Meet the Experts

The International Cholangiocarcinoma Research Network (ICRN) and the European Network for the Study of Cholangiocarcinoma (ENS-CCA) highlight global CCA expert scientists and physicians. This initiative will help CCA experts know each other and interact with a more diverse group of global leaders in the field. We hope that knowing each other better will stimulate innovative and collaborative ideas and opportunities.

Thomas Karasic

Name
	Thomas Karasic
Email
	thomas.karasic@pennmedicine.upenn.edu
Phone
	(215) 614-1858
Organization
	University of Pennsylvania
Can you tell us a bit about yourself?
	I am a medical oncologist at the University of Pennsylvania who specializes in the treatment of hepatobiliary and pancreatic cancers.
Can you share one or two of your specific research interests?
	My research is focused on clinical trials in immunotherapy in hepatocellular carcinoma and biliary tract cancers. I am also interested in expanding the role of liver transplant for patients with hepatobiliary cancers.
Why did you decide to specialize in hepatobiliary cancers?
	Treating hepatobiliary cancers is one of the ultimate team sports in oncology. I get to work with smart and dedicated colleagues in hepatology, surgical oncology, transplant surgery, diagnostic and interventional radiology, radiation oncology, and pathology on a daily basis. For patients who undergo liver transplantation, the team grows even bigger. It is incredibly rewarding to work within such a team to help patients who are often incredibly sick and need all hands on deck.
Can you describe one of the unforgettable moments in your patients care or research that has impacted your career?
	One of the first patients I treated with immunotherapy for hepatocellular carcinoma was a woman who developed ascites due to a large new liver tumor. She was unable to get embolization safely and did not tolerate sorafenib and so she gave away all of her Earthly possessions and moved to Philadelphia to live with her son. After a single dose of nivolumab, her ascites and liver function began to improve, and she ended up having a complete response to therapy. She has been able to remain in remission off of treatment and see the birth of her grandson. These success stories with immunotherapy in hepatobiliary cancers are what drive me to continue clinical research to expand the reach of these treatments to more patients.
Can you tell us one thing collaboration with colleagues could accomplish that you could not accomplish on your own?
	I enjoy working with my immunology colleagues to learn lessons about novel immune treatments in other cancers and find ways to apply those treatments to hepatobiliary cancers. I also hope that one day this collaboration will help determine upfront which patients with liver cancers are likely to respond to immunotherapy and which need a different approach.
If you had access to one resource that would move your research forward, what would that resource be?
	Many patients with cholangiocarcinoma miss out on clinical trials or curative procedures such as liver transplant because their doctors are not aware of the options. I believe that all patients with cholangiocarcinoma should receive an opinion at a major center specializing in treatment, and better patient and physician education as well as philanthropic support to overcome social barriers is critical to improving patient enrollment in cholangiocarcinoma clinical trials.
How did you learn about the Cholangiocarcinoma Foundation?
	I first heard of the Cholangiocarcinoma Foundation when I was a fellow attending GI ASCO and by chance sat at a table with Katie Kelley at a mentoring event.
Can you tell us why you became a member of the ICRN?
	Being a member of the ICRN helps connect me with colleagues across the world who are also dedicated to treating cholangiocarcinoma and helps keep me connected with the latest research
If you are one of our Cholangiocarcinoma Foundation Fellowship awardees, how has this Fellowship impacted your career?
	N/A

Mairead G McNamara

Name
	Mairead G McNamara Dr
Organization
	University of Manchester/The Christie NHS Foundation Trust
Can you tell us a bit about yourself?
	I am a Senior Lecturer and Honorary Consultant at the University of Manchester and The Christie NHS Foundation Trust, Manchester, United Kingdom (UK) since 2014. I completed my Medical training in Ireland and then did a three year clinical research fellowship in Princess Margaret Cancer Centre, Toronto, Canada before moving to the UK. Prior to studying Medicine, I was awarded a degree in Biochemistry and a PhD in Neuropharmacology (I spent 6 months of my PhD in the University of Mississippi Medical Centre, Jackson, Mississippi). I now treat patients with hepatopancreaticobiliary (HPB) malignancies and neuroendocrine neoplasms (NENs).
Can you share one or two of your specific research interests?
	My research interests span across the disease group malignancies that I treat (translational [specifically aiming to gain a better understanding of the biology of these diseases and identifying predictors for response, focusing on liquid biopsies and the microbiome] and clinical, including phase I to III clinical trials).
Why did you decide to specialize in hepatobiliary cancers?
	As I went through my specialist Medical Oncology training, I was most drawn to the sub-specialities of gastrointestinal cancer and neuro-oncology. In 2011, on commencing my clinical research fellowship in Toronto under the mentorship of the eternally enthusiastic and inspiring Professor Jennifer Knox, I became more exposed to patients with hepatobiliary malignancies and the burgeoning clinical and translational research in this area. I was introduced to the resources, people and societies behind these breakthroughs and ambitions, and wished to become an influential part of this evolutionary process.
Can you describe one of the unforgettable moments in your patients care or research that has impacted your career?
	I thought about this for a while and the “patient zero” for me was probably an inpatient that I saw as a Medical student when I was rotating through Medical Oncology in an Irish hospital. They had a very aggressive malignancy, with new subcutaneous lesions appearing daily, and they had exhausted all standard lines of treatment. I read up about the disease and came across a recent research abstract reporting on a novel therapeutic option. I told the registrar (resident) looking after the patient and they asked for a copy of the abstract and passed it on to the consultant (staff) responsible for the patient’s care, and this was then taken into consideration as part of their management plan. From then on, Medical Oncology, with its associated potential for instigating meaningful changes in patient outcomes, was the path that I wanted to pursue.
Can you tell us one thing collaboration with colleagues could accomplish that you could not accomplish on your own?
	One can have an idea, but it takes many (junior to senior and multidisciplinary) to tease out, support and challenge the intricacies, allowing for more mature development of a potentially practice-changing initiative.
If you had access to one resource that would move your research forward, what would that resource be?
	A more integrated efficient system for opening clinical trials (investigator-initiated and commercial) in a significantly shorter time frame.
How did you learn about the Cholangiocarcinoma Foundation?
	I learnt about the Cholangiocarcinoma Foundation from Professor Jennifer Knox in Toronto, during my fellowship there, and was envious of her attendance at the annual conference, and being at the forefront of cholangiocarcinoma programmes, proposals and community.
Can you tell us why you became a member of the ICRN?
	I became a member of the ICRN to self-educate, integrate, collaborate and apprise myself of potential future therapeutic opportunities for patients with a diagnosis of cholangiocarcinoma.

Previous Interviews

Nilofer Azad

Name
	Nilofer Azad
Organization
	Johns Hopkins
Can you tell us a bit about yourself?
	I am a very fortunate physician that went into medicine thinking I was going to take care of patients, and by happenstance over the course of my training, was exposed to wonderful mentors and research leaders who whet my appetite to make a difference through clinical research. I am a faculty member at Johns Hopkins, where I work with the best group of doctors and other medical professions to take care of patients while working to increase the options available to them. I have a wonderful family and group of friends who provide my life's foundation. I consider myself very lucky to get to do what I do.
Can you share one or two of your specific research interests?
	I have an interest in combining novel agents to advance the therapeutic options for advanced cholangiocarcinoma patients. I am particularly interested in epigenetic and immunotherapies, both together, and how epigenetic alterations may impact the immune response.
Why did you decide to specialize in hepatobiliary cancers?
	Good luck. I was running an early phase clinical trial in advanced solid tumors early in my career and saw some possible benefit for cholangiocarcinoma patients. I decided to open a dedicated trial arm to cholangiocarcinoma, and then it was off to the races. I began looking at all my drug development though the lens of how it might help cholangiocarcinoma patients, and how we might modify strategies to make them more appropriate to cholangiocarcinoma biology.
Can you describe one of the unforgettable moments in your patients care or research that has impacted your career?
	The beauty of our job is that there is no one moment that encapsulates the meaning of what we do. Rather, our careers are an amalgamation of hundreds of people we have taken care of and worked with -- all of whom have taught of the essence of what life is about. Family. Friendship. Health. Love. Generosity. Suffering. Perseverance. Intellectual Joy. We have been given such a gift to have found this particular calling, working with cancer patients.
Can you tell us one thing collaboration with colleagues could accomplish that you could not accomplish on your own?
	The underpinnings of cancer biology are so complex that no one investigator has the needed expertise to understand all of the nuances of any given approach. Team science allows for us to assemble groups of people with varied skill sets and knowledge bases which dramatically improve the chance we will find a new treatment and eventual cure for this cancer.
If you had access to one resource that would move your research forward, what would that resource be?
	More funding. There are so many exciting ideas that are delayed by the lack of funding to move them forward. For example, we have a personalized vaccine study that it extraordinarily expensive to generate for each patient. This kind of personalized immunotherapy approach is presently limited due to lack of funding.
How did you learn about the Cholangiocarcinoma Foundation?
	Honestly, I don't remember not knowing about CCF - it is so ubiquitous in cholangiocarcinoma patient and researcher circles.
Can you tell us why you became a member of the ICRN?
	It is an exciting group of people that pushes me to refine my ideas and make them into reality and work with others to do the same with theirs. It is an incredibly giving group of caring doctors and researchers. What a great community.

Katie Kelley

Name
	Katie Kelley
Email
	katie.kelley@ucsf.edu
Organization
	UCSF
Can you tell us a bit about yourself?
	I am a GI Medical Oncologist at UCSF and lead our hepatobiliary cancer clinical research program.
Can you share one or two of your specific research interests?
	Developing new targeted therapies and immunotherapies for biliary tract cancers and hepatocellular carcinoma. Identifying molecular and clinical factors associated with risk and response in hepatobiliary cancers.
Why did you decide to specialize in hepatobiliary cancers?
	I wanted to contribute my efforts to a complex family of cancers -- and the patients with those cancers -- with enormous unmet need in oncology.
Can you describe one of the unforgettable moments in your patients care or research that has impacted your career?
	Seeing some of my cholangiocarcinoma patients achieve complete and prolonged responses to immunotherapy has been among the most unforgettable, impactful, and meaningful moments in my career and has led to my goal of finding new combinations to improve patients' chances of experiencing an immune response.
Can you tell us one thing collaboration with colleagues could accomplish that you could not accomplish on your own?
	Collaboration is essential in cancer research, especially in rare cancers with even rarer molecular subgroups. Completing clinical trials of targeted therapies such as FGFR2 inhibitors or IDH1 inhibitors would not be possible without large collaborations, and these collaborations enrich all of our understanding of the disease.
How did you learn about the Cholangiocarcinoma Foundation?
	Stacie sent me an email long ago to introduce me to collaborators across the country -- a collaboration which is ongoing to this day!

Kabir Mody

Name
	Kabir Mody
Organization
	Mayo Clinic
Can you tell us a bit about yourself?
	I am of Indian descent, born and raised here in the US, mostly in New England. After college in Boston and a masters in NYC, followed by medical school in Grenada, I pursued internal medicine residency at St Luke's-Roosevelt Hospital in NYC and fellowship at Dartmouth Hitchcock Medical Center in New Hampshire. I then settled here in northern Florida at Mayo Clinic and am blessed and excited to work with such passionate, intelligent, patient-focused colleagues both here at Mayo Clinic and around the country. I live with my wife Nicole and our 2 young children, Grace and Nicholas. I love to play tennis, golf and pretty much any sport. I am also a die hard world traveler, never missing an opportunity to go somewhere new!
Can you share one or two of your specific research interests?
	My 2 primary research interest are: a. the use of circulating tumor DNA in hepatobiliary malignancies b. immunotherapy in hepatobiliary malignancies - in particular, novel therapeutics and incorporation into multi-modality treatment strategies, and modeling of hepatobiliary malignancies in the lab to enable personalized immunotherapy treatment for patients.
Why did you decide to specialize in hepatobiliary cancers?
	I was drawn to hepatobiliary cancers, particularly cholangiocarcinoma, after an unforgettable patient I cared for early in my hematology/oncology fellowship. Realizing the immense need for attention to the disease, research in the disease, and newer more effective treatments for patients, I immediately dedicated myself and my career to advancing the field for patients and toward a cure.
Can you tell us one thing collaboration with colleagues could accomplish that you could not accomplish on your own?
	In an uncommon cancer, such as cholangiocarcinoma, collaboration with colleagues dedicated to the care of patients with this disease is key. Collaborations enable joint brainstorming and discovery of new questions and ways of looking at things, in addition to enabling collection of larger amounts of data needed to answer important questions we have about this malignancy with more rigor and confidence. Additionally, these collaborations, such as that championed by the ICRN, stimulate thought provoking discussions and summon collective motivation and dedication to pursuing significant progress in this disease. These collaborations often also allow us the opportunity to involve patients in research efforts, offering their vitally important perspective.
If you had access to one resource that would move your research forward, what would that resource be?
	More research funding dedicated specifically toward hepatobiliary malignancies.
How did you learn about the Cholangiocarcinoma Foundation?
	I was initially introduced to the foundation by colleagues here at Mayo Clinic, and invited to come to the annual meeting in 2015. I immediately fell in love with the people involved, their collective motivation and passion for the disease. I have been actively involved ever since.
Can you tell us why you became a member of the ICRN?
	I was fortunate to be involved with the Cholangiocarcinoma Foundation during the inception of the ICRN, and have been excited to be involved as it affords us, as a community, to collectively and collaboratively mobilize toward a single goal on the research front in an organized fashion. The collaboration has stimulated thought provoking conversations and questions, and has brought us together with key industry and non-profit partnerships, all of which has already benefited our patients and continues to help drive dedicated research into cholangiocarcinoma and progress toward a cure.
If you are one of our Cholangiocarcinoma Foundation Fellowship awardees, how has this Fellowship impacted your career?
	N/A

Mitesh Borad

Name
	Mitesh Borad
Organization
	Mayo Clinic
Can you tell us a bit about yourself?
	I am a physician-scientist at the Mayo Clinic. My work involves both laboratory and clinical studies. I feel very fortunate to have wonderful colleagues both here and elsewhere, access to cutting edge resources, and a constant spirit of innovation and team science. I am always amazed by how courageous and altruistic our patients our in this journey and am always honored for them entrusting their care to our team. For better or worse, my endeavors are directed towards findings cures (and by that I mean collectively, not myself of course) for some of the most challenging cancers - liver and biliary tract cancers. In my spare time, I do enjoy traveling, cuisines of all types, cinema and kicking back with family and friends.
Can you share one or two of your specific research interests?
	The human genome and gene therapy fascinate me at a scientific level. Ultimately, cancer is a genetic disease. It seems that we are only at the tip of the iceberg in the precision medicine era. I am hoping that we find magic bullets like imatinib (Gleevec) for all cancers. After arriving at Mayo Clinic, I was introduced to the notion of "oncolytic viruses", genetically modified viruses with propensity to infect tumor cells relative to normal cells and "armed" with anything in the scope of imagination - immunomodulators, targeted antibodies, toxins and reporter agents for imaging and tracking. In my laboratory, we have been endeavoring to create precision medicine enabled oncolytic viruses, in an effort to integrate these two fascinating landscapes. Broadly along these line, I am a firm believer that we will revisit Cancer Gene Therapy, a field that has fallen by the wayside, due to limitations in therapeutic delivery.
Why did you decide to specialize in hepatobiliary cancers?
	Like the vast majority of things in my career, it was purely be serendipity. In 2010, At Mayo Clinic, with colleagues from the Translational Genomics Research Institute (TGen), we had launched one of the first efforts to perform whole genome and transcriptome sequencing in a real-time clinical setting. At the time, I had a number of treatment refractory patients with cholangiocarcinoma in my practice and had no idea what to do them. I enrolled them into the study, with considerable skepticism, not expecting to find much. To our surprise, more than half the patients had "actionable" findings, including FGFR2 fusions. There were no FGFR specific inhibitors at the time, but luckily drugs such as ponatinib and pazopanib had FGFR inhibitory activity and were available (after much pleading to pharma execs). Fortunately, all the patients we treated had some clinical benefit. Before I knew it, everyone was referring cholangiocarcinoma patients our way and it become apparent to me that I would need to learn more about the disease and its nuances, if I were to have any degree of credibility living up to the trust the patients were putting in us.
Can you describe one of the unforgettable moments in your patients care or research that has impacted your career?
	There are definitely many "forgettable" moments. During my time at TGen, we were developing vismodegib, the world's first smoothened inhibitor, along with other institutions, in first-in-human studies. I had been treating a patient with metastatic basal cell cancer at the time and the heat shock protein inhibitor he had been on, had been ineffective. The timing was quite fortuitous as we had just opened the trial. After having to jump through innumerable hoops before the patient met the eligibility barricade, he was all set to go. The team quickly realized that this was a momentous occasion as he would be the first patient in the world treated with the drug. The next day, the research nurse, my good friend and colleague Dr. Raoul Tibes and the pharmacist clamored together to get a photo-op with "Patient 1". There was much friendly debate as to who should get the credit - the treating physician (myself), the nurse (for administering the drug) or the pharmacist (for ensuring accuracy of investigational drug product). Luckily, the patient settled the score and said he should get the credit because he was the one taking it, and of course, he was right ! It was a reminder that in our line of work, humility is absolutely essential. I always remember that incident when I see things going out of hand in this regards when "experts" in our field get carried away sometimes.
Can you tell us one thing collaboration with colleagues could accomplish that you could not accomplish on your own?
	I was schooled in team science from the outset. As such, it is hard for me to imagine things one can really do on their own. Medicine and science have become vastly complex and the pace of knowledge and change has become exponential. It would be foolhardy to think that any one individual could have mastery over enough areas to credibly be an expert. I would want to give a shout out to all of the unsung heroines and heroes in this team sport - patients and their families, nurses, pharmacists, maintenance experts and many, many others. Without their selfless efforts, the scientific teams would not achieve any of the glories they are afforded.
If you had access to one resource that would move your research forward, what would that resource be?
	If you thought, I would have said money, you are wrong. I wish there was more appetite for high-risk, high-reward research. All the things we do routinely now, came about through tectonic shifts, not through the safe and underambitious proposals that populate the research landscape after every big shift in the field. I also wish people could share their ideas more freely. Currently, this does not happen because folks want to hold something back so that can be the one to get the next grant, patent or credit for the big paper everyone will cite. I totally understand that this kind of thinking would be considered utopian and stating such things would make others wonder if I live in an alternate reality. There are many senior colleagues and friends who I know have done it all, and already made their mark. It would be quite refreshing to see this "been there, done that" group try to set a new trend towards achieving solutions faster by sharing their ideas openly and selflessly. I am certain our patients expect this of us and there is nothing like being a trendsetter once you have kind of plateaued in academia.
How did you learn about the Cholangiocarcinoma Foundation?
	I was invited to participate in a Workshop some years ago by Stacey Lindsey, CEO and Founder of the Cholangiocarcinoma Foundation (CCF). She had assembled physicians and scientists from a number of institutions in Salt Lake City on that occasion. From what I can recall, we all went through these personality assessments, which I thought at the time, was quite peculiar. I think the goal of the exercise was to see if people with very different styles could actually work together to overcome a challenging problem such as cholangiocarcinoma. I don't think anyone from the group has remotely changed their personalities, but we have all learned to work together despite our idiosyncrasies, become good friends and are united by a common goal.
Can you tell us why you became a member of the ICRN?
	About five years ago, at the Annual Cholangiocarcinoma Foundation Conference, Stacie Lindsey asked for ideas on how the Foundation could impact research in the field. Having seen the success of the Pancreatic Cancer Research Team (PCRT), that my mentor Dr. Daniel Von Hoff had started, I suggested consideration of initiating a clinical-translational research network. Being the go-getter she is, in quick order, Stacie corralled my good friend and colleague, Dr. Milind Javle from Anderson and myself, to launch the International Cholangiocarcinoma Research Network (ICRN). Enthusiasm for ICRN was incredible and before we knew it, institutions from all around the world had signed up. Expertise was across the board - translational science, surgery, transplant, interventional radiology, radiation oncology, gastroenterology/hepatology, medical oncology, diagnostic radiology, interventional radiology and pathology. Being a non-profit endeavor, this was largely a volunteer activity and it was really heartwarming to see what are generally incredibly busy folks, being so giving of their time. Here we are five years later. In my mind it is still an experiment in evolution and showcases the power of people working together, realizing that in an uncommon cancer, there is simply no other way.
If you are one of our Cholangiocarcinoma Foundation Fellowship awardees, how has this Fellowship impacted your career?
	I did not have the good fortune of even being an applicant. However, I am now the proud mentor of one of the 2021 awardees (Dr. Alexander Baker). The impact CCF has made on supporting the bright, young minds who will solve the cholangiocarcinoma riddle, cannot be emphasized enough.

Jesus Banales, PhD

Name

Jesus Banales

Organization

Biodonostia Health Research Institute - Donostia Univ. Hospital (BHRI-DUH), San Sebastian (Spain)

Can you tell us a bit about yourself?

I was born in Pamplona (Spain) in 1979, graduated in Biochemistry (2001) and obtained my PhD (2006) from the Univ. Navarra (UNAV) studying the molecular mechanisms of bile flow generation/regulation in healthy and cholestatic conditions. Then, I moved to the Mayo Clinic (Rochester, MN) to carry out a posdoc (2006-2008, 2010; under the supervision of Prof. Nicholas F. LaRusso) focused on the study of the sensory features of the cholangiocyte primary cilium and the pathogenesis of polycystic liver diseases. After my training in National (UNAV) and International (Servier Laboratories, Paris; Univ. Colorado, USA; Mayo Clinic, USA) Institutions, I joined the BHRI-DUH (San Sebastian, Spain) in 2012 as Head of the Liver Diseases Group, which currently contains 3 subgroups and 30 multidisciplinary scientists (molecular biologists, hepatologists, oncologists, radiologists and surgeons). Our group is focused on studying the molecular mechanisms involved in liver pathobiology (cholestasis, chronic liver injury, polycystic liver diseases, non-alcoholic fatty liver disease, cirrhosis, hepatocellular carcinoma and cholangiocarcinoma), and looking for new diagnostic, prognostic and therapeutic strategies. In 2020 I was promoted to Professor of Biomedine at Ikerbasque (Basque Foundation of Science).

Can you share one or two of your specific research interests?

Regarding cholangiocarcinoma, we are interested in the study of the genetic, epigenetic and molecular mechanisms involved in the malignant transformation of cholangiocytes, and in the mechanism of cancer progression, in order to search for accurate non-invasive biomarkers (diagnostic and prognostic) and new targets for therapeutic intervention. Moreover, in collaboration with chemists from the Basque Country, we are developing new chemotherapeutic drugs for their preclinical evaluation in cholangiocarcinoma. Finally, we are deeply collaborating within the European Network for the Study of Cholangiocarcinoma (ENS-CCA; www.enscca.org / www.eurocholangionet.eu) for the multidisciplinary study of this cancer within international collaborative research programs, including the European Cholangiocarcinoma Registry (E-CCA Registry) of patients.

Why did you decide to specialize in hepatobiliary cancers?

All my scientific carrier has been focused in the study of liver pathobiology. I find the liver a very exciting organ, with unique regenerative capacity and immunobiology, and major functions for the human body. In particular, I put special attention into the biliary system, evaluating the role of cholangiocytes in the regulation of the bile flow and immune-tolerance, as well as their alterations under different cholangiopathies, including cholangiocarcinoma. Due to the low awareness and knowledge on cholangiocarcinoma, and the dismal outcome of patients this cancer, I decided in 2012 to focus my attention and studies in cholangiocarcinoma. Then, in 2015, together with a group of friends and colleagues from the field, we created ENS-CCA, which is currently an important scientific network for the multidisciplinary study of cholangiocarcinoma, and an EASL (European Association for the Study of the Liver) consortium.

Can you describe one of the unforgettable moments in your patients care or research that has impacted your career?

An unforgettable moment was the first time I attended the Cholangiocarcinoma Foundation Meeting in 2019. I became so impressed about such unique meeting, which involves scientists, clinicians, patients, caregivers, advocates, and pharmaceutical companies with the only aim to improve patient´s care and life. I was impressed about the personal support and recognition received by the patients, which strongly motivate me for keep investigating on this cancer.

Can you tell us one thing collaboration with colleagues could accomplish that you could not accomplish on your own?

Science is a "we" not an "I". This is a team effort that requires fair collaborations with other groups to move faster and better. ENS-CCA and ICRN are good examples of the importance of international collaborations. In science, there are multiple things interesting but less important. The important goal for cholangiocarcinoma is to improve the life of the people, so we must not to forget what is important when investigating interesting issues, and priorate the time and translation of the knowledge.

If you had access to one resource that would move your research forward, what would that resource be?

To involve more young scientists in the study of cholangiocarcinoma. Although material resources are fundamental, the most important talent in a research group is the people. We must to support, train and retain young talent scientists for working in this field in order to increase the knowledge on cholangiocarcinoma and the care and treatment of patients.

How did you learn about the Cholangiocarcinoma Foundation?

I learned about CCF by internet and colleagues some years ago, and in 2019 I was invited to attend the annual meeting in Salt Lake City for giving a talk about ENS-CCA and our research collaborative activities. Since then, I became strongly connected with CCF and ICRN. It is a great pleasure and honor for me to work and collaborate with them. They are doing an extraordinary work.

Can you tell us why you became a member of the ICRN?

ENS-CCA mainly involves European scientific groups because there are specific research funding grants from the European Commission to promote collaborative research within Europe. However, this collaborative vision is global and involves all the groups interested in cholangiocarcinoma worldwide, and of course the ICRN. We are trying to promote and boost more and more collaborations between ENS-CCA and ICRN, but also globally with Asia, and now with Latin America and Africa (through the recently created Ibero-Latin American Research Network on Cholangiocarcinoma (ILARN-CCA) and African Hepatopancreatico-biliary Cancer Consortium (AHPBCC). Moreover, in collaboration with the AMMF and CCF, it has been created the Global Cholangiocarcinoma Alliance with the mission to increase the global awareness on this cancer.

Rachna Shroff, MD

Name

Rachna Shroff

Organization

University of Arizona Cancer Center

Can you tell us a bit about yourself?

I am the Chief of GI Medical Oncology at the University of Arizona Cancer Center (UACC) where my clinical and research interests focus on biliary and pancreatic cancers. I also serve as the Director of UACC's Clinical Trials Office. I was previously on faculty at MD Anderson Cancer Center where I helped grow a prolific biliary research program with a robust clinical trial portfolio. Since joining UACC, I have helped grow the GI research program and have enjoyed building collaborations across the institution to grow translational research efforts. I am committed to improving outcomes for patients with pancreaticobiliary cancers and enjoy watching drug development blossom for my patients with cholangiocarcinoma. There is nothing more rewarding than holding our patients' hands through this journey and giving them hope as we see immense progress in these diseases.

Personally, I am happily married to a busy allergist on faculty at University of Arizona and we are kept busy raising two beautiful kids. We miss Houston, but have been enjoying the beautiful desert landscape and climate. We love to travel to new places (outside of global pandemics), I live to exercise for wellness, and dancing is my creative outlet.

Can you share one or two of your specific research interests?

My research interests focus on developing novel cytotoxic, targeted, and immune therapies for patients with biliary cancers and pancreatic cancers. I primarily engage in clinical trials but relish working with basic scientists to translate their discoveries into clinic.

Why did you decide to specialize in hepatobiliary cancers?

My focus in HPB cancers came from the clinic. Caring for patients with these diagnoses require committed researchers who are willing to think outside of the box, to advocate for research funding and to work collaboratively to improve outcomes. This is exactly what drove me into this space - a desire to impact patient care in a clinically meaningful way through scientific discovery and momentum. Giving hope to patients and watching the needle move forward is the most rewarding feeling for me as an oncologist.

Can you describe one of the unforgettable moments in your patients care or research that has impacted your career?

There are so many moments that help me keep my eyes on the prize. Taking a patient who was told that he/she had an incurable disease, putting them on a trial with a novel therapy, seeing a dramatic response and then taking them to a curative surgery is by far the most rewarding thing in my day-to-day. This is why I get out of bed every day - to see this progress happening in the clinic! For research, one unforgettable moment was when our national study, SWOG 1815 completed accrual in record time. This was an NCI-sponsored study and the first randomized phase 3 study in biliary cancers in the US. Being able to complete a study quickly to answer a meaningful question for this disease has been hands down one of the most rewarding moments in my research career.

Can you tell us one thing collaboration with colleagues could accomplish that you could not accomplish on your own?

The progress we have seen in understanding the molecular and immune landscape of cholangiocarcinoma is a perfect example of why collaboration is essential to eradicating this disease. We came together as researchers to learn about the importance of biomarker testing and its clinical relevance. This knowledge empowered us to launch clinical trials with targeted therapies that have led to FDA approvals in cholangiocarcinoma! None of this would have been possible if we, as researchers, did not come together to pool knowledge.

If you had access to one resource that would move your research forward, what would that resource be?

Funding! We are getting more and more funding dedicated to cholangiocarcinoma research (thanks in large part to advocacy from CCF), but we have so much more work to do! As we have come together as collaborators and built a repository of preclinical models, there are so many questions left to be asked and answered. More federal funding, philanthropic funding, and industry funding will drive us to progress. We have the momentum and we want to keep it going!

How did you learn about the Cholangiocarcinoma Foundation?

I have had the pleasure to be involved with CCF since (close to) the beginning. Being a junior faculty member at MD Anderson and working with Dr. Milind Javle, he introduced me early on to Stacie and CCF. It became readily apparent to me that this organization was going change the face of this disease and have a last impact. As such, I immediately began attending the national conference and getting to know other members. More recently, I have had the pleasure of chairing the 2020 National Conference and currently serve on the Scientific and Medical Advisory Board. I am so grateful to CCF to have them as a partner and as a force for our research in cholangiocarcinoma.

Can you tell us why you became a member of the ICRN?

I became a member of ICRN early on because I knew that to truly make an impact on this disease, researchers from all over the world would need to come together to ask important scientific questions. ICRN was a mechanism to bring US collaborators in close touch with our brilliant scientists in Europe, Asia, and beyond. Since joining, I have had the pleasure of working in the Immunotherapy Working Group and helping design novel questions in the space of immune-oncology. I also now serve on the Executive Committee and have enjoyed working elbow-to-elbow with international thought leaders to identify areas of focus for research that will have a global impact on cholangiocarcinoma.

Gregory Gores

Name
	Gregory Gores
Organization
	Mayo Clinic
Can you tell us a bit about yourself?
	Gregory J. Gores, M.D. is a senior academician with contributions to research, clinical practice, and education. His research contributions include sustained federal funding over three decades, over 700 publications, an H-index of 136, and over 57,000 citations (Scopus data base). His clinical focus on hepatobiliary neoplasia has led to novel protocols regarding liver transplantation for cholangiocarcinoma. Educational activities include mentoring over 80 fellows, and directing a liver transplant fellowship program. These activities have been recognized by receipt of an American Gastroenterological Association Mentorship Award. Extramural leadership positions include past presidency of the American Association for the Study of Liver Disease (AASLD) and the International Liver Cancer Association, and a past Councilor of the American Gastroenterological Association (AGA). His stature and accomplishments were recently recognized by prestigious awards from the Mayo Alumni Association, the AASLD, the German Society of Gastroenterology, and the Canadian Liver Foundation and Canadian Association for the Study of Liver. He was recently appointed as Editor in Chief for Hepatology (term 2021-2025).
Can you share one or two of your specific research interests?
	Early diagnosis of cholangiocarcinoma identification of the molecular dependencies of cholangiocarcinoma Immunotherapy for cholangiocarcinoma Liver transplantation as a therapeutic modality for cholangiocarcinoma
Why did you decide to specialize in hepatobiliary cancers?
	I specialized in hepatobiliary cancers as I saw this as an unmet need for patients
Can you describe one of the unforgettable moments in your patients care or research that has impacted your career?
	Observing the ability to cure patients with liver cancers with liver transplantation
Can you tell us one thing collaboration with colleagues could accomplish that you could not accomplish on your own?
	virtually nothing can be accomplished without collaboration
If you had access to one resource that would move your research forward, what would that resource be?
	high throughput assays
How did you learn about the Cholangiocarcinoma Foundation?
	Stacie and team reached out to me in the very beginning to engage me in the foundation
Can you tell us why you became a member of the ICRN?
	to enhance collaboration

Angela Lamarca

Name
	Angela Lamarca
Organization
	The Christie NHS Foundation Trust
Can you tell us a bit about yourself?
	I am a Medical Oncologist (MD, PhD, MSc), specialised in gastrointestinal malignancies (hepato-pancreato-biliary (HPB) and neuroendocrine tumours (NETs)); with special interest in biliary tract cancers. I completed my training in Medical Oncology (including my PhD) in Spain (Hospital Universitario La Paz, Madrid). I moved to The Christie NHS Foundation Trust (Manchester, United Kingdom) in 2013, where I completed a 4-year fellowship programme in HPB and NETs. I have also completed a Masters Degree in Molecular Biology of Cancer and a second Masters Degree in Biostatistics. I was awarded with an American Society of Clinical Oncology (ASCO) Conquer Cancer Foundation Young Investigator Award in 2017 and I was appointed as a Consultant in Medical Oncology at The Christie NHS Foundation Trust in May 2018 where I continues to develop my career as a clinical and translational researcher with special interest in biliary tract tumour (including cholangiocarcinoma). I am currently a member of the EORTC Gastrointestinal Cancer Group, ENETS Advisory board and a faculty member of the ESMO Non-Colorectal Gastrointestinal Cancer group.
Can you share one or two of your specific research interests?
	I believe that there are many areas of unmet need in the current management of biliary tract cancers, including cholangiocarcinoma. There is an urgent need of increasing rate of cure after curative surgery and we are in need of more effective adjuvant treatments and also development of biomarkers that could predict higher risk of relapse and tailoring of adjuvant strategies. In addition, in order to improve outcomes in the setting of advanced disease, two aspects are to be improved. First, we require, biomarkers for prediction of response to current chemotherapy options for tailoring approach in the scenario of cytotoxic chemotherapy. Second, development of new targeted therapies and a better understanding of resistance mechanisms to current therapies is needed.
Why did you decide to specialize in hepatobiliary cancers?
	I decided to specialise on biliary tract cancers because it is an area of urgent unmet need. Unfortunately, these cancers are usually diagnosed in advanced stages and they imply poor prognosis, with devastating implications for our patients and their loved ones. The only way of improving outcomes is through research and an in depth understanding of the disease.
Can you describe one of the unforgettable moments in your patients care or research that has impacted your career?
	I have had many moments that have reassured me of my career choice and that made me feel appreciated by my patients and their families. I share both happy and sad news with my patients and their loved ones like if I was part of the "family" and this makes my work very special. A smile or a "thank you" after a difficult discussion means the world to me and provides the best motivation to continue our search for better treatment options.
Can you tell us one thing collaboration with colleagues could accomplish that you could not accomplish on your own?
	Collaboration with colleagues is key in rare tumours like biliary tract tumours. I don't think there is anything that could be achieved by us individually and I strongly believe that collaboration between all health care providers and patients is the only way forward.
How did you learn about the Cholangiocarcinoma Foundation?
	My first interaction with the Cholangiocarcinoma Foundation was in 2017 when I attended the annual meeting. To me, this was a very special experience from which I would like to highlight the direct contact between patients and healthcare providers, which I believe makes this organisation (and this meeting) very special.
Can you tell us why you became a member of the ICRN?
	ICRN represents one of the most relevant networks worldwide working towards better treatment options for patients with cholangiocarcinoma and is an honour to be a member of this initiative.
If you are one of our Cholangiocarcinoma Foundation Fellowship awardees, how has this Fellowship impacted your career?
	I was awarded with the Elizabeth Dardenne Stefanini Memorial Research Fellowship on 2017. This fellowship allow for me to develop my own research project focused on better understanding biomarkers associated with worse/better outcomes from platinum-based chemotherapy in biliary tract tumours. this was one of my first steps into an independent research and I will always be grateful to the Cholangiocarcinoa Foundation for this career-changing opportunity.

The International Cholangiocarcinoma Research Network (ICRN) is a program of the Cholangiocarcinoma Foundation.