WCI Dialogue, Vol. 1, 2023

Breakthrough Research, Life-Saving Treatments, and a Team Approach to Breast Cancer

Letter from the Director

Hello Friends of the Wilmot Cancer Institute,

It’s hard to believe that we’re halfway through a new and busy year at Wilmot. Remarkably, it has been 15 years since we celebrated the opening of our primary building, the flagship Wilmot Cancer Center on the University of Rochester Medical Center campus. The new building brought a state-of-the-art, light-filled and healing environment to our patients, and for the first time convened researchers and clinicians in the same space to work together on projects to benefit those patients.

I recall wearing a hard hat during construction as I stood in what is now my office. At the time, I couldn’t have imagined all that has happened since those days in 2008. Our building is now full, the result of significant recruitment in both research and clinical disciplines. By 2012, clinical growth resulted in the need for an expansion, and we added three floors for an inpatient cancer hospital atop the initial four-story structure. More recently, we expanded our outpatient clinic space into an adjoining ambulatory care center. We also embarked on partnerships with other cancer providers and opened a dozen regional Wilmot sites throughout upstate New York, to bring care closer to home for thousands of our patients. These regional sites have more than doubled our infusion capacity, as well as the number of linear accelerators for radiation therapy.

Jonathan W. Friedberg,

M.D., M.M.Sc. Director, Wilmot Cancer Institute

Wilmot is now the largest cancer provider in the state outside of New York City. In research, we boosted and revamped our clinical trials operation to provide more opportunities to receive cutting-edge treatments. We recruited dozens of top-level researchers and physicians, established a Community Outreach and Engagement (COE) office and a new diversity program, and reorganized and reinvested in the entire cancer enterprise to meet National Cancer Institute expectations. We remain on a path to apply for NCI designation as a top center in the U.S.

On these pages, you’ll read about how we continue to grow. Specifically, our breast cancer services are thriving under new leadership at our Pluta location, and graduate students in cancer research — the next generation that will fill our building — are giving us new perspectives and fresh energy in Wilmot scientific labs.

Wilmot has a lot to celebrate. I’m exceedingly grateful to our community for many years of support and encouragement as we learn, evolve, and serve those who face cancer.

Advisory Board Members, '22-'23

Richard Yates, Chair

Scott Burdett

Patrick Cunningham

Garth Hankinson

Kathleen Landers

John McKenna

Ralph Olney

Walter Parkes

Mary Pluta

Ronald Pluta

Barbara Pluta-Randall

Victor Salerno

Erika Stanat

Dr. Eduardo Torrado

Jerome Underwood

Angela Uttaro

Kristin Vanden Brul

Paul Wilmot

Keith Yeates

John Zicari

Emeritus Members

Judy Linehan

Jim Ryan, Jr.

Ex-Officio Members

Kellie Anderson

Clare Flanagan

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

Hucky Land, Ph.D.

David Linehan, M.D.

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

Honorary Board Members

Dr. George Abraham

Elaine Bucci

Michael Buckley

Rina Chessin

Elaine Del Monte

Richard DiMarzo

Malik Evans

Joan Feinbloom

Janet Felosky

James Hammer

Paul Hanrahan

Gary Haseley

Mark Kokanovich

Michael Linehan

Ronald Maggio

Steve McCluski

Jett Mehta

Carol Mullin

Michael Norris

Jeffrey Pierce

Cheryl Pohlman

Larry Rabinowitz

Donald Rhoda

Gregory Smith

Philip Wehrheim

Steve Whitman

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

Kellie Fraver, Susanne Pallo, Kristine Thompson

Feature Photogaphy

Erich Camping, Jeff Witherow, Mary Cooke

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

On the Cover Anna Weiss, M.D., (green), Jennifer Harvey, M.D. (blue) and Ruth O'Regan, M.D., are leaders in breast cancer care. (Photo: Mary Cooke)

Front row, L to R: Christina Kaszuba, Emily Whitt; Back row, L to R: Emily Quarato, Zach Secrist, and Bachelard Dieujuste

Photo: Jeff Witherow

Guided by Research, Wilmot’s Breast Cancer Program Comes of Age

When military scuba divers are in training, they learn to hold their breath deep in the lungs for long periods. It’s crucial to their survival. Kim Gergelis, M.D., is working on a way to bring the same military-based training concept to breast cancer patients being treated with radiation at Wilmot Cancer Institute. Research shows that “deep breath holds” for 20 seconds moves the heart away from the breast temporarily, reducing the chances that highenergy X-rays aimed at breast tissue will inadvertently damage the heart.

Gergelis, who recently joined Wilmot from the “other” Rochester — the esteemed Mayo Clinic in Rochester, Minn. — has many fresh ideas like this one.

And, she arrived in upstate New York at a perfect time to make an impact. Wilmot’s growing and flourishing Comprehensive Breast Care program has an impressive list of new initiatives. These include groundbreaking clinical trials unique to this region; advanced technology not found anywhere else in the state to diagnose breast cancer; a popular new risk-reduction clinic that serves women with any type of breast concern; a retooled

survivorship program for individuals who want to continue to be seen by breast cancer specialists long after they enter remission; new directions in laboratory research, and a mobile unit — “the mammo van” — that launches later this year to bring mammography screening to patients in urban and rural areas with less access to quality care.

Kim Gergelis, M.D.

“I interviewed all over when I was looking to take the next step in my career,” says Gergelis, assistant professor of Radiation Oncology. “I felt like the University of Rochester and Wilmot were trying to make things better. There are a lot of places that are okay with the status quo. Here, the leadership wants to see changes, learn things from the outside, and make improvements. That’s really exciting to me.”

A dedicated team is working in harmony to bring patients the latest precision therapies, advanced technology, and new programs for wellness

“Collaborative Spirits” Drive Change

Breast cancer remains the number-one cancer in women nationally and locally, and since 2019, there’s been an uptick in breast cancer patients seen at various Wilmot sites, including its hub location, the Pluta Cancer Center in suburban Henrietta. Improvements in diagnosis and treatment of breast cancer are occurring rapidly in the field, but there are gaps in knowledge and in who gets quality care.

Wilmot leaders are building research into every facet of its breast cancer program, with the goal of becoming the premier center in New York state.

“Our mantra is, ‘enhancing clinical care, supporting and fostering research, and growing our team of highly academic oncologists,’” says Anna Weiss, M.D., the newly recruited director of Wilmot’s breast cancer service line, a surgeon who joined the UR in 2022 from Harvard University.

Research is the foundation for all new treatments, and Weiss’ other major objective, still unfolding, is enhancing connections between clinicians and lab scientists working on breast cancer across the Medical Center to build larger, cross-institutional research projects. Her kindred souls include Jennifer Harvey, M.D., chair of Imaging Sciences and an international expert in breast density, which leads to a higher risk of cancer, and Ruth O’Regan, M.D., chair of Medicine and a national thought leader in novel breast cancer

Breast Health Clinic

treatments, focusing on what’s known as triple-negative disease, the most aggressive type of breast cancer.

They are working in unison.

“The beauty of Ruth, Jennifer and I, is our collaborative spirits,” Weiss says. “We’re excited about moving things forward. We have a lot of enthusiasm and energy, which is going to lead to more innovation.”

This new program is already popular, logging more than 100 appointments in the first two months. The clinic is designed for any person who has any concern about breast health — but does not have breast cancer.

Complaints may include pain, infection, or an abnormal imaging scan. For those with an elevated risk due to a family history of breast cancer, newly discovered lumps, dense breasts, or exposure to chest radiation, the Breast Health Program can also provide genetic testing via Wilmot’s Hereditary Cancer Screening and Risk Reduction.

The focus is to assess cancer risk and then make a plan to reduce that risk. This may include personalized imaging plans, lifestyle changes (smoking cessation, weight loss, exercise, nutrition) and medications to reduce breast cancer risk.

The clinic formalizes services that were already provided at Wilmot, with dedicated resources and a more convenient, centralized approach. Crystal Regis, N.P., manages daily operations; additional program support comes from breast surgeon Jessica Gooch, M.D. For more information, please call (585) 486-0557. No referral is necessary.

New Technology Improves Breast

Cancer Diagnosis

To the surprise of many people, about 85% of breast cancers occur in patients with no family history. The biggest risk factors are simply being female and aging. But when detected early, most types of breast cancer are highly treatable and many are curable. That’s why talking to a physician about personal risk and undergoing consistent screening are so important.

Mammography is the gold standard screening test, but it’s not perfect. It’s physically uncomfortable — which causes some women to avoid it — and for individuals who have dense breast tissue, the density makes it more difficult to see tumors. Dense breast tissue is white on a mammogram, making it harder to see cancers, which are also white. Radiologists describe this as “looking for a snowball in a snow storm.” More than 40 percent of women of screening age have dense breasts, particularly in their younger years.

However, Wilmot is one of the first locations in the United States and the first in New York to offer an advanced ultrasound device designed to improve tumor detection in dense breasts. The device boosted detection by 20 percent, compared to mammography alone, in nationwide clinical trials conducted for the U.S. Food and Drug Administration. The imaging technique also is more comfortable for the patient: No touch or squeezing required. A person lies face-down on a table with an opening for the breast, which is immersed in a warm water bath as it’s being scanned.

Called SoftVue 3D Whole Breast Ultrasound Tomography, it was co-invented by a Wilmot faculty member, Neb Duric, Ph.D., professor and vice chair of research for Imaging Sciences. (The technology is available for eligible individuals at the UR Medicine Breast Imaging Center, 500 Red Creek Drive.)

In a prior career as an astronomer and astrophysicist, Duric’s niche was image-processing of stars and galaxies — a field that is surprisingly useful and similar to improving image quality for human health.

“Breast imaging radiologists are very aware of the limitations

‘Survive and Thrive’ Clinic

of mammography in women with dense breasts,” says Avice O’Connell, M.D., director of women’s imaging at UR Medicine, who will work with Duric to further develop of the SoftVue system.

“3D imaging is the wave of the future, and SoftVue ensures consistent and reliable images while offering a more comfortable patient experience. It is unmatched by any other imaging modality currently in the marketplace.”

For many reasons, though, it is not feasible for every woman with dense breasts to receive an ultrasound following a screening mammogram. Harvey, the chair of Imaging Sciences, is therefore studying new ways to discern who is most likely to develop a lump between mammograms, or to have a tumor hiding in that blurry “snow storm.”

“That’s been my lifelong passion,” Harvey says. “How do we do better in this regard?”

This new initiative was designed to seamlessly transition patients from their primary treatment team to a dedicated breast cancer survivorship team. Nurse practitioners and physician assistants will provide wellness assessments, sexual health, and frequent communication about health changes or concerns.

Patients will begin to see survivorship providers six-to-12 months after diagnosis, while also seeing their oncology treatment team if necessary. During years three to five after diagnosis, a patient will see a survivorship provider and, depending upon the type of breast cancer, may also continue to visit a medical oncologist. At five years of survivorship and beyond, patients will be supported by the survivorship team, and will be able to receive full physical examinations and assistance with obtaining breast imaging. To make an appointment, please call (585) 487-1700.

Neb Duric, Ph.D., with the advanced 3D imaging system that he co-invented

Jennifer Harvey, M.D.

Breast

Cancer Treatment Trends: Personalized and Precise

A decade ago, it was fairly common to treat most breast cancer patients with chemotherapy. Since then, research that focuses on overtreatment and molecular profiling of tumors has shown that many patients do not need chemo. The reasons are as complex as each individual — ushering in an era of truly personalized care.

“The less-is-more trend is most successful in low-risk estrogenfueled cancers,” says O’Regan, who also serves as physician-inchief at Strong Memorial Hospital at the University of Rochester Medical Center.

“Overall, research has prevented thousands upon thousands of patients with breast cancer from having to undergo chemo, and that’s a huge step forward,” O’Regan says. “The question now is: Are there more patients who don’t need chemotherapy at all, or who just need less chemotherapy?”

Thanks to O’Regan, Wilmot is one of only two places in the nation to enroll patients in a clinical study of a two-drug combination that sets up a direct hit on triple-negative cancer cells. Wilmot is also part of a larger national network of clinical trials, evaluating the effectiveness of the newest drugs for triple negative breast cancer. Those studies, led by Carla Falkson, M.D., involve collecting tissue samples from patients so that investigators can conduct correlative laboratory studies to understand why the drugs work or don’t work on TNBC.

The vast majority of breast cancer cases in the U.S. are hormonally driven cancers. They are the most treatable forms, particularly if found in early stages before the cancer has spread to the lymph nodes.

Less common subtypes — which is the focus of a lot of research at Wilmot and elsewhere — are known as HER2-positive breast cancer, and triple negative breast cancer (TNBC). The latter, which O’Regan primarily investigates, accounts for less than 15 percent of all breast cancer cases but is aggressive and has a lower survival rate. TNBC also comes with fewer treatment options because these tumors lack hormone receptors and do not make much of the HER2 protein.

Wilmot offers the latest treatments, including immune therapies for breast cancers that may have started to metastasize; targeted drugs known as PARP inhibitors for patients with the inherited BRCA gene mutation, a gene that greatly increases the risk of developing aggressive disease; and studies to discover if some patients with the HER2 gene signature can safely use a lesstoxic precision drug.

“We’re very on top of things in terms of new therapies,” O’Regan says. “The idea is to move away from the standard chemotherapy and give patients only the treatment that they need — to find agents that are more effective but with less toxicity, especially for patients with metastatic disease because they will be on treatment indefinitely.”

The same treatment trends are occurring in radiation therapy. For women who opt for breast-sparing surgery (lumpectomy), the standard care had been to follow up with six weeks of radiation treatment, five days a week. Later, research began to show that physicians could safely give slightly more radiation each day, and reduce the duration to three or four weeks. Today, some cases qualify for just a single week of radiation.

“Patients are shocked when they learn this,” says Gergelis. “It’s a pretty neat thing, to see where we’re evolving.” The treatments are biologically equivalent in terms of killing the cancer cells, but more convenient. Daily radiation is a burden, even though the treatment itself only takes a few minutes. It hampers work schedules, delays travel, and creates concern about injury to skin and nearby organs.

The evolution toward condensed radiation therapy, including partial versus whole breast irradiation, is often based on tumor type, age, lifestyle, and treatment goals. Wilmot has new clinical studies in this area.

Research allows physicians to be nimble, to design precision therapy.

“The whole point is to ‘right-size’ treatment for each person based on their circumstances,” Gergelis says. “To give all the treatment that’s needed and escalate it in the most aggressive cases, while customizing cancer treatment for those who have less aggressive disease.”

Ruth O'Regan, M.D.

Breast Cancer Research at

Wilmot

The median age for a breast cancer diagnosis is 62, according to the American Cancer Society. Wilmot is a national leader for treating older adults with cancer — no matter what type — and has a large portfolio of studies geared toward enhancing elder patient care by understanding the whole person and how cancer can impact functionality, memory, and family support.

Most recently, geriatric oncologist Allison Magnuson, D.O., a breast cancer specialist, started a novel project for older patients with preexisting dementia. She was recently funded by a $2.5 million National Institute on Aging grant, to evaluate ways to improve communication between physicians and people with cognitive problems as they face breast cancer.

At the other end of the spectrum, several Wilmot scientists are investigating how breast cancer develops and spreads. Paula Vertino, Ph.D., the Wilmot Distinguished Professor in Cancer Genomics, is looking at breast cells with invasive potential and the underlying signals during the earliest steps in their migration

toward metastasis. The goal is to reprogram cells to correct this aberrant behavior.

Another innovative project plunges into the root of cancer cells and how they behave — specifically, how breast cancer cells make their own antioxidants, which is their “food,” and then use the antioxidants to survive.

Isaac Harris, Ph.D., assistant professor of Biomedical Genetics and another recent Harvard University recruit, leads this research with advanced technologies and a thinkingoutside-the-norm strategic approach.

His scientific question: Is there something special about how cancer cells are feeding themselves? Is it different than normal tissue? He’s finding that antioxidants can be broken down into individual or groups of metabolites, essentially acting as storage facilities for tumor food.

Laboratory studies show that, generally, cancer cells need these metabolites to survive. Harris is trying to understand the process by which they obtain the metabolites. His developing views on how this occurs are different from other researchers. If his hypothesis is correct, the goal is to use currently available drugs to block the feeding of cancer cells.

“Our novel ideas,” he adds, “have been well-received in the scientific community.” In 2022, the National Cancer Institute funded Harris’ research with $1.9 million.

Tips to Reduce a Breast Cancer Recurrence

Five activities top the list of things to do to lower the risk of breast cancer returning, according to Wilmot breast oncologists:

1 Regular exercise

2 Keep a normal body weight, lifelong

3 Minimize alcohol consumption

4 Avoid tobacco products

5 Commit to a healthy diet for life

Exercise is a very powerful tool, when done regularly and faithfully. It’s never too late to start. If vigorous activities such as running or swimming are not possible, brisk walking, yoga, or tai chi also help.

As for diet, research shows that a plant-based or Mediterranean eating pattern, with little or no red meat and plenty of vegetables and extra virgin olive oil, is associated with a 62% relative lower risk of breast cancer compared to a standard diet. Focus on food in its natural form, such as choosing an apple instead of apple juice.

Stress is another important component to remaining healthy and cancerfree. Studies linking stress to cancer occurrence have mixed results, as stress is difficult to measure. What is stressful for one person, may not be stressful for the next. But oncologists suggest it’s important to find ways to relax and to make healthy living a priority.

Allison Magnuson, D.O.

Paula Vertino, Ph.D.

Isaac Harris, Ph.D.

Cooling Caps Reduce Hair Loss from Chemotherapy

In October 2022, Wilmot began offering the Paxman scalp-cooling treatment at the Pluta location for patients receiving certain types of chemotherapy for breast cancer.

Hair loss is one of the most troublesome side effects of chemotherapy, and cooling caps have been shown to minimize loss and enable faster, thicker hair growth after treatment. The Paxman cap was approved in 2017 by the U.S. Food and Drug Administration. It is most effective for patients receiving taxane-based chemotherapy. The cooling caps come with some side effects and are contraindicated in certain circumstances; anyone interested should speak to an oncologist about risks versus benefits.

Here’s how it works: Patients wear a tight cap (similar to a swimming cap) while a portable device pumps coolant into the cap to bring the scalp temperature down to 68-72 degrees while constricting the blood vessels. This occurs before a chemotherapy infusion begins. The cap remains in place during chemotherapy and stays connected for 60 to 90 minutes afterwards.

More than 20 Wilmot patients have used the cooling caps. Costs start at $350 a cycle, with a maximum out-of-pocket cost of $2,400 per patient in a lifetime. Some insurance plans will offer reimbursement, and the Pluta Cancer Center Foundation provides financial assistance to patients who qualify.

Coming Soon: Easier Access to Mammograms

UR Medicine Imaging will take mammograms on the road later this year when it launches a mobile coach vehicle to visit locations throughout the Rochester region. The focus will be on urban and rural areas to offer greater convenience to women whose access to health care is limited.

Scheduling mammograms at traditional imaging locations also is getting easier. MyChart now offers individuals the ability to choose a date and time that works best via the MyChart app or by visiting mychart.urmc.rochester.edu

“It’s a privilege to be working in an era with so many positive discoveries. The people who are dedicated to breast cancer at Wilmot are great, they have built a really nice culture, and we are excited about the future.”

– Anna Weiss, M.D.

MEET THE NEXT GENERATION OF CANCER RESEARCHERS

Education is a hallmark of an academic cancer center, and Wilmot Cancer Institute is building a pipeline of research trainees with fresh energy and a special interest in cancer. A new Cancer Biology curriculum is fueling the pipeline as it kindles its way across the University of Rochester School of Medicine and Dentistry, gaining momentum with each new crop of students.

The “team science” setting among cancer investigators is exciting to Zachary Sechrist, a second-year graduate student in the Pathology-Cell Biology program. “Being in this environment, where we’re all working on a big problem — it’s cool,” he says. “The work we’re doing — no one’s role is small.”

Christina Kaszuba, a second-year student in the Biomedical Engineering graduate program, appreciates the various perspectives, such as a lecture that covered complementary approaches to cancer care with diet, exercise, and social well-being.

Bachelard Dieujuste

Hailing from Haiti, Bachelard Dieujuste always knew he wanted to study cancer, due to misconceptions about the disease back home.

“In Haiti, we don’t have any idea about cancer,” he says. “We think it’s a disease for rich people and that we are safe.”

He wanted to learn more, and then, he was touched by cancer personally when he lost his grandmother to ovarian cancer in 2017.

The next year, he started studying at Hunter College and by 2021 he had received bachelor’s and master’s degrees in Biotechnology. As a second-year graduate student in the Vertino lab, he is focusing on the phenomenon by which chemical modifications turn genes on or off to promote breast cancer. For his thesis, he is choosing between two complex scientific questions involving cancer-causing genes.

Dieujuste hopes to bring his knowledge back home one day — to spread awareness of cancer screening and prevention. “Ignorance is another type of disease that kills millions of people in developing countries who can't afford to think about things like cancer,” he says.

“When I tell people what I do — whether it’s family or friends — they’re excited because they know I’m excited,” Kaszuba says. The special course concentration is the handiwork of Paula Vertino, Ph.D., the Wilmot Distinguished Professor in Cancer Genomics and senior associate dean for Basic Research at the UR Medical Center. Now overseen by Brian J. Altman, Ph.D., assistant professor of Biomedical Genetics and a member of Wilmot, the program is designed to train tomorrow’s leaders in cancer research.

“The concentration gives you a good link between bench and bedside,” says Bachelard Dieujuste, a second-year student in the Biomedical Genetics and Genomics graduate program. “It also gives you an overview of what’s out there. You have a web of opportunity.”

Following are a few stories about the trainees.

Christina Kaszuba

Christina Kaszuba has been interested in science for as long as she can remember. When she started college, she was keen to explore many different fields. It wasn’t until she did an internship at MERCK that she fell in love with cancer research.

“When my boss at the time introduced my project to me and gave me an overview of the disease and how many people are affected, that was my ah-ha moment,” Kaszuba says. In 2021, Kaszuba joined the Biomedical Engineering graduate program at the University of Rochester. She now works between the labs of Jeevisha Bajaj, Ph.D., a Wilmot member and assistant professor of Biomedical Genetics, and Hani Awad, Ph.D., professor of Orthopaedics and Biomedical Engineering. She studies leukemia’s microenvironment — the cells and molecules that support cancer development — in bone.

As an engineer, Kaszuba hopes to discover which cell types or components of the bone contribute to cancer development, which would add to existing knowledge and may uncover new drug targets.

Ultimately, she says her dream is to develop new cancer drugs.

Emily Quarato

When fifth-year toxicology graduate student Emily Quarato started graduate school, she was pretty set against studying cancer. “I have been very lucky and don't have much personal loss due to cancer,” she says, “so I felt that I would be more passionate about other sectors of research.”

But that changed when she rotated through the lab of her now-graduate mentor, Laura M. Calvi, M.D., the SKAWA Foundation Professor of Endocrinology and Metabolism and co-leader of Wilmot’s Cancer Microenvironment research program.

In the Calvi lab, where Quarato studies bone marrow cells, she learned about their connections to cancer. “I slowly saw how intertwined all mechanisms are and it's just determining which step goes wrong to lead to different outcomes like osteoporosis or cancer,” she says.

Her focus is on how aging or radiation, like cancer radiotherapy, can injure and weaken bones. She discovered how a certain type of stem cell becomes damaged, preventing it from developing into healthy bone.

Quarato earned bachelor’s degrees in anthropology and chemistry from the University of Alabama at Birmingham.

Zachary Sechrist

Emily Whitt

Emily Whitt, a fourth-year student in the Pathology — Cell Biology of Disease graduate program, wants to understand the molecular switch that tells breast cancer cells to spread to other tissues.

“There are effective treatments available for breast cancer when caught early, but metastatic breast cancer is currently incurable,” Whitt says.

While it’s not clear exactly what causes tumor cells to send tendrils out to invade surrounding tissues, it likely involves chemical modification of proteins, called histones, that turn genes on and off.

So far, Whitt has discovered that the loss of one such modifications on histone H4, causes breast cancer cells to invade surrounding tissues more efficiently. Now, she is working to understand the mechanisms behind this phenomenon.

When Whitt thinks about her job, she is inspired. “Keeping it in perspective is motivating,” she says. “In fact, what I do is actually benefitting people.”

Whitt grew up in Pullman, WA, and earned a bachelor’s degree in Biophysics from Brigham Young University before beginning her studies at the UR.

When Zachary Sechrist was 12 years old, his mother was diagnosed with breast cancer. For years, she underwent treatment and dealt with complications that physically drained her.

“As a kid, I knew she was sick but did not understand the gravity of cancer. As I become more involved in this field I realize that the worrying is the most draining part…” Sechrist says. “I hope to contribute to understanding this disease so we can take the worrying out of cancer treatment, reducing the burden on both the patient and family.”

Working with mentor Calvin Cole, Ph.D., assistant professor of Surgery and Orthopaedics and a Wilmot member, Sechrist is studying cancer-related cachexia (or muscle wasting), a common side effect that diminishes quality of life and can prevent patients from being able to withstand certain treatments. Cachexia may be driven by chronic, low-grade inflammation induced by the tumor. This is an active area of research locally and internationally; Wilmot was recently awarded a $2.6 million Cancer Grand Challenges grant to study cachexia.

For his thesis, Sechrist will tease apart the complicated cellular and molecular mechanisms underlying cachexia to identify a possible drug target.

With a bachelor’s degree from Clarkson University, Sechrist joined the graduate program at UR in 2021.

BUILDING A BOND AROUND CANCER

Any graduate student will tell you that having a strong social support group — one that understands the struggles — can be a lifesaver.

That is one reason why students in the cancer biology concentration banded together in early 2021 to form the Wilmot Cancer Trainees (WilCaTs) group. Emily Quarato and Emily Whitt are among the leaders.

“We try to bring together student cancer researchers, postdocs, and medical students, so that we can talk about our research, and connect in a more social way as well,” says Whitt, WilCaTs co-president.

“We’re not exclusionary,” adds Quarato, who serves as treasurer and community outreach coordinator. “If someone wants to come, hang out, and learn — that’s what the point of the group is… You don’t have to be doing something that’s specifically cancer-related.”

WilCaTs is growing and holding more student-led workshops where members can teach specific lab skills or techniques, or review grant applications or papers.

This sort of peer-to-peer learning can open up new research avenues. Students may learn a better way to perform a

technique that could get them out of a failed-experiment rut. Or they may learn a completely new skill that could help them ask and answer research questions. Leveraging the group’s collective knowledge and experience, they can work out the kinks on a grant proposal or ensure a scientific paper tells a coherent story. Ultimately, Quarato says, the goal is for students to “support each other not only in our own training, but also just mentally and socially.”

The group has started to get involved in more community events, like the 2022 Wilmot Survivor’s Night, a celebration and tribute to those who have faced cancer that takes place at a Red Wings baseball game each year. The WilCaTs group attended the event as a social outing and hosted an informational table where community members could learn about cancer research.

Quarato also helped organize the 2023 STEM Community Day, an event to inspire local high school students to pursue careers in science or medicine. Working with others, Quarato helped bring the event back in person — a first since the beginning of the COVID pandemic.

“A lot of us are really interested in trying to get the word out about our science and to interact with those that we can actually help,” Whitt says. “There seems to be students who are very interested in this field of research,” she adds. “We just need to give them a home.”

A Compelling Grassroots Perspective

The first time Karen Mustian, Ph.D., a Wilmot Cancer Institute research leader, met the Reverend Patrina Freeman and a group of community advisors, she was so moved that she wept.

“I didn’t expect it,” Mustian recalls. “I came home from the meeting that night, I turned to my partner to describe what we had talked about, and I actually had tears streaming down my cheeks.”

“I had not had that feeling — that powerful thing of being reminded of why we do this work — since years ago when I was just starting my PhD program and I interviewed a cancer patient for the first time,” she adds.

Freeman, an ordained minister at Helping Hand Missionary Baptist Church on Joseph Avenue in Rochester, touched a chord. She is part of a large group of people who comprise Wilmot’s Cancer Community Action Council (CCAC), providing a muchneeded grassroots voice to Wilmot’s endeavors. Sometimes, their voices can spur necessary uneasiness.

“I really like talking to researchers about the fact that you have to know your own culture as well as someone else’s culture before you can move forward and be successful,” Freeman says. “There are many nuances and also some elephants in the room. We have to recognize them and celebrate it. That’s what makes it fun and rewarding.”

Community engagement, done right, can have a major impact on cancer care and scientific advances. Wilmot’s Community Outreach and Engagement (COE) office is facilitating more of those inspirational moments between folks like Karen Mustian (Freeman calls her “Dr. Karen”) and CCAC members. In this case, Mustian was seeking input from Freeman and others on a National Cancer Institute grant involving yoga as a way to reduce pain among Black cancer patients.

Mustian has been studying this topic for years and has risen to the top of the field. She’s completed several nationwide clinical trials on yoga and cancer, and was involved in writing national guidelines for patient care. But, she admits, all of her work had a flaw — the accrual of Black individuals to her clinical trials has been almost non-existent. As a yoga enthusiast in Rochester, Mustian also noticed that few Black people join local classes.

“Yoga works for people facing cancer, but we’re not meeting the needs of underrepresented groups across the country, and most importantly, right here in our backyard,” Mustian says.

Freeman was happy to share some reasons why.

“Yoga can have Eastern medicine and religious associations that are a turn-off for Black and brown communities,” Freemans says. “I was able to explain the understanding of ‘religion’ to her among

African Americans. For example, when we say ‘church’ we aren’t talking about just Christian churches. And when we say ‘faith’ it doesn’t always imply Christianity. It can mean spirituality or our walk with God. Our church is what helped us make it through slavery and into the post-civil rights era.”

Freeman adds: “I told Dr. Karen, I would love to sit with the clinical trials screeners as they’re recruiting people for studies and show them that words really matter. Understanding the fear and apprehension Black folks have about health is so important. You need to know your audiences.”

Mustian says Freeman stirred her passion and opened up new possibilities. They are working together to design and conduct a pilot study using yoga to help cancer survivors in Rochester’s Black community. It will likely will be conducted in the basement of Helping Hand Missionary.

Mustian’s standard yoga program is being culturally adapted and, thanks to Freeman, was renamed “SOUL Yoga.” The S stands for “strengthening,” the O for “openness,” the U for “uplifting,” and L for “letting go.”

The pilot study will provide critical data for an NCI grant.

“Knowledge comes in all different shapes, sizes and from different backgrounds,” Mustian says. “My experience with Patrina and the CCAC proves that they are smart and know far more than we do about many, many things.”

Rev. Patrina Freeman and Karen Mustian, Ph.D.

Community Outreach and Engagement improves the health of local and regional residents through partnerships.

A FLIP SIDE OF THE "CHEMO BELL"

Hats off to Wilmot’s infusion nurses for their creativity. They devised a new way for people to celebrate an end to treatment without being insensitive or disruptive to other patients who have metastatic cancer or whose treatment is unlikely to have an end date.

As an alternative to the traditional ringing of a “chemo bell,” the nurses developed an appealing backdrop in a quiet hallway in the infusion center at the Wilmot Cancer Center, and created signs with uplifting quotes such as “Don’t ever give up,” and “It always seems impossible until it’s done.” They purchased an instant camera, and patients are invited to take snapshots with the signs to honor a milestone of their choice. The nursing team also created certificates to give out, with space for Wilmot staff to sign and write well-wishes.

“The response has been heartwarming,” says Erin Gibbs, R.N., B.S.N., infusion center nurse. “We are all excited about this and hope it becomes another example of the wonderful patient experience here at Wilmot.”

If the program is successful at Wilmot’s hub location on the UR Medicine main campus, Wilmot leaders may roll it out at other Wilmot treatment centers in the Rochester region.

RESEARCH ROUNDUP More News from Wilmot’s Bench

SURVIVORSHIP CHALLENGES among young people who had cancer is a critical area of research. As someone who faced leukemia at age 22, Wilmot scientist AnnaLynn Williams, Ph.D., knows this all too well.

In a new study that she led, a research team found signs of accelerated aging in young adults that was consistent with very early dementia symptoms. In fact, among 215 childhood Hodgkin lymphoma survivors who are now in their 30s, results showed that, biologically, a majority are an average of 7.7 years older than peers who never had cancer. The aging tended to impact memory most often. The American Society of Hematology (ASH) showcased Williams’ data in December 2022 at the ASH annual meeting and in a special press event.

What can be done? Williams is studying ways to intervene in the aging process but says that young cancer survivors can help themselves in the meantime by adopting a healthy lifestyle and keeping up with recommended health screenings.

“Try to be active, quit smoking, eat healthy, see your primary care physician to get proper testing, and exercise your brain,” she says — adding that it’s important to mix up activities and push yourself to stay social and connect with others. Williams is an assistant professor and part of Wilmot’s Cancer Prevention and Control research program.

FOR THE FIRST TIME in nearly 20 years, an advance has been made against aggressive brain cancer — and Wilmot was part of the discovery.

Researchers tested a personalized cancer vaccine made from a patient’s own immune cells and antigens from the tumor. In a phase 3 nationwide clinical study, the vaccine extended the life of individuals with newly diagnosed glioblastoma for a median of 22.4 months, and 13% of patients survived at least five years. Typically, patients can live for only about 15 months after diagnosis with this lethal brain cancer. People with a recurrence of glioblastoma also took part in the study and their survival was extended for an additional four to six months.

Kevin Walter, M.D., a Wilmot investigator and professor of Neurosurgery and Oncology, led the multi-site study locally. “Brain cancer is such an aggressive disease, and so many diverse treatments have failed in clinical trials. It is gratifying to be able to help advance a potential new treatment option for patients,” he says.

“Clinical trials, like this one, provide local and regional patients with access to promising novel treatments and help us advance medicine and cancer care for all,” adds Wilmot Director Jonathan Friedberg, M.D.

The vaccine, known as DCVax-L, is a product of Northwest Biotherapeutics. The clinical trial involved nearly 350 patients across the U.S., with more than 2,100 doses administered. The treatment was tolerated well, according to the study results reported in the journal JAMA Oncology. The FDA is working with researchers and the company to find the best way to bring the treatment to more patients.

AnnaLynn Williams, Ph.D.

Kevin Walter, M.D.

Accolades for Trailblazers in Cancer Research

Lynne Maquat, Ph.D., founding director of the Center for RNA Biology at the University of Rochester, received the 2023 Gruber Genetics Prize for her discovery of nonsense-mediated mRNA decay or NMD in humans. Maquat investigates the many complex roles that RNA plays in sickness and in health. “Her work will influence how we treat a range of inherited diseases, as well as many types of cancer,” says Steve Dewhurst, Ph.D., vice dean for research at the UR School of Medicine and Dentistry.

The Gruber International Prize Program, administered by Yale University, honors researchers from around the world whose groundbreaking science leads to fundamental shifts in knowledge and benefits mankind.

Supriya Mohile, M.D., M.S., who has an international reputation in geriatric oncology, was elected to the American Society for Clinical Investigation (ASCI), one of the oldest medical honor societies. ASCI receives hundreds of nominations annually and chooses less than 100 physician-scientists for membership,

all of whom are under age 50 with outstanding scholarly achievement. ASCI election also recognizes a commitment to mentor others.

Mohile’s pioneering efforts in geriatric oncology began several years ago, as she pursued the need for more data about the oldest cancer patients, who comprise the majority of cases but had been historically ineligible for clinical trials. That led to studies that established a new, standard way to assess an older cancer patient’s overall health — including cognition and memory, heart disease, diabetes, and other common co-illnesses, medication usage, living arrangements, and support systems.

M. Patricia Rivera, M.D., a noted lung cancer specialist who serves in many leadership roles at the University of Rochester Medical Center and Wilmot Cancer Institute, is the new president of the American Thoracic Society (ATS). She is the first Latino woman to lead the large, international organization — and also the first faculty member from the UR to do so.

Wilmot researchers have discovered the molecule responsible for steering an army of immune cells toward tumors, setting the stage for scientists to improve upon groundbreaking immunotherapy for cancer.

The daughter of Cuban immigrants who grew up in Brooklyn, Rivera came to Rochester in April of 2022. She was recruited from the University of North Carolina for her expertise in lung cancer, and serves as chief, Division of Pulmonary and Critical Care Medicine at URMC. She also filled a newly created position at Wilmot as Associate Director for Diversity Equity and Inclusion (DEI). The National Cancer Institute requires cancer centers to document and track efforts to improve disparities in the oncology workforce, and Rivera is charged with leading that program.

Paula Vertino, Ph.D., an accomplished cancer scientist and Wilmot executive, took a step forward in her career by being named senior associate dean for Basic Research at URMC. She will continue to play an integral role at Wilmot and its ongoing bid for NCI designation, and will also work across the Medical Center to enhance team science, build connections between all laboratory and clinical researchers, and enrich the educational opportunities for graduate students.

Treatments that activate the immune system to help destroy tumors, particularly CAR T-Cell therapy, are extending the lives of patients. But sometimes the therapy randomly migrates to places it shouldn’t go, tucking into the lungs or other noncancerous tissue and causing toxic side effects. That’s where the work of Minsoo Kim, Ph.D., and his team becomes significant. If they can ensure that more cancer-fighting immune cells will hit their targets, “we can create powerful new treatments,” says Kim, a professor and co-leader of Wilmot’s Cancer Microenvironment research program. His latest study was recently published in the high-profile journal, Nature Immunology.

Lynne Maquat, Ph.D. Supriya Mohile, M.D., M.S. Paula Vertino, Ph.D.

M. Patricia Rivera, M.D.

Minsoo Kim, Ph.D.

Two Decades of Gratitude

After years of giving, Gwyn Hankinson, a breast cancer survivor, and her husband, Garth, add to their support of Wilmot with a major philanthropic gift.

Twenty-one years ago, Gwyn and Garth Hankinson got the news they’d been hoping to hear: they were going to have a baby. They were thrilled — not knowing that soon their lives would turn upside down.

At Gwyn’s first prenatal visit, her obstetrician found a small lump in her breast. No one was too worried, but to be sure, the doctor ordered a biopsy. “I’ll never forget the phone call that came a few days later,” says Gwyn. “The biopsy showed ‘abnormal results.’ I was in shock.” Further testing confirmed that Gwyn had invasive breast cancer and needed immediate treatment. She was just 33 years old and two months pregnant.

Gwyn and Garth quickly started researching options, knowing that her pregnancy would make things more complicated. Gwyn called everyone she knew who had any experience with cancer, including her mother in North Carolina who was just completing her own breast cancer treatment.

Within a few days, the couple had an appointment at the Wilmot Cancer Institute Comprehensive Breast Center. Gwyn learned that she could get treated while pregnant and that she and the baby would likely have a positive outcome. The couple was impressed by Wilmot’s research-based approach to breast cancer. They also liked that Gwyn could receive all of her care close to home at the University of Rochester Medical Center, including high-risk OB/GYN support.

“It was a stressful time,” says Gwyn. “But we got through it thanks to Wilmot and many very helpful people.”

Gwyn's cancer treatment took place in 2002. During that time, one more unexpected event occurred when Gwyn went into early labor and her baby boy, Owen, was born seven weeks early.

Today, Owen is a healthy, 21-year-old business major at SUNY Geneseo, and the couple’s other son, Henok, is a high school junior with hopes of playing college hockey.

“Wilmot means so much to us,” Gwyn says. “In a sense, they gave us our son. It was a place that gave us hope.”

“I owe my family and the life we have today to Wilmot,” adds Garth. “This is why we have supported and been involved with the institute for so long.”

A MAJOR COMMITMENT

As a young couple in 2003, the Hankinsons wrote their first check to Wilmot for $100.

That support and their gratitude has blossomed over the years, financially and in other ways.

When Owen was a baby, for example, family members held a fundraising dinner that resulted in $3,000 for breast cancer research at Wilmot. The couple’s own annual donations have remained consistent since those early days.

In 2021, Garth joined Wilmot's advisory board. By then, he had become chief financial officer at Constellation Brands, and was happy to contribute ideas and knowledge drawn from his professional career. The couple also attends and supports Wilmot’s Discovery Ball, the cancer center’s largest annual fundraiser. And, for the past seven years — even through the COVID-19 pandemic — Gwyn has volunteered at the information desk at Wilmot’s primary location on the URMC campus. She greets patients, answers questions, and offers a friendly face.

“I love coming here,” she says. “It’s just a privilege to be in an emotional space with someone who’s going through cancer.”

In 2022, the couple made a major philanthropic commitment to Wilmot to recognize the institute’s vital role in changing the course of breast cancer research and care, and the impact WCI has had on their own family. The couple’s $250,000 gift supports Wilmot’s Discovery Fund, which helps advance research, provide world-class oncology care, expand clinical trials for patients, and train future clinicians and scientists.

“If anyone asks us for cancer guidance we tell them to do their research and make decisions based on what’s right for them — cancer is so personal,” Gwyn advises. “We also tell them about our experiences at Wilmot and the important work being done there. We’re proud to be associated with such a vital resource in our community.”

“Everyone at Wilmot was there for us 20 years ago — from the oncologists to the nurses to the office staff,” adds Garth. “We are now in a fortunate position to give back to the institute, to show our gratitude, and to do our part to help others have access to the exceptional, empathetic care and support we received.”

GET INVOLVED Contact Clare Flanagan, Executive Director of Advancement for Wilmot Cancer Institute, to learn more about how to make a difference.

clare.flanagan@rochester.edu

Wine Enthusiasts and High Bidders Generously Support Research at Wilmot

Wilmot Cancer Institute was the proud beneficiary of a record-breaking fundraising event in November 2022 at The Lake House in Canandaigua.

The Toast to Your Health Wine Auction, in its 19th year, is the University of Rochester Medical Center’s premier fundraiser. Last fall it sold out for the first time with an attendance of 220 people and raised more than $1.5 million, which was also a record.

All proceeds went to Wilmot to support its new developmental therapeutics initiative, which is designed to accelerate and translate basic scientific discoveries into clinical research. The goal is to continually bring leading-edge cancer treatments to the 27 counties in upstate New York from which Wilmot draw patients.

The event’s success was due to the leadership of Danny Wegman and Michael Misch; honorary chairs Sherwood Deutsch, R. Wayne and Beverly LeChase and Tom and Colleen Wilmot; auction cochairs Mike Jones, Patrick Cunningham and David Linehan (faculty chair); and the entire Wine Auction committee.

The elegant and fun-filled event featured 48 silentauction items, 18 live-auction items, notable wines from around the world, and an informative program highlighting Wilmot and its advances in care. High bids went to attractive and rare wine collections and exotic trips to Italy and the Caribbean. Wilmot is grateful to its longtime donors and new friends made through the wine auction event.

“Warrior Walk” Evolves into “Warrior Weekend” with New Bike Ride Event

For the first time, Wilmot is launching an entire weekend of outdoor charity events this year, on September 29 through October 1, in Rochester and the Finger Lakes region. The inaugural Wilmot Warrior Weekend will include its popular 5K race and 1-mile walk, with the addition of a bike ride called Wilmot Breakaway.

“We’re proud that our signature event, the Warrior Walk, has grown so much in the past decade and we are now ready to expand and capture the enthusiasm of a large cycling community in this area,” says Jonathan Friedberg, M.D., M.M.Sc., director of the Wilmot Cancer Institute.

“We encourage all of our supporters and the entire community to join us to celebrate the advances we are making in cancer research, and to honor all of those individuals who have faced cancer,” he says.

The Warrior Walk has been a signature community event for the past 10 years, bringing together more than 650 people annually to raise money for research and the Judy DiMarzo Cancer Survivorship Program. As it enters its second decade, the event has raised more than $1 million.

There are many ways to get involved in Wilmot Warrior Weekend: Start a team, sponsor the event, ride, walk, run, and/or volunteer.

Learn more at WarriorWeekend.urmc.edu

Start: 211

The event kicks off on Friday, September 29, with a fun evening from 4 pm to 8 pm, that includes food, beverages, and entertainment. Packet pick-up is from 4 pm to 6 pm.

Location: UR Laboratories, 211 Bailey Road, Henrietta.

Saturday, September 30, the Wilmot Breakaway bike ride takes place, offering three scenic routes — approximately 27, 50, or 75 miles long — with something for cyclists of all abilities. The longest route connects with Wilmot’s Sands Cancer Center in Canandaigua, with views of Canandaigua Lake along the way.

Sunday, October 1, the 11th annual Warrior Walk and 5K continues its tradition at Genesee Valley Park near the University of Rochester Medical Center campus. A 1-mile walk is available as well as a timed 5K run/walk.

Planners, teams, and supporters gathered for a Warrior Weekend kick-off event in April.

September 29–October 1, 2023

Register | Form a team | Sponsor warriorweekend.urmc.edu

#WilmotWarrior

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I walk to honor my friends and family, and the Wilmot Cancer Institute doctors, nurses, and researchers–they’re making a real difference and saving lives. They’re all part of my team.

Emily Robbins, T-Cell Acute Lymphoblastic Leukemia survivor