An Interview With MUSC Hollings Cancer Center’s New Director
Gustavo W. Leone, Ph.D.,began his appointment as the new director of the MUSC Hollings Cancer Center on March 1. As director of the state’s only National Cancer Institute (NCI)-designated cancer center, Leone will oversee patient care and lead cancer-related research efforts.
Leone earned his doctoral degree from the University of Calgary and completed a postdoctoral fellowship at Duke University in 1998 before joining the NCI-designated James Comprehensive Cancer Center at The Ohio State University. In his leadership positions as director of the Solid Tumor Biology Program and associate director for basic research, he was instrumental in the rise of the James Comprehensive Cancer Center to the top tier of all cancer centers.
Progressnotes (PN) spoke with Leone.
PN: What attracted you to MUSC?
First, the basic sciences here are really quite strong and that gives you a platform to spring from. Second, the leadership, right from the president, provost and MUSC Health CEO down to the deans and Hollings Cancer Center, are aligned, and I thought that was a real strength and a sign that this is a place where change and growth can be implemented. I thought, “they are ready for this.”
PN: What are some of your immediate goals for Hollings?
We are going to place a large investment in the recruitment and retention of physician-scientists — physicians who are doing research that can be translated into the clinic. Increasing investigator-initiated clinical trials is another area we need to focus on because, in the end, much of the basic research has to end with fruitful clinical trials that inform patient care. We should be leading the way towards new therapies, and we can only do that if we have strong basic sciences and an innovative clinical trials portfolio here.
PN: What are your long-term goals for Hollings?
Charleston is a beautiful city with a rich history, great food and a vibrant arts scene, and it’s becoming a center for advanced technologies and businesses. We need a health care system and research institute here that shine as brightly as any of that, if not brighter, to complete the package.
To do that, we first need to become world leaders in key areas of basic and clinical research. People are very savvy about their health care and are becoming savvier. They demand the latest, most innovative therapies from their local health care providers. Thus, our second goal is to develop state-of-the-art clinical care that can only be delivered by, or in partnership with, NCI-designated cancer centers such as Hollings, where expertise in advanced clinical trials is homegrown. If we succeed in attaining scientific eminence and developing advanced clinical trials, the third goal would be to take advanced clinical care to the rest of South Carolina. If we can accomplish all of this, then Hollings and South Carolina would serve as a model for how cancer centers and communities can work together to elevate cancer care across underserved populations in states with relatively modest resources.
PN: In which areas would you like for us to be world leaders?
Molecular epidemiology, for one. For the most part, we don’t yet know which of us is more or less susceptible to cancer and what the underlying reasons for these predispositions might be. If we knew, that would be an empowering, life-saving advantage. We could provide patients who are more susceptible to colon cancer with the necessary preventive measures, such as annual colonoscopies. But right now, for the most part, we don’t know. It’s a wait and see situation — I would rather know instead of waiting to see. Another strong area at Hollings is immunology and immunotherapy and I’d like to build on that. I would also like to strengthen our efforts in chemical and structural biology. These are fundamental sciences that tell us about the structure and chemistry of molecules to a degree of precision that enables successful drug design.
PN: What motivates you as a cancer researcher?
That moment of exhilaration when you first discover something new — it provides an elation I cannot describe. For a brief moment, you know something that no one else in the world knows. It’s an addiction that is probably like any other chemical addiction. You don’t know you have it until you experience it and then you can’t get enough.
What we accomplish scientifically today will provide stepping stones to what might be known 50 to 100 years from now. If we accomplish the goals that we are setting here at MUSC Hollings Cancer Center in the next five to ten years, the people of South Carolina will experience the positive health outcomes for generations to come and will know that Hollings is supporting every family’s well-being. It’s not an opportunity that most people get a chance to experience. We have the opportunity to do it here and I am privileged to be a part of it.
PN: Tell us about your own research.
There are two broad areas. One is understanding the regulatory mechanisms that control cell division. A cell that divides has to replicate its genome, the blueprint of what and who we are. After the genome duplicates, the cell divides and separates the two genomes equally into two daughter cells. This is incredibly complex and highly regulated because it has to be "perfectly" executed. It has to be precise because, in the duplication and separation steps, any mistake could lead to a platform for genetic mutations. We know many of the critical molecules that are involved in that division but we don’t know how they work exactly. So we are developing tools to understand how these proteins turn genes on and off, how they work individually and how they work together as a group. As it turns out, these “control” proteins are deregulated in almost all cancers. After all, unregulated cell division is one of the hallmarks of cancer.
Another side of cancer that we don’t talk about much is that these tumor cells grow in the context of our body’s other tissues and cells, such as blood vessels and immune cells that play normal roles in our general well-being. These microenvironments are typically inhibitory, so that every cell that has a mutation and goes wrong does not result in a cancer. But there are times when that environment is no longer suppressive but is either neutral or actually helps the tumor cells take off. That is why sometimes you can have a cancer for a long time and be okay and then there’s a switch and that switch coincides with changes in the microenvironment. I find that fascinating. How do cancer cells talk with neighboring cells? We know some of the language that cells use to communicate with each other but relatively very little. Cell-to-cell communication is the second focus of my laboratory’s research.
PN: Would you like to tell us something about your family?
I have two wonderful children, Anna-Maria and Marcelo Leone. One is going to medical school this year and the other has a master’s in computer engineering. They are my soul.