When Benjamin G. Neel, MD, PhD, joined NYU Langone Health in 2015 to lead Perlmutter Cancer Center, he was tasked with propelling the center into the elite echelons of cancer research. It was a lofty mandate tailor-made for Dr. Neel, a renowned cancer biologist who had just spent the past eight years at the helm of the largest cancer research center in Canada, the Ontario Cancer Institute at Princess Margaret Cancer Centre. In his new role, he quickly set in motion a trifold strategy, bolstered by a $50 million gift from Laura and Isaac Perlmutter to reinvigorate basic research, expand the center’s clinical trials, and recruit a new wave of top-notch physician–scientists focused on cancer.
Just four years later, these investments are paying off. In February, Perlmutter Cancer Center earned comprehensive status from the National Cancer Institute (NCI), a prestigious designation shared by only 49 other cancer centers nationwide and accompanied by $20 million in funding over the next five years. We sat down with Dr. Neel to discuss this recent milestone, its implications for patients, and the most important actions you can take to mitigate your cancer risk.
The NCI describes its Cancer Centers Program as the anchor of the nation’s cancer research efforts. What does its “comprehensive” designation mean for patients?
Comprehensive cancer centers are unique in that they offer full-service teams that can bridge the gap between basic science and clinical care. Ultimately, that means scientific insights and discoveries reach patients faster. Not only do patients benefit from a full complement of clinical services in one place—medical oncology, surgical oncology, and radiation oncology—but they also have access to the latest experimental therapies. Unfortunately, for too many cancers, the best medicine is still a clinical trial.
How are Perlmutter and its patients benefiting from NYU Langone’s continued growth?
NYU Langone’s dramatic expansion in recent years into Brooklyn, Queens, and Long Island means that Perlmutter Cancer Center now reaches more people than ever before. We’ve seen patient volume increase 110 percent over the past 5 years. What’s more, our enlarged footprint enables us to provide the highest-quality care to many patients who live in traditionally underserved areas. Sadly, minority groups have much poorer outcomes for almost every disease, including cancer. Among our priorities at Perlmutter Cancer Center is addressing these unacceptable health disparities.
You’ve recruited 30 distinguished cancer researchers and clinicians, many in leadership positions, since you joined NYU Langone. What’s been the impact?
One benefit is that our growing roster of top physicians and scientists has markedly improved our collaboration with pharmaceutical companies, providing our patients with access to more cutting-edge clinical trials. When I arrived, it could take up to 250 days to launch a new clinical trial. Today, on average, it takes less than 95 days. Thanks to the leadership of Daniel C. Cho, MD, who directs our Phase 1 Drug Development Program, we’ve gone from having two phase 1 clinical trials in 2015 to over 100 this year. Overall, the size of our clinical trials office has tripled since 2014.
Another huge benefit is enhanced clinical services. For example, with the recruitment of renowned hematologist–oncologist Samer Al-Homsi, MD, MBA, director of the Blood and Marrow Transplant Program, we’ve now built an elite team capable of tackling the most complex cases of blood cancer. This year, we’re on track to perform more than 100 bone marrow transplants, most of them allogeneic, meaning that a patient receives stem cells from a donor instead of himself.
Did that shift help attract the $75 million donation from an anonymous donor to fund a new Center for Blood Cancers, announced in February?
I’m sure it helped. The Center for Blood Cancers will also have a new focus on advancing treatments for multiple myeloma, a blood cancer originating in the bone marrow that kills nearly 13,000 Americans each year. We’ve recruited two top experts in the field and plan to expand our multiple myeloma clinical trial efforts.
Perlmutter Cancer Center is now the third NCI-designated comprehensive cancer center in New York City. How does that concentration of expertise motivate you?
Scientific research has always been, in my opinion, the most collaborative enterprise in the United States. That said, NYU Langone also competes with other research institutions. It’s that tension between collaboration and competition that drives progress in research. The reality is that people in my lab work harder knowing that somebody else might be working on the same thing. I do, too. It’s a good thing, a healthy thing. Humans thrive on competition. But as scientists we also thrive on the exchange of information. So our researchers will always collaborate with their counterparts here in New York City and beyond.
Do you see personalized medicine as the future of cancer therapy?
No two cancers are the same. In some types of cancer, no two cancer cells are the same. But it’s also true that no two humans are the same, even identical twins, and yet they still share common traits. Similarly, there are generally describable principles about cancers that apply to genetics and even the host response, which means you don’t necessarily need individualized therapy for every patient.
The truth is that we’ve made great progress in our understanding of cancer genetics. We know most of the genes that contribute to various types of tumors at the research level. What we haven’t fully figured out is how to apply that knowledge clinically to optimally treat most cancers. That remains a very active area of our research.
You’ve said that if any of your family members or friends were diagnosed with cancer, you’d insist that they are treated at an academic medical center. Why?
I’d pretty much insist on that if they needed to be treated for anything more serious than a broken bone. In general, academic medical centers are better positioned to deliver state-of-the-art care. Part of that is because they encourage a culture of competitive exploration, so there’s never really time to rest on your laurels.
The day after we received an overall “outstanding” rating on the renewal of the NCI Cancer Center Support Grant, I was on to the next grant. There’s a coterie of people whose raison d’etre is to push the boundaries of knowledge, and I think everyone benefits from that mind-set.
What can people do to reduce their cancer risk?
Obesity has surpassed cigarette smoking as the leading cause of cancer in the United States. The number of people who smoke cigarettes, which used to be about 35 percent of the population, has been cut in half over the last 30 years to around 17 percent. That’s an amazing success story. It’s an incredible testament to public policy, and we need similar policies for obesity. As a community, I think we need to do a better job of communicating relative risk. We’re unwilling to say, “Smoking is the single worst thing you can do for your health. It’s like playing in traffic.” Or, “Tanning beds are like cigarette smoking through your skin.” That’s pretty easy to communicate, but we don’t lay it out that bluntly.
The truth is there are certain things that are just really, really bad for you because they substantially increase your cancer risk—smoking, obesity, excessive sun exposure, excessive drinking, a sedentary lifestyle. We know that up to 60 percent of all cancers are preventable. It’s mind-boggling.
Of course, I’m very sympathetic to the challenges of behavioral change. I was a fat kid. I was fat all the way to medical school. There’s no question that genes play a role in appetite control and obesity. But the rate of obesity is climbing too fast to attribute it to genetics alone. Environmental influences play a major role, and many of those variables can be controlled.
Do you have to work at keeping your weight down?
Constantly. I walk to work. I try to get to the gym four or five days a week. That’s my goal. And I’m hungry all the time. It’s hard.
What’s the most common question people ask you about cancer?
“When is there going to be a cure for cancer?” Of course, that question underscores a pervasive misperception about cancer, because cancer isn’t one disease but many diseases. It’s like asking, “When is there going to be a cure for infectious disease?” Everyone realizes that what we need to treat pneumonia is not what we need to treat a urinary tract infection.
Unfortunately, we’re never going to wake up to the headline “Cancer cured!” The boring answer is that over the next decade, we’ll continue to make steady, and occasionally, major, progress against many different forms of cancer. And that’s our focus.