June 7, 2017
The Big Ten Cancer Research Consortium recently welcomed Diane M. Hershock, MD, PhD, of Penn State Cancer Institute, as a member of its Steering Committee. The committee consists of one representative from each member institution and is responsible to decide matters of policy for the consortium.
Hershock is co-director for experimental therapeutics and medical director in the Clinical Trials Office at Penn State Cancer Institute. She earned her Bachelor of Science in biology from Saint Joseph’s University in Philadelphia and spent four years doing biochemistry in the thrombosis and hemostasis department at Temple University Medical School. We were trying to develop an antibody to the GPIIb/IIIa receptor as well as to isolate/elucidate the mechanisms of action of platelet factor 4 and thrombospondin, advancing platelet research knowledge. She knew then that she wanted to continue her studies at a graduate level.
She obtained her PhD in pharmacology from Thomas Jefferson University of Jefferson Medical College, researching stress as a pharmacologic inducer of atherosclerosis through effects on cholesterol, free fatty acids and triglycerides. At that point, I also had an interest in trying to correlate membrane changes due to cholesterol/free fatty acid changes to inflammation, possibly cancer, Hershock said. I was looking at platelet release products during stress in rats, in particular thrombospondin, attempting to correlate platelet activation and increased free fatty acid/cholesterol levels with membrane changes as a potential etiology for either atherosclerosis or a possible pathway for changes leading to tumorigenesis.
After obtaining her PhD, Hershock went on to medical school at Jefferson Medical College and completed a post-doctoral fellowship in the pharmacology lab she received her PhD. She did her internal medicine residency at Temple University Hospital and a fellowship in hematology/oncology at the Hospital of the University of Pennsylvania. As a fellow, I trained in bone marrow transplant and hematology at the Abramson Cancer Center of the Hospital of the University of Pennsylvania. Ultimately she remained on the faculty of the Abramson Cancer Center after fellowship as an Assistant Professor of Medicine initially doing clinical research in hematologic malignancies and bone marrow transplant. However, there was a need for a faculty member to join the head/neck cancer team as well as the melanoma program so she transitioned to solid tumor oncology. She received additional faculty appointments in the Department of Otolaryngology, Head and Neck Surgery as well as Dermatology I had the great pleasure of working with globally recognized key opinion leaders in oncologic head/neck surgery and radiation oncology as well as in the melanoma program at Penn. Hershock came head of the head and neck program at Abramson Cancer Center until 2005, participated extensively in clinical trial work and was a an author on multiple published clinical trials and journal reviews.
In late 2005, Hershock added industry to her career pathway.
I was working on a Phase 3 clinical trial with Sanofi-Aventis as a site principal investigator, combining Tirapazamine with Cisplatin with radiation therapy in the upfront treatment of locally advanced head and neck cancers, she said. During an investigator meeting for this drug, she was convinced by a former Penn professor who was a senior director at Sanofi that she would learn much more about clinical development and the execution of clinical trials from the industry side than continuing in academics. Several months later, she was running that same Tirapazamine trial in head/neck as an associate director of clinical development at Sanofi-Aventis.
During her time at Sanofi, she was instrumental in achieving a submission for Taxotere as induction chemotherapy in head/neck cancer both in the US and in Europe, working with Jan Vermorken as well as Marshall Posner. Both studies had positive overall survival and progression-free survival; these two major trial were the first to demonstrate a role for upfront induction chemotherapy followed by combined modality chemoradiation (US study only) as organ preservation in the treatment of head/neck cancer. Therefore, she was the lead member of the team instrumental in convincing the FDA of the merit of Taxotere for head and neck cancer which was ultimately approved in the US; she was also part of the submission team for induction chemotherapy in the EMA. This data was presented at ASCO as well as published in the NEJM.
She then joined Merck as a director of clinical development and became the global clinical lead for Vorinostat. In addition to overseeing the Vorinostat portfolio, she was also involved in multiple phase I assets as well as starting an initiative combining novel agents with radiation with MDACC. I was working on several other Phase I drugs and realized that I enjoyed working with Discovery and initiating first in human studies. After leaving Merck, she moved to ICON, a CRO, where she had multiple studies from Phase 1-3, providing safety monitoring, clinical development strategy experience, writing INDs, thus working behind the scenes for major pharmaceutical companies such as GSK and BMS.
Hershock returned to clinical development on the sponsor side by joining Cephalon as a senior medical director in clinical development , where she worked in both liquid and solid tumor oncology overseeing studies from Phase I-3. However, she was mostly responsible for overseeing translational work, devising Phase I strategies for about 9 drugs in the pipelines. Cephalon was purchased by Teva Branded Pharmaceuticals and after that merger, there was significant interest in in-licensing multiple compounds, of which she was an integral part of the strategy team, working with business development and commercial, reviewing biotech companies pipeline assets as potential partners. However, Teva Branded Pharmaceuticals ultimately made a business decision to divest all their oncology assets, and she was now part of positioning Tevas assets in oncology for out-licensing. Many of the assets she had worked on are now currently being developed by other companies. Finally, Hershock was a senior medical director at GSK, working on early phase assets in the epigenetic space.
After ten years in industry, Hershock reached a career crossroads, considering a return to academic clinical research as well as patient care. Based on my prior experience at the University of Pennsylvania and my extensive clinical development experience on the pharmaceutical side, returning to academics seemed to be a natural fit. Luckily, Penn State Cancer Institute (PSCI) had a position for someone with significant clinical research experience to help drive their efforts as an aspirational NCI designated center. Thus, it was a perfect position to combine my love of caring for oncology patients, as well as to improve the clinical trial portfolio at PSCI and to treat patients on early phase studies that I may be intimately involved in in terms of identification of a molecule, hopefully developed at Penn State, as well as designing IND enabling studies and ultimately the first in human studies. She has been at PSCI for almost a year. It is such a pleasure working in a small town environment, despite a catchment area spanning 27 counties in central Pennsylvania. Although I have lived in Philadelphia my entire adult life and still do, I grew up in a small town only 30 miles from Hershey. So this does feel like home at times.
Hershock sees her experience in industry as a complementary to her work at Penn State Cancer Institute. I have become accustomed to overseeing clinical development plans for many assets in development and so I can use those tools to strategize and oversee clinical research programs on the academic side. We have very talented basic scientists and researchers in three large research programs including Experimental Therapeutics, Population Health and Cancer Control, and Mechanisms of Carcinogenesis both at PSCI as well as Penn States main campus. There is a wealth of science going on between the two campuses; so, it is analogous to a diamond in the rough in central Pennsylvania! There is so much potential for first-in-man studies from our own internal resources and I hope to have a significant role in strategically placing many of these compounds into our patient population.
Hershock is very familiar with a guiding principle of the Big Ten CRC: research requires cooperation among many institutions. It is incredibly important to collaborate, because it is the only way things move forward, she said. All of us learn from working within our institutions as well as with other centers. It is great to share ideas and to get constructive feedback from colleagues. If there is a novel concept that an investigator has, it is so beneficial to vet those ideas with other colleagues and especially with fellow colleagues in other institutions. Different perspectives and objective opinions based on experiences/knowledge are always helpful both in terms of designing trials as well as selecting the right patients from the institutions most familiar with a particular cancer. It is always a positive experience to speak with experts from other institutions, generate ideas, work with members of their labs as well as their oncologists, to drive studies forward. It is a win-win when people work as a team.
Hershock views equality as a key part of teamwork. We learn in pharma that everybody on the team is equal, she said. Nothing gets approved without a huge village of people behind it, so even if there is one person representing the company at the FDA, it would not be possible to bring a drug to market without the successful team which is ultimately responsible.
Hershock is involved in multiple working groups of the Big Ten CRC: Gastrointestinal, Immunotherapy, and Melanoma. I am very impressed at the interest level of the teams, the contributions they make when a concept is sent out for review, and how positive collaborative effort is from investigators as well as the clinical operations members who appear to have significant experience in running trials from start up to initiation, Hershock said. From my experience with the working groups so far, it has been a great start.
About the Big Ten Cancer Research Consortium: The Big Ten Cancer Research Consortium was created in 2013 to transform the conduct of cancer research through collaborative, hypothesis-driven, highly translational oncology trials that leverage the scientific and clinical expertise of Big Ten universities. The goal of the Big Ten Cancer Research Consortium is to create a unique team-research culture to drive science rapidly from ideas to new approaches to cancer treatment. Within this innovative environment, todays research leaders collaborate with and mentor the research leaders of tomorrow with the unified goal of improving the lives of all patients with cancer.
About the Big Ten Conference: The Big Ten Conference is an association of world-class universities whose member institutions share a common mission of research, graduate, professional and undergraduate teaching and public service. Founded in 1896, the Big Ten has sustained a comprehensive set of shared practices and policies that enforce the priority of academics in the lives of students competing in intercollegiate athletics and emphasize the values of integrity, fairness and competitiveness. The broad-based programs of the 14 Big Ten institutions will provide over $200 million in direct financial support to almost 9,500 students for more than 11,000 participation opportunities on 350 teams in 42 different sports. The Big Ten sponsors 28 official conference sports, 14 for men and 14 for women, including the addition of mens ice hockey and mens and womens lacrosse since 2013. For more information, visit www.bigten.org.
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