rates for advanced breast cancer patients. Mehta was also one of the first to use chemotherapy combined with Herceptin on women with breast cancer before surgery – rather than only after – to help shrink tumors. Now, more than seven years after Caleb’s birth, Clark-Salib remains cancer-free. And Maglinte has been cancer-free for more than six years. “I don’t know what I would have done without UCI,” Maglinte says. “We were at the right place at the right time with the right teams. Everything just fell into line. Everyone we needed to be there was there.”

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Steve Zylius / UCI

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The Speed King Professor Greg Weiss and collaborators have developed a method of detecting cancer molecules within minutes, a breakthrough that could save lives By Greg Hardesty

reg Weiss, a backpack slung over his shoulder, walks through Aldrich Park. The professor of chemistry has just left a meeting at UCI’s Paul Merage School of Business about University Lab Partners, Orange County’s first wet lab incubator, located at UCI Beall Applied Innovation. Weiss, who sits on the scientific advisory board of ULB, from which he plans to launch future companies, is heading to his office, clear on the other side of campus, in the Natural Sciences I building. This is no leisurely stroll. The 49-year-old, who’s also a professor of molecular biology & biochemistry as well as pharmaceutical sciences, maintains a brisk pace, easily passing scores of students rushing to get to their next class. Weiss is focused on speed. “At the end of the day,” he says, “I want to be faster than the next guy.” It’s a mindset that nearly got him killed as a road cyclist (more on that later). It’s also a mindset that perfectly suits his research specialty: streamlining cancer diagnosis by finding malignant cells as early as possible. Weiss, in collaboration with UCI professor Reg Penner, an electrochemist, and Dr. Jaime Landman, chair of the Department of Urology at UCI Medical Center, has come up with a way to detect cancer molecules in urine within 60 seconds – far quicker than conventional tests. Because cancer is a disease caused by molecules running amok in the body, doing what they shouldn’t be doing – hijacking cells that eventually form a tumor – Weiss’ research is a breakthrough that could save lives. And it’s a breakthrough thats’s playing out at the molecular level. Scientists at PhageTech, a biotech startup Weiss

co-founded in 2015 at UCI Beall Applied Innovation, have developed a method using bacteriophages – viruses that infect bacteria – that drags them onto an electronic circuit for measurement. “We have this new thing – we call it the Virus BioResistor, or VBR – that gives us this amazing way of detecting cancer molecules in urine really fast,” Weiss says. “Bacteriophages are a special kind of harmless virus,” he explains. “They’re long and skinny, so we line them up like a kelp forest. And these phages are able to reach into urine and grab onto cancer molecules more rapidly, which speeds up the whole process of identifying them.” Weiss and Penner began publishing papers on their VBR breakthrough in 2017. “We’re really excited about it,” Weiss says.

Bringing It to Market PhageTech is in the process of commercializing the technology. “The company is working on stuff like ‘How do we manufacture this? How do I make a ton of these things? How do I make it so it works in all patients and not just some of them?’” Weiss says. “For example, if a patient is on a lot of medications, those also show up in their urine and could interfere with the process. Things get complicated really fast.” He continues: “What we have achieved in the lab is amazing, but commercializing it is another fascinating challenge, and it’s something I’m really passionate about.”

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A Personal Motivation Weiss’ love for all things scientific began at age 7 when his mother, Marjorie, a teacher, gave him a periodic table. Weiss, who grew up in Palos Verdes, also took inspiration from his father, Arthur, a former U.S. Navy doctor who became a tumor surgeon. It was his father’s death at 59 from lung cancer that fueled Weiss’ desire to find a way to detect cancer in its early stages. He was nearing the end of his postdoctoral work at UCI when his father, who never smoked (25 percent of lung cancer patients report having never smoked), called him with the terrible news: “I have stage 4 lung cancer.” “I was devastated,” Weiss says. His father died two years later, in 2001. A couple of years after that, Penner – Weiss’ longtime research collaborator at UCI – lost his mother to cancer. “We looked at each other, and it was like ‘We need to do something about this,’” Weiss recalls.

The Egg Breakthrough Early on in his career as a professor, Weiss set a goal. “I wanted to become nationally recognized,” he says. “I wanted to compete at the national level. I’m just hypercompetitive. That’s who I am. I’m not sure why. My parents were completely normal about their expectations for me.” Early in 2015, Weiss made global headlines when, working with Australian chemists, he figured out a way to unboil egg whites. They came up with a method of pulling apart tangled proteins and allowing them to refold. “We showed that you could uncook the egg and then cook it again,” Weiss says. “We used mechanical energy to drive the proteins into the correct shape. I became really interested in how you transform things. How do you change chemicals and do it on a massive scale?” For the egg breakthrough, Weiss and his collaborators were awarded the annual Ig Nobel Prize in chemistry, presented at Harvard University. “The award is given for science research that makes you laugh and then makes you think,” Weiss says. The technique his team employed to unboil egg whites – which involves re-creating a clear protein known as lysozyme and a process at the molecular level that breaks up protein masses – can be applied to a lot of other foods as well as cancer proteins, he says. Weiss and his collaborators built on the unboilingan-egg results to show that they could use similar processes for accelerating enzymes in their catalysis of chemical reactions. 40

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“In other words,” Weiss explains, “we can make pharmaceuticals, beverages and other high-value chemicals faster, cheaper and with less waste, water and energy.” Research in this area is being conducted at another startup Weiss formed in the last year, Debut Biotech, based in La Jolla. Weiss co-founded the company, which has a wet lab (a lab in which a wide range of experiments are performed that sometimes involve dealing with hazardous substances), with Joshua Britton, a visiting student from Flinders University in Adelaide, Australia.

Keeping Up the Pace Unboiling egg whites is one thing; reversing critical and traumatic injuries is another. Weiss’ need for speed nearly got him killed in 2015, when the then-avid road cyclist crashed three times. In the most serious accident, his bicycle slammed into a car illegally parked in a bike lane and was catapulted through the rear window. He suffered numerous lacerations on his arm but narrowly avoided cutting a major artery – by millimeters. Much to the relief of his wife of 21 years, Kim, a history scholar who helps build museum exhibits in UCI’s School of Physical Sciences, Weiss has since given up road cycling but still rides a stationary bike in his garage in UCI’s University Hills residential community. His other non-research passions are photography, fly-fishing and his five cats. Weiss also loves teaching organic chemistry. He had 450 students in the fall 2019 quarter. True to form, he gets to class speedily. “I run to work every day because I love teaching so much,” says Weiss of the mile-plus route. “But there’s another reason I do it,” he adds. “About 50 percent of my students are first-generation college students. These kids are, like, the hopes of entire families. They have something to prove, and they want to get out there and make it happen.” “I find that inspiring,” Weiss says. “And I want to keep up with them.” Running to class helps keep him fit. And keeping cancer patients healthy drives his desire to stay in the race to detect cancer as early as possible. “If we can diagnose cancer early,” Weiss says, “we’ll be so much better at treating patients. Physicians will be more successful, it will cost us less money, and patients will go through less pain. I’m all about early detection.”

Professor Greg Weiss, shown here with his former student Stephan Kudlacek ’15, discovered how to unboil an egg several years ago, and now he and his colleagues have developed a way to detect cancer cells in urine within 60 seconds.

“We showed that you could uncook the egg and then cook it again. We used mechanical energy to drive the proteins into the correct shape. I became really interested in how you transform things. How do you change chemicals and do it on a massive scale?”

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Steve Zylius / UCI

In the Pink After women’s volleyball upset No. 11 Hawaii on the road for the first time in school history, the Anteaters returned home to participate in a UCI Athletics’ Breast Cancer Awareness Week game. Teams wore pink, and a portion of ticket sales went to UCI Health’s Breast Health Center. Here, freshman Carrissa MacDonald (left) digs a ball during that match versus Cal State Fullerton. Nick Gutierrez / UCI Athletics

R E F L E C T I O N S

Steven Georges

Going All-In on Life

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By Greg Hardesty

he 16-year-old girl sat cross-legged on her bed, surrounded by loved ones who were keeping an around-the-clock vigil in her hospital room. She and her family had decided to stop treatment for her leukemia after several rounds of chemotherapy and an acknowledgement by her oncologist that there was little

hope – she only had months. Yet the atmosphere in the room was loving and light as the girl and her relatives enjoyed each other’s company for what little time they had left together. The girl recently had turned 16, the age at which her mother said she could start wearing makeup. So there she sat, painting her nails after having applied lipstick and eye shadow. In my 30-plus years as a journalist, including 17 at The Orange County Register, I have had the honor of writing about several people like the 16-year-old girl basking in the final days of her life. She wasn’t dreading the inevitable

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but embracing it. She wasn’t obsessing about what was to come but relishing the gift of the present. I will never forget the words of a mother of four young children who was the subject of another story I wrote for The Register. She had a rare and aggressive form of breast cancer – IBC, or inflammatory breast cancer – and not much time left. With Christmas around the corner and traditional treatment ineffective, her immediate and extended family decided to pass on giving each other gifts that year.

Instead, they pooled their money to pay for alternative treatment options. The 38-year-old woman, her blonde hair gone from her latest round of chemotherapy, exuded gratitude and optimism. “Why not me?” she said of her diagnosis, refusing to feel sorry for herself. She remained all-in on life, with kids to love and raise and a husband by her side. Over the years, I’ve interacted with first responders, as well as nurses and physicians, whose days are filled with terrible things that happen in life. Many have told me that their often-difficult jobs have made them better wives and husbands, children and parents, siblings and friends. They know how quickly life can end, so they enjoy the now. Four years ago, I felt a calling to experience more of their world, to remind myself how priceless life is – and to live each day fully like they do, taking nothing for granted. I underwent 50 hours of training to become a volunteer for the Trauma Intervention Program of Orange County, one of 120 or so individuals who respond 24/7 to requests from police and fire agencies, along with hospitals, to provide emotional and practical support to those in need. TIP volunteers show up for at-home deaths, fatal car crashes, suicides – you name it. Thrust into often-chaotic scenes, our role is to be a caring and helpful presence for those going through the unimaginable. When I tell others about my volunteerism, their typical response is: “How can you do that? I could never do that.” For me, the reward of helping someone in their darkest hours – even just a bit – outweighs the challenging aspects of taking on someone else’s grief. I like to think that my years of interviewing people, like the 16-year-old girl with leukemia or the 38-year-old mother with IBC, have given me the strength and perspective to be an effective TIP volunteer. I tell myself, “Why not me?” I’m all-in. I recall an 11-year-old boy I wrote about. Dying of cancer, he treated his hospital room as his playground. On the day of the interview, the space was filled with books and board games and video games. The boy joked that he liked the hospital room more than his room at home because it had a bigger TV. He wanted to be transported from the reality of his fatal disease. He wanted, like all kids do, to have fun. He was all-in too. On one unforgettable TIP call, I sat bedside for several hours with a 7-year-old girl whose mother had taken her off life support and couldn’t bear to watch her child die. So TIP volunteers were summoned. We spent time with the girl for close to six days –

working in four-hour shifts around the clock – before she died. We sang to her, read her books, combed her hair, applied moisturizer to her lips and told her how much she was loved. We even painted her fingernails and toenails. While on a TIP call or interviewing someone, I strive to remain present – to be myself, to reach out and connect. The 16-year-old girl was connecting with her loved ones that day. So was the 38-year-old woman, whose 3-yearold son couldn’t peel himself away from her. So too was the 11-year-old boy, whose jokey ways had his mother, and nurses, in stitches.

“For me, the reward of helping someone in their darkest hours – even just a bit – outweighs the challenging aspects of taking on someone else’s grief.” And TIP volunteers were connecting with the 7-year-old girl who was slowly dying. Nurses were astounded that she had hung on so long after being taken off life support and were convinced that she hadn’t wanted to leave because she was receiving so much love. Another cancer patient I wrote about lived with the disease for 14 years. After it returned for the sixth time, she was done and decided to go on hospice care. Yet she continued to be a vocal advocate for ongoing research into cancer treatments and a loving supporter of people with cancer everywhere. I asked her about her thoughts on the meaning of life. “I think the meaning of life is to serve others in your own unique way,” she said. “We all have talents that we bring to the table. Whether you pick up trash for a living or split atoms, if you make some sort of contribution to the planet – well, that’s what really matters.” The 45-year-old knew her time was limited, but that didn’t stop her from starting projects around her home. She bought new sheets for her bed. She placed fresh flowers in vases. She even redid her fireplace in mosaic tiles. Dying hadn’t stripped her life of beauty. She was, to the end, all-in – as I strive to be in my pursuits, be it my career, spending time with my two children, or helping someone in need. It’s a lesson I learned from journalism and TIP. Greg Hardesty ’85, a frequent contributor to UCI Magazine, was editor-in-chief of UCI’s student newspaper, New University, and reported for The Orange County Register from 1997 to 2014. He has volunteered with TIP since 2015.

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A Landmark Tribute Santa Ana’s iconic water tower dons blue and gold in honor of UCI’s Brilliant Future campaign launch in October. The university’s $2 billion fundraising effort is the largest in Orange County history, and other locales – including the Huntington Beach Civic Center and Orange City Hall – were also swathed in Anteater colors.

Steve Zylius / UCI

A N T O U R A G E

Steve Zylius / UCI

‘Robin Hood’ With a Twist Alumnus tussles with big insurance companies in court – and serves as a UC regent .............................................................................................................. By Roy Rivenburg

“Modern-day Robin Hood” isn’t on William T. Um’s business card or LinkedIn profile, but that’s how he describes his career. “I take money from the rich and give it to … other rich,” says the attorney, who specializes in suing wealthy insurance companies on behalf of big corporations. Although the Palos Verdes Estates resident acknowledges mixed feelings about shuffling millions of dollars from one conglomerate to another, he says the job does have an upside: “It enables me to do significant volunteer and pro bono work.” One of his proudest accomplishments is the case of Shari Ho, a Taiwanese human-trafficking victim who was sold to a well-heeled family at age 7 and then spirited off to Orange County, where she was forced into servitude until escaping in her 20s. Although no criminal charges

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were filed against the family, Um crafted a civil lawsuit – gratis – that resulted in a six-figure settlement for Ho. Not all of his volunteer projects are court-related. In 2018, he was appointed to represent University of California alumni on the UC Board of Regents. Because the ex officio position rotates among campuses, Um is UCI’s first alumni rep in eight years. (A second alumni regent slot alternates between UC Berkeley and UCLA, the system’s oldest universities.) The time gap between Anteater regents was so long that UCI officials had to look up the process for picking one, which varies by campus, Um says. So how does he plan to gauge and channel the views of 2 million UC alumni around the globe? “We struggle with that question,” Um says, noting that there aren’t really any “alumni-specific issues” that come

before the board. Instead, he hopes to focus on helping UCI students and graduates understand the role of the UC’s 26-member regent panel and appreciate that Irvine’s campus is “part of a larger university ecosystem, not an independent entity,” Um says. He also hopes to serve as a role model for Asian Americans in higher education. They’re the largest ethnic group on UC campuses but woefully underrepresented in leadership spots, says Um, who was born in Seoul, South Korea, and moved to the San Fernando Valley with his parents and older brother when he was 6. As an undergrad majoring in economics and psychology, Um recalls admiring Chang-Lin Tien, who was UCI’s executive vice chancellor at the time and later became UC Berkeley’s top administrator, the first Asian American to head a major U.S. research university. “Seeing somebody who looked like me in a high position made a big impression,” he says. After graduating from UCI in 1990, Um attended law school at Boston University, where he also met his future wife, Christine Kim (who now works as in-house counsel for CIT Bank). Degree in hand, he then returned to Southern California and joined a firm representing large institutions and corporations in liability coverage disputes with insurance carriers. For example, after Yahoo Inc. was sued over privacy violations, Um went to court against its insurance company, which had refused to pay for Yahoo’s legal defense. Other Um clients have included the Roman Catholic Archdiocese of Los Angeles, when its insurer declined to cover legal costs in sex abuse cases, and aerospace

companies grappling with environmental cleanup litigation. In each of those instances, Um’s side prevailed. “Most jurors don’t like big corporations, but they dislike insurance companies even more,” he says.

served until last July. Talesh’s pitch didn’t require much arm-twisting. “I got involved because UCI was a very memorable time in my life,” Um says. “I made lasting friendships there – which you can’t put a price tag on – and the overall experience

“Simply walking around the campus and soaking up students’ enthusiasm for learning can boost your faith in the future.” At his current law firm, Um has added First Amendment conflicts to his portfolio, including defending The Huffington Post against a defamation suit filed by Arizona’s Joe Arpaio, the controversial former sheriff of Maricopa County. Such success is what his parents hoped for when they emigrated to the U.S. “They came here for me and my brother,” says Um, who learned English by watching TV and hadn’t envisioned himself as an attorney. Growing up in Granada Hills, where he was elected homecoming king at John F. Kennedy High School, Um originally planned to be a doctor – and enrolled at UCI with that career in mind. “I joke that the reason I went to law school was because I’m afraid of blood,” he says. In reality, it was trouble with chemistry that altered his path. While taking his first required class in the subject at UCI, he realized it “wasn’t computing in my mind” and began remapping his future. One thing that didn’t change was his friendship with freshman roommate Rameen Talesh, who went on to become dean of students and an assistant vice chancellor at UCI in 2010 – and who recruited Um in 2013 to join him on UCI’s Alumni Association board, where the lawyer

was very formative for me. I wanted to give back.” But such participation is not always the case among University of California alumni. “Although most have fond memories of their college years,” he says, it typically doesn’t translate into an active connection after graduation. Um thinks that might change if alumni visit UCI for a lecture, performance or other event. “Simply walking around the campus and soaking up students’ enthusiasm for learning can boost your faith in the future,” he says. Another option Um recommends is volunteering for a mentor program. “Students in many different majors are looking to explore career options and business opportunities with those of you who have been there,” he notes. When not working the alumni circuit or plotting court strategies, Um is primarily a homebody, he says, enjoying time with his wife and two children. He also guest lectures at UCI’s law school, aids various pro bono legal agencies, serves on the finance committee at his church and occasionally dabbles in local political campaigns. “Volunteer activities bring me joy,” Um says.

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Class Notes

Paula Tomei ’79, economics Entranced by a 1971 rock musical scored by Corona del Mar resident Toni Tennille (before she met the “Captain”), ninth-grader Paula Tomei became hooked on theater. Soon she was running the business side of productions for her high school drama department, a precursor to her current position as managing director and co-CEO of South Coast Repertory. But first came a brief flirtation with dentistry. Hoping to combat cavities for a living, Tomei enrolled at UCI as a biological sciences major. That plan ended when she took organic chemistry. Flummoxed by the subject, she transferred to economics. Following graduation, Tomei applied for a job handling subscriptions at SCR and was hired on the spot. “After the interview,” she recalls, “I was told to go to lunch and come back.” Forty years later, she’s still there, helping bring new plays to life. “Very few theaters produce the amount of shows that we do,” Tomei says. “It’s like running a new startup every six to eight weeks.”

..................................................... Jon Gribble ’83, mechanical engineering, MBA ’01 A fake severed arm that crawled across the floor via remote control was one of Jon Gribble’s early engineering projects, created while he attended Tustin High School. Since then, he has designed a vacuum toilet system for trains and a gaggle of electric chariots for Taylor-Dunn Manufacturing, which specialized in golf carts before segueing to airport baggage tractors, tour trams and utility vehicles. Some of the company’s industrial buggies have had cameos in movies and TV shows, including “Buffy the Vampire Slayer,” “Austin Powers: International Man of Mystery” and “Stranger Things.” Gribble, who started his career as an associate design engineer at Taylor-Dunn, took over as president in 2010 and stayed on after the firm was sold to Polaris Industries in 2016. His wife, Angela (Lee) Gribble, also studied engineering at UCI but finished her degree at Cal State Fullerton, returning to Irvine for an EMBA in 1999.

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Kelly Perine, M.F.A. ’98, drama He’s appeared on “Seinfeld,” “How I Met Your Mother,” “One on One,” “ER,” “Hangin’ with Mr. Cooper,” “Bones” and dozens of other TV shows. For 25 years, Kelly Perine has made a living as a character actor, but he first hit the stage long before that, joining his father in community theater productions at age 4. After studying film and co-founding an improv troupe at Pomona College, Perine enrolled at UCI and soon found steady work in Hollywood, primarily in commercials and sitcoms. He had his first recurring role on “The Drew Carey Show” and most recently played Sir Gareth on Nickelodeon’s “Knight Squad.” The Pennsylvania native is now branching into writing and starring in short and feature-length films, including “Rundown Mongoose,” a baseball comedy set in the Dominican Republic.

..................................................... Deepa (Ravindranath) Krishna, M.S. ’06, biomedical engineering What do you get when you cross a vegetarian lawyer, a kayak-crazy biomedical engineer and a yoga-loving MBA? Answer: Deepa (Ravindranath) Krishna, a Palo Alto startup executive who is all of the above. Originally from San Luis Obispo, she bounced around to India, Cupertino and San Diego before enrolling at UCI, where she liked to play pickup Ultimate Frisbee between engineering classes. After graduation, Krishna worked as a patent agent, then earned an MBA and a law degree at Northwestern University in 2013. She now serves as chief operating officer at ClearAccessIP, which uses artificial intelligence to help clients – including the University of California – manage, research, license, buy and sell patents. Two of her colleagues are fellow Anteaters: Catherine Kim ’01, Spanish; and Dylan Gittleman ’90, social sciences.

In Memoriam Joan Irvine Smith Philanthropist Joan Irvine Smith, who championed the creation and growth of UCI, died Dec. 19. She was 86. The great-granddaughter of Irvine Company founder James Irvine, Smith was serving on the firm’s board of directors in 1957 when the UC regents authorized the concept of a new campus in Southern California. Realizing that a research university built on Irvine Ranch property would transform south Orange County in a manner similar to UCLA’s effect on west Los Angeles, Smith helped persuade the Irvine Company to sell 1,000 acres to the University of California for $1 in 1960. “It is no exaggeration to say that without Joan Irvine Smith, there likely would not be a University of California, Irvine,” said Chancellor Howard Gillman. “What we are today, and all that we contribute to the world, is due in large part to her farsightedness, her tenacity and her generosity.” Over the years, Smith and her family have continued to play a central role in the advancement of UCI. Joan Irvine Smith Hall houses administrative offices, lecture space and research labs for the School of Medicine. After actor Christopher Reeve was paralyzed in a horse-riding mishap, Smith made the lead contribution to establish the university’s Reeve-Irvine Research Center. Her charitable foundation also provided the inaugural gift toward creating the UCI School of Law.

In 2016, Smith and her son James Irvine Swinden donated The Irvine Museum’s world-class collection of California impressionist art to UCI, setting the stage for the formation of the UCI Institute and Museum of California Art. Beyond her role with UCI, Smith was an accomplished equestrian, an advocate for the environment and a passionate art collector. She co-founded CHOC Children’s Hospital, helped launch the National Water Research Institute, lobbied to establish Crystal Cove State Park and received many honors – including being the first woman named Orange County’s “Man of the Year,” in 1961, and being recognized in 1990 with UCI’s Founders Award. One of her proudest achievements was opening The Irvine Museum in 1993, a move that combined her love of nature (many of the paintings show California in a pristine state), art and philanthropy. Admission was free, school field trips were encouraged, and the museum published 21 books about California impressionism. In lieu of flowers, the family has requested that donations be made to the Joan Irvine Smith Fund, which benefits the UCI Institute and Museum of California Art.

..................................................... Harold W. Moore, founding faculty member Harold W. “Hal” Moore, a founding member of UCI’s chemistry department who later, as dean of the School of Physical Sciences, played a key role in creating the Earth system science department, died Sept. 27. He was 83. Hired in 1965 by Professor F. Sherwood Rowland (a 1995 Nobel laureate) after postdoctoral work at the Stanford Research Institute, Moore was the chemistry department’s first synthetic organic investigator, studying molecules used in anti-cancer compounds and antibiotics. He wrote an influential piece published in Science in 1977 that detailed the bioactivation of naturally occurring and synthetic anti-cancer compounds in hypoxic tumor cells. Known as an inspiring mentor to students and faculty, Moore served two terms as department chair (1970-73 and 1982-85) and led the School of Physical Sciences from 1985 to 1994. He earned a bachelor’s degree in chemistry at Colorado State University – where he also met his wife of 60 years, Cathy Moore – and a Ph.D. in organic chemistry at the University of Illinois. In addition to his scientific endeavors, Moore was a talented musician and greatly enjoyed playing the clarinet, performing for many years with the Interactions jazz ensemble and the Laguna Beach Community Concert Band.

Joan Irvine Smith (left) and her mother, Athalie Richardson Irvine Clarke, at the Irvine Ranch house circa 1964

To submit or view additional Class Notes, go to engage.alumni.uci.edu/classnote.

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P A R T I N G

Z O T !

50 Years of Eclectic Sound In honor of KUCI-FM’s first half-century of broadcasting, longtime station boss Kevin Stockdale ’88 displays part of the campus radio outlet’s original 10-watt transmitter. The device was one of several artifacts on view at a November reunion.

UCI Magazine

Steve Zylius / UCI

Reunions • Festival • Basketball • Anteater Family Weekend

Get your tickets now!

HOMECOMING.UCI.EDU FRIDAY-SATURDAY, FEB. 28-29 REUNION WEEKEND Celebrating the classes of 1970, 1975, 1980, 1985, 1990, 1995, 2000, 2005, 2010 and 2015

ANTEATER FAMILY WEEKEND Are you a parent, guardian or family member of a current UCI student? Get a snapshot into their university life.

SATURDAY, FEB. 29 HOMECOMING FESTIVAL ALDRICH PARK Bring your friends and family to “Camp Aldrich” for a fun-filled day in the heart of UCI.

MEN’S BASKETBALL VS. UCSB BREN EVENTS CENTER Join thousands of Anteaters as we cheer on our men’s basketball team against the Gauchos in Big West Conference play!

ALL ARE WELCOME! ALUMNI • STUDENTS • PARENTS FACULTY & STAFF • EMERITI & RETIREES • FRIENDS