[Text on screen: WEXMED The Ohio State University Wexner Medical Center] [Text on screen: Rosa Lapalombella, PhD Associate Professor, College of Medicine Member, Leukemia Research Program, OSUCCC Director, Pelotonia Fellows Program] Peter Mohler, PhD: It's my pleasure to introduce Associate Professor, Dr. Lapalombella, who really is a great leader for our program, a true colleague, and is one of these people that really makes our programs better, so welcome. [Applause] [Mohler, PhD, exits the stage and Rosa Lapalombella, PhD, enters. The stage has a backdrop with the following text: WEXMED NAPLES] Rosa Lapalombella, PhD: Good evening, and thank you Dr. Mohler for the very kind introduction. So today, I would like to share with you a story of opportunity. I'm gonna start, take you back to 1996 when I left my hometown in the southern part of Italy. And I was the first one, and ended up being the last one, only one of my family went to college. I went to University of Bologna. At that time, I wanted to study biological science, but I didn't know where the future was gonna take me. And that's when a life-changing event happened. I lost a very good friend to a type of cancer called leukemia. And at that time, it was very unacceptable and it was really hard to explain. But I knew back then that I was gonna make a difference in my life and I wanted to do something for this type of leukemia. So that's when I enrolled in a PhD program in biotechnology, graduated 2006. And that's when I was really fortunate to win a fellowship of six months to just conduct a research experience abroad. And that, along with my passion for leukemia, it took me to join the laboratory of Dr. John Byrd, a very famous researcher studying a type of leukemia called chronic lymphocytic leukemia. So six months down the road, I was having fun, research was going great, but my fellowship was ended. And that's when, thanks to the opportunity made possible by one of Dr. Byrd donor, I was able to stay longer, and here I am 13 years later. [Slide is titled "~21,000 New US Cases 2018" and includes an image of an elderly person holding onto a walker and a graphic comparing the blood components of someone with leukemia to that of the blood of a healthy individual.] So chronic lymphocytic leukemia is the most prevalent type of adult leukemia. Indeed, just last year, in the US, about 20,000 new cases of this disease were diagnosed. This is a slowly growing cancer and is characterized by the accumulation of those cells that you heard from Dr. Oltz. They're called B cells and when they build out throughout the body, what they do, they don't function normally. [Microscopic image of cells is shown to the left and a diagram titled "CLL SYMPTOMS" is shown to the right detailing symptoms with small images corresponding to each. These symptoms include swollen lymph nodes, nose bleeds, bleeding easily, night sweats, weight loss, fatigue and loss of appetite, bone pain, severe infections, fever, chills, red spots on skin, and spleen or liver enlargement] And, at the very beginning, the disease may show no symptoms,but later on, you know, in the evolution of this disease, there are like very, very severe symptoms, like bleeding, weight loss, recurrent infections, that can really compromise any normal activities of those patients. They really require treatment at this point. Now, we are very fortunate that, really, the treatment landscape of CL, this disease, in the past ten years, has really witnessed a lot of evolution. We went from chemotherapy at the time I joined the lab, with all the toxicity associated with that, to very specific therapy, which we call targeted therapies, that really only hit the tumor cells and leave all the healthy cells attached. [The slide has the text "leukemia" and shows various images associated with the disease including medications, an antibody, stethascope, and a magnifying glass identifying blood cells on a human outline] And just to give you an example for CL, the most, you know like, beautiful example is a story of Ibrutinib. [Image of Ibrutinib is shown along with an image of a pill opening to expose a punching glove that is punching and breaking a nearby cell] It's a pill that patients take every day for their entire life. And what this pill does, it kills the tumor cells and allow these patients to live a longer life without the toxic effect of chemotherapy and just being active. How amazing is that? This was just incredible. [Applause] Thank you. Now, the problem is that, despite all of this, they have to take the pill for their entire duration of life, because this disease is still uncurable. So there are some patients that, unfortunately, they don't respond to Ibrutinib, others, they stop responding, and others, their leukemia transform to a different type of cancer called lymphoma, a process known as Richter transformation. [A microscopic image is shown comparing a lypmhocyte with lymphoma to one with CLL] Now, when this happens, the life expectation becomes really short, 'cause we really don't have anything to do for this type of patient. Despite all the progress in CL, there's nothing been done for Richter. Now imagine the devastation of these patients and their loved one that not only have experienced cancer once, but now they're fighting it twice. [Image of an ON switch is overlayed on top of the microscopic image shown previously of lymphoma compared to CLL] And imagine how impactful it would be if we'd be able to identify a switch that really is driving this transformation process. We'll be potentially able to control it, predict it, or even cure it. [Image of an OFF switch is overlayed on top of the microscopic image shown previously of lymphoma compared to CLL. Red X's are also placed on all of the cells with lymphoma.] So the problem we are facing trying to solve this puzzle is that we don't have any models to study Richter transformation in the lab—there are just none. The only thing we have is patient's derived samples that we can study. And we are very fortunate at OSU because we see the larger volume in all US of patients with this disease, so we have access to those samples. And just by looking at samples at the time of the CL and at the time of Richter, we were able to identify a few candidates that we thought we could direct target therapies to it, and by doing that, we'll be blocking this transformation process. Now, all of those studies, we really wanted to do it, but they're very expensive. And for someone like me starting the lab, I didn't have the money to do that. So, and for those of you who are not familiar with getting your science funded through the National Institute of Health, or any other foundation for that matter, this is a very tough process. I explained it to my nine-year-old; she came up with this picture. [Drawing of individuals in lab coats holding swords and blocking the path of a scientist holding a paper with writing] [Laughter] Those are the reviewers. They won't kill you, but it will kill your application. And if you ask any scientists, they will tell you, you really have to have most of your science done to be able to convince any reviewers to fund your science. So in other words, there's little to no room for high risk, high rewards ideas. Do you still believe in research grant? [Drawing of two creatures at a lab desk are shown. The first says, "I Asked SANTA for a research Grant." The other creature is shown with steam coming out of its head and saying, "you still BELIEVE IN Research Grants?" with "*mind blown* also written beside the creature] [Laughter] So well, here is opportunity number two for me. About ten years ago, 2,000 cyclists, they rode one event in Columbus that had one goal: to help cure cancer. They call it Pelotonia. Ten years later, this event is going strong. It became the largest community-based philanthropic event. And why am I telling you all of this? It's because Pelotonia had a program to fund high risk, high reward ideas, and that's what gave me the first money to do my research and just to produce preliminary data. And look what happened. Even three years later, the return of investment was amazing. [Graphic on screen shows text around a large circle with each phrase or word having a corresponding image. The text shown: Invited talks, Hired personnel, Mentorship, Publications, New drugs to clinic, Lab space, Funding, Collaborations] I was able to expand my lab, hire more people, produce some papers, get more funding—50 times more the original investment—and also develop new drugs, new concept for clinical trial. Now, you may be all impressed by this, but, you know, if you ask anybody, nobody is ever getting their funding through the process I just explained to you. And what makes OSU so special is that in our culture, we have this culture of mentorship where we start very early with our students to really, you know, engage them and get them through this pipeline. And how can we do that? Well we can do that because we have very lucky, we are fortunate, to have many philanthropic-based fellowships that allowed us to recruit the students and to take those through the pipeline. And what you don't realize is for many, this is the very first introduction to medical research. For others, this really launches the beginning of impressive careers. [Text on screen: Sponsored Fellowships (OSU) Gynecology Oncology Fellowship The Hendrix Fellowship Schweitzer Fellow Support Fund for Fellowship Block Surgical Oncology Fellowship Rinkov Ovarian Cancer Fellowship Seilhamer Lung Cancer Fellowship Stump Pancreatic Cancer Research Fellowship] So, just to explain you this, this is some of the amazing fellowship we have. I really wanna highlight three stories to tell you how impactful all you do is for these people. [Image of a woman is shown to the left along with the text: Dalia ElGamal, PhD, Assistant Professor. A research article entitled "Targeting BRD4 in Chronic Lymphocytic Leukemia (CLL) Disease Progression to Richter's Transformation (RT)" is shown to the right] So Dalia EIGamal, she is originally from Egypt, got her PhD in Austria, and in 2013, she landed in my lab. She was my first postdoc. Now, because of her visa status, she was not eligible to get in any other fellowship except for Pelotonia. So her research, she was very fortunate to be able to have two-year salary support to study Richter transformation. Well, look what happened five years later. Her research went strong. She published in a very procedural journal. She was able to receive funding through the National Institute of Health through a career development award. And most importantly, she was offered a job to start her own lab as an associate professor. [Image of a woman is shown to the left along with the text: Shauna Collins, MD. A research article entitled "Elotuzumab directly enhaces NK cell cytotoxicity against myeloma via CS1 ligation: evidence for augmented NK cell function complementing ADCC" is shown to the right along with an image of Empliciti (elotuxumab) and an FDA seal of approval] Or the story of Shauna Collins. This was a young Alabama student that joined OSU in 2011 as an undergrad. She joined the laboratory of Dr. Don Benson, I know some of you in this room know, to do some research of another type of blood cancer called multiple myeloma. Now, what's very special about Shauna is that she didn't know she wanted to do medicine. She knew she wanted to do some, you know, science. And her research was so impactful that she was able to present as first author in a very prestigious international meeting and also published her own paper, first author, which is very uncommon for undergrad. But most importantly, it was Shauna work that really led to the approval of this drug called Elotuzumab for patients with multiple myeloma, because it really was showing improvement in survival. Because of this very early experience, Shauna decided to enroll in the medical program, and now she is leading a career in pediatric hematology oncology. And another beautiful example comes from the Hendrix program. This is a fellowship sponsored by the Burr family, and it brings students from a very small college, Hendrix, which is the sponsor alma mater to OSU, just to let them experience what it feels to be in a large and renowned university. [Image of a woman is shown to the left along with the text: Sydney Fobare, MD, PhD Student (OSU) "The Hendrix Summer Program introduced me to the world of medical research as well as the life as a physician-scientist."] And by doing this, we were very grateful to have a student like Sydney Fobare. You know, she's originally from Nashville, went to Hendrix for, you know, conducting her Bachelor of Art in Chemistry. And then she was able to come to our lab for two summers in a row, 2015 and 2016, for two 10 weeks long experience. Very short-time, you know, period, but, in that time, she was able to contribute so much for a new drug for leukemia, that again, she was able to present in this international meeting, a forum of over 20,000 people from all over the world, and published her paper. And now she was exposed to the life as a physician-scientist, and that's what she wants to be. And she just enrolled in an MD/PhD program at OSU. [Image of The Ohio State University Wexner Medical Center campus] So all of this to tell you that we really have an incredible structure at OSU to really mentorship and, you know, take these students from early on. And as I reflect back on my 13 years at OSU, none of this impact on the students, on the institution, on the patients, will really be possible between the support of people like you and the fellowship program. So I really thank you for all you do. [Applause] [Text on screen: WEXMED ]