International Bladder Cancer Collaborative Research In the U.S. - John A. Taylor III
February 24, 2020
John A. Taylor III, MD MS, Urologist, Department of Urology, University of Kansas Medical Center, Kansas City, Kansas. He is the President and Director of the Leo & Anne Albert Institute for Bladder Cancer Care and Research. Dr. Taylor’s lab focuses on pathway analysis (inflammation, aging) related to carcinogenesis and novel drug development and biomarker discovery. His research team is recognized nationally as an expert in bladder cancer pre-clinical modeling and is routinely sought by academia and industry for collaboration.
Ashish Kamat, MD, MBBS Professor of Urology and Wayne B. Duddleston Professor of Cancer Research at MD Anderson Cancer Center in Houston, Texas.
Ashish Kamat: It gives me great pleasure to welcome a dear friend and colleague, Dr. John Taylor today to UroToday. Dr. Taylor is a Professor of Urology and Director of the Cancer Program at KU and knows a lot about bladder cancer, but John, today I want to pick your brain a little bit on a slightly different topic, not bladder cancer per se, but more about the opportunities and research collaborations that we have available in the United States today for bladder cancer internationally. And that's mainly because you've been very instrumental in founding and running the Albert Institute of Bladder Cancer Care and Research which I've been fortunate to be part of and it really is setting the stage for collaborative research in the U.S. Could you tell us a little bit more about that?
John Taylor: I think that as clinician-scientists, as you are, as much as I am, we tended to struggle a little bit in driving collaborations with Ph.D. scientists as well as with other folks that were doing work. You and I have been able to successfully do things much out of our own devices. But I think part of the Albert, which you were instrumental in helping set up was to facilitate and provide a platform to drive those collaborations. We put together the annual symposium where we identify topics that are critical or in critical need or have gaps in knowledge that need to be addressed. And it's created the platform that brings researchers from different universities together, not just clinicians, clinician-scientists, Ph.D. scientists, patients interested in advancing research, and it puts us all in the same room and it drives interaction between the groups focusing on critical issues of need in bladder cancer.
And one of the things that early on you and I had discussed to make different and meaningful was to fund research projects that come out of that. So we've been successful in doing that and funding two projects that are derived from the meeting each year. The mandate or the requirement in that is they have to be multi-institutional and they have to address a problem in a way that couldn't have been done as a single institution. So I think there's a tremendous amount of opportunity. I think the Albert is one platform to drive that type of research.
Ashish Kamat: And knowing you throughout the years you've always been a force in the collaborative spirit of things, getting people together, getting them in the same room to talk the same language. Could you share with the audience because they are obviously younger folks that are looking on and looking for guidance in their careers, what would be some of the tips that you would give them as far as getting involved in such an endeavor and process would be?
John Taylor: I think first and foremost is to be true to your goals and your research. If you're not interested in it, don't do it because that shows very early on. And if you're looking for collaborations, you'll be judged about how sincere you are. I think the clinicians are a little bit under the microscope as to whether we're really doing research or if we're going to be clinically oriented. So you have to build some reputation with small grants through your mentor, through your university to get the credibility that you're really going to be a researcher. But don't be afraid to ask for help. Don't be afraid to reach across to folks. In much as you and I started when we first met was, "What are you doing? What are you doing? Well is there a way that we can work together?" And that drove some of our early collaborations.
Ultimately it led to the development of the Albert, but stick with it, don't give up. Take your punches. There'll be lots of them from the NIH or other places. But if you're committed to it, stay true, reach out for collaborations. Don't be afraid to, don't be afraid to ask other senior people for advice or help. And don't worry so much about success it will come if you're persistent. So one of the first things I learned is the only grant that's not funded is the one that's not written. It's the only guarantee. You don't write it, you'll never get funded.
Ashish Kamat: Very good advice because if you don't take the shot you, you never make it, right?
John Taylor: Right, Yeah.
Ashish Kamat: ...same thing with grants. There's a lot of organizations now, of course, the AUA has its research arm, there's the Albert Institute, there's the International Bladder Cancer Group, which I lead and which we are collaborating on, with all these acronyms and different organizations out there, how would you recommend people select and pick and choose which part of which organization they should be part of? Or can everybody come together and work as one, how do you see this field moving forward?
John Taylor: Yeah, and that's been one of the... not difficulties in the area, but it's certainly changed a lot in the dynamics in the last 10 years. A decade ago, there was nothing. A little over a decade ago, there was nothing. Then there was BCAN Bladder Cancer Advocacy Network, which Diane founded and has pushed forward with the Think Tank and that was it for a long time. And then the Albert was developed, the IBCM, the IBCG. I think that one isn't better than the next. I think they all serve a slightly different purpose. And from you getting me involved in the international field, it's been eye-opening to see what they're doing over there. And for example, we just submit a UO1 with Fred Witjes, it's an NIH grant with Fred. So the international collaborations are very fruitful.
I think we're beginning to build in some redundancy and you and I have really worked very hard to identify where the Albert Institute could fit in more at the preclinical early phase conduit for early IP ideas to be supported and bounced off keeping your leaders to get inside, how do you move it forward? But we've really tried to fit into the early phase area preclinical Phase I with window trials and building a platform for that. BCAN tends to be a little bit later in the game of bladder cancer and they're also big for patient advocacy. I think the international groups are still figuring out where they are. The IBCG certainly is playing a big role.
I think that every entity has a unique aspect. I think there is potential for overlap. There is some overlap and I think that as things move forward we'll figure out how to integrate and work closer together as we've talked about IBCG and Albert, is there a way to integrate to some degree to facilitate the goals of each institution. So I don't think it's necessarily picking which one to be involved in. Much like I said earlier, don't be afraid to stick your neck out, get involved at all, see which one facilitates where you are in your career and what you want to do and go with that entity as long as it fulfills your needs but be an ambassador within the bladder cancer field, its too small to not be and help integration of the entities and the groups.
Ashish Kamat: Very important point because obviously when you and I started out in bladder cancer, it didn't have much going on as far as research and collaboration and now there's been an explosion of activity and the more young people we get involved in the field to help us in our patients obviously the better. In closing, I just want to ask you because you mentioned about early phase trials and of course you have several posters here at GU ASCO. Could you share with our audience some of the work that you've been doing as part of that and what's being presented here at GU ASCO?
John Taylor: Yeah, happily. As you know, most of my research is target identification and novel drug development. That's actually what got me from the East coast to the Midwest because of the drug program at the university I'm at. But we have a novel agent, ciclopirox, which is a long story which we don't have time for, but ultimately came down to being developed for bladder cancer and it's still unclear, originally it was focused for non-muscle, but we think it may have activity and muscle-invasive. So it is the first bench to bedside drug from the University of Kansas.
We've completed the Phase I three by three dose-escalation trial in all solid tumors. We got our Phase II dosing and we're now running an expansion cohort still Phase 1a essentially in a cisplatin-eligible muscle-invasive bladder cancer patients to try to a), show tolerability in the population we want to address it in, but more importantly see if we can get a marker of tissue activity in there so they're dosed prior so there's no other treatment to confound the findings that we'll get and then they get their cystectomy.
We'll take any remaining or residual tissue and we'll interrogate it for markers of activity of the drug. That's one of ours that came out of there and we also have a novel investigator-initiated trial, which we've, we've briefly talked about, you and I with vitamin C, a high dose intravenous vitamin C with gem/carbo in the cisplatin-ineligible space. Had some really intriguing initial results in the patients that have been through that already, but very promising. And then we have some other compounds that we're working with the NCI: SBIR & STTR program to develop for bladder cancer. So there's a lot coming down the pike, but the reason that it works is because there is a pipeline system in place and that's what we're trying to extend through the Albert to offer to all folks in bladder cancer, a plug and play window trials in non-muscle and muscle-invasive space for novel agents.
Ashish Kamat: Right, exactly. Well, I want to thank you again. This has been great for taking some time off your busy day here at GU ASCO.
John Taylor: Always a pleasure sitting down with you.
Ashish Kamat: Thank you, John.