New Chapter

Aaron Mansfield, M.D. (I ’09, CI ’11, HEMO ’13), is only five years out of training and already has made a big name for himself and played a key role in drawing national attention to Mayo Clinic. He’s accomplished this through clinical trials for lung cancer and mesothelioma that he’s initiated or brought to Mayo Clinic. His CV lists more than 30 clinical trials either underway or recently completed, and 81 peer-reviewed publications. He just received a competitive National Cancer Institute Cancer Clinical Investigator Team Leadership Award. The future looks bright for this native Californian.

You just received a 2018 NCI Cancer Clinical Investigator Team Leadership Award for outstanding midcareer clinical investigators at NCI-Designated Cancer centers. Tell us about that.

The award recognizes extensive involvement in NCI-funded collaborative clinical trials and efforts to promote clinical trials and research.

I’m humbled to receive the award. Dr. (Jamie) Bakkum-Gomez (OBG ’06, GYNO ’09) received this award two years ago, and Dr. (Julian) Molina (HEMO ’04) received it nine years ago. I look forward to promoting clinical trials and research through our Cancer Center with this award.

How did you become interested in medicine?

From the time I was in junior high through high school in Irvine, California, both of my parents (now deceased) had medical problems. My mom had breast cancer, and my dad had an aneurysm that required neurosurgery. My grandparents and I coordinated getting my brother to school and my mom to her appointments in Newport Beach, and getting to Los Angeles where my dad was in the hospital. I did all that while going to school. My aunt walked me to the UCLA bookstore to buy a textbook so I could educate myself for talking to my dad’s neurosurgeons.

Being at the hospital and interacting with the doctors and nurses got me interested in medicine. I went to college pretty certain I’d go to medical school.

How did you go from college and medical school in California to Mayo Clinic School of Medicine?

A palliative care physician in California told me that based on what he’d seen working with me, he thought I’d like Mayo Clinic. He hadn’t trained at Mayo but had worked with others who had.

How did you decide upon oncology?

I liked the thoughtfulness behind internal medicine, the challenges with diagnosis and how internists often lead the diagnostic charge. I liked forming relationships with patients and the continuity of care in internal medicine. I also really enjoyed research in tumor immunology and pharmacology.

When my mom died, I got a better appreciation for the family experience of going through diagnosis, which prepared me to help others.

Tell us about your areas of focus.

My focus area is thoracic malignancies including lung cancer and mesothelioma. I’m very involved in clinical trials — designing them or bringing in trials from phase I through III.

I like working with patients and finding opportunities to design or bring in clinical trials for them that move the field forward. Finding new data and seeing patients respond to a new drug that hasn’t been available previously makes coming to work every day exciting.

I have brought multiple first-in-human trials to Mayo Clinic and they, in turn, bring in National Cancer Institute or pharmaceutical funding that supports the efforts of our clinical research coordinators, labs, nurses, data entry staff and others. This work also has helped Mayo Clinic become a top contributor to some very large national efforts to use biomarkers to drive clinical trial enrollment with targeted therapies. These efforts have helped raise my status beyond where it would be otherwise. My name, our team and Mayo Clinic are at the top of certain national lists. As our trials mature, we’ll have opportunities to present findings at national meetings and publish, which hopefully will result in more funding and recognition.

You recently spoke at the American Society of Clinical Oncology (ASCO) meeting. That’s unusual for junior faculty. How did that came about?

There was a patient in hospice care who came to me for a third opinion. Our molecular analysis suggested he would respond to a drug that wasn’t yet FDA-approved for any indication. (It is now approved.) We received approval for compassionate use of the drug, and the patient responded to it. In fact, his tumor had a complete response to the drug, and the patient is still alive now more than three years later.

No one had yet published on this agent being used for this type of tumor. We published our experience in Annals of Oncology. That led to ongoing collaborations with some labs and additional funding opportunities. ASCO asked me to speak at its June annual meeting about the ins and outs of obtaining expanded access to medication. I also wrote for the educational book for the conference, with two others, about how to do this type of testing and navigate the expanded-access landscape.

How’s life post-training?

In training, I was always anxious about the next step. I’m thrilled to be done with all of that. I love focusing on applying what I know and working with our labs to help patients and advance patient care. I like this better than training. It’s thrilling to bring in a clinical trial and see patient benefit from treatment.

How do you find balance and prevent burnout?

Our son, Andrew, was born earlier this year. I’m a thrilled new parent. Now that we have a child, I’m still trying to figure out what works best for my schedule. I don’t want all of the care of our son to fall on my wife, who is a nurse practitioner in radiation oncology at Mayo Clinic. I’m trying to be more selective in the travel opportunities I take. I’ve already turned down six meetings where I was invited to speak or participate since I knew our son would be born. When I’m home, do I wake up early and go in to the office and write manuscripts and grants and leave at the end of the day to be able to help feed the baby and get him ready for bed? I don’t have the answers yet, but I’m trying to make it work. I talk to my friends about work-life balance and what works for them and what doesn’t.

My dad was my role model. He walked on water as far as I’m concerned. I don’t know how he did it all and was there so much for me. He was so kind, patient, understanding, supportive and present. I want to be as good a dad to Andrew as my dad was to me. There will be some things I won’t be able to do, like make a 4 p.m. sports event. I’ll have to explain to my son why I am sometimes away.

Managing my day is the biggest challenge due to the uncertainties in clinical trial and lab work. A colleague calls and says they have a patient interested in an open trial — can I add them to my schedule? A last-minute teleconference pops up to go over the results of a trial. Data comes from the lab, and I want to get it published quickly. A study coordinator has 30 pages for me to review and sign. IRB wants me to comment on a study’s design so they can approve it. You can’t anticipate those things, and no time is budgeted for them. I have lots of balls in the air, and they often get juggled well. Other days, three things happen at once, and the manuscript I’m writing has to be put on hold for another week.

What do you do in your spare time?

We enjoy hiking and cooking. We travel to California, Florida and Ohio to see family.

How do you define success?

Success means different things to me:

• Taking some of the data we’re getting ready to publish and seeing if the findings can be brought into clinical use and lead to funding to test and validate those discoveries.
• Having another baby or two and being the best parents we can be.
• Helping my wife meet her career goals.
• Find the right balance in my life.

Who are your mentors at Mayo Clinic?

I have many. On the clinical side are Alex Adjei, M.D., Ph.D. (ONCL ’95, Division of Medical Oncology); Aminah Jatoi, M.D. (ONCL ’98, Division of Medical Oncology); and Chuck Erlichman, M.D. (ONCL ’94), Division of Medical Oncology). On the research side are Svetomir Markovic, M.D., Ph.D. (I ’96, HEMO ’99, Division of Medical Oncology); George Vasmatzis, Ph.D. (HSR ’99, Department of Molecular Medicine); and Haidong Dong, M.D. Ph.D. (IMM ’01, Department of Urology).

See past New Chapter stories here.