813: Investigating the Impacts of the Gut Microbiome on Immunotherapy Cancer Treatments - Dr. Jennifer Wargo
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Hi everyone, and thanks for joining me today for episode 813 of People Behind the Science. Today we'll be rebroadcasting our interview with Dr. Jennifer Wargo. Listeners, Jennifer is a cancer physician who also conducts research on how to better treat patients with cancer and how cancer may ultimately be prevented. In our conversation, she shared some wonderful stories about her career, her life, and her research.

So I hope you enjoy this episode of People Behind the Science. Every day, discoveries are made that will change our understanding of the world around us. Dr. Marie McNeely is here to bring you the brilliant minds who are making these discoveries so they can share their incredible stories and take you on an amazing journey. Welcome to People Behind the Science. ♪

Hello, everyone, and welcome to the People Behind the Science podcast. Today, I am delighted to speak with our guest researcher, Dr. Jennifer Wargo. So, Jennifer, welcome to the show today. How are you? I'm doing well. Thank you so much. It's an honor to be on the show. Well, we are delighted to have you with us today, and I'm really excited to learn more about you and the work that you do. But before we jump into our interview questions, let me first take a moment to tell our listeners a little bit about your background.

So listeners, Jennifer is an associate professor in the Department of Surgical Oncology at the University of Texas MD Anderson Cancer Center and a stand-up to cancer researcher. She received her associate's degree in nursing and bachelor's degree in biology from Gwinnett Mercy College. Afterwards, Jennifer attended the Medical College of Pennsylvania, where she earned her medical degree. Jennifer completed her clinical internship and residency in general surgery at Massachusetts General Hospital,

And next, she was a research fellow in surgical oncology at the University of California, Los Angeles. Jennifer then accepted a clinical residency in general surgery at Mass General Hospital. From 2006 to 2008, Jennifer was a clinical fellow in surgical oncology at the National Cancer Institute of the National Institutes of Health.

She then served on the faculty at Mass General Hospital and Harvard University. In 2012, Jennifer received her Master's of Medical Science degree in medical science from Harvard University, and she joined the faculty at the University of Texas MD Anderson Cancer Center in 2013.

She is board certified by the American Board of Surgery and she has received numerous awards and honors throughout her career. These have included the Arlie Clark Prize and Best Boss Award from the MD Anderson Cancer Center, the Rising Stars and the Regents Health Research Scholars Award from the University of Texas System, the Outstanding Young Investigator and Outstanding Investigator Awards from the Society for Melanoma Research, as well as a Stand Up to Cancer Innovative Research Grant for her microbiome work.

Jennifer has also received other awards for excellence in teaching, research, and patient care. And in our interview today, Jennifer is going to tell us more about both her life and her science. But let's start by talking about life first. So Jennifer, what do you like to do when you're not very busy doing science?

So when I'm not doing science, I keep quite occupied. I have a wonderful partner and three kids, ages two, six, and eight. And so we stay quite busy outside of the work environment. We like to spend a lot of time together, do things outdoors, go for walks, biking. We go to the beach sometimes and go hiking. And we really just try to enjoy spending time as a family.

In addition to that, I enjoy art and photography, and I even enjoy surfing every once in a while when I got an opportunity, and staying active as well. So running, biking, yoga here and there.

Awesome. Well, it sounds like you have quite a lot to keep you occupied and I'm fascinated by this interest in art. So can you tell us how you got interested in drawing and painting and photography? So when I was growing up, I really enjoyed drawing and I actually in high school drew quite a bit and even painted. I even had an art show at one point and at first thought about going into art.

But however, I wanted to translate my creativity in other ways as well. So though I enjoyed art, I didn't want to necessarily do it for a living and knew that sometimes it's challenging to do so. So now I get to really express my creativity through science. As I was, again, growing up, very interested in art, but also found a real outlet of creativity in science. And so now I'm able to translate it that way.

I love it. And I'd love to talk about the science that you do and how you're able to incorporate your creativity in that work. So for people who might not be very familiar with the area of cancer biology or your specific role, how do you describe what you do? I'm actually what they call a physician scientist. And so I'm a doctor who takes care of patients, but I also perform scientific investigations to find better ways of treating disease. Certainly, I

As doctors, we know how to treat patients and we've been doing it the same way for a long time. But really to find the new ways and better ways to treat different types of diseases, we really need to do research. Research is critical to that. So for me, I'm a surgeon scientist. So I see patients one day a week. I operate one day a week. And then the rest of the time I spend in the research laboratory and lead a very passionate

powerful and awesome scientific team that really tries to better understand how to treat patients with cancer and ultimately how to prevent it. I like it. Well, I look forward to chatting more about the work that you do in some of your specific projects as we go through our conversation today. But I want to pause for a moment here to talk about motivation and inspiration. I think between all of the things you listed in terms of your hobbies outside of work, as well as trying to balance the research and the patient care, it can be a lot sometimes.

So Jennifer, do you have a particular quote or a saying or a mantra that really keeps you motivated?

Yeah, I think the most inspiring quote to me is attributed to Sir Isaac Newton. And it's, if I have seen farther, it is because I stand on the shoulders of giants. And I get a little choked up when I say this, because any success that I've had is certainly based on knowing and being mentored and being inspired by others. And that's really what has made a tremendous difference in my life and my ability to translate that creativity and to make a difference in this world.

Definitely. So can you tell us maybe about some of these shoulders you've stood on, some of these mentors and role models and people who've had a big impact on you and your career? My parents, first and foremost, when I was growing up.

taught me to be a better person. And so when I was growing up, youngest of five children, my mom was a nurse and my dad taught mathematics. So when I was growing up, I was kind of immersed in the environment of wanting to learn more, but also really being very interested in taking care of people. So when I was a child, I used to go out and see patients with my mom. She was a visiting nurse. So I would see firsthand sometimes the struggles that people were going through, but also

really being able to help people in one of the most vulnerable times in their lives. And so I was really inspired by that. So when I was growing up, and again, I was interested in art, but then thought maybe more towards science. But before going into science, I actually really wanted to go into nursing first. So my first degree was in nursing. I, after high school, enrolled in the nursing program and got a registered nurse degree and worked as a nurse for several years. And

and absolutely loved it. And what I found was that I really enjoyed the nursing part, but I wanted to do more in science. And so another mentor in my life was one of my professors in nursing school who was like, you really ought to think about going into medicine and that way you can couple the science as well as the care for patients. So he inspired me. So I went to medical school, got my medical degree, went into surgery and have been able to really translate that. And all along the way, I've had amazing mentors.

including people like Steve Rosenberg, one of the fathers of cancer immunotherapy. Tony Rebus, who's also an amazing physician scientist and member of Stand Up To Cancer and has done a tremendous amount in this world. And then Jim Allison, who's a Nobel Prize winner for cancer immunotherapy, has been a great mentor to me. And all along the way, my parents, my teachers, my colleagues, certainly patients and their families,

have really inspired me to do what I do. So I think the entire team has really inspired me, including the funding agencies and philanthropists who without their help, this work wouldn't be possible. Absolutely. Well, it sounds like you've had a wonderful network of people you've been able to work with over the course of your career and people who've supported you along the way. And I love that you mentioned this

idea of when you were younger, being interested both in art and in science. And I'm curious to hear a little bit more about how your interest in science began. Do you have any specific memories you can share with us of when you first started getting interested?

I think one of the key things that got me interested in science was first trying to better understand disease. And so as a nurse, certainly I saw a lot of people who were ill and battling illness and was able to help them through that from a very humanistic standpoint, but wanted to understand more. And that's really why I was inspired to go to medical school. And during medical school, I became very interested in the immune system and the interface between

surgery in the immune system. And I later went to my surgical residency at Harvard. And when I was at Harvard, I took care of a lot of patients with cancer and was really inspired by those patients and wanted to learn more about the interface between the immune system and cancer. And it was at that time when I identified a key mentor in my life, which was Dr. Tony Rebus, who is at the University of California, Los Angeles.

And I went out and performed a research fellowship with Tony trying to better understand how the immune system interfaces with cancer and how we could really tweak the body's immune system to make it work better. Following my fellowship,

fellowship with Tony Rebus, I finished up my surgical residency and then worked with Steve Rosenberg down at the National Cancer Institute. And again, really learned a lot more about this. And then I took a faculty position at the Massachusetts General Hospital where I started my research laboratory, really looking at the interface between cancer and the immune system and how we could use the immune system to combat cancer. So

Certainly. And during this period as well, you were taking coursework and getting that Master of Medical Science degree. What was that experience like trying to balance the schoolwork with the starting up your new lab? Definitely. It was a busy time. But again, it's so important to have key skills in order to understand how best to do research, how to interface.

interface with others to learn from them, how to really disseminate the information and to engage with others to all roll up our sleeves and work together to learn as much as we possibly can and to positively impact the VEs. Definitely. And then how did you decide then to make that move from Boston all the way to Texas?

It was a difficult decision. I absolutely love Harvard and I love my family in Boston, if you will. But there were unique opportunities for me and my family to move down to MD Anderson Cancer Center to help lead the Moonshot program and saw that as a very unique opportunity and to come and work with key leaders in cancer immunotherapy, such as Jim Allison.

Excellent. And Jennifer, I know you've got some phenomenal work going on both in the clinic as well as in the lab right now. So is there a particular project you are just so excited about that you want to share with me and our listeners today?

One of the projects that's the most exciting that we're currently working on is something called the microbiome. The listeners may ask, well, what is the microbiome? Well, interestingly, in our bodies, we have over 100 trillion microbes, and this includes bacteria and viruses. The number of microbes actually outnumber our normal cells by up to 10 to 1. And if you look at the DNA or the genetic content of our bodies, we're only about 1% human, interestingly. If you actually sampled the DNA, most of it's actually either

bacterial or viral. So for a long time, people really thought, well, mainly these bacteria and viruses aid in digestion. They help us exist as humans. But what we're now learning is that they actually have a tremendous impact on other aspects of physiology, such as our immune system. So we actually started studying some

the microbiome years ago when I was at Harvard, and it was a bit of a serendipitous experience. We're actually looking at patients and looking at tumors of patients with cancer. And through an interesting twist of fate, we actually identified that there were bacteria within the tumors of patients with cancer that could actually inactivate the cancer therapy or break down chemotherapy was one example. So we were really intrigued by these findings and we

We were then studying this for a while. And when I moved down to MD Anderson, I had gone to a conference and saw work presented by someone else that not only can bacteria and viruses within tumors of patients influence how they respond to treatment, but also the bacteria and viruses within the intestines or the gut microbiome. And that work showed that in mouse models, depending on what

these gut microbes looked like would actually dictate whether or not the mice responded to treatment with different forms of cancer therapy, like immunotherapy, and that by changing the bacteria in the gut, you could actually make these mice respond better. We wanted to study this better. And what we did is we studied this in patients with cancer going on to these cancer treatments, including immunotherapy, and actually profiled the gut microbiome and saw, again, that in patients, lo and behold, the

depending on what the gut microbiome looked like was associated with whether or not they responded to the treatment. And we now have clinical trials underway actually using a strategy to change the microbiome in hopes that it will actually make them respond better. Well, this is amazing work, Jennifer. And I know there are so many different kinds of bacteria that live in the gut. And there's, of course, that balance of different kind of communities and how they interact with each other. How do you tease out all of this complexity to find the perfect potion, if you will, to help people respond better?

I think that's a great question. It's like, what is the perfect microbiome in the gut that will make everyone's immune system work better, prevent cancer ultimately, make people respond better to cancer treatment? We don't know the exact answer yet, but the key and the way to get there is by doing research and certainly...

funding bodies like Stand Up To Cancer, when we were first starting our research studies and made this really important observation, the next step is really critical. And we were actually having trouble finding people that would support the research. So thankfully, through Stand Up To Cancer, they have a program called the Innovative Research Grant Program, where they fund high-risk, high-reward projects, knowing that some of them won't pan out, but the ones that do may make a big splash and make a

big, big difference for patients with cancer. And this was one of those projects that was funded. And I can tell you without the funding from Stand Up to Cancer, I don't know that we would have been able to do these research studies. And now I think there's certainly worldwide, there's an appreciation that these

microbes within our gut actually do tremendously influence our immunity, not only for patients with cancer, but probably for everyone walking around. And that by optimizing these bacteria and other microbes in the gut, could we actually make all of our immune systems work better?

Well, this is a fascinating area of research, but I know there are so many challenges and we just touched on one of them here. What are some of the other difficulties you've encountered either in these types of projects or just in different points of your career that you've had to work through to get to the point where you're at today?

So I think some of the most interesting results are unexpected. That's one take-home lesson. And I think sometimes in science, we get very fixated on, okay, I need to have a presupposed idea of what's going on. It's called hypothesis-driven research, and that's very important. But I think when things don't work out, you can't just give up. You have to say, okay, that's really interesting. Why didn't it work out?

And one example of that was when we were actually doing studies to look at pancreatic cancer and colon cancer as to why these types of cancer were so resistant to chemotherapy. And that's when we really identified that bacteria were actually breaking down the chemotherapy and

It was an interesting story in that we were studying these cancers in petri dishes, if you will, and treating them with chemotherapy in vitro. And it just turned out that one of the cell lines that we were treating actually was infected with bacteria that was breaking down the chemotherapy. And

It's something called mycoplasma. It's actually a common contaminant in laboratories. And we almost really threw away all that research, but we said, well, wait a second. What if this bacteria is actually helping to break down the chemotherapy? And lo and behold, that was the case. And now we find that in many different patients with cancer, we can actually find bacteria and viruses within the cancers that can sometimes contribute to the cancer developing. It can also make it more susceptible to forms of treatment.

Interesting. So what was it like when you started to see those results coming in to explain the situation?

It was incredible. I mean, I think sometimes it was a real wow, aha moment. And then the other one was when we were working on the intratumoral microbiome and I had gone down to a meeting to actually listen to some of the new work that was being presented on the role of the gut microbiome and saw another leader in the field, Tom Gajewski, present that work. And after I saw him present the work in mice, I was totally floored, couldn't believe what I saw. So I got up to the microphone after he showed all the data and said, well,

this is amazing. Have you studied this in patients? And they hadn't at the time. So saw it as a unique opportunity. And that's when we started to look in patients and at the gut microbiome. Gotcha. And I understand it's much more difficult to move from mice to working in patients. What are some of the challenges that you get in translating this area of research?

Definitely, the patients really make the research. I owe it to the patients for being able to donate samples, like fecal samples. When we were first starting to do these studies and we asked patients to donate a fecal sample so that we could test their microbiome, I think we got a lot of raised eyebrows, but

I can tell you people are now really excited to have their poop sequenced to see how good is their gut microbiome. And, you know, can we change it and make it better? It's really provocative to think about that. We're also looking at other ways to change the microbiome. And so diet and other lifestyle changes. Can we actually improve cancer patients' overall health and for that matter, everyone walking around by actually preventative?

providing adequate guidelines to change the diet so that we can actually make our microbiomes better. Absolutely. And I think there are these lifestyle choices that you can make to potentially change that microbiome, but you've also done some research in fecal transplants, which I find terrifying but fascinating at the same time. So can you touch on this process?

Definitely. So again, because of all this work in both in the mouse models and now in patients, it really suggests that depending on what the gut microbiome looks like in patients can really dictate how their immune system works and whether or not they might even respond to the treatment. So the really natural question is, well, can you change the microbiome and make

patients respond better to treatment. So we and others have launched into an effort to do that and really based primarily on the research work that we had done with Stand Up to Cancer. Now we have other funding that is helping to run some transformative research studies, including a clinical trial where we're taking patients with cancer who are going on to immunotherapy and then treating them with

a form of therapy to modulate their microbiome. One is a fecal transplant. Another is a special spore product, which is prepared by a company. And then other investigators are doing the same. And I can tell you that there were two recent stories that were presented at the

annual meeting of the American Association for Cancer Research, where they showed that in patients who had melanoma that had spread throughout their bodies and was resistant to immunotherapy, if they actually gave them a fecal transplant from a patient who had had a complete response, many of these patients actually

subsequently had a response to treatment, which is crazy, right? You think, well, gosh, how can a poop transplant really change things? But it does prove that even in someone who is potentially resistant to immunotherapy, could you actually change that set point in the immune system by changing the gut microbiome and actually help tip the balance so that now their immune system can function and they can actually respond to the immunotherapy? Dr.

Well, this is absolutely remarkable, Jennifer. And we've touched on some of the challenges that you've worked through in your research, but also some of the successes that you've had. And I think it is so important to celebrate these successes in science because oftentimes they're sort of few and far between. So do you have a favorite success story that you'd like to share with me and our listeners today? Well, I think it's important for us to celebrate the small victories to

to really share with each other and to roll up our sleeves and work together towards a common goal. Really kind of sharing successes individually as well as as a group. I think certainly I've had a number of great people in the research laboratory who have worked with me and have now are leading their own efforts. And that's amazing. It's sad to see them go, but it's amazing to see them now leading their own research efforts. So that's been a great success. I think all of our work and seeing others really

also learn from it and now replicate it and start their own studies on the gut microbiome has been incredibly inspiring. And then to see the entire community of healthy individuals really now looking at this and saying, wow, hey, wait a second, the gut microbiome actually does seem to have a close relationship to the immune system. How is my diet? What does my gut microbiome look like? So I think it's really important to celebrate the work that we do

That's including patients, postdoctoral fellows, graduate students, research nurses, investigators, philanthropists, but really kind of as a global community to say, okay, we know a lot about health and disease. There's still not more to learn. Let's share data, support one another and learn together. Absolutely. So does your lab group have a particular favorite way that they celebrate some of the successes? Yeah, I think we throw a lot of parties.

I often will throw parties at my house. I think I like to recognize that we're kind of the work hard, play hard adage, if you will. And one favorite party, we had a dunk tank where I let everyone have a crack at dunking me in the dunk tank. Oh my goodness, that's amazing. Which was a lot of fun. Also with the microbiome lab, there's no shortage of poop emojis that are floating around the lab and other jokes that we have going on. We have poop emoji t-shirts that we have for the laboratory. So-

But it's definitely amazing team, huge team effort and really could not have made this happen without that.

I like it. Well, congratulations on all of these successes, Jennifer. And it's been wonderful to hear more about life in the lab and some of the great things you're doing on the scientific side. And I know you probably spend so much of your time immersed in the literature, continuing to learn and grow as a scientist. But I'd love to talk for a moment about what you're reading, maybe outside of the journal articles. So do you have a favorite book that you'd like to recommend for me and our listeners today that you've really enjoyed, whether it's related to science or not?

I'll tell you right now, I think I've just become completely immersed in the microbiome. And there's a great book from Ed Young.

And the last name is Y-O-U-N-G. And it's called I Contain Multitudes. And it's about the microbiome, but it's written for a layperson. And it's just very profound. And it really highlights the impact of how we are living in symbiosis with these microbes that inhabit our bodies and the various factors that impact them and shape who we are as beings.

I like it. Well, I know this is on my to read list, but you're actually the first one to recommend it. So we are going to add it to our website as well for our listeners to find there. And we've talked about some of the great opportunities you've had in your career. And I think as a scientist, one of the wonderful things is the ability to travel, to work with people from all over the world, to go to conferences. So Jennifer, do you have a particular favorite or memorable place that your work has taken you that you can tell us about today?

One of the most memorable recent travel experiences was I had the great fortune to accompany Dr. Jim Allison, the Nobel Prize winning scientist to Stockholm, Sweden for awarding of the Nobel Prize. And Jim Allison is an amazing individual. Again, stand up to cancer awardee, part of a dream team and a tremendous mentor to me and just has helped change the world through the use of immunotherapy.

So he's also a very down-to-earth guy. He plays the harmonica. He's just a really incredible person. He's a PhD scientist and made this discovery. And it was one of those things where a lot of people kind of wrote it off. And he was very persistent and said, no, no, this will work. And eventually he got this therapy all the way to...

being tested in patients and now countless patients have been cured using immunotherapy. And I personally have received many notes from my patients that they say, please forward this to Dr. Allison, including patients who were told they had two weeks to live. And now you are walking their granddaughters or daughters down the aisle and holding their new granddaughters. I mean, pretty profound. So it's just totally an honor. And the other part of that is that Pam Sharma,

also an amazing scientist, and Jim's wife. She and Jim invited a group of around 50 scientists to actually join them in Stockholm for the awarding of the Nobel Prize. So we all got together and got to celebrate

triumph of cancer immunotherapy. And that included his first patient who was cured of cancer from immunotherapy, Sharon. So she came along to the Nobel Prize ceremony. So that was pretty remarkable. But I've also had many other memorable meetings. For instance, when I had seen Tom Gajewski's work presented at the Society for the Immunotherapy of Cancer and had that aha moment of, wow, this is amazing. This could really change the face of cancer treatment. And then also I think

A key thing about science is that you need to collaborate to push the field forward. I was at a meeting, again, a couple of years ago and met another leader in the microbiome and cancer, Laurent Zitvogel. And finally, I'd just like to say that I think through funding organizations and through different efforts like Stand Up to Cancer and the annual summit, it really is an opportunity to bring together key stakeholders. You know, that's

investigators, that is patient advocates, and really bring everyone together so that they can learn from one another, form important collaborations and drive the field forward. Absolutely. Well, it sounds like you've had so many wonderful opportunities to meet people from all over the world, some of these phenomenal researchers in the cancer field, including, as you mentioned, Jim Allison, who was a pioneer in this immunotherapy area. So I'm curious, what was it like being in Stockholm for the Nobel ceremony? I've heard wonderful things about it.

It was amazing. And you could just feel the energy. And to be there with Jim's first patient, he was cured. Pretty remarkable experience. And then to know that not only have we made a big difference already, we still have a way to go, but that we have the right people who are banding together to do it. Dr.

Absolutely. So were you able to do a little bit of sightseeing while you were in Stockholm? Yes, absolutely. And they also, after the actual Nobel ceremony, they throw a Nobel nightcap party, which was a pretty phenomenal party, which was thrown by one of the schools in Stockholm, Sweden. So got

Got to do some sightseeing and saw the museum there, but also had a chance to party with the Nobel laureates, which again was a pretty amazing experience. I love it. Well, it sounds like a great opportunity and again, a really emotional moment being able to be there with a mentor, with some of the patients who have been impacted by this therapy. And you mentioned a couple of times as well, the organization Stand Up To Cancer. And I know this is a great organization. Can you tell me and our listeners a little bit about it if they're not familiar out there? Okay.

Definitely. So Stand With The Cancer raises funds to accelerate the pace of research and to get new therapies to patients quickly and to save lives now. It's a division of the Entertainment Industry Foundation. It's a 501c3 charitable organization, which was established in 2008.

mainly by film and media leaders, and it uses the industry's resources to engage the public in supporting a new collaborative model of cancer research and to increase awareness about cancer prevention, as well as to build progress being made towards the fight against the disease. So it's really mainly a grassroots movement and

everyone can help. And by donating, you kind of help to support these dream teams and also the innovative research grants, like the one that actually accelerated this microbiome research. And today, Stand Up With Cancer is awarded actually 93 team science grants with 25 signature dream teams. So many of these dream teams are launched in collaboration with prominent cancer advocacy and research groups. And now they've actually funded up close to 50 of these innovative research groups, actually 46 total in Vancouver.

thank goodness, mine was one of them, and just have made a tremendous impact in this world. And I can say again, without Stand Up To Cancer, I don't know that these studies really could have been done. It contributed to FDA approval of several new cancer therapies, including treatment for breast cancer, ovarian cancer, pancreatic cancer, even some leukemias. And to date, more than $603 million has been pledged to support the innovative model of collaborative cancer research and

It's really kind of the way everyone can help, right? You can roll up your sleeves, donate $5, donate more. Whatever you can contribute will definitely make a difference. I can assure people of that. Wonderful. I love this idea that you've brought up of collaborative cancer research. And you've talked about some of the great people you've been able to work with over the course of your career. And this is also a wonderful aspect of life as a scientist. And I think it's

It's contrary to some of the stereotypes that people have out there about what doctors and scientists are like. And we try to break some of these stereotypes on our show by just talking about the human side of science, some of the fun and funny things that you're able to do with your colleagues, maybe traditions that you have in your research group. And we touched on some of them earlier in one of your responses, the poop emojis, the t-shirts, just the work hard, play hard mentality that you have in the lab. But are there other traditions or other funny or fond memories that you can share? Yeah.

On the serious side, one thing that we do is I definitely can share with my patients just the progress that we're making in the clinic.

You not only know that here they've contributed to the research, but that those findings and what they've contributed now can come back to other patients and help them and help advance the field. I think some of the fun things that we've done on the research side has been we recently had a phenomenal scientist graduate, if you will, and he graduated with his PhD, stayed on in the lab, and then went off to lead research.

microbiome efforts at a pharmaceutical company and his name's Deepak Kapalakrishnan, amazing guy. And when he left, we actually got him in honor of Texas in the microbiome, a cowboy hat with a poop emoji on it. So we definitely enjoy spending time together. A lot of us have kids. We lament about occasional childhood illnesses, but also celebrate the victories and the successes. Deepak is actually, his wife is going to be having a baby in about three or four weeks. So pretty amazing there too. So

I think it's important to recognize each other as human beings. We're on this journey together. We need to laugh. We need to play. We need to support each other. Absolutely. Well, thank you so much for sharing more about kind of the environment in your laboratory. And I think you're absolutely right. You need to kind of see these people you're working with, not just as scientists, not just as colleagues, but as people. And you're working together to try to solve some of these problems that are way bigger than any of us individually. So thank you for all the wonderful work that you do.

And I know there are some challenges that we touched on in our conversation that prevent you from being able to solve these issues, from being able to really understand what causes cancer and how best to treat it. So if we gave you all of the resources you could dream of today, Jennifer, what is the one question you'd want to solve or maybe the one problem that you would want to address most?

If funding, staff, technology, and feasibility weren't an issue, I would say that I would want to answer the question of how we can improve overall health for everyone. And I think a common denominator to that just may be the microbiome. We know that given the importance of the microbiome in shaping overall immunity, could we actually study the microbiome in people and understand what influences it and then devise strategies to improve overall health for everyone?

Now, this could be, could we study microbiomes of people and relate that to the diet and to the immune system and say, gosh, what dietary strategies and recommendations could we institute that would improve the microbiome and someone's immune system and keep them from getting sick and improve their response to vaccines and maybe even prevent cancer altogether? That would be a dream come true. Absolutely. So if you had to narrow it down, what is the biggest barrier right now to starting to chip away at that answer? Dr.

I think that sometimes funding is an issue. And I will say that certainly for some of the governmental funding, the pay line is well below 10%. So there's a lot of good scientists and a lot of good potential science out there, but it's not necessarily getting funded. The other thing is

People need to work together. So working in silos is not an effective strategy. And so I think people need to break down barriers, not be competitive, to work together as teams. And that's why organizations like Stand Up to Cancer are so important is because they provide funding and they also facilitate and encourage and mandate collaboration. And that's really the key because this is not competition. We are all here together to help people.

And I think it's really important to facilitate that mentality. Absolutely. And I think this idea of leveraging the microbiome to improve overall health is really fascinating. So I appreciate you talking us through some of the big directions that we could go in this area. And we've talked about a lot of wonderful aspects of your career and the work that you're able to do in our conversation today.

And I would love it if you could give our listeners one more thing, and that is a piece of advice. So Jennifer, is there one thing that someone had told you at some point in your life or your career that really helped you that you can pass on to our listeners today?

Probably the best piece of advice I was given is really to love what you do. I think it's important to try to find something that you love. If you do, it's not going to feel like work and really to embrace it. I think we all have a great ability and opportunity to make a difference in this world. And it's an important thing to recognize what you love to do and to seize that opportunity. Absolutely. Wonderful message to give our listeners today. Is there any other last message or a last note of inspiration you'd like to leave them with?

Well, I'd like to thank the listeners for their attention today and for their interest. And also thank you and thank Stand Up To Cancer and others for really banding together and for spreading the word and for funding this important research. I think we're all the better for it. Wonderful. Well, Jennifer, if our listeners want to learn more about you and your work, what's the best way to get in touch or to reach out to learn more?

Well, they can contact me at MD Anderson. My email is jwargo at mdanderson.org. That's A-N-D-E-R-S-O-N.org. I will warn people that I occasionally get up to three to 500 emails a day. So if they don't get an immediate reply, do not despair. Just send another one and know that I probably saw it, but that I may not have had time to actually answer it. I would say that

If people are interested, I definitely highly support the efforts of Stand Up To Cancer and we can all make a difference again. And if people want to make a difference in microbiome and cancer research, really being involved in supporting Stand Up To Cancer and making a donation is a great way to do it.

Wonderful. Listeners, definitely get in touch if you have any questions. Check out Stand Up To Cancer to learn more about the wonderful work they're doing. And Jennifer, thank you so much for joining us on the show to share a piece of your story. Thank you very much. It was an honor. And listeners, great to have you here with us as well. We'll see you next time on another episode of People Behind the Science.