American Urological Association - AUA Investigator Fall 2016

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AUA Investigator Fall 2016

Feature Articles

Investigating New Opportunities for a Urology Research Journal

Dr. Aria F. Olumi, MD
Dr. Aria F. Olumi, MD

After many years of educating the urologic community with its basic and translational science content, the Investigative Urology section of the Journal of Urology (JU) will go off the press in January 2017. Originally as a stand-alone journal and subsequently as a merged publication with JU, after 53 years of publication, Investigative Urology made a substantial contribution towards sharing the latest advances in urologic basic science and facilitating their translation to clinical impact. The hope now is that the legacy of Investigative Urology will be one of having opened new opportunities for urology researchers to share and advance their research.

Recognizing that there is a need for basic urologic research to have a home for publication, the AUA, with the help of its council and committees, and participation of subspecialty and research societies such as the Society for Basic Urologic Research, is exploring existing and new alternative options to effectively disseminate the advances of basic urologic research.

Starting a brand new journal without an identified readership, no prior track record and absence of metrics that many journals use like the “impact factor,” can be quite challenging. Therefore, our team has been in communication with established journals that have an interest in urologic basic research to publish and promote the science that is vital to our community. We have explored two models:

  1. To develop a partnership with a review journal and promote basic research from different subspecialty societies. Through a partnership with the AUA, the review journal would publicize and promote the subspecialty society’s annuaal meeting program via advance notices and social media support, along with an opportunity to publish an overview of the meeting in the journal.
  2. To explore an open access publishing model with an established and well respected publisher that will bring expertise of soliciting and circulating quality manuscripts. We believe that the publishing model for scientific work is rapidly changing and, potentially, the traditional model of printed journals that has been used for dissemination of scientific advances is going through a significant transformation.

We will continue to explore the different opportunities to promote urologic research, and in the meantime have a high quality journal for the research community in the absence of Investigative Urology. Seeking input from the scientific community will be vital in order to deliver the best possible product for scientists who are ultimately working to improve the urologic care worldwide.


AUA Early-Career Investigators Workshop Sees Tremendous Impact

John Leppert, MD, MS and John T. Wei, MD
John Leppert, MD, MS from Stanford University working with his scientific advisor John T. Wei, MD from the University of Michigan.

A recent outcomes analysis of the first two years of the AUA Early-Career Investigators Workshop (ECIW) found that participants were awarded a combined $1.2 million in federal funding. Given the amount of money the AUA has historically invested in this program and the amount of federal funding our participants receive, this workshop represents at least a 35:1 return on investment into the urologic research community.

Furthermore, the success rate for our participants in obtaining NIH funding far exceeds that of the general success rates. ECIW participants from the first two years of the workshop who submitted an NIH application saw a 60% success rate in funding. The average success rate for NIH applicants in 2015 was 18%.

The AUA remains steadfastly committed to advancing urology through research education. The ECIW was initiated in 2012 and has been offered annually since 2014. With the number of applications received increasing by more than 300%, the AUA continually seeks federal and private funding in order to accommodate more participants and faculty.

The ECIW fosters career development in urologic research by providing participants with a solid foundation for successful grant writing. The most impactful feature of this workshop is the one-on-one mentoring sessions with scientific advisors. Participants who are near to submitting a major grant application are paired with a senior scientific advisor to strengthen the project description and overall application. Since the workshop spans three days and the participant begins working with their advisor prior to the workshop, participants often receive several rounds of review by the end of the workshop.

Other activities of the workshop include presentations on navigating federally-funded grant programs and opportunities to directly interact with program officers, mock peer review, presentations on developing a fundable research program and career development presentations.

New for 2016: In order to best support participants who are not quite ready to submit a major research grant, the workshop now offers small-group sessions during which participants are matched with a senior scientific advisor. This will allow participants to share and expand their preliminary ideas facilitated by expert guidance from an advisor.

New for 2016: Recognizing that many of our participants are physician-scientists, the ECIW is now CME accredited. The 2016 workshop was designated for a maximum of 18.75 AMA PRA Category 1 Credits™.

Interested in serving as a scientific advisor or wish to share your experiences and expertise with the next generation of urologic researchers? Contact at investigator@auanet.org.

Urology Researchers Making a Difference

2016 Rising Stars in Urology Research Awardee: Dr. Matthew J. Resnick

Matthew J. Resnick, MD

Matthew J. Resnick, MD, MPH is Assistant Professor of Urologic Surgery and Health Policy at Vanderbilt University Medical Center in Nashville, Tennessee. His project, titled "The Effect of ACO Enrollment on Appropriateness of Cancer Screening," is funded not only by the American Cancer Society but also through the Rising Stars in Urology Research Award (the Urology Care Foundation) and Astellas Pharma, US, Inc.

As a call to improve the value of health care delivered to Americans through the Affordable Care Act (ACA), the Centers for Medicare and Medicaid Services (CMS) established the Medicare Shared Savings Program (MSSP), a unique Accountable Care Organization (ACO) payment model. Despite the potential of the ACO model to both reduce health care spending and improve quality, little is known about the potential impacts of this novel payment design on the appropriateness of cancer diagnosis, treatment and survivorship.

The purpose of Dr. Resnick’s study is to identify whether the net effect of cost and quality measurement as part of the largest Medicare ACO program results in better screening for breast, colorectal and prostate cancer, namely undertaking screening those most likely to benefit from early cancer detection, and withholding cancer screening from those unlikely to benefit. He will characterize both the intended and untended consequences of ACO enrollment on cancer screening with the goal of informing future policy efforts to optimize cancer outcomes.

The incentives underlying health care decision-making continue to evolve as providers and patients alike face dynamic pressures to improve health care quality and reduce associated costs. The net effect of these pressures with respect to cancer epidemiology remains poorly characterized. The overarching goal of Dr. Resnick’s research program is to determine the effect of payment reform on the diagnosis of screen-detected cancers. In doing so, this work aims to ensure that payment reform moves toward ensuring that the right services are delivered to the right patients at the right time.

Before Dr. Resnick began this work at Vanderbilt University Medical Center, he was awarded a Urology Care Foundation Research Scholar Award in 2013. According to Dr. Resnick, this award catalyzed his interest in evaluating both the intended and unintended consequences of health care delivery system reform. He writes:

My work as a Research Scholar afforded me critical exposure to relevant methods to be used in policy evaluation and to the strengths and limitations of using administrative claims to answer research questions. Most importantly, however, my research activities as a Research Scholar shaped the context for my career development, identified key knowledge gaps that evolved into my career development plan, and solidified my ongoing relationships with my mentorship team.

Mentored research training is a cornerstone of Urology Care Foundation-funded research, and the strength of an applicant’s mentoring team is a critical component to any grant application. The AUA and the Urology Care Foundation are committed to ensuring that our funded researchers are provided with exceptional training to support a successful research career. Recognizing this value, Dr. Resnick noted that he has been extremely fortunate to have developed productive and meaningful relationships with mentors at every stage in his career. There are myriad challenges in the path to becoming a successful surgeon-scientist in today’s health care environment, and in Dr. Resnick’s opinion, successful mentorship is a necessary component to overcome these barriers.


First Research Scholar Award Dedicated to NCI SPORE Project: Dr. Simpa Salami

Simpa Salami, MD, MPH

Simpa Salami, MD, MPH is the recipient of the first Urology Care Foundation Research Scholar Award dedicated to supporting a urology physician-scientist at a National Cancer Institute (NCI) Specialized Program of Research Excellence (SPORE). This award was made possible thanks to the long-standing commitment and support of the Society for Urologic Oncology, Inc. Dr. Salami’s year-long research project, titled “Molecular Profiling of Serial Targeted Biopsy Tissue to Predict Progression of Low to High Grade Prostate Cancer in Men on Active Surveillance,” is being conducted at the University of Michigan under the mentorship of Ganesh Palapattu, MD; Scott Tomlins, MD, PhD; and Leonard Marks, MD.

The University of Michigan Prostate SPORE was launched in 1995 and was one of the first NCI-funded SPORE programs in the country. The goals of the University of Michigan Prostate SPORE are “to foster research productivity, promote interaction and collaboration among researchers, and optimize the institution's strengths and unique scientific opportunities to advance prostate cancer prevention, diagnosis, treatment and survivorship.” Dr. Salami’s research is focused on optimizing prostate cancer diagnosis and accurately stratifying patients into risk categories.

Although clinical and laboratory markers such as digital rectal exam (DRE), prostate specific antigen (PSA) and PSA velocity or doubling time may be used to monitor patients on active surveillance (AS) for prostate cancer, they cannot reliably predict progression of disease and therefore cause potential delay in diagnosis and treatment. It is also unclear if low-grade tumors (Gleason 6) can truly progress to high-grade (Gleason ≥7) tumors. To help address this knowledge gap, Dr. Salami’s research project aims to determine if high-grade prostate cancers may arise clonally from low-grade prostate cancers, and to define the molecular profile of low-grade prostate cancers that exhibit disease progression.

Dr. Salami has assembled tissue obtained at two different time points (time=0 and time ≥1 year later) using a magnetic resonance imaging/ultrasound (MRI/US) fusion biopsy system that allows electronic tracking to ensure that tissue is obtained from the same intra-prostatic site. Immunohistochemistry for the prostate cancer-associated protein, ERG, will be performed to determine the clonality of the tumor foci at each time point. In addition, DNA and RNA will be co-isolated for targeted multiplexed PCR-based next generation sequencing (NGS) to identify potential driving genetic alterations including somatic mutations, copy number alterations and gene fusions.

The results from his project will empower patients with precise information as they decide on the best course of action following a diagnosis of low-grade prostate cancer. A better understanding of ‘low risk’ and ‘high risk’ Gleason 6 prostate cancer may profoundly alter the management of the rapidly growing number of men on AS. Patients will be able to determine if their newly diagnosed low-grade prostate cancer will progress to high-grade and thus make an informed decision regarding AS or definitive treatment. This project has the potential to prevent possible delay in diagnosis and consequent suffering from locally advanced or metastatic prostate cancer. 

This award will serve as a launching pad for Dr. Salami’s career in urologic oncology research and practice upon completion of his fellowship training in June 2017. He anticipates taking a lead role in the improvement of urologic care delivery through translational research that seeks to improve, refine and innovate the way prostate cancer is detected and managed. Dr. Salami is excited about his future of becoming an independently funded surgeon-scientist in an academic institution engaging in cutting-edge research and teaching and mentoring medical students, residents, fellows and junior faculty.

Research Funding Highlights

NIH Loan Repayment Programs

The NIH Loan Repayment Programs (LRPs) are a set of programs established by Congress and designed to recruit and retain highly qualified health professionals into biomedical or biobehavioral research careers. If you are a qualified health professional who agrees to engage in NIH mission-relevant research for at least 20 hours per week at a nonprofit or government institution, then you may be eligible to apply to one of the five NIH extramural LRPs. In exchange for your commitment, the NIH will repay up to $70,000 of student loan debt per two-year contract.

The LRP 2016 application cycle opened on September 1, 2016 and will close on November 15, 2016. The online application has been redesigned for this year’s competition in order to make applying quicker and easier. Applicants who are applying for new awards and renewals are required to have an eRA Commons ID to submit an LRP application. In addition, there is now one application submission deadline for all programs.

There are a total of five extramural Loan Repayment Programs, all of which are relevant to urologic research:

Clinical Research
For clinical investigators interacting with human patients in an inpatient or outpatient setting.

Clinical Research for Individuals from Disadvantaged Backgrounds
For clinical investigators coming from an environment that inhibited the individual from obtaining the knowledge, skill and ability required to enroll in, and graduate from, a health professional school, or from a family with an annual income below low-income thresholds.

Pediatric Research
For investigators conducting research directly related to diseases, disorders and other conditions in children.

Contraception and Infertility Research
For investigators conducting research in conditions that impact on the ability of couples to either conceive or bear young.

Health Disparities Research
For investigators conducting research that focuses on one or more of the minority health disparity populations defined by NIMHD and the Agency for Healthcare Research and Quality.

You can also view an informational webinar, hosted by the NIH Division of Loan Repayment.

Research Resources

Columbia University George M. O’Brien Urology Center Addresses the Causes of Congenital Urinary Tract Malformations

Columbia University George M. O’Brien CenterThe overall goal of the Columbia University O’Brien Urology Center is to generate the much-needed link between basic and clinical researchers in order to maximize the chances of solving important problems in urology. The center works towards this goal by providing research opportunities for students and fellows, as well as hosting seminars, internal research meetings and an annual symposium. These initiatives are all aimed at attracting new researchers to the field and educating the next generation of clinician-scientists and researchers.

Specifically, this center brings together research programs in human genetics and mouse models to address the causes of congenital urinary tract malformations. Urinary tract obstruction is a collection of abnormalities, such as posterior urethral valves, vesicoureteral reflux and hydronephrosis, that are common birth defects in humans accounting for 20% of chronic kidney failure in children. The origins of these congenital defects and the pathogenesis of their complications are not well understood, and so the O’Brien Urology Center seeks to use a multidisciplinary, cooperative approach to address this important problem in pediatric urology.

There is a great deal of collaboration between scientists at the Columbia University Medical Center, fostering interactions between investigators in the Urology, Nephrology and the Genes & Development Programs. The center is thus built on a long track record of original, joint research between the PIs and the success of their highly interconnected projects as predicated on the continuous exchange of ideas, expertise and data within the center. Importantly, all the projects involve reciprocal investigation of humans and mice, and will leverage NIDDK cohorts such as the Randomized Intervention for Children with Vesicoureteral Reflux (RIVUR), the Chronic Kidney Disease in Children (CKiD) as well as data from the Genitourinary Database Molecular Anatomy Program (GUDMAP).

The center also offers genetic and mouse model resources for researchers. 
Genetic Resources Cell type-specific gene expression profiles in the bladder

  • Profiles of gene expression from Sall1 mutants
  • Kidney damage
  • Kidney infection, cystitis and pyelonephritis

Mouse Model Resources

  • ShhCre; Pparg knockout mice
  • B6.Cg-Lamc2tm1Uit/Dcrj
  • Lama3 conditional knockout mouse
  • Cell specific gene expression in vivo
  • Megalyn CreERT2-MC
  • Megalyn CreERT2-MC5
  • Tamm-Horsfall

For more information, visit http://cumcobriencenter.com/.

Research and Patient Advocacy

Action to Cure Kidney Cancer

by Frederick L. Atkin, Vice President, Action to Cure Kidney Cancer

Action to Cure Kidney CancerAction to Cure Kidney Cancer (ACKC) is a 501(c)(3) not-for-profit organization founded in 2003 by patients and their families to advocate for increased federal and private funding for kidney cancer research to improve risk assessment, screening and treatment, and ultimately to find a cure for kidney cancer. To date, in addition to its advocacy efforts, the ACKC has provided close to $400,000 in direct funding to support kidney cancer research.

Early on, the ACKC discovered the existence of the Congressionally Directed Medical Research Programs (CDMRP) which was created to augment cancer research funding, given that members of the U.S. military suffer from similar or even higher rates of cancer than does the general public. As noted in the Summer 2016 issue of the AUA Investigator, “CDMRPs play a unique role in the medical research community, investing in high-reward research grants through a peer-review system. The initiatives under the CDMRPs are critical to advancing our understanding of a variety of health issues and have a proven track record of contributing to major medical breakthroughs.” The CDMRP is very different from the National Cancer Institute (NCI) grant review process, in that patient advocates and survivors are included as voting members in addition to the scientific members at both levels of review. In addition, the advocates participate in developing the vision for the research that will be funded in any given year. The patient advocates are respected members of the CDMRP panels because they provide the face to the disease and can identify from their experience where research is most needed.

In 2004, ACKC initiated a campaign calling for inclusion of kidney cancer as a separate line item in the CDMRP. We obtained bi-partisan Senate and House sponsorship of a “Dear Colleague” letter which was sent to the Defense Appropriation subcommittees asking for this funding. In 2006, kidney cancer was added as a topic area to the Peer Reviewed Medical Research Program (PRMRP) and was moved to the Peer Reviewed Cancer Research Program (PRCRP) in 2009. Kidney cancer in both the PRMRP and PRCRP had to compete with other diseases/cancers for research grants. From 2006 through 2015, kidney cancer researchers received a total of $10 million in research grants from these two programs.

ACKC has, until very recently, been the only not-for-profit organization to advocate for a stand-alone CDMRP kidney cancer research program. In addition to its “March on Washington” in the spring of each year, it has briefed Congressional staffers about kidney cancer and the need to fund research as it has been significantly underfunded compared with other cancers. This year, the ACKC attained a breakthrough, in that the House passed the FY2017 Defense Appropriations bill, which includes $10 million targeted for kidney cancer research.

To support the outstanding work of the ACKC, the AUA has recently joined in their initiative and, with these combined efforts, there is increased hope that kidney cancer will receive its own CDMRP research budget. If we are successful, a new and significant avenue for kidney cancer research will be amplified which will be very exciting news for the AUA research and clinical communities alike.

The ACKC website (www.ackc.org) emphasizes not only the latest news in kidney cancer research, but also provides four up-to-date patient guides for patients and caregivers:

  • Guide 1: Understanding My Disease is written for the newly diagnosed patient.
  • Guide 2: Managing My Cancer is about the care and treatment of kidney cancer patients
    with metastatic disease.
  • Guide 3: Caring for My Caregiver is for the people in your life who are helping you.
  • Guide 4: When Treatment Ends is designed for both patients and their loved ones.

Did You Know?

Did You Know Fall 2016

Calendar of Research Events

Nov 3-6

Sexual Medicine Society of North America Annual Fall Scientific Meeting
The Phoenician | Scottsdale, AZ

Nov 8-12

34th World Congress of Endourology
Cape Town International Convention Centre | Cape Town, South Africa

Nov 10-13

Society for Basic Urologic Research Fall Symposium
Scottsdale Plaza Resort | Scottsdale, AZ

Nov 30-Dec 2

Society for Urologic Oncology, Inc. Annual Meeting
Grand Hyatt San Antonio | San Antonio, TX

Opportunities in Urologic Research

Massachusetts General Hospital

Postdoctoral Fellow

The Laboratory of Dr. Aria F. Olumi at Massachusetts General Hospital has an open position for a highly motivated postdoctoral fellow to study the molecular mechanisms of benign prostatic hyperplasia, the most common neoplasm in adult males worldwide. We have found that in 30% of human adult men, epigenetic modification of the 5-alpha reductase 2 gene, the gene responsible for prostatic growth and development, silences the gene. The epigenetic modification leads to an “androgenic to estrogenic switch” in the adult male prostate tissue, which opens possibilities for targeted personalized care for men suffering from bladder outlet obstructive symptoms from BPH.

Applicants should possess a PhD and/or MD, with experience in molecular biology, cellular biology and/or bioinformatics. Experience in urologic research is a plus but not required. A strong publication record with independent writing skills and an ability to work in a team environment are essential. The start date is flexible and the salary is in accordance to the NIH scale.

Please direct inquiries to Olumi.Aria@mgh.harvard.edu. Applicants should submit a letter of interest, their CV and contact information for three references.


Are You Recruiting?

We encourage the submission of employment opportunities in urologic research—trainees and faculty only—to be posted in our next issue, which will be released this December. Submission is no guarantee of publication. Please contact the AUA Office of Research with any questions.

Stay Connected

We encourage the submission of employment opportunities in urologic research — trainees and faculty only — to be posted in our next issue, which will be released in March 2016. Submission is no guarantee of publication. Please contact the AUA Office of Research with any questions.


Eureka!

Eureka! is a bi-monthly email newsletter that contains urology research news, funding opportunities and updates from the AUA Office of Research. View the most recent issue!


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Did We Miss Something?

If you have any suggestions for urologic research-related content or are interested in contributing information from your own organization or institution, please contact us.

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