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2019 ANNUAL REPORT

University of Florida Health Cancer Center


Director’s Welcome I N 2 0 1 9, the University of Florida Health Cancer Center made numerous advancements. We further developed our research programs and broadened our basic and translational research efforts like never before. Our clinical trial enrollment increased dramatically and our offices overseeing education and training and community outreach made strides that have a far-reaching impact.

Over the past five years, our peer-reviewed cancerrelevant funding has more than doubled and a third of our total cancerrelated funding has been NCI funding. We have also recruited nearly 40 faculty members in seven colleges and 24 departments. Over half of those recruits have been early stage investigators.

We currently have 284 members representing 11 colleges and 63 departments. Every member is aligned to one of our three research programs — Mechanisms of Oncogenesis, Cancer Population Sciences, and Cancer Therapeutics and Host Response. In 2019, all three research programs held regular program meetings to stimulate collaborative research. Notable research achievements this year include the discoveries of a new anticancer drug that destroys cancer-causing proteins, a link between a common food poison toxin and colorectal cancer, and an effective, less expensive hepatitis C therapy. This past year, our Clinical Research Office enrolled 5,725 individuals in clinical trials. Enrollments in treatment trials went from 365 in 2018 to 449 in 2019. This represents an enrollment increase of

over 20% for 2019, further building on the momentum of our center members to bring new and innovative cancer treatments to more patients.

genomes in two days and to purchase two instruments that utilize leading-edge optical technology to analyze and sort cells.

We also made significant strides in cancer clinical care in 2019. Our colleagues in the Blood and Marrow Transplant Program at UF Health established UF Health’s first CAR T-cell therapy program and treated the first patient in October. Also notable, the UF Division of Hematology & Oncology established an adult sarcoma program and welcomed three new solid tumor faculty members.

The Biostatistics and Quantitative Sciences Shared Resource helped 62 Cancer Center members with requests in 2019 — 68% of those requests supported grant submissions. The Biostatistics and Bioinformatics Walk-In Clinic performed consults for 40 researchers and students with biostatistics or bioinformatics questions. Ji-Hyun Lee, DrPH, director of this shared resource, initiated the Biostatistics 101 course, an eight-lecture series that introduced the basic principles of biostatistics that graduated 35 students last year.

In support of basic and translational research, this year we collaborated with the UF Interdisciplinary Center for Biotechnology Research to acquire the “Beast” — the NovaSeq6000 DNA sequencing instrument — capable of fully sequencing 48 human

Our Research Career Enhancement core had a highly successful year. This past year, we initiated the

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OV E RV I E W

RESEARCH

CLINICAL EXC EL L ENC E

E D U C AT I O N & TRAINING

COMMUNITY


Cancer Policy Internship, introduced the University Scholars Program, graduated the first cohort of students in the Cancer Biology Concentration and hosted the second annual Cancer Research Conference for Science Teachers. In 2019, our Community Outreach and Engagement office launched initiatives to ultimately lead to better cancer prevention practices in our catchment area. The team played an integral part in raising the tobacco purchase age limit to 21 in Alachua County, the first county in the state to do so, and facilitated the Area Health Education Centers Rural Tobacco Summit in Starke, FL. The team also partnered closely with our Community Advisory Board to develop pilot projects related to cancer screening and linkage to care.

Also notable in 2019, the UF Health Cancer Network, comprising UF Health and the UF Health Cancer Center at Orlando Health, received a full reaccreditation by the Commission on Cancer, a quality program of the American College of Surgeons. The UF Health Cancer Network is one of seven facilities in the state of Florida to have achieved accreditation in the Integrated Network Cancer Program category from the Commission on Cancer, which is bestowed on cancer programs that meet or exceed the organization’s 34 quality care standards. These standards are evaluated every three years through a survey process and accredited facilities must maintain levels of excellence in the delivery of comprehensive patientcentered care.

In summary, there has been great progress in the development of cancer research programs at the University of Florida Health Cancer Center. These accomplishments and more are all made possible by our Cancer Center members and family — the UF and UF

Health faculty, staff, students, health professionals and administrators — dedicated to preventing, detecting, treating and ultimately curing cancer. Sincerely, Jonathan Licht, M.D., Director, UF Health Cancer Center

The University of Florida Health Cancer Center in Gainesville is dedicated to serving the residents of Florida through the provision of state-of-the-art cancer treatment, prevention and education. Our cancer experts work to ensure coordinated care is available to each patient through diagnosis, treatment and recovery. Our mission is to develop the tools that help prevent, detect and ultimately cure cancer.


The University of Florida Health Cancer Center stands alone in the state of Florida in its unique ability to blend comprehensive patient care and innovative research in a collaborative, multidisciplinary environment. It boasts a membership of more than 280 researchers and clinicians from across the University of Florida and UF Health, the Southeast’s most comprehensive academic health center. The UFHCC and its members are dedicated to providing leading-edge cancer care and conducting original research for the prevention, early diagnosis and treatment of cancer.

overview 4 | UF HEALTH CANCER CENTER


H IGH LIGHTS AN D ACH I EVEM ENTS The UF Health Cancer Center is consistently finding new and better treatments through research and exceptional patient outcomes. Some highlights from the center include:

Development of new types of brain immunotherapy

North Florida’s most successful bone marrow transplant program Several firsts in human trials, including cooperative group, industry-sponsored and national studies Collaboration with the UF Herbert Wertheim College of Engineering to develop new methods using 3D printed cells of soft matter Individualized leukemia and solid tumor treatments based on people’s genes and their mutations

UF Health Shands Cancer Hospital

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$33.8

284

Florida’s rank among 50 states in the number of cancer deaths

million total cancer-relevant grants

clinical and research faculty members

2019 ANNUAL REPORT | 5


UF Colleges • College of Agriculture and Life Sciences • College of Dentistry • College of Engineering • College of Health and Human Performance • College of Journalism and Communications • College of Liberal Arts and Sciences • College of Medicine • College of Nursing • College of Pharmacy • College of Public Health and Health Professions • College of Veterinary Medicine

Research • Florida Academic Cancer Center Alliance • Orlando Health UF Health Cancer Center • UFHCC Cancer Population Sciences Research Program • UFHCC Cancer Therapeutics & Host Response Research Program • UFHCC Clinic Research Office • UF Interdisciplinary Center for Biotechnology Research • UFHCC Mechanisms of Oncogenesis Research Program

At the Intersection of Collaborative Care and Research

UF COLLEGES

PATIENT CARE

RESEARCH

T H E U F H E A LT H C A N C E R C E N T E R A N D I T S M E M B E R S are an integral part of the UF Health system, which encompasses six health colleges, nine research centers/institutes, 10 hospitals, two veterinary hospitals

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Patient Care • UF Health Davis Cancer Pavilion • UF Health Medical Plaza • UF Health Medical Oncology/Adult Infusion Site • UF Health Radiation Oncology • UF Health Proton Therapy Institute • UF Health Shands Hospital • UF Health Shands Cancer Hospital • UF Health Shands Children’s Hospital • UF Health Springhill • UF Health Jacksonville

UF CENTERS & INSTITUTES

and a host of physician medical practices and outpatient services throughout North Central and Northeast Florida. Additionally, more than 90% of the center’s members also serve as faculty; the Cancer Center boasts

UF Centers & Institutes • Evelyn F. & William L. McKnight Brain Institute of UF • UF Center for Inflammation and Mucosal Immunology • UF Center for Natural Products, Drug Discovery and Development • UF Clinical and Translational Science Institute • UF Genetics Institute • UF Informatics Institute • UF Interdisciplinary Center for Biotechnology Research • UF Institute on Aging • UF Institute for Child Health Policy • UF Myology Institute • UF Nanoscience Institute for Medical and Engineering Technology • UF Pain Research and Intervention Center of Excellence • UF Powell Gene Therapy Center • UF Preston A. Wells Jr. Center for Brain Tumor Therapy • UF Health Proton Therapy Institute

members from 11 UF colleges. Members may also hold affiliations with other institutes and centers across the university or serve as physicians for the UF Health family of hospitals and clinical programs.


This unique intersection of innovation, education and treatment is where the UF Health Cancer Center is redefining expertise.

Accolades The National Pancreas Foundation

ACCREDITED PROGRAM

Clinical Trial Consortium Site

CENTER FOR EXCELLENCE Center of Excellence

2019 ANNUAL REPORT | 7


Locations

GAINESVILLE, FL

JACKSONVI LLE UF Health Proton Therapy Institute

Cancer and Genetics Research Complex Located on the University of Florida campus, the Cancer and Genetics Research Complex is the base of operations for the UF Health Cancer Center in Gainesville. The center has a membership of more than 280 researchers and clinicians who provide cancer care and conduct research for the prevention, early diagnosis and treatment of cancer. The UF Health Cancer Center delivers multidisciplinary cancer care using the most advanced drugs and treatment technologies, many of which are available only through clinical trials.

H H GA I N ESVI L L E  ancer and Genetics C Research Complex

HH

UF Health Davis Cancer Pavilion

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UF Health Shands Hospital

H

UF Health Shands Cancer Hospital UF Health Shands Children’s Hospital

ORLANDO

UF Health Springhill

Orlando Health UF Health Cancer Center

A F F I L I AT E R E S E A R C H M E M B E R S

The UF Health Davis Cancer Pavilion houses several outpatient cancer services such as radiation oncology, adult hematology and oncology and outpatient infusion (chemotherapy). Health professionals caring for patients can easily collaborate with scientists exploring cancer at the

H

H Tallahassee Memorial HealthCare H Orlando Health UF Health Cancer Center H Broward Health Medical System H North Florida/South Georgia Veterans Health System H Watson Clinic Cancer & Research Center

LEADERSHIP Jonathan Licht, M.D., Director John Wingard, M.D., Deputy Director Rolf Renne, Ph.D., Associate Director for Basic Sciences

Thomas George, M.D., FACP, Associate Director for Clinical Research Betsy Shenkman, Ph.D., Associate Director for Population Sciences and Community Outreach and Engagement

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Dietmar Siemann, Ph.D., Associate Director for Education and Training Robert Houlihan, D.H.A., M.B.A., FACHE, Associate Director for Administration Steven Madore, Ph.D., Associate Director for Shared Resources

Merry-Jennifer Markham, M.D., FACP, Associate Director for Medical Affairs Daohong Zhou, M.D., Associate Director for Translational and Drug Development

 F Health Davis Cancer U Pavilion at the UF Health Medical Plaza

External Advisory Board Chair: Eric Fearon, M.D., Ph.D. Nicholas Ambulos, Ph.D. Steven Burakoff, M.D. Walter Curran, M.D. Deborah Erwin, Ph.D. David Gosky, M.A., M.B.A. Roy Herbst, M.D., Ph.D. Karen Knudsen, Ph.D. Michelle Le Beau, Ph.D. Electra Paskett, Ph.D. Steven Rosen, M.D.

• • • • • • • • • • •

Jonathan Licht, M.D.


cellular, molecular and genetics levels, as they are located across the street at the Cancer and Genetics Research Complex.

UF Health Shands Hospital

UF Health Shands Hospital is a private, not-for-profit hospital that specializes in tertiary and quaternary care for critically ill patients. UF Health Shands Hospital is one of the most comprehensive hospitals and one of the leading referral medical centers in the Southeast. It is also home to several specialties with a cancer focus, including urology, radiology, colorectal cancer surgery and breast cancer surgery.

UF Health Shands Cancer Hospital

Located across the street from UF Health Shands Hospital, this 500,000-square-foot facility houses 192 private inpatient beds for a variety of patients, including those receiving diagnostic and therapeutic oncology services. The UF Health Shands Cancer Hospital also offers solid tumor inpatient services as well as bone marrow transplant and includes a critical care center for emergency and trauma-related services.

John Wingard, M.D.

Rolf Renne, Ph.D.

Thomas George, M.D., FACP

UF Health Shands Children’s Hospital

UF Health Shands Children’s Hospital is dedicated to pediatric services, including those related to pediatric cancer, and is located within UF Health Shands Hospital. The hospital’s pediatric hematology and cancer unit is one of the largest of its kind in the Southeast, offering the full spectrum of services and delivering the highest level of care for cancer and blood problems in infants, children and adolescents — including leukemia, lymphoma, brain tumors, solid tumors, nonmalignant hematology and stem cell/marrow transplant. UF Health Springhill UF Health Springhill is a four-story, 108,000-square-foot multispecialty medical facility serving Northwest Gainesville. Its specialties include dermatology as well as women’s health and diagnostic imaging.

ORLANDO, FL Orlando Health UF Health Cancer Center In 2013, UF Health and Orlando Health joined programs to form the Orlando

Betsy Shenkman, Dietmar Siemann, Ph.D. Ph.D.

Robert Houlihan, D.H.A., M.B.A., FACHE

Health UF Health Cancer Center, establishing one of the state’s largest, most comprehensive cancer collaborations. This collaboration allows for better-coordinated patient care and expanded research and educational opportunities. The home of the Orlando Health UF Health Cancer Center is the stateof-the-art Charles Lewis Pavilion, a 220,000-square-foot structure.

JACKSONVILLE, FL UF Health Proton Therapy Institute The UF Health Proton Therapy Institute, staffed by UF department of radiation oncology physicians, is the only proton facility located in the state of Florida that has achieved accreditation by the American College of Radiology. Since opening 11 years ago, approximately 6,500 patients have been treated with proton therapy at the institute. The UF Health Proton Therapy Institute includes clinics for the pre- and posttherapy and on-treatment evaluation of cancer patients, planning suites, an infusion and anesthesia suite, psychosocial services, a research office and faculty offices.

Steven Madore, Merry-Jennifer Daohong Zhou, Ph.D. Markham, M.D., FACP M.D. 2019 ANNUAL REPORT | 9


Welcome New Recruits T H E U F H E A LT H CANCER CENTER IS PLEASED TO WELCOME 12 RECRUITS WHO REPRESENT A WIDE RANGE OF RESEARCH AND CLINICAL EXPERTISE.

Daohong Zhou, M.D. College of Pharmacy, Department of Pharmacodynamics Start Date: 3/1/18 Previous Institution: Winthrop P. Rockefeller Cancer Institute, University of Arkansas for Medical Sciences Research: Dr. Zhou’s research has been focused on investigation of the long-term effects of genotoxic stress/DNA damage induced by ionizing radiation (IR) and chemotherapy on hematopoietic stem cell (HSC) self-renewal and genomic stability; and the role of HSC injury in IR- and chemotherapyinduced long-term bone marrow suppression and leukemogenesis. Guangrong Zheng, Ph.D. College of Pharmacy, Department of Medicinal Chemistry Start Date: 3/1/18 Previous Institution: University of Arkansas for Medical Sciences College of Pharmacy

Daohong Zhou, M.D.

Guangrong Zheng, Ph.D.

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Research: Dr. Zheng’s lab focuses on the design, synthesis and structureactivity relationship study of synthetically derived and natural productbased compounds for potential therapeutic uses or as molecular probes for biochemical/pharmacological research. Zhijian Qian, Ph.D. College of Medicine, Division of Hematology & Oncology Start Date: 3/9/18 Previous Institution: University of Illinois Cancer Center Research: The long-term goal of Dr. Qian’s research is to understand the mechanisms that underlie the development of blood cancer, with a focus on studying the genetic pathways that control the proliferation, survival and self-renewal of normal or leukemic hematopoietic stem cells.

Zhijian Qian, Ph.D.

Melike Caglayan, Ph.D.

Melike Caglayan, Ph.D. College of Medicine, Department of Biochemistry and Molecular Biology Start Date: 6/15/18 Previous Institution: National Institute of Environmental Health Sciences Research: Dr. Caglayan’s work focuses on mechanisms of repair of cytotoxic and mutagenic DNA damage that can lead to genomic instability, a precursor to cancer. Lina Cui, Ph.D. College of Pharmacy, Department of Medicinal Chemistry Start Date: 6/26/18 Previous Institution: University of New Mexico Comprehensive Cancer Center Research: The Cui lab explores the biochemical activities of glycan processing enzymes and develops therapeutic and diagnostic molecules or tools for various types of cancer and age-related diseases.

Lina Cui, Ph.D.

Ji-Hyun Lee, DrPH


Ji-Hyun Lee, DrPH College of Medicine, College of Public Health and Health Professions, Department of Biostatistics Start Date: 7/1/18 Previous Institution: University of New Mexico Comprehensive Cancer Center Research: Dr. Lee’s research interests include clinical trial design, group randomized trials based on communities, methods for repeated measurements, Bayesian approach and best statistical practices. Matthew Eddy, Ph.D. College of Liberal Arts and Science, Department of Chemistry Start Date: 8/16/18 Previous Institution: The Scripps Research Institute Research: Dr. Eddy’s lab studies the structures and activities of human cell surface receptors in contexts that closely mimic the cellular environment and also directly in cells. The focus of the lab is to apply an integrative

Matthew Eddy, Ph.D.

structural biology approach to unravel how the effects of the cellular environment and drugs can be rationally controlled to develop new therapies. Ryan Kolb, Ph.D. College of Medicine, Department of Pathology, Immunology and Laboratory Medicine Start Date: 11/2/18 Previous Institution: University of Iowa Research: Dr. Kolb’s primary research focus is on how changes in the tumor microenvironment, such as those caused by inflammation or obesity, effect the pathogenesis, tumor immunity and treatment of cancer. Weizhou Zhang, Ph.D. College of Medicine, Department of Pathology, Immunology and Laboratory Medicine Start Date: 11/6/18 Previous Institution:: University of Iowa

Ryan Kolb, Ph.D.

Weizhou Zhang, Ph.D.

Research: Dr. Zhang’s primary research interest focuses on the pathogenesis and therapy of breast cancer. The Zhang Lab studies the dynamic interactions between cancer cells and various tumor microenvironment components especially immune cells during the pathogenesis of breast cancer. Brian Ramnaraign, M.D. College of Medicine, Division of Hematology & Oncology Start Date: 7/1/19 Previous Institution: University of Pennsylvania Research: Dr. Ramnaraign’s expertise and research interests are in the fields of genitourinary cancers and gastrointestinal cancers. He is interested in the role of targeted therapies and immunotherapies in providing personalized treatments to individuals with advanced cancers.

Brian Ramnaraign, M.D.

Jonathan Chatzkel, M.D. College of Medicine, Division of Hematology & Oncology Start Date: 7/22/19 Previous Institution: Moffitt Cancer Center Research: Dr. Chatzel’s clinical and research interests include the care of patients with genitourinary cancers, including cancers of the kidney, bladder, prostate and testis. He believes strongly in delivering individualized care to each of his patients. Ke Ning, M.D. College of Medicine, Division of Hematology & Oncology Start Date: 9/30/19 Previous Institution: Hendrick Cancer Center Research: Dr. Ning is a boardcertified medical oncologist with special interests in thoracic, head and neck, and cutaneous oncology. He brings compassion and individualized cancer care, with integration with the most up-to-date modalities of therapy to improve patient outcomes and quality of life.

Jonathan Chatzkel, M.D.

Ke Ning, M.D.

2019 ANNUAL REPORT | 11


One of the great benefits of receiving cancer care at an academic health center like UF Health is unique patient access to the most advanced medical research, treatments and technologies. Our clinician-scientists participate in research that has a direct impact on improved patient outcomes, and allows patients access to the very latest cancer-fighting technologies and drugs. Activities and programs are acutely focused on early stage translational research that applies findings to clinical trials, resulting in improved patient care. Our leadership works with lab-based faculty to develop new ideas to collaborate on innovative cancer treatments and therapies.

research 12 | UF HEALTH CANCER CENTER


FINDING TOMORROW’S ANSWERS F O R T O D AY ’ S PAT I E N T S The overarching goal of the UF Health Cancer Center is to improve cancer outcomes. We aim to accomplish this, in part, by promoting research in cancer mechanisms, developing and conducting interventional clinical trials addressing the most prevalent cancers that affect our patients and improving our understanding of the determinants of cancer outcomes in rural, underserved and elderly patients. We are committed to interdisciplinary basic discovery and translational research, and the pursuit of scientific endeavors that have near-term clinical applications. The research priorities of the Cancer Center cut across and align with our research programs: CANCER THERAPEUTICS & HOST RESPONSE MECHANISMS OF ONCOGENESIS CANCER POPULATION SCIENCES

91,608

31

266

2,095

square feet of research space

U.S. patents issued relating to cancer

active cancer projects

scientific publications**

**Numbers represent cumulative data for 2014-2019

2019 ANNUAL REPORT | 13


Research Programs

The research priorities of the UF Health Cancer Center cut across and align with our three research programs.

 ancer Population C Sciences (CPS)  Mission: To understand and reduce cancer risks and cancer-related burden within the UFHCC catchment area. Program Co-Leaders: Janice Krieger, Ph.D. Diana Wilkie, Ph.D., R.N., FAAN Membership: 92 members from 10 colleges and 36 departments/schools

Program Aims: n Identify risk factors, improve cancer prevention and optimize screening n Reduce cancer burden by mitigating cancer-treatment toxicities, alleviating symptoms, improving palliative care and survivorship and increasing participation in clinical trials through tailored communication Working Group(s):  Tobacco Control Working Group n  Supportive and Palliative Care Work Group n  Health Disparities Working Group n  Cancer Communication and Technology Working Group n

Cancer Therapeutics and Host Response (CTHR)

Membership: 132 members from seven colleges and 31 departments/ schools

Mission: To advance understanding of interactions between tumor cells, immune cells and microbiota that mediate tumor development, progression and host responses, and to develop therapeutics that capitalize on these mechanisms and interactions.

Program Aims: Develop novel immunotherapies for refractory cancer n Elucidate microbiome function in cancer development and therapeutics n Identify and validate targeted therapeutics engaging key cancer pathways with small molecules and test new therapies in clinical trials n

Program Co-Leaders: Duane Mitchell, M.D., Ph.D. Christian Jobin, Ph.D.

RESEARCH PROGRAM LEADERSHIP Janice Krieger, Ph.D. 14 | UF HEALTH CANCER CENTER

Diana Wilkie, Ph.D., R.N., FAAN

Duane Mitchell, M.D., Ph.D.

Christian Jobin, Ph.D.

Rolf Renne, Ph.D.

Daohong Zhou, M.D.


Working Group(s): n  Immuno-Oncology Working Group n  Microbiome Working Group n  Targeted Therapeutics Working Group

Mechanisms of Oncogenesis (MOO) Mission: To elucidate the genetic and epigenetic events dysregulated during neoplastic transformation and to identify therapeutic targets. Program Co-Leaders: Rolf Renne, Ph.D. Daohong Zhou, M.D. Membership: 57 members from seven colleges and 21 departments/schools

Program Aims: n  Elucidate the role of neoplastic genomic instability and epigenetic alterations in cancer n  Define the role of regulatory RNAs, including microRNAs and long noncoding RNAs in oncogenesis n  Translate MOO discoveries into novel therapeutic approaches Working Group(s): n  DNA Damage Working Group n  Epigenetics and IncRNAs Seminar Series n  Viroholics Working Group

$1.2M

$32.6M

research training awards

in current active cancer-relevant grants

Research Programs in Action The three UF Health Cancer Center research programs hold monthly meetings and annual retreats and have established working groups centered around specific research program aims. At program-specific monthly meetings, research program members gather to address areas of common research interest, discuss current research projects, collaborate to achieve specific aims, foster professional and program development and identify member needs. Each research program also hosts an annual retreat to present research and brainstorm potential research projects that align with the program’s mission and aims. The retreats foster new interprogrammatic interactions by including members from other research programs. The three research programs have organized working groups aligned with program-specific aims. The research program leaders work closely with the working group leaders to provide support for basic scientists and clinical investigators. The objective of these groups is to provide a platform for investigators to interact, disseminate ideas, create new collaborations and strengthen ongoing interactions, with the goal of increasing submissions of multi-PI grant applications. The working groups include research program members as well as postdoctoral fellows, graduate students and research faculty from across UF.

$10.6M NIH/NCI DIRECT COST FUNDING

**Numbers represent recent active funding as of fall 2019

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Research Headlines

Ali Zarrinpar, M.D., Ph.D.

Mansour Mohamadzadeh, Ph.D.

UF researchers find link between demographics and liver cancer A study by UF Health researchers found that Hispanics, as well as the elderly and people with diabetes, have a higher risk of developing liver cancer. The findings showed alcoholic and nonalcoholic fatty liver disease, which are distinguished by the patient’s alcohol consumption, share the same cancer risk factors, suggesting demographic differences may be what puts some patients more at risk of developing liver cancer. Those over the age of 60 are almost four times more at risk while Hispanics and diabetics are nearly two times at risk.

UF Health researchers identify nine noncancer drugs with the potential to improve cancer survival

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Dorina Avram, Ph.D.

‘Fine-tuning’ certain cells may prevent gut inflammation, researchers find

UF Health researchers find new details of immune system’s molecular “switch”

Findings by UF Health researchers and their collaborators show how certain cells in the colon can be “finetuned” by chemically attaching a sugar molecule to a protein. That is crucial for developing prebiotics — non-digestible food ingredients that promote the growth of beneficial gut bacteria and protect against intestinal pathogens. The molecular “fine-tuning,” known as glycosylation, has the potential to prevent inflammation and the progression of intestinal diseases such as colitis.

A group led by a UF Health researcher found out how one molecular “switch” influences the immune system — a finding they say has major implications for future treatments for immune system diseases and cancer. The absence of a specific gene — known as Bcl11b — in regulatory T cells triggers fatal systemic inflammation in mice. When the Bcl11b gene is absent, T cells are unable to function normally to control multiorgan inflammation in the lungs, liver, skin and kidneys.

UF Health researchers sifting through millions of electronic health records found evidence that nine drugs already being used to treat other health conditions may also have the potential to improve cancer survival. The researchers, led by Yonghui Wu, Ph.D., hope that with additional study, some of these drugs — currently used to treat noncancerous health conditions such as high cholesterol, acid reflux, hypertension and diabetes — could be repurposed as effective cancer treatments.


New hepatitis C therapy effective, costs less for patients and payers, UF researchers find Haesuk Park, Ph.D.

UF researchers examined the clinical and economic outcomes of direct-acting antiviral therapy, which cures hepatitis C in nearly 95% of patients. When left untreated, hepatitis C can cause liver cancer; cirrhosis, or liver scarring; and other serious liver problems. In a finding the researchers called “disturbing,� 70% of hepatitis C patients in the nationwide health insurance database analyzed in the study had not received treatment, reflecting expensive drug costs and prior authorization policies.

David R Nelson, M.D.

UF researcher finds link between common food poison toxin and colorectal cancer

UF researchers, led by Christian Jobin, Ph.D., have found a link between colorectal cancer in mice and the most commonly reported bacterial cause of food poisoning in the United States. One of the key findings of the current cancer study is that using inflammatory inhibitors in a mouse model prevented both inflammation and cancer, suggesting the capability to manipulate cancer-causing activity of C. jejuni. It’s possible that carrying C. jejuni may also put humans at higher risk of cancer.

2019 ANNUAL REPORT | 17


Ramzi G Salloum, Ph.D.

UF study finds physicians, patients talking less about lung cancer screening Smoking rates are down nationally, but so are discussions among physicians and smokers about lung cancer screening, UF researchers have found. However, the study also found these patient-physician conversations did not affect current smokers’ intent or attempts to quit. The researchers expected to find that if patients who smoke engage in a discussion about lung cancer screening with their physicians, they will be more motivated to quit. However, the study showed physician-patient discussions were not associated with any changes in smokers’ behavior.

UF Health researchers find new combination therapy slows deadly brain tumor in mice

Discount stores’ tobacco sales tied to more women smoking while pregnant, UF Health study finds Tobacco sales at two national dollar-store chains may have negatively impacted the smoking rate among pregnant women in the southeastern United States, UF Health researchers have found. Smoking during pregnancy was associated with increased tobacco availability at thousands of dollar stores in the region. The study found the biggest declines in the rate of smoking during pregnancy occurred in counties that had no increase in tobacco retailers or even a decline in the number of stores due to the pharmacy’s decision not to sell.

UF Health Cancer Center and Massachusetts General Hospital researchers have found a combination approach that is showing promise. Researchers focused on cells known as myeloid-derived suppressor cells, or MDSCs, which help tumors flourish by inhibiting the immune system. The researchers tested a combination treatment: One of the therapies is a “checkpoint inhibitor,” which reactivates the anticancer response the tumor has shut down. The other, a new drug that targets a protein, CCR2, which helps recruit the MDSCs to the tumor. The new therapy blocked the MDSCs from infiltrating the tumors, stimulating an immune response that allowed the mice to live longer.

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Jaclyn M Hall, Ph.D.

Jeffrey Harrison, Ph.D.


UF researchers discover breakthrough anticancer drug UF Health Cancer Center researchers have discovered a safer and more effective anticancer drug to target leukemia, lymphoma, and breast and lung cancers. Known as DT2216, the drug acts on a protein called B-cell lymphoma-extra-large, or BCL-XL, which fuels the growth of malignant cells and strengthens their resistance to therapy. The researchers demonstrated in mathematical and mouse models that DT2216 suppressed the growth of several tumors on its own and in combination with other drugs. Guangrong Zheng, Ph.D., and Daohong Zhou, M.D.

UF researchers find gene mutation involved in cancer progression

UF researchers, led by Jonathan Licht, M.D., have found a new type of cancercausing gene. Histones help package DNA in cells so DNA can be protected from stresses and compacted into chromosomes during cell division. The research found a new class of mutations that interrupt the structure of the histone octamer, causing the disintegration of the nucleosome and the stimulation of cancer growth.

2019 ANNUAL REPORT | 19


Shared Resources The UF Health Cancer Center strives to provide cancer scientists with state-of-theart technology and expertise to foster and facilitate outstanding cancer research.

Flow Cytometry and Confocal Microscopy Shared Resource (CYT-SR) Director: Andria Doty, Ph.D. Mission: To provide UF Health Cancer Center members with easy access to costeffective, leading-edge cytometry instrumentation, novel methodologies and data analysis expertise, and facilitate instrument self-use through comprehensive user training. Program Aims: n Provide access to cost effective, state-of-the-art flow cytometry analysis and sorting and live cell confocal microscopy services.

DEVELOPING SHARED RESOURCES

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Provide training leading to certification in selfuse of flow and confocal microscopy instruments. n Provide consultation on experiment design, assistance with data interpretation and support for scientific publications and research grant applications. n Identify and evaluate new instrumentation and ensure alignment of instrument capabilities with user needs based upon end-user and faculty surveys and recommendations from the CYT-SR Scientific Advisory Group. n

Major Services: Multi-parameter flow cytometry n Confocal microscopy with live cell imaging n Microparticle analysis n Expert consultations in experiment design and n

eHealth

preparation of research grant applications n Instrument training, courses and workshops

Next Generation Sequencing Shared Resource (NGS-SR) Director: David Moraga, Ph.D. Mission: To provide members with easy access to costeffective state-of-the-art NGS services to support research activities. Program Aims: n Provide ready access to cost-effective, state-ofthe-art next-generation sequencing technologies and instrumentation as well as highly skilled technical staff to support research programs. n Provide expert consultation on effective use of NGS technologies, assistance with data interpretation,

and support for scientific publications and research grant applications. n Ensure rigor and reproducibility of all research conducted at NGS-SR through the use of standard operating procedures, continuous staff training, monitoring instrument performance metrics, and appropriate data handling, transfer and storage. n Lead efforts to acquire new instrumentation and develop and validate new methodologies to expand capabilities and expertise in NGS-SR to meet growing demands of membership. Major Services: Massively parallel, highthroughput whole genome sequencing n Library prep for genomic DNA/exome analysis, epigenetics, microbiome n

Cancer informatics is where information science, computer science and health care intersect. It is about acquiring, storing and using information about cancer in the most thorough and efficient manner. eHealth is an emerging field in the intersection of biomedical informatics, computer science, health communication, public health and health care delivery, referring to health services and information delivered or enhanced through the Internet and related technologies, such as mobile-based apps.


studies and RNAsequencing n Expert consultations in effective use of NGS technologies n Collaboration with the Biostatistics and Quantitative Sciences Shared Resource for streamlined data analysis of large-scale genomic datasets n Instrument training and workshops

The Biostatistics and Quantitative Sciences Shared Resource (BQS-SR) Director: Ji-Hyun Lee, DrPH Mission: To promote rigorous and reproducible statistical and quantitative sciences for research.

Gene Editing/ CRISPR

Program Aims: Provide biostatistical and quantitative assistance to members for the design of studies, development of grant proposals, analysis of data, publication and dissemination of findings. n Provide consultations and collaborate in the development and evaluation of innovative methodologies, data collection, and processing tools, and to select/ develop analytic software appropriate for study objectives pertaining to cancer informatics and electronic medical-record data. n Enhance transdisciplinary research and team science through coordination with other shared resources and facilitating collaborations among faculty. n

CRISPR technology facilitates the precise editing of targeted regions of mammalian genomes and remains one of the key recent advances in biotechnology. The CRISPR technology core offers Cancer Center researchers with access to expertise in Cas9mediated gene engineering in mammalian cells as well as custom services for CRISPRbased whole-genome phenotypic screens.

Support the Cancer Center Clinical Research Office, thereby ensuring high-quality of science, data integrity and patient safety in clinical cancer research. n Educate members, staff and trainees in current “best practices” and uses of biostatistics, bioinformatics and health informatics to ensure rigorous and reproducible research. n

Major Services: Biostatistics Support: •  Conceptualization of a research project •  Oversight for data collection and data management •  Reproducible statistical analysis •  Assistance in grant preparation, manuscript writing and report generation n

Drug Screening

Bioinformatics/Health Informatics/Computational Biology Support: •  Consulting for “omics” and health informatics •  Analysis and annotation of high-throughput genomic assays •  Assistance in the development of bioinformatics components •  Development of analysis tools and pipelines for high-performance computing environments •  Data integration and mining in health informatics •  Web-interface and database programming for clinical and administrative data •  Manipulation of large observational databases n Training in biostatistics and bioinformatics through a series of seminars and short courses n

The drug screening core has the capability to run medium- to high-throughput screens (96and 384-well plate format) and experienced personnel to miniaturize assays. Assay platforms include biochemical assays using colorimetric, fluorescence and ultra-sensitive luminescence outputs including assays designed to quantify protein concentration and protein-protein interactions using the AlphaLISA technology. 2019 ANNUAL REPORT | 21


UFHCC Selected Publications Authored by UF Health Cancer Center Members | 2019

The UF Health Cancer Center, along with Moffitt Cancer Center and the University of Miami Sylvester Comprehensive Cancer Center, joined in 2014 to create the Florida Academic Cancer Center Alliance, or FACCA. FACCA was formed to address the unique cancer burden of the state of Florida by expediting cancer research and maximizing the state investment in biotechnology. The alliance encourages and promotes collaborative research conducted by researchers at its partnering institutions and supports workshops and meetings to encourage the exchange of information and networking among Annual FACCA Retreat researchers.

Papp B, Motlagh N, Smindak RJ, Jin Jang S, Sharma A, Alonso JD, Toth Z. Genome-Wide Identification of Direct RTA Targets Reveals Key Host Factors for Kaposi’s Sarcoma-Associated Herpesvirus Lytic Reactivation. J Virol. 2019 PMID:30541837 | PMCID:PMC6384073 Swaroop A, Oyer JA, Will CM, Huang X, Yu W, Troche C, Bulic M, Durham BH, Wen QJ, Crispino JD, MacKerell AD Jr, Bennett RL, Kelleher NL, Licht JD. An activating mutation of the NSD2 histone methyltransferase drives oncogenic reprogramming in acute lymphocytic leukemia. Oncogene. 2019 PMID:30171259 | PMCID:PMC6358490

In 2019, over 100 physicians and researchers attended the annual retreat, hosted last year in Miami. Twenty-seven UF Health Cancer Center members attended the retreat, 16 speaking at the event. Two Cancer Center members were awarded FACCA pilot awards.

Bennett RL, Bele A, Small EC, Will CM, Nabet B, Oyer JA, Huang X, Ghosh RP, Grzybowski AT, Yu T, Zhang Q, Riva A, Lele TP, Schatz GC, Kelleher NL, Ruthenburg AJ, Liphardt J, Licht JD. A Mutation in Histone H2B Represents a New Class of Oncogenic Driver. Cancer Discov. 2019 PMID:31337617 | PMCID:PMC6774836

The alliance also accepts applications and awards grants for a wide variety of cancerrelated research by researchers located at one of the three partnering institutions. All alliance-funded research is conducted by Florida-based scientists and reflects the mission to attract and expand the state’s research capabilities to address the public health challenges of cancer.

Jiang Y, Gao R, Cao C, Forbes L, Li J, Freeberg S, Fredenburg KM, Justice JM, Silver NL, Wu L, Varma S, West R, Licht JD, Zajac-Kaye M, Kentsis A, Kaye FJ. MYB-activated models for testing therapeutic agents in adenoid cystic carcinoma. Oral Oncol. 2019 PMID:31606723

Nowialis P, Lopusna K, Opavska J, Haney SL, Abraham A, Sheng P, Riva A, Natarajan A, Guryanova O, Simpson M, Hlady R, Xie M, Opavsky R. Catalytically inactive Dnmt3b rescues mouse embryonic development by accessory and repressive functions. Nat Commun. 2019 PMID:31558711 | PMCID:PMC6763448 Bullard WL, Kara M, Gay LA, Sethuraman S, Wang Y, Nirmalan S, Esemenli A, Feswick A, Hoffman BA, Renne R, Tibbetts SA. Identification of murine gammaherpesvirus 68 miRNA-mRNA hybrids reveals miRNA target conservation among gammaherpesviruses including host translation and protein modification machinery. PLoS Pathog. 2019 PMID:31393953 | PMCID:PMC6687095 O’Grady T, Feswick A, Hoffman BA, Wang Y, Medina EM, Kara M, van Dyk LF, Flemington EK, Tibbetts SA. Genome-wide Transcript Structure Resolution Reveals Abundant Alternate Isoform Usage from Murine Gammaherpesvirus 68. Cell Rep. 2019 PMID:31242428 Zhang DD, Li Y, Xu Y, Kim J, Huang S. Phosphodiesterase 7B/microRNA-200c relationship regulates triple-negative breast cancer cell growth. Oncogene. 2019 PMID:30209363

*UF Health Cancer Center affiliates highlighted orange/bold. 22 | UF HEALTH CANCER CENTER

Yan B, Chen Q, Shimada K, Tang M, Li H, Gurumurthy A, Khoury JD, Xu B, Huang S, Qiu Y. Histone deacetylase inhibitor targets CD123/ CD47-positive cells and reverse chemoresistance phenotype in acute myeloid leukemia. Leukemia. 2019 PMID:30291336 Li X, Kozlov SV, El-Guindy A, Bhaduri-McIntosh S. Retrograde Regulation by the Viral Protein Kinase Epigenetically Sustains the Epstein-Barr Virus Latency-to-Lytic Switch To Augment Virus Production. J Virol. 2019 PMID:31189703 | PMCID:PMC6694827 Zhang Q, Narayanan V, Mui KL, O’Bryan CS, Anderson RH, Kc B, Cabe JI, Denis KB, Antoku S, Roux KJ, Dickinson RB, Angelini TE, Gundersen GG, Conway DE, Lele TP. Mechanical Stabilization of the Glandular Acinus by Linker of Nucleoskeleton and Cytoskeleton Complex. Curr Biol. 2019 PMID:31402305 | PMCID:PMC6736724 Shan J, Dudenhausen E, Kilberg MS. Induction of early growth response gene 1 (EGR1) by endoplasmic reticulum stress is mediated by the extracellular regulated kinase (ERK) arm of the MAPK pathways. Biochim Biophys Acta Mol Cell Res. 2019 PMID:30290239 | PMCID:PMC6311436


Karachi A, Yang C, Dastmalchi F, Sayour EJ, Huang J, Azari H, Long Y, Flores C, Mitchell DA, Rahman M. Modulation of temozolomide dose differentially affects T-cell response to immune checkpoint inhibition. Neuro Oncol. 2019 PMID:30668768 | PMCID:PMC6556847 Pohl-Guimaraes F, Yang C, Dyson KA, Wildes TJ, Drake J, Huang J, Flores C, Sayour EJ, Mitchell DA. RNA-Modified T Cells Mediate Effective Delivery of Immunomodulatory Cytokines to Brain Tumors. Mol Ther. 2019 PMID:30448196 | PMCID:PMC6453546 Cai W, Ratnayake R, Gerber MH, Chen QY, Yu Y, Derendorf H, Trevino JG, Luesch H. Development of apratoxin S10 (Apra S10) as an anti-pancreatic cancer agent and its preliminary evaluation in an orthotopic patient-derived xenograft (PDX) model. Invest New Drugs. 2019 PMID:30073464 | PMCID:PMC6360136 Sutaria DS, Jiang J, Azevedo-Pouly AC, Wright L, Bray JA, Fredenburg K, Liu X, Lu J, Torres C, Mancinelli G, Grippo PJ, Coppola V, Schmittgen TD. Knockout of Acinar Enriched microRNAs in Mice Promote Duct Formation But Not Pancreatic Cancer. Sci Rep. 2019 PMID:31367007 | PMCID:PMC6668398 He Z, Gharaibeh RZ, Newsome RC, Pope JL, Dougherty MW, Tomkovich S, Pons B, Mirey G, Vignard J, Hendrixson DR, Jobin C. Campylobacter jejuni promotes colorectal tumorigenesis through the action of cytolethal distending toxin. Gut. 2019 PMID:30377189 | PMCID:PMC6352414

Yoon SL, Kim JA, Kelly DL, Lyon D, George TJ Jr. Predicting unintentional weight loss in patients with gastrointestinal cancer. J Cachexia Sarcopenia Muscle. 2019 PMID:30834673 | PMCID:PMC6596456 Kellish P, Shabashvili D, Rahman MM, Nawab A, Guijarro MV, Zhang M, Cao C, Moussatche N, Boyle T, Antonia S, Reinhard M, Hartzell C, Jantz M, Mehta HJ, McFadden G, Kaye FJ, Zajac-Kaye M. Oncolytic virotherapy for small-cell lung cancer induces immune infiltration and prolongs survival. J Clin Invest. 2019 PMID:31033480 | PMCID:PMC6546459 Wang Y, Liu J, Ma X, Cui C, Deenik PR, Henderson PKP, Sigler AL, Cui L. Real-time imaging of senescence in tumors with DNA damage. Sci Rep. 2019 PMID:30765819 | PMCID:PMC6375927 Elsayed AH, Rafiee R, Cao X, Raimondi S, Downing JR, Ribeiro R, Fan Y, Gruber TA, Baker S, Klco J, Rubnitz JE, Pounds S, Lamba JK. A six-gene leukemic stem cell score identifies high risk pediatric acute myeloid leukemia. Leukemia. 2019 PMID:31645648 Wong SS, George TJ Jr, Godfrey M, Le J, Pereira DB. Using photography to explore psychological distress in patients with pancreatic cancer and their caregivers: a qualitative study. Support Care Cancer. 2019 PMID:29959574 | PMCID:PMC6289888 Kharod SM, Indelicato DJ, Rotondo RL, Mailhot Vega RB, Uezono H, Morris CG, Bradfield S, Sandler ES, Bradley JA. Outcomes following proton therapy for Ewing sarcoma of the cranium and skull base. Pediatr Blood Cancer. 2019 PMID:31736243

Holtzman AL, Stahl JM, Zhu S, Morris CG, Hoppe BS, Kirwan JE, Mendenhall NP. Does the Incidence of Treatment-Related Toxicity Plateau After Radiation Therapy: The Long-Term Impact of Integral Dose in Hodgkin’s Lymphoma Survivors. Adv Radiat Oncol. 2019 PMID:31673663 | PMCID:PMC6817558 Johnson Shen M, Ostroff JS, Hamann HA, Haque N, Banerjee SC, McFarland DC, Molena D, Bylund CL. Structured Analysis of Empathic Opportunities and Physician Responses during Lung Cancer Patient-Physician Consultations. J Health Commun. 2019 PMID:31525115 | PMCID:PMC6884685 Schoppee TM, Dyal BW, Scarton L, Ezenwa MO, Singh P, Yao Y, Suarez ML, Wang ZJ, Molokie RE, Wilkie DJ. Patients and Caregivers Rate the PAINReportIt Wireless Internet-Enabled Tablet as a Method for Reporting Pain During End-of-Life Cancer Care. Cancer Nurs. 2019 PMID:31517649 Huo J, Hong YR, Turner K, Bian J, Grewal R, Wilkie DJ. Utilization pattern and service settings of palliative care for patients with metastatic nonsmall-cell lung cancer. Cancer. 2019 PMID:31449674 LeLaurin JH, Theis RP, Thompson LA, Tan ASL, Young-Wolff KC, Carter-Harris L, Shenkman EA, Salloum RG. Tobacco-related counseling and documentation in adolescent primary care practice: Challenges and opportunities. Nicotine Tob Res. 2019 PMID:31074792 Flood-Grady E, Neil JM, Paige SR, Lee D, Damiani RE, Hough D, Savitsky Z, George TJ Jr, Krieger JL. A Pilot Study Determining Comprehension and the Acceptability of a Cancer Research Study Website for Cancer Patients and Caregivers. J Cancer Educ. 2019 PMID:30847837

Indelicato DJ, Rotondo RL, Uezono H, Sandler ES, Aldana PR, Ranalli NJ, Beier AD, Morris CG, Bradley JA. Outcomes Following Proton Therapy for Pediatric Low-Grade Glioma. Int J Radiat Oncol Biol Phys. 2019 PMID:30684665 Guo Y, Bian J, Modave F, Li Q, George TJ, Prosperi M, Shenkman E. Assessing the effect of data integration on predictive ability of cancer survival models. Health Informatics J. 2019 PMID:30672356 Ali AA, Tawk R, Xiao H, Campbell E, Semykina A, Montero AJ, Mogos M, Diaby V. Comparative effectiveness of radiotherapy for early-stage hormone receptor-positive breast cancer in elderly women using real-world data. Cancer Med. 2019 PMID:30548840 | PMCID:PMC6346228 Modave F, Zhao Y, Krieger J, He Z, Guo Y, Huo J, Prosperi M, Bian J. Understanding Perceptions and Attitudes in Breast Cancer Discussions on Twitter. Stud Health Technol Inform. 2019 PMID:31438134 Silver N, Dourado J, Hitchcock K, Fullerton A, Fredenburg K, Dziegielewski P, Danan D, Tighe P, Morris C, Amdur R, Mendenhall W, Fillingim RB. Chronic opioid use in patients undergoing treatment for oropharyngeal cancer. Laryngoscope. 2019 PMID:30613983 O’Dell W, Takita C, Casey-Sawicki K, Daily K, Heldermon CD, Okunieff P. Projected clinical benefit of surveillance imaging for early detection and treatment of breast cancer metastases. Breast J. 2019 PMID:30548515

429

Number of Scientific Publications in 2019

2019 ANNUAL REPORT | 23


The UF Health Cancer Center’s clinical enterprise uses a comprehensive care model, with multidisciplinary cancer programs offering advanced treatment options, such as minimally invasive and robotic surgery, proton and intensitymodulated radiotherapy, hematopoietic stem cell transplantation, chemotherapy, targeted therapy and immunotherapy in conjunction with the Precision Cancer Care Program, as well as access to clinical trials with limited availability elsewhere.

clinical excellence 24 | UF HEALTH CANCER CENTER


A TE A M A P P ROAC H TO C A N C E R T R E AT M E N T The UF Health Cancer Center is a state-designated Cancer Center of Excellence. The designation by the Florida Legislature recognizes hospitals and treatment centers that demonstrate excellence in patient-centered coordinated care for people undergoing cancer treatment and chemotherapy. UF Health is designated as a Center of Excellence for myeloma, myelodysplastic syndromes and pancreatic cancers. The UF Health Blood and Marrow Transplantation Program is one of 20 core centers nationwide that comprise the NHLBI/NCI Blood and Marrow Transplant Clinical Trials Network. The UF Health Proton Therapy Institute is one of the few proton facilities in the country that have achieved accreditation by the American College of Radiology. It is internationally recognized as a cancer care destination for pediatric radiation oncology patients. The UF Health Breast Center is accredited by the National Accreditation Program for Breast Centers and is the first in the state to offer intraoperative radiation therapy using Intrabeam®.

“I went to UF Health Shands because of the reputation, proximity and the unique skill set it offered.” — BILL, STAGE IV HEAD AND NECK CANCER SURVIVOR

2019 ANNUAL REPORT | 25


A Group Effort for Individualized Care T H E M U LT I D I S C I P L I N A R Y T E A M S at the UF Health Cancer Center meet weekly to discuss the details of each patient’s case. This approach leads to a personalized plan created to guide each patient through diagnosis, treatment and recovery. This plan also includes guiding patients who need several different therapies to their ideal cancer treatment combination. The plan is customized for the specific type of cancer, its stage and a patient’s needs and overall health. When a patient begins their journey, a nurse navigator coordinates all aspects of the patient’s care, including ensuring the patient and family understand the care plan.

Pathologists Radiation Oncologists Radiologists

Surgeons Nurses

Nutritionists

Medical Oncologists Patient and Nurse Navigator

Oncopsychologists Educators

Laboratory Researchers

M U LT I D I S C I P L I N A RY CLINICAL PROGRAMS

26 | UF HEALTH CANCER CENTER

Clinical Research Specialists

4 UF Health Breast Center 4  Blood and Marrow Transplant and Leukemia Program 4  Orthopaedic Oncology Program 4  Gastrointestinal Oncology Program 4  Gynecologic Oncology Program 4  Head and Neck Cancer Program

Genetic Counselors

Clinical Social Workers

Oncofertility Specialists

4 L ung Cancer Program 4 Metastatic Cancer Program 4 Preston A. Wells Jr. Center for Brain Tumor Therapy 4 Pediatric Hematology/Oncology Program 4 Skin Cancer and Melanoma Program 4 Urologic Cancer Program


C A NC ER C ENTER TUMOR B OA R DS

Patients and Patient Navigators F I G H T I N G C A N C E R is a complex and difficult journey, which is why the UF Health Cancer Center marshals all our resources for each patient’s care. Each week, our cancer-specific tumor boards bring together doctors from different areas of expertise to discuss and determine the best possible treatment options and to develop a care plan. During the meetings, each patient’s case is reviewed by a pathologist, radiologist, medical oncologist, surgical oncologist and radiation oncologist — all coordinated by a nurse navigator. In some instances, a physical therapist, nutritionist and psychologist will also be involved.

CELLUL AR THERAPIES

UF Health has successfully performed stem cell transplantation to treat a broad variety of malignant and benign hematologic disorders, including:

Every patient’s medical history and needs are considered. Each week, a thorough discussion of progress, changes and options ensures that our cancer patients receive a comprehensive treatment plan specifically tailored to their needs using the greatest number of resources available.

• Acute and chronic leukemia • Myelodysplastic syndromes • Multiple myeloma • Non-Hodgkin’s lymphoma and Hodgkin’s disease • Myeloproliferative syndrome • Severe aplastic anemia

2019 ANNUAL REPORT | 27


THE RIDE OF HER LIFE SANDRA DAVIS-QUINNEY has met bumps, curves and stops on the ride that is her cancer journey. Even with the rough roads she’s endured, Sandra tries to stay hopeful, resiliently staying on the ride. Staying on the ride is exactly what brought her to UF Health Cancer Center’s Jack Hsu, M.D. After her non-Hodgkin’s lymphoma failed to respond to multiple rounds of chemotherapy, Sandra’s next option was a stem cell transplant. However, when her physicians were unable to collect enough stem cells for a transplant, that option was taken off of the table. Heading home to Jacksonville to get back on medication and let her body “get itself together,” Sandra met with her local oncologist and began looking into other treatment options. When she learned about the novel chimeric antigen receptor (CAR) T-cell therapy, a genetic therapy that modifies the patient’s own cells to attack their cancer, at UF Health, she knew her ride was just gaining momentum. Sandra was a candidate for the treatment, but she wasn’t just any candidate — she was the first CAR T-cell patient at UF Health. Hsu and the UF Health Bone Marrow Transplant Unit team spent two years

A PAT I E N T ’ S J O U R N E Y 28 | UF HEALTH CANCER CENTER

preparing to become certified as a CAR T-cell therapy site — developing policies and procedures, building relationships with subspecialties and earning an accreditation for their stem cell lab. In October 2018, UF Health became a designated site for administering the therapy. “This is the first genetic therapy that was approved for the treatment of adult hematologic malignancies,” Hsu said. “It provides another option for patients who have very high-risk lymphoma.” The reality of being the first CAR T-cell patient at UF Health didn’t sink in for Sandra until the process was set in motion, she said. She had heard about different trials and new treatments, but now she was the star of the show in one. “Being the first patient is a big deal,” she said. “If it affords other people the opportunity and the availability is here for them, then that’s great.” The initial extraction of her cells wasn’t what she expected. Preparing for a more invasive and painful procedure, the procedure ended up being more like drawing blood. “You feel different in your body because naturally they extract the blood, extract what they need from the blood and put it back into the body,” Sandra said. “I was freezing cold, but it wasn’t painful.”

Going through the actual CAR-T cell therapy was a different story. Because she had been through multiple rounds of chemo, the therapy itself wasn’t too bad. “It was not pleasant at times, but it wasn’t really bad until I went through the process of where I had to go to the intensive care unit,” she said. There are two major side effects to the treatment — cytokine release syndrome, which causes the patient to develop swelling and their blood pressure to drop, and neurotoxicity, which causes changes to the patient’s mental status, Hsu said. Sandra developed both. “Getting her through that, since we didn’t have practical experience before this, was very exciting because although we knew what to expect, actually seeing it was a different experience,” Hsu said. Due to the neurotoxicity she developed, Sandra doesn’t remember the week she spent in the intensive care unit. For days, she was coherent and talking, but there’s a gap where the memories of those days should be. Although her body is still adjusting to life after CAR T-cell therapy, a recent evaluation, three months after her therapy, revealed the news Hsu, Sandra and her family started this journey to hear — her lymphoma is in complete remission.


“This is the first genetic therapy that was approved for the treatment of adult hematologic malignancies. It provides another option for patients.” “No pain, no gain,” Sandra said. “I just do what I need to do and live life as a happy day every day.” Hsu said treating the first CAR T-cell patient at UF Health was scary yet exciting. He was confident in the policies and procedures he and his team spent years perfecting. “I’m happy to say that because we spent some time ironing out the details and trying to figure out potential points of failure, we didn’t really have much of a problem,” he said. The CAR T-cell therapy program at UF Health opens doors to new opportunities for patients,

physicians and researchers. Now, UF Health can participate in CAR T-cell-specific trials and work with pharmaceutical companies to target other diseases. “Developing this program gives us the ability to participate in trials of this class of therapy because not all facilities are going to be able to do this,” Hsu said. CAR T-cell therapy is in active investigation, not only for other blood cancers like multiple myeloma but also solid tumors like colon cancer. These treatments will become an important therapeutic option for patients like

Sandra, especially as similar therapies are further designed and explored. The accessibility to novel treatments like CAR T-cell therapy is why Sandra chose UF Health. While her cancer journey hasn’t always been smooth, her determination to stay on the ride led her to the finish line. “There are challenges some days, but I don’t let them discourage me,” she said. “I keep praying, driving, putting fuel in my tank and propelling forward.”

2019 ANNUAL REPORT | 29


GRAND ADVENTURE

A PAT I E N T ’ S J O U R N E Y

30 | UF HEALTH CANCER CENTER


IN SEPTEMBER 2018, David Walther traveled from the Florida Panhandle to Arizona for another shot at adventure. The 62-year-old high school economics teacher from Jay, Florida, was looking to complete a rim-to-rim hike at the Grand Canyon in just a single day. David had conquered the 21-mile hike four times before, and he had logged numerous hours of training in preparation for this latest trek. But this time, something wasn’t right. The day before the hike, David felt severe head pain. He had been experiencing bad headaches for the past few weeks, but this time, the pain was almost unbearable. He knew he needed medical care and, with the help of three fellow teachers he traveled with, David went to an urgent care facility in Page, Arizona. An initial diagnosis suggested cancer, and David immediately booked a flight back to Florida. At a hospital in Pensacola, David underwent an MRI that confirmed he had a glioblastoma, a type of tumor that can occur in the brain or spinal cord. Headaches are one of the most common symptoms of a

glioblastoma because as the tumor grows, it increases pressure on the skull and the brain. David was advised to seek care at UF Health, so he and his wife made the five-hour drive to Gainesville. On Sept. 11, 2018, David underwent surgery performed by UF Health neurosurgeon, Maryam Rahman, M.D., an assistant professor in the UF College of Medicine’s department of neurosurgery. Following the surgery, David immediately began six weeks of radiation and chemotherapy treatment. He said the positivity and care from radiation oncologist Robert J. Amdur, M.D., a professor of radiation oncology in the UF College of Medicine, and his medical oncologist Ashley Ghiaseddin, M.D., made a world difference. “I had such positive experiences at UF Health,” David said. “There is always a great group of people around who look after me tremendously.” David quickly returned to work and finished out the school year in December, just under three months following his surgery. This August, the beloved Pace High School teach-

er entered his 41st year of teaching. Determined to make that fifth hike, David created his own workout routine. He did a mix of activities, including running the bleachers, bike riding and lifting weights. Periodically, he returns to Gainesville for a medical appointment and when he does, he typically heads to Ben Hill Griffin Stadium for some exercise. “I know I’m not back at 100%,” David said, “but I’m pretty close. It’s been an emotional time for me to be surrounded by loved ones as I try to redeem myself and complete what I had hoped to do last year.” And this past September, David returned to Arizona for some unfinished business. Accompanied by his wife, two daughters, granddaughters and former students — and with the assistance of UF Health helping his every step — David completed hike No. 5 through the Grand Canyon.

“I had such positive experiences at UF Health. There is always a great group of people around who look after me tremendously.”

2019 ANNUAL REPORT | 31


Clinical Research T H E M I S S I O N of the UF Health Cancer Center Clinical Research Office, or CRO, is to help deliver new and promising cancer treatments that improve the lives of our patients at the UF Health Cancer Center. The CRO provides support to our clinical investigators for the development and implementation of cancer clinical trials — facilitating the conduct of high-quality clinical research while adhering to the highest ethical standards and maintaining compliance with all governing bodies.

ABOUT THE CLINICAL RESEARCH OFFICE The CRO is committed to supporting clinical research addressing the complex needs of the catchment area and the patients we serve, with an emphasis on providing access to novel therapies. The

office provides comprehensive resources to investigators for the efficient conduct of cancer clinical research with representative inclusion of minorities, women, children and the elderly. Currently, the clinical research program consists of the CRO and 10 diseasespecific working groups (e.g., thoracic, GI, GU, neuro-oncology, hematologic malignancies). It also supports an experimental therapeutics group for early phase clinical trials as well as a Cancer Population Sciences group. These two groups support trials that may be relevant to patients across several different cancer types. Additionally, the CRO provides clinical trial support for institutions that are affiliated with UF Health, the university’s academic health center.

A F F I L I AT E C L I N I C A L RESE ARCH SITES I NCLUDE: • Broward Health Medical System (Fort Lauderdale, FL) • North Florida/South Georgia Veterans Health System (Gainesville, FL) • Orlando Health UF Health Cancer Center (Orlando, FL) • Tallahassee Memorial Cancer Center (Tallahassee, FL) • UF Health Proton Therapy Institute (Jacksonville, FL) • Watson Clinic Cancer & Research Center (Lakeland, FL)

253

115

47

active trials

trials open to patient enrollment

new trials in 2019

C L I N I C A L R E S E A R C H O F F I C E STAT S 2016

2017

2018

New Studies

55

62

82

Interventional Accruals

515

384

2398

32 | UF HEALTH CANCER CENTER

as of Dec 2, 2019


CLINICAL RESEARCH OFFICE LEADERSHIP

Thomas George, M.D.

Ashley Anderson, M.B.A., ACRP-CP

Alisha Daniels, M.D. Leslie Pettiford, R.N., M.S., O.C.N.

Alisha Daniels, M.D., M.H.A., CCRC, ACRP-PM Assistant Director, Project Management and Regulatory Affairs

Thomas George, M.D. Associate Director, Clinical Research Alison Ivey, R.N., M.S., O.C.N., CCRP Administrative Director Ashley Anderson, M.B.A., ACRP-CP Assistant Director, Clinical Research Administration and Compliance

25 disease sites being studied

18 years in operation

Alison Ivey, R.N., M.S., O.C.N., CCRP

Leslie Pettiford, R.N., M.S., O.C.N., CCRC Assistant Director, Study Coordination and Data Management

3 main areas of focus:

1. Adult Blood and Marrow Transplant and Hematologic Malignancies 2. Adult Solid Tumors 3. Pediatric Hematology/Oncology

2019 ANNUAL REPORT | 33


Clinical Research Highlights I N 2 0 1 9 , the Clinical Research Office helped the Cancer Center realize various accomplishments in alignment with its mission — to deliver new and promising cancer treatments in order to improve the lives of the patients at the UF Health Cancer Center. The CRO supported 5,725 accruals in cancer clinical trials. Enrollments to treatment trials climbed from 365 in 2018 to 449 in 2019 — over a 20% increase. By the end of 2019, 80% of all eligible CRO staff were research certified through either the Society of Clinical Research Associates or the Association of Clinical Research Professions. The CRO initiated Precision Promise, an initiative of the Pancreatic Cancer Action Network and the first largescale precision medicine trial designed to transform outcomes for patients with pancreatic cancer. UF Health is one of 14 national centers chosen to participate.

Ke Ning, M.D. Previous Institution: Hendrick Cancer Center Specialty: head and neck, thoracic and cutaneous oncology

WELCOMING THREE NEW ONCOLOGISTS

Brian Ramnaraign, M.D. Previous Institution: University of Florida Specialty: genitourinary cancers and gastrointestinal cancers Jonathan Chatzkel, M.D. Previous Institution: Moffitt Cancer Center Specialty: genitourinary cancers All three are assistant professors of medicine in the division of hematology and oncology at the UF College of Medicine.

34 | UF HEALTH CANCER CENTER

Ke Ning, M.D.

Brian Ramnaraign, M.D.

Jonathan Chatzkel, M.D.


S E L E C T I N G B E ST- S U I T E D C L I N I C A L T R I A L S UF Health’s Cancer Center has 12 Disease Site Groups, 10 disease-specific and two disease-agnostic, that consist of research and clinical leaders. Each Disease Site Group is charged with developing and maintaining a portfolio of trials that brings forward scientific hypotheses developed in the Cancer Center Research Programs and is relevant to the Cancer Center’s catchment area. All newly proposed interventional trials must be endorsed first by the appropriate Disease Site Group. During the first-stage of review, Disease Site Groups emphasize prioritization, catchment area and clinical needs. In 2018, the Disease Site Groups reviewed 228 interventional trials, only 74 of which were endorsed. This demonstrates that the Disease Site Groups are highly selective in bringing only the best-suited clinical trial options forward for their patients.

U F H C C PAT I E N T A N D FA M I LY A DV I S O RY B OA R D

To ensure patient- and family-centered care, the UF Health Cancer Center relies on the input of its Patient and Family Advisory Council, a volunteer group of individuals whose lives have all been touched by cancer. Collaborating with physicians and staff, the council helps improve the patient experience at UF Health by providing feedback in a number of key areas. BACK ROW: Travis Rockey, Amber Gay, Thomas Johns, Bo Ginn, Kate Walker; FRONT ROW: Merry-Jennifer Markham, M.D (Chair), Maureen “Moe” LaTour, Michele Scavone-Stone, Paula Barrett, Karen Miller

2019 ANNUAL REPORT | 35


Selected Clinical Trials PHASE

NCT NO.

INVESTIGATOR

STUDY TITLE

NCT02927249

Karen C. Daily Weinstein

A Randomized Phase III Double-Blinded Placebo-Controlled Trial of Aspirin as Adjuvant Therapy for HER2 Negative Breast Cancer: The ABC Trial

BREAST III

EXPERIMENTAL THERAPEUTICS GROUP II

NCT03207347

Thomas J. George

Phase II Trial of the PARP1 Inhibitor, Niraparib, in BAP1 and other DNA Damage Response (DDR) Pathway Deficient Neoplasms (UF-STO-ETI-001)

II

NCT03924557

Rhonda Marsha Dehoff

A Randomized Pragmatic Trial of Genotype-Guided Supportive Care in Symptom Treatment of Cancer Patients (UF-ETG-002)

CANCER POPULATION SCIENCE N/A

NCT03385577

Deidre Pereira

Feasibility, Acceptability, and Efficacy of a Yoga Intervention for Distress in Women with Gynecologic, Gastrointestinal, or Thoracic Cancer

N/A

NCT03209440

Diana J. Wilkie

Palliative Care for Elderly Outpatients

Steven John Hughes

Protein Signatures Improve the Diagnostic Yield of Fine Needle Aspiration (Aim 3)

Thomas J. George

A Phase II, Open-label Evaluating the Safety and Activity of naI-IRI in Combination with 5-FU and Oxaliplatin in Preoperative Treatment of Pancreatic Adenocarcinoma (UF-STO-PANC-004)

GASTROINTESTINAL N/A II

NCT03483038

GENITOURINARY III

NCT03091660

Paul Luther Crispen

A Phase III Randomized Trial to Evaluate the Influence of BCG Strain Differences and T Cell Priming With Intradermal BCG Before Intravesical Therapy for BCG-Naive High-Grade Non-muscle Invasive Bladder Cancer

II

NCT03658304

Paul Luther Crispen

A Single Arm Phase II Trial of the Intraoperative Intravesical Instillation of Mitomycin C During Nephroureterectomy for Urothelial Carcinoma of the Upper Urinary Tract

III

NCT03561220

Nancy P. Mendenhall

A Prospective Comparative Study of Outcomes with Proton and Photon Radiation in Prostate Cancer

Merry J. Markham

A Randomized, Double-Blind, Phase 3 Comparison of Platinum-Based Therapy with Tsr-042 and Niraparib versus Standard of Care Platinum-Based Therapy as First-Line Treatment of Stage III Or IV Nonmucinous Epithelial Ovarian Cancer

GYNECOLOGICAL III

NCT03602859

36 | UF HEALTH CANCER CENTER


PHASE

NCT NO.

INVESTIGATOR

STUDY TITLE

Robert J. Amdur

LCCC 1612: P53 Mutational Status and Circulating Free HPV DNA for the Management of HPV-associated Oropharyngeal Squamous Cell Cancers

HEAD AND NECK II

NCT03077243

MALIGNANT HEMATOLOGY III

NCT03016130

John R. Wingard

A Phase III, Randomized, Clinical Trial Comparing Two Diets in Patients undergoing Hematopoietic Stem Cell Transplant (HSCT) or Remission Induction Chemotherapy for Acute Leukemia and Myelodysplastic Syndrome

III

NCT02964325

Randall A. Brown

Clinical Effectiveness of Standard Versus Mirasol-treated Apheresis Platelets in Patients with Hypoproliferative Thrombocytopenia

Maryam Rahman

A Phase II Randomized, Blinded, and Placebo-controlled Trial of CMV RNA-Pulsed Dendritic Cells with Tetanus-Diphtheria Toxoid Vaccine in Patients with NewlyDiagnosed Glioblastoma

NEUROLOGIC II

NCT02465268

PEDIATRICS I

NCT03396575

Sridharan Gururangan

BRAVO: Newly-Diagnosed Brain Stem Gliomas Treated with Adoptive Cellular Therapy During Recovery from Focal Radiotherapy Alone or Focal Radiotherapy and Dose-intensified Temozolomide (Phase I)

II

NCT03155620

William B. Slayton

NCI-COG Pediatric MATCH (Molecular Analysis for Therapy Choice) Screening Protocol

Joanne P. Lagmay

A Phase Ib/II Study to Evaluate the Safety, Feasibility and Efficacy of Nivolumab or Nivolumab in Combination With Azacitidine in Patients With Recurrent, Resectable Osteosarcoma

Anamaria R. Yeung

Consecutive Vs. Non-Consecutive Stereotactic Body Radiotherapy For Early Stage Non-Small Cell Lung Cancer

SARCOMA I/II

NCT03628209

THORACIC II

NCT03624907

T H E R E ’ S A N A P P F O R T H AT ! The UF Health Cancer Center’s Clinical Trial NaviGATOR mobile app gives patients and clinicians the ability to browse cancer clinical trials at the center by disease site and criteria, and to contact the center to make referrals or get additional information. The NaviGATOR is available on the web and is also available as an app for mobile devices: ufhealth.org/navigator.

2019 ANNUAL REPORT | 37


The UF Health Cancer Center is dedicated to advancing progress towards prevention and cures for cancer. Achieving this goal requires the successful education, training and mentoring of the next generation of cancer researchers. The Cancer Research Career Enhancement core seeks to enhance and integrate cancer education, research training and career development activities at all student, trainee and faculty levels.

education & training 38 | UF HEALTH CANCER CENTER


CANCER RESEARCH CAREER ENHANCEMENT CORE The UF Health Cancer Center is committed to providing education and training to students and investigators at various stages of their cancer research careers. The mission of its Cancer Research Career Enhancement core is to serve as the universitywide center for cancer education and workforce enhancement. The core seeks to provide a broad oncology perspective and to incorporate opportunities in basic science, population science and clinical/translational research, with the goal of stimulating interest, providing enriched environments, offering support and guidance and nurturing the development of future cancer research scientists.

The mission of the Cancer Research Career Enhancement core is to serve as the universitywide center for cancer education and workforce enhancement.

Dietmar W. Siemann, Ph.D., Associate Director for Education & Training

2019 ANNUAL REPORT | 39


Highlights S E C O N D A N N UA L C A N C E R R E S E A R C H C O N F E R E N C E F O R S C I E N C E T E AC H E R S On July 15-16, 2019, the UF Health Cancer Center hosted its Second Annual Cancer Research Conference for Science Teachers. This free two-day conference took place at the UF Cancer & Genetics Research Complex and included a reception at the Samuel P. Harn Museum of Art. Participants heard about leadingedge research at UF and connected with scientists, physicians and students to engage in a dialogue about community health and well-being. Sixty-seven science teachers from 20 counties across Florida registered for the conference.

F L O R I DA 4 - H U N I V E R S I T Y — C A N C E R D I S C OV E RY WORKSHOP The Florida 4-H University enables 14- to 18-year-old students to participate in educational workshops, explore career opportunities and lead community service activities. On July 30, 2019, 20 high school students from the program attended the UFHCC Discovery Workshop. The group learned about cancer research, from the gene level to the protein level, including oncogenes and tumor suppressor genes. Students also participated in a hands-on DNAextraction experiment.

UFHCC PREDOCTORAL AWA R D S

40 | UF HEALTH CANCER CENTER

The UF Health Cancer Center Predoctoral Awards are given annually to up to five graduate students who are within 15 months of having passed their Ph.D. qualifying exams. These awards recognize and support outstanding predoctoral candidates conducting innovative research focused on cancer. The 2019 Predoctoral Awardees are:

Bayli DiVita Dean

Abdelrahman Elsayed

Biomedical Sciences Program – Immunology & Microbiology

Clinical Pharmaceutical Sciences Program


19 Total

Adaixa Padron

Mai Tanaka

Kartika Venugopal

Clinical Health Psychology Program

Biomedical Sciences Program – Cancer Biology

Biomedical Sciences Program – Cancer Biology

AWARDEES SINCE 2016

14: Women 3: Underrepresented minorities

2019 ANNUAL REPORT | 41


UFHCC UNIVERSITY SCHOLARS PROGRAM The University Scholars Program, a competitive two-semester program for UF undergraduates, provides students with cancer research experience in basic, clinical or population sciences. Scholars complete research projects, present their findings at a research symposium and publish in a peer-reviewed journal. Current graduate students and postdoctoral trainees serve as student mentors and teach monthly seminars that include laboratory demonstrations and career development lectures. The first cohort completed the program in May 2019 and the second cohort began in September 2019.

A DVA N C E D C O N C E N T R AT I O N IN CANCER B I O L O GY

42 | UF HEALTH CANCER CENTER

THE MISSION of the Cancer Biology Concentration of the UF College of Medicine’s Graduate Program in Biomedical Sciences, established by Dietmar Siemann, Ph.D., in 2015 and now co-directed with Maria Zajac-Kaye, Ph.D., is to train the next generation of cancer biologists to make significant contributions to basic and translational research in cancer prevention and diagnosis, cancer epidemiology, novel therapy discovery and cancer treatment. It currently boasts 27 UFHCC faculty mentors and 21 students. The first cohort of students have now earned their Ph.D.s and have moved on to new positions.

Mam Mboge, Ph.D. Postdoctoral Scholar Lawrence Berkeley National Laboratory


Varsha Sundaresan, Ph.D.

Amani Harrandah, Ph.D.

Yue Jiang, Ph.D.

Vindhya Vijay, Ph.D.

Julia Bray, Ph.D.

Rachel Nosacka, Ph.D.

Postdoctoral Fellow University of Southern California

Assistant Professor Umm Al-Qura University

Scientist, BeiGene Pharmaceuticals

Postdoctoral Fellow Harvard University

Postdoctoral Fellow MD Anderson Cancer Center

Actively pursuing new position

2019 ANNUAL REPORT | 43


Active NIH T32 Training Grant Programs

6

U F H E A LT H C A N C E R C E N T E R TRAINEE MENTORING 2 0 1 4 - 2 0 19

# of UF Health Cancer Center members who are PIs on T32 Training Grants

10

# of T32 Training Grants with UF Health Cancer Center members serving as mentors

25

# of UF Health Cancer Center members serving as research mentors on T32 Training Grants 2014-2019

39

# of graduate students with UF Health Cancer Center members as research mentors on T32 Training Grants 2014-2019

13

# of postdoctoral trainees with UF Health Cancer Center members as mentors on T32 Training Grants 2014-2019

21

# of trainees with cancer-focused projects on T32 Training Grants 2014-2019

CANCER POLICY INTERNSHIP PROGRAM

44 | UF HEALTH CANCER CENTER

94 faculty members 434 graduate students 215 postdoctoral fellows 219 women | 52 underrepresented minorities

Initiated in 2019, this four-month internship at the UF Office of Federal Relations in Washington, D.C., provides an immersive experience for UF graduate students to better understand processes associated with health care policy and implementation science. Interns develop a cancer-related project aligned with legislative policies and UF policies. Fizza Imran

Juliette Barbera

Spring 2019 Intern

Fall 2019 Intern


The annual UF Health Cancer Center Research Day

“This experience has influenced my future career because it has provided me with direct exposure to the health policy world and the legislative process.” Matthew R. Cretul Sr.

Donghee Lee

Zachary Sandoval

Fall 2019 Intern

Spring 2020 Intern

Spring 2020 Intern

— FIZZA IMRAN

2019 ANNUAL REPORT | 45


The UF Health Cancer Center is proud to be a part of a community that moves cancer care and research forward. It is this community that helps shape and guide our mission — to prevent, detect and treat cancer — and brings new therapies to patients through philanthropic investments. Together, we have unstoppable momentum.

community 46 | UF HEALTH CANCER CENTER


COM MUN IT Y OUTRE ACH AN D ENGAGEM ENT OFFICE The overarching goal of the UF Health Cancer Center’s Community Outreach and Engagement, or COE, office is to partner with community members, patients, families, clinicians, health system leaders, policymakers and Cancer Center scientists to reduce the cancer burden in the 22 counties we serve through novel outreach and engagement programs that span the cancer care continuum — from prevention to survivorship. The Community Outreach and Engagement Office is guided by the principles of Community-Engaged Research, which aim to form equitable collaborations and shared leadership among the community and researchers, with emphasis on transparent bidirectional communication, mutual benefit and sustained commitment to change. These principles mirror those of the Patient-Centered Outcomes Research Institute (PCORI) and emphasize reciprocal relationships, mutual co-learning, collaborations, transparency, honesty and trust.

The Community Outreach and Engagement Office is guided by principles that emphasize reciprocal relationships, mutual co-learning, collaborations, transparency, honesty and trust.

2019 ANNUAL REPORT | 47


The Population We Serve T H E U F H E A LT H C A N C E R C E N T E R is dedicated to serving the residents of Florida. Cancer is a leading cause of death for Floridians. Therefore, our efforts to serve our state with innovative research and leading cancer care have never been more critical. This map shows our catchment area, the counties that 86% of our patients call home. These counties face unique challenges of the cancer burden, and it’s our mission to address those challenges by developing creative prevention and treatment strategies that serve our diverse population.

UF Health Cancer Center

H U F H C C C AT C H M E N T A R E A SMALL TOWN / UNIVERSITY 30% of population • More diverse (66% white) • More higher education (35%) • Median age 32 years RETIREMENT 33% of population • Mostly white (86%) • Less higher education (22%) • Median age 55 years RURAL 37% of population • Largely white (77%) • Lowest higher education (15%) • Median age 41 years

BY T H E NUMBERS

48 | UF HEALTH CANCER CENTER

18%

22%

live without insurance

are over 65 years old

20% live below the poverty threshold


NEW CANCER CASES R A N K E D BY S I T E Lung Breast

Pancreas

10 Oropharynx

1

3 4

8 7 Bladder

Sarah Szurek, Ph.D.

Jodian Blake, M.P.H., CTTS

LaTrina Massey, M.P.H.

2

9

Kidney

Betsy Shenkman, Ph.D.

6 Melanoma

Colorectal

Prostate

5 Hematologic Malignancies

MEET THE COE TEAM Betsy Shenkman, Ph.D. Associate Director for Community Outreach and Engagement

15,000

Sarah Szurek, Ph.D. Program Director of Community Outreach and Engagement

the number of square miles in our catchment area; greater than the area of Massachusetts, Rhode Island and Connecticut combined

Jodian Blake, M.P.H., CTTS Community Health Resource Coordinator LaTrina Massey, M.P.H. Community Health Resource Coordinator

22

13

7

catchment area counties designated as medically underserved with lack of access to primary care services

catchment area counties with an adult smoking rate of 20% or higher

of the 10 most prevalent types of new cancer cases are tobacco-related

2019 ANNUAL REPORT | 49


Collaborations T H E U F H E A LT H C A N C E R CENTER COM MUN IT Y OUTRE ACH A N D E N G A G E M E N T A D V I S O RY B O A R D is a committed group of community experts who gather in the spirit of building equitable partnerships and infusing a community perspective into our cancer research agenda. Using a community-engaged research process, advisory board members meet and openly discuss cancer-related issues faced by residents of our 22-county catchment area. With encouragement from Director Jonathan Licht, M.D., the advisory board identified their top priorities: cancer screening, transportation services, the cancer-related needs of those with mental and behavioral health conditions and support through trained community health workers. In response to these priorities, Licht has dedicated funding for new cancer screening pilot projects targeting our most vulnerable populations — those who seek care at Federally Qualified Health Centers (FQHCs). With this support, the Community Outreach and Engagement office is launching Project CONTINUITY: CONnecTing hIgh risk aNd Underserved Individuals To care

UFHCC COMMUNITY OUTRE ACH AN D ENGAGEM ENT A D V I S O RY B OA R D M EM BERS 50 | UF HEALTH CANCER CENTER

C O M M U N I T Y O U T R E A C H A N D E N G A G E M E N T A D V I S O RY B O A R D

in the communitY. The long-term goals of Project CONTINUITY are: n

n

To increase bundles of cancer screening in diverse health care settings in our catchment area, including at FQHCs and;

To use novel, evidence-based strategies to link patients to needed treatment and follow-up.

FQHCs are located throughout our 22-county catchment area and provide needed care to marginalized populations in underserved areas. FQHCs are communitybased and comprehensive health care providers that offer primary and preventive services, dental care, mental health and substance abuse services, as well as

Chair: Sue Colson – Cedar Key (Levy County) City Commissioner Shirley Bloodworth – Citizen Scientist Amy Bucciarelli – UF Center for Arts in Medicine

specialty care and programs to address social and structural determinants of health. Bond Community Health Center (CHC), located in Tallahassee, Florida, has been a FQHC for over 30 years, providing patient-centered approaches to primary and preventive health care for residents of neighboring counties and access to highquality health services with a particular concern for lower socioeconomic groups, regardless of their ability to pay. Our partnership with Bond CHC has grown with the addition of LaTrina Massey, M.P.H., the Community Outreach and Engagement team’s newest Community Health Resource coordinator, who will be hosted at Bond CHC as she works to impact cancer health outcomes in the Big Bend region of Florida.

Ann Walsh Collett – Parent and community advocate Linda Cottler, Ph.D., M.P.H., FACE – Professor, UF Department of Epidemiology; UF HealthStreet

Jeff Feller – CEO, Well Florida Council, North Central Florida Cancer Control Collaborative Jeri Francoeur – Board Member/ Advocacy Chair, Florida Breast Cancer Foundation


Tobacco Impact 2 0 1 9 W A S A B I G Y E A R for the Community Outreach and Engagement office in terms of impact on disseminating leading-edge tobacco research and implementing broad policy change. While cigarette smoking continues to decline in Florida, rates in our catchment area remain some of the highest in the state, and lung cancer is the No. 1 diagnosed cancer in our 22-county catchment area. With these statistics in mind, the COE office set its sights on a multi-level strategy to address tobacco use guided by the efforts of our partners — Tobacco Free Alachua and Suwannee River Area Health Education Center. In January 2019, “Tobacco 21,” a countywide policy that raises the legal age of tobacco sales from 18 to 21 and creates a 1,000-foot buffer for tobacco sales around schools, was passed unanimously by the Alachua County Board of County

I N O U R C AT C H M E N T A R E A

Commissioners. This decision was a historic win, as Alachua County became the first county in Florida to implement this important policy change, and came after years of work by Tobacco Free Alachua, a dedicated group that works to envision “A Tobacco Free Life for All Floridians.” Sarah M. Szurek, Ph.D., Community Outreach and Engagement’s program director, and other UF faculty and staff went on official record at a County Commission hearing to present data on the catchment area’s tobacco use and lung cancer burden. Tobacco 21 also required retailers to purchase licenses to sell tobacco products and paved the way for Tobacco 21 nationwide. The work of Tobacco 21 continues as well as our partnership with Tobacco Free Alachua to oversee policy implementation by disseminating the regulations to local businesses and sharing strategies within and beyond our catchment area.

Tobacco Free Alachua team

Howard Freeman, Ed.D. – Stop Children’s Cancer

In May 2019, Suwannee River Area Health Education Center held its Annual Rural Tobacco Summit. The Community Outreach and Engagement office facilitated this outreach event by supporting the work of two UF researchers, Ramzi Salloum, Ph.D., and Jaclyn Hall, Ph.D. Salloum presented his research on how informational inserts in tobacco packages have been successful in other countries, and Hall talked about correlations between dollar stores selling tobacco and tobacco use in rural communities. The summit also discussed ongoing and broad systems change, as Area Health Education Center Program Offices and Centers work extensively with health care systems to integrate strategies that ensure tobacco use is assessed and treated at every patient encounter. The summit successfully engaged tobacco control advocates, hospital administrators, researchers and clinicians to identify solutions to impact tobacco use disparities in rural communities.

Rick Medina – Climb for Cancer board member

Harriette Hudson – Chair of Sisters Alive, an African American Advisory Board to the American Cancer Society

Francis Knight – Member of Sisters Alive, an African American Advisory Board to the American Cancer Society Robin Lewy – Director of Programming, Rural Women’s Health Project

Kendra Siler-Marsiglio, Ph.D. – Rural Health Partnership of North Central Florida, Inc.

Eunice Johnson, Ph.D. – Cancer community advocate for Waldenstrom’s macroglobulinemia

Michael McTiernan, M.D. – UF Community Health & Family Medicine

Terry Weber – Survivors for Research

Barbara Richardson, Ph.D. – Area Health Education Center

2019 ANNUAL REPORT | 51


Cancer Center Leadership Council T H E U F H E A LT H C A N C E R C E N T E R L E A D E R S H I P C O U N C I L plays a critical role for the center by increasing public awareness of its mission. Made up of approximately 20 volunteers from the local community, as well as from Sarasota and Orlando, in addition to foundations that support the UFHCC such as Climb for Cancer, Stop Children’s Cancer and the Ocala Royal Dames for Cancer Research, the members of the UFHCC Leadership Council are advocates for the center, hosting events and providing opportunities for faculty to interact with the public. In raising awareness, the council’s mission dovetails with the UF Health Cancer Center Office of Development’s efforts to secure philanthropic support through excellent service and stewardship to donors, patients and the entire community.

DEVELOPMENT PA R T N E R S

52 | UF HEALTH CANCER CENTER

MEMBERS David Arthurs Connie Brown Susan DiNatale Chuck DiNatale Ronald Farb Dianna Farb

By fostering philanthropic investment, the UF Health Cancer Center Office of Development supports the center in its mission of advancing cancer research, education and patient care. The Office of Development focuses on individual philanthropy, working with University of Florida alumni, private foundations and corporations, friends of

Howard Freeman Laurel Freeman Devin Gantzios Ivan Gonzalez Anna Gonzalez Stacey Hayes

the center and grateful patients. They also work with university and community partners, such as the Cancer Center Leadership Council and local nonprofit organizations, on awareness and fundraising events. The Climb for Cancer Foundation was founded in 2003 by Ron and Dianne Farb, following Ron’s

James Islam Sharon Jank Mark Jank DeeDee Smith Rod Smith

sister’s breast cancer diagnosis. Today, this nonprofit organizes group climbs around the world, on summits such as Kilimanjaro, to raise funds for patient-focused initiatives at UF Health. To date, Climb for Cancer has raised more than $1.5 million. The Ocala Royal Dames’ mission is to support educational


UF Health Shands Cancer Hospital

programs and activities that promote, enhance and further cancer research and education on a local and regional level. Comprising more than 240 women from the local community, the Dames host a number of events throughout the year to fund their philanthropic mission, including the Tiara Ball. To date, the Dames have provided more than $1.5

million in research support to UF, as well as support for continuing medical education for residents and clinicians. Founded in 2016 by Barb Thomas and Terry Weber, both breast cancer survivors, the primary mission of Survivors for Research is to raise funds to provide opportunities for research, education

and service to enhance the lives of those affected by triple-negative breast cancer. Through events such as their annual Tea for a Cure and Party on the Patio, Survivors for Research has invested $20,000 in cancer research at the UF Health Cancer Center. Founded in 1981 by Howard and Laurel Freeman, Stop

Children’s Cancer began as the vision of their daughter, Bonnie, to raise $1 million to end children’s cancer. Thirty-seven years and more than $8 million later, Stop Children’s Cancer has been an integral part of bringing clinical trials to the UF Health Shands Children’s Hospital and the UF Health Cancer Center.

2019 ANNUAL REPORT | 53


Photo Album 01

Making Strides

02

Link to Pink

In 2019, friends and family from UF Health participated in Making Strides Against Breast Cancer, a national awareness walk hosted by the American Cancer Society. Teams from UF Health raised more than $40,000.

The Gators gymnastics team hosted the UF Health Cancer Center during the annual Link to Pink meet at the Stephen C. O’Connell Center. The event is part of a Southeastern Conference initiative to raise awareness about breast cancer prevention and treatment — and attendees received UF Health Cancer Center shirts and pom-poms.

03

Climb for Cancer

04

Hyundai Hope on Wheels

The Climb for Cancer Foundation held its 7th annual Hogtown 5K Beer Run at Haile Plantation in March. All proceeds benefited the foundation, which supports UF Health cancer patients and their families. Hyundai Hope on Wheels presented UF Health Shands Children’s Hospital with a $300,000 Hyundai Young Investigator Grant in September. The grant supports the research of pediatric oncologist Elias Sayour, M.D., Ph.D. During the event, pediatric patients battling cancer participated in the program’s signature handprint ceremony, dipping their hands in paint and placing their handprints on a white Hyundai Santa Fe and Sayour’s lab coat.

05

Pancreatic Cancer Awareness — Volleyball

The UF Health Cancer Center raised awareness for pancreatic cancer at the Gators volleyball game in November. Steven Hughes, M.D., chief of surgical oncology at UF Health, served the game ball.

06

Cheers to the New Year

In January, UF Health Cancer Center faculty and staff gathered in the UF Cancer and Genetics Research Complex atrium to celebrate the center’s myriad achievements in 2018 and to toast to the opportunities and successes of the coming year.

54 | UF HEALTH CANCER CENTER

07

Chomp Melanoma

08

UFHCC Women’s Wellness Cancer Symposium

Chomp Melanoma, a group composed of UF medical and undergraduate students, hosted a free public skin cancer screening at UF HealthStreet. UF Health dermatologists and local practitioners were on hand to perform skin cancer checks and to provide information about how people can perform self-checks at home.

Hosted in March, three UF Health providers presented about women’s cancer prevention, treatment and research. The symposium was preceded by a Women’s Cancer Wellness Health Fair that featured women’s wellness services from UF Health providers.

09

Ocala Royal Dames — Tiara Ball

10

Ante Up Against Cancer

01

Held each spring, the Tiara Ball is the signature event of the Ocala Royal Dames for Cancer Research — a charitable organization composed of 200-plus women focused on supporting cancer research and education. A portion of the proceeds support UF Health research in areas such as pediatric hematologyoncology, breast cancer, prostate cancer and acute lymphoblastic leukemia.

In March, the third Ante Up Against Cancer annual poker tournament at the Cardroom at Oxford Downs in Summerfield featured live music, food and drinks. The event benefited the UF Health Cancer Center.

11

Danny’s Dream

12

Rick Croton Memorial Golf Tournament

05

The second annual Danny’s Dream event was hosted in March. The event, established in honor of Danny DiNatale, who lost his battle to Ewing’s sarcoma in 2016, has raised over $245,000 for Ewing’s sarcoma research at the UF Health Cancer Center.

The second annual Rick Croton Memorial Golf Tournament for Prostate Cancer Research was held at the Country Club of Ocala in May with over 100 participants honoring Rick’s fight against prostate cancer. Sponsored by the UF Health Cancer Center, the event also served to raise awareness of appropriate prostate cancer screening and advances in prostate cancer diagnosis.

09

06


02

03

04

07

10

11

08

12

2019 ANNUAL REPORT | 55


UF Health Cancer Center | P.O. Box 103633, Gainesville, FL 32610-3633

Profile for ufhealthcancercenter

UF Health Cancer Center | Momentum 2019  

The 2019 annual report for the UF Health Cancer Center.

UF Health Cancer Center | Momentum 2019  

The 2019 annual report for the UF Health Cancer Center.

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