/stories/2019/07/sylvester-the-new-crown-jewel-helping-to-fight-the-war-on-cancer

Sylvester the new ‘crown jewel’ helping to fight the war on cancer

Irma Infante with Dr. Nipun B. Merchant, director of surgical oncology research at Sylvester Comprehensive Cancer Center, who told Infante she was “a miracle” after Monday’s press conference on the medical campus. Photo: Mike Montero/University of Miami

By Maya Bell

Irma Infante with Dr. Nipun B. Merchant, director of surgical oncology research at Sylvester Comprehensive Cancer Center, who told Infante she was “a miracle” after Monday’s press conference on the medical campus. Photo: Mike Montero/University of Miami

Sylvester the new ‘crown jewel’ helping to fight the war on cancer

By Maya Bell
With the new NCI designation announced Monday, Sylvester Comprehensive Cancer Center will continue its dedicated commitment to clinical care, research, and community outreach.

Last summer, after suffering through days of nausea, Irma Infante expected her gastroenterologist to treat her for indigestion. But after a battery of tests, he delivered a devastating diagnosis: She had pancreatic cancer, a silent killer that often claims its victims within months of detection.

The first oncologist Infante saw near her south Miami-Dade home didn’t offer even a sliver of hope. He told her the tumor was inoperable and summoned a priest.

Yet more than a year later, Infante is in remission and she and her husband were on hand Monday to celebrate the prestigious National Cancer Institute (NCI) designation that Sylvester Comprehensive Cancer Center, which is part of the University of Miami Miller School of Medicine, just earned from the National Cancer Institute.

Only the second NCI-designated cancer center in Florida, and one of only 71 across the nation, the monumental achievement that Director Stephen D. Nimer assumed as his mission when he took Sylvester’s helm in 2012 officially recognizes the cancer center’s clinical care, research, and outreach to medically underserved communities  with innovative cancer prevention strategies.

“We have worked tirelessly to become one of the nation’s great cancer centers,” Nimer said in announcing the transformative distinction with University President Julio Frenk. “Now, we have confirmation from the NCI that we are one of the great cancer centers in the United States.”

The recognition hardly surprised Infante, who knows the value of having 300 world-class cancer physicians and researchers dedicated to finding the causes of cancer and developing new lifesaving therapies in her backyard. After her initial diagnosis, Infante, who came to the U.S. from Cuba on the 1980 Mariel boatlift as a teenager, spent two of the bleakest days of her life praying to Cuba’s patron saint, Our Lady of Charity. Then she returned to the Miller School, where she had worked as an administrative assistant and data manager for 16 years, for a second opinion.

She initially saw Dr. Alan Livingstone, a surgical oncologist at Sylvester, who confirmed her tumor was inoperable and, worse, that it had already spread.

“But he grabbed me by the shoulders, and said, ‘Irma, you are young. You are strong. You can fight this,” Infante, a 54-year-old mother of three sons, recalled. “In the darkest storm, he was my light.”

The light, and her hope, grew brighter when Livingstone sent her to Dr. Peter Hosein, a Sylvester oncologist who specializes in pancreatic cancer. On their first appointment, Hosein delved into Infante’s family history and upon discovering she had lost her maternal grandmother and an aunt to breast cancer, told her, “There’s a chance we might be able to get rid of your cancer.”

As he does for all his pancreatic cancer patients, he recommended genetic profiling for both Infante and her tumor, and confirmed his hunch. She carried the BRCA gene mutation, most commonly associated with breast and ovarian cancers. That was actually good news, because then Hosein knew he should prescribe the chemotherapy cocktail that exploits the BRCA mutation.

After 11 agonizing rounds of chemotherapy that ended in January, Infante’s tumor vanished, and, in hopes of keeping it from returning, Hosein enrolled her in the Targeted Agent and Profiling Utilization Registry, or TAPUR, Study. Conducted by the American Society of Clinical Oncology, the study matches patients with targeted therapies based on their genomic profile, and provided Infante with a drug the FDA approved for another use. She began taking it in February and today, feels like her life is almost back to normal.

“I have issues but I feel great,” she said. “I have an appetite. I can eat—a little too much—and I can dance. A lot.”

Now, with Sylvester’s NCI designation, Sylvester patients will have access not only to other cutting-edge information, like genomic testing, but to more novel, potentially lifesaving clinical trials—trials that can provide hope where once there was none. As Hosein noted, “The science is changing so quickly that if I keep the patient alive for six months, maybe a new treatment option will be available that could make all the difference in the world.”

When Infante and her husband, Joe, who she calls her rock, walked into the white tent on the Miller School’s Schoninger Research Quadrangle, where Monday’s historic announcement was made, she knew “something big” was up. Festooned with orange and green balloons, the tent was filled with dignitaries, including U.S. Congresswoman Donna E. Shalala, D-FL, and U.S. Senator Rick Scott, R-FL, who in their previous roles as, respectively, UM’s fifth president and Florida’s 45th governor, had played pivotal roles in positioning Sylvester for its NCI designation.

But as Frenk and Nimer, a pioneering leukemia specialist who Shalala recruited from New York’s NCI-designated Memorial Sloan Kettering Cancer Center to pursue this milestone, shared Sylvester's transformative news, one question ran through Infante’s mind.   

“Honestly, my thought was why didn’t they have it already?” she said. “This recognition shows everybody what I already knew—that Sylvester is the best of the best.”

Robert Croyle, director of the NCI’s Division of Cancer Control and Population Sciences, who called NCI-designated centers the “crown jewels in the nation’s war on cancer,” provided some insight on the rigorous standards. Saying Sylvester’s 1,300-page application and its leaders were put “through the ringer,” he noted that UM came in at a time when the NCI “raised the bar” by requiring cancer centers to engage their local communities—an area where he said “this institution really set the pace.”

Sylvester’s Firefighter Cancer Initiative, which is studying ways to reduce cancer risk among Florida’s firefighters, and the Game Changer outreach vehicle, which is bringing cancer screenings and health information to underserved South Florida communities, are among the public health programs that notched Sylvester’s NCI designation—33 years after philanthropist Harcourt Sylvester Jr. pledged $27.5 million to benefit the medical center’s 13-year-old cancer center.

Erin Kobetz, Sylvester’s associate director, spearheaded both those initiatives, and believes Sylvester is now poised to serve as a model for an increasingly diverse nation, and world.

“We believe strongly that the demographics of South Florida reflect what the composition of the larger United States will likely look like in 2050 and that we’re uniquely positioned to ask those research questions today that other cancer centers will be contending with in the future,” Kobetz said.