Bridging the Gap for Translational Research Success

"Bench to bedside" refers to the translation of scientific discoveries - made at the research bench - into practical applications for improved patient care at the bedside. While this term highlights the enormous potential of research to advance medicine, it also emphasizes the inherent gap between research and clinical practice. How can we prepare the next generation of scientists - current research trainees - to close this gap and fulfill the promise of translational research?

JAX Clinical Educationand the Maine Cancer Genomics Initiative(MCGI) have developed an innovative course for early career researchers to bridge the gap between cancer research and patient care. Through observation of clinical consultations, trainees gain skills to effectively communicate research findings to clinicians, an enhanced understanding of the clinical context, and exposure to new career opportunities.

The course, first piloted in 2022, aims to increase awareness of the cancer patient's journey and illustrate the complexity of applying genomic information to clinical decisions. It provides trainees with an opportunity to witness the clinical translation of research in action.

JAX Cancer Center trainees, primarily graduate students and postdoctoral associates, observe clinical discussions about tests that identify genomic changes found in a patient's cancer and using the information to make treatment decisions.

"We were thrilled to have received institutional funds to expand the course this year to include participants from Cold Spring Harbor Laboratory, another NCI-designated Basic Cancer Center, in addition to graduate students at Tufts University School of Medicine, UConn Health, and The University of Maine - part of JAX's network of Cooperative Ph.D. Program partner institutions," shared Kate Reed, M.P.H., Sc.M., CGC, director of precision oncology education at JAX.

But let's take a step back. Why is this important, anyway?

Research can produce better health outcomes

Translating basic research from the lab into clinical care and improving patient outcomes is complex. Translational science involves multiple stages and types of research needed to bring treatments and interventions into clinical practice.

It integrates the entire research continuum, from basic discovery research to changes in public health.

A patient-forward framework helps ensure that key questions in the clinic today are being addressed in basic research laboratories, so scientific findings ultimately contribute to advances in patient care.

While translating research to practice can take decades, in some cases, applying research findings to patient care can happen in real time. It involves bringing together individuals with expertise in different areas who often speak different "languages." The key to success is communicating complex information in a way that is relevant and clear to all involved.

How do we help future scientists gain the knowledge and skills to understand real-life clinical challenges and communicate the clinically relevant aspects of their research to clinicians?

Enter: Genomic Tumor Boards for Early Career Researchers.

Finding a common language

The course uses genomic tumor boards (GTBs) as a centerpiece to introduce research trainees to the complexities of applying genomic information to patient care. Leveraging MCGI's successful genomic tumor board model, course participants are offered a unique opportunity to observe the direct application of scientific discoveries to clinical care.

These collaborative GTB sessions bring clinicians, laboratory experts, and researchers together to discuss the implications of genomic test results on cancer patients' treatment options, focusing on providing actionable feedback to clinicians. The GTB discussions provide a rich educational opportunity, modeling discussions about the opportunities and limitations of applying emerging and complex genomic data to an individual patient. In the Genomic Tumor Boards for Early Career Researchers course, participants attend GTBs and biweekly live virtual sessions. Kate Reed, M.P.H., Sc.M., CGC, and Leah Graham, Ph.D., from JAX Clinical Education and MCGI respectively, help trainees unpack the discussions and introduce them to the clinical realities of accessing and using genomic information.

One thing that has stuck with JAX Predoctoral Associate Ryan Englander - a 2023 course participant - is the degree to which the GTB discussions are nonlinear and have very few straightforward answers. "Even with a talented team of research specialists, experienced clinicians, and reams of test results, it is exceptionally rare to see patients with simple [clinical solutions]," Englander shares. "I had expected to see more of an algorithmic approach applied - the patient has this mutation, so they are eligible for this treatment, or has this biomarker so they are eligible for that treatment - but so many of our discussions were far more detailed and nuanced than I expected."

Increasing the clinical impact of research findings to improve patient outcomes requires collaboration. Englander is deeply impressed with the theoretical and practical expertise that all team members bring to the GTBs. "Now that I understand this, I am much better able to tailor my presentations to clinicians at what their knowledge base is and what they are interested in, which generally comes down to, 'How will this help my patient?'"

For Mackenzie Callaway, Ph.D., a postdoctoral associate at Cold Spring Harbor Laboratory who participated in the 10-week course this spring, the experience served as a powerful reminder to continue to involve physicians, patient advocates, and other key stakeholders at the forefront of strategic research design. "Input from all of these groups is important to ensure we are asking the right questions and designing informative studies that can be translated appropriately and in a timely fashion," she shares.

Clinical perspectives enhance training experiences

Clinical education for research trainees facilitates their understanding of the connection of cancer research to patient care. It also increases their confidence in their ability to communicate with clinicians about research findings. At the end of the 2024 course, all participants felt they had enough training to communicate basic science for clinical application, whereas only 50% stated such prior to the course. The opportunity to observe clinically-focused discussions may address misconceptions about what happens in a clinical setting or help to re-set expectations for trainees who spend most of their time with other researchers.

John Bachman, Ph.D., a postdoctoral associate in the Rosenthal lab at JAX reflects, "In my own research with mouse models, the impact on humans seems very far away. However, this course taught me that all the genomic tumor information and clinical trial work is built on the back of basic research in order to improve human health somewhere down the line."

In addition to demystifying the translational research continuum, this program also provides trainees with new perspectives and understanding of a cancer patient's journey. Amber Habowski, Ph.D., a postdoctoral associate at Cold Spring Harbor Laboratory remarks, "It strongly highlighted the importance of clinicians seeking additional information to identify therapy options, advocating for their patients, and working with experts to interpret genomic results."

For Callaway, it was especially helpful to hear from physicians and individuals in other career fields during the course about the intersectionality of medical and research disciplines and alternative careers. "Investment from experts in training is incredibly important for aspiring scientists. This aspect of the course was exciting to experience."

Whether it's communication skills, new research ideas, or a refined focus for their research, the course has generated sustained enthusiasm among these researchers in training about career opportunities in translational research.

From bench to bedside and back again

Leah Graham, Ph.D., program director of MCGI reflects, "During my Ph.D. training, I always wanted to understand how the research I was conducting in the lab made a difference to people's health. This course is an example of how we can train early career scientists to think about the impact of their research and how they can adapt the explanation of their scientific discoveries to any audience, including a clinical one. I'd like to see this course offered to any Basic Cancer Center trainee, so we can share this opportunity broadly to scientists not able to have this experience at their home institution."

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