|Javid Moslehi, MD|
Sarnoff Fellow Years: 1998-99 Fellow
Instructor, Harvard Medical School
Co-Director, Cardio-Oncology Program, Brigham & Women’s Hospital & Dana-Farber Cancer Institute
What impact did the Sarnoff Fellowship year have on your career?
My Sarnoff year of research had a tremendous impact on my career. First, for the first time, I was exposed to research. I went to medical school at University of Connecticut, a school that gave me an excellent training in how to become a doctor, but did not give me an infrastructure for exposure to basic or clinical research. The Sarnoff Fellowship provided this. Second, the Sarnoff Fellowship provided me personal and professional mentorship from various physicians and scientists. Besides my Sarnoff preceptor (Dr. William Kaelin) and my Sarnoff sponsor (Dr. Arnold Katz), I continued to receive mentorship from members of the Scientific Committee including Drs. Mike Weisfeldt and Charles Lowenstein (who served as my scientific advisors and who interviewed me for the Fellowship). Third, the Sarnoff Fellowship provided for me a network of friendship and camaraderie from a number of other medical students from across the country. Many of the Sarnoff Fellows during "my era” would later become my co-residents, co-fellows and (now) co-junior faculty. The ability to have this group of friends and colleagues has been the single most important impact of the Sarnoff.
Why should medical students consider the Sarnoff Fellowship apart from other programs?
Many of the medical school research programs are "One and Done” programs. On the other hand, the Sarnoff Fellowship has provided me a longitudinal exposure to the Sarnoff Foundation, a network that includes my co-fellows, who have served as my life-long friends and colleagues, and senior physicians and scientists, who have given me advice throughout my career and even now as junior faculty.
How did your Sarnoff year of research affect where you are today?
During my Sarnoff Fellowship in 1999, I joined the laboratory of Dr. William Kaelin, at the time a young physician-scientist. Dr. Kaelin was an oncologist who was attempting to shed light into the molecular pathogenesis for kidney cancer by studying a rare, inherited syndrome called von Hippel-Lindau (VHL). VHL patients have an "inherited” mutation in the VHL gene and are at risk for kidney cancer, as well as other "vascular” tumors. Interestingly, many kidney cancers also harbor "sporadic” mutations in the VHL gene. At the time, very little was known about the VHL syndrome or kidney cancer. In fact, there were no effective chemotherapies for treating kidney cancer (there was one "FDA-approved” drug – Il-2 – which later proved to be no better than placebo). Like many other oncologists at the time, Dr. Kaelin had taken a very basic and reductionist approach to studying cancer by studying the biological role of the VHL gene (and VHL protein product – called pVHL), hoping that understanding what VHL normally did in the cell would shed light into the mechanisms for VHL syndrome and kidney cancer. In this way, my Sarnoff "project” in 1999 was very basic and involved protein-protein interactions between pVHL and other proteins in the cell. I completed my Sarnoff Fellowship in Dr. Kaelin’s laboratory becoming excited about research and continued to follow the scientific literature on the biology of VHL even as I finished my medical school studies and completed residency and fellowship.
I completed the clinical portion of my cardiology fellowship at Brigham and Women’s in 2007 and returned to Dr. Kaelin’s laboratory (at Dana-Farber) as a post-doctoral fellow. In the eight years since I was a Sarnoff Fellow in the laboratory, Dr. Kaelin’s laboratory (and other laboratories across the world) had elucidated the mechanism behind how mutations in the VHL gene led to cancer, via a model that also placed VHL machinery at the center of "oxygen sensing” in mammalian cells. As a cardiologist, I felt that this same machinery, that when mutated would lead to tumorigenesis, would normally have an important role in how the cardiovascular system and specifically the heart senses and adapts to hypoxia. As a post-doctoral fellow in Dr. Kaelin’s laboratory, and about a decade after my Sarnoff Fellowship, we have shown that this machinery plays an important role for several cardiovascular phenomena, including ischemic cardiomyopathy and ischemic preconditioning.
My Sarnoff Fellowship year has also played an important role in what I do clinically today. While in Dr. Kaelin’s laboratory as a post-doctoral fellow, I realized the explosion of new cancer therapies. (For kidney cancer, for example, there were eight FDA approved drugs in 2008; none were approved just four years earlier in 2004). Some of these novel cancer therapies would have an adverse effect to the heart, both during treatment, as well as during cancer survivorship. In fact, this new area of "cardio-oncology” is a new frontier in cardiology. With leadership provided by both the Dana-Farber Cancer Institute and Brigham and Women’s Hospital, I have been able to direct a "cardio-oncology” program and this has been a very satisfying part of my experience. Our program works to develop prevention and treatment strategies for the cardiovascular side-effects of novel chemotherapies, which include novel chemotherapies and radiation.
What is your most memorable Sarnoff moment?
My most memorable Sarnoff experiences occur every year at the Annual Meeting, which serves as a reunion for the former Fellows. The meeting brings together a diverse and talented group of colleagues. Some of my "co-fellows” have gone on to be cardiologists and academicians. Others work in industry, health policy, or even the FDA. I have been to every single meeting since the 1998 meeting (my Sarnoff fellowship year). Every year, I walk back from the meeting with a growing appreciation of the enormous talent that exists within the Sarnoff community. Every year, I feel privileged to be part of this organization.