Cancer research flourished with fast-paced breakthroughs in the last 15 to 20 years, and it should continue to now, the most recent director of the National Cancer Institute (NCI) told a packed audience Tuesday at a special Yale Cancer Center Grand Rounds.

“I feel that we are very much at a crossroads” in cancer research, treatment, care, and further advances, said W. Kimryn Rathmell, MD, PhD, the 17th director of the NCI. “There are tremendous possibilities.”

Dr. Rathmell weaved mentions of Paul Calabresi, MD, through her hour-long talk as the presenter of the annual Paul Calabresi MD Memorial Lectureship. Early on, she cited an assessment of the national cancer program by Dr. Calabresi in 1995 that had been unearthed early in her tenure at NCI. Its recommendations were “fantastic” even 30 years forward, she said.

Dr. Calabresi was an internationally recognized expert on the clinical pharmacology of anticancer agents, a Yale associate professor of medicine and pharmacology, and served in many NCI positions. He was remembered as a mentor by several in the audience and, as a mentor and a friend, by the host of Tuesday’s grand rounds, Roy S. Herbst, MD, PhD, Chief of Medical Oncology and Hematology and Deputy Director, YCC. Dr. Herbst was randomly assigned Dr. Calabresi’s son, Peter, as a roommate at Yale College 45 years ago.

The cancer research landscape has changed dramatically since those years.

The fast-paced and tumultuous nature of cancer research today requires everyone, from trainees to scientists with decades of experience, to be nimble, creative, and rigorous in their science and choices, Dr. Rathmell told hundreds in the Smilow Cancer Hospital auditorium and online.

In a nod to the grand rounds nature of the talk, Dr. Rathmell shared slides on an in-progress paper on kidney cancer metabolism and metastasis that included how cells make “choices” that help them migrate and flourish away from the original tumor. That led to the identification of a protein that the team found they could manipulate, as a type of “switch,” to help or hinder metastasis.

Such findings are important because, she said, an increasing number of drugs are entering the market that could control that ability of cancer cells to “set up shop” in a new location. As cancer treatments have progressed, leading to a “30% decline in cancer mortality in the last 30 years,” as Dr. Rathmell said. As a consequence more patients are dying of secondary causes, including cancers with metastasis.

In many ways, “we are living in a phased shift in how we are thinking about and doing our science,” Dr. Rathmell said, segueing her talk to consider where science goes from its present position. If the present could be thought of as a heart event of ventricular tachycardia, she said, it might be best to remain calm through the erratic and irregular rhythms by relying on the metaphorical scientific pacemaker to return research to a regular pace.

“So, how do we do this? How do we pace ourselves,” and still go faster than before, Dr. Rathmell asked. Then she offered answers.

“We need to tell our stories. We have really great stories. People forget that things have changed dramatically in the last 15 to 20 years,” in cancer treatment and care, she said, and emphasized the importance of engaging new communities, patients, advocates, foundations, biotech, and more.

As a self-described introvert, Dr. Rathmell said even she’s becoming comfortable talking to people on planes or at the grocery store. “Everyone is interested in cancer. Everyone is fascinated by what we do. We have an obligation to share that. It’s really super important.”

Of equal importance, she said, is the need to both support and lean on scientific trainees and early career investigators as partners. Speaking to the younger people in the audience, she predicted that they would weather the rapid changes better than their mentors, be more able to flex into new modes of working and new partnerships, while understanding how to harness social media to the needs of science.

“And doubling down on creativity and innovation,” she said, means asking bold new questions and finding partnerships in business, or law, and beyond.

In closing, Dr. Rathmell brought the conversation back to Dr. Calabresi’s 1995 assessment of the national cancer program. She said he created a roadmap for the future that is both “inspiring and heart-breaking” to read today because of what has been accomplished and what still needs to be done.

She asked if the cancer research community talked more to others than to its colleagues and sought new collaborations “What would the future look like in our new stable rhythm…one in which the community is our partner, not our client.”

The Paul Calabresi, MD, Memorial Lectureship began in 2006 to honor Yale’s first chief of medical oncology who is often regarded as ‘a statesman of oncology.’ In addition to the memorial lecture, a dinner was held in honor of Dr. Rathmell earlier this week and Medical Oncology-Hematology fellows, Surgical Oncology Residents, Radiation Oncology Residents, and Pathology Fellows met with her following her talk over lunch.