Under the Microscope: Providing Care and Pioneering Cures

It was the early 1990s and Bob Bast, M.D., was leading the Duke Comprehensive Cancer Center, caring for cancer patients in the clinic and making important inroads against ovarian and breast cancer in the laboratory. His colleague, Joe Moore, M.D., was caring for a patient named Jim Valvano who had just come to Duke. Bast could not have known how much that patient would change the face of cancer research—and continue to inspire and strengthen his own commitment to cancer patients and research for decades to come.

At the V Foundation’s launch in 1993, Bast and Moore joined the Board of Directors as the two physicians invited to guide the foundation’s research activities. Bast recruited a group of internationally respected authorities in cancer research to serve as a Scientific Advisory Committee and chaired that distinguished group for more than a quarter century. Earlier this year, he stepped down as chair, but remains integrally involved with the Scientific Advisory Committee and Board.

“Like many people associated with the V Foundation, I was inspired by Jim Valvano,” says Bast, Vice President for Translational Research at The University of Texas MD Anderson Cancer Center. “It’s been an incredible privilege to work with the V Foundation for more than 25 years, and a wonderful experience to help figure out where we could make the best and smartest investments with the funds that were raised.”

Answering an unmet need

While the bulk of cancer research funding in the United States comes from the federal government, there simply isn’t enough federal funding to support all of the most promising research ideas. From its launch through to today, Bast says the V Foundation has played a critical role in filling that gap with more than $225 million contributed by donors.

In his view, the Foundation has been especially impactful in two areas: advancing research aimed at speeding the transition from laboratory insights to helping patients (known as translational research) and supporting early-career researchers.

“It’s particularly hard for young investigators to get a start in cancer research, and there is a huge need to make sure that people who want to do cancer research have the opportunity to pursue that goal,” Bast explains. To answer that need, the V Scholars and V Clinical Scholars programs identify the ‘best and brightest’ laboratory scientists and clinical investigators early in their careers and provide a critical infusion of support to establish their own research program at a time when some might otherwise be forced to abandon ambitious research plans.

Drawing strength from connections

V Scholars come together for an annual Summit to build their communication skills and exchange ideas in what Bast calls “a truly inspiring event.” He points to a recent Summit talk by Jim Valvano’s daughter Jamie Valvano, who has won her own battle with cancer, as emblematic of the hope present in the room at any V Foundation event.

“Despite Jim’s admonition to laugh, think and cry each day, I rarely do the latter, but Jamie’s moving message brought tears to my eyes,” Bast recalls. “Strengthened by the V Foundation, we will never, ever give up.”

It was just one of many memorable moments and inspiring interactions during his tenure with the V Foundation. “[Jim’s] ESPY speech still resonates after 26 years,” Bast says. “[My wife] Blanche and I will also never forget the evening in Napa when, encouraged by  Coach K’s charisma, we raised $18 million dollars, dramatically enhancing our endowment so that we could grow and yet keep our pledge to 100 cents on every dollar raised going toward cancer research.”

Exponential improvements

Looking back, Bast marvels at how far cancer research and treatment has come over the past few decades. Targeted therapies and immunotherapies, for example, have substantially expanded the treatment options available for previously intractable cancers. While there is still much work to be done, survival rates for some cancers—notably, childhood leukemia, lymphoma, breast cancer, testicular cancer and chronic myelogenous leukemia in adults—have risen dramatically. Even for melanoma patients, long-term survival has improved thanks to new immunotherapy.

“Our understanding of cancer has gone up exponentially over the last three decades,” Bast says. “Preclinical work has developed a much more precise understanding of what goes wrong with each person’s cancer, and also what the vulnerabilities of each cancer so that we can apply the right targeted therapy or immunotherapy for a particular patient.”

While his role has been to focus on the science, Bast stresses that cancer patients and their families remain the driving force behind all of the Foundation’s work: “One of the greatest privileges of working with the V Foundation has been the opportunity to guide patients with cancer to oncologists and centers where they can get the best possible care. I have spoken with and met many, many amazing individuals with cancer and their families over more than two decades.”

A bright future

With the leadership of Nick Valvano and Susan Braun, with ESPN’s exceptional support guided by Steve Bornstein and George Bodenheimer, and with the passion and remarkable commitment of the Foundation staff and all of its Board members, the V Foundation has been able to celebrate many victories over the years, Bast says. In these past successes he sees a bright future ahead in the fight against cancer.

Reviewing research funding applications each year is an exercise in hope—seeing the seeds of ideas that may one day blossom into cures led by talented and enthusiastic young investigators who will conquer cancer. In this year’s batch of applications for the V Scholars, which Bast notes was particularly strong, he found a lot of reason to hope.

“It’s not whether cancer is going to be cured, but when,” Bast says. “And it’s not just one cancer, it’s a thousand. The process can never be fast enough, but I think the goal and the role of the V Foundation is to accelerate progress so that more and more patients with cancer will have longer and better lives.”