Strong Start: Nussbaum Named to Select NCI Surgeon-Scientist Program Cohort

Published

February 28, 2023

Daniel Nussbaum, MD, assistant professor, Department of Surgery, Division of Surgical Oncology, is one of 12 young surgeons nationwide to be selected by the National Institutes of Health/National Cancer Institute for the 2023 Early-Stage Surgeon Scientist Program (ESSP).

This pilot program brings together surgeon scientists from across the U.S.; building cohorts that will be trained together for up to three years per cohort.

ESSP participants are funded through either an administrative supplement to the grantee’s NCI-designated Cancer Center Support Grant (P30) (of which Duke Cancer Institute is a recipient) or Comprehensive Partnerships to Advance Cancer Health Equity (CPACHE; U54) to one of the institutions serving underserved health disparity populations and underrepresented students.

Nussbaum is also one of four faculty members at Duke to have been selected to receive a 2023 Physician-Scientist “Strong Start” award.

According to the Duke University School of Medicine, the awards program, funded with a gift from the Nanaline H. Duke Fund, supports promising early-career physician-scientists at Duke as they develop independent research programs. Each recipient will receive $75,000 annually for three years to support their research programs.

The Strong Start program is administered by the School of Medicine’s Office for Physician-Scientist Development (OPSD) and integrates with other physician-scientist development programs including the Medical Scientist Training Program (MD-PhD students) and the Lefkowitz Society (clinical residents and fellows). 

Nussbaum, who's a member of the Lefkowitz Society, has been an assistant professor of Surgery and a Duke Cancer Institute member since 2021. Previous to Duke, he completed his Surgical Oncology Fellowship at Memorial Sloan-Kettering Cancer Center (2019 - 2021) and a General Surgery Residency at Duke (2011-2019). He earned his MD from the University of Southern California in 2011.

The "Strong Start" award will support his research project: "Deciphering Mechanisms of Hepatic Immunity Governing Pancreatic Cancer Liver Metastasis." Nussbaum will be working under the joint mentorship of Peter Allen, MD, and H. Kim Lyerly, MD, and with collaborators/co-mentors Erika Crosby, PhD, Zachary Hartman, PhD, Joshua Snyder, PhD, and Christopher Counter, PhD.

A Silent Killer

Even in its earliest stages, pancreatic cancer remains "an essentially incurable disease," explains Nussbaum. Among patients who undergo potentially “curative” surgery, greater than 95% will nonetheless die within 10 years of diagnosis. The vast majority (~80%) of these patients develop liver metastases — often within one year of surgery — and these metastases dictate survival outcomes.

“While we can treat a single tumor with surgery and chemotherapy, which currently represents our standard-of-care approach, it is overwhelmingly difficult to truly cure patients with these conventional therapies alone," says Nussbaum. "The challenge lies in eradicating pancreatic cancer cells that have already spread to the liver by the time the primary tumor in the pancreas is discovered. Because these metastatic cells can't be picked up with radiographic imaging — what we call "occult" cancer cells even patients who present at an early stage face a very high risk of postoperative recurrence. Due to the microscopic nature of occult metastases, our fundamental understanding of the mechanisms behind this disease state has lagged. In order to offer truly curative treatment for patients with “localized” pancreatic cancer, it's critical that we find ways to target those pancreatic cancer cells that have evaded detection."

"The Strong Start Award will provide a crucial springboard for my career and support a novel line of investigation with the potential to foundationally shape our understanding of occult metastatic disease," says Nussbaum, who will focus on related research with the NCI Early-Stage Surgeon Scientist Program (ESSP) cohort.

Nussbaum is also receiving research support for his project — "Comprehensive Profiling of Hepatic Immune Populations to Target Occult Liver Metastasis in Pancreatic Cancer." This grant is supported by the Hopper-Belmont Foundation (2023 - 2024).

"My long-term goal as a pancreatic cancer surgeon-scientist is to develop therapeutic strategies, which build on this research, in order to improve cure rates for my patients," says Nussbaum.