Ohio State was at the forefront of cancer care and research in 2019, with new innovations, initiatives and insights from the team at the OSUCCC &ndash; James. Here are some of the ways our doctors and researchers moved us all closer to a cancer-free world over the past year. Raising the bar for immuno-oncology With help from the Greatest Team Ever, The James launched the Pelotonia Institute for Immuno-Oncology, a comprehensive bench-to-bedside research initiative focused on harnessing the body&rsquo;s immune system to fight cancer at all levels &mdash; from prevention to treatment and survivorship. &ldquo;This opportunity at Ohio State was amazing,&rdquo; says the institute&rsquo;s director, Zihai Li, MD, PhD. &ldquo;There is such a huge commitment from the university and the Pelotonia community. There is a commitment to do something major to advance immuno-oncology.&rdquo; Farrar continues longtime leadership as James CEO After serving as our interim CEO for two years, William Farrar, MD, assumed the role officially in August. Farrar is a familiar face at Ohio State, arriving on campus as a surgical resident in 1975. Farrar has been a leader at The James since its creation in 1990, directing medical affairs and the Division of Surgical Oncology for decades before becoming CEO. &ldquo;We&rsquo;ve built a tremendous cancer hospital and research enterprise in Columbus, and I am honored to continue to do my part to help lead our clinical enterprise as we embrace a very hopeful new area of genomic-driven care and immuno-oncology approaches that allow us to offer personalized, more effective treatment options to our patients,&rdquo; Farrar says. Access advocacy for stage IV cancer patients James leaders are teaming with Ohio lawmakers in an effort to ensure immediate access to treatment for stage IV cancer patients through legislation proposed in December. The bill would require Ohio insurance providers to eliminate &ldquo;fail first&rdquo; provisions that require patients to first try insurers&rsquo; preferred and often generic alternative drug prior to receiving financial coverage for the therapy prescribed by a treating physician. &ldquo;Patients with stage IV cancer simply don&rsquo;t have time to waste, and &lsquo;fail first&rsquo; provisions do a disservice to individuals facing this diagnosis by restricting access to newer targeted therapies as a first course of treatment for cancer and its associated conditions,&rdquo; says OSUCCC director Raphael Pollock, MD, PhD. &ldquo;The first oath in medicine is to do no harm, and as such, we should be able to make treatment recommendations for patients based on what drug science tells us is most likely to achieve cancer control for that specific patient versus what the patient&rsquo;s insurance company is likely to cover.&rdquo; Increasing knowledge to improve care Studies from OSUCCC &ndash; James researchers provided new knowledge about many types of cancer in 2019, which could help guide treatment, care and prevention practices across the globe for years to come. Included in that research are multiple studies aimed at answering questions about the health effects of vaping. Among researchers&rsquo; findings is the first reported evidence of biological changes correlated with e-cig use in never-smokers. In December, the findings of another vaping study led by OSUCCC &ndash; James deputy director Peter Shields, MD, were published, strengthening the link between vitamin E acetate and E-cigarette or vaping product use-associated lung injury (EVALI). The study, which was conducted in collaboration with the Centers for Disease Control, provides researchers and regulators with more knowledge as they work to answer questions about the possible health effects of vaping. &ldquo;These findings support the conclusion that vitamin E acetate is a potential causative agent of EVALI, and that is an important discovery as decisions are made about how to best regulate the rapidly evolving e-cig industry,&rdquo; Shields says. Also in 2019, Ohio State researchers worked to increase the effectiveness of immunotherapy through two studies designed to determine some of the reasons that the promising treatment sometimes fails. In a study led by Yiping Yang, MD, PhD, researchers reported the discovery of specific cellular mechanisms that limit the ability of certain T cells to infiltrate the tumor microenvironment, while in another study, Sameek Roychowdhury, MD, PhD, and his team examined donated samples to underscore the importance of genomic analysis of rare malignant tumors that are genetically unstable and have high numbers of gene mutations. Ohio State breast cancer researchers also made strides during the year, including a study that could shorten treatment times for some early-stage patients, who could undergo fewer treatments through partial breast irradiation, according to findings from a clinical led by Julia White, MD. &ldquo;A significant portion of the breast cancer patient population nationally &mdash; about 25,000 to 30,000 women &mdash; would qualify for partial breast irradiation,&rdquo; White says. &ldquo;This is tremendously important because it allows us to give women the right amount of treatment for her disease and potentially allows better access to effective breast conservation for those who live far from a radiation facility.&rdquo; New treatments bring new hope to patients The future of cancer care was forming in OSUCCC &ndash; James labs again in 2019, with researchers developing and testing new drugs that could one day improve outcomes for patients in central Ohio and beyond. In November, the FDA approved the use of the drug acalabrutinib for first-line therapy in chronic lymphocytic leukemia (CLL) and small cell lymphoma (SLL). The treatment, which was developed and tested at The James, works by blocking BTK&nbsp;&mdash; a chain of proteins that relays growth signals from the surface of the cancer cell to genes in the cell nucleus &mdash;&nbsp;halting the flow of these growth signals, causing the cancer cells to die. &ldquo;Acalabrutinib is remarkably well tolerated and results in longer progression-free survival. We are honored and thrilled that this research is helping patients thrive,&rdquo; says clinical trial leader John C. Byrd, MD. Some patients with advanced cancers, including lymphoma, could benefit from a new targeted oral treatment that was developed through research discoveries at The James. The drug, now known only as PRT543, targets a dysregulated enzyme called PRMT5 that was discovered at Ohio State. The James is one of four cancer centers participating in a national clinical trial of PRT543. If proven effective in clinical testing, this could radically improve how we treat certain aggressive, recurrent cancers,&rdquo; says research leader Robert Baiocchi, MD, PhD. Focus on patients earns recognition from colleagues Our faculty and staff&rsquo;s commitment to patient-focused care was honored by several organizations in 2019, including Press Ganey, which named The James as one of its Guardians of Excellence for the fourth straight year, while also bestowing its Pinnacle of Excellence Award on the institution. The James&rsquo; medical intensive care unit (MICU) nurses were also honored in 2019 with a three-year, Gold-level Beacon Award for Excellence from the American Association of Critical-Care Nurses (AACN), which honors units that distinguish themselves by improving every facet of patient care.