The State of Yale Cancer Center and Smilow Cancer Hospital

Transcript

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