Scientists aim to continue work after Nevada Cancer Institute’s closure

Today, Giuseppe Pizzorno is a research professor with the Desert Research Institute. But the pharmacologist with a background in researching anti-cancer molecules came to Nevada in 2002 with the hopes of building a world-class cancer treatment and research facility at the Nevada Cancer Institute. When the cancer institute’s troubles came to a head in recent years, there were some, including Pizzorno, who didn’t want to consider the worst possible scenario — a complete closure of the site and hard-fought research dollars leaving the state. Unfortunately, that’s exactly what did happen.

Pizzorno, former head of research at the cancer institute, recalled a chaotic October 2011 when he was notified of University of California, San Diego’s plans to terminate the institute’s research efforts.

“I had about 10 days to place 25 people,” he said. “You can only imagine what it was like.”

Pizzorno said there were still about 15 principal investigators on site at the time. Some, like Sheri Holmen, had left earlier. Holmen, now an investigator at the University of Utah’s Huntsman Cancer Institute, is a researcher whose work involves identifying specific cancer tumor-causing genes, particularly in melanoma sufferers, then developing therapies against them. Her husband was a researcher at the Nevada Cancer Institute as well.

“They (Nevada Cancer Institute) weren’t too happy when I left, but we couldn’t fathom both being unemployed,” she said. “I want to focus on my research, not on whether I’m going to have a job next week.”

With a $2.5 million National Institutes of Health grant in place, she was attractive to universities looking for researchers. When the offer to leave came, even prior to the Nevada Cancer Institute bankruptcy announcement, she took it.

Like others who left the cancer institute and the Las Vegas Valley, Holmen still owns a home in Las Vegas and travels here on vacation. She maintains she has no hard feelings toward the institute and wished she and cancer institute founders Jim and Heather Murren could have built a world-class melanoma research center as originally envisioned. Melanoma took the life of Jim Murren’s father, Don, Holmen explained while remembering the enthusiasm surrounding her arrival at the Nevada Cancer Institute.

Others, such as Michael Gach, waited to the very end in hopes of a resolution. Like Pizzorno, he came to the cancer institute early in its history. His role was to help establish research collaborations that involved imaging technologies, particularly MRI (magnetic resonance imaging) machines. Meanwhile, he would develop his own advances to MRI technology, most notably a technology that predicts the future location of an organ so that patients wouldn’t need to hold their breath while undergoing an MRI.

“That job was made for me. I loved it there. I really wanted to stay,” Gach said.

Before being informed of the cancer institute’s research arm’s closure, Gach had landed an NIH grant and some other grant money from the U.S. Department of Defense to continue his work. The NIH grant stipulated he needed a dedicated MRI machine for his research, which would no longer be the case with the closure of the research group. He looked at other possible scenarios locally, but a lack of dedicated equipment was the ultimate reason he had to leave. Gach ended up going to the University of Pittsburgh, where he previously completed his doctoral work.

“It was my ticket out. I don’t think they (University of Pittsburgh) would’ve hired me had I not had the grants,” he said.

Pizzorno said about seven or eight investigators have managed to stay in town. Others have gone to universities in New York, Texas, Boston and other areas. Like others, he is still hoping for a way to salvage and even grow a greater cancer research base in Las Vegas without Nevada Cancer Institute.

“The results were starting to come in (at the cancer institute). Young investigators were starting to get grants,” he added.

Holmen and Gach were proof of that.

Hanging on

One young investigator choosing to stay is biophysicist Timothy Le, now also with the Desert Research Institute, who develops microscopy technology that has helped to bring better understanding to the role of lipids, or fat molecules, in cancer cells.

Le’s research focus revolves around circulating tumor cells, or cells originating in a tumor that make their way into blood. He has developed a technology called coherent anti-stokes raman scattering, or CARS, microscopy, which helps to detect circulating tumor cells, but also sees a little more clearly what he refers to as cancer cells’ “affinity for lipids.”

With circulating tumor cells seeking fat molecules for energy, Le is now looking to different kinds of lipophilic cancer drugs, or drugs that are bound to lipids that can deeply penetrate circulating tumor cells and attack them. Physicians conducting clinical trials can use CARS microscopy to know when the circulating tumor cells are in the bloodstream and better time lipophilic drug doses. Once the circulating tumor cells leave the bloodstream and escape to organs, it’s difficult to target them with drugs, Le explained.

Hui Zhang and Hong Sun, a husband and wife team who now make their home in the University of Nevada, Las Vegas’ chemistry department, came to Nevada Cancer Institute in 2007 from Yale’s Department of Genetics. The idea of starting something new in the desert appealed to them, even after getting an offer from the University of Chicago at the time.

Zhang, who was the head of proteomics at Nevada Cancer Institute, researches stem cells and cancer-fighting compounds and works to develop compounds that battle cancer cells but are safe for normal cells. Sun’s work is centered on using chemistry and molecular genetics, particularly in trying to find molecules and pathways that are resistant to radiation.

The pair have used a combination of NIH and Department of Defense grants to fund their research and will be seeking more funds from the NIH and other sources to continue their work. They’re confident they will get the money with the support of their new research environment at UNLV and are a bit stubborn about leaving what they see as an up-and-coming international city despite all the naysayers’ claims.

But Le and other researchers are also needing that next step to their work: physicians putting together clinical trials with patients willing to try the experimental approaches. One former Nevada Cancer Institute physician and clinical investigator, Dr. Oscar Goodman Jr., could be a major catalyst for maintaining local cancer research initiatives and helping them to advance as potentially successful therapies.

Goodman recently signed on with Comprehensive Cancer Centers of Nevada, an affiliate of the U.S. Oncology Network, after weighing options of leaving the city he and his family of former and current mayors champion.

“I didn’t want to leave but I did have to look out of state,” he said.

With the choice to stay, Goodman also teams up with Dr. Nicholas Vogelzang, Nevada Cancer Institute’s former director, and Dr. Wolfram Samlowski, who oversaw melanoma, renal cancer and immunotherapy treatment at the institute. But more importantly, he is now linked to U.S. Oncology’s network of about 175 clinical trials, he said.

Goodman is in the process of outreach for funding for several clinical trials, one involving Le’s work and another involving stem cells that block blood vessel formation in prostate cancer.

Goodman foresees cancer research in the valley moving forward in what he describes as “a community-based academic medical learning center ... where bricks and mortar are spread around rather than in one localized place.” He said Las Vegas’ geographical footprint is small and accessible for researchers and doctors, even if things seem a little scattered right now.

Pizzorno said not having all the researchers housed under one roof makes collaboration tough, but not impossible. He misses the camaraderie he experienced at the Nevada Cancer Institute, though.

“There is certainly a lack of synergy by being separated,” Pizzorno added. “Most of the ideas are discussed at the vending machines and water fountain. That’s what we’re missing the most.”

Seeking Home base

A geographical common ground for the valley’s researchers could be the $50 million, 180,000-square-foot Ralph Engelstad building only a few doors down from the now-closed main Nevada Cancer Institute building. The Nevada Cancer Institute Foundation, which owns the almost completely vacant site, is said to be seeking more tenants. At this time, only a fraction of the first floor is leased.

The building was largely funded by a $20 million donation from the Ralph Engelstad Foundation. The Nevada Cancer Institute Foundation declined to give specifics on the financial health of the building or its efforts in recruiting more tenants at this time.

While the Desert Research Institute has a presence in the modern but underused space, perhaps the most important tenant, taking up about 9,000 square feet of space on the first floor, is Roseman University. The health sciences college that started as a pharmacy school in 1999 in a small Henderson industrial park is the fastest growing educational institution in the state. Now with a campus in Utah as well, expansions have added degrees in dental medicine, nursing and an MBA program.

Since 2010, the school has been building a research department. Roseman’s director of research, Ronald Fiscus, left Nevada Cancer Institute in late 2009 to help head up the effort, which has, up to this point, focused on issues such as obesity, diabetes, cancer and cardiovascular diseases. In two years, the group, which also has its share of cancer institute alumni, has published three book chapters, seven research articles, among other research contributions.

Fiscus, a professor of pharmaceutical science, and his research group have made discoveries in the area of resistance to chemotherapy agents and most recently a discovery of stem cells that transform into cancer stem cells, or seeds of tumors.

But above all, Fiscus, who also wants to partner with Goodman on future trials, emphasizes the role of the pharmacologist at the early stages of drug development. About 98 percent of cancer drugs fail, and unfortunately most of them in very late stages after many millions of dollars have already been spent on development, Fiscus explained. Having a pharmacologist with advanced instrumentation on hand at the outset would help to weed out unproductive drugs earlier and save dollars and improve outcomes.

Making the pharmacologist even more important to the situation is arming him or her with a capillary electrophoresis-based protein analysis machine. Fiscus helped develop the instrumentation, which allows for 500 times better analysis than the traditional, 30-year-old Western Blot technology used by most cancer researchers.

“I brought that to NVCI (Nevada Cancer Institute). We were the first cancer institute in the U.S. to have that and use it for cancer research,” he said. “We can use it to test therapeutic agents right at the beginning so that you’re not wasting a lot of time.”

Funding questions

For Le, a young investigator at 37, there are concerns about future funding. NIH grant funding for cancer research has remained flat for the past decade. Factoring in inflation, some studies estimate the grant funding has lost 20 percent in purchase power in that time.

Research proposals such as Le’s have felt the pinch as well. Only five years ago, the agency could award the top 20 to 30 percent of applicants for grants, Le said. Le’s work easily placed in that range. Two recent applications placed at 13 and 19 percent ranges. But now, he noted the NIH can only fund the top 7 percent of applications. For his work, Le sought out other funding sources and landed a $1 million research grant in 2010 from the American Cancer Society and Vons Breast Cancer Foundation.

“I am still working because we have other funding sources,” he said.

But when the funds run out in another couple of years, Le, who has published his recent findings in peer-reviewed medical journals, is not sure whether he’ll be able to stay in Nevada, especially without having the crucial tie to a research and treatment facility.

“I would like to stay around. I think this research is critical for the valley,” he added. “But they like to see the stability in the research support environment. ... It definitely negatively impacts their (the NIH) view in making the funding decision.”

Le recalls some Nevada Cancer Institute researchers whose promising applications were automatically rejected once the bankruptcy news broke. With no state support in sight, other researchers who want to stay will need to look for alternate funding sources as well.

“There is a bias against us now. So we have to climb a very steep slope,” he added.

Goodman, too, acknowledges that there will be an uphill battle for funding without Nevada Cancer Institute’s presence, but he still thinks a different model can prevail.

“I think the time is right for a new beginning here. I think if anything what NVCI did was bring the human capital here,” he added.

For now, some of that capital has chosen to stay. The only question that remains is for how long.