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By: Seth P. Lerner, MD, Baylor College of Medicine, Dan L. Duncan Cancer Center, Houston, Texas | Posted on: 19 Sep 2023

I am honored and humbled for the tremendous honor of receiving the 2023 Urology Care Foundation Distinguished Scholar Alumnus Award. I was an AUA AFUD (American Foundation for Urologic Disease) scholar during my oncology fellowship at the University of Southern California with Don Skinner and Peter Jones as my clinical and research mentors. The AUA’s long-standing commitment to support young investigators with these awards and peer-reviewed research funding is critical to the success of urological surgeon-scientists. We all face daily challenges balancing the demands of a busy clinical practice and establishing oneself as an independent investigator. Dr Skinner and other mentors encouraged me to be a finisher, noting that it is not research until it is published. Peter Jones fostered a vibrant collaborative lab experience where I honed the basics of translational research. He coined the term “molecular urologist,” which perhaps presaged my involvement 2 decades later in The Cancer Genome Atlas Project in Bladder Cancer. This experience provided me a foundation to build upon, and when I returned to Baylor to start my academic career I was encouraged by many basic science and clinical faculty who shared a similar vision of supporting young investigators in their mission to build a research program.

We have been successful in building a multidisciplinary team focused on translational and clinical research focused on bladder and upper tract cancers. I initiated and continue to lead the Partnership for Bladder Cancer Research program, which is funded in part by extraordinary philanthropic support including the Beth and Dave Swalm Chair in Urologic Oncology. As Vice-chair for Faculty Affairs, I mentor our younger faculty to help them develop and achieve their personal and professional missions and to integrate them into the department. My research interests include use of selective estrogen receptor modulators for treatment of bladder cancer, gene therapy, surgical quality and outcomes, and integrated proteogenomic characterization of bladder and upper urinary tract cancers. I have 3 decades of experience as a clinical investigator for both National Cancer Institute and industry-funded clinical trials.

Through the support of countless mentors and professional colleagues I have been continuously engaged in clinical trials and hold leadership positions in SWOG (the Southwest Cancer Chemotherapy Study Group) where I have personally led practice-changing phase III trials and mentored several young investigators leading their own large phase II and phase III trials within SWOG and across the National Clinical Trials Network. For the last 10 years I have been actively engaged with the FDA (Food and Drug Administration), collaborating with many leaders in the bladder cancer field to engage the FDA to organize and hold workshops to address several disease states in bladder cancer. We also collaborated on the development of guidance documents for drug development and defining a registration pathway for patients with bacillus Calmette-Guérin–unresponsive nonmuscle-invasive bladder cancer. This led to the first new drug approval in 2020 for any nonmuscle-invasive disease state since 1998. I was the founding cochair of the Bladder Cancer Task Force, which is a National Cancer Institute/Cancer Therapy Evaluation Program Committee charged with helping investigators in the cooperative groups develop clinical trial concepts, and review and approve for submission to the Genitourinary Steering Committee.

I have had a long-standing desire to bring the multidisciplinary research field together to characterize bladder cancer at the genomic level. The Cancer Genome Atlas Project was planning to do this for bladder cancer, and I co-led this effort with a team of world-class genomics and bioinformatic experts. We published our first marker paper in 2014, and I kept the team together and published a more comprehensive analysis tripling the cohort size in 2018. We are now building on these efforts to describe the bladder proteome focusing on patients with a high unmet need who do not respond to standard of care neoadjuvant chemotherapy. This will be the first integrated analysis at the DNA, RNA, and protein level interrogating prechemotherapy tumor tissue using fresh tissue, and we expect to publish these findings in the next few months. I am forever grateful to the AUA and its leaders for paving the way for my career and supporting these programs vital to our specialty and our patients and caregivers.