Episode 22 | Fireside Chat with Dr. Kim Rathmell | Empowering Innovation in Women's Health

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Podcast Guest Speakers

Brittany Connors, PMP, serves as the Director of Investor Relations at NCI SBIR. She has worked at NCI SBIR in various roles since 2013, playing a major role in the center’s Investor Initiatives program. She has maintained a vast network and works with more than 70 industry-leading investors and strategics each year to review the NCI SBIR portfolio and to select companies to attend and pitch at events like BIO.

W. Kimryn Rathmell, M.D., Ph.D., M.M.H.C., began her work as the 17th director of the National Cancer Institute in December 2023. She previously led the Vanderbilt University Medical Center as physician-in-chief and chair of the Department of Medicine. 

With a specialty in the research and treatment of complex and hereditary kidney cancers, Dr. Rathmell also focuses on underlying drivers of kidney cancers using genetic, molecular, and cell biology to develop interventions to improve patients’ lives. Beyond her research interests, Dr. Rathmell is also a steadfast champion for mentorship and development of early career researchers.

Dr. Rathmell earned undergraduate degrees in biology and chemistry from the University of Northern Iowa and her Ph.D. in biophysics and M.D. from Stanford University. She completed an internal medicine internship at the University of Chicago and an internal medicine residency, medical oncology fellowship, and postdoctoral studies at the University of Pennsylvania. In 2022, she completed her Master of Management in Health Care from the Vanderbilt University Owen Graduate School of Management.

As Senior Vice President of Extramural Discovery Science (EDS), Christina Annunziata, M.D., Ph.D., leads a team of scientific directors and staff to identify the most innovative and promising research from research grant applications to end cancer as we know it for everyone.

In addition to leading the grant Peer Review process at the ACS, Dr. Annunziata builds and fosters critical relationships with cancer researchers across the nation and with international scientific communities.

Dr. Annunziata received her M.D. and Ph.D., as well as, completed graduate school and residency training in internal medicine at Georgetown University Medical School.

Programs referenced in this episode

• Empowering Innovation in Women’s Health
• NCI Cervical Cancer ‘Last Mile’ Initiative
• ACS Voices of Black Women
• RFA: Extramural Discovery Science Accelerator Award 
• ACS BrightEdge Entrepreneurs program
• ACS Collaborate Network
• NCI SBIR Small Business Transition Grant
• NCI SBIR Investor Initiative
• Clinician Scientist Development Grant
• ACS Research Scholar Grants

Transcript

BRITTANY CONNORS:    Hello and welcome to Innovation Lab, your go to resource for all things biotech startups brought to you by the National Cancer Institute’s Small Business Innovation Research, SBIR Development Center. Our podcast hosts interviews with successful entrepreneurs and provides resources for small businesses looking to take their cutting-edge cancer solutions from lab to market. I'm Brittany Connors, the Director of Investor Relations at NCI SBIR and today's host. 

     In today's episode, you'll hear highlights from my fireside chat with NCI Director Dr. Kimryn Rathmell and American Cancer Society Senior Vice President of Extramural Discovery Science Dr. Christina Annunziata during our Empowering Innovation in Women's Health event. During the discussion, we will dive into the vision, priorities, and overall goals of the NCI and ACS in women's healthcare, as well as the journeys of these two leaders and the hurdles faced on the way to their current roles. 

     So with that, I think we should just go ahead and get started. So, it is my absolute honor to introduce Dr. Kimryn Rathmell, the Director of the National Cancer Institute, and Dr. Christina Annunziata, the Senior Vice President of Extramural Discovery Science at the American Cancer Society. Thank you both for being here. 

CHRISTINA ANNUNZIATA:    Thank you.

KIMRYN RATHMELL:    Glad to be here.

BRITTANY CONNORS:    Great. So, I think I'd like to kick us off with intros, but I think the way we could do that is maybe tell us a little bit about how you got started in science research. What interested you, what inspired you? Dr. Rathmell, would you like to pick us up? 

KIMRYN RATHMELL:    OK, sure, yeah, I'll get started. So, I'll keep it brief. But I got started more in medicine than science, to be honest. I grew up in a small town in Iowa that was -- I knew what doctors were, and I knew I liked science, so I thought I would go towards medical school. But in college, I – So, I'll stick with that for just a minute. I worked in a nursing home. I was really very sort of solidly committed to patient care and understanding the intersection between health and disease, but in college was where I learned that you could do a little bit more and you could discover something that was new, and that got me to thinking about the physician-scientist path. 

     My path is actually pretty straight, a traditional academic. I went to medical school. I didn't do the MD Ph.D. in the way where they pay for your medical school. [laughter] So, I have an MD Ph.D., but I got to pay for all of it. But I did an M.D.-Ph.D., I'm a medical oncologist. I just at every step it was reinforced to me how much I loved the finding something that was new, the curiosity driven, questioning, and being able to learn things that were not in the textbooks and being able to push that forward, whether it was in biophysics, molecular biology, which is the kind of science that I really love, or if it was in the clinic and doing clinical investigation, translational studies and things that could that could move things in that arena. 

     And then moved into administration because I think I could speak both of those languages or maybe all three of those languages, and that's the people that they kind of tap into, well, maybe wouldn't you like to lead the place and make more that. And so, I just did more and more and more of that and then I got to be here. So, you know, and this is the best job that I could ever imagine for the kinds of things that I love, which is to be able to look at the whole landscape. As NCI Director, I'm charged with the National Cancer program. And so, thinking about how do we, how do we create the discoveries and get them into the hands of patients? 

     And so, that's the academic part that I'm comfortable with, but that's also really getting into the hands of patients is in commercialization and working across industry partners and in foundations. And so, I just love, again, like, learning a whole new piece of the landscape. 

BRITTANY CONNORS:    Thank you very much. Dr. Annunziata?

CHRISTINA ANNUNZIATA:    Great. OK, so, excuse me. Hi, Tina Annunziata from the American Cancer Society. My career started actually more from the Ph.D. side, I was very interested in the scientific side, but then when I was working on my research in college, I saw that really the whole point of doing the type of research that I was enjoying doing was to get it to the patients. So, I decided to do the combined M.D.- Ph.D. program that was paid for, so, that was very, that was a perk. So, I did the combined and I did undergrad, M.D., Ph.D., and residency all in one place in Georgetown University, so, I didn't move very far. 

     And then I actually did a shortened residency in internal medicine so that I can get to my fellowship quicker. I ended up going to the National Cancer Institute for my fellowship, and then I didn't move very far, again, I stayed at the National Cancer Institute for 21 years. So, I did my fellowship there and then I did sort of additional training in the lab and I did a tenure track investigator and then senior investigator. 

     So, just recently in 2023, I moved to the American Cancer Society. And again, this was a sort of a big change, but a natural change for me in that I was reviewing and I was actually doing the research, I was reviewing other people's research as a peer reviewer, and as the study section chair, and so I took that to the American Cancer Society, where now I oversee all the grant funding that goes out. 

     And in this role, actually the American Cancer Society has many different aspects. It has the research arm, which is what -- the extramural research, which is what I am in charge of. It has the intramural research, which is probably everything that every cancer researcher sites, the cancer facts and figures, the epidemiology studies, the cohort studies looking at cancer risk, and then also the cancer guidelines. So, there's that in the intramural research program. 

     And then there is also the American Cancer Society Cancer Action Network, which has the government relations and really the lobbying side of it. And then there's the patient support arm, which really takes the discoveries to the patients and identifies the needs that are -- where we need more research and where we need more advocacy. So, the American Cancer Society really puts kind of all these things together and has a really strong niche in the cancer research and advocacy and patient support arms. 

     So yeah, so, my career started in the research and, sort of, like, continuing research, but now with a more big picture view of where can we really make the most impact, where are the needs, where are the gaps that we need more research to fill, that we need more patient support to fill, and we need more legislation to cover? 

BRITTANY CONNORS:    Great. Thank you so much. And a fun fact that we learned as we were speaking with our guests here, developing these questions is that you know, Christina just mentioned that she has experience at NCI in the women's malignancy branch and Dr. Rathmell also has experience at ACS. So, it really is kind of the perfect marriage up here of experience. So Dr. Annunziata, would you mind sharing a little bit more about your experience at NCI, how that, you know, inspired your women's health interest and how that has continued today? 

CHRISTINA ANNUNZIATA:    Yeah. Actually, I could say a lot of things about that. So, I started there as a fellow and actually my research at that point, I was very interested in B cell malignancy, so, I was into the lymphoma. I had studied for my Ph.D. I had studied Hodgkin's lymphoma. And then for my fellowship, got a postdoctoral training, I was studying multiple myeloma. But I was really inspired in the women's cancers by the patients that I was seeing with women's cancers at the National Cancer Institute and also by the mentors that I found there. 

     So, I found very strong research and very strong mentorship in the women's clinic. So that's why when I started my own career, my independent research, I kind of melded the techniques and the pathways, molecular pathways that I was studying in multiple myeloma and kind of transferred those over to say hey, how can we use these types of tools to learn about ovarian cancer? And my research was mainly focused on ovarian cancer. 

     The inspiration that I saw in the clinical trials by the mentors that I had at the National Cancer Institute was that they really looked at the clinical trial as another experiment. So, there was a hypothesis, there was materials and methods, there was results, there was data analysis. And so, we needed to collect information at each point in the trial in order to address the hypothesis and to get the results that we needed to really say yes or no. You know, the hypothesis was proven or disproven. 

     So, we did a lot of clinical trials where we collected patient samples, both biopsies and, you know, biopsies of tumor, but also liquid biopsies of circulating DNA. We did urine samples for protein. We did a lot of questions and really asked is the drug hitting its target, why is it not causing the response that we wanted, what other pathways are being up regulated? So, a lot of science was in the clinical trials and that's really what drew me to that area. 

     So, as I, you know, as I progressed in the career, I really took on a mentorship role of myself because I wanted to give back to the career, to the careers of, you know, up and coming researchers and that's something else that I very, very much enjoyed. I had medical oncology fellows, I had Ph.D. post-docs, I had high school students, which I actually just met up with one of them who's in Harvard right now, I've met up with him for coffee this morning. One of my other students is now a professor at MIT, you know? So, I love that aspect of the mentoring as well. So, I brought all that into looking at and of course got them very interested in women's cancers. 

BRITTANY CONNORS:    Great. Thank you so much. And Dr. Rathmell, I know you've had some experience with ACS as well. Do you mind describing that? 

KIMRYN RATHMELL:    Yeah, no, I think it's important to see that cancer is just a huge ecosystem and it all, it all fits together. So, I really liked that we were going to talk about some of this crossover. So, when I well -- Because when I got started, I don't know that I was aware that there were sort of camps or there were alliances. I was just an investigator who needed some funding, right? So, I started off coming out of fellowship, I had a K Award. So, I was NCI funded and that's enough to do like, this much of your work and so you know, it's time to start thinking about some more. So, I wrote grants like mad, many, many of you probably had this experience. I sent them to multiple agencies. 

     I'll actually tell you the story of my first grant. I submitted to both NCI as an R01 and to the American Cancer Society as a research program grant, our Research Scholar Grant, RSG. And I got the RSG, great sigh of relief. The government moved slow, so I didn't know yet about the other one. I got it started; I had it for about 6 months. And then I got the R01 as well, and so I thought, “Surely they'll let you keep both.” [laughter] 

     And they don't, like, you really have to pick. And so, I picked the R01, I let the ACS grant go, but of course that meant I was still eligible for ACS, so I wrote for -- and I had more projects now, I had a couple of other students in the lab, so I wrote for another RSG. I got that one. I thought this is how it's going to work. I'm going to write that one and an R01. That R1 never got funded, out of 22, so close. And then I resubmitted. Out of 21, and I think I quit at that point. And the RSG supported that grant or that project.  

     So, that was the major funding that I had from American Cancer Society, but by then, they knew me a little bit. I had a lot of phone calls with my program officer at American Cancer Society, at first pleading to keep the grant, and then understanding how you relinquish it, and then getting another one. So, shortly after they put me on a grant review panel. I was ad hoc for about five years and then I was permanent for another four or five years. So, I was for like, 10 years on the same study section. 

     And they do a really nice grant review program. At the time it was in person, I don't know if that's still true, but you really got to know the other peer reviewers, you really got to see the way it should work, which is how it works as well at NIH, but I'll tell you, the American Cancer Society really knows who's putting grants in. You see them, you're -- you know, that if they don't get funded, you see them again and you advocate for them because every one of those is a new investigator that you're trying to make sure gets funded and trying to figure out how to make it all work. 

     So, I really enjoyed being a long term member of that panel. I also worked on NCI study sections as well and saw, you know, very, very much the same kind of process, although probably not the same level of complete stability. And then, you know, as a member of the cancer ecosystem, first of all, I was granted, I was funded by other agencies too, because you went to where the funding was, but also I was very honored to be picked to do things like speak at Relay for Life events around North Carolina. And those were really special to get to see, you know, patients and advocates in the community where they live, not in your clinic room, but you know, as you're walking around and around and around that track, you know, you talk to a lot of people and you get exposure in a very different way. 

     So, to me, it's just, it's a little bit special for cancer I think than other parts of medical care, but health in general is so pivotal to everyone that these kinds of connections extend beyond any given agency. 

BRITTANY CONNORS:    Absolutely. Thank you so much. And you mentioned connections, Dr. Annunziata, you mentioned mentoring. So, as early stage, you know, entrepreneurs, people getting interested in entrepreneurship, you know, clearly starting a business is terrifying, but with this current VC environment and the fact that so few dollars go to women led companies, much less women led companies focused on women's health, what advice would you give people starting this journey so they don't get deterred? And how do they find mentors? How can they connect with people? Dr. Annunziata?

CHRISTINA ANNUNZIATA:    So, I would say, I mean, just sort of a general piece of advice is probably an obvious one is stick with it. A lot of times as Dr. Rathmell was mentioning, you don't succeed on the first try and you sort of have to have that grit and persistence to stick with it, you know, have faith in your ideas and look, source out, look for different sources, different sources of funding. Mentorship is very important. I am not a business owner, so I can't give you the specifics on the on the business side of it, but mentorship is very important to sort of find someone who's not only an instructor, but a sponsor, somebody who is really going to be in your in, you know, go to bat for you and give you support. It doesn't necessarily need to be -- sometimes not even in the same subject area, but somebody who is of the same, sort of, outlook in life experience. I would say those would be sort of general pieces of advice. 

BRITTANY CONNORS:    Great. Thank you, Dr. Rathmell? 

KIMRYN RATHMELL:    Yeah, I'll just build on that a little bit. I think knowing that you'll have lots of mentors is really important. There may be a primary mentor, but being able to reach out and find other people, that primary mentor might make that connection. I mean, I'll just share a recent post-doc of mine has a thing that he wants to develop, that's not exactly what I do, but I know someone who does something like that in that world. And so, you know, one e-mail, you know, introducing and the follow up from the former post-doc was like, “That was great. I feel like I know what I'm doing now.” 

     So like, so, I think not being afraid to make some of those requests for connections and then not being afraid to speak up. I think that the specific topic of the low levels of funding for women that, you know, these perennial disadvantages keep kind of permeating some of our discussions, they do get better and they do get overcome by, you know, just getting known, developing networks, being up there and being present. I mean, I can speak, I was a biophysicist. Like there were not very many women, I was told over and over again, I'm sure you probably were that early on, that this was not a career for women, being a physician scientist, that leading a division, not a career for women, when I was a department chair, not a career for women. And I just did and it was OK, and I just kept showing up sometimes, and just, you know, pulling up to the table. 

     I mean, I will say some of the some of the cheesy things that they say are legitimately valuable in finding your way and I -- You know, I'm not someone who's that immersed in talking to people in the venture capital space, but I know in, just in making connections and getting the kinds of responses that you want from people, often is just right, being right there, being willing to deliver, being willing to ask a question. And that has proven to be valuable for me over and over again, just to show up and ask. 

BRITTANY CONNORS:    Thank you. And what about self organizing? I know we've had this conversation before. What is the importance of self organizing and having support that's not necessarily geared toward the science or the business? 

DR. KIMRYN RATHMELL:    Excuse me. So I'll jump in, but I think that I think, particularly around women, I think that we do this naturally so that this is something that we should recognize as an asset of how women are often raised or how they, how they talk. I'm so impressed by the numbers of women billionaires out there who are organizing around creating VC for women entrepreneurs. You know, that that's -- You know, once you've got a cluster or a group of people that you know, I think young people can organize to be able to initiate the conversations and the senior people can organize as well. 

     And I've encountered groups of mixed genders as well, but women especially, it's been pivotal in my career at least two junctures where several of us that, particularly when I was a young physician scientist, there were several other scientists, women -- there were not -- This was all of them, there were like five of us, right? And so, we realized that we were raising kids. We were trying to get grants. We were trying to mentor students. We were trying to manage, you know, all of the things. And we were trying to do it alone. 

     And so then we started, you know, partnering up. And it was partly just a colleague to debrief with. And it turned out to oftentimes could be somebody else who could push you up. You know, someone who could advocate for you because they happen to be at the meeting that you weren't at or who could speak up for you in some other way. And we actually coordinated nominating each other for awards. I mean, like, there are things that women do. And I guess this is recorded -- We didn't do that. That that self organizing can really go a long ways. 

BRITTANY CONNORS:    Thank you. Dr. Annunziata?

CHRISTINA ANNUNZIATA:    Yeah, I mean, definitely I agree with everything that you said. You know, I think another aspect of it is that sometimes women can be competing against each other. And then there's another set, you know, there's another aspect where women are lifting each other up. So, I think we really need to, you know, go towards the lifting each other up because you can always grow the pot. There's, there's never really, I mean, not never, but there's sometimes a limited pot, but usually you can, by working together, the pot will grow, not have to be kind of split and compromised. 

     So, I would say that that is the aspect I would encourage everybody to, sort of, work together to lift each other up rather than trying to compete. I think women are for the most part, willing to support each other, willing, you know, used to mentoring, used to, you know, working with people above them and below them. So, I think that is also a very good strength that people can work on. 

BRITTANY CONNORS:    Great, thank you. So, now to kind of switch gears and focus on the organization level, I'm really interested to know how NCI and ACS approach women's health in general, given that women experience cancer differently. How does that go into developing, you know, the plans and the processes for the organizations themselves? Dr. Rathmell?

KIMRYN RATHMELL:    Yeah. So, for us, women's health has been, or women's cancer health has been a major initiative and I’m a member of the Women's Malignancy Branch, right here. Right? And so, you know, recognizing that breast cancer is a major part of the cancer portfolio, second, ovarian cancer, big initiatives around cervical cancer. I mean, one of the things that I'm so excited about is that if we do this right, we have all the tools to make cervical cancer not a problem anymore, right? [light applause] It's so cool. 

     So, because of the Women's Health Initiative that the Biden administration put forward earlier this year, that was a real impetus for us to stop and take stock of what we were doing to make sure that we were really doing this well. And I will say first that we have over a billion dollars that goes every year to really dedicated women’s health research, we have a number of, I think, seven SPORE’s for breast cancer. SPORE’s are like Specialized Program of Research Excellence. They're big multi-project awards around a disease topic. So 7 in breast, 6 in ovarian, we also have one in endometrial, I think one in cervical cancer. 

     So, those are sort of the obvious things, but of course women get more cancer than just the women's cancers. And so, to me it's also really important that we are looking at how women respond to therapy in other cancers. I was a GU oncologist, so, predominantly kidney, women have kidneys, too and women get kidney cancer as well. But the effects of surgery can be different in women and men. And I tend to put -- I'm trying to push our teams to really think about how we look at sex and gender differences as, sort of, major discriminators in looking at how cancers evolve and how people respond to cancer. And so, we have a number of initiatives that are already in play but thinking harder about how we address those, it is a big part of what we're doing. 

BRITTANY CONNORS:    Very cool. Dr. Annunziata?  

CHRISTINA ANNUNZIATA:    Yeah, I think that -- excuse me. Very important what you said about how any cancer can affect women and the biological differences of how the drugs are metabolized, how the, you know, how the cancer will progress, the sites that it progresses to. These are all very important questions in addition to the women specific cancers. I think another aspect is what we've at the American Cancer Society has found an alarming rate of increase in cancer in young women, meaning people under the age of 50. Large increase in colon cancer, breast cancer as well and cervical cancer. So, those are -- that is a kind of a niche area that needs to be explored and we need to look at what are the lifestyle factors that are affecting that. What are the, you know, biological, hormonal, or other metabolomic differences that are happening in the women compared to the men? So, so very important aspects to study in women's cancers and also cancers in women. 

BRITTANY CONNORS:    Thank you so much. And you know, to that point, are there certain programs that you could highlight at NCI and ACS that are, you know, following these conversations and you know, the things coming out of all of these conversations? 

KIMRYN RATHMELL:    Yeah, there are lots of different programs that we could highlight. I think one of the ones that I really want to make people aware of, I'm really excited about how much enthusiasm cervical cancer got and I think the awareness is there. But you know, getting us to the level of vaccination in young women that we need to get to, to get there is still hard. But they’re a generation who still will need to be tested, right? So, we have good testing procedures, but there are for a variety of reasons that people can't get to a gynecologist and get the kind of cervical screening that they need. 

     So, part of what's called the Last Mile Initiative, which I love because I hope that means that we're almost done is testing, HPV testing and putting it into the hands of women to self test for HPV. I think of this as a bigger initiative in general. It's called the Ship Trial by the way and it's open in 25 centers across the United States testing how effective individual women testing is and does it get people to the right follow up screening? 

     I think that's actually the really critical piece because it's going to inform us a lot about how do we enable individuals to own and know their risk for cancer and to be able to act on it really effectively. And so, I can't think of a better place to start with than cervical cancer, but that's one big initiative that I that I want to highlight. 

BRITTANY CONNORS:    Thank you. 

CHRISTINA ANNUNZIATA:    Yeah. So, I'd like to highlight American Cancer Society has just recently launched Voices of Black Women, and this is actually a study looking at cancer risk in specifically in Black women, cancer risk, so, this is before they develop the cancer. Cancer in Black women tends to be diagnosed at later stages, tends to be more aggressive histologies, and really, is a big burden on society. So, my colleague Alpa Patel in the Intramural Research Program at American Cancer Society has launched 100,000 Black women collecting, to collect samples from 100,000 Black women between the ages of 30 and 50. And they'll collect various samples, blood, urine, saliva and do questionnaires throughout a period of time to be able to assess what are the risks. 

     And what I always say to people it's always better to find cancer before or to prevent cancer, to find the risk factors and prevent cancer rather than to have to treat cancer. So, I think this is a really, really important initiative. It's launched in various areas of the United States where we have the highest mortality in cancer in Black women. So, those sites are available and we can get that information to you. 

BRITTANY CONNORS:    Thank you so much. I'm getting so excited for our next panel because the technologies and the people you will meet, it's just inspiring and I think they are going to say a lot of the things that you're saying up here about the importance of HPV testing service, cervical cancer, care, and it's going to be really, really nice. So, you know, going off of that, are there any recent success stories or particular success stories that you would like to highlight focused around women's health? 

KIMRYN RATHMELL:    Well, I'll actually point to one that's still sort of grants in progress that I'm really excited about, back, again, when the Women's Health Initiative was launched and we did, we really did stop and look at where are we putting our funds. And we realized that our funding for endometrial cancer or uterine cancer was actually kind of low. We do have a SPORE, but the number of R01s across our portfolio was not what it needs to be for the incidence of that cancer and the population that gets it. 

     And so, so, we put out a supplement and got an amazing response. So, the interest is there, the opportunities are there to be able to ask people to pivot into cancers that were previously underserved. So, I'm really excited about that and then to see what comes from that is going to be really terrific. 

     And then onto endometrial cancer in general, so we do support clinical trials for endometrial cancer like that, and that has been a cancer where there's really been almost no effective therapy. It's one of the recalcitrant tumors and just this year, Pembrolizumab was approved, I think in two different variations, so, treating with immunotherapy, offering a real hope and response for a cancer that just previously didn't have much that would touch it. So that's really exciting. And once you have that edge, you know that there's more there. 

BRITTANY CONNORS:    Absolutely. Thank you. Dr. Annunziata?

CHRISTINA ANNUNZIATA:    Yeah. So I mean, we have -- Excuse me. American Cancer Society funds probably almost 50 or over 50% of our grantees are women. We're about to announce our next slate of grants and we really have a lot of women in all levels of funding. So, from the post-docs, actually, even from the from the post backs to the post-docs and out to the research scholars and the professors. So, I think that's been really a success in the American Cancer Society.

BRITTANY CONNORS:    That's great. Thank you. And for people interested in getting to know more about some of the programs that you mentioned, how could they, you know, approach each organization and get started? 

KIMRYN RATHMELL:    And it's always, it's always on the website and we're doing a lot to keep that up to date. All of the NCI folks who are here would be glad to talk. It really is a personal organization. And so you know, getting to know people so that you have a contact can be incredibly valuable, you know, to understanding how the system works. It is not meant to be a big secret or a black box. It's actually really it -- We don't get to keep the money if we don't spend it, so we -- our goal is to really get the best research going and get it out there. 

     I did want to, because we're at a business event, just to mention a little bit more about the SBIR Program, looking to be a mentor and to find similar to what American Cancer Society is doing, trying to create entrepreneurs as well and to help people be able to get to the point where their small business is being funded. So, if that's you, you know, the road maps are out there on the website and everybody here knows how to get to them. 

BRITTANY CONNORS:    I also think it's super interesting, when we travel and meet people interested in the program, they are super shocked that our program officers are willing to have a conversation before they even start thinking about applying. Even if you're just curious, specifically to our office, we have 12 program officers and that's part of their job is to talk to people interested in our program. And they will help you identify the right path and kind of be there to support you along the way. And so, like we said previously, don't be scared, just reach out and we're more than willing to have those conversations. Yep. Definitely don't be afraid to do. Dr. Annunziata?

CHRISTINA ANNUNZIATA:    Yeah. So, so similarly we have, we have our, we call them scientific directors, which are essentially the same as program officers. Scientific directors are very willing to discuss grant opportunities. One I'd like to mention is our Accelerator Grant. This is a small grant that we give for people who are thinking of launching a company, but still need additional data to decide. It's kind of go/no go experiments, still need additional data to decide whether they want, whether they're viable to start a company. So, we have that Accelerator Program that's run by Scientific Director Doug Hurst also on our website. 

     And then the Entrepreneurs Program, which Farnaz has talked about. So, this is kind of our bridge between the discovery research and the commercialization between Farnaz and Doug. 

KIMRYN RATHMELL:    Can I say one more thing about program officers?

BRITTANY CONNORS:    Absolutely.

KIMRYN RATHMELL:    Really, I just want to emphasize what you said about their willingness to talk and be a part of your experience. I'll just share a couple of anecdotes of my own experience with program officers. So, first of all, when I got to this job as NCI Director, I was so excited, I almost cried when I met my program officer because, you know, he has been with me through thick and thin, like the grants that almost got there and then the grants that didn't. I mean, he really has become a friend. 

     But I had another program officer. I had an educational grant, a K24 -- Well, I just gave away the good part of the ending. I submitted a K24 and everyone told me, “Oh, you're a great candidate for this. It's going to be perfect. Here's what you need to do.” I did it. This is not my program officer this is just general wisdom of people which was wrong. And the program officer called me and said, “You are the right person for this award. But what you wrote is not right at all. So my advice to you is to withdraw your grant.” And I was like, “You've got to be kidding me. Like, I just wrote this grant.” 

     And she told me why and like, what the grant was really meant to be. And so I withdrew it, put it in the next time and got a perfect score. So you know, she really saved me and was a real asset throughout the duration of that grant. 

BRITTANY CONNORS:    What a great story. That's fantastic. I think now is a good time to jump into some questions. I want to make sure that we have plenty of time. Are there any currently in the audience? Feel free to raise your hand and Lauren will come find you. 

AUDIENCE MEMBER A:    It's actually a question about the ACS and the funding, right. So, you described everything that seems to describe an academic funding cycle. Is there an independent academic for like, for profit small businesses in the ACS? 

CHRISTINA ANNUNZIATA:    So, can I turn that order to Farnaz?

FARNAZ BAKHSHI:    I mean, so if you're a for profit company, you can apply for either an investment through our ACS and back venture arm. So, those are larger check sizes for more developed companies. If you are a company at the very early stages, so, you've kind of just incorporated, you have maybe a couple of employees, I would encourage you to apply for the BrightEdge Entrepreneurs Program. That's a small investment in the company, $100,000 check size in the form of a safe, and it really helps sort of with, with mentorship, with educational programming. I think the team talked a lot about mentorship. We have a large, robust mentor network that we pair folks with. And yeah, so, if you're a for profit company looking for funding, the BrightEdge Entrepreneurs and/or if you're a larger company, you can go through the look for investment through our ACS Impact Venture fund. ACS BrightEdge is our website, yeah, BrightEdge. 

     We have a flyer outside on the sign in sheet. And on the flyer, our website is on there, so I would I would look that up. We also have a LinkedIn page that we are pretty active on, so, I would check that out as well. And our phenomenal managing director Alice Pomponio is also here. You can also ask her questions. She's leading the whole thing. 

AUDIENCE MEMBER B:    Thank you. I have a question about just how little women get -- how little of venture money women founders get. I myself, I'm an academic founder, so I'm a founder of a company, but I'm also a professor at the University of Southern California and it's really hard. I do have -- I was able to raise a seed round, but just wanted to ask you what you can do at the National Cancer Institute and also at the American Cancer Society to help women get funded for their ventures? And if there's a way to like, for specifically the SBIR mechanisms, similar to being an early stage investigator or a new investigator, if there isn't or shouldn't be like, kind of a bonus, some bonus marks for women applying.

KIMRYN RATHMELL:    Yeah, actually this is your question, right?

BRITTANY CONNORS:    Yep, I’m happy to answer it. So, specifically for NCI and the SBIR Program, once you're in our portfolio, you become eligible for a program that I run called the Investor Initiatives Program where once a year you submit an additional application. It's just a short PDF, and you include all the information you would pop into a pitch deck, and I actually go out and recruit about 70 investors and strategics to then review those applications. And through that process, we determine the top 30 to 40 companies to then sponsor to attend big industry events like Bio, Resy, JP Morgan, the events around JP Morgan where you really can start getting your foot into the door of the networking process, if you haven't yet done so. 

     And I think it's just a great program to be involved in because you know, no matter if you're selected, you're showing your technology and your business to potential investors through the review and you get all of those comments back. So, it's kind of like you've already been through peer review, but now you're also going through kind of a mini industry peer review as well, and I think it's a good way to get exposure. And then if you become a part of the program, we do our best to, you know, make sure investors in our network and new people that we're meeting are aware that you're in our showcase company portfolio. 

     We have a little investor book that we hand out to investors. And if they request an introduction, we'll make a direct introduction or get them information about your company. So we're always trying to, you know, create that networking community and you know, keep it going. And I will say LinkedIn is also your best friend, I have just come to learn that, add people, message them, connect and see if they're going to events that you're going to. If you want to talk to them, use any partnering system you have access to and just try to make those connections. 

FARNAZ BAKHSHI:    So, just from that, I just want to say I could not agree with you more, it's atrocious. And, you know, 0.9% of VC funding was women in our state, 1.9% nationally, but still the numbers are just absolutely atrocious. For the BrightEdge Entrepreneurs program, 7 of the 9 are female CEO's. Now, you were saying about sort of getting an extra support, we actually did it the opposite way. We looked at the applications without knowing who would apply, who it was, male, female, whatever. We just looked at it and thought these are the nine best technologies, companies, we want to support them. It happened to be that seven of them were, right, brilliant, you know, brilliant women were the CEO's of these companies. And so, we don't need extra, we just need someone to, like, not look at us when they're deciding, right, whether to support or not. 

     So, I agree with everything that was said. Get out there, talk to people, apply to programs. If you don't get in, that's fine, you keep applying, you don't give up. Find women like Don. I mean, she is a female CEO. Her company is a portfolio company of ours. She is mentoring other people. She is mentoring Eve who is also in our cohort. So, find amazing women like Don that can mentor you and support you because that is really I think key and I think great question because it is atrocious and we are all responsible for doing something and changing that. 

     And having women VC's is also important, right. So, having Alice Pomponio as our managing director amazing, right? Like, she is in that 7%. So, having that and supporting women and having those careers is also very important because if women are making those decisions, it's going to really hopefully change the needle. Anyways, I can talk about this all day. 

BRITTANY CONNORS:    And I would like to add that we did a little analysis yesterday and we found out that 24% of our portfolio are women PI’s. And so, you know, while that's not, I think where it should be, I think we're headed in the right direction. And both Kristen and Anu, who you will hear from in a little bit, are in our Investor Showcase Program. And so, I think it's just exciting to see these things in action. 

MONIQUE POND:    All right. Thank you. So, we have a couple of people attending online today who are early career scientists. And they have a couple of ideas that they think are innovative, pretty cool. So what advice would you have for them? Where should they start out? Who should they be talking to? How can they start getting funding for their idea? 

KIMRYN RATHMELL:        So, it depends a little bit on where they are in early career. So, we have a terrific program for post doctoral fellows who are entrepreneurs and are getting a project and getting it launched. If they're further along and moving on forward, I think the place to start is, one, to find some other mentorship around, you know, to reach out and look for someone who's done this before and get some guidance from them. And I'll come back to, you know, talking to the SBIR Program and asking about the right time and what you really need to be able to use that as the tool to get a company launched. 

CHRISTINA ANNUNZIATA:    Yes, so, e also have that, as I mentioned, the Accelerator Grant if it's something that needs like a little bit more of a boost. We've also actually just launched our collaborative learning community where it can be -- so anybody can join it and learn from the lessons, from the chats, from the discussions that happened on the clever learning community in order to get a better lay of the land and see where they can, you know, at what point they need to jump in. 

KIMRYN RATHMELL:    I'm going to add one more piece, because I'm making the assumption that they might be at an academic institution with an idea that they want to take forward and that is to get to know their tech transfer people, and ask them questions early, for sure before they need to get that patent filed, way early. I have two patents, one I learned that the hard way and one I did write. But it's not just about the patent, they're like program officers, they've kind of been there, done that. They also can help with making some of the connections. You know, if their immediate mentor doesn't know, you know, someone to connect them to, tech transfer, those people will know somebody who did this just last year or two years ago and can help to put them together. 

CHRISTINA ANNUNZIATA:    Yeah, I mean, that's absolutely, absolutely true. I mean, the intellectual property is a major part of starting a company. 

MALE:    Hi. I just wanted to ask a quick question about the role of physician scientists in research and innovation in women's health. And I think about OBGYN residency as four years to learn medical and surgical training with very little opportunity for research. So, it seems like a really tough place to get people really excited that are probably best positioned to be working in this area. So, I'm just wondering if you have any insight on if you also see that as an issue and if there's ways to kind of fix that. 

CHRISTINA ANNYNZIATA:    So yeah, so, I'm a medical oncologist who works in GYN cancers, but I've trained many OBGYN and gynecologic oncologists in my clinic and in my lab. So, I would say the opportunities where people get excited, if they take, let's say, from the OBGYN residency; take some time in between residency and fellowship to do some training program either at the NIH or in the lab. I've trained people in that situation. The Gynec Fellowship used to have two years of required research, now it only has one, just a little bit harder to get people going. 

     But, you know, I've trained several gynecological oncology fellows in the research, one of which is actually running a nationwide clinical trial based on the research she did in my lab. So, that's definitely an opportunity to learn about research specifically in that OBGYN. We do have also programs from -- in the American Cancer Society, starting with high school students and getting them interested in research mainly focused on underrepresented minority populations. We have summer student programs. We have post back programs that can start even before they get to medical school. 

KIMRYN RATHMELL:    Yeah, I'll answer that from a couple different perspectives. The first is that I went all the way through my Ph.D., so, the first part of med school, Ph.D. saying I was going to be a gynecologist all the way through, until I discovered how much of a surgical specialty it really was because I thought GYNOC was where I was headed and so, I made the pivot to medicine. And so, I think there, you know, this was -- this was a long time ago. So, but even then, there was a, you know, a definite perspective that this was a harder road to go. 

     I think though my other hat is that I ran an M.D.-Ph.D. program for a long time and saw a lot of people who wanted to go into surgical specialties, and we need good surgeon scientists and so, we need OBGYN's who do this well, and the challenge there I think anybody who does something procedural is that the, you know, the muscle memory is different than a Med Onc, who can go like, read a book and then come back in. Right? So, you know, or I could tell my patient, I got to leave the room for a minute, come back, right? You can't do that in the OR, you got to be really there. 

     So, I think there's a natural structural barrier. But at the same time, the access, the opportunity to see in the realm of cancer, to see cancer in its native setting is -- that's sort of unparalleled and so, we need those good scientists there. So, I always encourage people to go into those fields and many very successfully, but to go in eyes wide open, to know that they need to go someplace where there was good leadership that was going to support them, that was going to be aware of what kind of challenges that they had. 

     And then on the other topic that you brought up about physician scientists in these innovation areas, I think we need more physician scientists there. My first real introduction to that, which is kind of stunning to me still today because it's late in my career, was when I went to do a sabbatical. I did a traditional academic sabbatical, but my husband did a sabbatical with Novartis and he was asked to go there by a guy who was a physician scientist, and I was like, “Whoa, you know, you really took a big left turn.” But I realized how important it was because he really could speak all the languages and his skill set, knowing what the patient issues were, knowing what it was in, you know, in the medical literature that was driving the kinds of questions and knowing the science behind it was really golden. So, I think we need more physician scientists, but we need them in all of these spaces. 

MICHAEL WEINGARTEN:    Kim, you actually mentioned this program earlier on, but we do have a program, it’s fairly new, it's called the Small Business Transition Grant and it's specifically targeted at early career scientists still in the lab, but interested in entrepreneurship and interested in moving their technology out of the lab. And so, it's a grant that you can apply for funding while you're still at the university. It will fund your research at the university for a year, and it will also fund both a business mentor and a technical mentor to guide you in that research. 

     And the way that the program works is it has the potential of being what we call a Fast Track Award, which is a combined Phase 1, Phase 2 award. The Phase 1 is you receive while you're still at the university a year-long project. And then at the end of the Phase 1, assuming you've accomplished all the goals of the project for the Phase 1 part, then you move out of the university to a small business, you bring the grant with you, and you continue the development of your technology at the company. And the funding continues for the research, but also for the business and technical mentors to continue guiding you on the project. 

     So, for anyone who's kind of in that space, you know, the whole reason we created the program was the cancer centers, NCI Cancer Centers came to us and they said, you know, a lot of times it's we're looking for the right person to move this technology out of the lab and an early career academic could be that right individual, but there really wasn't a good source of funding for those individuals, so this really helps kind of fill that gap. 

MONIQUE POND:    So, someone online has a question about if ACS has a focus area funding for young women who want to potentially preserve ovarian function including fertility and hormone health. I guess they have found resources before at NCI and they're just wondering if the ACS has something to complement that. 

CHRISTINA ANNUNZIATA:    We do have several grant mechanisms that would support that type of research. We don't have a specific request for applications out right now in that area, but we have several grant mechanisms that would support that. For example, we have the Clinical Scientist Development Program. If it is in that area, those tend to be, those tend to be clinicians in training. We also have Research Scholar Grants as Dr. Mattoon mentioned. And then we have some larger health equity research centers, if it would fit in sort of that niche. So, definitely reach out whoever is interested and we can walk you through where we might be able to fund that. 

EVE MCDAVID:    Thank you very much. I wanted to ask a specific question on the Ship Trial, if that is all right. I'm really curious about this. So, we also work in cervical cancer innovation and we focus on treatment. And one of the things that we've seen in global settings is that when we increase access to screening, which is a very important thing and really mission critical, it also increases, at least for some time, the diagnosis rates and increases the demand for need for treatment. 

     So, number one, I'm curious about how this is sort of estimated and projected in the Ship Trial. And then at what point, whether it is penetration or frequency, does the increase in access to screening really tamper down the need for treatment because early detection is just so much more effective with that population coverage? 

KIMRYN RATHMELL:    I hope we get to that point, for sure. You know, so, it just launched, although those are the exact questions that it's really asking. The testing itself, it is already proven. Being able to move it to like a home based test is going to be one of the first questions that we ask. But the real question is, do people use the information the way we expect them to do to get further follow up? Do they have access when they do have a positive test to get to where they need to go? And what does that do to the rates in those regions? 

     So, the populations, the clinics that were chosen were all chosen because they were underserved serving and because they had very poor rates of penetration of traditional screening. So, I think we will learn a lot because if it were easy to move on to get, you know, traditional gynecologic exam that probably would have happened already. So, whether this is going to be the motivation that it needs and doesn't overwhelm our current healthcare system, because there are limitations to what we can offer, I think we're just going to learn so much. 

     But I do hope that we get to the point where we see a big blip, you know. We will probably -- If it works well and then moves out broadly, we should see an increase in incidents as we find cases and then a nice drop off would be just, would be exactly what we'd like to see. And we'll count on ACS facts and figures to show us the curves, so. 

EVE MCDAVID:   Thank you. 

BRITTANY CONNORS:    Great. This is for Dr. Rathmell. How do you convey to Congress about the industry's role when submitting the NCI budget request? 

KIMRYN RATHMELL:    So, I get this question from members of Congress all the time is how are we interacting with business? They love the SBIR Program, by the way. They, you know, really understand the connection at that level. But industry has become such a bigger part of everything that we do, but it hasn't taken away, I mean, if anything actually as the pie grows, you know, everything has gotten a lot bigger. 

     So, when I'm putting my budget together, so I've been in the role 10 months, so, the one time that I put my budget together, it was really around the expectations that are on us. But if we want to do what people are looking for us to do, it's a lot more clinical trials, it's a lot more infrastructure to do translational work and that costs a lot of money. It also happens part and parcel with industry, because that is all, you know, that's all the things that you all are making that we want to be testing in the clinic. 

     So, they do understand that there's a give and take there. So, I spent a lot of time getting to know the members of Congress who are on the Appropriations Committee. So, it's just like all the networking and mentorship and relationship building that we've been talking about it. It's all about relationship building there as well, both with the members as well as with their staffers, they're really key that they understand the value, the importance. And the thing that's most interesting to me in talking to them is not sort of the lofty big numbers and who's doing what and sharing that, that glosses over a little bit compared to when you tell a story. 

     And so, I go in armed with a lot of stories and the story can be about, you know, a really exciting, you know, drug that was developed from a discovery in the basic science lab that takes, you know, one, we can use them in endometrial cancer, that takes, you know, one woman with endometrial cancer and offers, you know, something that extends life for, you know, six months or a year. And you can paint a picture of an individual and they can get it, right? So usually it's about patients, sometimes it's about students, sometimes it's about the things that I know are important in their communities, whether it's a rural state or a very urban state or a state that has a large indigenous population, but putting a real spin on exactly how this is going to impact someone that they will care about always goes a whole lot further.

BRITTANY CONNORS:    It’s so important. Thank you. 

ALICE:    plus Pomponia with BrightEdge. So, we spent the first half talking about empowering women to innovate in health, and I'm just looking, you can't see behind you, but the title is “Empowering Innovation in Women's Health.” And so, moving out of survival into what is the agenda moving forward, what gets you most excited in terms of innovation in women's health? And how will women leaders who are proximate leaders to these issues and understand all of the barriers to research, funding innovation, pave way?

CHRISTINA ANNUNZIATA:    Mine is very short. I think what inspires me most is that we have a women leading the National Cancer Institute. [applause] And literally, there's only one other woman who led the National Cancer Institute before, that woman is now leading the NIH. [applause] Literally, Monica was the first woman NCI Director. 

     So, I mean, I think the fact that we have women in the highest levels points to the fact that we will have more interest in women's health and more support on raising women into positions of leadership that they can then make a big impact.

KIMRYN RATHMELL:    Yeah. Well, yeah, I agree. I'm glad that I'm here too. [laughter] But the part that I specifically want to agree with is I think that it's changing the dialogue. I mean, the thing that I think I'm excited about is that people are talking about women's health and what it means and how we make a difference for women. And I think it does take some women at the table to be able to, you know, offer up some of the challenges that otherwise might have been ignored and put up the question. I mean, this is not unlike the way it was, you know, 20, 15, 20 years ago at giving, you know, going to our respective areas of research, you know, symposia where it was not uncommon to have a full panel of all men who only answered from their perspective, that is not acceptable anymore. 

     And that the same is true now as we're thinking about what trials we design, as we're thinking about what kinds of questions we're trying to answer. The dialogue is open and there are, you know, features of the research that we invest in that are not acceptable anymore. And so, I'm really excited about the future because of that.

BRITTANY CONNORS:    Thank you so much, Dr. Rathmell and Dr. Annunziata for an inspiring discussion. As always, don't forget to check our website sbir.cancer.gov for the latest funding opportunities and commercialization resources to support your journey from lab to market. This was Brittany Connors from NCI SBIR. Please join us again for the next installment of NCI SBIR Innovation Lab and subscribe today wherever you listen. 

     If you have questions about cancer or comments about this podcast, e-mail us at nciinfo@nih.gov or call us at 800-422-6237, and please be sure to mention Innovation Lab in your query. We are a production of the US Department of Health and Human Services, National Institutes of Health, National Cancer Institute. Thanks for listening. 

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