innovations - leading the cure for cancer

SUMMER 2013, INNOVATIONS 1

Hundreds of research collaborations around the world pool the best ideas for fighting cancer

GOINGGLOBAL

LEADING THE CURE FOR CANCER • SUMMER 2013

2 INNOVATIONS, SUMMER 2013

12Pioneering the Next Generation of Melanoma TreatmentsImmune system treatments represent a promising approach to melanoma.

22Global ImpactJWCI scientists collaborate with colleagues around the world in a prestigious research alliance.

The illustration depicts some of the Institute's hundreds of research collaborations around the world including the INCORE study group. See the story on page 22.

16Dr. Donald MortonHaving cherished his own education, Dr. Morton is shaping the careers of young cancer researchers.

18Dr. Delphine Lee and Martin DirksThe Dirks/Doughery Laboratory for Cancer Research is home to some novel ideas about halting and preventing cancer.

20Dr. Junko Ozao-ChoyA young researcher uses her fellowship to investigate why cancer turns deadly.

3Letter from the Chairman of the Board

4JWCI Faculty Listing

5Welcome from the Chief of Medicine

6At the Forefront

10Seeds of Innovation

11What’s Happening

INSIDE

PROFILES FEATURES ON THE COVER

SUMMER 2013

12 18Peggy Maddox says she owes her life to innovative cancer treatment pioneered at JWCI.

The Dirks/Dougherty Laboratory supports the work of Dr. Delphine Lee.

27Memorable Events

31Honor Roll

39Philanthropy


My family has been proud to be a part of the John Wayne Cancer Institute for more than three decades. I continue to be amazed by the talented scientists who work within its walls to demystify the complex disease of cancer and improve the lives of cancer patients worldwide.

Throughout the Institute, researchers are pursuing novel ideas that are transforming the way we think about cancer treatment. From studies that identify blood-based biomarkers for the early detection of colon cancer to therapies that enlist a patient’s immune system to fight advanced skin cancer, our dynamic faculty works at the cutting edge of science. Our future is incredibly bright.

The achievements of the faculty at the John Wayne Cancer Institute are even more impressive because they have been accomplished without the scope of resources available at many larger institutions. It’s more difficult than ever to obtain support for medical research from the federal government, and private contributions have been the lifeblood of the Institute. Our researchers’ progress, described in this issue of Innovations, would not be possible without your support and the contributions of so many donors who share my family’s passion for finding cures for this dreadful disease. I hope you enjoy the new name, look and feel of Innovations (formerly Perspectives).

Patrick Wayne Chairman of the Board of Directors

LETTER FROM THE CHAIRMAN OF THE BOARD

Investing In Our Future

The achievements of the faculty at the John Wayne Cancer Institute are even more impressive because they have been accomplished without the scope of resources available at many larger institutions."

REMEMBERING THE DUKE

THE BIG TRAIL, 1930This movie tells the story of a young trapper named Breck Coleman as he leads a large convoy of covered wagons westward from the Mississippi River.Filmed in black and white, this early "talkie" was originally set to star Gary Cooper, but Cooper was booked, and the role went to John Wayne—his first starring credit. He was 23.Directed by Raoul Walsh, the film also starred Marguerite Churchill and Tyrone Power, Sr.

“When you stop fighting, that’s death.”

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JOHN WAYNE CANCER INSTITUTE EDITORIAL STAFF

Acting President and Chief Executive Officer

Mike Wall

Chief of Medicine Anton Bilchik, MD, PhD

Vice President, Public Affairs and Development

Andy Trilling

Director of Marketing, Public Relations & Communications

Andrea R. Salazar

Marketing Coordinator Angie Johnson

VP, Branded Media Emily S. Baker

Art Director Ajay Peckham

EditorShari Roan

Copy Editor Laura Watts

ContributorsLinda Marsa

Jeannine Stein

PhotographersSiri Berting, Remy Haynes

President & CEO Charles C. Koones

Chairman & Founder Todd Klawin

INNOVATIONSFACULTY

If you have a change of address or would like to be removed from our mailing list, please

contact the Public Affairs and Development Office at 310-315-6111.

JWCI FACULTYGarni Barkhoudarian, MDAssistant Professor of Neuroscience and Neurosurgery Anton J. Bilchik, MD, PhDProfessor of Surgery Chief of MedicineInterim Chief of ScienceChief of the Gastrointestinal Research ProgramMyles C. Cabot, PhDProfessor of BiochemistryDirector of Experimental TherapeuticsLisa Chaiken, MDAssistant Professor of Radiation OncologyMaureen Chung, MD, PhDProfessor of Surgery Director of Margie and Robert E. Petersen

Breast Cancer Research ProgramDirector, Margie Petersen Breast CenterDirector, Breast Oncology Fellowship ProgramMaggie DiNome, MDAssistant Professor of SurgeryAssociate Director of Margie Petersen Breast CenterMark B. Faries, MDProfessor of SurgeryDirector of Complex General Surgical Oncology FellowshipDirector of Melanoma Research and Therapeutic ImmunologyLeland J. Foshag, MDSurgical OncologistDave S. B. Hoon, MSc, PhDProfessor and Director of Molecular OncologyChief of Scientific IntelligenceDirector of Genomics Sequencing

Sharon Huang, PhDAssistant Professor of Molecular OncologyReiko F. Irie, MDDirector of BiotechnologyHitoe Torisu-Itakura, MD, PhDAssistant Professor of ImmunologyDaniel F. Kelly, MDProfessor of Neuroscience and NeurosurgeryDirector of Brain Tumor Center and Pituitary Disorders ProgramDelphine J. Lee, MD, PhDProfessor of ImmunologyDirector of Translational ImmunologyLaurent Lessard, MDAssistant Professor of Molecular OncologyDonald L. Morton, MDDistinguished Professor of SurgeryChief of Melanoma ProgramDirector of Complex General Surgical Oncology FellowshipPeter A. Sieling, PhDProfessor of ImmunologyAssistant Director of Translational ImmunologyMyung-Shin Sim, MS, DrPHAssociate Professor and Director of BiostatisticsFrederick Singer, MDDirector of Endocrinology and Bone Disease Program Roderick Turner, MDProfessor of PathologyJinhua Wang, PhDAssistant Professor of Molecular Oncology

JWCI ADJUNCT FACULTYStan Alfred, MDDermatologyPeter Boasberg, MDMedical OncologyStanley A. Brosman, MDUrologySant P. Chawla, MDMedical OncologyAlistair Cochran, MDPathologyRebecca Crane-Okada, PhDOncology Clinical Nurse SpecialistL. Andrew Di Fronzo, MDSurgical OncologyDavid Elashoff, PhDBiostatisticsRobert Elashoff, PhDBiostatisticsJoshua Ellenhorn, MDAdjunct Professor of Surgery Clark B. Fuller, MDCardiovascular/Thoracic SurgeryEdwin Glass, MDNuclear Medicine Chester Griffiths, MDOtolaryngologyOmid Hamid, MDMedical OncologyVivanti N. Jain, MDPlastic SurgeryJ. Arthur Jensen, MDPlastic Surgery

Peter Jones, MDAdjunct Associate Professor of SurgeryDavid Krasne, MDPathologyRonald S. Leuchter, MDGynecologic OncologyAli Mahtabifard, MDAdjunct Assistant Professor of Thoracic SurgerySilvana Martino, DOMedical OncologyLisa C. Moore, MDAdjunct Assistant Professor of EndocrinologyCarol Nishikubo, MDMedical OncologySteven J. O'Day, MDMedical OncologyJay S. Orringer, MDPlastic SurgeryLawrence D. Piro, MDMedical OncologyLauren L. Reager, MDDermatologyJaime M. Shamonki, MDPathologyIra Smalberg, MDRadiologyMarilou Terpenning, MDAdjunct Professor of Medical OncologyRobert C. Wollman, MDRadiation Oncology


At the John Wayne Cancer Institute, we have long taken great pride in our programs to teach, train and inspire the next generation of physicians and researchers. That practice has served our community and country well, producing hundreds

of talented individuals who are now leaders in oncology with the goal of saving their patients’ lives and preserving their quality of life.

Our commitment to teaching was acknowledged in March by the Accreditation Council for Graduate Medical Education (ACGME), which granted our fellowship program accreditation for complex surgical oncology. Our program is one of the first in the country to receive this distinction and is only one of 13 programs currently approved in the

United States. Graduating fellows will therefore be among the first surgeons ever to become board- certified in surgical oncology.

The recognition by the ACGME is a tribute to the visionary leadership and teaching skills of Donald Morton, MD,

whose remarkable career is featured in this issue of Innovations. Dr. Morton’s world-renowned expertise in cancer and, in particular, melanoma put the Institute on the map a long time ago, attracting the finest students—such as Junko Ozao-Choy, MD, whose story you will also read about in this issue. Like many of our fellows, Dr. Ozao-Choy chose JWCI for her training after hearing about Dr. Morton’s pioneering research. We are grateful that the

fellowship program remains in the capable hands of directors Mark Faries, MD, and Dr. Morton, who will help carry it forward into the future.

This issue of Innovations also tells the less well-known story of our painstaking efforts to collaborate with researchers around the world in order to advance our knowledge of cancer prevention and treatment. You will learn just why international collaboration is vitally important to the field and how fruitful such

relationships can be. We remain deeply grateful for

the support of our donors who make it possible for us to continue a tradition of excellence.

Anton Bilchik, MD,PhDProfessor of SurgeryChief of Medicine and Chief of the Gastrointestinal Research Program

WELCOME FROM THE CHIEF OF MEDICINE

With New Accreditation, A Legacy Continues

This issue of Innovations also tells the less well-known story of our painstaking efforts to collaborate with researchers around the world in order to advance our knowledge of cancer prevention and treatment." p.22

John Wayne Cancer Institute at Saint John’s Health Center is a cancer research institute dedicated to the understanding and curing of cancer in order to eliminate patient suffering worldwide.

Our mission is accomplished through innovative clinical and laboratory research and the education of the next generation of surgical oncologists and scientists.

OUR MISSION


What brought you to the John Wayne Cancer Institute at Saint John’s?

“This is a rare opportunity for a sur-

geon who is also interested in research. One

of the strengths of John Wayne is its involvement in translational research—research that is going to be applied to patients. We see a problem in the clinic, we take

it back to the lab and try to find a solution. Even though breast cancer is a common problem, we see recurring difficulties in the clinic. That is where the research program is focused. We’re always asking: Can we make our treat-ments better? Can we make them specific for individuals? Can we tailor and personalize their breast cancer care?”

Can you explain your re-search on nanoparticles?

“One of the problems in breast

surgery today is we cannot see cancer cells as we operate. We offer patients breast conservation surgery, or lumpectomy, and take out what looks like the entire tumor. However, after we look under the microscope, we see can-cer cells at the margins, and the patient needs a second operation. What we want to do is to attach nanoparticles to breast cancer cells so that they fluoresce—or give off a special light—so we can see cancer cells as we operate.”

What is cryoablation, and how might that become a treatment for breast cancer?

“We’re asking: Do we even need to operate on patients? Instead of operating on cancers, can we freeze them and have the

body take care of it? That’s called cryoablation. It’s been evaluated for non-cancerous breast tumors and now is being studied for invasive breast cancer. What’s unique at John Wayne is that we’re not just looking at whether cryoablation can kill breast cancer cells. We’re looking at whether cryoablation can stimulate an immune response. In other words, can cryoablation turn a breast cancer into a tumor vaccine?”

What other research plans do you have?

“One of the major resources of John Wayne is its tumor repository. Dr. Donald Morton has been saving tumors and blood samples from patients for the past 20 years, and these samples are linked to patient outcome.

AT THE FOREFRONT

Maureen Chung, MD, PhD, joined John Wayne Cancer Institute last year as director of the Margie and Robert E. Petersen Breast Cancer Research Program. She was previously an associate professor in the department of surgery at Brown Medical School in Providence, Rhode Island. After 10 months on the job in Santa Monica, she shares her vision of breast cancer research.

Reaching the Crucial Tipping Point in Breast Cancer Research


We can use these samples to evaluate new genes and proteins, linking their expression to patient outcome without having to wait 20 years. The tumor repository is a unique resource and a credit to the vision of Dr. Morton.”

What is the biggest change you’ve seen in breast cancer treatment and research?

“We have learned that breast cancer is not one disease; it is a conglomerate of many biolo-gies, and we’re getting better at understanding each biology. You don’t want to treat a breast cancer that may respond to minimal treatment with a machine gun.

And conversely, you don’t want to undertreat an aggressive breast cancer. We want to tailor treatments to the biology of the cancer, be more specific with targeted therapies and maximize benefits while minimiz-ing side effects.”

What is happening in terms of learning how to prevent the disease?

“We still have a long way to go. We know that diet and lifestyle influence whether you develop breast cancer and whether the disease recurs. But we’ve never understood why. Now we’re begin-ning to look at how these things interplay to cause breast cancer.”

What excites you the most about where this field is headed?

“Already I’ve seen in my professional career that cancer treatments have gotten better. It’s exciting that we can take this dreaded disease and turn it into a chronic disease. When you talked about breast cancer years ago, there was an immediate thought of losing a breast and perhaps dying. Today it’s about outpatient surgery and maybe not even needing chemotherapy or ra-diation. The idea that we may not need to operate on breast cancer is exciting.”

After several decades of struggling, has cancer treat-ment entered a new phase?

“Yes. We needed to understand how cells worked. It’s very hard to study abnormal cells until you know how normal cells work. Now that we have the human genome sequenced, we’re getting to that crucial tipping point where it’s all coming together. I’m excited to be here. It’s a wonderful time for John Wayne Cancer In-stitute. We have a lot of new ideas and new faculty. Coupled with the foundation already here, we’re expecting great things to happen. And we couldn’t do it without the support of our donors.”

AT THE FOREFRONT

We have learned that breast cancer is not one disease; it is a conglomerate of many biologies, and we’re getting better at

understanding each biology.”


Cancer surgery is an increasingly sophisticated specialty. But few institutions train surgeons in this fine art better

than John Wayne Cancer Institute. In March, the

Institute became one of only a handful of programs in the United States—and one of only two in California—to be accredited for complex surgical oncology as designated by the Accreditation Council for Graduate Medical Education (ACGME).

The ACGME oversees all training programs that may result in board certification,

and only graduates of such programs are eligible to take board examinations. At JWCI, specialty training was pioneered by educators such as Donald Morton, MD, even before fel-lowship programs existed. When the Society of Surgical Oncology standardized a system of evalua-tion for fellowship programs, the program at JWCI was one of the first to be accredited.

Specialized training in surgical oncology is a new board certification of the ACGME. JWCI fellows graduating from the program this year will be the first class to be board-eligible.

“We are delighted that our program had earned this prestigious designation,” said Mark Faries, MD, program director of the JWCI Surgical Oncology Fellowship Program and director of the Melanoma Research Program. “It is a testament to the quality of education the Institute provides and allows our graduates to achieve the highest level of certification. We take great pride in the success of our graduates, who are now leaders in surgical oncology throughout the nation. This accreditation assures our fellows can continue to be leaders into the future.”

Translational medicine. That’s the term used for moving knowledge attained in research laboratories to patients’ bedsides as rapidly as possible. The potential to turn pioneering

therapies into life-saving treatments is on full display at the John Wayne Cancer Institute Molecular Oncology Laboratory. Researchers are studying cancer at its most basic level: the molecules that cause tumors to

behave in specific ways.The research is augmented by

a technology called fluorescence-activated cell scanning (FACS). A machine separates cells that are phenotypically different from

each other. It identifies how many cells have expressed key proteins and how much these proteins have been expressed—details that help unravel the mysteries of cancer.

JWCI will soon replace its

current 11-year-old cell-sorting machine with a new FACS ma-chine. The upgrade in technology will help the Institute recruit top scientists and continue to reap the benefits of translational medi-cine. JWCI wishes to thank the

generosity of John Wayne Cancer Institute Auxiliary, Roy E. Coats Memorial Fund/Laura Coats and Thom Schulz, Mary Ann and Marvin Weiss, and Maria Lim McClay for their contributions toward this important acquisition.

Surgical Oncology Fellowship Program Receives Prestigious Accreditation

AT THE FOREFRONT

Accreditation Council for

Graduate Medical Education (ACGME)

JWCI researchers embrace a new cell-sorting machine.Accelerating Research at the Molecular Level

The upgrade in technology will help the Institute recruit top scientists and continue to reap the benefits of translational medicine.


Mastectomy rates are rising in the

United States, but more women are also choosing to have breast reconstruction surgery, according

to an analysis by Elizabeth Arena, MD, a

surgical oncology fellow at John Wayne Cancer Institute.

Overall, the rate of breast reconstruction rose from 13% in 1998-99 to 27% in 2008-09. The increase is likely due in part to a federal law mandating insurance coverage for breast reconstruction that was passed in 1998.

Dr. Arena used data from the federal SEER (Surveillance Epidemiology and End Results) program to explore trends in reconstruction. She found the highest rates of reconstruction were among more affluent, non-Hispanic whites who live in metropolitan areas. The lowest proportional increase in reconstruction rates was in black women. Dr. Arena also found that the type of reconstruction surgery has changed. While tissue transfer was the most prevalent choice in 1998-99, implant reconstruction was more popular in 2008-09.

“I think women are probably better educated about

reconstruction compared to when we were first collecting data,” says Dr. Arena, who presented the study in January at the Southern California chapter of the American College of Surgeons meeting. “But certain groups are potentially benefitting more from the law than other groups. It leads to the question: What kind of access are women having to reconstruction? How much is patient choice, and how much has to do with having access to the option?”

Dr. Maureen Chung was the senior investigator of the study, which was supported by the Margie and Robert E. Petersen Breast Cancer Research Foundation.

More Women Undergo Breast Reconstruction

Following Mastectomy

A New Treatment Targets Cancer In The Liver

Breast reconstruction surgery after mastectomy has become more accepted, but rates are higher in white women compared to other groups.Source: John Wayne Cancer Institute

27.8%Caucasian

19.7%Hispanic/Latino

20.2%African-American

18.2%Asian/Pacific Islander

19.5%Amer. Indian/ Alaska Native

14.8%Caucasian

10.6%Hispanic/Latino

12.5%African-American

6.7%Asian/Pacific Islander

7.3%Amer. Indian/ Alaska Native

2008-09Average 27%

1998-99Average 13%

Researchers at John Wayne Cancer Institute at Saint John’s Health Center continue to pioneer cancer treatments that are being used around the world. Mark Faries, MD, director of JWCI’s melanoma research program, has helped develop a treatment called “isolated liver perfusion” and has been training other surgeons in England, Germany and France to perform this cutting-edge procedure.

Oncologists know that advanced melanoma (skin cancer) tends to spread more often to particular areas, including

the liver—a vital organ. This innovative, interdisciplinary technique, called hepatic perfusion, involves physically isolating blood vessels leading to and from the liver and then delivering chemotherapy directly to the organ in doses far higher than patients can normally tolerate. By isolating the blood vessels, the poisonous therapy doesn’t escape into the body.

Using this method, Dr. Faries and other researchers in the United States have demonstrated remarkable responses in patients whose tumors were resistant to

all other forms of therapy. Saint John’s Health Center is the only site on the West Coast approved to perform this procedure.

“It sounds complex, but this treatment is really just a combination of fairly standard techniques,” says Dr. Faries. “The problem with melanoma is that it is fairly resistant to chemotherapy, and the amount of chemotherapy we have to use to kill the melanoma is probably enough to kill the person as well. But this method enables us to target the liver without harming the patient.”

AT THE FOREFRONT


• Tumor-infiltrating lymphocytes. Mark B. Faries, MD, is leading therapeutic immunology research in a new JWCI laboratory. He hopes to develop personalized melanoma cancer treatments using immune cells derived from a patient’s tumor—a strategy called tumor-infiltrating lymphocytes. Dr. Faries envisions a process where adoptive immunotherapy can be simplified and become more effective.

• Overcoming drug resistance for the treatment of cancer. Sometimes chemotherapy to treat breast cancer is not as effective as it could be, because the cancer cells become resistant to a drug. Myles C. Cabot, PhD, director of the Department of Experimental Therapeutics, is focusing on a method to overcome drug resistance using nanotechnology to deliver drugs and molecular agents to breast cancer cells. Dr. Cabot and his colleagues are currently testing nano-agents capable of delivering tumor-toxic doses to cancer cells.

• Earlier cancer detection through the study of genetic changes and blood tests. Is it possible to detect breast cancer with a blood test? Researchers in the Department of Molecular Oncology believe it may be. Dave S. Hoon, MSc, PhD, is pursuing research on a technology that will isolate breast cancer cells in blood and reveal genetic changes that hint at the disease in its primitive stages. The research could lead to a better understanding of how cancer cells invade a new tissue. Moreover, by collecting blood samples and following patients, researchers hope to learn how these biomarkers affect disease progression.

• The role of bacteria and viruses in breast cancer and prevention of the disease. Delphine J. Lee, MD, PhD, is also looking at how bacteria living in the intestines can contribute to cancer. Bacterial and viral infections may contribute to cancer-promoting changes in breast duct cells. A better understanding of the role of viruses and bacteria could yield methods to prevent infection and block cancer from developing.

SEEDS OF INNOVATION

Your Private Funding Can Help Launch Promising Research Projects John Wayne Cancer Institute’s Seeds of Innovation program is a remarkable opportunity for individual donors to help spark important new findings in cancer research. The funds permit faculty at the Institute to turn novel ideas into large, promising research projects aimed at advancing the diagnosis, treatment and prevention of the disease. Unlike government grants, which are typically restricted to pre-established projects, the Seeds of Innovation program is entirely funded by private support, allowing scientists to dream big yet start small.

Seed grants have been vital to the development of innovative treatments pioneered at the Institute that are making an impact on cancer patients around the world today.

For more information about these and other programs in need of funding, please call JWCI at 310-315-6111.

Projects in need of funding include:


WHAT’S HAPPENING

August 3Buehrle Golf ClassicMissouri Bluff Golf Course Saint Charles, MOThe Buehrle Golf Classic, the premier fundraiser of The Buehrle Family Foundation, will benefit JWCI as well as other institu-tions. Proceeds from the tournament will benefit breast and colon cancer research in memory of Sharon Buehrle and Alan Pinkstaff. The two-shotgun event includes more than 300 participants.

December 8JWCI Benefactors Dinner Four Seasons Hotel, Los AngelesThe Institute will honor its generous annual and major donors who have supported innovative cancer research at the highest levels of giving.

October 1FFANY Shoes on SaleWaldorf Astoria, New York CityThe John Wayne Cancer Institute is honored to be a partner at the 20th Annual QVC Presents “FFANY Shoes on Sale” event. To date, the Fashion Footwear Association of New York Charitable Organization (FFANY) has contributed more than $5 million to JWCI to support innovative breast cancer research that has helped eliminate patient suffering for women around the world.

October 17JWCI Auxiliary Annual Boutique and Membership Luncheon Honoring Susan Love, MD and Patricia EltonBeverly Hills Hotel, Beverly Hills The annual boutique and lun-cheon help support the operations of the JWCI Auxiliary, which for 28 years has raised money for Institute projects.

September 7-8Avon Walk for Breast CancerSanta BarbaraThe Santa Barbara coastline and stunning Santa Ynez Mountains provide the backdrop for the two-day, 29-mile Avon Walk. The event, launched in 2003 by the Avon Foundation, raises funds for breast cancer programs. The John Wayne Cancer Institute is proud to partner with Avon as a Medical Sponsor and as a beneficiary. Thanks to our dedicated walkers and volunteers who support this incredible event.

October 12Saint John’s Health Center Caritas GalaBeverly Wilshire Hotel, Beverly HillsEach year, the Saint John’s Foundation and the Irene Dunne Guild host the Caritas Gala to honor those who demonstrate compassion and concern for others through exceptional service to the community. Proceeds from the Caritas Gala benefit the Health Center’s programs and services such as the Child and Family Development Center, Women’s Health Services and the Irene Dunne Guild Gift Shop.

November 912th Annual Cathy ClassicKissimmee Bay Country Club, Kissimmee, FLHosted by the Hasselberger family, this annual golf tournament celebrates the life of the beloved Cathy Hasselberger. This 12th annual tournament raises much-needed funds to support mel-anoma research at John Wayne Cancer Institute at Saint John’s Health Center. If you’re in the Sunshine State, grab your clubs and join us on the green!

November 23Associates for Breast and Prostate Cancer Studies (ABCs) Annual "Talk of the Town" Fundraising Gala Beverly Hills Hotel, Beverly Hills The ABCs’ most extraordinary evening takes place each November when the organization recognizes individuals who have made a difference in the fight against cancer. A glittering, black-tie event, the party attracts more than 800 guests as well as major media attention. Celebrities and supporters alike gather to raise much-needed funds for JWCI’s breast and prostate cancer research. The evening includes dinner, dancing, guest performances and a boutique.

For more information on any of the events, please contact us at

[email protected] or 310-315-6111.


NEXT GENERATIONof Melanoma Treatments

Pioneering the

Researchers harness the power of the immune system to fight advanced disease.

WRITTEN BY LINDA MARSA

PHOTOGRAPHED BY SIRI BERTING

Peggy Maddox enjoys a round of golf with her husband, Richard.


Doctors gave Peggy Maddox only a few months to live. In the summer of 1983, the Torrance resident discovered a lump under her arm that turned out to be melanoma—the most deadly form of skin cancer.

She was operated on by Donald Morton, MD, chief of the melanoma program at John Wayne Cancer Institute, who removed more than 60 lymph nodes from her neck and under her arm. He discovered that 14 of them were cancerous, which meant the disease has spread throughout her body.

“I was devastated,” recalls Maddox, who was 42 at the time and had two young kids, ages 11 and 14. “He told me I had a 2% chance of survival.”

But in September 1984, Maddox volunteered to undergo an experimental treatment that Dr. Morton had devised and became the first person to be treated with a new cancer vaccine that had been concocted from melanoma cells cultured in the lab. The vaccine was designed to make her immune system see the cancer cells as foreign invaders so it would mount a defense.

The strategy worked. For the next 16 years, the continuing educa-tion teacher dutifully went to JWCI for a dose of the vaccine until she was declared cured.

“Every September, I send Dr. Morton an anniversary card,” says Maddox, who’s now 71 and semi-retired, enjoying a life filled with grandchildren and golf outings. “He saved my life.”

In the nearly 30 years since, Dr. Morton and his research team at JWCI have consistently been at the forefront of devising therapies to combat this potentially deadly skin cancer, which will be diagnosed in more than 76,000 Americans this year and claim nearly 9,500 lives. While early-stage melanoma is quite curable, once the cancer spreads beyond the skin and invades the lymph nodes and vital organs like the liver, five-year survival rates drop precipitously—to about 10%, which lends urgency to the search for better treatments for people with advanced disease.

The latest generation of therapies that researchers are studying har-ness the patient’s own immune system to attack the cancer. Originally


developed at the National Cancer Institute, JWCI is one of five research centers here in the United States and in Israel that are testing and refining this experimental technique.

The goal is to develop individ-ualized treatments using immune cells taken from a patient’s tumor. Patients’ tumors are first incubated in special cultures that enhance the growth of cancer-fighting white blood cells. White blood cells are the foot soldiers the immune system dispatches to fight disease. Scientists cull out the ones that kill the malignant tumors—which are called tumor-infiltrating

lymphocytes (TILs)—and then make billions of copies of these cells, which are injected back into the patient.

“Essentially, what this does is beef up the patients’ immune response since they’ve developed an immune response against the tumor already,” says Mark B. Faries, MD, director of melanoma research and director of therapeu-tic immunology. “But for various reasons, their response may not be strong enough to overcome the resistance mechanisms of the tumor.”

Results from earlier tests on patients with metastatic

melanoma—disease that has spread—were quite encouraging and have improved cure rates by 20% to 40%, according to the most recent research. Scientists are awaiting the go-ahead from the Food and Drug Administration to move forward for the final phase of human tests.

Right now, this technique is too scientifically complex to be done outside major cancer centers like Saint John’s Health Center’s JWCI. But because of JWCI’s experience in immunotherapy and cell culture, the Institute will aim to develop simplified and more effective therapies. Once they can

• If you tan, stop. Tanning outdoors and using tanning beds and sun lamps are not safe activities. Research shows indoor tanning increases a person’s melanoma risk by 75%.

• Spend time outdoors when the sun is less in-tense—before 10 a.m. and after 2 p.m.

• Wear sunscreen every day, even on cloudy, rainy and snowy days. Use a sunscreen with a Sun Protection Factor (SPF) of at least 30 and with both UVA and UVB protection.

• Apply sunscreen at least 20 minutes before you go outside.

• Put sunscreen on all skin that will not be covered by clothing.

• If you spend time outside, reapply the sunscreen every two hours.

• Wear sunglasses with UV protection. Melanoma can develop in the eyes.

PREVENTING SKIN CANCER

• Columbia University Medical Center

• H. Lee Moffitt Cancer Center

• Hospital Clinic Barcelona

• Johns Hopkins Medical Institute

• MD Anderson Cancer Center

• Melanoma Institute Australia

• Memorial Sloan-Kettering Cancer Center

• Netherlands Cancer Institute

• Northwestern University Feinberg School of Medicine

• Ohio State University

• Roswell Park Cancer Institute

• Saint Thomas Hospital of London

• Sharp Memorial Hospital

• St. Louis University

• Swedish Melanoma Study Group/University Hospital Lund

• Tel-Aviv Sourasky Medical Center

• Universitair Medisch Centrum Groningen

• University of Michigan

• University of Wurzburg

• University of Zurich

JWCI is leading one of the largest melanoma trials in the world—the Multicenter Selective Lymphadenectomy Trial II (MSLT-II). Some of the 65 institutions in the collaboration include:


demonstrate its feasibility, says Dr. Faries, this could be done at a broader range of institutions.

Immunotherapy research has implications beyond melanoma, because the technique is one of the few that has demonstrated durable regression of metastatic disease. Now that the therapy has been shown to work in melanoma, scientists may turn their attention to applying cell transfer treatments to other types of solid cancers.

Also in a continuation of research pioneered by Dr. Morton and his melanoma research

team, Dr. Faries, Dr. Lee and other researchers are studying patients treated with Bacillus Calmette-Guerin (BCG), a tuberculosis vaccine injected into metastatic melanoma skin lesions as an immune-boosting therapy used to treat advanced melanoma.

In a 2012 study of nine JWCI patients with metastatic mela-noma who received BCG along with another immunostimula-tory cream (topical imiquim-od), five patients saw all their lesions disappear, another had a partial response, and three were completely healed once solitary resistant lesions were surgically re-moved. (Two elderly patients died of unrelated causes.) And not only did the melanoma lesions that were injected with BCG shrivel in size, but the ones that hadn’t been treated regressed as well.

“Somehow, the immune cells find their way to the other melanoma lesions and kill them too,” explains Dr. Lee, who is the director of the department of translational immunology at JWCI. She envisions that someday insights from studying immune stimulatory therapies might lead to a treatment which prevents future recurrences for low-risk patients who have had successful surgeries.

Her team is also studying the

autoimmune disease vitiligo, a skin condition that causes blotchy white patches, to under-stand how the immune system kills the pigment-producing cells called melanocytes. “These are the cells that give rise to mela-noma,” says Dr. Lee. “We know some people with melanoma who develop a loss of pigmentation have a better outcome.”

There must be a connection between this heightened immune reaction and stopping the spread of the skin cancer, she says. Uncovering the mechanism might pave the way toward better, more targeted therapies.

“Despite emerging thera-pies and new Food and Drug Administration approvals, only a fraction of patients respond, and many recur. We don’t have that much to treat melanoma, especially after it has spread,” she says. “We have to do better.”

On other fronts, John Wayne Cancer Institute researchers continue to head an international

trial network involving more than 4,000 patients that is evaluating whether immediate extensive surgery is beneficial for melanoma patients whose disease has spread to their lymph nodes. Lymph nodes are small, round structures that trap cancer cells or other harmful substances which may be circulating in the lymphatic system.

The current practice is to immediately remove all lymph nodes if there is evidence of can-cer in the sentinel lymph node—the regional lymph node that is most likely to contain malignant cells that have spread from the skin. Studies have consistently shown that this approach results in a longer disease-free survival rate in the estimated 15% to 20% of patients in whom melanoma has penetrated beyond the skin. Scientists are looking at wheth-er it’s better to immediately

remove the lymph nodes or to do ultrasound monitoring of the lymphatic system and only step in if the disease spreads.

“How invasive do you have to

be to save a person’s life?” ponders Dr. Faries. “That’s the question we’re trying to answer, because the less surgery we can do, the better for the patient.”

It’s especially important to recognize the early signs of melano-ma, the most serious form of skin cancer. Detected early, the disease is almost 100% curable. Here are some tips from the American Academy of Dermatology.

Finding MelanomaExamine your skin thoroughly. Look at moles and use the

ABCDE formula that may suggest the presence of a melanoma in a mole.

A — Asymmetry. One half not like the other half.B — Irregular, scalloped borders.C — Color. Shades of tan and brown, black; sometimes white,

red or blue.D — Diameter. While melanomas are usually greater than six

millimeters—about the size of a pencil eraser—when diagnosed, they can be smaller.

E — Evolving or changing in appearance.

Make notes about the size and shape of your moles and watch for any changes in the appearance.

Check your scalp, palms, feet, nails and genital area. Make an appointment to see a dermatologist if you find a

mole or growth that is growing, unusual, bleeding or not like the rest. An expert evaluation is important for any skin lesion that is worrisome.

For more information about skin cancer, please contact the JWCI Melanoma Research Program Department at 855-530-SKIN.

One half unlike the other half.

While mel-anomas are usually greater than 6mm (the size of a pencil eraser) when diagnosed, they can be smaller.

Irregular, scal-loped or poorly defined border.

A mole or skin lesion that looks dif-ferent from the rest or is changing size, shape or color.

Varied from one area to another; shades of tan and brown, black; some-times white, red or blue.

ASYMMETRY

DIAMETER EVOLVING

BORDER COLOR

6mm

WARNING SIGNS OF MELANOMA

EXA

MPL

E

A B C

D E


Donald L. Morton, MD

PROFILE

A living legend, Dr. Morton shaped the field of surgical oncology.WRITTEN BY LINDA MARSA

In the field of oncology, Donald L. Morton, MD, is a giant. Over the past half-century, Dr. Morton, chief of the melanoma program and co-director of the surgical oncology fellowship program at John Wayne Cancer Institute, has led revolutionary changes in a field that was too often stumped by the complexity and tenacity of cancer.

“Don Morton is one of the most famous cancer surgeons in the world today and has been instrumental in changing the face of cancer and cancer research,” says Anton J. Bilchik, MD, PhD, chief of medicine and chief of gastrointestinal research at JWCI.

In his long career, Dr. Morton has made significant contributions in two distinct fields: surgical oncology research and surgical fellowship training. On the research side, he devised


a procedure that has become the standard of care for melanoma and breast cancer. He was also a pioneer in the development of cancer vac-cines. On the education side, he has worked hard to establish the next generation of surgical oncologists, training more than 135 fellows.

“I’m very proud that 80% of

them are university professors,” Dr. Morton says. “Ten percent of them are deans or department chairs, and 45% are chiefs of their respective divisions of surgical oncology. They are widely distributed throughout the country and will continue to make contributions to cancer research long after I’m gone.”

It’s been a remarkable journey for the world-renowned surgeon, who was chief of the division of surgical oncology at UCLA before he established the John Wayne Cancer Institute at Saint John’s Health Center in Santa

Monica in 1991. Donald Morton grew up amid rural poverty in a small West Virginia coal-mining town and attended Berea College, a small college in Kentucky geared toward disadvantaged youth in Appalachia. His mother stressed the importance of education.

“For me, I think the greatest accomplishment was making it from rural West Virginia to the Westside of Los Angeles,” he says. “I grew up during the Depression in a house that my dad built. We had no running water, no indoor

plumbing and no electricity.” As a youngster, Dr. Morton tended pigs, cows and chickens in the morning before school and again in the evening. “Only then could I do my homework by the light of a kerosene lamp.”

After college at UC Berkeley he received his medical training at UC San Francisco Medical School. When he arrived at the National Cancer Institute in 1960, he began what became a lifelong study of melanoma. The surgical oncologist was intrigued by reports of spontaneous recov-eries from cancer, which suggest-

ed the body was mounting an immune response to fight off the malignancy. He felt that rallying the immune system through the use of therapeutic vaccines could be a way of combating cancer.

These keen powers of observation also led Dr. Morton to devise the sentinel node biopsy technique. In the past, surgeons would remove all lymph nodes surrounding a cancerous tumor to see if a tumor has spread. Doctors now inject a radioactive dye near the tumor, which illuminates the

drainage pathway of the tumor and tracks the primary or sentinel drainage node. If the tumor is going to spread, according to numerous clinical trials, it would have to go through that node.

“The sentinel node concept saves the U.S. health care system about $3.8 billion a year and countless unnecessary operations and suffering from lymphedema for patients,” he notes.

Dr. Morton was able to gain acceptance of his innovative work by creating a vast clinical trial network that involved institutions throughout the world. The way

he organized this international consortium became a model for similar research efforts.

In a 2011 editorial in the Journal of Surgical Oncology, Charles M. Balch, MD, professor of surgery at Johns Hopkins in Baltimore, wrote of his colleague: "Donald Morton is truly a legend in surgical oncology, an icon as a surgical investigator, a pioneer in melanoma, a valued mentor, an authentic role model and a cherished friend to many of us around the world."

For me, I think the greatest accomplishment was making it from rural West Virginia to the Westside of Los Angeles. I grew up during the Depression in a house that my dad built. We had no running water, no indoor plumbing and no electricity.”

Dr. Donald Morton operates with his colleague Dr. Mark Faries.


When Delphine Lee, MD, PhD, was recruited to move from UCLA to John Wayne Cancer Institute, a couple of factors made it an offer she couldn't refuse. One was the opportunity to work with world-renowned melanoma researcher Donald Morton, MD. But another reason was the generous financial support of philanthropist Carolyn Dirks, a Life Trustee of Saint John's Health Center Foundation, and her husband, Brett Dougherty, to what is now known as the Dirks/Dougherty Laboratory for Cancer Research.

The Dirks/Dougherty funding has helped Dr. Lee, who is also a dermatologist, launch promising investigations to identify cancer subtypes as a way to direct therapy, to define the mechanisms of immune regulation that can be used to control cancer and to explore new ideas about what causes breast cancer.

“This support gave me an unprecedented opportunity to do the kind of unfettered scientific exploration that often leads to great discoveries,” says Dr. Lee, director of the Department of Translational Immunology at JWCI.

Breathing life into ideas, hopes and dreams is the hallmark of Carolyn Dirks' approach to philanthropy. Before she became president of the Joseph B. Gould Foundation, a charitable organization founded by her father, Carolyn had her own dreams. As a teenager growing up in Los Angeles, she enjoyed the benefits of good health while training as an elite swimmer. She also pursued a career in the fashion industry before meeting husband, Brett, an oil and real estate investor.

As philanthropists, the couple's outreach reflects Carolyn's love of wellness, the arts and sports. Carolyn's and Brett's involvement at Saint John's Health Center is long and noteworthy. They were recipients, in 2010, of the Spirit of Saint John's Award, presented by the Saint John's Health Center Foundation, for their multiple gestures of support, including funding for the ambulance entrance and trauma bay and the beautiful Sister Marie Madeleine Chapel. The couple's involvement is truly a family affair with Carolyn's son, Martin Dirks, involved as a board member of the Joseph B. Gould Foundation.

The couple also provides robust support for JWCI's research and fellowship programs. Funding the Dirks/Dougherty Laboratory for Cancer Research, which comes through the Joseph B. Gould Foundation, is yet another gesture of their desire to make a difference.

"We're delighted to support the work of Dr. Lee and are excited with the direction her research is taking," says Carolyn, who is a member of the JWCI board of advisors. "I know with her vision and hard work, we will make great things happen.”

WRITTEN BY LINDA MARSA

PHOTOGRAPHED BY REMY HAYNES

Delphine Lee, MD, PhDIn novel research, the Dirks/Dougherty Lab looks for microbial causes of cancer.

PROFILE

Adds Martin: "We are happy to have someone of Dr. Lee's caliber leading the team."

Among Dr. Lee's projects is an investigation on whether microbes have anything to do with breast cancer. In recent years, studies have shown that human papilloma virus is linked to several forms of cancer, such as cervical cancer. Breast cancer, too, may be linked to viruses.

Another major theme of the Dirks/Dougherty lab involves investigating how both T-cells and other lesser immune cells contribute to cancer. Dr. Lee and her team are isolating breast cancer tissue and


healthy adjacent tissue to investigate T-cell function. What they find out may help explain why some women have a recurrence of breast cancer and others don't. "Part of the job of T-cells and other immune cells is to recognize when normal cells go rogue," she says. "If they're not doing their job, we develop cancer."

The support from Carolyn Dirks and her family permits the impressive range of research taking place in Dr. Lee's lab.

"Sometimes, you need to wander around to see what you find," Dr. Lee notes. "If you just go looking for what you know, you won't find the things

you're not looking for, but that's when you'll make the breakthrough discoveries. Carolyn Dirks and Brett Dougherty have enabled us to do experiments that, in this day and age of limited finances, are high-risk, high-reward experiments."

Dr. Lee's research is generously supported by: Carolyn Dirks and Brett Dougherty/Joseph B. Gould Foundation, National Institutes of Health, Avon Foundation for Women, Fashion Footwear of New York Charitable Foundation and The Associates for Breast and Prostate Cancer Research (ABCs).

Part of the job of T-cells and other immune cells is to recognize when normal cells go rogue. If they're not doing their job, we develop cancer."

Martin Dirks and Delphine Lee, MD, PhD, in the Dirks/Dougherty Laboratory for Cancer Research.


Junko Ozao-Choy, MD, has known her way around a research laboratory since she was a teenager. While most of her high school peers were enjoying their summer vacations, she was working in an immunology lab studying melanoma.

It should be no surprise that the lab is still familiar territory. Today she’s in her third year as a surgical oncology fellow at the John Wayne Cancer Institute, where her research focuses on immunotherapies to treat cancer.WRITTEN BY JEANNINE STEIN

PHOTOGRAPHED BY REMY HAYNES

Junko Ozao-Choy, MDWhen her parents were stricken with cancer, Dr. Junko Ozao-Choy knew what she had to do.

FellowshipPROFILE


Why cancer research?“At the very core, I was very interested in why cancer kills people, why

it’s so deadly,” she says, sitting in her office at the Institute. “When it’s localized, you can cure it with surgery, but when it spreads, it becomes a very different animal. That’s the central question I was always interested in.”

But there was another reason behind her motivation to work in the field. While growing up in Scarsdale, New York, her mother was

diagnosed with colon cancer, and her father developed liver cancer. Her mother survived the disease, but her father did not, passing away when Dr. Ozao-Choy was just 13 years old.

“In a very real way, I was about to be orphaned by the disease,” she says. “It was one story of how modern medicine really helped my mother, but with my father, it didn’t work out that way.”

Dr. Ozao-Choy received her undergraduate degree at Yale and medical degree at Dartmouth and came to JWCI after hearing about the melanoma research pioneered by Donald Morton, MD, chief of the JWCI melanoma program. In the lab and in clinical practice as an oncology surgeon, she searches for answers about how cancer spreads.

“The fellowship is set up so that you have all the tools and the patients you need," she says. "You come in with questions, and then you have a relationship with very experienced researchers who help you refine those questions."

Dr. Ozao-Choy’s current research is on the role of myeloid-derived suppressor cells (cells that help

regulate immune responses and tissue repair) in people with advanced melanoma. She is investigating those cells, taken from samples of white blood cells from a trial to assess a prospective melanoma vaccine.

Moreover, while recently investigating scalp melanomas, she found those tumors may have a worse prognosis than others on the head, neck, trunk and extremities. She presented a paper on the topic last year at the annual cancer symposium of the Society of Surgical Oncology.

Dr. Ozao-Choy also works with patients and credits them for much of her motivation to dig deeper into her research.

“I’m always inspired by the patients,” she says. “They’re remarkable. They have sometimes very devastating illnesses and side effects from treatment, and they’re very strong people. They teach me a lot about being strong and courageous. I think that’s a big part of why I want to do what I do.”

Her dedication to her job runs deep. While nearing her due date for the birth of her second child last year, Dr. Ozao-Choy felt well enough to assist in a day-long slate of four surgeries that stretched from early morning to midnight. After finally making it home and going to bed, she woke up an hour later to find her water had broken.

“I must have missed labor somehow, because I went to the hospital and had the baby in a short amount of time,” she says, laughing. “There wasn’t even time to do the paperwork to admit me.”

She and her husband, attorney Jason Choy, enjoy spending time with daughter, Evelyn, now age 1, and older daughter, Isabelle, 4. Isabelle’s hand-drawn pictures decorate a wall of the office.

Ultimately, Dr. Ozao-Choy would like to leave a legacy of finding better cancer treatments and faster cures for future generations, like those her daughters’ ages. “I think it will be a reality in the future that we’ll be able to personalize treatments and make them less toxic for patients—and ultimately have better outcomes.”

I’m always inspired by the patients. They’re remarkable. They have sometimes very devastating illnesses and side effects from treatment, and they’re very strong people. They teach me a lot about being strong and courageous. I think that’s a big part of why I want to do what I do.”


DISTANCEto improve cancer care

Going the

Brooke Army Medical Cen-ter, Fort Sam Houston TX

Dr. Anton Bilchik is part of an international cancer research collaboration that has made major advances in the staging of colorectal cancer in recent years. The group is part of the International Consortium of Research Excellence and works in partnership with the U.S. Military Cancer Institute.


Hadassah University Medical Center, JerusalemRabin Medical Center, Tel Aviv

Institute of Oncology of Vojvodina, Sremska Kamenica, Serbia

WRITTEN BY SHARI ROAN

Dr. Anton Bilchik engages colleagues around the world in a world-class research consortium.

For a man who dislikes travel, Anton Bilchik, MD, PhD, certainly has an impressive network of

out-of-state and international colleagues. He nurtures each relationship, too—reaching out with frequent late-night telephone calls and dragging his bags through LAX to meet with his co-workers from Tacoma to Tel Aviv.

Dr. Bilchik does it because he believes wholeheartedly that future progress in preventing and treating cancer will come through worldwide collabora-tion. Gone are the days when a scientist or a small group of colleagues sharing a laboratory can expect to change the course of cancer care with a single, stunning discovery.

Today, Dr. Bilchik says, the



name of the game is cooperation. Patients who see a cancer doctor should know the advice they are getting reflects the collective wis-dom of specialists from around the globe.

“I’m not someone who particularly likes traveling,” says Dr. Bilchik, chief of medicine and chief of gastrointestinal research at JWCI. “But I think that if you want to practice cutting-edge cancer care—if you want to tell your patients with all honesty that the information you’re providing them has been carefully thought out and is the most beneficial to them—then you have to be involved in dialogue with your colleagues and with other experts.”

Dr. Bilchik and his colleagues are setting a new standard in that regard. He is involved in a multi-center clinical trials network known as INCORE—the

International Consortium of Research Excellence, which includes the California Oncology Research Institute, the United States Military Cancer Institute and medical centers around the world.

The group has generated a wealth of important data on the staging of colon cancer and biomarkers present in early colon cancer, among other findings, and have had papers published in leading medical journals, helping establish national guidelines and quality measures for cancer patients. Group members have presented their data at the most prestigious research meetings in the United States, including three

presentations in the past five years at the ultra-competitive American Surgical Association meeting.

“That is how our work has been regarded by our peers,” says Dr. Bilchik, who is considered one of the country’s leading specialists in gastrointestinal cancers.

Working with people who live thousands of miles apart may not seem like the easiest way to advance cancer research. But in fact, it may be the only way to make headway these days, he says.

After decades of effort and billions of dollars spent, scientists now have the battle scars to show that cancer is an extraordinarily complicated disease that will not yield to simple approaches. Recent advances in molecular medicine, for instance, show that cancer often behaves differently and may respond to various medications differently based on an individual’s particular genetic profile.

“Cancer research now is complex,” Dr. Bilchik says. “It

involves multiple disciplines. It involves people of different areas of expertise, and it involves access to patients to enroll in clinical trials. What international collaboration does is provide all three.”

Economics also demand that scientists pool their talents to streamline research. The U.S. government funds only about 7% of the grant applications received, Dr. Bilchik says.

“We’re living in a financially challenging environment right now where there’s limited funding for cancer research. Where before researchers could work in isolation, now it’s important not to duplicate work that’s being done elsewhere.”

The National Cancer Institute, which distributes those limited funds, has called upon various smaller research groups to merge and become more inclusive. “I think that people now realize that, given the changing environment

The biggest winner in accelerated cancer research is the patient."

—Aviram Nissan, MD, associate professor of surgery at Hadassah University Medical Center–Ein Kerem and a member of the INCORE group


Our findings are likely to be more meaningful because they’ve been tested in different parts of the world and in different groups."

—Anton Bilchik, MD, PhD, chief of medicine and chief of the gastrointestinal research program

we’re in,” Dr. Bilchik says. “The only way to really succeed is by finding loyal research partners.”

Dr. Bilchik arrived at JWCI in 1998 and was quickly schooled in the art of collaborative research by Dr. Donald Morton, who had successfully advanced his pioneering research on melanoma and sentinel node mapping by forming global partnerships. Dr. Bilchik wanted to perform research on colon cancer in that same successful manner.

“I recognized that by putting a group of people together both in the U.S. and internationally, we would be able to rapidly increase the number of patients that we could put on the study and that our findings are likely to be more meaningful because they’ve been tested in different parts of the world and in different groups,” he says.

Of course, the biggest winner in accelerated cancer research is the patient, says Aviram Nissan, MD, associate professor of

surgery at Hadassah University Medical Center–Ein Kerem and a member of the INCORE group. Dr. Nissan praises the individual talents of the group, including Col. Alexander Stojadinovic, MD, professor of surgery at the Uniformed Services University of Health Sciences in Bethesda and gastrointestinal cancer program at the United States Military Cancer Institute.

“This collaboration benefits each and every one of us, but it benefits the patients more,” Dr. Nissan says. “We’ve had remarkable achievements for such a small group of researchers, funded by peer-review and philanthropic grants. We conduct high-quality clinical and translational research in order to identify patients with early colon cancer that can be cured by surgery alone, without the need for additional chemotherapy. We have shown that by ensuring the quality of surgery and pathology by focusing on better staging of

lymphatic nodes, the disease-free survival of colon cancer patients may be improved.”

Patients benefit as quickly as possible from research findings because the data is shared in an expedient manner, Dr. Bilchik says. “The most important thing is the sharing of data, the sharing of findings, the sharing of authorship. We all embrace each other’s success rather than compete against each other.”

That level of cooperation demands that egos be set aside—something that ambitious researchers may find a bit unnatural. Many scientists today still work alone and somewhat secretively, Dr. Bilchik says.

“Most scientists have a possessive nature,” he says. “They don’t want other people taking credit for their own work, their own breakthroughs. Everyone knows of a story where someone else has done the work and a second party has taken credit for the work. So there is this general

feeling of paranoia.”Some institutions also

discourage collaboration, he adds. “Every institution is looking for something new or exciting or something they can take credit for. Collaboration is not done enough.”

There are challenges to such far-flung associations, to be sure. But, Dr. Bilchik says, “The biggest challenges are not related to us and our enthusiasm and our trust in one another. The biggest challenges are related to bureaucracies and regulatory agencies.”

Each hospital and each country has its own regulations and laws regarding scientific research. Forms must be translated into several languages. Databases and software systems must be compatible. Institutional review boards at every single facility have to approve the study before it can move forward. Paperwork can threaten to inundate everyone.

“All of that stuff takes an


INTERNATIONAL CONSORTIUM OF RESEARCH EXCELLENCE

•WalterReedNationalMilitaryMedicalCenter,

Bethesda, MD

•MadiganArmyMedicalCenter,Tacoma,WA

•BrookeArmyMedicalCenter,

Fort Sam Houston, San Antonio, TX

•EisenhowerMedicalCenter,PalmSprings,CA

•UCLA,LosAngeles,CA

•Cedars-SinaiMedicalCenter,LosAngeles,CA

•JohnWayneCancerInstitute,SantaMonica,CA

•HadassahUniversityMedicalCenter,Jerusalem

•RabinMedicalCenter,TelAviv

•InstituteofOncologyofVojvodina,

Sremska Kamenica, Serbia

The United States may have among the most sophisticated health care systems in the world, but when it comes to cancer research, we’re relying more than ever on people in all nations. Nowadays, many of the largest and most noteworthy cancer clinical trials are international or emerge from countries other than the United States, says Anton J. Bilchik, MD.

Cancer research depends on the participation of patients. But Americans have long shown reticence to enroll in studies—even though many clinical trials offer not only the best available care but promising treatments that are currently unavailable outside of the study.

“Many of the important cancer trials are coming from abroad,” Dr. Bilchik says. “It’s largely because many countries have socialized medicine. Physicians are salaried, so they’ve got the time to enroll people in studies. They don’t have to deal with trying to see as many patients in a day as possible and some of the issues we face in the States because we have a different health care system.”

Research is also more expensive to conduct in the United States. Patient attitudes about participating in research also vary overseas. “Patients in Israel or Serbia are, for whatever reason, enthusiastic about being enrolled in clinical trials, whereas in the U.S., people may see it as being guinea pigs,” Dr. Bilchik says.

The growth of cancer research overseas stands to greatly benefit countries in need of more sophisticated care. Cancer rates are rising in many impoverished nations as the average lifespan increases and as more people are introduced to tobac-co products and Westernized diets. By 2030, about 70% of the global cancer burden will arise in developing countries, accord-ing to the International Association for Research on Cancer.

International research can help shine a light on unique areas of need, Dr. Bilchik says. “It brings attention to certain countries where patients often present with more advanced cancers. Often when you start looking at these studies, you see different presentations in different parts of the world. It leads to more questions and comparing why their outcomes are different than outcomes in a Western country. There are so many additional satellite research projects that develop.”

CANCER RESEARCH THRIVES OUTSIDE U.S. BORDERS

insurmountable amount of time,” Dr. Bilchik says. “That’s why, once you get through that, many groups that set up collaborations keep them going for many years. You know the individuals you’re working with and the administrative personnel.”

But once those hurdles are overcome and the research findings start to trickle in, the fun begins, says Dr. Nissan. The collaboration with Dr. Bilchik and other members of the INCORE group, he says, “is based on true friendship. International collaboration exposes us to different views and different ways of thinking. It is always fascinating to hear other people’s views on a certain topic

and learn from the others.”That’s why those slogs through

airports are, indeed, bearable, Dr. Bilchik says. His favorite moments are attending medical meetings and hearing one of his collaborators present the team’s findings to their peers.

“It’s the satisfaction of learning new things from my colleagues,” he says. “That’s why we put up with all of the negative aspects of cancer research—the bureaucracy and administration. It’s the satisfaction and the thrill when a colleague calls and says, ‘We’ve looked at the data, and you’re not going to believe this, but this is what we’ve found . . .’ That’s our high. That’s our thrill. That’s what keeps us going.”


MEMORABLE EVENTS

Many thanks to the individuals and organizations that have coordinated special events to benefit the John Wayne Cancer Institute.

John Wayne Cancer Institute at Saint John’s Health Center celebrated a decade as a proud partner of the AVON Walk for Breast Cancer on September 22–23 in Santa Barbara. JWCI served as the medical sponsor for the walk, led by Maureen Chung, MD, PhD, director of the Margie Petersen Breast Center, and assisted by Julie Billar, MD, JWCI Auxiliary Breast Fellow. Several JWCI Surgical Oncology Fellows, Saint John’s Health Center nurses and volunteers provided support in the medical tent. JWCI staff and volunteers also hosted a Cheer Booth along the route to offer encouragement, distribute water and JWCI pink bandanas, and offer walkers a chance to be photographed with “the Duke.”

Walkers included many

Institute supporters, led by “Team Duchess,” who have raised tens of thousands of dollars over the years. Special thanks to Teddi Gilderman, Misha Wayne, Cynde Wilen, Dana McCormick, Kimberly Slevin, Sue Emmer, Susie Gesundheit, Veronica Mendez, Griselda Carrion and all of the dedicated walkers.

The AVON Foundation recently awarded a $300,000 grant to JWCI to support innovative breast cancer research led by Delphine Lee, MD, PhD, director of translational immunology in the Dirks/Dougherty Laboratory for Cancer Research. This year’s AVON Walk for Breast Cancer will be held on September 7–8. For more information, please call JWCI at 310-315-6111.

JWCI and AVON Walk for Breast Cancer

PHOTOS1. Dr. Delphine Lee accepts a check in the amount of $300,000 to support innovative breast cancer research. 2. JWCI Surgical Oncology Fellows with Saint John's Health Center nurses and staff 3. JWCI Auxiliary Breast Fellow Dr. Julie Billar and director of the Margie Petersen Breast Center, Dr. Maureen Chung 4. JWCI Team Duchess walkers

2 3

1

KEEP YOUR SKIN HAPPY AND HEALTHY WITH CLARINS— AND SUPPORT SKIN CANCER RESEARCH!

HERE COMES

THE SUN

Shoppers purchasing Clarins skincare products at Bloomingdale's throughout May saw 5% of their total purchase donated to support melanoma research at the John Wayne Cancer Institute.

Clarins Skincare Promotion at Bloomingdale's

4


MEMORABLE EVENTS

John Wayne Cancer Institute Educational Evening and ReceptionOn March 21, 2013, Benefactors and friends of JWCI enjoyed an Institute report and update on some of the latest clinical trials and research projects underway at the Health Center. The evening included an in-formative Q&A, live demonstrations, tours of the laboratories, and the opportunity to visit with many of the JWCI faculty in attendance.

Benefactors DinnerJohn Wayne Cancer Institute honored its major support-ers at the 2012 Benefac tors Dinner at the Four Seasons Hotel in Beverly Hills on December 2. Benefactors who have supported innovative cancer research at the highest levels of personal giving were joined by the Institute’s faculty and surgical oncology fellows. A highlight of the evening was the announcement by Anton Bilchik, MD, chief of medicine, that Donald L. Morton, MD, was named the In stitute’s first-ever distinguished professor.

PHOTOS1. Lenny Eisman 2. Sheri Rosenblum and Elaine Lerman 3. Acting President and CEO Mike Wall 4. Dr. Anton Bilchik gives Institute update 5. Dr. Mark Faries and David Keller 6. Arnetta Notkin 7. Dr. Mark Faries discusses progress in melanoma research 8. Dr. Delphine Lee describes her work in the Dirks/Dougherty Laboratory for Cancer Research

1 2 3

5 6

7 8

4

Dr. Daniel Kelly, Danielle Brown Ross and Ronald Ross

Joan and Stephen Reeder, Joyce Green, Lorraine and

Dr. Donald Morton

JWCI chairman Patrick Wayne, Danielle Brown Ross, Michael Caan, Ronald Ross and Michael Wayne

Michael Morgan, Dr. Maureen Chung, Jim Saletnik and Carlye Morgan


MEMORABLE EVENTS

Tim and Anita Swift

Carl and Victoria Murray

Maria Lim McClay and family

Patrick Wayne, Dr. Donald and Lorraine Morton, Joan Mangum Gold, Valerie

and Eric Borstein, Bud Erhardt, Joan and Stephen Reeder and Michael Wayne

Robert and Suzanne Davidow, Dr. Anton Bilchik

Michael and Christine Wayne,

Patrick and Misha Wayne,

Marisa Wayne, Tony Ditteaux,

and kids

Sandra Krause, Ruth Weil, Joan Mangum Gold and Bill Fitzgerald

Maria and Emilio ArechaederraSurgical Oncology Fellows Dr. Anna Leung, Dr. Connie Chiu and Dr. Joslyn Albright with Ruth Weil

Surgical Oncology Fellow, Dr. Victoria Stager

Jerome and Carol Coben

Dr. Lawrence Piro, Donna Tuttle, Gloria and John Gebbia

Patrick Wayne, Joyce and Stanley Black Misha and Patrick Wayne

Michael Wayne, Beti Ward, Patrick Wayne, Barbara and Stephen Allen Jack Esensten and Ilene Eisenberg


Girls Pitch in to Support Breast Cancer Research at the Surf City TournamentThe John Wayne Cancer Institute was the beneficiary of the Surf City Girls Fastpitch Softball Tournament on October 22 to 23, 2012, in Huntington Beach. The Institute was on hand to pass out educational materials and sunscreen and to answer questions. Special thanks to Dan Hay, President and CEO of Surf City Tourneys, Inc., and all the teams who participated in the tournament to raise $23,000 for innovative breast cancer research at the John Wayne Cancer Institute at Saint John's Health Center.

Power of PinkThe inaugural Power of Pink fundraising event was held November 12, 2012, at Sony Studios to recognize and celebrate the strength of women who battle and beat breast cancer. Grammy award-winning artist P!nk gave a rousing

performance for more than 500 attendees. Funds from the event helped establish the Nurse Navigator Program at the Margie Petersen Breast Center at Saint John's Health Center.

MEMORABLE EVENTS

P!NK with associate director of the Margie Petersen Breast Center, Maggie DiNome, MD, and director of the Margie Petersen Breast Center, Maureen Chung, MD, PhD

Power of Pink guests Heather Locklear and Valerie Bertinelli

FFANY Shoes on SalePatrick Wayne greets Joe Moore, Chairman of FFANY, at the annual QVC presents "FFANY Shoes on Sale" event October 24, 2012, in New York City. The Fashion Footwear Association of New York charitable organization has contributed more than $5 million to JWCI to support innovative breast cancer research that has helped eliminate patient suffering for women around the world. The 20th annual FFANY Shoes on Sale event will be held October 1, 2013, at the Waldorf Astoria.

Patrick Wayne greets Joe Moore, chairman

of FFANY


HONOR ROLL

PAVE DIAMOND CIRCLE ($1,000,000+)Dr. Miriam & Sheldon G. Adelson Medical Research FoundationThe Ahmanson FoundationAssociates for Breast and Prostate Cancer Studies (ABCs)Avon Foundation for WomenDonald and Brigitte Bren in Honor of Marion JorgensenThe Eli and Edythe L. Broad FoundationRoy E. Coats Memorial FundRita and Bill CoorsThe Davidow Charitable FundCarolyn Dirks and Brett Dougherty and the Joseph B. Gould FoundationBen B. and Joyce E. Eisenberg FoundationThe Fashion Footwear Charitable Foundation of New YorkGloria and John GebbiaLeslie and Susan Gonda (Goldschmied) FoundationMarion and Earle M. Jorgensen

Linda Tallen and David Paul Kane Cancer Education and Research FoundationThe Harold McAlister Charitable FoundationMaria Lim McClayMelanoma Research AllianceNancy and Carroll O’ConnorMargie and Robert E. Petersen FoundationQVCGene Raymond EstateThe Lois Rosen FamilyCheryl and Haim SabanThe Samueli FoundationThe Tarble FoundationThe Wayne and Gladys Valley FoundationThe John Wayne Cancer FoundationJohn Wayne EnterprisesThe Family of John WayneGretchen and Michael Wayne John Wayne Cancer Institute AuxiliaryRuth Weil

DIAMOND CIRCLE ($500,000+)Mrs. James M. Amyx, Jr.The Danny Arnold FamilyMarsha and Martin BranderLarry and Lynn BrownPatricia C. Brown FoundationMr. and Mrs. Christopher H. Buehrle in Memory of Sharon Buehrle & Alan J. PinkstaffBuehrle Golf ClassicConstance and Sydney Dunitz Randa and Ghassan GhandourThe William Randolph Hearst FoundationsThe Lincy FoundationTom Mullin Memorial FundMr. Lloyd L. RossSusan G. Komen for the CureWhat A Pair!The Wrather Family

YELLOW SAPPHIRE CIRCLE ($250,000+)The Carole Zumbro and George Adler FamilyJackie and Howard BanchikJoan Berlin ReederLouis L. Borick FoundationLinda L. Brown / Maddocks- Brown FoundationMaria Lucia and Fernando Diez BarrosoIlene and Juels EisenbergDiane and Daniel Feldman

Sandra Krause and William FitzgeraldMargo GrogerHenry L. Guenther FoundationThe Bob and Gaye Harris FoundationJudy and Sandy LitvackMichael KadoorieMr. and Mrs. James G. McFarlaneAlice and Verne McKinneyAnn MoorefieldJess and Palma Morgan FoundationDr. Donald and Lorraine MortonNational Operating Committee Standards Athletic EquipmentHRH Prince Nawaf Bin NawafMr. and Mrs. Cyril NiggRoberta and Bob NovickLynda and Stewart ResnickDonna and Harvey RosenSimon-Strauss FoundationThe Steele Foundation in Honor of Laura Perkins

EMERALD CIRCLE ($100,000+)America RemembersLance Armstrong FoundationMarilyn and Martin B. AugustSheri and Arthur BerkEstate of C. June BisplinghoffMr. and Mrs. James R. BoboBorstein Family FoundationMilicent BoudjakdjiBulova Gale FoundationThe Rita Burkett Living Trust

The John Wayne Cancer Institute is deeply grateful for the philanthropic support of all our donors and friends. Your generosity funds breakthrough cancer research, sparks promising new treatments and provides inspiration to our physicians, scientists and fellows. Thank you for your partnership in our mission to eradicate cancer.


CUMULATIVE GIFTSJohn Wayne Cancer Institute at Saint John’s Health Center is honored to recognize the following Circles of Distinction members who have made cumulative gifts and pledges of $25,000 or more through January 31, 2013. Circles of Distinction members are recognized on individual plaques in the Institute’s main lobby.


The Campion FamilyThe Carnegie Hall CorporationBonnie E. CobbIn Memory of Ellen CoopermanMr. and Mrs. John CreanMr. and Mrs. Neal DemThe Doornink FamilyEastman Kodak CompanyMr. and Mrs. Louis W. EhlersThe People of Elko, Nevada, in Memory of John Ellison, Jr.Patricia EltonEntertainment Industry FoundationMickey and Bud ErhardtMax Factor Family FoundationFarmers InsuranceThe Rod Fasone Memorial Cancer Research FundArthur J. Gallagher and CompanyHarold and Julia Gershman Family FoundationDrs. Cheryl F. and Armando E. GiulianoFrank L. and Helen G. GofrankLeon and Toby Gold FoundationGreat Western BankThe Family of Jack GreenWilliam H. Hannon FoundationThe Nan M. and Reed L. Harman Foundation

Barbara and Ben HarrisSelma L. HerbertGeorge Hoag Family FoundationSue and Larry HochbergImmenroth Family TrustIn Memory of Raymund A. Kathe Berton and Todd KirshnerHildegard T. and Norbert E. KnollThe Stanley S. Langendorf FoundationCynthia and Edward Lasker FoundationElaine and Kenneth LeventhalEvan and Carol Li and FamilyRobert H. LorschMPI Media GroupMike and Muffy Murphy FundVictoria and Carl MurrayHeather and Jim MurrenGeorge W. OgdenThe Estate of Edgar Bishop Pease and Eiko M. PeaseThe Rabinovitch FoundationThe Estate of Carl RomerSABCO Racing, Inc.The Estate of Edgar J. SaltsmanMr. and Mrs. Jeffrey SchwartzElizabeth and Henry SegerstromRuth L. and Norman ShacknoveThe Al Sherman FoundationThe Dinah Shore FoundationJaclyn S. Smith

The Candy and Aaron Spelling FoundationMr. and Mrs. Sheldon E. StunkelThe Tenenbaum FamilyEarlane and Robert VallierMr. Robert J. VignoloThe Wallis FoundationDel E. Webb FoundationMr. and Mrs. Leonard WeilMrs. Kimberly Harris and Mr. Scott WeinerMary Ann and Marvin WeissRodney F. Williams and Elizabeth M. Williams TrustElizabeth WoodardMr. and Mrs. Joseph Zukin, Jr.Robert and Joan Zukin

RUBY CIRCLE ($50,000+)Mr. and Mrs. Stephen AllenRussell and Evelyn AnsethBloomingdale’s, Inc.Helen and Harry BlusteenAndrew and Deborah BogenM’Lou and Bill BornThe Saul Brandman FoundationGracia Bremer Charitable FoundationMary Frances and Jack BrennanAbbott BrownChartwell Charitable FoundationCarol and Jerome CobenSandy and Irv CohenThe Collector’s Armoury

Gary CoullMr. Robert L. DonleyPat and Jerry EpsteinMary Frances and Andrew J. FenadyBarbara J. ForemanThe Franklin Mint Foundation for the ArtsBeatrice and Philip GershRonald and Catherine Gershman FoundationMr. and Mrs. Harvey S. GettlesonMarilyn and Allen GoldenLisa L. GoodmanMadelaine and Gene GordonGaile Gray RyanThe Green FoundationThe Brad and Jill Grey Family FoundationMr. and Mrs. Richard HaftMr. and Mrs. Lloyd G. HallamoreThe Hammock Family FoundationHauptman Family PhilanthropiesBarbara A. HillmanThe Bob and Dolores Hope Charitable FoundationDr. Reiko F. IrieJudianne and Kenneth JaffeKantor FoundationLenore Golden Kessler in Memory of Rudy PerkalJanice White and Eugene Krieger

Circles of Distinction Members who have made cumulative gifts and pledges of $25,000 or more are recognized on individual plaques in the Institute’s main lobby.

HONOR ROLL


CUMULATIVE GIFTS (continued from page 31)


Lefkowitz Family FoundationIna and Bernard LewisDr. and Mrs. Israel LichtensteinMacDonald Family FoundationThe Family of Lorraine Mann Ruth K. March and FamilyMr. and Mrs. Leonard MautnerBernard John and Beatrice McMorrowThe Melanson Family FoundationModern Business InteriorsMuller Family FoundationMr. and Mrs. Jimmy MurphyNational Asset Recovery Services, Inc.Arnold and Sherri NelsonMr. and Mrs. John F. NickollBradley S. O’LearyVictor H. PalmieriRalph and Marcia PetersonJennifer ProvineRichard RogersMarianne J. ReisStanley and Maida RichardsMildred and Chapin RileyBernard J. Korn, M.D. and Betty RoachAnn and Nathan Stafford RogersEleanor RothbergLinda Bernstein Rubin and Tony RubinGertrude and William RutledgeJaclyn SmithDean Smith Celebrity RodeoJohn ShawHerb and Jacque SpivakThe Caryll M. & Norman F. Sprague FoundationConservatorship for Eugene Thames, Belle ShayerRobert and Diana ThomTower Imaging Medical Group, Inc.Warren TreppTustin Brewing CompanyUniHealth FoundationUniversal Studios, Inc.Inna VainshtockValley Radiotherapy AssociatesBea Blondell, Ursula J. Scarrow, and Mary Van HoutenVidfilm Services, Inc.

Sandi and Dan WalkerHollace Brown and Lewis WallenskyThe Walt Disney CompanyBeti WardThe Weingart FoundationThe Weisenfeld FamilyWestern Classics - Wilma RussellWitherbee FoundationF. Michael and Roberta Simmons Wong FoundationMr. and Mrs. Martin J. Wygod

BLUE SAPPHIRE CIRCLE ($25,000+)Marianna and Harry AllgauerMaria and Emilio ArechaederraTimothy Aycock Melanoma Research FoundationThe Solomon R. and Rebecca D. Baker FoundationJannell and Randy BanchikIrene and Don BaronAnne Barry Cecile and Fred Bartman FoundationBernice and Harold BelferDaisy and Daniel BelinRichard BenderMr. Jeffrey C. BeyerThe Boudjakdiji FoundationR. J. BrennerGerald BronsteinJacqueline BurdorfDr. Michael CaanThe Dr. Patrick Cadigan FamilyDr. MaryLou Ozohan and Mr. Andy CamachoBarbara and Harlan CareyMr. and Mrs. William ChristopherEvelyn Mandel and Geralin Clark Breast Cancer Research FundHorace O. Coil Living TrustJoan Walkup CorriganMarissa CoughlanIn Loving Memory of Donna J. CoxeterJoe Crail Western Mutual Insurance GroupFrances CutlerMrs. Nancy DeanDeluxe Laboratories

In Memory of Irene R. DiamantMrs. William H. Doheny, Sr.Farmers Insurance Western DivisionMichael V. FerroneWilda and Paul FetterolfMrs. Bernice Fine Edward and Sandra FinemanLynne and Michael FlynnDarlene FogelSteven FogelFoote, Cone & BeldingAlain and Myra GabbayEstate of Claude E. Gainer and Thelma J. GainerThe Robert Garthwait FamilyLucy and Francis GartlanThomas and Gerrianne GoffElma Sylvia and W. Earl GoldbergStan and Pat GoldmanJohn GouldthorpeJulia and Ken GouwReva GraziadioPamela and Neal GreenLisa and Marty GreenbergGuthy-Jackson Charitable FoundationRita Wilson and Tom HanksAnn G. HarmsenIn Memory of Cathy HasselbergerIn Memory of Morrie HazanJanet and Stanley ImermanThe JS TrustKaren and Lonnie KaneLinda KaplanKarl-Storz Endoscopy-AmericaAndrea KatzKelton Fund - Lenny and David KeltonMichael KingMrs. Virginia M. KnottAndrea and Larry KopaldJoyce and Lou KrasnyDiane KriegerAlice and Nahum LainerMr. and Mrs. Tom H. LangRichard C. LeviSuzanne and Jay LichterHal LindenThe Litt Family FoundationLOGS Financial Services, Inc.

Barbara and William LongLorraine and Elliot B. LubinWendy and Greg LumsdenEvelyn MandelMarilyn MaroneyBruce and Sandra MassmanMargaret A. MawKathleen L. McCarthyPatricia and Don McFarlaneDon H. MeinholdDonna J. MettlerMilken Family FoundationPatrick MortonMr. and Mrs. Terry MullinMutual of OmahaJosephine NaifyThe Kenneth T. and Eileen L. Norris FoundationThe Ronald Newburg FoundationJames R. OlsenSandra and Robert TeitsworthShelley J. PerelRudy PerkalSandra and Lawrence PostWilliam H. Prusoff FoundationMr. and Mrs. Phillip PurerGladys and Ralph ReisfeldJ. Marshall RobbinsMaxine RobinsonMr. and Mrs. Robert RoemmeleLee RogersConstance E. RopoloSheri RosenblumPhilip and Monica RosenthalDanielle Brown Ross and Ronald RossStephen RuvitusoAda and Leonard SandsAlvin SargentDena SchechterSandra and Vincent ScullyKreetta K. ShanerDavid and Beth ShawTeresa and Alan SmithRuth Z. SolomonStark Family TrustLarry and Marlene SternBarbara StreisandGloria StrelitzSherry Sexton Striepeke and Dan StriepekeSurf City Tourneys, Inc.

HONOR ROLL



Anita and Tim SwiftEugene and Florence TandeFerne Marshall TheisLawrence H. ThompsonSandy TsukamotoJoe and Janet TydlaskaUnion Bank of CaliforniaSusan L. and Richard VeermanEmily and Gregory WaldorfSharon and Joel WallerAudrey J. Walton and Ann Walton Kroenke Charitable FoundationWells Fargo FoundationHarriet WernerRoberta M. White in Memory of Harvey I. WhiteThe Gary and Karen Winnick FamilyRobert and Joan Young

DIAMOND CIRCLE ($500,000+)Dr. Miriam & Sheldon G. Adelson Medical Research Foundation

YELLOW SAPPHIRE CIRCLE ($250,000+)The Ahmanson FoundationThe Fashion Footwear Charitable Foundation of New YorkJohn Wayne Cancer Institute Auxiliary

EMERALD CIRCLE ($100,000+)Associates for Breast and Prostate Cancer Studies, Inc.Avon Foundation for WomenThe Eli and Edythe L. Broad FoundationThe Harold McAlister Charitable FoundationThe William Randolph Hearst Foundations

RUBY CIRCLE ($50,000+)Linda L. Brown and Maddocks- Brown FoundationPatricia C. Brown FoundationRoy E. Coats Memorial FundDoornink FamilyHenry L. Guenther FoundationEstate of George W. OgdenThe Lois Rosen FamilyJohn Wayne Cancer Foundation

BLUE SAPPHIRE CIRCLE ($25,000+)The Carole Zumbro and George Adler Family

The Bob & Gaye Harris FoundationBorstein Family FoundationMr. and Mrs. Christopher H. Buehrle in Memory of Sharon Buehrle & Alan J. PinkstaffMickey and Bud ErhardtEstate of Claude E. Gainer and Thelma J. GainerKarl-Storz Endoscopy- America, Inc.Suzanne and Jay LichterAlice and Verne McKinneyDanielle Brown Ross and Ronald RossCarole and Jeffrey SchwartzThe Al Sherman FoundationRuth Weil

PLATINUM BENEFACTORS ($10,000+)America’s CharitiesJackie and Howard BanchikJoan Berlin ReederEstate of C. June BisplinghoffGracia Bremer Charitable FoundationAbbott BrownMichael K. BrownBulova Gale FoundationCarol and Jerome CobenJoan Walkup CorriganThe Davidow Charitable FundMr. and Mrs. Neal DemDonna F. Tuttle and David G. ElmorePatricia EltonPat and Jerry EpsteinRobert H. FeldmanMary and James FlahertyLeon and Toby Gold FoundationThe Hammock Family FoundationWilliam H. Hannon FoundationImmenroth Family TrustLinda Tallen and David Paul Kane Cancer Education and Research FoundationKiwanis Club of Tustin Club No. 05103Hildegard T. and Norbert E. KnollSusan G. Komen for the CureLou Lazatin

Rama R. MantenaMr. and Mrs. Leonard MautnerHarry T. McMahonDonna J. MettlerDr. Donald and Lorraine MortonMike and Muffy Murphy FundVictoria and Carl MurrayRichard RogersLinda Bernstein Rubin and Tony RubinSheryl K. ShermanSurf City Tourneys, Inc.Audrey J. Walton and Ann Walton Kroenke Charitable FoundationMary Ann and Marvin WeissWells Fargo FoundationRobert and Joan Zukin

GOLD BENEFACTORS ($5,000+)Allos Therapeutics, Inc.The Angeles Clinic and Research Institute Inc.Maria and Emilio ArechaederraTimothy Aycock Melanoma Research FoundationThe Solomon R. and Rebecca D. Baker FoundationMilicent BoudjakdjiGerald BronsteinThe Carole and Robert Daly Charitable FoundationDiane and Daniel FeldmanMary Frances and Andrew J. FenadySandra Krause and William FitzgeraldBarbara J. ForemanFraternal Order of EaglesThe Robert Garthwait FamilyLucy and Francis GartlanJudianne and Kenneth JaffeKantor FoundationKevin R. KellyRonald A. LairdKathleen L. McCarthyRobin and Phillip McGrawMedical Oncology Association of Southern California, Inc.Roberta and Bob NovickRalph and Marcia PetersonPhilip and Monica Rosenthal

ANNUAL GIVINGJohn Wayne Cancer Institute at Saint John’s Health Center is honored to recognize the following generous donors who have made an annual commitment of $250 or more between January 1, 2012 and January 31, 2013.

HONOR ROLL



The Dinah Shore FoundationSiemens HealthcareSimon-Strauss FoundationJacquelyn and Larry StephensonTEVA Neuroscience, Inc.Tower Imaging Medical Group, Inc.Linda and Stanley TrillingHollace Brown and Lewis WallenskyJanice WeilF. Michael and Roberta Simmons Wong Foundation

BRONZE BENEFACTORS ($2,000+)21st Century OncologyMr. and Mrs. Stephen AllenThe Amyx Foundation, Inc.Jannell and Randy BanchikDoug BaronJohn R. BaronePaul B. BarsamianThe Cecile and Fred Bartman FoundationMichael BednerDebbie A. BritzDr. Michael CaanKarina Calvert - JonesGerald J. CohenMichael J. CohenKarrie and David DeatonMrs. William H. Doheny, Sr.Peter R. DunnIlene and Juels EisenbergRobert L. FlorenceMr. and Mrs. Harvey S. GettlesonBruce L. GoldsmithJulia and Ken GouwJames D. GrayCarol L. HaskinLawrence J. HasselbergerDonna and Mel HeierBradley A. JabourKaren KaplanLenny and David KeltonKelton Fund, Inc.Lawrence J. KussThe Lafferman Family FoundationAlice and Nahum LainerRena and Kirk Lenhard

Melinda LernerKathleen LewisThe Litt Family FoundationRobert MacDonaldBruce and Sandra MassmanVan and Donna McWhirterPaula Kent MeehanAnn MoorefieldMr. and Mrs. Michael MorganCathalee and Ken MoyleArnold and Sherri NelsonAlice R. NeumanThe Ronald Newburg FoundationAndrew and Helen PalmerDan S. PalmerMark B. PearceLee M. PolsterAnette Gilbert and Paul RatoffReal To Reel, Inc.Belle C. ReedMaura and Harold RichardsonNoah RosenbergMansel and Brenda RubensteinKreetta K. ShanerCharles and Donna SouthardHerb and Jacque SpivakHarold R. and Winifred R. Swanton FoundationBarbara A. TaubWilliam H. Tilley Family FoundationDr. Karen Zoller and Dr. David B. TillmanJoe and Janet TydlaskaThe Wain FoundationBeti WardPhilip WelchCarol and Robert WilsonStacey F. WinklerRobert and Joan YoungMr. and Mrs. Joseph Zukin, Jr.

ANNUAL DONORS ($1,000+)David C. AndersonMargot and Mark ArmbrusterAutozone Distribution CenterIna BezahlerThe Bidstrup FoundationLenore F. BroughtonJohn R. CopelandJoe Crail Western Mutual Insurance Group

Michael CunninghamDale E. DrumDonald S. EisenbergPamela EltonJamie B. ErlichtJoan and William FeldmanPatricia L. FentonFirst California BankPatsy P. FranklinFriars Charitable FoundationIrene M. FurlongMartin GardnerGloria and John GebbiaDonna and Norman GleitStan and Pat GoldmanMadelaine and Gene GordonFrances W. HamermeshMartha HarperSue and Larry HochbergSue and Jerry JamesonWilliam KoierJanice White and Eugene KriegerLaskey-Weil CompanyHenry M. LedermanAnna M. LehrerDavida and Don LettiereBari Lipp FoundationBarbara and William LongRuta Lee and Webb LoweDana R. MartinMaria Lim McClayDana McCormickPatricia F. McTeagueRichard F. MoganCharles MoultonMuller Family FoundationBronwyn MurdockMr. and Mrs. Jimmy Murphy Katherine OkunPaula L. PinhasPoint Dume, Ltd.Evgueni A. PopovFred PostDon QuonMarla A. RosenGertrude and William RutledgeSteven C. SchumannRita L. SchwartzThomas SloneSmiedt Family Fund Solomon, Winnettt and RosenfieldKevin Tighe

TruistJulie R. VanderboomSusan L. VeermanMelinda Wayne MuñozWells Fargo Los Angeles Real Estate GroupMrs. Florence F. WheelerRoberta M. WhiteMisty WidelitzBarbara WilsonCarl E. Wynn FoundationRichard F. ZamboniZapTel SupportStore.comMarisol ZarcoZolla Family Foundation

ANNUAL DONORS ($250+) Buzz AldrinLois Driggs AldrinHarriet AlefBen AllenMary K. AllisonRobyn L. AltmanBarbara J. AndrewJoseph A. BalbonaDiana L. Balfour QuineThomas J. BarberMargot A. BarronLuster BaylessLaurie L. BecklundHarriet Leva and Norman BeegunJudy A. BellRonald J. BellJames P. BirdwellKathleen E. BishopLisa BlonsMargaret M. BloomfieldCarl F. BohnGeorge I. BoyadjieffApril A. BradleyJoanna and Robert BrentBarbara K. BrownCharles W. BrownJacqueline BurdorfJanice H. BurrillCabrera and Associates, Inc.Elaine R. CaplowDorothy M. CarterRoxanne CarterSusana CervantesDwayne R. ChurchesClaude D. Clark

HONOR ROLL



HONOR ROLL

Wendell W. ClementsMilton L. CliftIrving A. CohenToby K. CohenThomas W. CooneyRichard CooperBrian CorminGerald K. CorneliusCornerstone Support, Inc.Thomas C. CrouseTerry and Greg CurtinSharon DanePaul C. DeutschDavid S. DiazTrish DixonBrian P. DolanCarolyn Dirks and Brett DoughertyJoseph F. Dox

Adam DuncanChet E. DyeJ. R. EganJennifer and Ralph EhrenpreisLois S. EisenbergElman Family FoundationHarold C. EricssonFloyd R. EverhartMarc EzralowLouis R. FabbianoValerie FarisJohn FarrerMarta M. FernandezPatricia R. FieldJames B. FisherFrances and Terry FlanaganDarlene FogelDan FordForest Family FoundationCyndie C. FosterNancy FoxDavid FradinGeorge W. FrankMartha J. Franklin

Ardyth FreshmanMarlene Bronson and Cliff FriedJanine and Jordan FriedbergJeri A. FukumotoKaren FurieGayle M. GardnerEvan and Valarie GardnerJack GarlockWilliam GerberStephen GetzoffTeddi and Brad GildermanClorie GillMoira GillBob GirardCherna L. GitnickPatricia S. GjerdeLesli L. GlatterGlenn R. Shuman, CPAVanessa R. GoldMarilyn and Allen GoldenEllie and Allan GoldmanDiane B. Goldstein

Neal GoodwinJoseph G. GormanLaura GrantBarbara S. GregoryBetty L. GriffithJames M. GriffithGeorge H. GrifkaLaurie HaagsmaTom J. HallEllen HallalMeryl HalpernG. P. HamatiNat HandelKeith HarmonJeff A. HastingsElizabeth HearneNancy HeilBarbara HeinrichJohn C. HeslingLynne HeslovCarolyn T. HigginsDave S. B. Hoon, MSc, PhDDiane Weil and Leslie HorowitzDoug Horton

Hospice Partners of Southern CaliforniaLeonard I. HurwittIDS Real Estate GroupIndulgence, Ltd.Janet E. InksterDeanna JackmanMary Rose and John JardineDavid JarrettDolores H. JohnsonGordon R. JohnsonJTS Technology & Realty ServicesMarla and Michael KantorAlbert M. KatzAndrea KatzJoan W. KatzPaulette KatzenbachSharon H. KesslerPatricia A. KiferSheldon M. KirschBilly E. KoenigClaire KogaDevin P. KramerDavid L. KrasneCarl D. KruegerJanet KrusiJuanita LangsfordMichelle P. LassTheresa and Robert LassAnette LevineIna and Bernard LewisDiane and David LichtAron LichtenbergRuth C. LimaShirley LipstoneGloria LitvakMarjorie H. LoebPeter M. LoisidesWilburn H. LongEvelyn and Martin LutinCorey L. LutzM.T. Novick ConstructionAlexander MarmureanuCecilia MattaAnn MazirowJames P. McNultyBrent McClaskeyTheodore L. McCluerLaurene T. McCollumMary McCormick ThomasJohn C. McGinleyAnne B. McKinley

Raylene and Bruce MeyerJodi MillerKenneth MillmanRichard MiyauchiHelene MoskowitzF. Dian MroskoMary P. MuellerFred NasonPhyllis NaultMehran M. NavidChristine and Richard NewmanBarbara D. NicholsMichael NovickNancy and Harrison OliffAnn OsherArthur B. PachecoRauna and Alvin PerryMauricio PierPeter PoulsonWilliam L. PyleDecio M. RangelMaureen N. RankinAdnan RawjeePamela RechtschaffenMarianne J. ReisNancy ReskinRespiratory Consultants of Santa MonicaDan S. RhodesRhonda Fleming FoundationJ. A. RiordanJ. Marshall Robbins FoundationJill and John RobertsonKenneth J. RodgersSylvia and Herbert RoseSandra D. RosenbaumSam RosenbergSheryl A. RossPatricia RubinsteinWendy and Kenneth RubyS.B.R., Inc.Joanne SackheimThe Samueli FoundationAda SandsYoriko SaneyoshiTimothy ScarneEve ScheinmanMichael G. SchmitzDonna L. SchweersAnne Marie ScibelliMichael S. SegalAdam SenterGary M. Shafer

We also gratefully acknowledge all of our anonymous donors.


ANNUAL GIVING (continued from page 35)


Prediman K. ShahAva T. ShambanLeigh M. ShapiroCarolyn ShelleyJoanna ShewfeltTracci ShibuyaAngela ShukittDeborah SiegelEdwin B. SiegelJames E. SimsScott L. SingerHans E. SkacelAnsel A. SlomeSt. Monica Catholic High SchoolJackie and Bob StiborCatherine A. StoneArline and Donald StroupStunt Partnership, Inc.David SugarmanKathie TakowskyMatt A. TebbettsPatience F. TekulskyLaurie A. TissotElisabeth Tolmie-NaveUniversity Scholarship FoundationStephanie VahnValley Radiotherapy AssociatesDick Van PattenBernard Van TolRichard VargasMichael VasseghiDee D. VickMr. Robert J. VignoloRicky Vinyard MarderKim VoAmir VokshoorAbraham WachtAngelle G. WackerToby WaldorfCharles WarnerJerry WashingtonWechsler FoundationGail WedrallCathleen and Gregory WerveyCynthia and Mitchell WilenDiane R. WinklerKaren B. WongAlison WoodsLaurence M. Young

Young Presidents Organization Beverly HillsLaurie ZaballosAndrea Zuckerman

Barbara and Stephen L. AllenAgnes AndersonPatricia L. AntunaAvazian Revocable Living TrustMr. and Mrs. Gordon S. AyersJackie and Howard BanchikJannell and Randy BanchikMr. and Mrs. Marvin M. BarofskyBernice and Hal BelferMarilyn BernardC. June BisplinghoffHelen and Harry BlusteenBrenda and Alan BorsteinMs. Janice H. BurrillDouglas and Mary ByardJerome C. ByrneThe Patrick F. Cadigan FamilyRobert Campbell and Alpha de Monte-CampbellRobert E. and Carol T. CanigliaGeralin A. ClarkRoy E. CoatsSandy and Irv CohenHorace O. CoilGary W. CookMr. and Mrs. Mohammad Courah

Janien DaleySherry and Charley DarganNancy L. DeanRobert L. DonleyCarolyn Dirks and Brett DoughertyConstance and Sydney DunitzMickey and Bud Erhardt Richard Andre EspinosaDiane and Daniel FeldmanSteven FeldmanMary Frances and Andrew FenadyDavid Gabriel FineJulia Fischer and Howard D. NunnMarte J. FranklinClaude E. Gainer and Thelma J. GainerGloria and John GebbiaBrian and Tracy GeschickterMr. and Mrs. Paul GilbertElma Sylvia and W. Earl GoldbergThe Harry and Eve Goldberg Foundation Julie and Stanley GoldhaberLeslie and Susan Gonda (Goldschmied) FoundationMarcia L. GoodmanJoyce GreenMargo GrogerWilliam B. Grover and Joyce R. GroverLawrence S. HamiltonRuth and Harry HansonRuth HenkinSelma L. HerbertSue and Larry HochbergGlenn IinoEmma and Otto ImmenrothJanet E. InksterDavid and Carlene IwerksJudianne and Kenneth JaffeSharon JamesLinda Tallen and David Paul Kane Cancer Education and Research FoundationLinda M. KaplanLinda and Alan KatzMrs. Beatrice S. Kaufman

Mr. and Mrs. Barry KayeRobert KelljanMichael S. KennedyHildegard T. KnollRev. James KollingRonald A. LairdAudrey and Jack LeifEdel LimprechtJudy LitvackPhyllis and George LorentzenTerrence G. MaloufEvelyn MandelRobert L. MartinLorraine and Donald MazzeoProfessor Gerald T. McLaughlinMr. and Mrs. Van N. McWhirter, Jr.Rose M. MikuleckyMrs. Maureen MillerMarilyn W. MitchellLillian and Richard MoorePat MortonPeter Richardson MullenJosephine Wayne NiggGeorge W. OgdenKatherine and Ronald OkunJuanita J. PattersonDr. Edgar B. Pease and Eiko M. PeaseAngela PorfidoRichard PriceEarl and Victoria PusheeAnnette PyesCarole D. RalstonDale and James RansomMaida and Stanley RichardsAnn and Nathan Stafford RogersCarl RomerMs. Constance E. RopoloThe Lois Rosen FamilyMs. Eleanor RothbergGaile Gray RyanEdgar J. SaltsmanJudy and Thomas SchatzmanDr. Stanley R. SchoenEllen SchuckGary L. SchwandnerSherry Sexton Striepeke and Dan StriepekeMr. and Mrs. Steve Shagan

GUARDIANS OF THE FUTUREJohn Wayne Cancer Institute is honored to recognize the following visionary donors who have included the Institute in their estate plans as members of a special honor group, the Guardians of the Future. Members are listed permanently on the Guardians of the Future plaque in the Institute’s main lobby.

HONOR ROLL

We have made every effort to ensure the accuracy of this listing. If we have made a mistake, please accept our apologies and let us know so we may correct it. Please contact 310-315-6111 or email: [email protected]


Patricia C. Brown FoundationCarolyn Dirks and Brett Dougherty and the

Joseph B. Gould Foundation Eastman KodakBen B. and Joyce E. Eisenberg FoundationRonald and Catherine Gershman Foundation Leon and Toby Gold Foundation William H. Hannon FoundationWilliam Randolph Hearst FoundationsJohn Wayne Cancer Foundation John Wayne Cancer Institute Auxiliary Lance Armstrong FoundationThe Lincy FoundationCompaq Computer Corporation Judy and Sandy LitvackThe Harold McAlister Charitable Foundation The Family of Robert Novick Mrs. Lois Rosen The Samueli Foundation The Tarble FoundationThe Ruth and Martin H. Weil Foundation The Wrather Family Foundation

* Cumulative giving of $50,000 or more to the Surgical Oncology Fellowship Program

HONOR ROLL

James A. ShanleyCaroline and Richard ShineeJohn Shuba, Jr.Jack SilberkleitMr. Albert E. SmithMarjorie and Ronald SouzaDiane Joy SweetMary and Eugene SzeEugene ThamesHazel M. ThrockmortonVickie Tomastik-SproattMary Van Houten, Ursula Scarrow, Bea BlondellEarlane and Robert Vallier

Anita and James VieceliMr. and Mrs. Robert Ray WallacePrimavera and Luis WatkinsDorothy WatsonMelinda Wayne Muñoz Martin and Ruth WeilMary Ann and Marvin WeissHarriet Phillips WernerRodney Fargo Williams and Elizabeth M. Williams Living TrustLee and Bill WoodIrene and Edwin Wright

If you would like to learn more about the Guardians

of the Future and benefits of charitable estate planning for you and your family, please contact Andy Trilling, Vice President of Development and Public Affairs, or Tanya Lopez, Director of Planned Giving, at 310-315-6111.

2012 SPECIAL EVENTSMany thanks to the individuals, groups and organizations that have coordinated special events to benefit the John Wayne Cancer Institute at Saint John’s Health Center.

ABCs Talk of the Town GalaABCs Mother’s Day LuncheonAvon Walk for Breast CancerBuerhle Golf ClassicCathy ClassicJohn Wayne Cancer Institute Auxiliary Membership LuncheonJohn Wayne Cancer Institute Auxiliary Odyssey BallPower of PinkQVC Presents Fashion Footwear Association of New York “Shoes on Sale”Surf City Tourneys, Inc.Tustin Brewing Company Golf Classic

The John Wayne Surgical Oncology Fellows

Thanks to the Generous Supporters* of the John Wayne Cancer Institute Surgical Oncology Fellowship Program

SPECIAL THANKS

GUARDIANS OF THE FUTURE (continued from page 37)


Our donors become our partners in pioneering research that is leading to innovative strategies against cancer, especially when it's at its early stages and most curable—and when it's at its most advanced stage, when few treatment options exist.

The Institute has been successful in securing highly competitive grant awards from government resources — however, cancer research at its earliest stages requires private funding to advance to a level where it can be considered for government support. With your generous

philanthropy, the Institute's scientists are able to pursue new ideas leading to early detection and greatly improved cancer care.

Benefactors and Circles of DistinctionThe Benefactors and Circles of Distinction members make up an esteemed and loyal group of annual and major donors to the John Wayne Cancer Institute who share the Wayne family's vision to eradicate cancer. We are grateful for their giving leadership to sustain our research and broaden our scientific and clinical investigation.

Benefactors Benefits (Annual giving of $2,000 or more)

• Invitation for two to our annual Benefactors Dinner in December with Institute faculty

• Invitations to special events and educational evenings

• Listing as a benefactor on donor recognition materials

Circles of Distinction Benefits(Cumulative giving of $25,000 or more)In addition to Benefactor's benefits, Circles of Distinction members receive:

• Custom-designed gold John Wayne Cancer Institute pin

• A commemorative plaque on the Circles of Distinction donor wall in the Institute's main lobby

Gold Card ProgramAnnual donors of $10,000 or

more to the Institute will become part of the Saint John's Health Center "Gold Card" Program, which includes:

• Complimentary parking• Private room priority• Expedited admission• A variety of other benefits

PHILANTHROPY

Importance of Individual Giving to JWCI

You make it possible for the Institute's physicians and scientists to make breakthrough advances in the fight against cancer!

When you designate a planned gift to the John Wayne Cancer Institute, you empower our physicians and scientists to advance the frontiers of scientific knowledge and cancer care for future generations.

In addition to supporting innovative cancer research, you and your family can also reap significant financial and tax benefits through a charitable gift from your estate.

Most planned gifts are through a will or living trust. With these, you can name the John Wayne Cancer Institute as a beneficiary, designating either a specific amount, real property and/or a

percentage of your estate. Other planned gifts, such as charitable trusts or gift annuities, can earn you or your family income and can help avoid capital gains. With the charitable IRA rollover or designation, you can save significant income and estate/ gift taxes, which can be taxed up to 70% or more!

If you would like additional information, sample language or illustrations for you and your financial advisors, please call Andy Trilling or Tanya Lopez in the JWCI Development Office at 310-315-6111. We would be pleased to provide you with information without any commitment.

The Institute is honored to recognize individuals who inform us that they have included the Institute in their estate plans on the Guardians of the Future donor wall at JWCI.

Thank you for considering a lasting legacy at the John Wayne Cancer Institute at Saint John’s Health Center.

To ensure proper fulfillment of your bequest, the correct legal description of the Institute is:

John Wayne Cancer Institute 2200 Santa Monica Blvd. Santa Monica, CA 90404Federal ID #95-429-1515

Become a Guardian of the Future for the John Wayne Cancer Institute.The Future is in Your Hands

For more information about supporting lifesaving cancer research, please contact the JWCI Development Office at 310-315-6111. Thank you!

PROFILE:

Dr. MortonHaving cherished his own

education, Dr. Donald Morton began shaping the careers of

young cancer researchers.

Stay up to date on the latest news in cancer research by following us on Facebook:

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INNOVATIONS is made

possible by the generous

support of The Juels Eisenberg Fund.

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