Symposium ushers in NIH-Lasker Clinical Research Scholars Program

Symposium ushers in NIH-Lasker Clinical Research Scholars Program

By Raymond MacDougall
NHGRI Staff Writer

Dan Kastner, far left, Christine Seidman, Marston Linehan and Charles Sawyers, far right, presented talks at the NIH-Lasker Clinical Research Scholars Program symposium.

The dual role of the physician-scientist is part biomedical research and part clinical care. The National Institutes of Health (NIH) has played an important part in nurturing this breed of expert — who is as comfortable at the laboratory bench as at the bedside — and perhaps, more importantly, spanning the translational divide between the two.

To help perpetuate this training tradition, the NIH announced in December the establishment of the NIH-Lasker Clinical Research Scholars Program. NIH partnered with the Albert and Mary Lasker Foundation (known for the granting the prestigious Lasker Awards in basic and clinical medical research), for this career opportunity. The program will support a select group of exceptional clinical researchers, designated as Lasker Clinical Research Scholars, in the early stages of their careers. The goal is to promote their development to fully independent clinical researchers.

A symposium to kick off the program featuring talks by four exemplars of the physician-scientist experience took place March 31 in the Masur Auditorium on NIH's Bethesda campus.

NIH Director Francis Collins, M.D., Ph.D., NIH Deputy Director of Intramural Research Michael Gottesman, M.D., and National Cancer Institute (NCI) Director Harold Varmus, M.D. set the stage for the symposium with remarks that applauded the new career award. Lasker Board President, Maria Freire, Ph.D., and Board Chairman Alfred Sommer, M.D., matched the tone of exectation. "NIH is a great place for this and putting together a program to support this is timely," said Dr. Collins, cautioning that physician-scientists are a vanishing breed. He predicts that Lasker scholars will be among future Lasker Award and Nobel Prize recipients.

Lasker scholars will receive NIH funding for clinical research for upwards of 11 years. The program combines a period of independent research as a principal investigator in the NIH Intramural Research Program for 5 to 7 years, with the opportunity for additional years of independent financial support either at the NIH or at an extramural research institution. The NIH expects to appoint at least three Lasker scholars in the first year of the program.

NHGRI Scientific Director Dan Kastner, M.D., Ph.D., addresses symposium attendees at Masur Auditorium on March 31.

"The expectation is that this program is going to draw in talented physician-scientist investigators who will come to the NIH and take advantage of the clinical opportunities at the Clinical Center to boost their careers," said National Human Genome Research Institute (NHGRI) Scientific Director Dan Kastner, M.D., Ph.D., one of the four presenters, who came to NIH in 1985 as a rheumatology fellow. "It is a win-win-win situation-for the Clinical Center, the individuals and the wider biomedical research community."

Each of the four science talks presented at the symposium featured a first-person perspective into the experience of accomplished physician-scientists and their unique forays into basic science discovery applied through access to patients in the clinic.

Marston Linehan, M.D., chief of the Urologic Oncology Branch at NCI, described his extensive clinical and bench investigation into the genetic basis of kidney cancer. At the outset of his career, it was widely held that kidney cancer had a single genetic cause. Dr. Linehan's lab is now far advanced in studying several different causal genes for kidney cancer as well as the biological mechanisms that make each form of the disease unique. Some slow growing tumors can be managed and watched but more virulent ones require aggressive treatment. Dr. Linehan's research with patients at the NIH Clinical Center is advancing therapeutic approaches in managing the disease.

Charles Sawyers, M.D., Howard Hughes Medical Institute investigator and chairman of the Human Oncology and Pathogenesis Program at Memorial Sloan-Kettering Cancer Center in New York City, described his early training and being part of a diaspora of peers, from leading research universities to important clinical research positions around the country. His career achievements include a key role in conducting clinical trials for Gleevec (imatinib), a drug that targets the molecular defect in chronic myeloid leukemia, with dramatic arrest of the disease.

For the National Human Genome Research Institute's (NHGRI) Dan Kastner, M.D., Ph.D., his story of prominence in the field of immunology began with a chance encounter in the rheumatology clinic of the NIH Clinical Center. His patient had a recurrent inflammatory condition known as Familial Mediterranean Fever (FMF), caused by an ancient mutation in a gene that Dr. Kaster's laboratory subsequently identified. In the years he studied the disorder, and various other autoimmune conditions, the laboratory and clinic resided in the same complex. "One of the wonderful things about the Clinical Center is the ability to interact with patients and go back again to the bench," said Dr. Kastner.

His laboratory determined the prevalence of another disease, called Beçhet's disease that traces its genetic origins among populations from the Middle East to the Far East, along Marco Polo's ancient silk trade route. "More than silk was traded along the silk route," said Dr. Kastner.

Dr. Kastner's encounter in the clinic early in his career set him on a path to advance the concept of an entire class of unprovoked, inflammation conditions called autoinflammatory diseases. With his own experience as a backdrop and prototype, his rousing endorsement of the NIH-Lasker Scholars Program -"...just absolutely one of the most exciting developments of this new decade at the NIH" - came as no surprise.

Christine Seidman, M.D., Howard Hughes Medical Institute investigator and Thomas W. Smith Professor of Medicine and Genetics at the Harvard Medical School and Brigham and Women's Hospital, described her study of the genetic causes of cardiomyopathy. Among the various forms is hypertrophic cardiomyopathy, which is among the causes of sudden death among youth athletes, a tragic result when the condition goes undetected. Another form of heart condition is dilated cardiomyopathy, in which nuclear membranes in the cells of the heart muscle are distorted. Dr. Seidman has studied this abnormal condition and its genetic cause-mutations in the largest gene in the human genome, called TITIN (TTN). This gene's very size, containing the largest number of exons in any single gene and producing a protein composed of 33,000 amino acids, poses a daunting prospect for biomedical researchers. But over the years, as Dr. Seidman and her collaborators have worked in the laboratory and with cardiac patients, they have made significant progress in knowing where amid this vast gene to look for disease- causing mutations, at the carboxyl end versus the amino proximal end.

In a letter in the NIH Catalyst, NIH Deputy Director of Intramural Research Michael Gottesman, M.D., wrote, "By combining intra­mural and extramural research support, the new program will make careers in clinical research more attractive and per­haps recapture the golden years of NIH intramural research when talented inves­tigators routinely spent formative time here before moving on to leadership posi­tions in academic medical centers."

For more information about the NIH-Lasker Scholars, go to www.nih.gov/science/laskerscholar.