Since Candace Johnson’s appointment as president and CEO of the Roswell Park Cancer Institute in February 2015, the institute has recruited 22 new faculty members and promoted 19 faculty members into senior leadership positions.
“I’m a new leader. I have a new style, a new vision of where Roswell Park is going,” Johnson, the Wallace Family Chair in Translational Research, said to The Cancer Letter. “We have new and different challenges, and unless my entire workforce understood these challenges and embraced the changes I’ve been implementing, we wouldn’t have a chance.”
Prior to becoming president and CEO, Johnson was the deputy director and chair of the Department of Pharmacology and Therapeutics. She has also served as cancer center director for the institute since November 2014.
Johnson has led the scientific strategies and achievements of Roswell Park for 13 years. Before coming to Roswell Park, she served as deputy director of basic research at the University of Pittsburgh Cancer Institute, and professor of pharmacology and medicine at the University of Pittsburgh School of Medicine.
Johnson spoke with Paul Goldberg, editor and publisher of The Cancer Letter.
Paul Goldberg: There are several comprehensive cancer centers that are run by a chief executive who is not a clinician. How difficult has it been to transition from the deputy for research to have responsibility for the whole institute?
Candace Johnson: It’s been a really comfortable transition since I’ve spent my entire career working in clinical and translational research, which allowed me access to bedside care. I’ve always familiarized myself with the clinical side of research by working within disease site research groups where integration from bench-to-bedside investigators was commonplace.
I was one of those PhD researchers who was continually seeking collaboration by going up to my physician colleagues and saying, “I want to work with you on this clinical trial! When can we talk?”
Over the years that I spent as deputy director, I would be at the table adding my perspective as clinical decisions were being made. So now I’m the one sitting at the head of the table and dealing with a much broader organizational vision, but I believe I’ve come to this place very well prepared to steer the strategic direction of tomorrow’s cancer center.
PG: Has the leadership structure at Roswell Park changed in any way under your leadership? Who runs the day-to-day clinical operation?
CJ: It has changed in that I’ve created some new roles and charged others with carrying out new goals and plans to support the vision I have for the institute.
Dr. Kunle Odunsi, a talented physician-scientist and head of our Center for Immunotherapy, runs the research operation as deputy director, which was my former role. Kunle comes to this position well trained and accomplished.
On the clinical side, I have a chief medical officer, Dr. Boris Kuvshinoff, who is a GI surgeon with sub-specialization in hepatobiliary tumors. He has the respect of his peers and is focused on quality initiatives, value-based care and the development of our clinical pathways project—which we anticipate will be a game changer for the industry.
I appointed another clinician, Dr. Victor Filadora, as chief clinical operations officer. Previously, the person in this role was never a physician, but Victor is an anesthesiologist who has extensive experience in organizational development and operational efficiency.
I also have another physician leader who is our chief of strategy for business development and outreach. That’s Dr. Thomas Schwaab, who looks at integrating Roswell Park into the community and expanding the reach of Roswell Park’s innovative therapies beyond our campus—that’s part of our obligation to our community, and one we take very seriously. And all these clinical chiefs work closely with our nursing leadership team, who’ve built an oncology nursing program that draws the cream of the crop in oncology nursing and nursing research talent.
PG: What is the status of recruitment to fill leadership positions? Are you recruiting a new clinical research leader? Surgical oncology leader?
CJ: We’ve been so fortunate in recruiting quality faculty to Buffalo, even over this first year that I’ve been the president and CEO. I have a new leader of Medicine. He’s the senior vice president for clinical investigation, Dr. Marc Ernstoff, from the Cleveland Clinic. He’s really my go-to person in Medicine and a clinical leader who joined my senior team April 1. Marc is a well-known clinician scientist in the area of melanoma and novel immunotherapeutic approaches. I’ve known Marc a long time and have worked with him in the past.
We have appointed a new chair of surgical oncology, Dr. John Kane. He has been at Roswell Park a number of years, and has a proven track record. He’s a pre-eminent melanoma/sarcoma surgeon and has great leadership skills. He’s also been in charge of our training programs for our surgeons.
We have a new head of pediatrics, Dr. Kara Kelly, who has come to us from Columbia, and have recruited another pediatric oncologist, Dr. Clare Twist from Stanford, who is now leading our pediatric experimental therapeutics program. We’re really defining our clinical programs around some very strong leaders. We’ve recruited some outstanding individuals who will soon be joining the team in senior leadership positions.
I have a strategy for Roswell Park, and I will continue to look for new and innovative people to contribute as a physician-scientist or researcher. For now, I believe I have the infrastructure to make a big difference.
PG: In the past year-and-a-half, what have been your largest challenges and what do you anticipate they will be over the coming years?
CJ: To be honest, my initial challenge was internal. I needed to make sure the entire Institute understood my vision and my style of leadership. The delivery of cancer care in the current health care field has become extremely competitive and highly regulated. In order to move forward, we need to think differently. We have new and different challenges, and unless my entire workforce understood these challenges and embraced the changes I’ve been implementing, we wouldn’t have a chance. So much of my work is internal and at the local and regional level.
I needed our community leaders to understand the changes I was making and why they were necessary. I’ve been invited by these leaders to speak at community meetings, to become a member of their think tanks, to bolster the viability of this community and to provide leadership on subject matter that is better understood by places like Roswell Park.
At the state level, I am doing everything in my power to complement the activities of Governor Cuomo and our New York State commissioner of health to enhance their population health, cancer screening and biotechnology strategies. As a cancer center that receives funding from the State of New York, I view our relationship as a partnership—we work together in reducing the emotional, physical and financial burden of chronic illness.
On a national level, every cancer center in the U.S. faces the same challenge: the need for federal funding. If we can’t fund our research, if we can’t come up with the innovative discoveries, how are we going to move patient care forward and provide our patients with the newest and best therapies out there? Basic science is really the heartblood of an institution. I’m really encouraged by the increase we saw for the NIH budget this year, but it’s going to take long-term, stable investment for us to really make progress and make sure our research and education programs are adequately supported.
PG: Has the presence of RPCI scientists participating in the AACR and ASCO programs increased or diminished in the past five years or so? Do you have those numbers and can you elaborate? Of course, if you’d rather use another metric, such as NIH funding, go ahead.
CJ: I think those numbers have remained pretty constant, and I expect that with some of our new faculty I’ve hired for our more strategic areas and our emphasis on new immunotherapies, we’re likely to be participating even more actively in the coming years. As far as NIH funding, we’ve managed to stay competitive despite the climate and the dramatic cuts we’ve seen. The striking thing as we look at our funding over the last five or 10 years is how far we’re taking each federal dollar we receive—we’re pursuing many more projects than we did in years past. And we’ve had some big wins with major program grants.
PG: Buffalo often gets portrayed as cold and snowy—have you found it difficult to recruit new talent to the institute? Have you encountered any other obstacles to recruitment?
CJ: Buffalo is snowy, but actually not that cold, and was just on a list of the top 10 up-and-coming cities in the U.S. If you come to Buffalo today versus even just three or four years ago, the whole downtown is just booming with restaurants, hotels and family-filled activities. We’ve taken its gorgeous architecture and rebuilt old hotels and buildings into multi-use space enhancing their structural beauty to its original grandeur. So when you bring visitors here and recruits, they see a Buffalo that’s energized and vibrant.
I haven’t experienced an issue in recruitment thus far. However, if you don’t like cold weather and don’t want to live in any sort of snowy place, maybe we’ve got to finesse that a little bit, but so far we really don’t have issues recruiting people to Buffalo since the people we’re recruiting are looking to advance their work in science or wanting to get to the next level in their career.
PG: I have a list of your recruitments. It looks impressive, and it will appear as a sidebar to this story. How does this list measure up against folks who are leaving?
CJ: I’m a new leader. I have a new style, a new vision of where Roswell Park is going. The people I’ve recruited and the people who are going to join this team were hired because they have the right skills to take us to the next level. When I look around, I see that we are recruiting exactly what we need in both research and cancer care.
Every institution experiences some turnover, but the key is what you do with that opportunity. I think I have taken advantage of that opportunity and have recruited very well.
We’re just about to open a new facility, the Scott Bieler Clinical Sciences Center, which expands our clinical footprint with a full-service women’s center for breast and gynecologic malignancies, a new and expanded chemotherapy infusion center and a clinical area dedicated to prevention and survivorship.
Our immunotherapy and personalized medicine programs are growing, and we are integrating and translating these research advances so they can benefit our patients. We’re also growing strategically in cancer services for our community, where we can make a big difference in bringing cutting-edge therapies and cancer care with our community partners.
PG: Freestanding centers have often had difficulty with their sister medical schools vying for resources and control. What is your relationship with the medical school at the University at Buffalo?
CJ: We have a great relationship with the University at Buffalo. One of my first orders of business was to spend time with the president of the university. As Roswell Park’s academic partner, I needed to share my vision for Roswell Park Cancer Institute with UB’s leadership, and to develop ongoing strategic discussions with the dean of the medical school. We need the University at Buffalo for our academic training programs. Through UB, we have a phenomenal PhD program, master’s program, and fellowships in all the oncology disciplines.
In turn, we are the oncology program for the university. We work hard at keeping a very synergistic relationship between the two organizations. It was no coincidence that the new UB School of Medicine and Biomedical Sciences will be a part of the Buffalo Niagara Medical Campus and right next to Roswell Park, so we’ll soon be able to collaborate even more.
PG: The medical school in Rochester used to have a cancer center core grant over twenty years ago, and in recent years has been contemplating re-submission of an application for review, or so the story goes. Have you had any discussions with them about collaborative efforts?
CJ: We have a longstanding relationship with the University of Rochester. The two organizations have worked together on collaborative projects, as well as conducting joint research grants that would enhance the caliber of specific research programs.
This relationship continues. We’re currently collaborating on some things in genomics and other areas where we can complement each other. So it’s been and continues to be a productive relationship.
PG: Given the competitive medical environment, is RPCI positioning itself to produce more trainees and provide better outreach into the Western New York region in coming years?
CJ: We have very robust training programs at Roswell Park. At any one time, we have over 1,800 trainees here—a very diverse group that includes postdocs, undergrads and high school students. As I’ve said, the University at Buffalo is our main academic partner, so its oncology trainees rotate through Roswell Park, and we also have nursing students from all the nursing programs around the city being trained through our nursing education program.
We have special partnerships with some of the Buffalo Public Schools, with Howard University, and a great program with a local Native American community, led by one of our faculty members, Dr. Rodney Haring, who is Native American and grew up in that community. So we have some really creative and unique education and outreach programs.
PG: What is the level of support for the growth and development of RPCI on the part of the BOD and board chair and the state and governor?
CJ: I am fortunate to have an extremely supportive board of directors. Each one of them is right there to lend their expertise and to help the institute in any capacity that they can. I am also grateful to Governor Andrew Cuomo and our state legislators, who have been very supportive of Roswell Park—their state cancer resource—and I appreciate the time they’ve taken to really get to know us and the expansive mission of the comprehensive cancer center.
We are the only NCI-designated comprehensive cancer center in the central and western parts of the state. I continually underscore the value that we provide for these regions and in this state. For example, Roswell Park needs to be the beacon of cancer screening and prevention programs, and we need to expand the voice we have on issues like electronic cigarettes and tobacco control and HPV vaccination. I take very seriously our role in the state of providing value for the people of New York.