Shelley Earp steps down at UNC Lineberger, ending a 22-year directorship

Shelton “Shelley” Earp said he will step down as director of the UNC Lineberger Comprehensive Cancer Center effective June 2024. 

Earp, who has been a member of the UNC faculty since 1977 and who has led the institution for a total of 22 years, said he will be focusing on his just-renewed R01 grant and mentoring faculty members. Earp served as director between 1997 and 2014 and then again from 2018 on.

At 78, Earp is two years younger than Joe Biden, who is running for re-election. “The president is going to run the country at age 80, but I’ll be 79, and the new person is going to have to do something much harder than running the country, which is to write a CCSG grant,” Earp said to The Cancer Letter.

The committee charged with finding Earp’s successor will be chaired by Norman “Ned” Sharpless, former director of UNC Lineberger as well as former NCI director and former acting FDA commissioner. In fact, Earp both preceded and succeeded Sharpless at the UNC job.

“Now, it’s one of the best cancer center director jobs in academia for a lot of reasons, not the least of which is this terrific institution that has a great school of public health, a great basic science, a great clinical shop, and a large university where you’ve got a law school and a business school and an undergraduate college,” Sharpless said to The Cancer Letter.

“They all collaborate together in cancer research, and really make this a formidable and wonderful matrix cancer center. And the state supports it,” Sharpless said. “So, there’s very generous support for the University of North Carolina Cancer Center through the thing called the University Cancer Research Fund, which is more than $50 million a year.”

I came here in 1966, to the School of Medicine, and became imbued with our desire and ability to be the state’s hospital. I’ve grown up under that, and I’ve tried to use that.

Shelton Earp

Earp said the North Carolina legislature established the University Cancer Research Fund in 2008 to support cancer-related research and infrastructure at UNC Lineberger and across the university and the UNC system. 

“From the beginning, it has bipartisan support, and still does,” he said. “The fund’s use is outlined by UNC Lineberger and its director, with direct oversight by the Cancer Fund Committee, which is chaired by the UNC chancellor and has six other members: the deans of the Schools of Medicine, Public Health, and Pharmacy, UNC Lineberger director, and two at-large members appointed by the committee (currently Ed Benz and Gary Gilliland). The cancer center also is required to submit an annual report to the legislature outlining accomplishments, expenditures and economic impact.”

Earp said he timed his exit to give his successor maximum time to prepare for CCSG renewal. 

“The reason for doing this this year rather than next year, which would’ve also been a possibility, is that this will give the new director three solid years to be in charge,” Earp said. “And then, kind of towards the end of that three-year period, to start writing the grant. So, we’re only in year three of what will hopefully be a seven-year grant.”

As director, Earp built premier programs in cancer health disparities and diversity, equity, and inclusion, accomplishments for which he credits his wife, Jo Anne Earp, who died last year (The Cancer Letter, Dec. 2, 2022). “To the extent that I’ve been successful, it’s been because of this wonderful partnership I had with Jo Anne.”

Earp’s lab looks for new therapeutic options to treat a range of cancers including breast, lung, pancreatic, and prostate cancer, as well as leukemias and melanoma. “I, like many other people, am struggling to become a card-carrying immunologist, because that’s how we cure cancer,” Earp said. “So, my lab focuses on some genes that we clone that actually have, potentially, an effect in the tumor microenvironment.”

Earp holds patents on tumor cell inhibitors and is the co-founder of Meryx, an oncology-focused biopharmaceutical company.

Earp’s tenure as director is split into two stretches. After the first—1997-2014—Earp was replaced by Sharpless, who stayed for four years, leaving to become the NCI director. After Sharpless’s departure for Washington, Earp returned to the director’s office. (Actually, if we are to talk about office space, Earp never left. During the Sharpless interregnum, the two shared the director’s office.) 

If he steps down on schedule, Earp will have served a total of 22 years as a center director at a single institution, which would make him the fifth longest-serving director of an NCI-designated cancer center. 

If you tabulate years of service as director at a single institution, University of Michigan’s Max Wicha holds the longest single-institution record—28 years (The Cancer Letter, Dec. 3, 2013). The second place is shared by I. David Goldman and Steven T. Rosen, each with 25 years as directors, at Albert Einstein Cancer Center and Northwestern University, respectively (The Cancer Letter, Aug. 11, 2023). 

Earp trails George Weiner, of the University of Iowa Holden Comprehensive Cancer Center, with a 23-year total (The Cancer Letter, Feb. 24, 2023).

If you compare career totals of CCSGs (including grants obtained at multiple institutions) Goldman and Rosen log the highest career totals—7 CCSGs. They are followed by Wicha, with 6 CCSGs, and Earp and Weiner tie—at 5. 

“When I was cancer center director, I thought it was the best job in the world. Over the past few months since stepping aside, I have come to realize that ‘former cancer center director’ is even better,” said Weiner, whose column about life after center directorship appears in The Cancer Letter.

Earp said Sharpless’s search committee should be able to identify his successor quickly. 

“The idea that you need a year to run a search is just poppycock, frankly. People here want to be involved, and a job like this is such a good job that if candidates are serious, they will make themselves available for Zoom calls or for visits,” Earp said. “There’s no need to stretch this out.”

Earp and Sharpless spoke with Paul Goldberg, editor and publisher of The Cancer Letter. The conversation is available as a podcast. 

Paul Goldberg: Well, gentlemen, thank you very much for finding the time to meet with me. Shelley, are the rumors correct that you’re thinking of stepping down as director?

Shelton Earp: Yes, I wrote something that said, “I’m going to quote Mark Twain that the rumors of my retirement are greatly exaggerated, but I am going to step down as cancer center director.”

It’s time, for several reasons. The president is going to run the country at age 80, but I’ll be 79, and the new person is going to have to do something much harder than running the country, which is to write a CCSG grant.

So, they’ll need a little time to get together and do that. So, this is the right time to make a transition.

Can we do some baseball statistics here? How many years have you been directing—both stints?

SE: So, let me go back.

I joined Joe [Pagano] in 1977 and helped write that core grant, which was the second one from UNC. I think I became assistant director in 1981, but I think there were only three people, so it was a rapid rise. And then associate deputy.

And then I actually took over as director in 1997. So, in essence, from 1997 to now with an interregnum for my colleague on this call. Well, let’s do the math. It’s probably 22, I guess.

How many CCSGs, since I’m going to do the numbers?

SE: Again, it depends on how you count. So, I’ve been substantial author since 1977. So, how many does that count? As director, it’s what, five, I think. But I’ve had a long run at dealing with this arcane process.

Ned Sharpless: I did one, and that was plenty.

Well, Ned, you are running the search for Shelley’s replacement.

NS: Yes, that’s correct. Shelley has done a masterful job as cancer center director for decades at the University of North Carolina and has really built that institution from the three people he described to this several hundred FTE, multi-million-dollar organization.

That is a terrific job.

Now, it’s one of the best cancer center director jobs in academia for a lot of reasons, not the least of which is this terrific institution that has a great school of public health, a great basic science, a great clinical shop, and a large university where you’ve got a law school and a business school and an undergraduate college.

And they all collaborate together in cancer research, and really make this a formidable and wonderful matrix cancer center. And the state supports it.

So, there’s very generous support for the University of North Carolina Cancer Center through the thing called the University Cancer Research Fund, which is more than $50 million a year. That’s been, I don’t know, what are we in, like year 14, Shelley, or something like that?

SE: It’s actually probably 15.

NS: So, very considerable support from the state of North Carolina for cancer research.

So, it is a wonderful job.

And with Shelley stepping down, the dean has asked me to direct a national search to replace Shelley Earp—and the job I used to hold.

So, certainly something that’s very dear to both of our hearts, and I’m very excited to do that.

I think we should get a terrific crop of candidates, and hope to bring in the person who has a vision for this great matrix cancer center.

There’s a saying about the NCI cancer centers, Paul, that you’ve heard, which is if you’ve seen one cancer center, you’ve seen one cancer center.

They are all different. And all these jobs are quite different.

And as someone who’s visited the majority of the United States cancer centers, I can tell you what’s special about UNC is this tremendous state support.

It’s this great public university with all these capabilities and significant state support.

So, as opposed to other institutions where the cancer center director has to kind of find funds from the clinical service line or from development or these other pools—the cancer center at UNC does that, too—but in addition to that, it has this very strong and generous state support that doesn’t exist, except in a few places.

And it’s very collaborative, and it allows the cancer center to build across the school of public health, and the medical school, and the undergraduate university, and other parts of the university to create these dynamic programs with multiple parts.

And having some funding from the cancer center to do that is just crucial.

SE: And, Paul, it’s bi-directional.

What’s important is the reason this was instituted by the state legislature—and it’s been bipartisan. It was led by Democrats when it was actually voted on at the same time they voted to fund the cancer hospital at UNC. But it’s been bipartisan, and the Republicans have supported it just as much. 

It relies on the fact that we’re the state’s hospital and we take care of people regardless of their ability to pay.

And in order to do that so that everybody gets the same quality care, that state support has allowed us to develop research and innovations across this, and it serves the state.

So, there’s a lot of work that we’re doing with the Cancer Fund in statewide prevention. We have a remarkable database. We have the last 1 million cancer cases in the state of North Carolina in a database that are linked to claims data, not just Medicare, which everybody has, but Medicare, Medicaid, Blue Cross/Blue Shield, which is our primary employer and state employees’.

So, we can link everybody in the state who has cancer to claims and we can tell which counties have colon cancer deaths, and people did not get colonoscopy prior to that.

So, we can use that to develop prevention programs with the cancer fund across the state.

But you also are one of the cancer center directors who’ve been especially visionary on disparities. You jumped on that and really made it happen.

SE: Paul, that’s a wonderful piece of it.

One of the key things that ever happened in the history of the cancer center was, really, in the early 1990s, when we got together with a number of other people who were working on multidisciplinary care.

We put in for the breast cancer SPORE in the first round. We were not a household word in breast cancer at that time, but what we proposed, a lot of things sprung out of that, because we devised The Carolina Breast Cancer Study, which was this population-based study that was the one that showed that African American women had a higher rate of triple negative breast cancer.

That’s the original observation.

Everybody’s gone on to see that. But it flowed from that part of the SPORE. And the other part of the SPORE was called the North Carolina Breast Cancer Screening Program, where we did an actual five-county test of whether lay health advisors would be able to increase the rates of mammography in African American women.

Now, who led that?

SE: That was my wife.

It’s not that we weren’t interested in disparities, but she gave us not only the passion, but an imprimatur nationally to continue that work. And it’s flowed from that ever since.

NS: If I may, Paul, when I grew up at the University of North Carolina, under Shelley’s leadership, when I was junior faculty and then deputy director under him, and then actually cancer to director—while Shelley never moved from his office—so, in some ways, we were sort of co-directors for that period.

I want to be the first of many to thank Shelley for his work on behalf of cancer patients nationally and in the state of North Carolina and the wonderful work he’s done.

Norman E. Sharpless

I sort of marinated … I was a basic scientist and ran a lab. But I certainly saw the great things going on in health services research at UNC, and particularly the focus on cancer disparities, which is an important topic to the state of North Carolina, which has an Appalachian population in the west, has both the American Indian population and a Black and Hispanic population in the east, and certainly diverse SES in terms of socioeconomic status and education—and a great school of public health to study these topics.

And so, when I went to the National Cancer Institute, this felt very familiar.

The NCI has this strong focus that had been growing strongly for years before I got there, but, certainly, during the period I was there under Bob Croyle’s leadership to study cancer health disparities.

And it felt very familiar, because this is a topic that I think Shelley had identified a decade earlier and really focused on.

Another area like that also was Shelley’s focus on women in science.

I think he was really one of the first people to say that having successful women scientists is more than just-go-out-there-and-get-a-grant, guys.

I mean, you had to create a culture and environment that would support women, and would understand the challenges of women in science. And I think he was really an early adopter of spotting some of those problems and promoting women aggressively in science.

And that was, again, something that really came to the fore when I was at NCI, but felt very familiar, because Shelley had been doing that for decades.

SE: That certainly would be something that Ned and the search committee should be taking into account.

I mean, in the end, it’s a big job. It requires somebody with some good scientific skills, but much better interpersonal skills. And often those are found in women, I’ve found over my lifetime.

So, I think that that’s something that will be part and parcel of the decision making. It’s not my decision. In the end, it’s the decision of the dean of the School of Medicine. But the search committee, I think—and I’ll turn it over to Ned—will clearly concentrate on how we diversify leadership.

NS: As you know Paul, a search like this is governed by state law, and so any qualified candidate we will consider strongly, but I think this would be a great job to bring in some diversity in terms of leadership with regard to gender, race, ethnicity, or any of the other wonderful ways we can promote diversity within the institution.

I think at the NCI and FDA, I had a lot of luck hiring terrific women into wonderful jobs. Katrina Goddard, for example.

And I think that there are many qualified leaders in cancer research who are women or who are underrepresented minorities who would be great candidates for a role like this.

The cancer director job is changing. It’s gone under some evolution. And I think it used to be a bit more, particularly in the larger centers, focused on basic science. And because of the large complexity of running a large protocol office, the job has migrated a bit more clinical at most centers that are not basic science centers.

And for that reason, I think, we’ve seen an evolution in what kinds of candidates are running cancer centers. And it used to be more sort of hardcore basic scientists, and now we’re seeing more clinicians and the health service researchers and other types.

So, we would consider qualified candidates with a diversity of interests and a diversity of backgrounds as well as the other types of diversity I mentioned. It’s a great job. It’s the opportunity to build things across basic science, clinical health services, research, and a wonderful collaborative university. And I hope we will attract those sorts of candidates.

But as Shelley said, ultimately it is the dean’s decision, and I’ve told the dean that we will strive for a diverse candidate pool that will allow him to make the ideal selection.

SE: And Paul, I would say that this school, under the last two deans, Bill Roper, and now Wesley Burks, has done an excellent job at the chair level.

I think we’ve gone from one or two women chairs of our multiple departments to almost half of our chairs. Our executive dean is now a woman, and I was involved in searches last year at the university level for four deans of schools, and all four selected were women.

So, I think UNC, and its leadership who will make these decisions, is really doing a good job in that arena, finding great people that happen to have more diversity.

So, I’m hopeful in that way.

SE: “Simone’s Maxims”: When you’ve seen one cancer center and one university, you’ve seen one.

In 2025 we’ll be a 50-year cancer center. So far, we’ve had three directors.

So, I think longevity works in some places. It really depends upon, again, the interpersonal skills and the trust that one develops, and also the personal aspects.

I mean, Ned was a fantastic [director], and would’ve had a long run, because he was young when he started and he got plucked for something that, obviously, was great national service.

So, I wouldn’t say that we couldn’t have somebody that has a decade- or two-decade-long run. You’d have to start with somebody that’s a little bit younger. And so, I think that’s part of it, but I don’t think age is going to be the determination.

It would be good to think of somebody that’s going to be here for at least a decade.

Do you have any thoughts on this?

NS: We used to talk about this a lot when I was at NCI—about what would be the ideal thing you would want for the cancer centers.

And I think Shelley pointed out that because these jobs are so different, it’s really hard to say that there’s any one specific phenotype that works for all cancer centers that some places may have different needs from others.

But there’s certainly, I think, even now, today, while we talk a lot about the process of running a cancer center and the complexity of the job and the demands on a cancer center director, but having said that, there’s certainly still some really great jobs—running cancer centers nationally.

And I do suspect there will be individuals that stay in some of those jobs for a long time, that find these places that are great to work, and also where they feel fulfilled, and want to stay.

So, I don’t think the era of the two-decade cancer center directors is over, I think that we’ll continue to see that at certain places.

But as Shelley said, it’s both. There’s got to be the right kind of niche to foster a cancer center director who wants to stay for a long time. And then also that cancer center [director] can’t get plucked off to be a dean, or an NCI director, or some other job, which happens occasionally too.

But I think the skillset may be changing, as I alluded.

I think the protocol office of the clinical cancer centers is now so significant that understanding that is really a requirement for the job.

I think also in many cancer centers, population sciences and health service research is so large that having an understanding of that part of the shop is really important.

And then, of course, there are cancer centers that are very, very committed to molecular biology, basic science, and the director of those places might be more skewed to that end.

So, there’ll be a diversity of styles. And then, of course, there’s also the whole difference between the matrix cancer centers that are embedded in large universities and the freestanding cancer centers, where the job is quite different, and you are sort of the CEO of a hospital system at the same time.

So, I think the goal of the NCI was to remain flexible with a mechanism that their funding could work for all of those different approaches to integrated cancer research at various institutions.

In terms of transition, how much time will your successor have to prepare the next grant? I think you have qualified for a two-year extension.

SE: We’re going in for that, Paul.

And so, the reason for doing this this year rather than next year, which would’ve also been a possibility, is that this will give the new director three solid years to be in charge.

And then, kind of towards the end of that three-year period, to start writing the grant. So, we’re only in year three of what will hopefully be a seven-year grant. 

So, that’s one of the reasons for the timing, is that it is an interesting thing that the CCSG is so important in our minds and in our training as cancer center directors.

It’s a pretty small part of our budget, but it’s so important to us for bragging rights and for bringing people together that we decide to make the decision this year, so that we’ll have even a little bit more time.

But it is an interesting conundrum about how important the CCSG is with respect to how you feel about yourself and your cancer center versus the actual financial piece.

How long do you think it will take to run the search?

SE: I think we have one of the best administrators in the country doing that.

It would be good to have this done in six months, which is, I think, very doable. I just ran a search for the university for the Office of the Vice Chancellor of Research for the entire university, and I was able to get that search done in three-and-a-half months.

So, the idea that you need a year to run a search is just poppycock, frankly. People here want to be involved, and a job like this is such a good job that if candidates are serious, they will make themselves available for Zoom calls or for visits.

There’s no need to stretch this out.

I’ve been struggling with this. How does a cancer center function now, with the new political environment, the recent Supreme Court rulings? How does that fit into what UNC has in its DNA?

SE: I’ll start with that.

I’m on the NCI Board of Scientific Advisors, and we had a long discussion about this with Monica and everybody at the last couple of meetings.

And Ned, actually, certainly, knows about this.

The NCI and NIH have said that they have guidelines that they would like to see people take and use for helping to run their research organizations.

But they do understand that it has to be done in the context of state law, that the NIH cannot overrule state law.

The Supreme Court has ruled, with us and Harvard, to change the ability of the university to use affirmative action writ large in the selection of its undergraduates.

I think we’re all waiting to see whether that kind of decision gets broadened.

But even in that decision, there was a recognition that diversity of thought—and they may not have used that language—is important in many ways, and that people needed to construct language and guidelines that allowed this to happen without race being the number one criteria.

And so, when we look at disparities and underrepresented individuals in medicine, I think a lot of us have already shifted.

Obviously, there’s a deficit of African Americans at the highest level in universities, but there also is a need for looking at rural areas and people from lower socioeconomic status backgrounds.

So, I think broadening the criteria is certainly something that our university is grappling with in this year’s admission, because we really don’t want to see a lack of—and I’ll use the word “diversity”—across our undergraduate or our faculty.

So, I think we have to be realistic about law, but the law does not preclude us from really looking to take populations that can help us solve problems.

And DEI… Does [the ruling] affect that? Well, I think it’s interesting.

SE: There seem to be words that are particularly problematic politically. And I think “diversity” of thought and background, I don’t think is a problem. 

I think “equity” [and] “inclusion” seemed to be a little bit more of buzzwords. So, I think that diversity of thought that improves your institution, your company, your cancer center, is still important.

NS: I think, obviously, we wrestled with these topics extensively over the last decades, and particularly when I was at NCI, even before this ruling.

And I can tell you, I don’t think the ruling, in terms of running a cancer center, changed things that much.

I think we should get a terrific crop of candidates, and hope to bring in the person who has a vision for this great matrix cancer center.

Norman E. Sharpless

As you know, Paul, the first initiative, which the NIH-funded and NCI directed—and was really developed by Sanya Springfield and Dinah Singer and others at the NCI, working with other parts of the NIH, like the National Institute of Minority and Health Disparities, Eliseo Perez-Stable’s shop—I think that initiative is unchanged by this ruling that focused the language about what are the priorities of promoting diversity in the science workforce.

That language was extensively scoured by various levels of government lawyers and really the idea was to promote diversity of thought, as Shelley said.

And that’s a broad rubric that includes differences in background and ethnicity and race and gender and geographic part of the country and interest.

And so, I think that the promotion of diversity is uncontroversial and an unqualified good.

I think we all believe that an exciting, vibrant institution is not going to look monolithic in terms of its leadership and composition. So, that, I think, is still the case today, and I think is unchanged by the ruling.

I think explicit policies that targeted race or ethnicity won’t do well post the recent ruling, but actually weren’t something that we used in the state of North Carolina extensively prior to the ruling for activities related to faculty promotion and things like that that really affect the cancer center roles.

So, I think that in some ways, the job of the cancer center director to promote a culture that is vibrant and diverse and recognizes a variety of faculty efforts is unchanged and still something that you can do in a positive, meaningful way.

Along the lines of the goals of the first initiative, I do think that Shelley is correct that whether this affirmative action ruling, the Supreme Court ruling, had anything to do with this or not, I don’t know.

But there is, I would say, nationally, an appreciation that rurality in particular is a disparity that hasn’t gotten enough focus at the national level—that if you really look at the cancer statistics, there are parts of the country where cancer mortality is not improving, where the gap between urban and rural populations is yawning and growing worse.

And that topic perhaps didn’t get enough focus over the last few years, as that gap kind of worsened and worsened. It was really Bob Croyle, and Sanya Springfield, and others that sort of brought this to the NCI’s attention as well as the NIH’s, and certainly led to this focus on, for example, regions of persistent poverty, where there’s been low socio-significant status in a significant population part of the county for decades.

And the cancer outcomes, as you can imagine in those areas, are really poor.

And so, I don’t know that that had anything to do with the Supreme Court ruling, but that is a new area of focus today that I think is good.

If we’re going to make progress in this country in terms of cancer mortality, we have to make progress for all patients, even those that live in areas with low access and low SES, and these sort of structural barriers to good care.

So, I think that there is some evolution in terms of what we’re thinking about at academic centers in terms of what does diversity look like? What does it mean to create an inclusive workforce? What should be the goals of care in terms of promoting equality of outcome?

But I think the day-to-day job of a cancer center director, particularly at a public university cancer center like the University of North Carolina, really hasn’t changed that much.

I think what was a good idea five years ago remains a good idea today in terms of promoting a diverse workforce.

I’m glad to hear that both of you see it this way. I guess one question, a really crucial question, is, Shelley, what are you going to do next? What’s the next chapter?

SE: So, one, I just got a five-year R01, and I have an active lab in a fascinating area.

I, like many other people, am struggling to become a card-carrying immunologist, because that’s how we cure cancer.

So, my lab focuses on some genes that we cloned that actually have, potentially, an effect in the tumor microenvironment. So that’s a big part of it.

So, Paul, we’ve recruited 93 people over the last three and a half years. And when you’re recruiting, you get very close to people and you try to convince them to come here and you’re going to take care of them, and then you go on to the next year’s recruitment.

I feel like I have a lot of meetings to do with the people that I’ve recruited and to try to help them feel like I’m there for them in mentoring. 

So, I think I’ll have a lot more time rather than answering emails all the time to actually talk to junior faculty and help create the kinds of interdisciplinary types of things that we do well, but we can always do better.

And then I’m pretty sure I’m the only cancer center director that actually has experience in stepping down and helping the new director.

I’ve been trained by Nancy Davidson, who is head of our external advisory board, on how to sit in the back of the room and be quiet. But I will hopefully be helpful to the next person.

It’s a complicated university, and so I’ll be around. I’m not going anywhere.

Well, does it mean you’ll be in the same office? You did not move out when Ned was the director.

SE: I think that will be up to the next director. They may want that for a while, or they may say, “Shelley, get closer to your lab.”

We’ll let them decide that.

That’s fantastic. Is there anything I forgot to ask?

NS: Let me reiterate, before Shelley answers, that Shelley’s been a terrific leader for the University of North Carolina for decades in these multiple roles.

And he’s built this wonderful organization, and the University of North Carolina and the state of North Carolina, and cancer patients nationally owe this real debt to the great research he’s led and the teams he’s led.

And so, I want to be the first of many to thank Shelley for his work on behalf of cancer patients nationally in the state of North Carolina and the wonderful work he’s done.

SE: Paul, the only thing I would emphasize—I came here in 1966, to the School of Medicine, and became imbued with our desire and ability to be the state’s hospital.

I’ve grown up under that, and I’ve tried to use that. 

I had the great good fortune to get drafted. And the only reason why that was good fortune was because one, I didn’t have to go to Vietnam. I had a lab in the army.

And, secondly, I met my wife and started that 50-year journey. We came back here. We’ve been so lucky. We would tell each other that all the time. But I just want to emphasize that to the extent that I’ve been successful, it’s been because of this wonderful partnership I had with Jo Anne.

I understand that. Well, thank you very much for talking with me.

SE: Well, Paul, we always appreciate The Cancer Letter, and in many ways I think we’ve managed to stay out of certain aspects.