At University of Iowa Holden Cancer Center, a change at the top at Iowa’s only National Cancer Institute

IOWA CITY — Nearly 50 years ago — when he was 17 and living in Cincinnati — George Weiner’s mother died of multiple myeloma, a type of cancer that forms in plasma cells.

Her illness progressed quickly, and she lost her battle just nine months after diagnosis.

“She just had a horrible course,” Weiner, now 65, told The Gazette about that time in his life as a teenager about to graduate high school and begin his undergraduate pursuits at Johns Hopkins University in Baltimore.

“I think that influenced my decision, because I saw how caring her doctors were and how little they had to offer,” Weiner said about how losing his mother swayed his decision to pursue medicine — and, specifically, cancer research and therapy. “I always wanted to go into a field that I thought would change significantly during my time in it.”

And it has — thanks, in some fashion, to Weiner himself, who’s led the 41-year-old University of Iowa Holden Comprehensive Cancer Center for over half its existence and recently announced plans to step down after 24 years.

When Weiner first started as the UIHC center’s interim director in 1998, it wasn’t “comprehensive” and it didn’t have a relationship with the Holden family. In fact, the then-18-year-old operation had failed twice to establish National Cancer Institute designation.

“At that time, the cancer center was really a shell,” Weiner said. “I think we had three employees. … It wasn't really functioning the way most cancer centers did.”

The UI center had been through several directors and launched a national search for its next, bringing in for the interim Weiner — who first arrived at UI in 1989 as a newly-minted assistant professor, having just wrapped his fellowship in hematology, oncology, and immunology at the University of Michigan. At UI, Weiner initially spent 40 percent of his time in clinic and 60 percent on research, looking into the novel prospect of treating cancer with the immune system.

“That was at a time when many people didn't think that would ever work,” he said. “But we persisted, along with others across the country, and nowadays the immune system is among the most exciting areas in cancer medicine and cancer research.”

Despite the university’s nationwide search for a new center director, administrators found their best prospect already on campus in Weiner.

And shortly after his appointment, Weiner helped foster a relationship with the Holden family of Williamsburg — leading to a $25 million naming gift in 2000, the same year Weiner led the center to its first National Cancer Institute designation.

That inaugural designation delivered not only the evasive primary recognition but also the top-tier comprehensive label — awarded to centers demonstrating expertise in laboratory, clinical, and population-based research, while also conducting outreach and education activities.

“We were actually the last cancer center who’s gotten the basic designation and the comprehensive designation at the same time,” Weiner told The Gazette.

Transformation

When asked what he did in those early years to launch the UI center into what it’s become — a world-renowned research, clinical, education and outreach operation of 300-some employees, excluding doctors and nurses with collegiate appointments — Weiner said he thought collaboratively.

“The main thing was to bring people together,” he said. “One of the keys of a successful cancer center is you bring people together from different backgrounds, with different experiences, but with a common goal focused on cancer. And that extends across the spectrum of research, clinical care, education, and community outreach.”

Since that first National Cancer Institute recognition in 2000, UIHC has been redesignated — without interruption — in 2005, 2011, 2016, and recently in 2021, maintaining its status as Iowa’s only comprehensive cancer center.

That doesn’t just bring prestige, lure top-tier faculty, produce innovative science and attract patients from across the state and nation. It generates millions in research funding. Comprehensive centers can apply for up to $1.5 million a year from the Department of Health and Human Services.

And, in the past five years, Holden has landed more than $70 million in total National Cancer Institute funding — bolstering private gifts and other grants aimed at UIHC cancer research and care.

“He transformed the efficiency and collaboration of cancer research here by obtaining and maintaining funding from the National Cancer Institute,” UIHC hematologist and oncologist Brian Link told The Gazette, crediting the national recognition to Weiner’s “leadership and grant-writing skills.”

The UIHC cancer center’s most recent review yielded an overall score of “outstanding” and an “exceptional” rating for Weiner’s direction and the center’s interdisciplinary coordination. Weiner’s leadership prowess was inherent and organic, according to Link.

“I will remember his joy in watching younger investigators succeed in their personal goals, and his dogged determination to advocate for all cancer researchers and clinicians,” he said, "that we might have the best resources available to enable success in improving cancer care for patients.”

Achievement

Over the years, Weiner has helped realize and actualize his teenage vision for change.

“I love the intersection between discovery and bringing those discoveries and advances to help patients,” he said. “I like the idea of continually striving to do better.”

Acknowledging “we had so much to learn” and “our tools were pretty primitive” when he first joined the global pursuit for cancer-care innovation and discovery in the 1970s, Weiner said, “There was a glimmer of the fact that if we could really understand cancer better, we'd be able to use that information to help.”

In attacking its mission to “decrease the pain and suffering caused by cancer in Iowa, surrounding communities, and the world,” the Holden cancer center has focused its resources into four areas: patient care, research, education and community outreach.

Within clinical care, the center is organized into 11 multidisciplinary teams based on cancer type, Weiner said.

“One of the things that sets us apart is most of our cancer doctors specialize in one type of cancer, which allows them to keep up on the research and provide superb interdisciplinary care,” he said. “Often, the medical oncologist and the surgical oncologist and the radiation oncologists and pathologists and the genetic counselors and pharmacists are all working together around specific cancer types.”

The center supports 14 different tumor boards — groups of medical experts who consult on specific patients to determine best treatment paths and options.

“Then we have additional interdisciplinary teams that work together to provide certain types of care — an example would be the cellular therapy and bone marrow transplant team,” Weiner said. “We're becoming a national and world leader in our ability to test new cellular therapies.”

He cited “CAR T-cell” therapy, an approach where you take the cells out of the patient, “reprogram them genetically to attack the cancer, and then put them back in.”

Another team focuses on adolescents with cancer, and yet another on psychological needs of patients.

In addition to taking a collaborative approach within UIHC, Weiner has expanded his cooperative vision beyond his campus — designing and developing interdisciplinary programs with other institutions, like the Iowa Cancer Consortium, the Big Ten Cancer Research Consortium and the Iowa/Mayo Lymphoma SPORE, which conducts research on lymphoma, chronic lymphocytic leukemia and small lymphocytic lymphoma.

Future

The 300-plus-strong UIHC center hasn’t stalled at that size, according to Weiner.

“It’s continuing to grow,” he said. “And I think one of the areas that's growing the fastest is our clinical trials office, where we offer novel therapeutics to patients. There was no clinical trials office when I started, and now we have over 70 employees.”

Weiner will stay in his director role until the university hires a successor. And even then, he’s not planning to retire. Rather, Weiner will remain on faculty as the Dr. C.E. Block Chair of cancer Research, allowing him to refocus on his research and special projects.

His area of expertise — and the research group with which he’s been most involved over the years — is immunotherapy.

“I still have a very active research lab, and as a matter of fact one of the things I'm excited about is getting back into the lab and strengthening that effort,” Weiner said.

Announcing plans to step down now made sense, given the university just obtained its renewed National Cancer Institute designation and Weiner wants a new director to have time to prepare and submit the competitive 2025 application.

“Putting the grant together that gets and maintains our designation as an NCI comprehensive cancer center is a huge multiyear effort,” he said.

In announcing Weiner’s resignation, UIHC noted the state of cancer research and care is at an “inflection point:”

“This transition provides us as an institution with the opportunity to forge a promising new future that aims to solve the most complex medical questions and deliver the most individualized care for our patients.”

Link said he’s glad Weiner will remain a part of that future.

“It is reassuring to know that his personal scientific contributions will continue and likely increase as he has more time available to focus on his own work,” he said.

Former UI President David Skorton — who led the campus from 2003 to 2006, was an internal medicine professor for decades prior, and currently serves as president and chief executive officer of the Association of American Medical Colleges — told The Gazette he recalls “fondly how much I enjoyed working with and learning from (Weiner).”

“He has laid a strong foundation for continued excellence under the next director, and I am confident in its lasting success.”

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