Robert Winn tells us how he led VCU Massey to obtain Comprehensive designation

VCU Massey Cancer Center can now add the word “Comprehensive” to its name.

The Richmond, VA, institution received its Cancer Center designation in 1975. While reaching the next, highest, level was in the plans over the ensuing decades, the final push was led by Robert A. Winn, who joined VCU Massey as director in 2020.

How did Winn get it done?

“I think it was leaning into what the institution does best, and that is, I actually think that VCU Massey has always had a unique role to play, particularly within the Richmond community,” Winn said to The Cancer Letter. “We just simply embraced that role, which is to make sure that everybody, independent of their ability to pay, independent of their race, creed, or color, or gender gets access to care.”

In addition to recalibrating his institution for a final push to obtain NCI’s prestigious Comprehensive Cancer Center designation, Winn has taken on a significant number of national roles, becoming a leading advocate for improving cancer care for underserved communities and increasing diversity in clinical trials and in the workforce at America’s cancer centers.

He is the president-elect of the Association of American Cancer Institutes, the newly appointed chair of the National Academies’ National Cancer Policy Forum, a member of the board of the American Cancer Society, and chair of the American Association for Cancer Research 2024 AACR Cancer Disparities Progress Report. Also, the Bristol Myers Squibb Foundation has established the Robert A. Winn Career Development Award, a two-year program that trains early-stage investigators with the goal of training over 290 community-oriented clinical trialists by 2027.

Winn also serves as a guest editor of The Cancer Letter and the Cancer History Project during Black History Month.

Winn said he takes on these roles because it’s important to use national policy platforms to speak about diversity. “The only way to do it is to be at the table,” Winn said. “Unfortunately, even in 2023, there are so few minority cancer center directors and others, and senior leaders that, ultimately, I’ve found it to be necessary to be at these tables.”

For me, chasing the comprehensive, as difficult as it was, actually made us, at the end of the day, a better cancer center. And so, for me, the comprehensive status is not so much a gold seal of approval as it is an actual activity that made us better.

When Winn became the center director at VCU Massey, he was the only Black director of an NCI-designated cancer center. Now, the number of Black directors at designated cancer centers has increased to four: Winn; Kunle Odunsi at the University of Chicago, Selwyn M. Vickers at Memorial Sloan-Kettering Cancer Center, and, starting on June 30, John D. Carpten at City of Hope.

“I still would submit that we certainly need to get an African American woman to be head of the NCI-designated cancer center,” Winn said. “You can’t convince me that in over 50 years, that we don’t have a qualified African American woman to be a director, but that’s another topic for another day.”

Refocusing an institution is a challenge under any circumstances.

“I would also say that COVID did not help. When I took over in January 2020, I really had a lot of plans that I was gonna roll out. And by April of 2020, we had to put many of those plans on the shelf,” Winn said. “So, it really is an amazing testament to me of the greatness of VCU Massey that we’re not only able to obtain the comprehensive status now, but we did it during a pandemic.”

Winn said the exercise of meeting the criteria for the comprehensive designation has improved VCU Massey.

“The comprehensive status that we got was in part because we were very bold about making sure that we put the community first. It really was a community-focused approach,” Winn said. “And the cool part about that is that the science didn’t get diluted. In fact, the science improved. Our NCI direct dollars actually increased substantially. Our number of high-impact papers actually increased substantially. Our number of clinical trials actually improved substantially.

“It goes to prove that by serving the community you don’t actually have to necessarily sacrifice the science for focusing on community. And I think that that was probably one of the things that was a unique distinguishing factor for us.”

Winn spoke with Paul Goldberg, editor and publisher of The Cancer Letter. A video recording of the conversation is available here.

Paul Goldberg: Well, Dr. Winn, thank you so much for finding the time to meet with us—and this is the day we’ve all been waiting for. Congratulations!

Robert Winn: Thank you.

You now have the comprehensive designation for VCU! How many years has this been in the making?

RW: It’s been a while. We were first NCI-designated in 1975, and I think the cycle after that, probably five years, probably since the eighties, we’ve been chasing the comprehensive status—and we finally brought it home.

How did you do it?

RW: I think it was leaning into what the institution does best, and that is, I actually think that VCU Massey has always had a unique role to play, particularly within the Richmond community.

We just simply embraced that role, which is to make sure that everybody—independent of their ability to pay, independent of their race, creed, or color, or gender—gets access to care.

The comprehensive status that we got was in part because we were very bold about making sure that we put the community first. It really was a community-focused approach.

And the cool part about that is that the science didn’t get diluted. In fact, the science improved. Our NCI direct dollars actually increased substantially. Our number of high-impact papers actually increased substantially. Our number of clinical trials actually improved substantially.

It goes to prove that by serving the community you don’t have to necessarily sacrifice the science to focus on the community. And I think that that was probably one of the things that was a unique distinguishing factor for us.

So, it could have been done before, except I guess NCI has changed as well—because suddenly disparities have become front and center of the designation.

RW: I think the biggest thing that has happened at the NCI level, particularly with NCI cancer centers, was the insertion of the community outreach and engagement piece that is now not only looked at and evaluated as part of your score, but as a significant score driver.

I think that having a community outreach and engagement piece has encouraged many cancer centers to really look at the impact we are having on the people we take care of.

And so, in that context, I think that the COE has helped us do what we were going to do anyway, which is to focus on the impact on community, and making certain that whether it’s the molecules that become medicine, or the screening processes, or the education processes, that all of those are focused on making sure that the people that we serve have access to it.

Well, you know, Joe Simone—I always end up quoting Joe Simone—used to say… One of his maxims is “leadership matters.”

RW: I think, first of all, it was made a lot easier by the foundation that was put in place by Walter Lawrence, by Dr. [I. David] Goldman, and by Dr. [Gordon] Ginder.

They left me with a very strong foundation. VCU Massey certainly had lots of talented researchers and talented clinicians. The thing that they weren’t doing as well was working together.

An example is that once I got them to understand that being talented is great, but when they were able to work as teams, we’d get more done. We went from having almost zero team science grants to having several team science grants.

I think that the other thing we did really well was bring in the community.

I think, for example, having a Facts & Faith Friday, where we meet every Friday with faith-based leaders throughout Virginia—and being able to disseminate information was a unique model.

But at the end of the day, we did it because the people believed we could.

We have had some of the best years we’ve ever had. We’re putting people on treatment trials, interventional trials…

But I think what happened was that there was a spark that I was able to release, and to provide that, I think allowed people to believe that by working together, we can get the job done. And we got the job done.

So, basically Joe Simone is right, and leadership matters.

RW: I think leadership does matter. And I think that I would say that the leadership that my predecessors brought to bear set the stage for me coming in and making some minor tweaks to the Massey Cancer Center that enabled us to be competitive for comprehensive status.

What was the heaviest element of this? What was the heaviest lift?

RW: I think the heaviest lift was getting people to believe that we could do it.

It was the most interesting thing, I think, that people had wanted to do this for years.

I think since the 80s, there was almost a sense that it was like the Chicago Cubs, you know; that we’d get close, but we’d never get it.

I think that the community at large was hopeful that we could get it, but had some doubts. I think that our faculty and the cancer center members had been at it for a very long time, and, again, felt that maybe we could get it done, but weren’t really all that certain.

But I think what started happening is when we started putting up some wings. When we started getting the team science grants, when we started actually improving the numbers of people being put on clinical trials, when we started actually improving our ability to screen patients, I think more and more people believed we can get the job done.

And so, it’s been a challenge; I can’t lie about that, but it’s been really pretty fun to be a part of. I would also say that COVID did not help. When I took over in January 2020, I really had a lot of plans that I was going to roll out. And by April of 2020, we had to put many of those plans on the shelf.

So, it really is an amazing testament to me of the greatness of VCU Massey that we’re not only able to obtain the comprehensive status now, but we did it during a pandemic.

We did it disadvantaged in many ways, but we still put up the best numbers we’ve ever had, despite the pandemic. I’m really proud of VCU Massey, and I’m proud of our members, and our faculty, and our senior leaders.

They came together and they’ve done a great job.

So, you used to be the only Black director of an NCI-designated cancer center, and the second ever, now you are the first Black director of an NCI-designated cancer center to get the comprehensive designation. My gut tells me this is important, but you actually have an answer as to why this is important. Why is this important?

RW: You know, this is important for a number of reasons. For me, in 2020, when I was the only African American cancer center director, I’ve never been good about being by myself.

And so, it is really good to now to see John Carpten, and Kunle [Odunsi], and [Selwyn Vickers].

I still would submit that we certainly need to get an African American woman to be head of the NCI-designated cancer center. You can’t convince me that in over 50 years, that we don’t have a qualified African-American woman to be a director, but that’s another topic for another day.

It is important, because I think that as we move in the 21st century, it’s becoming obvious that having different lived experiences and different backgrounds matter. It matters in the context of the approaches that we bring to the table.

It matters in that different voices that are at the table, but more importantly, it matters because, for example, I think the type of research is actually influenced by having women from different backgrounds, and folks from different backgrounds all becoming cancer center directors.

The funny part about it is that the more diverse we get, what you’ll see is that the cancer centers, I believe, will be serving the public even more and better. I love science, and believe in science, and understand that the basic science drives translational science, but I also have to understand that discovery, that the discovery science is frequently disconnected from the implementation of that science and the health delivery of that science to our communities.

What I brought to the table was a love and a passion for science, but an equal love and passion for making sure that the science that we create and that we do actually has an impact on our communities.

Having people from different backgrounds and different experiences can actually strengthen, I think, the NCI-designated programs. Having different voices at the table.

Why is it important to have the Comprehensive Cancer Center designation? What does the exercise really mean, besides the core grant, which I think doesn’t really pay for itself very well.

RW: I think the “comprehensive” allows an institution like ours to be better organized, to be better aligned, to provide better service, and to do better science.

I really like the program, because the truth of the matter is the NCI could just say, “Oh, you know, [we can have an] almost pass/fail NCI designation. We don’t need anything past that.”

I think by having the comprehensive, it forced us, in this case, VCU Massey, to step its game up. It forced us to have our individual investigators, who were doing great on their own, to work together as a team.

It forced us to have the health system and our research center, which is run by Vice President Srirama Rao, to be more communicative and more aligned and work together to put more people on clinical trials.

For me, chasing the comprehensive, as difficult as it was, actually made us, at the end of the day, a better cancer center.

And so, for me, the comprehensive status is not so much a gold seal of approval as it is an actual activity that made us better.

I think as a result of obtaining it, if people were to look at where we were in 2020 and where we are now, there is not a single measure that we have not done better in.

And that’s a result of actually being focused on trying to get the comprehensive status. So, I’m really grateful for getting the comprehensive status, but the important thing about getting it is that I think it just simply made us a better cancer center, because we had to do more, be more aligned, and be more productive and effective at our day-to-day operations. But more importantly, that our science improved.

It’s documented. We’ve done better in almost everything, including our high-impact publications, including our grants, and including team science. At every level, the comprehensive has provided me with an opportunity to bring really good people together in a way that I would not have been able to do without chasing the comprehensive status.

Actually, I should ask another Joe Simone question, which is, “if you’ve seen one cancer center, you’ve seen one cancer center.” So, what is VCU Massey? And, by the way, I should probably just add one more bit to that question. I believe VCU Massey is one of the few NCI-designated cancer centers that takes Medicaid patients.

RW: Absolutely. We are one of the few safety net hospitals, still, that actually has a [Clinical & Translational Science Award], has an NIH-sponsored MD/PhD program, and now a Comprehensive Cancer Center. And we take whoever comes to our door.

I love that about VCU Massey, that we can deliver high-impact science, but that we definitely are accessible to all people within our area. If you can get to us, we’ll see you. And that’s what I really love, that we don’t turn anybody away.

I think that leads into your question about when you see one cancer center, you’ve seen one cancer center. Dr. Simone is right. This cancer center is different, because we extended the concept of a bench-to-bedside model to a community.

We really leaned into this whole concept of a people-to-pipette approach, meaning that we believe that by getting more information from our communities through our community outreach and engagement efforts and other things, that information, interestingly enough, was able to help refine our scientific questions, even at the basic science level.

In fact, we just had a retreat in which our cancer biology program has been meeting with our cancer prevention control and our community outreach engagement folks to get more information about our catchment area, to get more information about the communities we serve, that ultimately will lead to some of our basic scientists actually refining their scientific questions.

I  think that’s a win. We’ve been unapologetic about the health disparities angle. We’ve been unapologetic about making sure that Massey actually serves our at-risk rural communities.

But the one best thing that I really love is that this is all supported at the highest level. Without the support of the president, Michael Rao, without the support of our senior leaders, without the support of our community, we would not have been able to do this.

And they really got behind the message that we serve all people, and therefore, in science, you serve all people. A critical distinction between us and many other cancer centers is that we are unapologetic about the people we serve. We serve everyone. Therefore, our science should be reflective, reflected in the types of science we do to have an impact on our communities.

Also, you’ve taken on a lot of local leadership roles, like your Faith Sundays.

RW: That’s Faith Fridays.

But you’ve also probably taken on more national leadership roles than really anyone in this field. Can you list all of this, because this is a lot? It’s a lot.

RW: I’ll start off first with sort of saying that one of the promises that I made to the communities that I would get out behind my desk, and so I have the Facts & Faith Fridays, for example, was setup between a community activist Rudene Mercer Haynes, pastor Todd Gray from the storied Fifth Street Baptist Church, and myself.

That initially was just a program that we set up to inform faith-based leaders about whether they could even attend services early on in COVID.

That’s now morphed into a weekly, or every other week, meeting, where we talk about everything from depression to cancer screening, to new technologies, to new medicines that are coming out to fight cancer.

It’s been wonderful in that way. I also have to tell you that the thing I love most about being a cancer center director is that we do these things called [District Walks].

Unfortunately, even in 2023, there are so few minority cancer center directors and others, and senior leaders that, ultimately, I’ve found it to be necessary to be at these tables.

And so, I’ll get to one of the state senators, or one of the state delegates, or one of the council people, councilmen and women, and I get to actually meet them in their communities, and then walk, and then meet folks within the community as I’m walking to learn more about what are the needs of the community.

That’s been one of the major shining activities that we really get to do here at VCU Massey. I, along with my community outreach and engagement team, with Dr. Vanessa Sheppard, have been able to, not just theoretically think about communities, but we go into our communities, we walk, we talk, we learn, and then we wind up following up with our with our leaders in those communities.

And that’s been great.

On a national level, it seems that I’m doing a lot, but I think what I am trying to do is just to try to get a better sense of how to align the efforts. So, I’m working, for example, at the AACR; I’m the head of their next health disparities report that will come out in 2024.

I’m certainly on the board of the ACS. I will become the new president of the AACI starting in October.

I certainly have done some work with the National Cancer Policy Forum for the National Academy, which I am taking over, starting this year.

And several other organizations. I think the goal here is to ultimately be able to be involved, because it’s important to put in a national platform that diversity matters, and the only way to do it is to be at the table.

Unfortunately, even in 2023, there are so few minority cancer center directors and others, and senior leaders that, ultimately, I’ve found it to be necessary to be at these tables.

I hope in the future that there’ll be many more people of color, many more women, and more diversity, to be quite honest with you, where I won’t feel the need to have to be present at these tables.

But for now, the message of diversity, the message of the importance of diversity, is center on my mind, and at the moment the best way to get that message through is to be active in many of these organizations.

And so, that’s the overall rationale for being involved. You only have a limited amount of time where you have a national platform, and I’m using that national platform to let everyone know that diversity matters, and that diversity at the end of the day is a good thing, not just for us, but for the people we serve.

So, you have to be at these tables, because there aren’t that many people who can be at these tables, and it’s important to have your voice there. I agree.

RW: We always joke to people that we all have a shelf life. But when you’re up, and you’re in a leadership position, the question isn’t so much what you’re leading, it’s what you’re doing, and what’s the impact.

The impact as a cancer center director is certainly one of the things that I’m focused on, and I’m really locked into that. But the second mission of making sure that diversity matters, whether you’re talking about rural, gender, racial, or ethnic, that those conversations are also important to have, and they’re more critical now than ever.

And you can’t do that when you aren’t at the tables. And so, at the moment, I just happen to be fortunate enough to sit at many of these tables, and I’m hoping that over time I’ll be sitting at less and less of these tables, because they’ll meet more and more diversity, without me being there. That’s my hope anyway.

RW: Man, listen, I’m having the time of my life. I’m meeting with people that I respect, and I get excited about many of the conversations we have. I’m able to align my mission with my work.

I don’t really feel like I’m doing as much work as that; I’m living out the things that make me the happiest.

And that is making a difference from a work-life balance sort of perspective. We’re always working, man, we’re workaholics. And so, I’ve readily admitted that, I’ve embraced that.

But when you’re doing work that you like, and when you’re meeting people and working with people that you like, it’s a lot more fun than it is work. And so, I’m actually having a really good time.

Well, you’ve also been a really important voice throughout this very difficult time, starting with George Floyd, and also the Buffalo situation, that shooting. That’s your neighborhood.

RW: It’s my neighborhood. And to be honest with you, this is even more of a reason why it’s more of an avocation for me than an occupation, being a cancer center director.

It turns out that science is important, but the science of public health is also important, and bringing to light these issues. I first of all want to thank you for what you are doing at The Cancer Letter, and being able to actually have folks like me and Otis and many others, being able to bring this type of information to your readers. It has actually been something that I have not only great admiration and respect for, but I am eternally grateful for it. These topics don’t always get covered.

And that The Cancer Letter has actually had the courage since I wrote the first article that I could have been George Floyd, to all these other topics.

The fact that you’ve had the courage to be able to embrace that and publish it, again, I’ll always be eternally grateful.

But to your point, the reality is the work’s not done. And as we think about cancer, most people think about cancer as cancer. I think about cancer as a chronic disease, and that chronic disease disproportionately affects people who are at risk, for example, people who are poor, people who are rural, and people of color.

And so, for me, this is much more than bringing science to the community; it’s bringing an awareness that where people live, that is your ZNA, ZIP code neighborhood of association, and it is also a significant driver of disease, and we need to pay as much attention to the ZNA as we do the DNA.

And that’s been really my key motivating factor of being a cancer center director. Both matter.

What keeps you up at night now, now that you’ve got a Comprehensive Cancer Center designation?

RW: The simple answer is keeping it. So, now it’s almost like the dog that caught the car [it had been chasing].

It’s like, now we really have to go to work. It was hard to get it, but it will certainly be even harder to maintain. And so, what keeps me up at night is thinking about—already, right now—what we have to do to improve for the next round, when we go in for the next site visit.

Is there anything we forgot to mention? Is there anything we didn’t cover?

RW: I think the only other thing that I’ve been really happy about is the Bristol Myers Squibb Foundation that happened right after George Floyd—being able to also have a national impact in the way people are being trained as clinical trialists.

That program was set in place with the Bristol Myers Squibb Foundation and gave me an opportunity to start thinking seriously that if we wanted to get more diverse people on the clinical trials, then we had to do business differently.

For years, we’ve been training clinical trialists to do the best, most high-impact clinical trials by design and implementation.

But the interesting thing is, many of those things have not gone out to minority or rural communities. The other interesting part is that we’ve had a tremendous amount of success, I think, with community outreach and engagement efforts, but many of the people doing community outreach and engagement have almost zero idea about how difficult it is to get a molecule to a medicine and then a medicine out to trials.

The program was an attempt to blend those two efforts. And so, I’m really happy to know that there’s a third cohort of what are called Robert Winn Diversity Scholars, who are learning how to not only design and implement trials, but are also learning that there is a rigorous skill set to learning how to do things—before you design a trial, to do asset mapping of how communication and communication skills with various people within communities matter, how to understand, and how to actually identify, and how to leverage leaders within the community that will actually assist you in getting people on the trials.

One of the things that I’m super proud of is being able, during this tenure of mine as a cancer center director, to have a national program that is really teaching clinical trialists how to be much more aware and have the skill set necessary to engage your community, so that we may have a fighting chance of bringing more diverse people onto clinical trials. So, I’m super excited about that as well.

This is pretty incredible to see that, and it’s just also wonderful that your leadership has been embraced by this field and that you’re willing to do this—to step up. So, thank you for that. And thank you for talking with me.

RW: Thank you. And listen, what I love about being a cancer center director, when I go in the room and I meet the other cancer center directors, and I’m able to interact with them, it gets me energized.

The funny part about this is that I would not have been able to do this if I didn’t have the support of Michael Rao, the president, if I didn’t have the support of the board that supports Massey.

And I have to say, the fact that I’ve done this over the last three years, there’s never been a moment that I have not felt supported, either by my colleagues and other cancer center directors or others.

And so, as I said before, I’m excited. I’m really happy we reached comprehensive status, but I’m much more excited about our future and what we’ll do over the next five years to even get better.

That’s what I’m super excited about.

Well, thank you so much.

Illustration by Kamo Frank