Talia Aron at home with her husband, Chad, and daughters Lily and Abigail. (Photo by Eamon Queeney.)
New Hope
Published
Talia Aron at home with her husband, Chad, and daughters Lily and Abigail. (Photo by Eamon Queeney.)
TALIA ARON, MD, WASN’T ALARMED AT FIRST WHEN SHE STARTED TO FEEL SOME NASTY LOWER BACK PAIN. Last September, the medical director at a telehealth company had been traveling to professional conferences for days, sitting on airplanes and in hard-backed chairs.
But instead of getting better when she returned home to Greensboro, North Carolina, the pain got worse. “Looking back at a picture of me [at a conference] in Nashville, I was kind of a grey color,” Aron said.
By the time she saw her OB-GYN, the pain was so bad that her physician sent her straight to the emergency department in Greensboro.
Doctors at first thought that Aron had a kidney stone or infection. Then she was diagnosed with kidney cancer.
When she sought a second opinion at Duke, she received what would turn out to be the correct diagnosis: a urothelial cancer that had already clawed its way into her kidney. Urothelial cancers include all cancers that grow out of cells that line the bladder and the ureters (tubes that drain urine from the kidneys to the bladder).
Historically, people with advanced urothelial cancer live, on average, for 16 months, with only 10% surviving five years or more on standard-of-care therapy.
But doctors at Duke had a new treatment in mind for Aron that offered her much better odds. The only problem was, the combination therapy, developed by a medical oncologist at Duke Cancer Institute, was only approved for a select population of patients at that time. She would need help from friends and physicians at Duke and beyond to get the best treatment for her.
Getting the Right Diagnosis
Talia Aron at home in Greensboro, North Carolina. (Photo by Eamon Queeney)
After Aron returned home, imaging showed a mass on her kidney, and it was growing rapidly. A urologist in Greensboro scheduled her for surgery to remove the kidney.
But just a few days before the scheduled surgery, James Wantuck, MD, one of her senior colleagues, encouraged her to seek a second opinion through 2nd MD, one of the health benefits offered by their employer, Accolade. That virtual consult — with David Braun, MD, PhD, a genitourinary medical oncologist at Yale School of Medicine — led her to Duke.
“Dr. Braun told me, ‘You are an hour away from Duke. You need to see the best,’” she said.
Braun reached out to Daniel George, MD, a genitourinary medical oncologist at Duke Cancer Institute and co-leader of the DCI Center for Prostate and Urologic Cancers. Braun asked that George be on the lookout for Aron. Meanwhile, Aron arranged a meeting with Deborah Kaye, MD, a Duke urologic oncology surgeon, to get a biopsy of her tumor.
Even before seeing the biopsy results, Kaye suspected that Aron’s tumor might not be kidney cancer.
Kaye asked Aron the location of her pain. “When I pointed to my side, Dr. Kaye said that I should not be having pain there if this were kidney cancer. Then Kaye looked very carefully at my previous images and said that she thought I might have urothelial cancer. And she was the first one to have said that,” said Aron.
While Aron was waiting in the clinic for her biopsy results, she started feeling worse. “I was getting rigors — shakes. I couldn’t get warm. I had a very high fever, which I now know is not uncommon with very aggressive cancers, but I didn’t know it then.”
The biopsy confirmed an upper-tract urothelial cancer that appeared like a kidney cancer because it had already spread there.
“Nailing down the specific type of tumor that someone has is critical, because the drugs we use to treat urothelial cancers are completely different from kidney cancer drugs,” said George. “And it’s something we do well at Duke, where we have experts from medical and surgical specialties who work closely with cancer-specific pathologists and radiologists.”
“I’m a little tearful when I talk about it. If it wasn’t for Duke and Dr. George being willing to take me on, I don’t know if I’d be here for my two daughters, who are 9 and 15.” — Talia Aron, MD
The Tough Road to a New Therapy
The therapy that Aron would ultimately receive is a combination of pembrolizumab, an immunotherapy agent, and enfortumab vedotin, an antibody drug conjugate. Duke medical oncologist Christopher Hoimes, DO, had been studying this combination since 2017.
Hoimes’ reasons for believing that these two agents would work well together were complex, but he boiled down his thinking to this: targeting the cancer’s surface adhesion receptors, which is what enfortumab binds to, could potentially enhance the immune response.
But the odds were against Hoimes in a field where hundreds of cancer therapies and combinations had been tested and failed. Another matter threatening to hinder progress: the drugs he wanted to study were owned by two different companies.
“Companies are typically reluctant to combine their investigational products with an agent owned by another company because the new combination can limit their indications and increase side effects,” said George, who was not involved in the trials. “They must be convinced that a collaboration is worth the risk, extra time, and resources.”
Hoimes was motivated to push for a study of the combination because he was frustrated at watching patients suffer. For years he had seen patients get months of grueling chemotherapy and life-altering surgery that rewarded them with only a small increase in survival. And too many of his patients weren’t even eligible to get the chemotherapy due to other health issues, he said.
After Hoimes and the team of investigators convinced the two companies to work together on a phase 1 study, he led a trial of patients who could not receive standard chemotherapy. Positive data from that trial spawned a phase 2 study, which Hoimes also led.
It was 2019 when George heard Hoimes present data about the new combination at the European Society for Medical Oncologists and decided to recruit him to Duke. “Medical oncologists who specialize in urothelial cancer are rare. We’re lucky to have Chris here, where he is teaching a new generation of young oncologists to manage urothelial cancer patients and conduct clinical research in this space,” said George.
Race with the Clock
Talia Aron and her husband, Chad, play at home with one of their daughters. (Photo by Eamon Queeney)
When Aron landed on Duke’s doorstep, Hoimes’ phase 2 data had already won a hard-earned FDA approval for the promising combinatation treatment. When her insurance company denied the coverage, George called Aron’s insurance arbitrator, who was himself an oncologist, to discuss the unpublished phase 3 data and try to secure Aron a chance to take the new combination before the FDA approval. “At the end of the conversation, he was just as impressed by the data as I was. He actually thanked me for sharing the data and approved coverage for her treatment,” George said.
Aron’s first scan after starting the new treatment showed that tumors in her kidney had shrunk, while tumors in her lung and lymph nodes had disappeared. And her pain diminished to the point where she no longer needed narcotics to manage it. “Not even a Tylenol,” she said. “I’m a little tearful when I talk about it. If it wasn’t for Duke and Dr. George being willing to take me on, I don’t know if I’d be here for my two daughters, who are 9 and 15.”
The outlook for people with advanced urothelial cancer may improve even more in the future, after completion of a phase 3 study of the combination therapy used at an earlier stage: before and after people undergo surgery to try to stop the cancer from spreading. Hoimes is the global lead principal investigator and on the scientific committee for the international study, called Keynote-B15, which fully enrolled patients in the fall of 2023.
“This trial raises the stakes even more. This is the curative-intent setting, where a greater proportion of patients with urothelial cancer who are candidates for surgery may be cured of their disease,” he said. “I’m certainly hopeful for similarly stunning results as what we just had for patients who are metastatic, but we need to wait for the data to guide us.”
Duke Cancer Institute kicked off its first signature fundraising event with a powerful show of support for cancer research, innovation, and patient care. Duke Rides, held on October 3 in Wilson Gym, united more than 1,100 donors, sponsors, volunteers, and supporters in a shared mission to improve the lives of people affected by cancer.Duke-blue strobe lights and high-energy music like Taylor Swift’s “Shake It Off” and Britney Spears “Hit Me Baby One More Time” kept everyone energized while they took turns cycling on stationary bikes. During rider changes, cancer survivors told their stories, with members of their care teams at their sides.“Raising more than $675k in our first year is nothing short of extraordinary,” said Diane Reidy-Lagunes, MD, physician vice president of cancer services, Duke University Health System.“What makes this event so special is the way it brings together the entire Duke community—our patients and families, physicians, nurses, researchers, staff, students, alumni, and friends. We are united by a shared commitment to beating cancer and being part of something bigger than any one of us,” said Reidy-Lagunes."We have wanted a signature event for many years," said Debbie Taylor, assistant vice president, Duke Cancer Institute and Duke Children’s Development. "But we don't have a big events team, which makes getting something like this off the ground incredibly difficult. We are so grateful for the colleagues and donors who stepped up and helped us turn an idea into a reality."Among the event’s top fundraisers was a team led by Tony and Teddie Brown, which raised an impressive $233, 859.For Tony Brown, supporting Duke Rides is deeply personal. A Professor of the Practice Emeritus in Duke’s Sanford School of Public Policy, where he taught for 28 years, Brown has experienced firsthand the impact of exceptional care. His treatment under Hope Uronis, MD, a gastrointestinal medical oncologist, and his broader care team inspired him to help ensure that other patients receive the same support.“The care I’ve received from Dr. Uronis and my entire team has been remarkable,” Brown said. “The combination of competence, compassion, and collaboration has meant more to me than words can express,” said Brown.Lenny Santoro, another survivor, echoed that sentiment. "I'm here today because of the excellent care that I received more than eight years ago for my prostate cancer. And because of three clinical trials that Dr. Dan George and Duke gave me the opportunity to join," he said.Other top fundraising teams included the Duke Alumni for Cancer Survival and those supporting the following disease groups: pancreatic cancer, breast cancer, gastrointestinal cancer, genitourinary cancers (prostate and urologic), and pediatric cancers.The funds raised will provide much needed support for research aimed at improving treatment options and outcomes for cancer patients."Next time," said Taylor, "our goal is to raise over a million."
More than 300 patients, caregivers and family members gathered for the 2026 Genitourinary Cancers Community Education Event, an opportunity to learn directly from experts belonging to the Duke Cancer Institute’s Center for Prostate and Urologic Cancers. Presentations focused on longer, healthier lives for people living with GU cancers.The event brought together more than 23 specialists representing medical oncology, urology, radiation oncology, radiology, clinical psychology and cancer support. Speakers included Andrew Armstrong MD, Mike Abern MD, Hannah Fisher PhD, Jeff Gahan MD, Daniel George MD, Paul Koffer MD, Tim Dougherty MD, Diana Kozman MD, and Danielle Kruse MD, who shared their expertise on topics ranging from new treatments and clinical research to imaging, surgery and Duke’s multidisciplinary approach to cancer care.The keynote address was delivered by Robert M. Califf, MD, whose career has included leadership in clinical research at Duke and service as commissioner of the U.S. Food and Drug Administration. Califf spoke about “Clinical Research Improves Patient Care,” highlighting the connection between rigorous research, advances in treatment and the care patients receive. His career at Duke included leadership of the Duke Clinical Research Institute, and his work has spanned clinical research, patient care and health policy.The program also recognized that living well with cancer involves more than medical treatment. Hannah Fisher, MD led an interactive session exploring mind/body approaches to coping with cancer. Keegan Zavodnik discussed nutrition and diets for people living with cancer, while Alexis Monks addressed the role of fitness and physical activity. These sessions complemented the medical presentations with practical approaches to supporting patients throughout their cancer journeys.One session, called The Great Wait, focused on building a personal philosophy for living life to the fullest in the post-treatment phase of cancer, when a person is in remission. “Some of you in the audience today probably have only a 5% chance of your cancer recurring, but you’re still living every day in fear. Instead, go out and enjoy life. Let us tell you if it is ever time to worry again,” said Dan George, MD, who gave the talk along with Sarah Wood, MSN ANP-CH.The event's emphasis on hearing from a variety of cancer experts, with opportunities to interact with those experts, was reflected strongly in post-event survey responses from attendees.One participant wrote, “It’s a gift to the community. Love hearing about the latest developments in research particularly.” Another shared, “This event has been life changing for me. A cancer diagnosis for my husband was devastating. This event help to enlighten, encourage and ground me. I will be forever grateful for that.” Another said: “I appreciated the warm, respectfulness, and candidness of the healthcare professionals.”For others, the opportunity to connect with fellow patients was just as meaningful: “What I liked best is the connection with patients and learning their stories.” Another said “I appreciated the community-building nature of this event. It’s very gratifying to see the GU Cancer Center making this effort to engage us beyond the clinic visits.”Held for the second time at North Carolina Central’s student center, the event was made possible through the efforts of 13 volunteers from the GU Patient Advisory Council, who staffed registration tables, welcomed attendees at the entrance and helped direct patients and families from parking areas to the event hall. More than 65 people gave scholarships or made donations so that anyone could attend for free.Other expert presenters: Sarah Wood MSN ANP-CH, Sundhar Ramalingam MD, Jordan Infield MD, Michael Superdock MD, Dominic LaBella MD, Christopher Hoimes DO, Mike Harrison MD, Joe Park MD, and Dillon Cockrell MD, Jeff Shevach MD, Matt Labriola MD, and Jennifer Freedman, PhD.
Duke Cancer Institute kicked off its first signature fundraising event with a powerful show of support for cancer research, innovation, and patient care. Duke Rides, held on October 3 in Wilson Gym, united more than 1,100 donors, sponsors, volunteers, and supporters in a shared mission to improve the lives of people affected by cancer.Duke-blue strobe lights and high-energy music like Taylor Swift’s “Shake It Off” and Britney Spears “Hit Me Baby One More Time” kept everyone energized while they took turns cycling on stationary bikes. During rider changes, cancer survivors told their stories, with members of their care teams at their sides.“Raising more than $675k in our first year is nothing short of extraordinary,” said Diane Reidy-Lagunes, MD, physician vice president of cancer services, Duke University Health System.“What makes this event so special is the way it brings together the entire Duke community—our patients and families, physicians, nurses, researchers, staff, students, alumni, and friends. We are united by a shared commitment to beating cancer and being part of something bigger than any one of us,” said Reidy-Lagunes."We have wanted a signature event for many years," said Debbie Taylor, assistant vice president, Duke Cancer Institute and Duke Children’s Development. "But we don't have a big events team, which makes getting something like this off the ground incredibly difficult. We are so grateful for the colleagues and donors who stepped up and helped us turn an idea into a reality."Among the event’s top fundraisers was a team led by Tony and Teddie Brown, which raised an impressive $233, 859.For Tony Brown, supporting Duke Rides is deeply personal. A Professor of the Practice Emeritus in Duke’s Sanford School of Public Policy, where he taught for 28 years, Brown has experienced firsthand the impact of exceptional care. His treatment under Hope Uronis, MD, a gastrointestinal medical oncologist, and his broader care team inspired him to help ensure that other patients receive the same support.“The care I’ve received from Dr. Uronis and my entire team has been remarkable,” Brown said. “The combination of competence, compassion, and collaboration has meant more to me than words can express,” said Brown.Lenny Santoro, another survivor, echoed that sentiment. "I'm here today because of the excellent care that I received more than eight years ago for my prostate cancer. And because of three clinical trials that Dr. Dan George and Duke gave me the opportunity to join," he said.Other top fundraising teams included the Duke Alumni for Cancer Survival and those supporting the following disease groups: pancreatic cancer, breast cancer, gastrointestinal cancer, genitourinary cancers (prostate and urologic), and pediatric cancers.The funds raised will provide much needed support for research aimed at improving treatment options and outcomes for cancer patients."Next time," said Taylor, "our goal is to raise over a million."
More than 300 patients, caregivers and family members gathered for the 2026 Genitourinary Cancers Community Education Event, an opportunity to learn directly from experts belonging to the Duke Cancer Institute’s Center for Prostate and Urologic Cancers. Presentations focused on longer, healthier lives for people living with GU cancers.The event brought together more than 23 specialists representing medical oncology, urology, radiation oncology, radiology, clinical psychology and cancer support. Speakers included Andrew Armstrong MD, Mike Abern MD, Hannah Fisher PhD, Jeff Gahan MD, Daniel George MD, Paul Koffer MD, Tim Dougherty MD, Diana Kozman MD, and Danielle Kruse MD, who shared their expertise on topics ranging from new treatments and clinical research to imaging, surgery and Duke’s multidisciplinary approach to cancer care.The keynote address was delivered by Robert M. Califf, MD, whose career has included leadership in clinical research at Duke and service as commissioner of the U.S. Food and Drug Administration. Califf spoke about “Clinical Research Improves Patient Care,” highlighting the connection between rigorous research, advances in treatment and the care patients receive. His career at Duke included leadership of the Duke Clinical Research Institute, and his work has spanned clinical research, patient care and health policy.The program also recognized that living well with cancer involves more than medical treatment. Hannah Fisher, MD led an interactive session exploring mind/body approaches to coping with cancer. Keegan Zavodnik discussed nutrition and diets for people living with cancer, while Alexis Monks addressed the role of fitness and physical activity. These sessions complemented the medical presentations with practical approaches to supporting patients throughout their cancer journeys.One session, called The Great Wait, focused on building a personal philosophy for living life to the fullest in the post-treatment phase of cancer, when a person is in remission. “Some of you in the audience today probably have only a 5% chance of your cancer recurring, but you’re still living every day in fear. Instead, go out and enjoy life. Let us tell you if it is ever time to worry again,” said Dan George, MD, who gave the talk along with Sarah Wood, MSN ANP-CH.The event's emphasis on hearing from a variety of cancer experts, with opportunities to interact with those experts, was reflected strongly in post-event survey responses from attendees.One participant wrote, “It’s a gift to the community. Love hearing about the latest developments in research particularly.” Another shared, “This event has been life changing for me. A cancer diagnosis for my husband was devastating. This event help to enlighten, encourage and ground me. I will be forever grateful for that.” Another said: “I appreciated the warm, respectfulness, and candidness of the healthcare professionals.”For others, the opportunity to connect with fellow patients was just as meaningful: “What I liked best is the connection with patients and learning their stories.” Another said “I appreciated the community-building nature of this event. It’s very gratifying to see the GU Cancer Center making this effort to engage us beyond the clinic visits.”Held for the second time at North Carolina Central’s student center, the event was made possible through the efforts of 13 volunteers from the GU Patient Advisory Council, who staffed registration tables, welcomed attendees at the entrance and helped direct patients and families from parking areas to the event hall. More than 65 people gave scholarships or made donations so that anyone could attend for free.Other expert presenters: Sarah Wood MSN ANP-CH, Sundhar Ramalingam MD, Jordan Infield MD, Michael Superdock MD, Dominic LaBella MD, Christopher Hoimes DO, Mike Harrison MD, Joe Park MD, and Dillon Cockrell MD, Jeff Shevach MD, Matt Labriola MD, and Jennifer Freedman, PhD.
