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

Episode Transcript
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BRITTANY CONNORS (00:08):
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

(00:31):
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

(00:51):
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,

(01:13):
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.

DR. CHRISTINA ANNUNZIATA (01:29):
Thank you.

DR. KIMRYN RATHMELL (01:30):
Glad to be here.

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?

DR. KIMRYN RATHMELL (01:47):
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

(02:12):
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

(02:35):
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

(03:00):
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

(03:22):
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.

(03:47):
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

(04:08):
foundations. And so, I just love, again, like, learning a whole new piece of the landscape.

Thank you very much. Dr. Annunziata?

DR. CHRISTINA ANNUNZIATA (04:16):
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

(04:40):
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.

(05:01):
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

(05:30):
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

(05:51):
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

(06:13):
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.

(06:37):
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.

(07:00):
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,

(07:24):
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?

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,

(07:58):
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 (08:07):
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.

(08:31):
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

(08:52):
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.

(09:18):
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

(09:42):
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

(10:08):
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

(10:33):
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

(10:54):
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.

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 (11:13):
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

(11:36):
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.

(11:59):
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

(12:23):
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

(12:45):
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.

(13:11):
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

(13:35):
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,

(13:55):
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

(14:21):
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

(14:48):
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.

(15:12):
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.

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

(15:54):
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?

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,

(16:29):
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

(16:52):
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.

Great. Thank you, Dr. 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

(17:36):
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

(17:58):
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,

(18:19):
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,

(18:40):
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

(19:07):
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.

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?

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

(20:10):
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,

(20:35):
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

(20:57):
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

(21:20):
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.

Thank you. Dr. 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,

(22:06):
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

(22:35):
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.

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?

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,

(23:35):
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

(23:57):
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.

(24:18):
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

(24:40):
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

(25:00):
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.

Very cool. Dr. 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.

(25:46):
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

(26:10):
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.

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?

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,

(27:09):
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

(27:33):
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

(27:59):
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

(28:20):
with than cervical cancer, but that's one big initiative that I that I want to highlight.

Thank you.

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

(28:48):
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

(29:12):
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,

(29:34):
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.

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,

(30:15):
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?

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,

(30:47):
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

(31:10):
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

(31:32):
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.

Absolutely. Thank you. Dr. 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,

(32:21):
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.

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?

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

(33:10):
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,

(33:37):
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.

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

(34:18):
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?

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

(34:58):
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

(35:20):
of our bridge between the discovery research and the commercialization between Farnaz and Doug.

Can I say one more thing about program officers?

Absolutely.

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,

(35:53):
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,

(36:14):
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.”

(36:40):
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.

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 (37:10):
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?

So, can I turn that order to Farnaz?

FARNAZ BAKHSHI (37:33):
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

(37:57):
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

(38:21):
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 (38:48):
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

(39:08):
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,

(39:30):
if there isn't or shouldn't be like, kind of a bonus, some bonus marks for women applying.

Yeah, actually this is your question, right?

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

(40:00):
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.

(40:24):
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,

(40:46):
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

(41:09):
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 (41:32):
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

(41:55):
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

(42:18):
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.

(42:42):
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

(43:04):
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.

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,

(43:43):
I think it's just exciting to see these things in action.

MONIQUE POND (43:46):
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?

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,

(44:27):
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.

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

(45:09):
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.

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

(45:48):
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.

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

MALE (46:21):
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

(46:43):
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 (46:55):
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

(47:15):
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.

(47:37):
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,

(48:01):
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.

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

(48:38):
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,

(49:00):
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,

(49:22):
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

(49:43):
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

(50:09):
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,

(50:31):
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,

(50:55):
I think we need more physician scientists, but we need them in all of these spaces.

MICHAEL WEINGARTEN (51:00):
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

(51:24):
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

(51:51):
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

(52:17):
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

(52:41):
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 (52:51):
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.

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

(53:37):
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 (53:58):
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,

(54:22):
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,

(54:42):
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?

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

(55:15):
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

(55:42):
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

(56:02):
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

(56:27):
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 (56:41):
Thank you.

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

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,

(57:16):
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,

(57:40):
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

(58:04):
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

(58:26):
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

(58:50):
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,

(59:11):
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

(59:31):
this is going to impact someone that they will care about always goes a whole lot further.

It’s so important. Thank you.

ALICE (59:39):
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

(01:00:04):
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 (01:00:19):
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.

(01:00:46):
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 (01:01:04):
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

(01:01:25):
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

(01:01:52):
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

(01:02:12):
in that are not acceptable anymore. And so, I'm really excited about the future because of that.

BRITTANY CONNORS (01:02:20):
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.

(01:02:45):
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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Episode 22. Fireside Chat with Kim Rathmell | Empowering Innovation in Women's Health

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.css-14f5ked{margin:0;word-break:break-word;display:-webkit-box;-webkit-box-orient:vertical;box-orient:vertical;-webkit-line-clamp:2;overflow:hidden;}Episode 22. Fireside Chat with Kim Rathmell | Empowering Innovation in Women's Health