RESEARCH / EDUCATION / COMMUNITY OUTREACH / CLINICAL CARE
THE ACADEMIC DIFFERENCE
Where discovery drives care
DIRECTOR’S MESSAGE
Dear UVM Cancer Center community,
Expertise, Quality, Impact, Cutting-Edge Care. These are the hallmarks of an academic cancer center—and they define our work at the University of Vermont Cancer Center (UVMCC). We strive to understand the basic etiologies of the cancers affecting our communities in Vermont and northern New York, and we leverage this information to optimize cancer prevention, screening, and treatment. Informed by disease-specific expertise that is unrivaled across our region, our scientists and clinicians are making new discoveries that reshape fundamental paradigms, clinical practice and cancer policy.
In this issue of Innovations, you will read about ground-breaking deintensification clinical trials led by Cancer Center members. These studies aim to reduce toxicity of treatment while maintaining efficacy; simplify cancer care and delivery, particularly for our rural residents; and prevent long-term complications of cancer treatment. Novel approaches such as deintensification clinical trials are not available outside of an academic center.
This issue also showcases other practices that set our cancer center apart. You’ll read how our research directly addresses the cancers that are most prevalent in our region; how we invest in the career development of the next generation of cancer scientists; and how we connect with communities in Vermont and northern New York to promote cancer prevention and screening. You’ll also meet a caregiver whose personal experience inspired a project that supports glioblastoma research and care.
The UVM Cancer Center stands at the intersection of the University of Vermont, the Larner College of Medicine, and UVM Health. As a unified hub for cancer research, education, community outreach, and clinical care, we harness the strengths of each institution. It’s through these synergies that UVM Cancer Center delivers the academic difference, bringing innovation, expertise, and impact to the communities we serve.
Randall F. Holcombe, M.D., M.B.A. J. Walter Juckett Chair in Cancer Research Director, University of Vermont Cancer Center
Associate Dean for Cancer Programs, Larner College of Medicine
Vermont has the third-highest incidence rate of melanoma in the U.S. UVMCC’s philanthropy-supported Outreach and Education Van, in partnership with UVM Health Dermatology, makes skin cancer screening and sun safety accessible for people across our catchment area. Here’s where we’ve been in 2025.
2025 SUN SAFETY EVENTS
Sun Safety events + skin checks
Sun Safety events
1 Firefighters Community partner: South Burlington Fire Department South Burlington, VT
2 Community Health Fair Community partner: Janet S. Munt Family Room Burlington, VT
3 St. Regis Mohawk Tribe Annual Health Fair Community partner: St. Regis Mohawk Tribe Health Services Akwesasne, NY
4 Holland Food Shelf Community partner: Nulhegan Band of the Coosuk Abenaki Nation Derby Line, VT
5 Safety by the Lakeside Community partner: KidSafe Collaborative Burlington, VT
6 Champlain Valley Fair Senior Day Community partner: Age Well Vermont Essex, VT
“THE AVAILABILITY OF DOCTORS IS SO SCARCE THAT HAVING SOMEONE CHECK ALLEVIATES SOME OF THE STRESS AND ANXIETY BY HAVING AN ANSWER.” — KARON THIBAULT, TOWN LIBRARIAN, HOLLAND, VT
53 Referrals Made SUN SAFETY SINCE 2023
7,976 People Engaged
EVIDENCE-BASED, PEOPLE-FOCUSED RESEARCH
At UVMCC, research is deeply connected to the lives of Vermonters and northern New Yorkers. Here are four innovative research projects, each designed to make a meaningful impact across our catchment area.
Sniffing Out Cancer— With Probiotics
Lung cancer is Vermont’s most common cancer—but screening rates are only average, leaving many high-risk residents undiagnosed. Biomedical engineer Michael Brasino, Ph.D., is working to change that by addressing one factor that might hold people back: convenience.
Brasino is working on a home-based alternative to the traditional low-dose CT scan, which is only available at select locations. His solution: a two-part test using genetically modified probiotic bacteria—safe strains already found in food. Inhaled through a nebulizer, the bacteria enter the lungs and detect early cancer biomarkers. If they sense trouble, they release a synthetic protein that travels through the bloodstream and exits in urine. “That signal can be picked up with a simple at-home test—just like a pregnancy test,” Brasino explains.
Brasino will collect feedback from patients and providers to ensure that this at-home approach to lung cancer screening is easy to use and follow up on.
His team has already proven the concept in mice with proxy tumors. Early results suggest this method could be even more sensitive than current scans. Next up: testing it in more realistic, genetically-engineered models. Once the test has entered the trial phase, Brasino will collect feedback from patients and providers to ensure that this at-home approach to lung cancer screening is easy to use and follow up on.
“If it’s not convenient, people might not do it,” Brasino says. “But if it is, we can catch cancer earlier—and save lives.”
HART Over Harm: A New Kind of Palliative Radiation
Nearly half of cancer patients receiving radiation at UVMCC aren’t being treated to cure their disease. They’re receiving palliative radiation, aimed at easing symptoms like pain, bleeding, and discomfort. But across much of the U.S., this treatment relies on a decades-old technique known as APPA, which emits radiation across larger fields. It works— but often at the cost of damaging nearby healthy organs.
Natanial Lester-Coll, M.D., and his colleagues at UVMCC hope to shift that paradigm with a hybrid approach that sidesteps toxicity in palliative radiation. Called the Hybrid Palliative Radiation Therapy or HART technique, and developed at UVMCC, it works by emitting small doses of radiation in an arc. The beam still targets the tumor, but its movement spreads out the dose, reducing collateral damage to surrounding tissue.
After noticing fewer side effects in patients treated with the HART method, Lester-Coll launched a single-arm trial to formally compare patient-reported side effects against historical data. “Palliative radiation is an understudied space,” he says. “We need innovation here to move the needle.” By lowering the frequency of side effects, the new
The beam still targets the tumor, but its movement spreads out the dose, reducing collateral damage to surrounding tissue.
technique could significantly improve patients’ quality of life and lessen their treatment burden. This is important for UVMCC’s rural patients, many of whom have limited access to follow-up care. “We’re trying to make treatment safer and less burdensome,” Lester-Coll says. “Because even when curing the cancer isn’t the goal, comfort and dignity still are.”
The UV Puzzle: Vermont’s Skin Cancer Mystery
Vermont consistently ranks among states with the highest rates of melanoma in the country. The usual suspects—fair-skinned populations, outdoor-driven lifestyles, and higher elevations—might help explain it. But as with most scientific puzzles, the full story is likely more complex.
Molecular biologist Steven Roberts, Ph.D., is on a mission to uncover what’s really driving Vermont’s high skin cancer rates—particularly melanoma, the deadliest form. “Sun exposure is a known cause of skin cancer, mainly because ultraviolet (UV) light can damage DNA and trigger mutations,” he explains. “Around 70% of melanomas carry a specific mutation that drives tumor
The idea is to see if any common mutational patterns emerge, which may indicate a uniqueness to local UV light.
growth and has unique features, suggesting it’s caused by a rare type of DNA damage from UV light. If we can measure how often mutations caused by this rare damage appear across the population, we might learn whether UV exposure in Vermont, or something about people who live here, makes them more prone to developing this skin cancer-linked mutation.”
To bring this fundamental research to life, Roberts is teaming up with dermatologist and fellow Cancer Center member Melanie Bui, M.D., Ph.D. Together, they’re launching a study that will analyze the DNA of UVexposed skin from Vermont patients. They will examine the mutational signatures in those samples and compare them to yeast cells exposed to Vermont’s natural sunlight. The goal is to see if any common mutational patterns emerge, which may indicate a uniqueness to local UV light.
Next, they’ll compare those samples with others taken at partner research programs in Florida and Washington State—two regions with very different climates and UV profiles. If the mutational fingerprints differ, it could point to environmental or geographic factors that influence how skin cancer develops, and may even inform guidance around sun safety in Vermont. Says Roberts, “The question I always ask myself—and one I encourage my students to ask—is: What are we going to learn, and how is it going to help people?”
Beyond Screens: Rethinking Connection in Telehealth
Telehealth has emerged as a promising alternative for rural Vermonters, offering a way to connect with providers without the burden of long drives, parking hassles, or waiting rooms. But what’s gained in convenience may come at the cost of intimacy. Does virtual care affect how patients feel about their relationships with their providers?
That’s the question Elise Tarbi, Ph.D., APRN, set out to answer. From June 2024 to March 2025, Tarbi spoke with cancer patients living in rural areas about their telehealth experiences. She wanted to know: Did virtual visits change how they connected with their providers? Did it impact their overall experience of care, and if so, how?
What she found surprised her. While the time-saving aspect of telehealth was a perk, it wasn’t the only benefit. Patients described how eliminating travel and stints in waiting rooms gave them time to breathe, reflect, and ask questions. “It gave them the space to slow down,” Tarbi
Patients described how eliminating travel and stints in waiting rooms gave them time to breathe, reflect, and ask questions.
says. “The accessibility and convenience of telehealth may help people feel more connected to their providers, especially those living with cancer who maybe can’t get out of bed that day.”
But the real key to connection wasn’t the technology— it was the provider themselves. “People said they felt connected when their provider really saw them as a person,” Tarbi explains. “I went into the study looking for specific communication tactics like eye contact, body language, and camera setup. These practices are important, but what mattered more was when providers took time to get to know patients beyond their diagnosis.”
“IT’S ABOUT TAILORING CARE TO THE PATIENT AND AVOIDING UNNECESSARY TREATMENTS.”
LESS CAN BE MORE: DEINTENSIFYING CANCER CARE IN VERMONT
Most cancer clinical trials aim to improve outcomes by adding new therapies to the standard of care. Deintensification clinical trials flip that model, asking whether less treatment could be just as effective as the standard of care, while offering better quality of life with fewer side effects.
Researchers at UVMCC are exploring ways to safely reduce the dose, shorten the duration, or even eliminate phases of treatment for select patients. Especially for those in Vermont’s rural areas, fewer trips for care and less toxicity result in meaningful quality of life improvements. “It’s about tailoring care to the patient and avoiding unnecessary treatments,” says Tracy Smith, M.Sc., Ph.D., UVMCC’s protocol writer for investigator-initiated cancer clinical trials. “Less time in treatment, lower costs, and fewer side effects—that’s a win for everyone.” Here are two trials that demonstrate those benefits.
MOHSAHRTSS study (UVMCC-funded)
Catchment area relevance: Vermont has one of the highest incidence rates of melanoma in the United States.
UVMCC PI: Chris Anker, M.D.
What it is: Radiation therapy is a standard treatment for Cutaneous Squamous Cell Carcinoma (cSCC)—but is it always necessary? Radiation oncologist Chris Anker, M.D., is exploring that question in a clinical trial offering tailored alternatives. “Patients deserve more pragmatic options,” says Anker. “Based on research looking at past patients, we’ve identified a moderate-risk group of patients who are typically encouraged to pursue radiation therapy but who did well without it, so now we’re building on that data. These moderate-risk patients, most of whom are in their 70s and 80s, can opt for structured surveillance through the trial—routine physical exams and ultrasounds to monitor for recurrence—in place of radiation.”
Additionally, the MOHSAHRTSS study (MOHs Surgery and Adjuvant Hypofractionated short-course Radiation Therapy and Structured Surveillance for cutaneous head and neck cSCC) offers patients with high-risk cSCC a shortcourse radiation protocol: just five treatments, instead of the typical 20 to 30.
Early results are promising. One patient expressed relief at avoiding unnecessary hospital visits and radiation side-effects—both of which can be challenging for elderly patients. “Independence matters to our patients—especially in rural areas, where support might be limited,” Anker says. “Treatment should reflect the patient’s needs—not just the disease.”
14
99
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— TRACY SMITH, M.SC.,
PH.D.
DEINTENSIFICATION TRIALS OPEN AT UVMCC
DIFFERENT TYPES OF CANCER TARGETED PATIENTS ENROLLED
4 INVESTIGATOR-INITIATED TRIALS FROM UVM CANCER CENTER RESEARCHERS
DEBRA Trial (nationally-funded)
Catchment area relevance: Among Vermont women, breast cancer is the most commonly diagnosed cancer and the second leading cause of cancer death in the state, after lung cancer.
UVMCC PI: Puyao Li, M.D.
What it is: Breast cancer treatment has evolved dramatically over the past four decades—thanks in part to tools like the Oncotype score, a genetic test that predicts the likelihood of recurrence or spread. These scores are guiding the national NRG DEBRA clinical trial (DE-escalation of Breast Radiation in Adjuvant therapy), which explores whether women ages 50 to 69 with low Oncotype scores can safely skip radiation therapy after surgery.
Participants in this randomized controlled trial—about a dozen of whom are enrolled at UVMCC—have undergone lumpectomies and are receiving standard endocrine therapy. The study aims to determine whether radiation is always necessary for this subset of breast cancer patients— and if not, to make omission a standard option for women in this age group.
“There’s evidence that patients—especially those with breast cancer—feel more satisfied when they’re empowered to choose a treatment that aligns with their values,” says Puyao Li, M.D. “If my patient leaves feeling informed and confident in their decision, I know I’ve done my job.”
INSPIRE. TRAIN. MENTOR.
The need for cancer scientists and clinicians is ever-increasing. But what does it really take to build a career in cancer care and research? UVMCC’s Cancer Research Training and Education Coordination (CRTEC) team explores that question every day by training and mentoring trainees as they navigate the field and develop their skills. One’s path is rarely linear, and often deeply personal. Here, we share the stories of two individuals who’ve taken different journeys through the program—and where those journeys have led.
Greta Joos: Third-year medical student, UVM Larner College of Medicine, UVMCC trainee member
UVMCC Mentor: Jessica Heath, M.D.
Area of focus: Pediatric oncology, with a focus on patient access to non-FDA approved cancer therapies
Extracurricular: Promoting health literacy and health care accessibility for unhoused community members (Schweitzer Fellowship awardee)
7/2019 Shadowed and volunteered at UVMMC; met Dr. Heath
5/2021 Graduated with Distinction in Biology from Duke University
5/2021–8/2023 Clinical Research Coordinator in pediatric inherited bone marrow failure at Boston Children’s Hospital/Dana Farber Cancer Institute
8/2023 Joined Dr. Heath’s lab to conduct clinical research
3/2024 Awarded Larner’s Schweitzer Fellowship to organize foot care clinics in shelters for the unhoused
6/2024 Awarded UVMCC Juckett Summer Research Fellowship
8/2024 First author publication in Journal of Pediatric Hematology/Oncology, PMID: 38934594
9/2024 Presented at UVMCC Summer Research Poster Session
3/2025 Presented at UVMCC Scientific Retreat
4/2025 Panelist for UVMCC Careers in Cancer
5/2025 Awarded the Jerold and Ingela Lucey Early Career Investigator Prize for Innovations in Infant or Child Health (aka “the Lucey Prize”)
5/2025 Presented clinical research at ASPHO conference
Future Pursuing a career which merges her passions for clinical care, research, and advocacy
Petra Kapsalis: UVM Class of 2025, UVMCC trainee member
UVMCC Mentor: Jason Stumpff, Ph.D.
Area of focus: Development of cancer therapeutic resistance
Extracurricular: Led the UVM Women’s Club Lacrosse team to two national championships
1/2023 Joined the Stumpff Lab to conduct research
5/2023 Organized a Morgan’s Message Lacrosse game dedicated to athletes’ mental health
6/2023 Awarded UVMCC Summer Research Fellowship
10/2023 Presented at UVMCC Summer Research Poster Session
3/2024 Awarded Nicole J. Ferland Summer Grant to continue cancer-related research in the Stumpff Lab
4/2024 Elected Women in STEM Community Outreach Director
5/2024 WCLA DII National Champions for UVM Women’s Club Lacrosse
8/2024 Elected UVM Women’s Club Lacrosse President
11/2024 Organized Women in STEM Hope Lodge dinner
4/2025 Distinguished Undergraduate Research defense
5/2025 Second UVM Women’s Club Lacrosse National Championship
5/2025 Awarded Warren R. Steinberg Outstanding Senior in Microbiology Award
5/2025 Graduated Magna Cum Laude with a major in Microbiology and minor in Health Sciences
Current Working as a Clinical Care Associate at UVMMC
Future Plans to attend medical school
PETRA KAPSALIS
GRETA JOOS
University of Vermont Cancer Center
89 Beaumont Ave.
Burlington, VT 05405
www.vermontcancer.org
MARLENE’S CARDINALS: A LEGACY OF LOVE AND HOPE
Below: Norton Latourelle (center) and his one-of-a-kind cardinals support cancer patients and research.
After losing his wife Marlene to glioblastoma, Vermont folk artist Norton Latourelle found healing in the familiar rhythm of carving wooden cardinals—symbols of love, memory, and presence. What began as a personal tribute has become “Marlene’s Cardinals,” a project supporting glioblastoma cancer patients, caregivers, and research at the UVM Cancer Center. Each hand-carved cardinal is sold for $100, with every dollar donated going to help families facing the financial and emotional toll of cancer.
To donate and receive a cardinal, scan the QR code or visit go.uvm.edu/cardinal
