13. Pioneering Dramatic Advances in Patient Care

Alfredo Quinones-Hinojosa is a world- renowned brain surgeon whose research in finding better treatments for brain cancer has dramatically improved life for thousands of patients. Holder of more than a dozen patents, he has started several companies to translate his labwork back to the patient.

And there is even more hopeful news on the horizon.

Earlier this year, he and colleagues at Mayo Clinic published details of a biospecimen repository they have developed — the first of its kind in the world — that promises to unlock new insights into brain cancer and to speed treatment advances through new collaborations and clinical trials.

For Quinones-Hinojosa, the repository marks the culmination of a career-long quest (see box) that got its start at Johns Hopkins. As a young physician-researcher, he led the Brain Tumor Surgery Program at Johns Hopkins Bayview as well as the Brain Tumor Stem Cell Laboratory. It was during these years that he came into the orbit of David Hellmann and the Center for Innovative Medicine, when the clinician-scientist was invited to Hellmann’s office for early-morning leadership gatherings.

“I felt so blessed at the time to be part of something so spectacular,” says Quinones-Hinojosa. “We talked not just about leadership but about health care and politics, about the future not just of Johns Hopkins, but of medicine itself.”

Quinones-Hinojosa also shared with Hellmann his hopes and dreams for building a biospecimen laboratory that could revolutionize treatment for brain cancer and other neurological disorders. This was in the first decade of the new millennium, before today’s advances in high-speed data gathering and artificial intelligence.

“We were getting brain tissue samples from patients in the OR, but we weren’t able to collect and analyze other vital clinical data, such as imaging studies, family history, pathology reports, social history,” says Quinones-Hinojosa. “It was like trying to navigate the sea without a compass.”

Crucially, he says, Hellmann recognized the incredible promise of his ambitious quest — to create a biospecimen repository that would bridge the OR with the basic science laboratory — and provided CIM funding that proved pivotal to getting the biorepository off the ground.

Quinones-Hinojosa left Johns Hopkins in 2016 to join Mayo Clinic as the William J. and Charles H. Mayo Professor and Chair of Neurologic Surgery, and to direct the Neurosurgery Brain Tumor Stem Cell Laboratory, where his vision would ultimately come to fruition.

“The Mayo Clinic got a tree complete with leaves and branches,” says Quinones-Hinojosa, now the James C. and Sarah K. Kennedy Dean of Research at Mayo Clinic in Florida.

“But David Hellmann got a seed. He had to plant it and water it — and that ‘watering’ was the financial support for what today has become the most prominent biobank in the world for human tissue linked with data.

“None of this would have happened,” says the esteemed neurosurgeon, “without that seed being watered and planted back then.”

Always Breaking New Ground

Quinones-Hinojosa’s experience is hardly an isolated one. Time and again, over these past 20 years, Hellmann has identified physician-scientists with pioneering ideas, and CIM donors have generously come through with funding to jumpstart their pathbreaking research. The pay-off for patients at Johns Hopkins — and beyond — has been significant.

Consider those suffering from vasculitis, an autoimmune disease that causes inflammation of the blood vessels. Rheumatologist John Stone, who received early funding from CIM as a Cosner CIM Scholar in Translational Research, pioneered a game-changing new treatment, called rituximab, for a common form of the disease (ANCA-Associated Vasculitis HRAVe). Since the breakthrough was first published in The New England Journal of Medicine in 2010, rituximab has become the treatment of choice for vasculitis patients the world over, in what has been hailed as one of the most important advances in rheumatology in the 21st century. Stone, who co-founded the Vasculitis Center at Johns Hopkins, is now director of clinical rheumatology at Harvard’s Massachusetts General Hospital.

Rheumatologist Antony Rosen has served as vice dean for research at Johns Hopkins Medicine since 2013 and as director of the Division of Rheumatology from 2002 to 2022. Under his leadership, the division grew from 14 to 26 faculty and began its run of being ranked #1 in the country by U.S. News — now extended under Director Ami Shah — for 21 years in a row.

He’s seen firsthand the impact that CIM funding has had in advancing bench-to-bedside research in key areas.

“David Hellmann is an iconoclast at heart. He is always wanting to break new ground,” says Rosen. “To do that, he is focused on identifying the best young researchers with the best ideas — and keeping it tied to what really matters to real patients.”

Pulmonologist Michelle Sharp, a Mary Gallo CIM Scholar, can attest to that. Since joining the faculty at Johns Hopkins Medicine five years ago, she has led efforts to improve care for individuals living with sarcoidosis, a difficult-to-diagnose inflammatory disease in which the immune system overreacts.

While 90% of patients with sarcoidosis experience inflammation in their lungs, the condition can also impact the heart, eyes, nervous system, kidneys, bones, joints and skin. Every person with sarcoidosis is affected differently.

Sharp quickly moved to strengthen the multidisciplinary approach of the Johns Hopkins Sarcoidosis Program, which today cares for more than 2,000 patients a year. She’s also launched efforts to address disparities in care through new patient education efforts and established a Patient Advisory Board and Patient Support Group. “As we have been building our capacity, it has been so important to me that we hear from our patients so that we can learn firsthand their needs and the challenges they face,” she says.

The research side of Sharp’s work has gotten a significant boost from her CIM Scholar funding from Mary Gallo and also from the late Everardo and Elena Goyanes, she notes gratefully. She and her colleagues are building a biorepository holding patient data and biological samples. “Working together as a team,” she says, “we are well positioned to solve the mysteries that have remained in sarcoidosis for more than 100 years.”

For Johns Hopkins gastroenterologist Pankaj “Jay” Pasricha and psychiatrist Glenn Treisman, CIM funding enabled them to launch what was considered to be the first clinic in the world that brings together gastrointestinal and psychiatric experts to treat patients in both physical and psychological distress. Established in 2014 thanks to a generous gift from Courtney and Paul S. Amos, the Amos Food, Body and Mind Center has focused on studying the links between diet and disease, and also the role of good and bad bacteria in making us sick and keeping us healthy.

“People have talked about the gut-brain connection for a long time, but usually in the context of people who are depressed or anxious and, as a result, have physical symptoms. But that’s not the whole story,” says Treisman. “We are emphasizing that this is bidirectional. Signals emanating in the gut can influence how the mind feels.”

He estimates that close to 600 patients have come to the Amos Center for treatment — “complicated patients” who have been struggling for years to find relief. “We helped a lot of these people get better,” he says.

Well-Placed ‘Bets’

Bruce Bochner was already a professor of medicine and division chief, leading the Division of Allergy and Clinical Immunology at Johns Hopkins Bayview, when he received CIM funding as the CIM Cosner Scholar in Translational Research.

“The support that I received from CIM toward my salary was almost as good as having an endowed chair. It allowed me to do all the administrative things I needed to do as division chief and also see patients and do research in a way that was very impactful. That ability to wear all three hats at once was extremely important,” he recalls.

Wearing his physician-scientist hat, Bochner focused on advancing his research to find therapeutic targets for patients suffering from allergic and allergic-like conditions — ranging from gastritis to eczema to hives — caused by a problematic build-up of eosinophils (a type of white blood cell) and mast cells. Ultimately, he zeroed in on a surface protein called Siglec-8, developing an antibody that was licensed by Johns Hopkins to a start-up company, Allakos, with Bochner as co-founder.

Bochner left Johns Hopkins in 2013 to return to his hometown of Chicago, becoming the Samuel M. Feinberg Professor at Northwestern University School of Medicine’s Division of Allergy and Immunology. Once there, his work with Siglec-8 continued, hitting a high-water mark with a successful phase 2 clinical trial reported in The New England Journal of Medicine in 2020. More recently, Allakos, where Bochner continues to consult, has shifted its focus to a mast cell-specific target, Siglec-6.

“For me as a physician-scientist, the dream is to work on a project that somehow changes the way we diagnose and treat patients,” says Bochner, now professor emeritus at Northwestern. “It’s been a real thrill for me to have co-discovered and co-founded aspects of projects that have the potential to help many patients.”

Early support from CIM, he says, was crucial to his journey in academic medicine — and that of so many other physician-scientists at Johns Hopkins. “David Hellmann has an uncanny ability to place bets on people he thinks will not only succeed in various aspects of academic medicine, but also help them to go above and beyond what they are already accomplishing,” says Bochner. “CIM’s support enables them to thrive.”