On Tuesday, May 10, four Washington University residents presented their research in front of Washington University faculty and guests at the 21st annual Samuel A. Wells, Jr., Resident Research Day Competition. Heidy Cos, MD, Franklin Olumba, MD, Kenneth Newcomer, MD, and Paul Kepper, MD, were selected from a group of sixteen resident submissions for their outstanding research in two categories: Clinical, Outcomes, Innovation and Education Research, and Basic and Translational Research. While each finalist was awarded $1,000 for their work, faculty voted to recognize one winner from each of these two categories. Present among the audience were Evarts A. Graham Visiting Professor David C. Linehan, MD, from the University of Rochester School of Medicine and Dentistry and former Department of Surgery Chair and the competition’s eponym Samuel A. Wells Jr., MD, himself.
Cos and Olumba kicked off the competition and presented under the Clinical, Outcomes, Innovation and Education Research category.
Cos’s presentation, entitled “The Surgical Rehabilitation and Readiness (SPAR) Program Reduces Postoperative Length of Stay and Need for Postoperative Discharge to Post-Acute Care Facilities in High Risk Surgical Patients,” focused on research from the program of Dominic Sanford, MD. The SPAR Program outlines a physical, dietary and mental health plan to bolster patient health before surgery in the hopes of improving post-surgical outcomes. Cos delivered excellent research on a study of the program when implemented among a group of 100 patients with high frailty risks. The study showed that participation in and compliance with the SPAR program lead to a decreased median of hospital stays (from an average stay of eight days reduced to five days) and a decrease in discharges to further rehabilitation facilities postoperatively. These results open doors for further study and implementation of the SPAR program to ease the process of surgery and recovery for high-risk patients.
Olumba was named the winner of the Clinical, Outcomes, Innovation and Education Research category for his presentation from the research program of William Chapman, MD, the Eugene M. Bricker Chair of Surgery and section chief of Abdominal Transplantation, entitled “RESTORE Declined Livers Study: A single center prospective trial to increase transplant opportunity.” Olumba emphasized the vast shortage of viable living donor livers and the high rate of donor livers which are discarded in the United States and stated that the disparaging ratio between available organs and patients who need them is only expected to get worse over time. The groundbreaking RESTORE trial utilized Normothermic Machine Profusion (NMP) technology on donated livers that were destined to be discarded by other facilities due to lack of confidence in organ quality. The NMP process infuses oxygen-rich blood into the livers and can both further test the quality of the organ and improve organ function. In the RESTORE study, these NMP-restored livers, after rigorous testing to ensure patient safety, were placed into consenting waitlisted patients who otherwise had little hope of receiving an organ. These post-profusion livers that passed the NMP’s tests are expected to achieve successful results similar to those in cases with typically accepted donor livers. Olumba presented an example of one of the success stories from the trial in which a patient experiencing hemophilia and liver failure received a restored liver and, five months out from his transplant, is active, healthy and cured of his hemophilia. He reported extremely hopeful results from other cases and emphasized that the patients in the trial were considered with only the highest standards of care in such a high-risk process. This trial opens doors for further research and sparks hope for other waitlisted patients in desperate need of the few organs which are typically accepted for transplant. Dr. Wells himself commented on Olumba’s work during the competition, stating simply that Olumba’s was an “excellent presentation.”
Under the category of Basic and Translational Research, Newcomer and Kepper presented exciting new research in the fields of pancreatic cancer methodology and Hirschsprung’s Disease etiology.
Newcomer’s winning presentation, “Co-Inhibition of xCT and MEK Presents a New Therapeutic Methodology for Pancreatic Cancer,” stemmed from the research program of William Hawkins, MD, the Neidorff Family and Robert C. Packman Professor and section chief of HPB-GI Surgery. Newcomer described the process of developing a new approach to treating pancreatic cancer. As a particularly difficult cancer to treat, research in pancreatic cancer therapies is invaluable. Newcomer explained the prospects of a combination of the ACxT molecule and the MEK inhibiting drug Trametinib. ACxT, as described by Newcomer, is a molecule first designed and synthesized at Washington University. Newcomer reported that this cancer cell-targeting molecule has the potential to be lethal to cancer cells, but on its own, fails to completely eradicate tumors. He then went on to describe the search for a companion drug for a more complete anti-tumor therapy. Newcomer’s research discovered that Trametinib, a drug already sometimes used alongside chemotherapy, can attack the cancer cell’s survival methods that allow them to survive a dose of ACxT. Together, these therapies cause metabolic collapse of the cancer cells by both targeting xCT and inhibiting the MEK enzyme. Newcomer reported impressive results: Even in low doses, this combination can rapidly kill cancer cells over a period of 24-48 hours. In an ongoing experiment wherein the therapy is administered in a laboratory setting, the current survival rate has yet to drop below fifty percent. As it stands, Newcomer is looking toward a clinical trial for this drug, which could revolutionize the treatment of pancreatic and other cancers.
The Department of Surgery congratulates Olumba and Newcomer for their outstanding presentations and all four finalists for their impressive research and dedicated work. “We celebrated the 2022 Samuel Wells Research Day with four fantastic finalist presentations highlighting the breadth and impact of research at our institution,” Director of Resident Research Ryan Fields, MD, Chief of the Section of Surgical Oncology, said about the event. “Drs. Cos, Olumba, Newcomer, and Kepper were exceptional in showcasing their amazing work.” Their efforts carry the mantle for Washington University’s proud history of expanding knowledge through clinical care, education and research.
Kepper’s presentation, from the research program of Associate Professor of Developmental Biology and Genetics Samantha Morris, PhD, and Brad Warner, MD, the Jessie L. Ternberg, MD PhD Distinguished Professor and division chief of Pediatric Surgery, was entitled “Deconstructing the etiology of Hirchprung’s Disease via single-nucleus and spatial transcriptomics.” In order to investigate the causes of Hirschprung’s Disease (HD) and expand single-cell research methods, Kepper and his team examined genes and cell types distally along an HD-affected bowel. In the process, they discovered a decrease in smooth muscle cells along this path, several genes present not previously associated with HD and the fact that the transitional section of the bowel is also part of the diseased portion. This is remarkable not only as progress in researching the origins of HD, but in the process of single-cell technology. “This is a huge step forward,” Morris said of Kepper’s work. “Paul really integrated himself into the lab in terms of the molecular biology, but also in terms of the computational biology in order to put these data sets together.”
Samuel A. Wells, Jr., MD, served as the Chair of Washington University’s Department of Surgery from 1981 to 1997. During his time as Chair, Wells emphasized the importance of advanced academics and helped to uplift Washington University as a world-class academic and research institution. Wells is a highly decorated surgeon and has received a number of awards for his work, including the Jean Vicks Inspiration award for his contributions to thyroid cancer research and treatment and the Medallion for Scientific Achievement – the highest honor bestowed by the American Surgical Association. His legacy at Washington University continues in the exceptional research done by residents and the dedicated faculty within the Department of Surgery today.