Wilmot Cancer Center Dialogue 2022

2022 Volume I

Wilmot Cancer Institute | University of Rochester Medical Center

Connections and New Directions at Wilmot

Letter from the Director Hello Friends of the Wilmot Cancer Institute, The people and programs at Wilmot have been through a tremendous revitalization effort during the past several years. We’ve alluded to it recently, but in this edition of Dialogue you will hear more details from me about the “why,” the “how,” and the team spirit it engendered. Everything we have done has been toward a singular goal: to achieve a designation by the National Cancer Institute as a top cancer center in the U.S. We are in the final stages of this long and ambitious process and no matter the result, Wilmot, and its patients, have benefitted substantially.

You’ll also read about some of the remarkable new people we’ve recruited to Wilmot to build or strengthen many of our initiatives. For example, Ruth O’Regan, M.D., is a breast cancer specialist who also serves as the new Chair of the Department of Medicine at the University of Rochester Medical Center. She plays a major role at Wilmot, working with Carla Casulo, M.D., to steer our vibrant education and training programs in new directions. Last summer, we were among the first in the nation chosen by the American Society of Clinical Oncology to host a group of medical students with diverse backgrounds in an immersive internship program. The idea was to give the students exposure to oncology and, ultimately, improve the diversity of the profession.

I think you’ll see they were energized by the experience.

Jonathan W. Friedberg, M.D., M.M.Sc.

Another story focuses on our data guru, Eric Snyder, whose invaluable knowledge has allowed us to see our region with clearer eyes. We've learned so much from Snyder's data maps about the needs of our region and new ways in which to serve those communities.

We also welcomed Dan Mulkerin, M.D., to Wilmot, to serve as the new regional oncology director. He will supervise our latest satellite facility in Webster (opening in the spring of 2022) and the 13 other offices Wilmot operates in central and western New York. He is also developing a broader strategy to engage our network of referring providers.

Our success reflects incredible community support from Rochester and across our region. Armed with a bold strategic plan, I’m confident that our trajectory will continue to make Wilmot ever better. Meliora!

Jonathan W. Friedberg, M.D., M.M.Sc. Director, Wilmot Cancer Institute

On the Cover Left to right: Ashley Marie Cortes, Iman Mahoui, Bianca Duah, George Olverson, and Joshua Arguello, students at the University of Rochester School of Medicine and Dentistry, spent part of last summer immersed at Wilmot.

Photo Erich Camping The Wilmot Cancer Institute is a component of Strong Memorial Hospital.

Advisory Board Members, '21-'22 Richard Yates, Chair Elaine Bucci Scott Burdett Rina Chessin Patrick Cunningham Garth Hankinson Kathleen Landers John McKenna Jett Mehta Carol Mullin Ralph Olney Doug Parker Walter Parkes Mary Pluta Ronald Pluta Barbara Pluta-Randall

Cheryl Pohlman Victor Salerno Erika Stanat Dr. Eduardo Torrado Jerome Underwood Angela Uttaro Steve Whitman Paul Wilmot Keith Yeates John Zicari Faculty Members Yuhchyau Chen, M.D., Ph.D. Aram Hezel, M.D. Gary Morrow, Ph.D., M.S. Christian Peyre, M.D. Paula Vertino, Ph.D.

Emeritus Members Judy Linehan Jim Ryan, Jr. Ex-Officio Members Kellie Anderson Jonathan W. Friedberg, M.D., M.M.Sc. Hucky Land, Ph.D. David Linehan, M.D. Mark Taubman, M.D. Honorary Board Members Dr. George Abraham Richard “Dick” Bell Michael Buckley Elaine Del Monte Malik Evans Richard DiMarzo Joan Feinbloom Janet Felosky

James Hammer Paul Hanrahan Gary Haseley Sandra Hawks Lloyd Mark Kokanovich Michael Linehan Alyssa Lozipone Ronald Maggio Steve McCluski Michael Norris Jeffrey Pierce Larry Rabinowitz Donald Rhoda Gregory Smith Philip Wehrheim Timothy W. Williams Colleen Wilmot Dennis Wilmot Timothy P. Wilmot Thomas Wilmot Bruce Zicari II

Dialogue Editor / Writer Leslie Orr Leslie_Orr@urmc. rochester.edu Contributing Writers Margaret Bogumil Kellie Fraver Ruth Harper-Rhode Designer Beth Carr Feature Photogaphy Erich Camping Matt Wittmeyer Jeff Witherow

2022 Volume I

THE TRANSFORMATION Wilmot set a lofty goal five years ago to become designated by the National Cancer Institute as an elite cancer center. Director Jonathan Friedberg, M.D., M.M.Sc., talks about taking the leap, teamwork, and believing it will happen........................................................ 2 DATA GURU Eric Snyder makes data easy for everyone to understand. They say he’s also a really nice guy....................................................................................................................................................6 TAKING DIVERSITY TO HEART A new summer internship program paves a clearer path to oncology for students from underrepresented demographic groups. ...............................................................................................8 WILMOT IN WEBSTER Meet Dan Mulkerin, M.D., who is in charge of expanding Wilmot’s regional presence, including a new facility this spring east of Rochester................................................... 11 NEWS BRIEFS................................................................................................................................................12 ADVANCEMENT NEWS............................................................................................................................. 14

Sonali Sharma, Ph.D., a post-doctoral fellow in the Bajaj lab, studies cancer stem cells.

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New Beginnings: Wilmot’s Five-Year Journey to the ‘Blue Ribbon’ On a chilly Saturday morning in March of 2016, dozens of doctors, nurses, researchers, and staff at Wilmot Cancer Institute gave up part of their weekend to talk about how to build a more cohesive and comprehensive cancer center. At that informal retreat, they set an ambitious goal to apply to the National Cancer Institute in 2021 for a P30 Cancer Center Support Grant (CCSG). This would require a restructuring of the cancer center, millions of dollars in investment from the University of Rochester and outside donors, and other herculean efforts. The retreat participants left wearing NCI buttons on their jackets and scrawled their signatures of commitment on a white board, which still sits in the office of Wilmot Director Jonathan Friedberg, M.D., M.M.Sc. It was a sign of good things to come.

If awarded, the NCI-CCSG grant would place Wilmot into a coveted club amid 71 NCI-designated cancer centers in the U.S., proving that it meets the most rigorous standards for research, prevention, and cancer care.

Remarkably — following the most hectic and exciting five years imaginable — Wilmot met its goal in September 2021 when the executive team uploaded the 1,100-page grant to the NCI. The review process is underway, and a decision is expected in the summer.

In the following question-and-answer story, which has been lightly edited, Friedberg offers his thoughts on the fundamental changes that carried Wilmot through the journey.

Going through the NCI designation process, he says, is the capstone since his appointment as Wilmot Director in 2013. “Whatever the outcome,” Friedberg notes, “I can say without hesitation that this process revitalized Wilmot, galvanized our faculty and staff toward a common goal, and made us better.”

Let’s start with this: After all of the hard work, what did it feel like when you hit ‘send’ to upload the NCI grant?

evaluation process with changing levels of expectations — it really pushes you to become ever better.

I would say a combination of relief and a little bit of intimidation. I also had a feeling of accomplishment. We actually did this in the timeframe that we had projected!

At the core level, NCI designation comes with a research grant for infrastructure, salary support, new equipment that allows us to recruit the best and brightest, and support for clinical trials and education.

It was a personal goal; when I was hired I was not told that it was a mandate. So, it’s always been on my mind. For the first two years that I served as director, though, my focus was on building our regional network, which needed to be in place to serve our patients throughout western and central New York. We now have more than a dozen locations.

When we called the retreat in 2016 and made the commitment, I remember feeling a little concerned about putting the (2021) date out there. But, I think we all needed some motivation to rally around. I think we’ve really wowed everyone with what we’ve been able to achieve in such an accelerated fashion.

What does it mean to get NCI designation?

This is the blue ribbon. There’s really nothing better for a cancer center. And the designation has to be renewed every five years, so it’s not like you get it once and you’re done. There’s a constant

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“I take tremendous pride on behalf of our entire team on what we’ve accomplished, and I can go to bed every night knowing that Wilmot is much better in so many ways.”

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Patients want to be treated at an NCI-designated center. There’s a certain cachet to it. They want to know that the interaction between physicians and scientists is happening on a daily basis, and that the top doctors want to come here to work.

In addition to Wilmot, a number of other centers are pursuing designation as well. The NCI gives it out very sparingly. Over the last decade, only two or three new cancer centers have received this top designation.

What if the NCI does not designate Wilmot in 2022, as hoped?

I can’t pretend it wouldn’t be disappointing. But I take tremendous pride on behalf of our entire team on what we’ve accomplished, and I can go to bed every night knowing that Wilmot is much better in so many ways.

Jonathan Friedberg with the 1,100-page grant submitted in September 2021 to the National Cancer Institute.

We have a deeper understanding of the region’s cancer burden.

We have many important, new research collaborations in place, and two new programs for community outreach and for education.

We’ve doubled down on our clinical trials efforts, which helps our patients and our research mission. All of these things will endure whether or not we get the blue ribbon. I firmly believe we belong in the NCI-designation group, and I’m going into the next stage of the review process with confidence.

You’ve brought in a lot of new talent during the past five years. What was it like to embark on the biggest strategic recruitment drive in the cancer center’s history?

“Strategic” is the key word. Historically, many of our recruitments of physicians and scientists were opportunistic. People were brought in to fill an important slot or expand a program. But with the NCI process in the background, we were able to leverage many positions all around the same goals and ensure that we were bolstering our research programs in a very intentional way. I give (University of Rochester Medical Center CEO) Mark Taubman a lot of credit for ensuring that we had the funds and the ability to recruit in that way.

My pitch to incoming talent was: You have to have the enthusiasm

to build something. We needed to harness universal appreciation for the NCI goal. The caliber of people that we wanted here were expecting us to be an NCI designated center, and many of them would not have come here if NCI designation was not reasonable.

So, we just had to encourage people to take the leap and believe that what we were saying and doing was true.

Some of our recruitment efforts were very memorable. For example, when we were talking to Paula Cupertino about building our new Community Outreach and Engagement office, we put on the full-court press. She worked in New Jersey at the time and had been up here, but the deal wasn’t sealed. I flew down there over Christmas break that year to take her out to lunch in her neighborhood. I think it was a Cuban restaurant. It was a long day in and out of Rochester, but I remember getting on the plane to go home and feeling like, ‘We’ve got this.’

Getting her to come to Wilmot was essential. Earlier, when we visited the NCI to outline our plans to achieve designation, they told us that for a new cancer center the most important aspect — in addition to everything else we needed to do — was to have a community engagement program with an experienced leader from another NCI-designated center. Paula was the absolute right person for that. She came here quickly, started working as the pandemic struck, and despite that has done an enviable job.

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I want to add that every single person we recruited was important.

Some of the younger people we brought in, for example, are now starting to get their first grants here. We picked good candidates all around who have talent and drive.

Speaking of faculty and staff, what has this journey been like for them?

It’s very important to recognize that this has been selfless work.

Let’s start with faculty. There are a lot of pressures on them. If you’re a physician, you have to do a certain amount of work to support your salary and those numbers get carefully tracked. If you’re an investigator, you need to obtain grants, publish, and keep your laboratory running. Any time spent on cancer center work toward NCI designation is time away from other things that are mandates.

For me, it’s been humbling. Every day I’m grateful for the support of patients, community fundraisers, medical center leadership, and everyone at Wilmot who has toiled many long hours. People realize that this project is for the greater good. That’s an important statement. Five years is a long time, and getting ready for the next step has been constant. People rolled up their sleeves and did what they had to do. When it’s August and a beautiful day outside, do you really want to be working on the NCI grant? Is this worth it?

It’s been so worth it when you reflect on how much we’ve gained and the transformation of Wilmot.

As part of the NCI process, Wilmot developed a homegrown data-tracking tool to investigate cancer incidence in this region. As data came to life, what struck you?

Seeing that we have one of the highest incidence rates of cancer in the entire country was surprising to me. We are right behind Kentucky. And the truth is, in many ways our rural demographics mimic that of Kentucky’s with health-care access problems, high rates of smoking, and other health issues. It caused us to pause and realize that we’re the only institution in the region equipped to help solve the problem.

The tool is remarkable in many ways. We can look at the entire region, and we can also zoom in on hotspots, zip codes, even at the street level. Take pancreatic cancer, for example: We have a higher incidence than what you would expect in New York and in the U.S., but among certain populations, like Black men, it’s significantly higher. That gives us a mandate to reach out and help that population.

“It's very important to

recognize that this has been selfless work.”

When you look at the maps we’ve developed, quickly it becomes sobering. There’s a lot of suffering out there due to cancer.

That’s our strongest case for NCI designation: We have a problem and we’re committed to fixing it. The numbers ensure that we’re focused and grounded in a way that we’ve never been before. It’s a reminder of why we do what we do. And that urgency is particularly present here, as opposed to other places.

You’ve received a lot of support from civic leaders for NCI designation. And the new mayor of Rochester, Malik Evans, sits on the Wilmot Cancer Institute advisory board. Tell us about those partnerships.

Everybody fears a personal confrontation with cancer — and having top-quality care and the most advanced treatments accessible through clinical trials, close to home, is something that any politician would support. A thriving NCI-designated cancer center is an important asset for the city, and I think Malik realizes that.

We’ve enjoyed terrific bipartisan support. Every representative from the 27-county region, as well as our U.S. Senators, has provided letters to the NCI on our behalf. Even Congressman Brian Higgins of Buffalo supports us, and he’s not even in our direct area.

For Malik, what’s remarkable is how quickly he saw that our pursuit of NCI designation was aligned with his vision for improving Rochester. He’s been a terrific partner at so many levels, and is looking at us to overcome disparities in cancer outcomes. He participated in making a video with us for the NCI and I think he really spoke from the heart. Both of his parents were treated at Wilmot, and he wants to see this thing through.

Wilmot's executive committee, left to right: Paula Vertino, Ph.D.; Paula Cupertino, Ph.D.; Hucky Land, Ph.D.; Gary Morrow, Ph.D.; David Linehan, M.D.; Ruth O'Regan, M.D.; Jonathan Friedberg, M.D., M.M.Sc.; Brian Martin, M.P.A.

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Top Ten Accomplishments since 2016:

Submitted grant to NCI seeking blue-ribbon designation; application is under final review with a decision expected in 2022.

Doubled research funding; more than half comes from NCI.

Buoyed team science approaches; assembled three broad research programs, five shared resource programs, and 100 scientific members, executive team.

Defined a data-based, 27-county “catchment area” for patient care and research encompassing western and central New York, and includes 3 million residents who seek care at Wilmot.

Completed a comprehensive five-year strategic plan with center-wide participation.

Restructured Clinical Trials Office; 70% increase in patient participation in trials.

Built an informatics team and data-mapping tool for cancer hotspots.

Built a new education and training program; serves high school students to junior faculty and emphasizes diversity.

Created a Community Outreach and Engagement office; connects patient needs with physicians, scientists and addresses disparities.

Strategically recruited more than 20 top-flight physicians/scientists.

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Eric Snyder Builds Data Systems, Informatics Tools — and Relationships Data paint a true picture, and it can be startling: If the 27-county area from which the Wilmot Cancer Institute draws patients were its own state, for example, it would be bigger than Vermont and New Hampshire combined — and it would have the second highest cancer incidence in the United States, behind Kentucky.

Thanks to Eric Snyder, Wilmot’s data wizard, this type of information is now available with the click of a mouse, customized, easy to grasp, and made relevant for research and clinical planning.

Brea Lipe, M.D., a specialist in multiple myeloma, a rare blood cancer, is a big fan of Snyder’s. Lipe says that he helped her to quickly expand a growing myeloma program with accurate data to support hiring, a more nuanced electronic patient record, new algorithms to standardize supportive care, and better analysis of treatment disparities.

She is one of many fans — because in the past, a physician/ scientist such as Lipe would’ve had to wait in line for weeks or months at the University of Rochester to get such detailed and personalized informatics support.

“And, he’s just a really nice guy,” Lipe says. “So, when I ask for crazy things, he thinks for a moment and then says, ‘No problem. I can figure that out.’ And he has everything I need within days.”

JUST THE FACTS Managing data and putting it to good use is at the forefront of most industries, and health care is no exception. The “secret sauce,” Snyder says, is figuring out what physicians need to do their jobs better.

Because he is married to a physician, Snyder says he has a keen perspective for the tools needed by doctors who don’t have the time to master the basics of informatics or advanced technology.

Snyder also played a critical role in developing meaningful data for the researchers who wrote Wilmot’s 1,100-page grant application to the National Cancer Institute (NCI) for designation as a top center in the U.S. As part of the grant — submitted in September 2021 and currently under evaluation — Wilmot needed accurate and persuasive data on the patient population that it serves, their unmet needs, and the response to those needs with clinical and basic research.

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Shortly after he joined Wilmot in 2018, Snyder worked with researcher Charles Kamen, Ph.D., assistant director of Wilmot’s Community Outreach and Engagement Office, to holistically define what is known as Wilmot’s “catchment area.” It extends south to the Pennsylvania border, west to Batavia, east to Cooperstown, and north to Watertown. With an eye toward race and gender disparities in cancer care and outcomes, Snyder layered information from the New York State Department of Health and several national databases, and created a customized geospatial mapping tool called CANVAS. It merges and refines data specific to Wilmot and displays it, color coded, on maps. He and Kamen made some relevant factual discoveries: ■

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People living in the Wilmot region are older than state and national averages. This partly explains the high cancer incidence because cancer is a disease of the aging. It also validates and informs new research specific to cancer and aging.

Lung cancer is a huge problem, due to a higher percentage of smokers in the region compared to New York as a whole and the nation. Rural and Latino residents could benefit the most from smoking cessation programs and lung cancer screening, data show.

By integrating Cornell University’s pesticide database into Wilmot’s system, Snyder also assisted a team to launch a study of cancer rates among rural farm workers and pesticide exposures.

And, the Clinical Trials Office now has an up-to-the-minute data dashboard — broken down into categories — clarifying who is enrolled in clinical studies throughout the region. It allows oncologists to pinpoint opportunities.

THE ENVY OF OTHERS Wilmot Director Jonathan Friedberg, M.D., M.Sc., says he wanted Snyder “on the scene and not behind the scenes,” and to be able to work at the top of his game. Snyder was able to

assemble a dream team of industry-level, professional informatics developers, folks who came in with more education and experience than computer programmers. The team includes a software architect, data visualization specialist, population health analyst, and a Wilmot practicing oncologist, Erika Ramsdale, M.D., with dual training in data science.

“Plenty of institutions want to replicate us,” Snyder says, noting that Silicon Valley organizations have reached out. Interestingly, he tells them, it’s relationships that make Wilmot stand out. He talks about the connectedness in Rochester, how he’s looped into strategic decisions; and that he works smack dab in the middle of the cancer center.

“Someone in my position can’t be out in the middle of nowhere,” Snyder says. “You need to be having daily conversations with physicians, study coordinators, nurses, cancer center leadership.

No matter how great you are at developing technology, if you don’t see the day-to-day needs, you won’t succeed.”

During his 20-year career, Snyder has worked in health care, in cybersecurity, and as a consultant. In August 2021, he was invited to discuss the CANVAS tool and Wilmot’s achievements with an audience of thousands at the Healthcare Information and Management Systems Society (HIMSS) annual meeting, the largest gathering for that industry. He plans to publish a related manuscript.

He emphasized that the real deal involves looking beyond software and the next iteration of artificial intelligence — it’s about those daily hallway conversations that break down silos and acquaint IT pros with physicians, to elevate patient care and research.

“He sets a really high bar for the rest of the world,” says Lipe, the multiple myeloma specialist. “There is no way to overstate this.”

With a background in computer science and cybersecurity, Eric Snyder brings new skills to Wilmot. He is shown with his CANVAS geospatial mapping tool.

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ASCO summer interns seen here with Chunkit Fung, M.D., and Richard Dunne, M.D.

Summer Internship Program Helps Wilmot Blaze a More Diverse Path in Oncology The oncology field has a diversity problem. It’s no secret and there are no easy solutions. Less than one percent of medical oncologists are Black, Native American, or Hispanic, according to the American Society of Clinical Oncology (ASCO), and yet research has shown that a more diverse physician workforce improves patient care.

Wilmot Cancer Institute’s Cancer Research Training and Education Coordination (CRTEC) program wants to do its part to make things better in Rochester and nationally.

Last year, Carla Casulo, M.D., took a new step in that direction. An enthusiastic mentor who already supervises Wilmot’s fellowship program, Casulo learned of an opportunity, through an ASCO committee that she sits on, to encourage students who are underrepresented in medicine to consider the field of oncology.

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She applied to ASCO to host an inaugural summer internship program geared toward diversity — and that’s how the University Carla Casulo, M.D. of Rochester became one of five medical schools in the country to offer this unique experience to rising second-year medical students.

“The U.S. is a country of immigrants,” Casulo says. “Having that reflected by demonstrating that we’re taking this seriously, and that we’ve been recognized

by ASCO as a leader in the field to shepherd them, is really important.”

While the program began with a longterm desire to help diversify the field, in the short term, the students were the real winners. The five of them spent an

immersive four weeks listening to talks given by prominent oncologists from around the country, participating in social events with Wilmot physicians, and shadowing faculty in clinic appointments with patients.

It had a big impact on George Olverson.

“I didn’t know a lot of mentors or know a doctor or a lot about medicine. I knew what I saw on TV,” Olverson says.

“This was my first experience in a clinical setting seeing patients, having more patient interactions and seeing the clinical aspects.”

Olverson thought his medical career might veer toward research; the experience helped him realize how much he enjoys being able to help patients, too. Specifically, he felt a kinship with two Black patients he met. They seemed to appreciate having someone who looks like them in the room, and it made him want to help more patients.

“You meet people who make the decision to fight with treatment,” Duah says, “and others who choose to live life out the best way they can.”

“Now I need to do something impactful,” he said.

The internship has also placed oncology on Ashley Marie Cortes’ radar, providing an “eye-opening” experience, she says.

Not only did she enjoy witnessing the resilience of patients, but she also learned a lot about cancer.

But it wasn’t just the patients who inspired the student interns. Both Duah and Cortes commented on the kindness they saw in the Wilmot oncologists they met – perhaps because an oncologist has to offer a mix of hope and honesty, especially when dealing with someone facing advanced cancer.

“I didn’t understand completely how many different types of cancer there are, and the many biomarkers and ways to identify and treat the disease,” she says.

She felt nervous about meeting patients facing a devastating disease but seeing how patients and physicians interacted was insightful.

“I expected more tears,” Cortes says.

“One thing that really struck me is that the older people took it in stride. A lot of people were very calm and just wanted to know all of their options. They were very collected.”

In medical school, students learn about life-changing diseases, but seeing firsthand how cancer treatment decisions are made between doctor and patient was powerful for Bianca Duah.

Wilmot Internship has Deaf Students Dreaming of Possibilities Cortney McElroy didn’t think a career in nursing or medicine would be possible because she is deaf. But then she spent part of a summer in an internship program at Wilmot Cancer Institute.

“They are so down to earth,” Duah says. “The work they do shapes their perspective on life.”

“Now seeing the folks here, I can chase my dream,” says McElroy, who is most interested in nursing.

She adds that she was already considering oncology, “but I was worried that I didn’t have emotional strength.

Now I think it’s feasible to push ahead.”

Over the course of four weeks, she experienced medical oncology and integrative oncology at Wilmot’s Pluta Cancer Center, surgery at Strong Memorial Hospital and a basic science research lab, and was introduced to the Community Outreach and Engagement Office at Wilmot. McElroy was joined by five other high school students and recent graduates. In each specialized area, the interns participated in short lectures, fireside chats with prominent deaf medical professionals and researchers from around the country, and shadowing experiences that offered the students a look at many different opportunities.

While the official program ended in the summer, Casulo and others at Wilmot believe this is only a beginning. She encouraged the students to continue shadowing and meanwhile, Casulo and the education team hope to strengthen the program, serving more students in the future.

The program took place in partnership with the Rochester School for the Deaf – a connection that makes sense given that Rochester, N.Y., is home to one of the largest deaf communities in the world. The internship aligns with Wilmot’s strategic goals to teach and mentor the next generation of scientists, clinicians, and practitioners and to foster a love of science among early learners and throughout a person’s career.

“I need to do something impactful.”

– Medical student George Olverson

“At Wilmot, we are working to create more opportunities and pathways for students of diverse backgrounds to get introduced to oncology. This is one example of a program helping us do that,” says Ruth O’Regan, M.D., URMC chair of Medicine and associate director for Education and Career Development at Wilmot.

“We are so delighted to have had such an inspiring and engaged group for this first year,” O’Regan adds, “and we look forward to continuing and expanding this program in future years.”

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Taking Diversity Seriously: Q&A with Ruth O’Regan As Wilmot’s associate director for the Cancer Research Training and Education Coordination (CRTEC) program, Ruth O’Regan, M.D., realizes that building a more diverse workforce means reaching out to bright minds and persuading them to embrace the prevention, diagnosis, and treatment of cancer. Aspiring doctors face a lot of choices in their careers, and O’Regan is confident that Wilmot leaders will coax new faces aboard. Here are some of her thoughts:

What are your main challenges?

In regions where you have a predominantly white population, the faculty tend to be not very diverse. This is a problem everywhere, not just in the broader Rochester region. It’s also important to get as many training grants, such as T32 grants, as possible. When physicians are coming out of fellowship training, these grants allow them to have more protected research time and to fund their salaries early on. Those first few years are the most critical time for early-stage faculty, and likewise for PhDs. A big focus for getting these grants is: What is the diversity of the trainees who will benefit? The institution needs to show it’s making a strong effort in that area, to be taken seriously.

What is Wilmot doing to take things to the next level?

We actually have a couple of very strong programs to begin with, including our postdoctoral fellowship program. And then in the past year or so, Carla Casulo and the team at CRTEC obtained the ASCO summer internship grant (related story on pages 8–9), and I think the students who participated found it to be very rewarding. Continuing this fellowship is of critical importance and funding will be provided by Wilmot when ASCO no longer sponsors it. We’d love to keep these students as residents and ultimately as fellows. Additionally, our Deaf internship program for high school students offered time with cancer physicians and they also got to spend a week in a lab for a science perspective, doing things like extracting DNA. It’s been very inspiring to see this, and how the students responded.

Why are these students inspiring to you?

Oh, because they are just all very ambitious and engaged in the whole process. We talked with them about their backgrounds and they really have a lot of hurdles to climb. For that reason, it’s important to try to support them in their careers as best as we can.

Describe some future initiatives.

A lot of exciting things are happening. We’ve developed a new curriculum with a cancer biology focus for bringing new students into an academic cancer research career, and we’re putting resources into recruiting a diverse population. We are also reaching out to community oncologists and are planning educational sessions, including speakers from other area institutions such as Roswell Park. We’re also working with the state medical society, which helps to build relationships with other oncologists and spread the word about what we’re doing at Wilmot. I think we have a lot of strength in education and look forward to steering it into the future.

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Dan Mulkerin Tapped to Help Expand Wilmot’s Regional Footprint New Webster Facility is Next on the Horizon Dan Mulkerin, M.D., at the Webster construction site last year.

In February of 2021, Dan Mulkerin, M.D., boarded a plane headed for Rochester, N.Y. He was on his way to tour the University of Rochester Medical Center and the Wilmot Cancer Institute for a new job opportunity, thanks to an invitation from a colleague, Ruth O’Regan. She had just landed in Rochester herself, having joined the URMC as the Charles A. Dewey Professor and chair of the Department of Medicine and Wilmot Cancer Institute’s associate director for Mentoring and Career Development.

It was this “foot in the door” and longtime connection that intrigued Mulkerin — again. Thirty years ago, in the winter of 1991, as a then-medical student at Thomas Jefferson University in Philadelphia, Mulkerin was weighing his options for residency programs. URMC had a strong reputation and was near the top of Mulkerin’s list. But he ultimately chose the University of Wisconsin Hospital and Clinics, completing his education and serving patients there for more than 20 years, including at the Carbone Cancer Center, where he worked closely with O’Regan.

This time, he was ready to make the leap to Rochester.

“At Wilmot, the thing that got me excited again was the incredibly positive energy,” Mulkerin explains. “The director and executive team had a clear vision that Wilmot would become an NCIdesignated cancer center, that they were going to raise the level of science and research being done here, and raise the level of clinical care, not only in Rochester, but in the entire community that we serve in upstate New York.”

The energy carried through Mulkerin’s entire visit. He toured parts of Wilmot’s 27-county catchment area, including stops at regional locations in Greece, Canandaigua, and Dansville. He understood

WEBSTER

that not only had this cancer center set exciting goals, they had already accomplished so much.

For example, well before Mulkerin stepped off the plane, Wilmot had made a significant investment and effort to care for patients beyond Monroe County, west to Batavia, east to Canandaigua, and south to places like Wellsville, Olean, Hornell, and Elmira.

As Mulkerin saw the region, his decision to move to Rochester became a little easier. He accepted the positions of associate director, Regional Operations for Wilmot Cancer Institute and vice chair, Regional Operations for the Department of Medicine for the University of Rochester. Mulkerin started in his new post last September.

Not taking long to settle in to his role, Mulkerin will help Wilmot open its 14th location in Webster this spring. The site makes sense: In 2020, for instance, Wilmot drew more patients from Webster than from any other town in the area. The new Wilmot Webster Cancer Center will provide multidisciplinary cancer care for patients, including medical oncology, radiation oncology, surgical oncology and other services. The 21,000-square-foot facility, on Hard Road near Route 104, will offer 18 exam rooms as well as infusion and radiation therapy areas.

“Wilmot is extending the benefits of a university cancer center and program into communities where patients live,” he says.

“We aren’t just offering exceptional clinical care, but offering access to innovative care in the forms of research through clinical trials and by educating doctors and nurses who live and work in those communities.”

Mulkerin also has big plans for the future: He’s dedicating time and resources to recruit additional faculty members to grow the overall capacity to care for patients, to extend collaborative research throughout the region, and to enhance education opportunities.

More than half of Wilmot’s patients receive their care at regional locations. “We can’t put the Wilmot Cancer Center in every small community in our catchment area but we can create partnerships in these areas to make the care the best possible, and to offer patients innovation through clinical trials in the communities they live in,” he adds.

At the Carbone Cancer Center in the Midwest, he opened several regional locations and is poised to do the same for upstate New York.

Olean

“We have the opportunity and unique skills to take care of people at very difficult points in their life,” Mulkerin says. “And it’s up to us to use our skills to do just that. Shouldn’t everyone have access to that in some way?”

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N E WS B RI EFS Lung Cancer Screening, Targeted Therapy, Offer a “Fighting Chance” Jeff Clark, 42, who never smoked but developed lung cancer, has become an advocate for lung cancer awareness and erasing the stigma.

“The truth is, anyone with lungs can get lung cancer,” says the Webster, N.Y., resident. “Really everyone deserves a fighting chance.”

Jeff Clark with his wife, Kathy.

Lung cancer is one of the most prevalent diseases in the nation and the deadliest cancer in the Rochester region — and Wilmot Cancer Institute has a multipronged approach for attacking the problem: ■

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Screening via low-dose CT scan is recommended for adults ages 50 to 80 who have a 20 pack-year smoking history (which, for example, is two packs a day for 10 years or half a pack a day for 40 years) or who currently smoke or have quit within the past 15 years.

To improve rates of lung cancer screening, UR Medicine has expanded its program offering the low-dose scans that provide detailed pictures of the lungs. Services are available in Rochester, Dansville, and Hornell. For more information, call (877) 728-4543 or email ctlungscreening@urmc.rochester.edu.

A new broncoscopic robot at UR Medicine upgrades the quality of biopsies and helps to find cancer earlier, when it is often easier to treat.

For support to quit smoking, contact a tobacco treatment specialist at (585) 287-4539 or by email at quitcenter@urmc.rochester.edu.

To join a free, virtual support group for quitting, contact the Center for Community Health and Prevention: healthy_living@urmc. rochester.edu.

Lung cancer patients — including non-smokers such as Clark — also benefit from advanced treatment at Wilmot, which is fueled by research and includes a number of clinical trials. Depending upon the gene signature of their disease, for example, some people may receive therapy that precisely targets those genes to keep the cancer in check. Clark was diagnosed with stage 4 cancer in 2013, and is stable after receiving three different targeted treatments as well as stereotactic radiotherapy for cancer that had spread to other parts of his body.

“I haven’t let the cancer let me skip a beat,” Clark says.

“I’ve been really pleased with my care here at Wilmot,” adds the father of three sons. “I have a great relationship with my doctor. I’m just hopeful for continued research and development of drugs and solutions.”

University Award Honors “Passion for Diversity” Paula Cupertino, Ph.D., is credited with changing the culture at the Wilmot Cancer Institute toward a stronger focus on diversity and inclusion. Her efforts were recently lauded when she received the University of Rochester School of Medicine and Dentistry Faculty Diversity Award.

Cupertino joined Wilmot in March of 2020 as an Associate Director, and started a new Community Outreach and Engagement (COE) office. Despite the pandemic, she found ways to interact remotely with key people in the 27-county Rochester area, including with many individuals who are underserved and underrepresented in health care. She also recharged Wilmot’s Cancer Community Action Council, which helps to inform research priorities and aids in outreach.

Paula Cupertino, Ph.D., right, celebrates with Candace Lucas, a member of the COE team.

The Rochester region has higher cancer incidence rates than in New York state overall and nationally, and smoking is known to be a major risk factor for many cancers. Much of Cupertino’s work centers on tobacco cessation and innovative ways to deliver treatment, particularly in the Latino community. She brings a background in health disparities and social behavioral science, and is a professor of Public Health Sciences.

“Paula’s passion for diversity and inclusion has already made a huge difference at Wilmot in the short time she has been here, and we look forward to many good things to come,” says Wilmot Director Jonathan Friedberg, M.D., M.M.Sc. “We are fortunate to have her as part of the team.”

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Study Reinforces Major Strides in Geriatric Oncology Doctors can safely lower the dose of cancer treatment such as chemotherapy without impacting survival for adults older than 70 who are at high risk for toxic side effects, according to results from a potentially practice-changing new study, published in The Lancet. The research was led by Supriya Mohile, M.D., a Wilmot Cancer Institute scientist and national leader in geriatric oncology.

Oncologists are often fearful of straying from standard guidelines for cancer treatment. But the new study proves that more personalized care can be delivered safely to older adults, based on their medical histories and individual circumstances.

Supriya Mohile, M.D.

The randomized clinical trial involved 718 patients with a mean age of 72, who had advanced cancer and other agingrelated conditions. Results show that patients who received a geriatric assessment benefited from less serious side effects, fewer falls, and other favorable medication changes that protected their overall health.

The research adds to a growing collection of evidence on the value of geriatric assessments, which give oncologists a fuller picture of the patient. It measures physical and mental function, and the level of family support, for example. Geriatric assessments are not used frequently, however, despite being recommended by major oncology professional groups. Mohile’s team believes the powerful new study could boost usage. She is the Philip and Marilyn Wehrheim professor of Medicine, Hematology/Oncology and Surgery at the University of Rochester.

Research Roundup: More News from Wilmot’s Bench An innovative team is leveraging the emergency room — a health system’s “front door” — to find patients who are behind on cancer screenings. Researchers are conducting three similar projects to evaluate if a text-message reminder tool can motivate individuals to follow through with missed cancer David Adler, M.D. screenings. The focus is on colon, lung, and cervical cancer, and the team is directing its attention to underserved people who visit the Strong Memorial Hospital emergency room or other UR Medicine ERs in the region, using the wait time as an opportunity for education. David Adler, M.D., a Wilmot investigator and professor of Emergency Medicine, and Beau Abar, Ph.D., associate professor of Emergency Medicine, are leading the studies. They are funded by the National Cancer Institute and by seed grants from the University of Rochester Research Award and the URMFG Healthcare Innovation Award. The studies have their roots in a pilot study that was funded by the University of Rochester’s Clinical and Translational Science Award in 2018.

The “junk DNA” that litters the genome may be useful in developing future cancer treatments, according to Wilmot Cancer Institute investigators and University of Rochester biologists Vera Gorbunova, Ph.D., and Andrei Seluanov, Ph.D. Their work was published in Nature Immunology. The DNA elements under investigation are known as retrotransposons. The bad side of retrotransposons is that if left to run amok, they can give rise to tumors. But researchers found that if they are kept in the correct balance and leveraged properly, retrotransposons can trigger the immune system to destroy cancer.

Andrei Seluanov, Ph.D., and Vera Gorbunova, Ph.D.

Two new recruits expand knowledge of cancer biology and imaging sciences: Eric Wagner, Ph.D., whose research focuses on RNA processing, joins Wilmot from the University of Texas, where he also served as director of the graduate program in Biochemistry and Molecular Biology. He is returning to Rochester, where he earned an undergraduate degree in Molecular Genetics at the UR. The second new faculty member, Neb Duric, Ph.D, focuses on improving ultrasound tomography for breast imaging — his work contributed to the first FDA approval of this technology for breast cancer screening. Duric joins Wilmot from Michigan, where he served as co-leader of Molecular Imaging and Diagnostics at the Karmanos Cancer Center in Detroit, and as a professor at Wayne State University. He will continue to study breast cancer detection, risk, and the best ways to assess treatment.

Neb Duric, Ph.D.

Eric Wagner, Ph.D.

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A DVA NC EM E N T N E WS

Wilmot Advisory Board Welcomes Five New Members "Our new advisory board members represent a broad spectrum of experience and skills, and each is passionately committed to the mission of Wilmot.

On behalf of the entire board, we look forward to making our community better with their efforts."

–Richard Yates, board chair

Garth Hankinson, executive vice president and CFO of Constellation Brands, and his wife, Gwyn, have supported Wilmot for many years, helping fund advances in breast cancer research. Hankinson brings sales knowledge and business intelligence to the board.

John McKenna ’88, ’92S (MBA), P’20, president and CEO of Tompkins Bank of Castile, has been in the banking industry for more than 30 years. A multiple myeloma survivor, he has experienced Wilmot’s innovative care firsthand. He and his wife, Martha, formed one of the top fundraising teams for the 2021 Warrior Walk.

Victor Salerno, CEO of O’Connell Electric Company, recently completed terms as chair of the Center for Governmental Research and chair of St. John Fisher College’s Board of Trustees. Salerno’s community involvement will bolster support for advanced cancer research at Wilmot.

Jerome Underwood, president and CEO of Action for a Better Community, is originally from the Caribbean island of Antigua and has called Rochester home for more than 30 years. He is interested in supporting Wilmot’s efforts to address existing health disparities and helping to improve cancer outcomes for Black and Brown residents in the Rochester region.

Angela Uttaro is retired from a career in finance at Oppenheimer Funds. A pancreatic cancer survivor, she joins the board to advocate for the critical need for cancer research funding. Her Warrior Walk team, Mary’s Angels, has raised significant funds for pancreatic cancer research.

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“They Started an Avalanche” for Pancreatic Cancer Support Twelve years ago, three women were separately in search of the same thing: camaraderie as their families were shaken by pancreatic cancer. Two were grieving the loss of loved ones and the other was supporting someone in the throes of a tough battle.

They had joined a popular nationwide online discussion forum, and to their surprise, they discovered they lived just a few miles apart in the Rochester suburbs.

They started meeting for coffee, eventually forging a grassroots regional organization for those who are passionate about turning pain into action. The Pancreatic Cancer Association of Western New York (PCAWNY) was born in 2009. Today, it remains an eclectic collection of volunteers with diverse skills and common goals: engineers, teachers, nurses and medical personnel, marketers, business managers and administrators, and retirees, aiming for better diagnosis and treatment of this devastating cancer by funding research and providing advocacy, awareness, and education.

As their network expanded, the three PCAWNY founders — Mary Pettinaro, Lynn Platt, and Judy Rockafellow — began building a relationship with the Wilmot Cancer Institute.

Early on, they worked with Aram Hezel, M.D., the chief of Hematology/Oncology at Wilmot and an expert in pancreatic cancer and other gastrointestinal malignancies, as well as Hucky Land, Ph.D., deputy director of Wilmot and a research leader.

Land says the group influenced Wilmot to engage more actively with the community and to raise the bar to combat pancreatic cancer.

“They pushed us and incentivized us to strengthen our research activity,” Land says. “As a result, we have recruited additional scientists and it created a snowball effect of attracting even more researchers with a shared interest in collaborating on pancreatic

cancer. In a way, they started an avalanche.”

PCAWNY Executive Director Mary Ellen Smith describes Wilmot’s doctors and researchers as “strong and forward-thinking.”

“It’s just a beautiful relationship based on shared goals.”

“They give us credibility and they are part of our drive and passion,” she says. “At the same time, we’ve become a driving factor for them. It’s just a beautiful relationship built on shared goals.”

When PCAWNY was established, the five-year survival rate for pancreatic cancer was five percent, Smith recalls. Since then, the survival rate has risen to about 10 percent, although it depends on the stage of cancer at diagnosis and other factors.

“We appreciate everything the doctors do, and the more we learn about research it allows us to feel hopeful,” Smith says. “A lot of people think doctors are unapproachable but we don’t see that.

They step up any time we’ve asked for updates on their work so that we can inform our supporters, or for any request we make of them, such as speaking engagements. They want to get rid of this disease as much as the rest of us. We have a shared passion that drives us both.”

PHILANTHROPIC IMPACT PCAWNY has donated $770,000 to Wilmot so far — including its $500,000, five-year pledge made in 2015 toward establishing a Pancreatic Cancer Center of Excellence at Wilmot. The group’s fundraising events include an annual “Step It Up! Cure Pancreatic Cancer 5K Walk” in the fall and a summer golf tournament in memory of Michael F. Contestabile.

Donations are often used toward pilot studies at Wilmot, with the goal of producing preliminary data to secure larger scientific grants. One of PCAWNY’s earliest gifts, for example, led to a $2 million basic science award for investigating how to stop or slow pancreas tumor growth. More recently, PCAWNY pilot funds have supported work toward NCI grants for new immunotherapy clinical trials for some pancreatic cancer patients.

Founders of the Pancreatic Cancer Association of Western New York: Lynn Platt, Judy Rockafellow, Mary Pettinaro.

PCAWNY funds have been used to recruit top new talent, such as Stephano Mello, Ph.D., who is investigating pancreatic cancer biomarkers, and Darren Carpizo, M.D., Ph.D., who joined Wilmot in 2020 and was named chief of Surgical Oncology at the University of Rochester Medical Center, where he also runs a translational science lab and co-leads Wilmot’s Genetics, Epigenetics and Metabolism research program.

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Warrior Walk Plans for 10th Anniversary To date, has raised $1M for Cancer Research The 2021 Wilmot Warrior Walk was a great success — 824 participants raised a record $205,000 for cancer research and the Judy DiMarzo Cancer Survivorship Program at the Wilmot Cancer Institute. Over the past nine years, participants have collectively raised more than $1,000,000 during the annual community event.

Thanks to the support of hundreds of community sponsors, research is producing new treatments and new ways to deliver care that improve the quality of life during and after cancer for many people who face the disease.

Please save the date for the 10th anniversary Wilmot Warrior Walk on Saturday, September 11, 2022. Exciting plans are underway to celebrate this important milestone.

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Call it a gift.

We call it the momentum behind monumental discoveries.

After his close friend died of breast cancer at age 34,

“

W E H AV E T O H U S T L E .

Wilmot researcher Isaac Harris made the disease his mission. He is now on the forefront of boundary-defying research thanks, in part, to gifts made to our Discovery Fund—a Wilmot Cancer Institute fund that helps fuel even bigger breakthroughs in cancer research.

WE NEED TO BE ASKING VERY BIG QUESTIONS AND

M A KE A G I F T TO T H E D I S C OV E RY F U N D

MAKING BIG DISCOVERIES.”

uofr.us/discoveryfund

A N D H E LP U S C O N Q U E R CA N C E R .

ISA AC HA RRIS

For questions about supporting research, contact

Assistant professor of Biomedical Genetics

Clare Flanagan at 585-276-4713.

WILMOT CANCER INSTITUTE

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Wilmot Cancer Institute 601 Elmwood Avenue, Box 704 Rochester, NY 14642

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