Cancer Center at 50

Original Purpose from Bequest—To Identify Causes, Prevention, and
Cures—Has Spurred Growth, Innovation
By Christina Hernandez Sherwood | Photographs by Jörg Meyer

Columbia’s cancer research program began in earnest more than a century ago when the millionaire son of a railroad magnate, after losing his wife to stomach cancer, died in his mid-50s of the same disease. Despite the tragic beginning, the program now known as the Herbert Irving Comprehensive Cancer Center has developed into the source of some of the most important cancer research of our time.

“I think of our cancer center as a combination of a think tank and a service organization,” says Anil Rustgi, MD, the center’s director since early 2019 and an expert in gastrointestinal oncology. “That’s our credo. If we follow that credo, we’re accomplishing our missions to advance science and medicine and to serve our members, our campus, our patients, our communities, and beyond.”

Anil Rustgi

The birth of Columbia’s cancer research program can be traced to a 19th century ultimatum. When Charles Crocker, a founder of the Central Pacific Railroad, died in 1888, he bequeathed his children each a share of his fortune. But one son’s inheritance came with a catch: George Crocker would not receive his $6 million until he proved to his brothers he could abstain from alcohol for five years. George received his inheritance after eight years and a stint in a sanitarium. He lost his wife, Emma, to cancer then received a cancer diagnosis himself. When George died in 1909, he left $1.5 million to Columbia for what the New York Times described as “the prosecution of researches as to the cause, prevention, and cure of cancer.” The university established the Crocker Special Research Fund to oversee the research.

The National Cancer Act signed into law by President Richard Nixon in 1971 was the catalyst for the expansion of Columbia’s Herbert Irving Comprehensive Cancer Center, which has members from six schools and 35 departments across the university.

Today, 50 years since the National Cancer Act served as a catalyst for the growth and expansion of cancer research and care at Columbia, the HICCC spans six schools and 35 departments across Columbia. It has more than 250 members and associate members, including more than two dozen faculty who have been inducted into the National Academy of Sciences and/or the National Academy of Medicine. In 2020, the National Cancer Institute renewed the center’s comprehensive designation through 2025, with outstanding merit and a 40% increase in funding.

The next five—or 50—years are full of possibilities for the center. With a new clinical cancer building planned and the additional funding, aspirations are high. Says former director Riccardo Dalla-Favera, MD, the center’s director from 2005 to 2011, “What I hope will happen, and what I think is happening, is a better exploitation of the enormous talent and discoveries that we have here at Columbia.”

When President Richard Nixon declared a “war on cancer,” the disease had become the second leading cause of death in the United States, a grim statistic that has not changed over the past 50 years. Nixon used the National Cancer Act of 1971 to assemble the troops, enlisting the National Cancer Institute to distribute grants that would build and support strong centers of cancer research across the country.

Several members of the Herbert Irving Comprehensive Cancer Center pose for a photo outside the Irving Cancer Research Center building.

In 2020, the National Cancer Institute renewed the Herbert Irving Comprehensive Cancer Center’s comprehensive designation through 2025, with outstanding merit and a 40% increase in funding.

Columbia, already established in cancer research thanks to the Crocker fund (since organized as the Institute of Cancer Research and occupying two floors in what is now the VP&S Building), received one of the first NCI grants to create a new entity, the Cancer Research Center. The center eventually merged with the Institute of Cancer Research.

The Hammer Health Sciences Center, which opened in 1976, included nine floors of cancer research laboratories. And in 1979, the NCI awarded the fledgling Cancer Research Center “comprehensive” status, indicating that it was conducting both basic research and clinical trials, including those that enroll patients from across the country. The comprehensive status also acknowledged the center’s epidemiological studies of cancer in groups of patients.

What's New in Fighting Cancer

The legacy of innovation at the Herbert Irving Comprehensive Cancer Center will carry over into its next 50 years. Here are a few of the latest research and patient care initiatives:

RADIOTHERAPY: Artificial intelligence-driven radiotherapy has been available since the recruitment of Lisa Kachnic, MD, a pioneer in implementing novel and effective radiotherapies, to VP&S as chair of the Department of Radiation Oncology. She brings hands-on experience with Ethos, a nascent commercial technology that empowers clinicians to provide daily personalized patient treatments by leveraging advanced AI technologies. The Ethos system can efficiently image and detect daily variations in the location and shape of a patient’s internal anatomy. Ethos uses this information and the radiation oncologist’s prescription and treatment objectives to generate several new, custom treatment plans with the patient never leaving the treatment machine couch (i.e., “online” adaptive radiotherapy). After a thorough review validating the accuracy of the automated workflows, the radiation oncologist chooses the best plan to deliver for that day’s treatment. An equivalent process using conventional technology typically requires hours of effort across multiple professional groups spanning days. Conversely, Ethos online adaptive radiotherapy treatments can be completed within approximately 30 minutes in a single outpatient visit. 

DIVERSITY IN CLINICAL TRIALS: The Columbia-Pfizer Clinical Trials Diversity Initiative is intended to reduce health disparities by increasing the participation of underrepresented minorities in clinical trials, including cancer trials, and enhancing the diversity of clinical researchers. A three-year, $10 million grant will fund the initiative to ensure that research reflects the diversity of the population. Says HICCC Director Anil K. Rustgi, MD: “Increasing diversity in trials will improve the treatment of patients from underrepresented groups and is a moral imperative as well as a fundamental medical issue.” The initiative will examine barriers that prevent participation in clinical trials by individuals from underserved groups by expanding Columbia’s Community Health Workers Program network to connect with underserved populations and create culturally sensitive engagement tools. The effort also will include identifying new ways to make clinical trials more accessible through telemedicine, wearable technology, and home visits. The training component of the initiative aims to help Columbia expand its pipeline of diverse clinical investigators through a new National Diversity Clinical Trials Leadership Program to increase the number of faculty and staff from underrepresented groups.

PRECISION MEDICINE: The recruitment in January 2021 of physician-scientist Adam Bass, MD, to the HICCC has energized precision medicine. He is the founding director of the Center for Precision Cancer Medicine at Columbia and NewYork-Presbyterian/Columbia. The center will combine strengths in cancer research and care across multiple disciplines to exploit the interface of cancer biology and the development of new cancer diagnostics and therapies. “Our deep bench in basic and translational science coupled with our meticulous care and innovative clinical trials are the defect-discovering and phenotype-defining foundational aspects of precision cancer medicine,” says Donald Landry, MD, PhD, chair of the Department of Medicine. “The new Center for Precision Cancer Medicine will build on and advance our efforts at the leading edge of the field of precision oncology.” Adds Dr. Bass: “Instead of looking at cancer like a target to hit with a certain drug or therapy—a traditional, one-mutation-one-drug approach to precision medicine—we are looking at cancer like a game of chess, working to predict the appropriate combinations of drugs that are needed, based on the nuances of cancer biology, including how cancer cells adapt to specific drugs and how to integrate different classes of therapies. Precision cancer medicine is an ecosystem. Key to this ecosystem is laboratory research, working in the lab with not just cancer biologists, but computational biologists, systems biologists, biomedical engineers, and experts in many other fields to uncover how cancers work.”

BREAST CANCER: A trend in oncology is the de-escalation of therapy, says Katherine Crew, MD, director of the HICCC Clinical Breast Cancer Prevention Program. “Can we spare some patients from unnecessary treatment? We don’t want to overtreat breast cancer. As we understand the biology of these tumors a little bit better, one breakthrough is that we can better classify patients. There are different molecular tumor tests we use and a breast cancer index that give us the opportunity to personalize a woman’s breast cancer care. Based upon a woman’s tumor biology, we can assess who needs chemotherapy, who may benefit from extended hormonal therapy, who can do well with just five years of anti-estrogen therapy, and then we can spare them from a lot of the side effects that we’ve seen from some of these drugs.”

The Columbia-Presbyterian Cancer Center—renamed in the early 1990s to reflect Columbia’s partnership with what was then known as Presbyterian Hospital—burst with scientific innovation over the next few decades. In 1977, center scientists Richard Axel, MD, Saul Silverstein, PhD, and Michael Wigler, PhD, developed gene transfer techniques that allowed the introduction of virtually any gene into any cell. The effect of these techniques on cancer research was immediate and profound, leading cancer research laboratories worldwide to discover malignantly activated oncogenes in human tumor cells. The process earned the University millions of dollars in licensing revenues from pharmaceuticals made possible by the gene transfer techniques. In the 1980s, Frederica Perera, PhD, DrPH, and I. Bernard Weinstein, MD, introduced the concept of molecular epidemiology to cancer research. And in 1993, Dr. Dalla-Favera, a cancer geneticist, identified the BCL6 proto-oncogene, a critical step in understanding lymphoma.

In recognition of a $12 million gift from Herbert Irving, the co-founder of Sysco Corporation, the nation’s largest food distributor, the center in 1996 was given the name it maintains today: the Herbert Irving Comprehensive Cancer Center.

A new building, the Irving Cancer Research Center, opened in 2005. “Having most of the cancer research under the same roof was, by far, the most important point in the development of the cancer center,” says Dr. Dalla-Favera. “It led to a major expansion in research, which was underdeveloped before the building, and a very interactive environment, which put us on the map much more in cancer research.”

Many researchers consider the center’s collaborative atmosphere and 12 shared resources, such as a database service and a specialized microscopy facility, key to fostering meaningful innovation. Richard Baer, PhD, joined the center in 1999 and led extensive studies of the BRCA1 breast cancer gene. He is now working with the center’s computational scientists to examine the DNA genomes of experimental tumors in mice to understand the impact of BRCA1 mutations on genome stability and breast tumor formation. “I’ve had the opportunity to get to know a number of other cancer researchers on campus who have different skills in basic science,” Dr. Baer says. “We have real experts here.”

In 2012, Herbert Irving and his wife, Florence, gave an additional $40 million to the cancer center, and the appointment of Stephen Emerson, MD, PhD, as its next director ushered in a five-year period of increased clinical recruitment and research, along with a buildout of the center’s portfolio of tumor types. As the laboratory side of cancer research continued to grow during this time, the center also expanded its work in population science and community outreach and engagement. The center was named an NCI Minority and Underserved Community Oncology Research Program, offering local residents greater access to clinical trials.

“A lot of our research focuses on disparities because we see it every day,” says Dawn Hershman, MD, a breast oncologist and co-leader of the center’s cancer population science program. “One of the great things about the center is that you can take care of anybody who walks in the door. That’s not true for all cancer centers.”

Dr. Hershman’s recent work focuses on how specific financial factors, such as having Medicaid insurance, can influence the quality of care a patient receives as well as the patient’s ultimate outcome. This knowledge can help providers make better decisions, she says, and could inform future health care policy. “We are in this incredibly diverse and rich community where we can take advantage of the experiences of the people around us,” Dr. Hershman says, “and learn a lot more, not just about the etiology of cancer, but also about how different it can be for different patients with different backgrounds.”

When Dr. Rustgi became the center’s sixth director, he streamlined research programs into four major areas: cancer genomics and epigenomics, precision oncology and systems biology, tumor biology and microenvironment, and cancer population science. New resources include a community outreach and engagement office to work with community members, cancer patients, and their families to reduce the burden of cancer; formal programs to strengthen diversity, equity, and inclusion; and a cancer research career enhancement core to provide cancer research training and career enhancement opportunities.

With more than $30 million in new NCI funding, more than $100 million in research grants, and a new dedicated clinical cancer building planned, the center is poised for a new wave of growth and innovation. Dr. Rustgi says he anticipates advances in medicine to predict how an individual’s disease will progress or how a disease will impact groups of people based on common features. He wants to integrate the center’s voluminous clinical and research data into a tool that can be interpreted by both experts and patients. And Dr. Rustgi hopes to see an increased focus on cancer prevention.

“We understandably spend a lot of time on cancer care through cancer therapy,” he says, “but if cancer incidence can be decreased through prevention, it’s a healthy and holistic approach and benefits government and society.”

More information about the Herbert Irving Comprehensive Cancer Center can be found here.

Read the 2021 Herbert Irving Comprehensive Cancer Center annual report here.