Michael Caligiuri, MD, President of the American Association for Cancer Research (AACR) 2017-2018, was recently appointed president and physician-in-chief of the City of Hope Medical Center, Duarte, California, and assumed that post as of February 2018. Here, he discusses his leadership role and what he perceives as the direction of future cancer care.
Known for his work in immunology, Dr. Caligiuri was previously director of The Ohio State University Comprehensive Cancer Center and CEO of the Arthur G. James Cancer Hospital and Richard J. Solove Research Institute. As a physician-scientist, Dr. Caligiuri’s work in immunology focuses on human natural killer cells and their modulation for the treatment of leukemia, myeloma, and glioblastoma.
OBR: Most of your career has been grounded in research as a physician-scientist. How will that experience shape your new role and vision as president and physician-in-chief at the City of Hope (COH)?
MC: I’ve been a physician-scientist for 27 years. In 2008, I became CEO of the nation’s third largest cancer hospital. Becoming president of COH is in my wheelhouse. COH has doubled in size in the last 7 years. I hope I can continue to build a great culture and maintain the spirit of entrepreneurship and reputation of outstanding patient care.
OBR: Can you outline your primary objectives at AACR for 2018, and what you hope to pass on to your successor?
MC: This will be a cutting-edge, scientifically, robust meeting. My focus will be on cancer health disparities. This gave me an opportunity to build a platform to create impact through the organization. This focus will extend for the next several years.
OBR: Your organization is very focused on the disparities in cancer care that affect a disproportionate segment of the population including racial and ethnic minorities, those belonging to a lower socioeconomic bracket, and the elderly. What initiatives does AACR have underway? How do those initiatives compare with the mission at City of Hope?
MC: When I think of healthcare disparities, I think about abysmal statistics for African Americans, who are diagnosed more frequently with cancer and more advanced cancer. One likely culprit is genomic differences between races and ethnicities, which contribute, along with environmental, social and behavioral issues, to the greater cause of cancer. If we can study pathways leading to cancer and identify African Americans with those mutations, we can develop preventive strategies in those selected populations.
I cofounded the Oncology Research Information Exchange Network (ORIEN) to collect genomic and clinical data for researchers, which now involves 17 cancer centers, the US military and COH. I have asked the AACR board for $500,000 to help build out infrastructure at Morehouse School of Medicine to access incoming patients, obtain tissue samples, and clinical data. The goal is to accrue at least 2020 patients by 2021.
I feel strongly if we can build out infrastructure at this historically black college and have sustainable ways to collect cancer genomic data, this will attract other foundations, not-for-profits, and the federal government to fund these institutions with a predominance of under-represented people.
OBR: AACR’s 2017 Cancer Progress Report highlighted immuno-oncology and precision medicine as being at the forefront of our progress on cancer, and this past year we’ve seen some historic FDA approvals in those two areas. What do think the recent highlights were in these two areas of study? Do you think we’re just scratching the surface in immuno-oncology and precision medicine?
MC: I think that these are two huge areas. I believe that immuno-oncology is the fifth pillar of cancer care along with surgery, radiation, chemotherapy, and targeted therapies. Targeted therapeutics and immunotherapy are new fields that are here to stay. As we learn more, we will develop preventive strategies that will be the real cure to cancer. Big data will take us quicker down that pathway. Genomic, clinical, pathologic, and behavioral data can identify patients and put them into cohorts. Treatments can be found if we assemble enough data.
OBR: Going deep into the frontier, are there new approaches to cancer therapy that haven’t hit the mainstream media yet that excite you? Can you think of any strategies that could deliver a larger incremental gain the way that immunotherapy has?
MC: Computation is the future of cancer. We need large numbers to tease out patients and genomes. AACR is facilitating convergence with other scientists. We have called on our nearly 40,000 members, including chemists, engineers, mathematicians, and physicists to sit down with cancer biologists and drug developers. You will see new science emerging from this convergence.
OBR: Do you consider yourself lucky to be a physician in this revolutionary time of cancer treatment?
MC: Yes, I consider myself incredibly fortunate. I went into cancer because I enjoyed the challenge of taking care of people who were dying. Now, we all know people living successfully with cancer or who are cured. We are still just scratching the surface of new equipment, intraoperative imaging, and computations. The growth in cancer care is exponential.
OBR: Do you think cancer therapy will be impacted positively or negatively by the new administration’s policies? What are your concerns going forward?
On the positive side, the administration retained Francis Collins, MD at the National Institutes of Health (NIH) and appointed Norman “Ned” Sharpless, MD to lead the National Cancer Institute. They will provide great leadership with the Cancer Moonshot underway. Scott Gottlieb, MD at the FDA supports advancing regulatory science, oncology in particular. AACR supports the FDA’s Oncology Center of Excellence. On the negative side, cutting NIH funding is completely unacceptable to the scientific and medical community. This is the wrong approach. Fortunately, Congress rejected that and put forward another $2 billion increase for NIH this year. AACR leads the fight to support medical research. The more people in clinical trials, the more likely we find a cure for cancer and preventive strategies. We have discovered more than a dozen drugs for breast cancer by having patients.