 It's a distinct honor to introduce our speaker for the Novik lecture this year, Dr. Christopher Wood. Dr. Wood graduated from Purdue University with an honors degree in molecular biology. He completed in medical school and his residency training in neurology in Chicago at Northwestern. He also completed a urologic oncology fellowship at MD Anderson in Houston, and after fellowship joined the faculty at MD Anderson. He's focused his career on the treatment of locally localized, locally advanced and metastatic renal cell cancer. He's published over 240 peer-reviewed manuscripts, 25 book chapters, and as many sentinel publications in renal cell cancer, and has really been a pioneer in multimodal therapy for advanced renal cell cancer. He's a member of the Board of Directors and the Steering Committee for the Kidney Cancer Association. He's currently the Doug Johnson Endowed Professor and Deputy Chairman of the Department of Urology at MD Anderson. He has trained countless fellows in residence, including myself. I know there are at least six of his fellows here today, which is a tribute to his capacity for mentorship. He travels more than anyone I've ever met to lecture around the world, and he still has done over 4,000 nephrectomies. He is truly an amazing surgeon, and I can honestly say he genuinely cares about each patient, and it's a privilege to have worked with him. Dr. Wood. Well, here's a little secret. I think I'm here in spite of myself. Not really sure I deserve it. I got a lot of people to thank, and if you indulge me, I hope to do that through this talk. Andy Novick was an amazing guy. I remember I met him in 1988 when I was interviewing for residencies. I remember meeting him and walking into the room and saying, hi, Dr. Novick. Pleasure to meet you. He said, call me Andy. I looked across that desk and I said, man, you're going to be a lot of things to me, but you are never going to be Andy. Our paths crossed again when he was visiting professor at Northwestern. And again, he has, through the years, tossed me a bone here and there that has tremendously helped my career. I got this picture off the internet at a website, and I thought it was interesting that even in death, the guy is still promoting the importance of the kidney. Here he was at our Faneschenbach Lectureship in 2004. I think I finally was able to call him Andy at that point. And then in 2008, two weeks before this meeting, he called me on the phone again to toss me another bone. He offered me a chapter in Campbell's, the Bible of Urology. And I remember that discussion and saying, well, I'll see you at the KCA in a couple of weeks, and I was shocked to hear of his death. He'll be greatly missed, and I'm truly honored to be giving this lecture and his honor. So here's the problem with invited lectureships. They tell you, talk about whatever you want. And one of the things I hate when I see other people giving invited lectureships is when they steal other people's thunder. So this meeting covers the gamut of kidney cancer. So what the heck am I going to talk about? You know, I'd like it to be memorable, and it has to be something that, you know, I would be considering an expert on, but I don't want to steal someone else's talk. So after agonizing it for quite some time, I decided I'll talk about me. So I want to give you a perspective of where I came from, how I got to be here, how I tried to pay it back, and then talk a little bit about our clinical and translational research program at MD Anderson. And, you know, I hear my laboratory is amazing. I hope to actually visit it someday. I was born in Rhode Island, born and raised in Warwick. I was actually born the day that John F. Kennedy was assassinated. Now, probably two-thirds of the people in this room weren't alive when John Kennedy was assassinated. And the other third are, frankly, are frantically doing the math. They knew where they were when JFK was assassinated, and they're trying to figure out, well, it was 50 years ago this year. I'm not happy about it. I don't want to talk about it. So that was our family. Back in the 60s, my older brother Ken, my hero, my best friend, and my parents. And then Mom came to us in 1969 and said, guess what? We're going to have a new addition to the family. I remember my brother and I cried, asked if we could, you know, give it back. But unfortunately, Todd was here to stay, and so there we were, the Wood family. My older brother Ken's an engineer, and as I said, my best friend in the whole world. My younger brother Todd is a drug rep. We tolerate him. I was a Patriots fan before it was fashionable to be a Patriots fan. I remember my brothers and I used to sit on the couch on Sunday afternoon and say, let the pain begin. I'm currently going through similar struggles with my Houston Texans. I will always be a Red Sox fan, and I'll always be a Celtics fan for the rest of my life. I can say everything I am today, I go to my parents. They saw something in me that I could never ever see myself. If two people were ever meant for each other, it was Mom and Dad. There they are. The first Dad was going with the James Dean look, and then he's going with the Elvis look I think. They were married in 1959, and they lived the rest of their life together. I lost Dad to cancer in 2001, and Mom to cancer in 2008. And I laugh every time I hear people complain about their parents, nagging them, having to call them all the time. I'd give anything to be able to talk to them again, even if it was to tell me what an inadequate son I was. So, as I say, I'm here in spite of myself. The gray hair you saw on my mother's head, and the bald head that my Dad had, that was me. I didn't really want to go to college. I think if you pulled the people in high school, they would have said, Chris Wood, most likely to work at Burger King. In fact, I actually worked at Newport Creamery, which is the home of the awful, awful. Sounds awful, but it's actually fantastic. And just to give you an idea of what a restaurant like that is like, it's kind of like two steps below Denny's. I started off as a dishwasher, started working the grill, and by 17 I was the assistant manager. And I remember I was in the office filling out applications for college that my mother made me do. And the manager came in and said, you know, what are you so upset about? And I said, I don't want to go to college. I'm not, you know, it's a waste of time, a waste of money. He said, hey, this is what you can do. You can join our management training program, and in two years you could have your own store. So I went home and I said, Dad, I got the answer. I'm going to save you and Mom a lot of heartache, a lot of money. I'm going to join that management training program. Now my Dad, he was a religious man, not a zealot, but he was a religious man, not prone to profanity. I can't say out loud what he said, but basically his response still rings in my ears was that, you're nothing if your family doesn't support you. I'm very lucky. My son Chris graduated high school this year as a freshman in college. My daughter Sarah is 15, my wife Colleen. They've sacrificed a lot for me to be where I am today. There's no question, although they've also had some of the benefits of where I am today. I did go to Purdue University not because of the great pre-med program, not because of the outstanding molecular biology program. I went there because it was a thousand miles away from my parents and because my brother was there to bail me out of jail just in case I needed it. But I was lucky enough to encounter a woman who saw something in me again, Meredith Appleberry, who was a vision researcher. She saw something in me, took me under her wing, mentored me, and actually, amazingly, I was a second author on a science paper as a senior in college, something almost unheard of. I moved off to medical school. It was called Northwestern University Medical School then. I got accepted to a variety of different medical schools. Northwestern was probably one of the more expensive medical schools in the country, but I decided to go there, prompting Dad to say, Janet, how the hell are we going to pay for this? I went through medical school and actually was initially focused on potentially a career in gastroenterology. And I tell the fellows in residence that in the OR and they all start laughing. They can't picture me looking at people's rear ends all day. I had no idea what a urologist did until I counted this man, John Greyhack, one of the legends in urology who valued education, again, saw something in me, and really pushed me in that direction. The other two people that I have to thank from Northwestern who are responsible for where I am today is Jim Kozlowski and Chung Lee. Dr. Kozlowski pushed me toward urologic oncology, otherwise I'm not sure I would ever have gone there. And Chung Lee taught me again the importance of research in urologic cancers. So Dr. Kozlowski told me I had to do a fellowship, and then the plan was for me to go back to Chicago and join the faculty at Northwestern, and my wife's response was, why do you need a fellowship? I thought you were already a doctor. It's time to get a real job. And my response was, I promise we'll only have to live in Texas for three years. Then we'll go right back to Chicago where you can see how that worked out. I actually went to M.D. Anderson to work with Lee-Lin Chung, who about four months after I got there promptly left. So there was a vacuum in terms of mentorship that was filled by this guy, Dr. Van Eschenbach, who again saw something in me that I could never see myself, who mentored me, fostered my career, and taught me the importance of academic medicine and research. Also, David Swanson, who became chairman after Dr. Van Eschenbach, he's like a father figure to me, really directly responsible for many of my successes. He tried to keep me out of the operating room as best he could so I could write grants and do research, and I'm forever grateful to him for the successes in my career. I always laugh when I hear the fellows negotiating their positions, their jobs, they're, you know, looking for letters, how much am I going to make, how much time am I going to have off. What's funny is Dr. Van is the one who offered me the job, and then he promptly quit and moved on to other things. And then Dr. Swanson became chairman. I had no idea if I had a job. I went home and my wife said, how much they're going to pay? I have no idea. I left the office on June 30th as a fellow and kind of slinked back in on July 1st and helped nobody notice. I was actually grateful to find that there was a door with my name on it, so I knew I was there to stay. I was actually hired to be the prostate guy. Dr. Van hired me to take his place so that he would move on to bigger and better things. But the problem was we had this huge volume of kidney cancer patients coming in the door. Colin Denny used to take care of the kidney cancer, but he wanted to move on and study bladder and take care of bladder patients, so there was really nobody left to do the kidneys. And since I was a young guy, as we all know, things rolled downhill, all of a sudden my practice almost entirely consisted of patients with kidney cancer while I was still doing research in prostate cancer. And so ultimately I made the decision to convert and do kidney cancer research. And Dr. Van's response was, I think you're making a big mistake. Prostate cancer is where the action is. Nothing exciting ever happens at kidney cancer. I didn't say it was always right. My success certainly could never have been done on my own. I have so many people to thank for it. I actually have three wives. This is my second wife, Carol, my secretary, my assistant. She knows everything about me, and she reminds me on a daily basis she could ruin me anytime she wants to. And this is my nurse, Jan. Jan's been with me for 15 years. When we first met, I hated her and she hated me. I remember going to the clinic administration saying, I can't work with this woman. But like a fine wine, our relationship has matured, and now she's indispensable to my practice. Oh yeah, her too. I have a fantastic operating room team. Ed and Sarah have been with me for many, many years. They know exactly what it takes to keep me calm in the operating room during difficult moments. They also know how to push my buttons when they want to tease me and then sit back and laugh. It has been an amazing ride. I've traveled to six continents. I've seen sites I never dreamed I would see. I've made some amazing lifelong friends. This is Sudhir Rawal, who's my friend from New Delhi, India, and we're in actually Kathmandu, Nepal, getting ready to go paragliding in the Himalayas. But now it's time to pay it back. One of the first fellows I ever had the opportunity to work with is Ricardo Sanchez Ortiz. Ricardo was a fellow many years ago. He currently is associated with the University of Puerto Rico, and he is actually the man in urologic oncology on the island of Puerto Rico. And I forever grateful to him because as a young faculty member, the fellows that want to work with you, they want to work with the established guys. And then came Vitaly Margulis, who was my second fellow, probably the most prolific fellow at MD Anderson when he's not apparently posing for glamour shots. He was a tremendous force in the laboratory and in the clinic and is currently working at UT Southwestern where he is a rising star in the field of urology. Maduro Merchant came to me as a high school student and wanted to work in the laboratory. And I have followed his career over time and I'm actually amazed to believe that I had some influence on him becoming ultimately a urology resident out in California. Steve Brassel came to us for a one-year fellowship. He was in the Air Force at the time. And again, he's currently a urologic oncologist in Boise, Idaho, doing great things. Stephen Culp was an ex-fellow that came along and he did some fantastic things in the laboratory with non-clear cell histology. And he's currently on the staff at the University of Virginia where he has an active lab in addition to his clinical practice. Jason Abel, who you just saw introduce me, was again another one of our famous fellows. He did outstanding things at MD Anderson and is going on to do great things in the field of kidney cancer and is a rising star. Scott Delacroix, once you meet Scott, you never forget Scott. He's an amazing guy. He's actually flying in tonight to go on this party so I would ask you that if no one sees me tomorrow, please call the local police stations and have the lake dragged, largely because of Scott. Scott's currently on the staff at LSU in New Orleans. Jose Karam is my right-hand man, my junior partner. He is, again, a rising star in the field of kidney cancer. He's done some really amazing things at our place and I'm very happy to call him a colleague on our staff. Brian Chapin also was a fellow in the laboratory. Now, Brian actually joined our faculty in the prostate cancer program, not the kidney cancer program. Brian's the most connected guy that I know. He always knew when chairmanship's opened up, I think he knew it before the chairman that was leaving knew it was going to open up and he always used to tell me about him and I always thought, wow, this guy's great. He really is concerned about my career and wants to advance it. I actually think what he was trying to do was get me to leave so he could take my job. Nice try, Brian. Saad Al-Dusari was one of our fellows from Kuwait. He's currently back in Kuwait and he is the man in urological oncology in Kuwait. Pat Kenney was one of our recent fellows who just recently graduated and he's on the staff at Yale University. So all of these guys have gone on to academic positions, something that I'm very proud of and hope to believe that I had some influence on. Last year we had a lot of estrogen in the lab. Megan Merrill is currently one of our clinical fellows and Karababayan is currently doing a fellowship out in California. You can see that mentorship is not all about just papers and research. I think all three of us look pretty much hammered in that picture. And then Chi Chi Su was a postdoc for me that did some tremendous things in the lab that I'll talk about and currently is actually at a university in Taiwan as an assistant professor. I've noticed that really nobody ever invites me to talk about my translational or clinical research and I never really understood why, but I think I've narrowed it down to potentially two potential reasons. One is that maybe nobody knows about the fantastic research that my lab and clinical research group does and we're toiling away in relative anonymity, developing promising targets and therapies that will cure cancer in my lifetime. And if it's not that, then it must be that my research sucks and it's doomed to failure. The Wood-Karam Laboratory in Jose is definitely a major part of our laboratory effort in collaboration with Dr. Nazar Taneer from Genitourinary Medical Oncology have made a point of focusing on developing human models of kidney cancer in the laboratory and we now have a variety of different histologies that are growing both in vitro as well as in vivo in the laboratory that we can use to ask critical questions with regards to the biology of kidney cancer. And here we are at a research summit together at the Dead Sea in between massages and here we are in Kathmandu, Nepal just prior to going paragliding. It's been an amazing collaboration, one that continues to be fruitful. One of the things that Jose has championed in the laboratory is the concept of clinical co-trials where patients undergo surgery. Their tumor is removed, it's brought to the laboratory and implanted in a mouse. It's expanded, characterized, and then treated. And our hope is that eventually this could give us some insight into potential therapeutic choices for the patient in real time. We recently had a paper accepted, actually two weeks ago, we had a paper accepted by clinical cancer research where we identified the auto-taxin axis as a potential mediator of acquired resistance to targeted therapy in patients with kidney cancer. Our laboratory is also focused on identifying circulating biomarkers, be it microRNAs or proteins that are associated with disease recurrence in response to systemic therapy. Jose is focused on studying the biology of sarcomatoid de-differentiation and we're also looking at identifying tumor-derived endothelial cell molecular pathways that are associated with tumor resistance. We also do clinical research and I've been very active in the field of adjuvant therapy. I was the lead PI of the Wittespen trial. We did a Thalidomide trial in MD Anderson. MD Anderson was the lead accruer for the Assure trial and also a major accruer for the Patek trial. In collaboration with Eric Jonas, we've done trials in the pre-surgical setting and in collaboration with my partner Jose, we actually just recently completed a trial in neo-adjuvant therapy with XITNIP. This is one of the first trials ever conducted in this disease space. It was very challenging to accrue patients. I want you to imagine this conversation with the first patient. So we have this agent. We don't know if it works. In fact, your disease may progress while you're on this agent and your curable disease may become incurable. We'd like you to take it for three months. It's going to make you feel like crap. What do you say? Patients with locally advanced disease were asked to take XITNIP in a dose escalation fashion over a period of three months before being taken for curative surgery. They started at a dose of 5 milligrams for 12 weeks. We titrated them up to a dose of 10 milligrams. The XITNIP was stopped 36 hours prior to surgery. We had 24 patients. You can see the breakdown. All of these patients had locally advanced disease and had clear cell histology on biopsy. Two patients had to stop therapy early because of toxicity, but all patients ultimately did go to surgery as planned without delay. And in this particular series, 11 patients or 46% of these patients actually had a partial response based on resist criteria, which is significantly better than what we were seeing with some of the first-generation targeted agents. 13 patients had stable disease, and again, no one progressed. So here's the waterfall plot looking at these patients. 46% of them had a partial response based on resist criteria. These are the surgical parameters associated with these patients. 19 ultimately had a radical nephrectomy, but five who probably would have had a very difficult or impossible partial nephrectomy were able to undergo partial nephrectomy, and you can see the pathology as it's outlined there. The therapy by and large was pretty well tolerated. Hypertension was probably the most significant toxicity associated with it with the others as shown there, but by and large, it was very well tolerated by all of the patients. And here's just an example of a really dramatic response associated with XITNIP, locally advanced tumor involving the left kidney, and after three months of therapy, this actually could have been done as a partial nephrectomy, but the patient just wouldn't go for it. You can see the dramatic response around the tumor associated with that therapy. So, the Androcynobic MD Memorial Lecture. Well first, I want to thank the patients and their families. They put our trust in us to make things better. Hopefully most of the time we succeed, but certainly we always try to do our best. I want to thank my friends, colleagues, fellows, residents, and medical students. With your constant input, hard work, and excitement, the cure of kidney cancer will always remain my passion. I love my job, and I can't imagine doing anything else. And the truth is, although don't tell them, I'd probably pay them to do what I do every day. Thank you to the Kidney Cancer Association. As a medical student, resident, fellow, and faculty member at MD Anderson, I never dreamed that Christopher G. Wood and Androcynobic, whatever be mentioned in the same sentence, never mind getting an award in honor of his memory. I'm truly humbled. He is and always will be missed. Thank you very much.