This year’s Clip In 4 the Cure drew hundreds of participants to Geodis Park for a relay-style team cycling event featuring top Nashville spin instructors and live DJs.
The high-energy fundraiser began in 2022 to raise money for cancer initiatives at Vanderbilt-Ingram Cancer Center and Monroe Carell Jr. Children’s Hospital at Vanderbilt.
Clinicians and patient ambassadors highlighted the impact that the fundraising efforts have on cancer care and research.
There are many types of cellular therapy. Vanderbilt-Ingram has one of the nation’s best stem cell transplant centers based upon procedure volume and patient outcomes. The center was the first in Tennessee to offer CAR-T (chimeric antigen receptor T cell) therapy, which reengineers a patient’s immune cells to recognize and attack cancer. Another cellular therapy Vanderbilt-Ingram recently added is TIL (tumor-infiltrating lymphocyte) therapy for advanced melanoma. TIL became the first cellular therapy approved by the Food and Drug Administrations for solid tumors in February 2024.
In the summer of 2021, I was diagnosed with Stage 4 renal cell carcinoma. Needless to say, my world was turned upside down. Cancer is such a devastating disease, and no one wants to be a part of that club. No preplanning for this one. Yet, there I was, handed this diagnosis with no plan in hand.
“What’s next?” I thought. While the radiologist was giving me some direction on my recent discovery, I totally passed out! “This couldn’t be happening, could it? Look at me, I’m a healthy, physically fit, soon to be retired happy-go-lucky male.” Ironically, in all of this, I just received my very first Social Security deposit earlier that morning. Good luck seeing my next one!
Two weeks later, I was undergoing a serious operation to remove my right kidney and 11 centimeter tumor when the unimaginable happened. Parts of the tumor broke apart during the resection. A loose thrombus from the large tumor traveled up my inferior vena cava and into my heart, which stopped my blood flow for up to 10 minutes. That generally means instant death! Obviously, I didn’t “expire,” as I am here writing this dialogue for you. However, there are many excruciating details of how I ultimately survived that surgery and lived to talk about it. That particular incident and my cancer journey that followed are quite a story. In fact, I authored a bestselling book describing that operation and what really happened in those 10 “lifeless” minutes.
The book recounts that major event along with the six months that followed. It was quite a ride enduring the cancer emotions for both me and my wife along with the continual cancer treatments. My therapy following the operation involved a regimen of pembrolizumab infusions, which is an immunotherapy, along with a daily intake of Inlyta pills, a targeted therapy that inhibits the growth of cancer cells.
After following this schedule for the two years that was prescribed, it was decision time. I had great success with the mix of these two drugs in fighting my cancer, although I encountered many side effects along the way. I was determined to stay the course no matter what the consequences were. Now at this crossroad, I had many options to consider. Keep the medication intake the way it was? Reduce the number of medications? Or a combination of many other variables? After giving this much thought, I asked my oncologist at the Medical University of South Carolina, Dr. Theodore Gourdin, about getting another opinion. Dr. Gourdin was gracious regarding my question and suggested two other oncologists who specialized in kidney cancers. One of the doctors he mentioned was Dr. Brian Rini at Vanderbilt-Ingram Cancer Center in Nashville. I researched Dr. Rini online and felt like he was my guy. After all, he had authored the treatment study that I’d been on for the past two years.
Hollings Cancer Center at the Medical University of South Carolina contacted Vanderbilt-Ingram and introduced me to them in order to get the ball rolling. I followed their introduction with a call to set up an appointment. I was impressed from the moment the receptionist answered the phone. She was very welcoming, and after some discussion she switched me over to Dr. Rini’s navigator who was already familiar with my case. She scheduled an appointment for a Thursday at 10 a.m. That was only 48 hours from the time I was speaking to her.
I would need to step it up as the cancer center was over 500 miles away involving an eight-hour-plus drive. We would have to leave early Wednesday morning to arrive in Nashville at a reasonable hour. Considering that MUSC and VUMC used the same software company, (Epic Systems Corp.), I was able to merge the two systems so Dr. Rini would have immediate access to all my medical records. It was amazing how all of this came together in short order.
William and Linda Douglas take a stroll on the beach with their standard poodle, Gianni.
My wife, Linda, and I, along with our standard poodle, Gianni, loaded up our SUV Wednesday morning and headed toward Nashville. Ingram Content Group, the company that would print my book on cancer is located in La Vergne, Tennessee, southeast of Nashville. Considering it was along the way, I thought it would be beneficial to stop and see the facility that would ultimately publish my book when it came out. This trip was kind of full circle for me, being that the cancer center that I was heading to was named in honor of the family who made a large contribution to Vanderbilt University Medical Center for the cancer center. This was all very surreal to me in a good way.
We arrived in Nashville on Wednesday evening and checked into a hotel near the Vanderbilt campus. After unpacking, we drove around the college campus and noted the beauty of it all. We found the cancer center and parked our car in the convenient parking garage adjacent to the large glass building. I had Linda take my picture next to the Vanderbilt-Ingram Cancer Center sign located in front. We noticed that they had complimentary valet parking. We thought that was a nice offering, but we would forgo that service the next morning. After finding a good barbecue restaurant that evening, we went to bed with great anticipation for my appointment the next morning.
We woke up early and took Gianni for a nice stroll in the downtown area. Nashville is a very friendly town that displays country music everywhere you look. The downtown atmosphere was relaxing and a joy to walk through. After our short dog walk, we got Gianni situated in our motel room and headed to our appointment with Dr. Rini.
When we walked into the lobby of the cancer center, I immediately noticed the piano situated against the paneled wall of the room. It was a shiny black piano that had a calming appearance to it. It all made sense being we were in Nashville.
The flooring was carpeted, with comfortable seating scattered throughout the spacious room. I took note of the coffeepot on the self-service bar that I thought was a nice touch. It was obvious that Vanderbilt went to great lengths to make its cancer patients feel comfortable while visiting their oncologists. We checked in with the nice lady at the front desk, who entered my information into their system, then we took a seat in the lobby. It was approximately 10 minutes to 10 a.m. when Dr. Rini’s nurse called my name. “That didn’t take long,” I thought. We followed her to the exam room, where she asked a few questions and said that Dr. Rini would be in shortly.
At precisely 10 a.m., Dr. Rini entered the room. He didn’t have a medical chart, laptop computer or anything such as this with him. He was sharply dressed; however, he wasn’t wearing the usual white coat that most doctors wear. This created a much more relaxing atmosphere. We shook hands; he introduced himself; and we all took a seat.
He looked me in the eye and said, “I have studied your case and know it very well. Your situation is very unique, and I’m glad you’re doing so well after a rocky start to your journey.” We jumped into some particulars regarding my nebulous cancer outlook. I was very impressed that he didn’t have to refer to any notes on the topics we discussed. After a 30-minute conversation, we jointly came to a satisfactory conclusion as to how I needed to proceed going forward. As we exited the exam room, Dr. Rini said he would keep up with my progress and to never hesitate to reach out to him if I felt the need to do so. I felt comfort in knowing that.
As I exited the Frances Williams Preston Building, I turned around, took a good look and thought, I know I came to the right place, at the right time, and saw the right doctor. This is probably the most satisfied feeling I’ve had since my cancer diagnosis. To have the validation from this wonderful cancer facility along with the work that my magnificent cancer center in Charleston has already accomplished, I couldn’t be in a better place. I’m very fortunate to have been treated by two outstanding National Cancer Institute-designated Cancer Centers, and my success in fighting this terrible disease will be a reflection of that.
The cellular therapy programs at Vanderbilt-Ingram Cancer Center, Monroe Carell Jr. Children’s Hospital at Vanderbilt, and the VA Tennessee Valley Healthcare System have received reaccreditation from the Foundation for the Accreditation of Cellular Therapy (FACT).
Founded in 1995, FACT establishes standards for high-quality medical and laboratory practice in cellular therapies. FACT is a nonprofit corporation co-founded by the International Society for Cell and Gene Therapy and the American Society for Transplantation and Cellular Therapy for the purposes of voluntary inspection and accreditation in the field of cellular therapy.
“FACT is an internationally recognized accrediting body for hospitals that offer stem cell transplant and cellular therapy, and recognition by FACT indicates that the accredited institution has met the most rigorous standard in every aspect of cellular therapy,” said Adetola Kassim, MBBS, MS, professor of Medicine and clinical director of the Adult Stem Cell Transplant Program. “This covers the entire spectrum of stem cell therapy from clinical care to donor management, cell collection, processing, storage, transplant, administration and cell release.”
The Vanderbilt and VA Tennessee Valley Healthcare System programs received accreditation notification April 14 after on-site inspections in October 2024. The accreditation is effective for three years.
Cancers that were once almost always fatal for children are now curable because of advancements in cellular therapies that Vanderbilt-Ingram Cancer Center pediatric oncologists and hematologists have introduced to Tennessee.
The advancements have included improvements for HLA (human leukocyte antigen) matching with stem cell donors, better medicines for infection prevention, new therapies for graft-versus-host disease (GVHD) and CAR-T therapies.
“We were one of the first sites in the state to be able to use CAR-T to treat our patients, and that’s really been a big game changer for some of our patients who had relapsed or refractory leukemia that would have otherwise been fatal,” said Carrie Kitko, MD, Ingram Professor of Pediatric Oncology and medical director of the Pediatric Stem Cell Transplantation Program.
The program has established itself as a leading innovator in preventing and treating GVHD, which occurs when donor immune cells begin attacking the stem cell recipient’s healthy tissue. Vanderbilt-Ingram is part of an international consortium called MAGIC that has developed risk-stratified treatments according to both GVHD symptoms at presentation and biomarkers, or certain proteins in their blood, to predict patients who are more or less likely to respond to treatments for GVHD.
“We have had several clinical trials to potentially improve outcomes for patients with GVHD. If you’re a low-risk patient, we’ve been able to offer trials where we avoid steroids, which are normally what we use to treat our GVHD patients, but steroids have lots of side effects that can be quite unpleasant,” Kitko said.
“You can identify those low-risk patients that don’t need steroids, and you can use a less toxic therapy. And then for the high-risk patients, if we know that they’re unlikely to respond to steroids, why wait for them to fail on steroids. We have been able to offer some of these studies to both pediatric as well as adult patients.”
Kitko is the senior author of a study published in 2024 in The New England Journal of Medicine that led to the Food and Drug Administration approving a new drug for recurrent or refractory chronic GVHD. Patients who were given the drug, axatilimab, had an overall response rate of 74%.
“Now, patients have access to more drugs to treat chronic GVHD, which is really a very morbid condition for many of our patients,” she said. “Moderate to severe chronic GVHD really impacts their quality of life and their ability to do normal day-to-day activities.”
Vanderbilt-Ingram Cancer Center is committed to doing more than treating patients with the latest advancements in cellular therapies. Its physician-scientists are focused on expanding their use for more types of cancer and improving response rates among patients.
Andrew Jallouk, MD, PhD, assistant professor of Medicine, is a translational scientist committed to hastening the progression of laboratory discoveries into better treatments for cancer patients. After finishing an undergraduate degree in biomedical engineering and chemistry from Vanderbilt University, he then obtained a dual MD/PhD degree from Washington University in St. Louis followed by a clinical fellowship at MD Anderson Cancer Center in Houston, where he conducted clinical and laboratory research on the use of engineered cellular therapies for lymphoma. He was recruited to Vanderbilt-Ingram in 2023.
Q: Can you describe the role of a translational scientist in the medical realm?
A: Historically, there have been clinical investigators that run clinical trials, and there have been physician-scientists who work in the lab. That’s been great, but what this field needs are people who can speak both languages and really bring the two together. That’s what we are trying to do.
Q: What’s the next step for the advancement of cellular therapies?
A: With cellular therapies, we take the immune cells out of the patient, reprogram them and then put them back in. What’s really unique about this is the manufacturing step. If the treatment doesn’t work for some patients or is not working as well as we would like, we can figure out what’s going on there and then make tweaks during the manufacturing process to improve the therapies. What fascinates me about this technology is the bench-to-bedside (science lab progression to clinical use) and back to bench perspective. We’re putting these cellular therapies into patients, and we can see what’s happening — what is going well and what is not going well; what are the toxicities and how can we avoid these toxicities. We have a lot of ability to then feed that information back into the lab, optimize our manufacturing, optimize our patient selection and really try to make things better.
Q: What you’ve described is CAR-T therapy or chimeric antigen receptor T cell therapy. Isn’t that primarily for blood cancers?
A: There are no CAR-T cells approved for any solid tumors right now. There are other therapies called TIL therapies or TCR therapies. One of those, TIL, has just been approved for melanoma, and there’s a TCR therapy that’s been approved for synovial sarcoma. They all fall within the realm of immune therapies, where you’re using cells to fight cancer. The issue with that historically has been that solid tumors have a hostile tumor microenvironment, so it’s been hard to develop immunotherapies that overcome that.
Q: How much does your training as a biomedical engineer play into what you do?
A: I think it helps in terms of speaking both languages. I have a lot of great scientific training and give a lot of credit to my mentors, both in undergraduate and graduate school and throughout my training. The engineering background has really made it easy to pick up the concept of cellular engineering and the technologies that are associated with that. The PhD work that I did gave me a lot of experience and insight into various laboratory techniques, so it’s made it easier to keep doing what I’m doing on the laboratory end even when I have responsibilities on the clinical end as well.
Cancers that were once almost always fatal for children are now curable because of advancements in cellular therapies that Vanderbilt-Ingram Cancer Center pediatric oncologists and hematologists have introduced to Tennessee.
The advancements have included improvements for HLA (human leukocyte antigen) matching with stem cell donors, better medicines for infection prevention, new therapies for graft-versus-host disease (GVHD) and CAR-T therapies.
“We were one of the first sites in the state to be able to use CAR-T to treat our patients, and that’s really been a big game changer for some of our patients who had relapsed or refractory leukemia that would have otherwise been fatal,” said Carrie Kitko, MD, Ingram Professor of Pediatric Oncology and medical director of the Pediatric Stem Cell Transplantation Program.
The program has established itself as a leading innovator in preventing and treating GVHD, which occurs when donor immune cells begin attacking the stem cell recipient’s healthy tissue. Vanderbilt-Ingram is part of an international consortium called MAGIC that has developed risk-stratified treatments according to both GVHD symptoms at presentation and biomarkers, or certain proteins in their blood, to predict patients who are more or less likely to respond to treatments for GVHD.
“We have had several clinical trials to potentially improve outcomes for patients with GVHD. If you’re a low-risk patient, we’ve been able to offer trials where we avoid steroids, which are normally what we use to treat our GVHD patients, but steroids have lots of side effects that can be quite unpleasant,” Kitko said.
“You can identify those low-risk patients that don’t need steroids, and you can use a less toxic therapy. And then for the high-risk patients, if we know that they’re unlikely to respond to steroids, why wait for them to fail on steroids. We have been able to offer some of these studies to both pediatric as well as adult patients.”
Kitko is the senior author of a study published in 2024 in The New England Journal of Medicine that led to the Food and Drug Administration approving a new drug for recurrent or refractory chronic GVHD. Patients who were given the drug, axatilimab, had an overall response rate of 74%.
“Now, patients have access to more drugs to treat chronic GVHD, which is really a very morbid condition for many of our patients,” she said. “Moderate to severe chronic GVHD really impacts their quality of life and their ability to do normal day-to-day activities.”
The cellular therapy programs at Vanderbilt-Ingram Cancer Center, Monroe Carell Jr. Children’s Hospital at Vanderbilt, and the VA Tennessee Valley Healthcare System have received reaccreditation from the Foundation for the Accreditation of Cellular Therapy (FACT).
Founded in 1995, FACT establishes standards for high-quality medical and laboratory practice in cellular therapies. FACT is a nonprofit corporation co-founded by the International Society for Cell and Gene Therapy and the American Society for Transplantation and Cellular Therapy for the purposes of voluntary inspection and accreditation in the field of cellular therapy.
“FACT is an internationally recognized accrediting body for hospitals that offer stem cell transplant and cellular therapy, and recognition by FACT indicates that the accredited institution has met the most rigorous standard in every aspect of cellular therapy,” said Adetola Kassim, MBBS, MS, professor of Medicine and clinical director of the Adult Stem Cell Transplant Program. “This covers the entire spectrum of stem cell therapy from clinical care to donor management, cell collection, processing, storage, transplant, administration and cell release.”
The Vanderbilt and VA Tennessee Valley Healthcare System programs received accreditation notification April 14 after on-site inspections in October 2024. The accreditation is effective for three years.
The Vanderbilt-Ingram Cancer Center 26th Annual Scientific Symposium, held April 22, focused on the theme “Artificial Intelligence in Cancer Research and Clinical Care.” The event also highlighted the achievements of trainees with a research poster competition and the announcements of graduate and undergraduate students of the year.
Jared Rhodes discusses the findings of his research with Alain Gobert, PhD.
Xiaopeng Sun, PhD, co-graduate student of the year, speaks about his research studying blood cell markers related to immunotherapy outcomes.
Pictured left to right are Christopher Willliams, MD, PhD, associate director for Research Education at Vanderbilt-Ingram, Michael Robinson, MD, Guochong “Damon” Jia, PhD, postdoctoral scholar of the year, Katie Brown, PhD, co-chair of the Scientific Symposium, Candace Grisham, MS, PhD, co-graduate student of the year, Xiaopeng Sun, PhD, co-graduate student of the year, Jared Rhodes, co-chair of the Scientific Symposium, and Ben Ho Park, MD, PhD, director of Vanderbilt-Ingram.
Joshua Bauer, PhD, talks with Nourhan Aboomar about her research poster.
Cancer patient Easton Reeder (center) who has undergone surgery and chemotherapy for pilocytic astrocytoma — a type of brain tumor — shared about his experiences living with cancer. He received a jersey signed by the Vanderbilt Commodores baseball team, including pitchers Cody Bowker, left, and Connor Fennell.
Candace Grisham, MS, PhD, co-graduate student of the year, speaks about her research involving treatment challenges for tumors that develop within the membranes surrounding the brain and spinal cord.
Lili Liu, PhD, (right) and Huy Le Duc, PhD, chat in front of Duc’s research poster.
The dietary supplement nicotinamide has been recommended by dermatologists for people with a history of skin cancer since 2015, when a clinical study with 386 participants showed that those who took the vitamin B3 derivative developed fewer new occurrences.
However, data to validate those findings in a larger study group has been lacking because nicotinamide can be purchased over the counter without being entered into patients’ medical records.
In a new study published Sept. 17 in JAMA Dermatology, researchers found a way to get that data by analyzing records from the Veterans Affairs Corporate Data Warehouse. Nicotinamide is on the VA’s official formulary, so the researchers checked the outcomes of 33,833 patients for their next skin cancer diagnosis following baseline treatment with 500 milligrams of nicotinamide twice daily for longer than 30 days. They looked for occurrences of basal cell carcinoma and cutaneous squamous cell carcinoma.
The researchers compared 12,287 patients who received the treatment with 21,479 who did not. Overall, there was a 14% reduction in skin cancer risk. When nicotinamide was taken after a first skin cancer, the risk reduction rose to 54%, but the benefit declined with treatment initiation following subsequent skin cancers. The risk reduction was much larger for squamous cell carcinoma.
Lee Wheless, MD, PhD
“There are no guidelines for when to start treatment with nicotinamide for skin cancer prevention in the general population. These results would really shift our practice from starting it once patients have developed numerous skin cancers to starting it earlier. We still need to do a better job of identifying who will actually benefit, as roughly only half of patients will develop multiple skin cancers,” said the study’s corresponding author, Lee Wheless, MD, PhD, assistant professor of Dermatology and Medicine at Vanderbilt University Medical Center and a staff physician at VA Tennessee Valley Healthcare System.
The researchers were also able to ascertain the outcomes of 1,334 patients who were immunocompromised due to having received solid organ transplants. Among solid organ transplant recipients, no overall significant risk reduction was observed, although early nicotinamide use was associated with reduced occurrences of cutaneous squamous cell carcinoma.
Wheless received research support from a Department of Veterans Affairs grant (IK2CX002452). Other Vanderbilt authors on the study are Katyln Knox, Rachel Weiss, Siwei Zhang, PhD, Lydia Yao, MS, Yaomin Xu, PhD, and Kyle Maas.
