The Original Cohort
HOW THESE ESTEEMED EXPERTS HELPED
TRANSFORM THE CANCER CENTER
When Mark Evers, M.D., arrived in Lexington in 2009, the foundation was already laid for the Markey Cancer Center’s future growth. A group of faculty with a deep commitment to the cancer center and Kentucky was already hard at work making a demonstrable difference in the lives of the people of the Commonwealth. In the coming years, their contributions would help Markey become a nationally recognized place of research and healing.
Building Hope Through Clinical Trials
An eighth-generation Kentuckian, Susanne M. Arnold, M.D., was a junior faculty member with NIH funding when Dr. Evers asked her to take on a leadership role. She wasn’t sure she was ready, but Dr. Evers had no doubt. “He’s willing to take a risk, but he also reviews your qualifications to make sure you can do the job before he asks you,” she said.
A medical oncologist and now the associate director of clinical translation, Dr. Arnold has shepherded the expansion of clinical trials at Markey. The growth includes trial participants from almost every county in the Commonwealth. “The way we make progress in cancer is through cancer research,” she said. “New drugs that are being used today were in clinical trials five or 10 years ago. New discoveries at the bench today will be the future treatments of tomorrow.”
In fact, maintaining this focus on high-level research to advance clinical trials is at the epicenter of the comprehensive status awarded to Markey. The center was able to share with the NCI that participation in its clinical studies had increased by 51% (2013-2017 compared to 2018-2022). And it takes someone like Dr. Arnold, with her background and expertise, to lead this charge. It was under her guidance that Markey became a member of the Experimental Therapeutics Clinical Trials Network (ETCTN), which was created by NCI for the early clinical evaluation of innovative cancer therapies. The impact of her leadership has resonated throughout Markey.
This work also has personal significance to Dr. Arnold. She has had three close family members with cancer, so she understands the emotional toll of the disease and that is what drives her. “First and foremost, I think Markey means hope. It means care and concern,” she said. “We all recognize that at the end of the day, we just want to cure more cancer.” And her dedication is proven in her track record of achievements, including her pioneering field research in Appalachia to study populations at high risk of developing lung cancer.
A Research Expansion
Daret St. Clair, Ph.D., recently retired after working at Markey for 32 years. She was a senior faculty researcher in the department of toxicology and cancer biology when Dr. Evers asked her to serve as the associate director for basic research. “He really energized me and helped me to become a leader,” she said.
St. Clair’s groundbreaking research at Markey has fundamentally shaped the understanding of free radicals in cancer and her innovative studies have propelled redox biology to a cornerstone of cutting-edge cancer research.
Since basic science research is a foundational pillar for research institutions, a large part of putting Markey on the national map has included building and bolstering its research capabilities; this infrastructure included increased grant funding, new researchers and facilities, and expanded education. The basic science departments from across the university have grown with even more researchers and large programmatic project grants in recent years, said St. Clair, whose leadership influenced the career of many fellow researchers and trainees. “Our team has always had an eye and focus on Kentucky’s unique cancer problem,” she said. “We have not solved all the cancer problems, but we have come a long way.”
A Commitment to Patients
In 2009, Markey was a locally and regionally recognized cancer center, but one with the feel of a community-based cancer center, said Frederick R. Ueland, M.D., chief medical officer and director of oncology clinical services, who joined Markey in 1998.
A clinician-scientist and gynecologic oncologist, Dr. Ueland’s research led to the first-ever FDA-approved preoperative blood test for ovarian tumors in 2009. As director of oncology clinical operations, he has seen the number of new cases diagnosed annually at Markey grow significantly (from 1,400 in 2000 to more than 4,500 today). To address this growth, Markey paired clinical and research teams to think deeply about treatment options, offering patients more than the standard of care.
“Markey’s resources provide a unique opportunity for multidisciplinary care where doctors from many specialties participate in the patient’s visit,” said Dr. Ueland. “Markey also has an extensive number of clinical trials available to our patients, providing innovative treatments not offered anywhere in the state. For these reasons, patients are choosing to come to Markey or one of our affiliate sites.”
And none of it would be possible, he notes, without the commitment, talent, and devotion of Markey’s providers, nurses, and staff. “It’s our people and our culture that has made us exceptional,” he said.
The Measurable Impact of Research
Thomas C. Tucker, Ph.D., M.P.H., came to Kentucky in 1984 to help establish the cancer center. He was the founding chair of the Department of Epidemiology in the UK College of Public Health and established the Kentucky Cancer Registry (KCR).
Tucker’s research has centered on the heart of the Commonwealth, with an emphasis on the people of rural and Appalachian Kentucky. He also built a population-based virtual tissue repository using data from the KCR. The repository gives basic science researchers access to both a wealth of high-quality data and population-based tissue samples in a streamlined process. This is one of only two similar population-based virtual tissue repositories in the nation.
Cancer centers designated by the NCI must have strong programs in basic science, cancer prevention and control and translational research. “But what the NCI really wants to see is that we work across those disciplines,” said Tucker. “The key ingredient is engaging people in specific projects where they have to work together to be successful, which Dr. Evers does, and that’s a brilliant strategy. Cross-disciplinary work is where Markey made significant progress.”
The progress is measurable and real, said Tucker, who previously served as an associate director on Markey’s senior leadership team. Markey’s collaborative colorectal cancer screening program has reduced cancer incidence by 30% and mortality by 34%. “That means every single year there are 390 Kentuckians who didn’t get colorectal cancer because they were screened,” he said. “And it means that there are 260 Kentuckians who no longer die each year of colorectal cancer. That’s a pretty significant public health impact.” And while Kentucky has the nation’s highest lung cancer rates, mortality rates are dropping after the implementation of Markey’s work in lung cancer screening, propelling Kentucky to the state with the second highest lung cancer screening rate in the nation.
Strength in Unity
Dr. Evers leveraged the groundwork laid by those who came before him, from researchers and oncologists to Ben Roach, M.D., and Lucille Parker Markey, whose efforts resulted in the creation of the Markey Cancer Foundation in 1983. This group of community donors helped secure funding for the new building, managed the money raised and then deeded the building to the university in perpetuity.
By bringing everyone together and fostering a sense of camaraderie, Markey has grown into a cancer center making an impact far beyond Kentucky. It was a unified effort with support and funding from the highest levels and the efforts of the team of clinical and research leaders.
“It’s the people that have made this place comprehensive,” said Dr. Ueland, “but without a dreamer and a leader with the vision to put it all together, it wouldn’t happen.”
“We are dedicated to Kentucky — we don’t have another boss,” said Dr. Arnold of the Markey team. “We are here for the people and hopefully that matters when they need us most.”
