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Andrea Miyahira: Hi, I am Andrea Miyahira at the Prostate Cancer Foundation. Thank you for joining me today. With me is Dr. Ulka Vaishampayan, a professor and medical oncologist at the University of Michigan. She'll be joining us today to talk about her many roles as the leading woman in science. Dr. Vaishampayan, thank you so much for joining me today.

Ulka Vaishampayan: Thank you for this invite, Andrea.

Andrea Miyahira: First, tell us about all of your roles that you hold at the University of Michigan.

Ulka Vaishampayan: I think since I joined the University of Michigan, I was first started off as a chair of the phase I team, so I was a GU medical oncologist, but also leading the phase I team here. In addition, then I took on the role of co-leadership of the Translational Clinical Research Program within the Rogel Cancer Center, which is the University of Michigan's Cancer Center. And I'm also the chief of Ambulatory Clinical Services within the cancer center for hematology-oncology. So with all these local leadership roles, it has been an interesting development over the last three or four years where I'm getting attuned to a new place, COVID came along right as I joined, and it's been some challenges, but a lot of exciting translational work going on here between the basic science researchers and taking that forward to the patients where it really matters. Doing that translational clinical research work has been the exciting part.

Andrea Miyahira: Well, this sounds so exciting. I would love to hear about your career path and how you got into all of these roles.

Ulka Vaishampayan: In my fellowship, probably all my research was directed towards lymphoma, because in internal medicine residency, I was really attracted to the research path because we had a lecture by Dr. Alkhatib, who was a lymphoma researcher at the time, and he sort of explained the logical progression from the preclinical all the way into clinical trials. Each of those steps and how he had done that for an agent at the time. That truly attracted me and then I asked to work with him. So I did some research with him in the lab during my internal medicine residency, then into fellowship, also, I continued to work with him. So I was very much geared into going into lymphoma research and clinical work until my second year of fellowship when I got involved in a bladder cancer trial and I was asked to write a review paper by my attending at the time on prostate cancer.

So I was doing this GU work and I looked up prostate cancer and I could not find anything past just hormone therapy at the time. There were some chemotherapy trials, but I kept thinking, "I'm missing something." And at the time, we didn't have internet capability so easily, so we were basically looking through library books and I was thinking, "I'm missing some journal, some article." And I went back to Maha Hussain, who was my mentor, so I was really lucky to have a phenomenal role model, and I asked her, "Am I really missing things that I cannot put in this paper?" And she said, "No, unfortunately, that is the reality of today's world."

So then I suddenly got very interested in both bladder, kidney, and prostate cancer because I just realized that there's nothing here, and really, there's so much untapped potential, luckily. So when I started in GU oncology, actually, everyone made fun of me somewhat saying, "You're not going to have a whole lot to do because medical oncology really doesn't have a role here." Luckily, that has changed tremendously and we've come full circle with so many exciting products and therapies now available for our patients. So I'm glad that I could be a part of that and contribute in some small way.
So clinical trials and developing those sort of developed as a passion. And I stayed on as faculty first at Wayne State, and then I'm at Michigan now. But that has continued to be my driving, really, my research and my work because it keeps me excited about getting up every day, going to work. And it's so gratifying to see those responses. I wait to see my patients afterward. Even if it is a toxicity, at least you realize what you're dealing with with a specific agent. And then, of course, bringing these very exciting lab research products into the clinical field, which, to me, at least, that's where the true impact comes in, where you're taking it to the patients who needed it yesterday. So that, I think, has been sort of my career story. And it hasn't stopped because every day there's still so much to do and there's so much work to be done.

Andrea Miyahira: Well, on behalf of patients and their families, thank you so much for everything that you've done. Were there any challenges that you faced as a woman either during your training or in your career that you'd like to share about?

Ulka Vaishampayan: Yeah. I think, as a woman, two main challenges come to mind. One is that just because I did not self-promote myself enough, I was frequently passed over for opportunities. And some of them I realized it was blatant. There may be tons of others, which I didn't even realize that I was being passed over behind the scenes because I did not put myself out there. I did not continuously go to my superiors and say, "This is the paper that I published. This is what I did."

So I think it is a learning moment that talking about yourself is not bragging. And I think, in general, women have a much tougher time with that than men do. I think we do need to change that. Because, truly, it may not be necessarily malicious by some of the leadership, but if they truly don't know or haven't taken the pains to find out about what you're doing, they are not going to think of you for different leadership opportunities or even promotion or specific roles within to lead clinical trials, for instance. And I would appeal to a lot of the pharma companies and things where there isn't any specific audition for leading a clinical trial or for doing the work on a specific project, that they do need to consider this. Because if these decisions are just made over dinner and things like that without just my personal connection, then a lot of the merit and the talented folks are being missed out. And I think women especially miss out in that regard in all of those positions.

The reality is, I think there are some unique qualities that most women possess or develop because they're in a crunch, and a lot of them have to do with organization efficiency. Somehow, I think as a woman, I can relate better to my patients and their caregivers, but also establishing that personal connection and the personal touch is, I think, a little bit closer with my patients than with men. But again, there are clearly personality differences, but I hate to generalize like that.

But in general, I think it is true that women don't self-promote enough and don't take the praise very well. So if you praise a man, he will be surrounded by his team and all of them are just heaping accolades on him. And a woman, if you just compliment her on something, she'll say, "Oh, it wasn't too much. Somehow I got it. I did this." So there is such a stark difference, and somehow we need to make that happen with bringing things to people's attention.

The other thing I notice is that within family and friends, the expectations of a woman are much higher than of a man. So in terms of any little crisis in my kids' life, any little thing happening within the family, I'm the one looked at to make the arrangements. Even if I don't specifically go cook, it is up to me to figure out how the meals are happening for everybody. Or whatever else, the transportation, it may be. Whatever. But the expectation is that people look to me to arrange that. Again, I think that is changing with the times, but at least in the times that I was building my career, that definitely strikes me, looking back, as something that was a given and automatic that people look to me to organize and arrange that.

Andrea Miyahira: Okay, that is all such great advice. Thank you. Are there any initiatives or programs that you've been involved with that support women in science?

Ulka Vaishampayan: Yes. When PCF started their women's program networking and developing the women in leadership, that was very attractive to me and it really has served as a blueprint to go out and do that similar type of thing in other cancers. So we established the Women in RCC for Kidney Cancer Initiative, and we are now working with Kidney Cancer Association who has now partnered with us to develop that further. And we've been able to do some leadership programs starting, as well as give young faculty a platform to be able to present. Because when we surveyed a lot of these women faculty, that was the main thing that came out. That they don't have a platform. When they go for promotion or when they go for advancement, they have not been invited for regional, local presentations, national presentations. So that is what we first started as a program, to give them the platform to be able to present their research, get their work transmitted elsewhere, network, things like that.

And then now we are hoping to be working. We did the GU ASCO networking luncheon, and that was extremely well received and very well attended. The room was full. There was tremendous demand for mentorship and we had some really good mentors in the field who were talking to these women.

I think, going forward, I would like to have a more formalized program where we do sessions maybe potentially for leadership and maybe learn a little bit from the corporate world because they also have similar types of challenges for women that we do. And maybe they have figured it out a little bit better and medicine has been sequestered, so not discussing these issues as much. But I think we can definitely learn from each other and uplift each other.

Andrea Miyahira: That's so wonderful to hear that you're doing all of that. Thank you so much.

Ulka Vaishampayan: Yeah.

Andrea Miyahira: Are there any research achievements or projects that you very excited about and want to share?

Ulka Vaishampayan: I have a couple of things. One is that in my position as a lead of the Advanced Kidney Cancer Committee and SWOG, I have managed to start a clinical trial that we are leading nationally called the PROBE trial, which is a study that is randomized phase III trial of immune-based regimen in metastatic disease, followed by randomization to nephrectomy or not to look at the role, whether cytoreductive nephrectomy still holds a role and makes a difference in survival outcomes in metastatic kidney cancer.

Besides that, we are now working on a Live-biotherapeutic, adding that to immune checkpoint therapy to see if that enhances outcomes in advanced kidney cancer. And maybe that could potentially be a blueprint for starting a number of other studies in cold tumors like prostate, for instance, is my hope. That maybe if we overcome the microbiome resistance to immune checkpoint therapy, that may help us get some traction in advanced prostate cancer with immune therapy.

Besides that, a number of early-phase trials, immune checkpoint TGF beta-1 inhibition that I will be presenting at ASCO, a combination of pembrolizumab and TGF beta inhibitor study that we did showing promise in kidney cancer and a number of other phase I compounds that are coming along. More are homegrown things that will be coming from the University of Michigan lab.

Andrea Miyahira: Well, that's all so exciting. Thank you so much, Dr. Vaishampayan, for sharing your story and your advice with me today. It was such an honor to have you.

Ulka Vaishampayan: Thank you for this opportunity.