From the Desk of Dr. Louis M. Weiner

December. Hard to believe. Each passing year whizzes by, seemingly faster than the one that preceded it. So much of the year was dominated by the renewal of our CCSG, which was submitted in May and then defended at our Site Visit on September 12. This past week we got some encouraging news, though the final determinations will be made by NCI over the next couple of months. Our cancer center has never been better, and our future is bright.

I am really excited about the progress in my lab. We now have a paper in review in Nature Immunology describing our findings that fibroblast activation protein (FAP) promotes the migration of human natural killer (NK) cells, and that forced overexpression of FAP by NK cells further promotes their invasion into tumors. This work was initiated by former MD/PhD student Allison Fitzgerald and advanced by current MD/PhD student Rachael Maynard. I’ll submit an R01 on the topic in February. Another paper, led by Zoe Malchiodi, a PhD student in my lab, will be submitted soon, describing the ways pancreatic cancer defeats NK cell invasion. Finally, a clinical trial of a novel combination immunotherapy in patients with advanced pancreatic cancer, based on work initiated by Allison and now continued by Alex Lekan, an MD/PhD student in the lab, is being led by Ben Weinberg and is accruing patients.

Overall, work, while always challenging, is going well. And life on the home front could not be better. We celebrated Hanukkah with two of our kids and their families, and my soul was filled to the brim watching our grandchildren playing with their cousins as they explored their new gifts. My family is the true source of my happiness. I am very, very lucky. The only tinge of sadness was the passing in September of my son-in-law’s father, who was my age — a sobering reminder that life does not come with guarantees. But of course, I have always known that, for I am an oncologist.

So, things are going well. Why, then, do I feel such foreboding, discomfiture, and a sense that the world is going mad? Perhaps because it is. The very foundations of liberal democracy are under attack. While I remain hopeful that it will prevail, I am not so sure.

I just finished reading a very thought-provoking book, “Gangsters of Capitalism,” by Jonathan Katz, exposing the flaws of Americans’ perceptions about the goodness of our country through the life journey of Gen. Smedley Butler, a Quaker Marine (let that contradiction sink in for a second) who participated in many episodes of unsavory American conquest, beginning in 1898 until his conscience led to his emergence as an anti-war activist in the 1930s, fueled by revulsion of what he had seen and done. It seems that some of my liberal democracy conceits were built on literal trails of tears. However, I still believe that liberal democracy, despite its seamy underside, is far more desirable than fascism, which is the current fashionable alternative. 2024.will tell the tale. It starts with an end to intolerance.

I find intolerance to be intolerable. Terrorism is never justified — especially when it leads to the loss of innocents. I don’t believe that hate speech should be protected free speech. I don’t believe that physical intimidation by people or countries is defensible, or that violence or threats of violence are justified except in true self-defense. Intolerance is both the cause and byproduct of extremism, which can lead to senseless injustice and violence. I abhor extremism in all forms .

I guess I am out of step with the times. I find it unimaginable that here, in the 21st century, people face serious consequences for being who they are, rather than for their actions. This country has always had its challenges, but the fabled American “melting pot” has always been more of a bouillabaisse, with each component remaining distinct, yet inspired by the alchemy of our Constitution, yielding a delicious, textured broth. Identity is important, but not if it overpowers the soup. I yearn for a sensible middle, aiming for the common good, leavened by modern sensibilities of inclusivity.

So what do I hope for in 2024? Let’s get the final approval of our CCSG competitive renewal and continued progress in the fight against cancer. Then, how about a reaffirmation of the principles of liberal democracy, just ends to the wars in the Ukraine and Middle East, an embrace of governing for the common good, and the re-emergence of a sensible middle based on tolerance for our fellow humans. Is that too much to ask? It probably is, I am sorry to say. But I am an optimist; at least some of my dreams will come true. I hope yours do, too.

This is my last blog of 2023. Happy Holidays, and Happy New Year. And, as always, stay safe and be well.

Lou

The views, thoughts, and opinions expressed in the text belong solely to the author, and not necessarily to the author’s employer, organization, committee or other group or individual.

I hope you enjoyed the Thanksgiving break. We had a wonderful long family weekend, starting with Thanksgiving at Dave and Kelly’s house (they have more space than we do), with 20 total guests. Then, on Saturday, we celebrated our oldest grandchild’s bar mitzvah (now called a brit mitzvah).

Irrespective of what it is called, it was wonderful in every respect. It is an ancient Jewish coming-of-age ritual that requires a 13-year-old to learn to read and speak a complicated and difficult language, and to prepare a learned commentary (for a 7th grader) on the meaning and modern context of a portion of the sacred text of the Torah. It’s a struggle for anybody who goes through it, but I see it as a wonderful preparation for living a life of the mind with an ethical point of view.

Last week was primarily devoted to working on a new grant. It was initially conceived of as an R21, but I think it has enough meat to qualify as an R01, so I’ll be working on that in the coming weeks.

We snuck away for a quiet weekend in St. Michaels and had a wonderful time, despite the dreary weather. The coming week has a bunch of meetings that can’t wait until after the Christmas break, so I’ll be pretty busy!

For those celebrating Chanukah, Chag Sameach. I wish you light and peace.

Stay safe and be well.

Lou

The views, thoughts, and opinions expressed in the text belong solely to the author, and not necessarily to the author’s employer, organization, committee or other group or individual.

Like most of you, I feel like I am living in a washing machine — tumbling, twisting, hit by unexpected items as the many events of the day, some of them ominous, swirl about. However, I have much to be thankful for as we head into Thanksgiving week.

It goes without saying that I am supremely grateful to my wife and family, each of whom makes my life worth living. I remain thankful for my continued good health and energy, particularly as many of my near-contemporaries have had their struggles. For example, one of our friends succumbed just this week to ALS. Her courageous example reminds me that every day of life is a profound gift that I do not intend to waste

I am thankful to live in a country which, while hugely imperfect, remains the world’s greatest hope and beacon of light.

I am thankful for my wonderful colleagues and friends, whose work inspires me and shines its own beacon of light on the world. I cannot begin to state how grateful I am to the many wonderful people who worked tirelessly to support our NCI CCSG competitive renewal. You will always have a special place in my heart.

I am thankful to have the rare opportunity to contribute to advancing knowledge and patient care through my research. My laboratory remains my happy place, and I cherish my current and many former colleagues who have contributed to that work. I am especially grateful to Sandy Jablonski, who is retiring on December 7. She has been the true constant and foundation of the lab since I moved to Georgetown. Everything we have accomplished has her mark on it. I am looking for Sandy’s successor, but she will never, ever be replaced. Please join me in wishing Sandy happiness and contentment as she enters this new chapter of her life.

There will be no blog next week. Have a happy Thanksgiving, and as always, stay safe and be well.

Lou

The views, thoughts, and opinions expressed in the text belong solely to the author, and not necessarily to the author’s employer, organization, committee or other group or individual.

Greetings on a cool autumn afternoon. Given all the tumult in the world around us, it has been a deceptively peaceful weekend, following a busy, productive week of work. But, I worry.

Mostly, I worry about the increasingly endangered concept of respectful discourse, even when people, principled or otherwise, disagree passionately about important topics. I see degradation of that respect in our government, which no longer is capable of even generating a yearly budget, in our universities, where disagreements have rapidly degenerated into hate speech, and on our streets, where hateful acts based on race, religion and nation of origin are increasingly common.

This is not a new phenomenon to anybody who has studied 19th century American history or has lived through Jim Crow, the Civil Rights era, the far-right movements of the 1930s, the McCarthy hearings and so much more. However, this time it feels different, because in many ways these previous challenges (with the exception of the American Nazi movement before World War II) were home-grown, distinctively American problems.

Today’s challenges certainly retain some of those all-American characteristics, but now that we live in an ever more deeply connected world, we have imported new types of unrest that feel more unstable, angrier and more ominous.

Many of us hope this is a temporary spasm of societal insanity, and that as political turmoil settles down in the United States and issues in the Middle East move toward some form of resolution (probably placing a temporary lid on boiling passions in that region of the world), things will return to “normal,” whatever that is. I am not so sure. The genie has escaped from its bottle and cannot be shoved back in all that easily.

These larger worries carry with them important implications for the work we all do. In times of chaos and turmoil, society invariably takes its eyes off science (except when it serves military objectives). For example, if/when the Congress fails to keep the government open, we will not know the score of our CCSG competitive renewal. We thus will not know what we can expect moving forward until the impasse is resolved. More importantly, what will happen to federal funding of cancer research over the next few years?

I hope my fretting is no more than that, but I imagine that many of you share my angst. More than ever, I feel that my words should be measured and infused with the type of respect that is founded in my personal values and those of Georgetown University. We all have a right to speak our minds and to be true to our ideas and beliefs, but I am determined to avoid contributing to the hate that, like an inferno, destroys everything in its path.

Stay safe, be well and make the world a better place.

Lou

The views, thoughts, and opinions expressed in the text belong solely to the author, and not necessarily to the author’s employer, organization, committee or other group or individual.

I usually write my blogs on Sundays, but will be busy, so I am writing on Saturday evening.

I just returned from San Diego, which is hosting the annual meeting of the Society for Immunotherapy of Cancer. On Friday evening, SITC held a black-tie reception and dinner at the iconic Hotel del Coronado to introduce and celebrate its third class of members of the Academy of Immuno-Oncology. The Academy now has 33 members, with six new inductees, including our own Mike Atkins. He was honored for his innumerable contributions in translating immunology into immunotherapy advances, starting with the development of high-dose IL-2 therapy in the 1980s, continuing to the present day, where he has led the charge to identify the proper way to combine immunotherapy with signaling inhibitors in advanced melanoma.

Mike is in very good company, attesting to the way in which immunotherapy has transformed cancer research and cancer care. Fellows of the Academy include luminaries such as Jim Allison and Tasuku Honjo (immune checkpoints; 2018 Nobel laureates), Mark Davis (T cell receptor structure and function), Lisa Coussens (tumor microenvironment and immune function), Olivera Finn (cancer immunoprevention), Zelig Eshhar (concept of CAR-T cells),Gordon Freeman and Arlene Sharpe (PD-L1 and immune checkpoints), Steve Rosenberg (IL-2, TIL, CAR-T therapies), Carl June (CAR-T therapy for leukemias and lymphomas), Ron Levy (monoclonal antibody therapy) and Bob Schreiber (immune editing), among others. I was honored to be elected to the second class of Fellows last year for my work in monoclonal antibody therapeutics — one of the greatest honors of my career.

Mike accepted his very well-deserved award with grace and humility. I am so lucky to have access to his talent, expertise and perspective on a daily basis, even though he roots for the Boston sports teams! I am better for having him as a colleague and dear friend for more than 30 years, and I know that he makes our cancer center a better place. Congratulations, Mike, for what you have done, for what you do, and for how you will continue to shape a better future for cancer patients.

Stay safe and be well.

Lou

The views, thoughts, and opinions expressed in the text belong solely to the author, and not necessarily to the author’s employer, organization, committee or other group or individual.

World and national events are truly overwhelming, but the sun rises every morning and sets in the evening. I am fully back into the swing of things at work post-CCSG site visit. We’ll get our score shortly after December 1.

The workweek was very busy. One highlight was the 13th annual Dickson Lecture, in fond remembrance and honor of Bob Dixon, who passed away unexpectedly shortly before I moved to Georgetown. Mary Beth Martin was the featured speaker this year, and she did a lovely job. A luncheon followed, but I had to scoot early because I had been exposed to someone with COVID, was developing symptoms of an upper respiratory infection, and did not want to endanger anyone (I later tested negative for COVID, thankfully).

Our son David also was exposed, and as a result we were not able to go to the Eagles-Commanders game at FedExField on Sunday, as we had planned. Following the Eagles’ victory, we decided to overcompensate by going up to Philly this coming weekend to attend the Eagles-Dallas game, which should be a barnburner. Sunday’s win compensated (alas, only a tiny bit) for the Phillies’ epic collapse in the National League Championship Series earlier in the week. I think that, given the options, I would have preferred a Phillies win over an Eagles win, but one does not get to choose.

Our cancer center is doing great, and we are about to submit a couple of important papers from our lab. I genuinely believe that harmless diversions have helped me stay on course. It sounds silly to care about sports when it feels like the world is on fire, and when cancer continues to kill. But it brings me temporary diversion, fellowship, joy (and temporary anguish) in the face of so much sobering reality, and recharges my batteries so I am ready for the challenges of the day.

Stay safe and be well.

Lou

The views, thoughts, and opinions expressed in the text belong solely to the author, and not necessarily to the author’s employer, organization, committee or other group or individual.

Current affairs have necessarily focused on death and destruction and the threat of more violence. So, it was incredibly inspiring and affirming to focus on the sanctity of human life. That is what happened with our second BellRinger ride on Friday and Saturday.

Sequels are not guaranteed hits. But we had another BellRinger blockbuster this past weekend. The energy was palpable on Friday night, Saturday morning and throughout the day. The event was nearly seamless, attesting to the professionalism and dedication of our BellRinger team and our army of volunteers. The quality of the event was first-class all the way. The 25-mile route was fabulous — a lovely ride that was not too strenuous. I hear that the 50-mile route was very challenging due to the wind and a few tough hills near the end. Can’t do much about the weather …

I heard so much praise about the event from people at the 25- and 50-100-mile finishes. This event is worthy of our patients and families, and of Georgetown and Medstar Health. And I loved those cowbells to welcome the riders at the finish lines!

The event was so much fun, but let’s not forget that the funds that were raised support our high-impact research. The more we raise, the more we can do.

We almost broke the thousand-rider mark this year. None of this happens without the incredibly hard work of so many people, but I particularly want to thank Chris Timko, Jonathan Thomas and Kate Colgan for leading the charge. They are absolutely awesome.

Building a brand is hard. So is curing cancer. But we are on our way, and the world is better for it.

I am so grateful for the opportunity to make a difference while having some fun. And, as I write this blog on Sunday afternoon, I am not even all that sore after my ride. If I can ride 25 miles, so can you. So, get ready for next year!

Stay safe, and be well.

Lou

The views, thoughts, and opinions expressed in the text belong solely to the author, and not necessarily to the author’s employer, organization, committee or other group or individual.

It’s hard to write about work at this moment. I have so many conflicting feelings that I hardly knew what to write this week. As the son of a Holocaust survivor, I imagine that I am more sensitized than many to the horrors of antisemitic violence, and am deeply troubled when I detect indifference or worse in the wake of such horrors.

The inconceivably barbaric assault by Hamas last weekend has been met by widespread condemnation. Polls suggest that the American public generally supports a strong response by Israel to protect itself and its citizens. But I am disquieted by the emerging narrative that focuses less on the innocent victims of terrorist atrocities than on the impact of the Israeli response in Gaza. The two are causally linked, but they are not morally equivalent. Irrespective of the status of Israeli-Palestinian relations, Hamas chose to brutally kill, maim and hold hostages, without direct provocation. They are solely responsible for this crisis.

During the week, I was thinking about an alternate scenario, in which violent extremists from a historically aggrieved group with legitimate complaints set out to kill as many residents of Washington, DC, as they could so they could claim the city as their own. They planned extensively, and on a quiet weekend morning embarked on a lethal rampage in a nice section of town, killing more than 1,000 innocent people, including children and the elderly, taking hostages back to their secure enclave and threatening to broadcast executions of the hostages if they don’t get their way. How would you feel? How would you want our government to respond? Throw up its hands? Do nothing? Give in to the terrorists? I don’t think so.

Yet that is what some, including students at elite universities, seem to desire. It is not my nature to be on the lookout for antisemitism, but I can’t help feeling that the vehement anti-Israel sentiments floating around since the Hamas attack echo hateful ancient tropes. Universities should be homes for vigorous, open-minded and respectful debate, and everyone ¾ everyone ¾ should feel cared about and welcome. No scapegoats. I fervently hope that the Georgetown community embraces these ideas at this unprecedented, trying time.

As I mentioned in my blog last week, there is an essential difference between terrorism and the complex, confusing issues that have bedeviled the Middle East for a very long time. Violence is not the answer. Murdering babies in front of their parents solves nothing. Eliminating terrorism is necessary if there is to be justice for everyone in the Middle East.

I stand for the end of terrorism and for continued work toward justice. I hope you do too.

Stay safe and be well.

Lou

The views, thoughts, and opinions expressed in the text belong solely to the author, and not necessarily to the author’s employer, organization, committee or other group or individual.

I write this on Sunday night, having taken a blog breather last week. We still await word on the results of our CCSG Site Visit, and I am finally recovering from my lingering non-COVID upper respiratory infection. The Phillies are in the playoffs and doing very well so far, and the Eagles remain undefeated. We will have seen all our kids and grandkids over the long weekend and had a chance to catch up with some dear “lifer” friends too. But it’s hard to feel good about anything today.

Our government is in turmoil, and it’s hard to see how we’ll end up with a budget or anything resembling rational governance given the chaos in the House of Representatives. Political rivals have become bitter enemies, and we all suffer as a result.

Then, there is Israel. An unprovoked brutal assault by Hamas, seemingly with Iran, has wreaked unprecedented carnage amongst innocent civilians, with whole families wiped out, not as a byproduct of war, but as the purpose of the assault. More carnage is inevitable, and Israel no doubt will respond in kind, and then some, aiming to preserve the nation and its future. As for Iran, Hezbollah, other countries in the region, who knows? All I do know is that too many ordinary people, in Israel, Gaza, and elsewhere, trying to live their lives, love their families, do their work and continue the human experiment will have their hopes, dreams and very existences shattered or exterminated.

I am well aware of the many grievances held by both Palestinians and Israelis. Many of them are legitimate and merit continued efforts toward a workable and equitable solution. On the other hand, Hamas has only one objective, the destruction of Israel, and this weekend’s actions reinforce that assessment. Maya Angelou famously noted that when somebody tells you who they are, believe them the first time.

The violence of the coming days may well be painfully necessary, but it will be unbearable for those of us who treasure the sanctity of life. It’s hard to be hopeful at this time, but perhaps this will prove to be a reckoning that ultimately promotes progress. May the painful coming days be followed by an enduring, equitable peace.

Stay safe and be well.

Lou

The views, thoughts, and opinions expressed in the text belong solely to the author, and not necessarily to the author’s employer, organization, committee or other group or individual.

I have been taking off time since the site visit on September 12. I do not expect to get our preliminary results before the possible government shutdown, which would occur on October 1, so we may have to wait a while longer.

We headed to the beach last week, intending to come back today before Yom Kippur this evening. However, our plans were altered because of Tropical Storm Ophelia, which was more or less barreling towards the Delaware coast, with projected torrential rains and high winds on Friday night and Saturday morning. We decided to return home on Friday, and I promptly developed an upper respiratory virus infection, non-COVID division. I am not very ill, though I now have a nagging cough. The beach house appears to have survived.

Hopefully, I will recover in time for Tuesday evening’s Kovach Lecture, to be held in the Copley Formal Lounge at 4 p.m. The lecture focuses on cura personalis and is named in honor of one of John Marshall’s former patients. This year’s speaker is U.S. Rep. Jamie Raskin, congressman from Maryland, who undoubtedly is known to you. Rep. Raskin is a Georgetown Lombardi patient and is now a two-time cancer survivor. As is customary at these events, the lecture is actually a conversation, which this year will be led by me (cough permitting), with participation by Rep. Raskin and his primary hematologist/oncologist, Dr. Joe Roswarski.

I had the privilege of reading Rep. Raskin’s wonderful book, “Unthinkable,” in preparation for this event. Written before his most recent cancer diagnosis, the book chronicles his son Tommy’s suicide, just one week before the tumultuous events of January 6, 2021, and then the second impeachment trial of Donald Trump. Raskin tells a story of amazing personal resilience and fortitude in the midst of nightmarish tragedy. Little did he know that, shortly after finishing his book, another existential challenge was looming.

I have so many questions, and very much look forward to the conversation.

Stay safe and be well.

Lou

The views, thoughts, and opinions expressed in the text belong solely to the author, and not necessarily to the author’s employer, organization, committee or other group or individual.