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News Highlights

October 21, 2016

Star Advertiser| Name in the News: Dr. Randall Holcombe

Editorial| Name in the News
Randall Holcombe: Director sees bright future for UH Cancer Center
*Courtesy: Honolulu Star Advertiser and Vicki Viotti
*Photo courtesy: Bruce Asato

Dr. Randall Holcombe, 59, looks out over an appealing shoreline vista from his new office as director of the University of Hawaii Cancer Center. The researchers he hopes to attract will find it appealing, too, he said.

But it's also generated $8 million in annual payments for the bond debt, and that's one challenge he's on board to help solve — all without losing sight of the center's mission. Success, he said, will hinge in part on collaboration with the adjacent John A. Burns School of Medicine (JABSOM). Holcombe, married with four grown children, is New Jersey born and raised. His career most recently led to his posts as chief medical officer for cancer for the Mount Sinai Health System, deputy director for the Tisch Cancer Institute and director of the ambulatory oncology services at Mount Sinai Hospital.

He acknowledged there's been a history of upheaval, with fiscal and personnel struggles, but he remains bullish.

"The center is not the building," he said. "The center is the people in the building, and the people here are doing phenomenal cancer research. And that's why I'm so optimistic."

QUESTION: You've said the center's cigarette tax revenue is $14 million a year, about $5 million below where it was originally. Is that why the center has been asking the Legislature for that much?

ANSWER: That's the reason for the $5 million … I feel that with the additional $5 million of support from the Legislature, we can close any remaining gap in the budget over the next three years, so that we will be functioning on a stable and sustainable fiscal platform moving forward for the long term.

I feel that there are some potential avenues for both increasing revenue into the center through some alternative means, as well as cutting some of our expenditures to close that budget gap.

Q: Can you give examples of what you can do?

A: First, I think we can improve some of the efficiencies here at the center and at the Kakaako campus in conjunction with the School of Medicine. For example, we are already working with the School of Medicine on a vivarium — that's animal research space — so that this is a joint project to improve efficiencies. …

We're also working together with the School of Medicine related to a genomics shared resource. That has to do with studying the genes of various tissues. We're interested in cancer genes, the School of Medicine is interested in other genes, but it's the same type of equipment and shared resource. …

These types of coordinated activities will help us to save some money and actually improve efficiencies and provide a better platform for research. …

From an additional revenue point of view, we are actively engaged in research — and filing patents on some discoveries from our laboratories — that we hope in the future will lead to additional revenue.

We also have some additional space in this building that is not currently being utilized and we plan to identify funds … to refurbish that space into usable laboratory space, or to refurbish it into space that could be utilized for activities in conjunction with biomedical companies, for example, to try to generate some extra revenue for the center.

Q: So this would be like leasing the space eventually?

A: We could do a few things if we open it up as lab space, then bring in new faculty. New faculty bring in new grant dollars, federal funds, that brings with it some operational funds. We already bring in over $20 million of federal support every year here to the cancer center.

At this moment the space is not being utilized so we're paying bond debt on it. So we'd like to make it usable space that actually brings in revenue.

I think we could eventually lease that space out to some biotechnology companies but… it looks like it would be at least two years before we can have those bonds redone so that would be allowable under the current structure.

Q: This center differs from other National Cancer Institute cancer centers that are attached to hospitals. This one works with a consortium of hospitals for its clinical trials to raise revenue. Can this model work?

A: Yes. Before I get to the clinical part, one of the main strengths of this center is that it focuses on cancer center research that reflects the ethnic and cultural diversity of the people here in Hawaii and across the Pacific. We have a specific cancer prevention program. It's actually quite rare that there's a formal, specific program related to cancer prevention.

We do use the Hawaii Cancer Consortium, which is made up of the Queen's Health System, Hawaii Pacific Health System as well as Kuakini Medical Center, and we use that as our clinical outlets. I think this can work.

We've already developed a clinical trials infrastructure that is expanding across those medical centers to try to bring oncology or cancer clinical trials for people who need them. I think we can increase the availability of clinical trials for patients.

And what I particularly would like to see is the University of Hawaii Cancer Center developing an infrastructure where we can bring what I call early-phase or Phase 1 trials to people who really need them. These are the earliest trials that are done in humans that bring very novel compounds to people who need them for their treatment of cancer.

That requires recruiting physician scientists who have expertise in directing those type of trials and I think we could do that with the support of our clinical partners.

Those types of clinical trials typically require someone with particular expertise, training and exper- ience, and it's those types of individuals who can be recruited to an NCI-designated center, but they probably will not go to a non-NCI designated center. And so, maintaining that National Cancer Institute designation … is critically important for this center.

Q: How do you plan to move the center toward greater autonomy?

A: One thing that has been proposed in the past is a semi-autonomous model where the cancer center would have a little more freedom to contract with commercial entities and support their research endeavors with that type of arrangement. I think that's not something that's going to be done in the short term. …

I think we do function as a relatively autonomous unit within the University of Hawaii system and we are responsible for our faculty appointments, recruitment as well as our budgets. .… We have to get various faculty appointments approved through the Board of Regents, but I don't see that as in impediment to doing excellent cancer research. We can work under the system we have at the moment.

I think the reason that some of these proposals have come up about being more autonomous is really related to the finances of the center. I think we can improve the finances with some additional support from the Legislature. I think that as we bring in more physician scientists and novel clinical trials, availability to our clinical partners, that we'll get more support from our clinical partners as well.

The longer-term goal is to really expand our programs in ways that are going to additionally benefit the people of Hawaii. So we'd like to expand in the area of cancer immunology. …That's not been an area of focus for us here in the past but I think it's an area that we can grow, and an area that will have some direct benefit for the people here in Hawaii.

Q: So, you're optimistic the center can overcome its long-term challenges?

A: Well, there's definitely been some challenges, and I recognized that before I accepted this position. But I have to be honest, I am extremely optimistic about the future of the cancer center. …

We're never going to be as large as MD Anderson or Memorial Sloan Kettering or John Hopkins or Duke, but we can still be a jewel … and do cutting-edge research here and research that's specifically focused on the cancer burden here in Hawaii.


News Highlights

September 21, 2016

6th Annual Quest for a Cure

2016 Quest Event
Thaddeus Pham with Hep Free Hawai'i
and Paula Higuchi

HONOLULU – More than 100 community members attended the University of Hawai'i Cancer Center's 6th annual Quest for a Cure: Progress in Cancer Research outreach event that took place on Saturday, September 17. The topic of the free public education event was "Fighting Cancer at the Front Lines: Prevention and Early Detection."

Quest was for anyone who wanted to learn more about cancer. UH Cancer Center experts addressed topics related to cancer prevention involving diet, heredity and the Human Papilloma Virus (HPV). The talks included:
  • The relationship between diet and cancer, Carol Boushey, Ph.D.
  • Hereditary cancer syndromes, Terrilea Burnett, Ph.D.
  • Human Papilloma Virus (HPV)-related cancers, Lee Buenconsejo-Lum, M.D.
  • My personal journey with Lynch Syndrome, Kurt Osaki
Attendees were able to take an optional tour of the UH Cancer Center after the conclusion of Quest.

For more photos from the event:


News Highlights

October 20, 2016

Top Oncologists Honored at UH Cancer Center Appreciation Dinner

The University of Hawai'i Cancer Center honored some of its top oncologists at the 2nd Annual Clinical Faculty Appreciation Dinner.

"The event allows us to show our gratitude to the dedicated doctors that work side by side with us. Their support is critical to our work here at the Center," said Dr. Randall Holcombe, UH Cancer Center director. Holcombe continued, "They help us coordinate the enrollment of patients to clinical trials and insure the quality of data collected to ensure that patients get the best and safest care available."

The doctors honored at the dinner included the Center's Clinical and Translational Research Faculty, Hawai'i Cancer Consortium members, and community oncologists.

"Without these oncologists working with the Center, cancer providers and their patients would be very challenged to participate in clinical trials in Hawai'i, and most of the trials would not be available to residents in the state," said Dr. Charles Rosser, director of the UH Cancer Center's Clinical and Translational Research Program.

UH Cancer Center Clinical Trials
Since the Center was founded in 1971, thousands of Hawai'i residents have been able to participate in UH Cancer Center coordinated clinical trials.

Currently, the Center is running about 150 active national clinical trials of new treatments and technologies for adults and children, currently following about 1,000 patients and enrolling about 324 new clinical trial patients each year.

The local residents participating in the trials (most performed in partner hospitals and clinics) include underserved and minority populations who (through UH Cancer Center coordinated trials) have access to the most innovative and latest treatments without having to travel and live on the mainland.

The UH Cancer Center honored its clinical faculty oncologists from:
University of Hawai'i Cancer Center
The Queen's Medical Center
Tripler Army Medical Center
Straub Clinic and Hospital
Kapiolani Medical Center
Pali Momi Medical Center
The John A. Burns School of Medicine
Hawai'i Oncology, Inc.
Hawai'i Cancer Care
Cancer Center of Hawai'i
Kaiser Permanente Hawai'i

Exceptional Service Honor (Highest accruals for the year):
Jeffrey Berenberg, MD Tripler Army Medical Center

Top Registering Awards (Accrued the most patients for studies):
Jared Acoba, MD The Queen's Medical Center, Hawai'i Oncology, Inc.
Mark Carmichael, MD Tripler Army Medical Center
Jonathan Cho, MD The Queen's Medical Center, Hawai'i Cancer Care
Clayton Chong, MD The Cancer Center of Hawai'i
Kenneth Sumida, MD Kuakini Medical Center, Hawai'i Oncology, Inc.
Ronald Yanagihara, MD Straub Clinic and Hospital

Top Reviewing Awards (Excellence in reviewing clinical trial studies):
Lara Au, PharmD Tripler Army Medical Center
Brian Issell, MD University of Hawai'i Cancer Center
Ian Okazaki, MD Straub Clinic and Hospital
Ian Pagano, PhD University of Hawai'i Cancer Center
Keith Terada, MD The Queen's Medical Center


The University of Hawai'i Cancer Center through its various activities, cancer trial patients and their guests, and other visitors adds more than $54 million to the O'ahu economy. This is equivalent to supporting 776 jobs. It is one of only 69 research institutions designated by the National Cancer Institute. Affiliated with the University of Hawai'i at Mānoa, the center is dedicated to eliminating cancer through research, education, and improved patient care.
Learn more at Like us on Facebook at Follow us on Twitter @UHCancerCenter.


News Highlights

August 24, 2016


HONOLULU – University of Hawai'i Cancer Center researchers discovered new genetic markers associated with a fast rate of nicotine metabolism, which potentially leads smokers to smoke more, thereby, increasing their risk for lung cancer.

Dr. Loïc Le Marchand, a professor and leading epidemiologist in the UH Cancer Center's Epidemiology Program, and his colleagues, identified differences in the CYP2A6 gene that are associated with a high rate of nicotine metabolism. Smokers who have these CYP2A6 markers may smoke more cigarettes and/or inhale a greater amount of nicotine per cigarette than smokers who metabolize nicotine less rapidly, in order to maintain stable levels of nicotine in the blood.

"Smokers adjust the way they smoke to satisfy their craving for nicotine. Nicotine is the highly addictive component in cigarettes that makes people want to smoke. Smokers with the genetic markers we discovered, smoke more extensively in order to keep their nicotine levels high and achieve the desired effects of nicotine in the brain," said Dr. Le Marchand.

"This new finding could identify smokers who are at greater risk for lung cancer. The knowledge of these markers will help doctors and public health leaders improve strategies for cancer prevention, a major focus of research at the UH Cancer Center. In addition, application of this research may improve the survival and quality of life of lung cancer patients, since continued use of tobacco products after diagnosis is known to correlate with poor outcomes," said Dr. Randall F. Holcombe, incoming director of the UH Cancer Center.

Smoking exposes individuals to tobacco-derived carcinogens. The increased exposure that occurs in individuals with the specific genetic markers leads to an increased risk for lung cancer, according to the study.

The Multiethnic Cohort Study
Le Marchand's findings published in Cancer Research used data from the UH Cancer Center's Multiethnic Cohort Study (MEC) and an international consortium of lung cancer genetic studies. Smokers are about 25 times more likely to develop lung cancer in their lifetime compared to non-smokers (Hawaii Tumor Registry). Smokers identified as being at high risk for the disease could be offered regular screenings by low-dose CT scans.

Le Marchand collaborated with University of Minnesota and University of Southern California researchers to evaluate nicotine metabolism among 2,239 smokers participating in the MEC Study.

"We were able to translate differences in lung cancer risk that we first observed among Hawai'i's ethnic groups into information that has implications for the occurrence and prevention of a common and very deadly cancer."

Lung Cancer in Hawai'i
Lung cancer remains the leading cause of cancer-related deaths in Hawai'i, with 776 new cases and 526 deaths every year. The five-year survival rate for lung cancer remains very low at 18 percent (Hawaii Tumor Registry).

The University of Hawai'i Cancer Center through its various activities, cancer trial patients and their guests, and other visitors adds more than $54 million to the O'ahu economy. This is equivalent to supporting 776 jobs. It is one of only 69 research institutions designated by the National Cancer Institute. Affiliated with the University of Hawai'i at Mānoa, the center is dedicated to eliminating cancer through research, education, and improved patient care.
Learn more at Like us on Facebook at Follow us on Twitter @UHCancerCenter.