The Right Place at the Right Time

dr-birrerThe new head of the UAB Cancer Center prepares for an exciting future.

By Joe O’Donnell

As he has throughout his career, Michael J. Birrer, MD, PhD feels that he is in just the right place at just the right time as he begins his tenure at the UAB Comprehensive Cancer Center.

“It is a spectacular cancer center and was long before I got here. It was one of the original eight cancer centers in 1972. There aren’t many cancer centers that can say that,” Dr. Birrer says.

Of particular interest is the outstanding program in health disparities and dealing with underserved populations. “That is really special because there are not that many cancer centers that can do that,” he says.

“Big powerful cancer centers are continually criticized for not engaging the community and more importantly dealing with minority and underserved populations. The typical patient that walks through the door of Mass General is very different than here. UAB reaches out into areas of Alabama and Mississippi and other areas of the South and sees patients that otherwise may have no cancer care let alone be offered a clinical trial.

“That is part of the reason I came here. I would not have come to a place unless it was outstanding, but I think we have the potential of taking it to the next level. That next level is a pretty massive expansion of the clinical research component. We put 500 patients a year on clinical trials. I would like to see that become 1,000 or 1,500. In addition a good portion of that would be what I call early drug development phase one, phase two trials. We put about 100 on right now, we’d like to get that to 300, maybe 400.

“This is important because oncology has changed. It all moves much faster now. These drugs are coming through with a lot of laboratory based science so the chance that they will be effective and not particularly toxic is high. So our patients are asking for them and they deserve them,” Dr. Birrer says.

Dr. Birrer earned his undergraduate degree at Rensselaer Polytechnic Institute and graduated with a BS in Biology.  He subsequently was accepted into the Medical Scientist Training Program at the Albert Einstein College of Medicine and completed his MD and PhD in 1982 with his principle area of study in Microbiology and Immunology.  He performed a medical internship at the Massachusetts General Hospital (MGH) and subsequently completed a residency in medicine at MGH. Dr. Birrer entered the medical oncology fellowship at the National Cancer Institute in Bethesda, Maryland and upon completion performed a postdoctoral fellowship in the laboratory of Dr. John Minna on the molecular genetics of lung cancer.  After completing his fellowship, Dr. Birrer joined the faculty at the NCI in the Division of Cancer Treatment as an investigator in 1988.  Three years later, Dr. Birrer was appointed as a senior investigator (with tenure) and established the molecular mechanism section in the Division of Cancer Prevention and Control.  Over the next 17 years, Dr. Birrer held a number of positions including the Committee for the Protection of Human Subjects, Gynecologic Oncology Tumor Board, Extramural IRB, Clinical Oncology Fellowship Selection Committee, Chair of the Gynecologic Oncology Working Group in the Division of Clinical Sciences and Deputy Branch Chief of the Cell and Cancer Biology Branch.
Dr. Birrer is recognized nationally and internationally as an expert in gynecologic oncology.  He has published over 270 peer reviewed manuscripts and another 27 book chapters and review articles. He has served in leadership positions within the greater gynecologic oncology community. He has been the Chair and Chair Emeritus of the DOD Ovarian Cancer Research Program, Chair of the Committee for Experimental Medicine of the Gynecologic Oncology Group, a member of the Gynecologic Cancer Steering Committee and Chair of the Translational Science Working Group of the Gynecologic Cancer Intergroup. Dr. Birrer has been a member of the Society of Gynecologic Oncology, American Society of Clinical Oncologists, American Association of Cancer Research and the International Gynecologic Cancer Society.
In November 2008, Birrer was appointed Professor of Medicine at the Harvard School of Medicine. He assumed the position of Director of Gynecologic Medical Oncology at MGH and the Gynecologic Oncology Research Program. This program integrates important new discoveries in translational research into clinical trials.
In August 2017, Birrer accepted the position of Director of the Comprehensive Cancer Center at the University of Alabama at Birmingham.  He is a Professor of Medicine in the Division of Hematology-Oncology and holds the Evalina B. Spencer Chair in Oncology.
For Birrer, the ability to grow clinical trials and continue to serve underserved populations are a particular focus for the new director of the cancer center as the institution reaches out across the larger region.

“You can ask a patient to drive six hours in a car and come to UAB. That model works at many major cancer centers. I used to treat patients from Florida up at Mass General. But there are obviously limitations to that, where people might not have the resources to get on a plane. So can we find institutions who have the proper infrastructure that could become affiliated with UAB in the four corners of Alabama and potentially beyond that. And then develop clinical trials with UAB trained cancer care experts so that perhaps patients will come to the mother ship for a second opinion. But then we will say, ‘For your particular situation this trial is perfect, and by the way it is five minutes down the road from you.’ It is a model that I really get excited about,” Dr Birrer says.

“I have always been very focused on the clinical care aspects of oncology. I am an MD PhD and I have run a lab all my life, but that never overshadowed what I consider to be a service. We provide a service, and if we do it right we provide a great service to patients suffering from this disease.

“Our goals are not just prolonging life but improving the quality of that life. That is a passion of mine.

“Add into that underserved populations. There is nothing more tragic than a patient who could benefit but never gets offered a clinical trial. That should never happen in this country, but it does. So I consider that to be one of the major goals of what we do here at UAB,” Dr. Birrer says.

“Other aspects of what we are going to focus on are six research projects that are lab based where we can transfer ideas into the clinic. We want to strategically hire so that the bench is deeper. The science is outstanding here but we want to make sure we are on the firmest ground with more researchers focused on those questions. We may start a couple of programs.

We have an obesity epidemic, which has a relationship to the instance of certain cancers such as endometrial and breast cancer. The relationship between the caloric intake and the risk of developing cancer is a really hot area so I think creating a program like that makes a lot of sense for UAB.

“It is a major issue and we have the ability to do cutting edge research to get to the bottom of how that kind of lifestyle and metabolism can increase risk of certain cancers. Because of our cancer network and Deep South network we could devise intervention trials with nutrition and exercise and see how that affects the incidence of certain cancers. That is very exciting to me,” Birrer says.

One of the big needs, Birrer says, is to brand UAB Cancer Center in a more visible way. “If you ask patients where is the UAB Cancer Center they kind of just look at you. This building is research. It is not where the cancer care takes place. We have cancer care in at least four different buildings. So two goals: Short term to begin renovating the outpatient clinics to provide us with state-of-the-art equipment that will serve patients; the long term goal is a free standing building of about five to seven floors which will contain all of the outpatient clinics, research facilities, interventional radiology, everything. So that patients can see it and say, ‘There is my cancer center,’” Birrer says.

Birrer decided on a career in oncology in the second year of medical residency. “I wanted to be in an area where there was going to be a lot of research done and oncology fit the bill.

“Today it is moving 10 to 50 times faster.  Where it used to take us 10 years to develop a drug, we now are doing it in three. It has been a very, very exciting journey,” Birrer says.

“You can be absolutely honest with patients by saying, ‘You know, I don’t know how long you are going to live with this disease, but I can see that things are changing every week. My goal is to give you new therapies and to treat you so that this changes to a potentially chronic disease. Then we can wait for the next round of discoveries.’ It is a very hopeful message and yet very realistic.

“People are very generous particularly here in Birmingham. When you match the funding with scientists doing important work, it is incredibly rewarding. You take good scientists and match them with donors, who feel a sense of closure with the suffering they’ve seen because they have dedicated money to solving the problem. It is a great story.”

Birrer’s transition to Birmingham has been a smooth one. “My wife and I are country people. I grew up in Jersey, but it was western Jersey and really quite rural. My wife grew up in the Catskills. We were in Maryland for 21 years and we owned a farm out in Frederick County. We still own it. So coming down South to a more rural setting fit. Add to that we had nine feet of snow in six weeks three years ago in Boston, so we get nauseated when we see the white stuff.

One daughter is in Nashville, where she teaches school. Another daughter is in Miami in medical school. Birrer’s son, an attorney, still lives in Maryland.

Now in the latter part of his career, Birrer will get “to impact a large number of cancer patients and do it at a great institution like UAB in an area where we are going to really enjoy living. It is a very exciting time.”

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