Yearly Archives: 2018

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Photo from Suffolk County Police Department

Suffolk County Crime Stoppers and Suffolk County police 6th Precinct crime section officers are seeking the public’s help to identify and locate the man who allegedly stole liquor from a Selden store last month.

A man allegedly stole a bottle of Don Julio 1942 Tequila from Ace Liquors, located at 359 Independence Plaza, Nov. 13 at approximately 6:30 p.m. The tequila was valued at approximately $150.

Suffolk County Crime Stoppers offers a cash reward of up to $5,000 for information that leads to an arrest. Anyone with information about these incidents can contact Suffolk County Crime Stoppers to submit an anonymous tip by calling 1-800-220-TIPS, texting “SCPD” and your message to “CRIMES” (274637) or by email at www.tipsubmit.com. All calls, text messages and emails will be kept confidential.

New York City Ballet’s Brittany Pollack and Daniel Ulbricht are this year’s special guests. Photo courtesy of New York Dance Theatre

New York Dance Theatre, under the direction of former New York City Ballet soloist Frank Ohman, will present its 37th season of “The Nutcracker” at Hofstra University, 1000 Hempstead Turnpike, Hempstead, on Saturday, Dec. 15 and Sunday, Dec. 16 with performances each day at noon and 5 p.m. 

Special guest artists Daniel Ulbricht and Brittany Pollack of New York City Ballet return to perform as the Sugarplum Fairy and her Cavalier.   

Over the years, Frank Ohman has created original dances and scenes that have been incorporated into the ballet, but as a former student and soloist under George Balanchine he is one of a select few authorized to use the original pas de deux choreography of his mentor. Ohman will continue his tradition of playing the role of the grandfather in the party scene that opens the ballet.

The role of Clara’s mysterious godfather Herr Drosselmeier will be played by former New York City Ballet soloist Robert Maiorano.   

With the elegant Christmas party scene, the drama of the magical growing Christmas Tree, the Battle of the Toy Soldiers and Giant Mice, the live Snow Storm and the brilliant dancing in the Land of the Sweets, “The Nutcracker” appeals to all ages.

In all, a cast of 80 children, preprofessional and professional dancers will bring this classic story ballet to life on the stage of the university’s John Cranford Adams Playhouse. The children’s roles are performed by students of the Frank Ohman School of Ballet in Commack, representing a variety of towns in Nassau and Suffolk counties.

Tickets for this full production ballet are $42 adults, $32 seniors and children 12 and under. To order, visit  www.ohmanballet.org or call 631-462-0964. 

A bypass trust was designed to prevent the estate of the surviving spouse from having to pay estate tax. Stock photo

By Nancy Burner, Esq.

Nancy Burner, Esq.

For a traditional married couple, the estate planning has become simpler in many ways. Before the estate tax was increased on both the state and federal level, we were fixated on saving estate taxes. Simple techniques like bypass and marital trusts and insurance trusts called ILITs were the gold standard in estate planning. Today many of those types of plans are irrelevant and maybe even harmful in an estate plan.

Bypass trusts are trusts created in the estate of the first spouse to die. So, for example, if a husband died when the exemption was $1.0, his will left $1.0 million in his bypass trust to protect his exemption (the amount he could pass to a nonspouse tax free) and then the balance would be distributed to his surviving spouse tax free. The idea was that when the second spouse died, she would have her own exemption and the monies in the bypass trust would pass tax free to the next generation.

If the exemption was $1.0 (or more) when the survivor died, then both the bypass trust amount and the exemption amount when the second spouse died would escape estate taxation. This is the most common type of estate plan that was utilized in the last 25 years and many clients still have these documents in place. In instances where the first spouse has died, there still exists a bypass trust for the benefit of the surviving spouse. For those couples with these types of estate plan but with assets under $5.25 million, it’s not too late to change them.

But, what if one spouse has died and the surviving spouse is still alive with assets in a bypass trust. Is there more planning to be done?   

Assume a couple in 2000 with $1.8 million worth of assets. Husband died and $1.0 million was payable to the bypass trust under his will for the benefit of his wife. According to the terms of the trust: (1) she can have all the income, (2) she is entitled to distributions for her health, education and support, and (3) a trustee can distribution all the trust assets to her for any purpose, even if the trust is depleted. The purpose of this trust was clearly to shield the first million of the estate from estate taxes when the surviving spouse later died but gave the trustee the power to make unlimited distributions to the spouse.

Now also assume the wife has, in the intervening years, protected her own $800,000 from the cost of long-term care by placing those assets into an irrevocable trust. In the meantime, the bypass trust has grown to $1.6 million dollars. There are two glaring problems: Capital gains tax and cost of long-term care.

When the surviving spouse dies, the assets in her irrevocable trust will be counted as part of her taxable estate. If she dies this year, she will have a New York state estate tax exemption of $5.25 million (increasing to $5.49 million in 2019) and her federal exemption is $11.18 million. Clearly, she does not have a taxable estate. Her assets will pass tax free to the next generation. However, the assets in the bypass trust will have a capital gains tax for any growth in principal.

Assuming the capital gain of $600,000 and a capital gain rate of 33 percent, there could be a capital gains tax of just under $200,000. If the bypass trust assets were not in the trust, but in the surviving spouse’s estate, there would be no estate tax and no capital gains tax. In this case, assuming no other facts, it would be best to distribute the assets to the surviving spouse and allow the assets to obtain a “step-up in basis at her death.”

The second problem with the bypass trust is that the broad distribution rights under the trust makes those trust assets available to pay for the spouse’s long-term care. She has protected her own assets, but likely the $1.6 million is available to be spent down. In this case, if the trustee were to distribute the trust assets to the surviving spouse, she could add those assets to her irrevocable grantor trust. She would enjoy the income in the trust, her estate (i.e., her heirs) would get a step-up in basis on her death, and the assets could be shielded for the cost of nursing home care or catastrophic illness after five years.

This same scenario applies in the case of insurance trusts that were created during the life of the first spouse to die. The trust was likely intended to shield the surviving spouse’s estate from estate taxes, but the increased exemptions make the insurance trust unnecessary. There is an income tax return due each year that is a burden in both time and money. There is no step-up in basis at the death of the surviving spouse, and the assets are probably not protected from the cost of long-term care.

While the trusts in this example give the trustee wide latitude in distributing trust assets to spouses, not all trusts are the same. If the trustee does not have the power to distribute outright to the spouse, there may be an alternative way to accomplish these objectives. New York state has a very generous decanting statute that may be utilized to “fix” the trust. It may not be too late.

Nancy Burner, Esq. practices elder law and estate planning from her East Setauket office.

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A photo of a partly destroyed French church was taken by Lt. Marco C. Smith Jr. in 1918. Photo from the Smith family

By Beverly C. Tyler

On Nov. 15, 1918, Lt. Marco Carmelich Smith Jr. wrote to his grandmother Eliza Tyler from France: “To say the least, one can live somewhat in peace, now that the Armistice is signed. Beforehand we had had rumors of one but as old Lame Rumor is always present we passed it off as such until the official notice came. We all had our watches out at 11 a.m. on [Nov.] 11th and it was very noticeable that cannon that had been thundering away all morning ceased firing exactly on the hour. So now, as I say, we can live in peace. No more gas masks or helmets, and at night we can have all the light we want.”

A 1918 photo of Marco C. Smith in uniform. Photo from the Smith family

Smith was born Oct. 2, 1886, at his father’s family home, called Fairholme, which was built circa 1824 and expanded circa 1860, in what is now the Village of Old Field. His great-great-grandfather, Walter Smith, a descendant of one of Setauket’s original settlers, Arthur Smith, was the Old Field Point Lighthouse keeper from 1827 to 1830. Marco Smith’s father, the first Marco C. Smith married Mary Amelia Tyler, daughter of Charles and Eliza Tyler, this writer’s great-grandfather and great-grandmother.

Marco Smith Jr. enlisted in the U.S. Army July 8, 1918, and was commissioned as 1st Lt. of Engineers, Company F, 2nd Battalion, 22nd Engineers. He was first assigned to Fort Benjamin Harrison, near Indianapolis, Indiana, and then transferred to Camp Merritt in Bergen County, New Jersey, where troops boarded ships on their way to the war in Europe.

Smith was on leave briefly July 28, when he married in Mamaroneck, Marjorie Aldrich, daughter of Capt. Clarence Aldrich and Irene Hand of East Setauket. According to a newspaper clipping, “Military orders hastened the ceremony, and the groom is now supposed to be on his way to France.”

Smith sailed for France July 31. He was assigned to the 1st Army Aug. 28, as an engineer on light railway construction for the Meuse-Argonne Offensive until the end of the war Nov. 11. He spent most of his time in the area around the village of Montigny-sur-Meuse and continued to be stationed there until March 3, 1919.

On Dec. 16, 1918, Smith wrote: “My dear Grandma, Here it is past the middle of the month and I haven’t started my usual monthly letter to you so here goes for this evening.”

Smith noted that the mail was arriving more regularly since the Armistice and that he had just received a letter from his grandmother written Oct. 18 as well as one written by his mother and dad Nov. 27. He continued the letter: “Sometimes I marvel that I am not sick as we sure are subjected to some pretty severe conditions at times. One night I just slept on the wet ground in a pouring rain and felt fine the next day. … We are very historically located too being near to Dun [Dun-sur-Meuse], Stenay and Sedan. This was sure some hard earned ground as everywhere are evidences of many battles. I believe the part where we were tho’ is about as bad as any. We sure thought so at the time. … Lord, when you see some of the shells old ‘Fritz’ uses to amuse us with, it’s no wonder we were “alarmed” at times. But after all, most of my feelings go to the poor French people who are slowly returning to their destroyed homes. … How they are going to make a go of it this winter is beyond me. … and the tales they tell of the hardships endured while prisoners. They are barely believable. I cannot write of them; they are too sad. Loads & loads & loads of love for yourself and everyone, Your loving grandson Marco — Merry Christmas and Happy New Year.”

Marco C. Smith and his wife Marjorie in an undated photo. Photo from the Smith family

In his Jan. 22, 1919, letter, Smith writes: “Just now we are trying to arrange for some pleasure trips for the men. They have been my faithful workers ever since the drive began on Sept. 26th. And it has been rather tiresome and tedious to them to have seen nothing but shell torn areas since that date. The trip we are planning for them is to Sedan which is only about 25 miles from here.”

The three villages mentioned by Smith — Dun-sur-Meuse, Stenay and Sedan — are between 29 and 40 kilometers northeast of Verdun, site of the longest lasting battle of World War I. During 1916, there were more than 300,000 French and German casualties there.

Smith was reassigned to the engineers office, District of Paris, from March 10 to June 3, 1919. He returned from overseas July 11 and was discharged July 31, 1919. On Feb. 21, 1920, he was commissioned a captain in the Engineer Reserve Corps. He returned home to his wife Marjorie, with a house in Brooklyn and a job in Manhattan as an engineer with the New York Central Railroad. According to family information, Smith and his wife maintained the house in Old Field as a summer home until four months after their first child, Marco C. Smith III, was born April 25, 1927. Smith became a trustee of the Village of Old Field when it was incorporated in 1927, and he also served the village as mayor. The couple’s second and last child, Judith, was born Aug. 9, 1932. Marjorie died in 1953 and Smith died July 8, 1961.

The three letters Smith wrote to his grandmother Eliza, written between Nov. 15, 1918, and Jan. 22, 1919, and copies of the photographs he took in France will now be a part of the Three Village Historical Society archival collection.

Beverly C. Tyler is Three Village Historical Society historian and author of books available from the society at 93 North Country Road, Setauket. For more information, call 631-751-3730 or visit www.tvhs.org.

A common grackle collects mud from the banks of the Swan River in East Patchogue to use to build its nest. Photo by Luke Ormand

By John Turner

As the famous philosopher Yogi Berra once said, “You can observe a lot by just watching,” and between the passage of the 2,018 common nighthawks we tallied over the 41 days of the 2018 season at the Stone Bridge Nighthawk Watch, we had plenty of time to watch and observe.

One of those observations involved the daily movement of large mixed-blackbird flocks, flying north each evening, their destination being the communal nightly roost they established in the reed (Phragmites) beds at the southern edge of Conscience Bay, just north of the Grist Mill in Frank Melville Memorial Park in Setauket.

Joined by European starlings, red-winged blackbirds and brown-headed cowbirds, the flocks, numerically dominated by common grackles, would stream over us at the Stone Bridge and then, as they passed over the northern bridge at the northern end of the pond, descend abruptly to land on the narrow and slightly arching stalks of the Phragmites.

Their predictable movement each night of the Nighthawk Watch reminded me of another characterization, this one by the famous scientist Rachel Carson, who described the regular movement of birds such as these blackbird flocks as “faithful commuters” in the sky.

As they flew over us, the members of the flock vocalized continuously with quick sharp calls and we wondered why they might do that. One answer for the continuous calling may be a way for a bird in a flock to let neighboring birds — in front, behind and to the sides — know of its presence, helping to maintain a buffer between the birds, thereby reducing the chance of collisions.

Maintaining this space is vital given the fact the several dozen to several hundred members of the blackbird flock are moving through the sky together, at 20-30 miles per hour, separated by mere inches. Makes you wish drivers on the Long Island Expressway were so talented, no?

One evening recently my wife Georgia and I walked to the north bridge to watch the blackbirds spill from the sky into the reeds. They descended into the marsh on both sides of the meandering tidal creek that flows from the spillway at the bridge. A constant cacophony of squeaks (one call sounds like a rusty gate opening), rasps and whistles filled the air as the birds called incessantly. Having landed, the grackles and other blackbird species must now be vocalizing for a different reason, but frankly we have no idea.

Scientists conjecture that crows murmuring together at the end of a day in a winter communal roost do so to exchange information about the day they just experienced, such as what predators they encountered and food sources discovered. Could this be at least a partial answer to explain the thousands of garrulous grackles vocalizing into early evening, as they settle in to sleep for the night in the marshes of Frank Melville Park? Could there be other reasons? Maybe, but we just don’t know.

I often encounter grackles in different settings, as evidenced by a recent walk in the county park just north of the Sherwood-Jayne House. Heading up the west side of the property, I came to an opening in the forest where a small flock of 20 to 25 grackles was feeding on the ground. They systematically flipped over leaves, pieces of bark and other woodland debris searching with their beautiful golden-yellow, black-centered eye, for food which for them consists of a variety of small insects, other invertebrates like slugs and worms, caterpillars, small salamanders and fruits and seeds, which collectively make up their omnivorous lifestyle.    

If you are an astute observer of grackles you might notice that adult birds vary in their coloration. Not surprisingly, males are showier than the females, their plumage infused with a purplish iridescence. But you might occasionally see, especially during the colder months, individual grackles tending to have more of a bronzy-colored tint to their feathers, rather than purple. The latter bird is referred to as the “bronzed grackle” while the former is the “purple grackle.” For many years they were considered different species but are now recognized for what they are — interbreeding color morphs of the same species.   

If you leave the friendly confines of the Three Village area and travel to the Island’s South Shore, you might encounter another grackle species native to Long Island — the boat-tailed grackle. This larger species, a breeder amid the salt marshes of the South Shore bays, gets its name from the keel shape tail tip of the bird, quite visible when a male flies directly away from you.

Want to experience grackles and their blackbird brethren closer to home though? Just head to the bridge next to the Grist Mill in Frank Melville Park (www.frankmelvillepark.org) as dusk descends on an autumn day and face north toward the dense phalanx of reeds. If your senses aren’t overloaded by the sound and movement, perhaps you can figure out what the birds are saying to each other.

John Turner, a Setauket resident, is conservation chair of the Four Harbors Audubon Society, author of “Exploring the Other Island: A Seasonal Nature Guide to Long Island” and president of Alula Birding & Natural History Tours.

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Cast call

Theatre Three, 412 Main St., Port Jefferson will hold open auditions for “The Miracle Worker” on Thursday, Nov. 29 at 7 p.m. and Sunday, Dec. 2 at 10 a.m. All roles open. Readings will be from the script. Please bring picture/resume. Read-through will be held Feb. 28 with full rehearsals beginning on March 2. Performances will be held from April 6 to 28. For further information and full details, call 631-928-9202 or visit http:theatrethree.com/auditions.html.

The decision to take a statin is an important one. Stock photo
Fatigue and cataracts are downsides

By David Dunaief, M.D.

Dr. David Dunaief

Statins are one of the most commonly prescribed medications in the United States. Yet, some in the medical community believe that more patients should be on this class of drugs while others think it is one of the most overprescribed medications. Suffice to say, this is one of the most polarizing topics in medicine — probably rightfully so.

The debate is over primary prevention with statins. Primary prevention is treating people with high cholesterol and/or inflammation who may be at risk for a cardiovascular event, such as a stroke or heart attack.

Fortunately, most physicians would agree that statins have their place in secondary prevention — treating patients who have had a stroke or heart attack already or have coronary artery disease.

We are going to look at benefits and risks for the patient population that could take statins for primary prevention. On one side, we have the statin as Rocky Balboa, coming out to fight off cancer risk, both overall and esophageal, as well as improving quality of life and glaucoma. On the other, we have the statin as Evel Knievel, demonstrating that reckless heroics don’t provide longevity, but they do increase diabetes risk, promote fatigue and increase cataracts. Let’s look at some of the evidence.

Effect on cancer

A study published in The New England Journal of Medicine involved 300,000 Danish participants and investigated 13 cancers. It showed that statin users may have a 15 percent decreased risk of death from cancer (1). This is exciting news.

However, there were major limitations with the study. First, the researchers did not control for smoking, which we know is a large contributor to cancer. Second, it was unknown which of the statin-using population might have received conventional cancer treatments, such as radiation and chemotherapy. Third, the dose of statins did not correlate to risk reduction. In fact, those who took 1 to 75 percent of prescribed statin levels showed more benefit in terms of cancer mortality risk than those who took more. We need a better-designed trial that is prospective (forward looking) to determine whether there really is an effect. I would say that Rocky Balboa came out of this fight pretty banged up.

Another study showed that statins may play a role in reducing the risk of esophageal cancer. This is important, since esophageal cancer, especially adenocarcinoma that develops from Barrett’s esophagus, is on the rise. The results showed a 28 percent risk reduction in this type of cancer. The authors of the study surmise that statins may have a protective effect. This was a meta-analysis of 13 observational studies (2).

Although there is an association, these results need to be confirmed with randomized controlled trials. Remember, aspirin has about the same 30 percent reduction in colorectal cancer, yet is not recommended solely for this use because of side effects.

Eye diseases: mixed results

In two common eye diseases, glaucoma and cataracts, statins have vastly different results. In one study, statins were shown to decrease the risk of glaucoma by 5 percent over one year and 9 percent over two years (3). It is encouraging that the longer the duration of statin use, the greater the positive effect on preventing glaucoma.

Statins also help to slow glaucoma progression in patients suspected of having early-stage disease at about the same rate. This was a retrospective (backward-looking or looking in the past) study analyzing statin use with patients at risk for open-angle glaucoma. There is a need for prospective (forward-looking) studies. With cataracts, it is a completely different story. Statins increase the risk of cataracts by over 50 percent, as shown in the Waterloo Eye Study (4). Statins exacerbate the risk of cataracts in an already high-risk group: diabetes patients.

Quality of life and longevity: a mixed bag

In a meta-analysis involving 11 randomized controlled trials, considered the gold standard of studies, statins did not reduce the risk of all-cause mortality in moderate to high-risk primary prevention participants (5). This study analysis involved over 65,000 participants with high cholesterol and at significant risk for heart disease.

However, in this same study, participants at high risk of coronary heart disease saw a substantial improvement in their quality of life with statins. In other words, the risk of a nonfatal heart attack was reduced by more than half and nonfatal strokes by almost half, avoiding the potentially disabling effects of these cardiovascular events.

Fatigue effect

Some of my patients who are on statins ask if statins can cause fatigue. A randomized controlled trial published in the Archives of Internal Medicine reinforces the idea that statins increase the possibility of fatigue (6).

Women, especially, complained of lower energy levels, both overall and on exertion, when they were blindly assigned to a statin-taking group. The trial was composed of three groups: two that took statins, simvastatin 20 mg and pravastatin 40 mg; and a placebo group. The participants were at least 20 years old and had LDL (bad) cholesterol of 115 to 190 mg/dl, with less than 100 mg/dl considered ideal.

In conclusion, some individuals who are at high risk for cardiovascular disease may need a statin, but with the evidence presented, it is more likely that statins are overprescribed in primary prevention. Evidence of the best results points to lifestyle modification, with or without statins, and all patients with elevated LDL (bad) cholesterol should make changes that include a nutrient-dense diet and a reduction in fat intake, as well as exercise.

References:

(1) N Engl J Med 2012;367:1792-1802. (2) Clin Gastroenterol Hepatol. 2013 Jun; 11(6):620–629. (3) Ophthalmology 2012;119(10):2074-2081. (4) Optom Vis Sci 2012;89:1165-1171. (5) Arch Intern Med 2010;170(12):1024-1031. (6) Arch Intern Med 2012;172(15):1180-1182.

Dr. Dunaief is a speaker, author and local lifestyle medicine physician focusing on the integration of medicine, nutrition, fitness and stress management. For further information, visit www.medicalcompassmd.com or consult your personal physician.

The threat of rain may have dampened activities, but hundreds bundled up to watch the 9th annual Huntington Holiday Parade Nov. 24.

Huntington Town officials called off the afternoon festivities as weather forecasters predicted a freezing rain would start sometime in the afternoon. Supervisor Chad Lupinacci (R) decreed the parade would happen, rain or shine.

Luckily umbrellas were not needed as highly decorated floats and parade marchers proceeded from the Big H Shopping Center on New York Avenue to Main Street, winding its way along West Neck Road, east on Gerard Street before ending on Wall Street for the annual tree lighting.  The most anticipate, at least by children, were Santa Claus and Mrs. Claus who arrived in Huntington Village at the end of the parade.

Click through the photos above to see the photos from the festive performance and parade. 

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I may be conflating two holidays, but this year, I’m thankful for love. Yes, I recognize that Valentine’s Day is a few months away.

I’m not just talking about romantic love between two people who laugh, plan and enjoy building a life together while dealing with the inevitable chaos and curveballs.

No, I’m talking about the kind of love that makes a cold, wet day manageable. We recently added a puppy to our home. We brought this new furry creature into our lives because we were moving and it seemed liked a way to add something to our house that would be ours in a new setting.

It also seemed to be a way to enhance our ability to socialize with our neighbors. Who, after all, can resist a cute puppy bounding down the street? Well, as it turns out, almost everyone, particularly on unexpectedly cooler days in a city that was supposed to be much warmer. Sure, people wave through their gloves and smile behind the wheel, but no one has stopped to ask if he or she can pet the little fella. No one has asked his age, his name or where we got him.

But, hey, this isn’t about love for our neighbors, although I suspect over time we may come to love the distance we have from everyone or, on the bright side, a friendship that may seem inevitable after we meet other people eager to connect with those living nearby.

No, this is about that moment when I open the door to the puppy’s room and he greets me with a tail moving so quickly that it could generate enough electricity to power the house for the day.

As we and our kids get older, the excitement at greeting each other after absences, even for a few hours or a day, left the arena of unbridled joy. Sure, we’re delighted to see each other, but the squeal with delight moments have morphed into understated greetings and subtle head nods that don’t displace carefully coiffed hair.

We can also love the moments our senses pick up a familiar signal. That could be the scent of a pumpkin pie wafting across the living room, sending us back to our childhood when we visited with extended family that has long ago moved away. It could be the sound of our children practicing an instrument with such dexterity that the end of the composition brings both pride and sadness as the intricate sound has given way to silence.

It could also be an appreciation for a warm, crackling fire late on a cold day as the winter sunset turns the light outside a deep orange, contrasting with the yellow hue near the sizzling logs.

This is also the incredible season of anticipation, as we love the prospect of seeing people we haven’t seen in person in weeks, months or years. We can love the expectation of seeing their faces, sharing stories, taking long walks on quiet roads or windy beaches, as we tell tales about everything from the miraculous to the mundane in intersecting lives interrupted by time and distance.

As well, we can love the gift of time with each other, on our own or without particular commitment.

Then again, we can love a positive result at work, if we’ve sold the unsellable property, finally checked something off a to-do list that seemed to be festering forever, or found some unexpected result in a lab that may one day lead to a treatment for an insidious or life-depriving disease.

We are a thinking species, which ruminates over the past, contemplates the present and ponders the future. We are also blessed with the power of love, as Huey Lewis and the News sang in 1985. It’s still a powerful thing, even 33 years later.

Photo by Ela Elyada

By Daniel Dunaief

What if, instead of defeating or removing enemy soldiers from the battlefield, a leader could convince them to join the fight, sending them back out to defeat the side they previously supported? That’s the question Giulia Biffi, a postdoctoral researcher at Cold Spring Harbor Laboratory, is asking about a particular type of cells, called fibroblasts, that are involved in pancreatic cancer.

Fibroblasts activated by cancer cells secrete a matrix that surrounds cancer cells and makes up about 90 percent of pancreatic tumors.

Giulia Biffi. Photo by ©Gina Motisi, 2018/CSHL

Responding to a molecule called IL-1, an inflammatory potential tumor-promoting fibroblast may enhance the opportunity for cancer to grow and spread. Another type of fibroblast responds to TGF-beta, which potentially enables them to restrain tumors.

Researchers had suggested that the inflammatory fibroblasts are tumor promoting, while the myofibroblasts are tumor defeating, although at this point, that still hasn’t been confirmed experimentally.

Researchers knew TGF-beta was important in biology, but they didn’t know that it was involved in preventing the activation of an inflammatory tumor-promoting version.

Biffi, however, recently found that IL-1 promotes the formation of inflammatory fibroblasts. She believes these fibroblast promote tumor growth and create an immunosuppressive environment.

In an article published in the journal Cancer Discovery, Biffi showed that it’s “not only possible to delete the population, but it’s also possible to convert [the fibroblasts] into the other type, which could be more beneficial than just getting rid of the tumor-promoting cells,” she said.

Biffi works in Director Dave Tuveson’s CSHL Cancer Center laboratory, which is approaching pancreatic cancer from numerous perspectives.

Her doctoral adviser, Sir Shankar Balasubramanian, the Herchel Smith Professor of Medicinal Chemistry at the University of Cambridge, suggested that the work she did in Tuveson’s lab is an extension of her successful research in England.

“It is evident that [Biffi] is continuing to make penetrating and important advances with a deep and sophisticated approach to research,” Balasubramanian explained in an email. “She is without a doubt a scientist to watch out for in the future.”

To be sure, at this stage, Biffi has performed her studies on a mouse model of the disease and she and others studying fibroblasts and the tumor microenvironment that dictates specific molecular pathways have considerable work to do to extend this research to human treatment.

She doesn’t have similar information from human patients, but the mouse models show that targeting some subsets of fibroblasts impairs cancer growth.

“One of the goals we have is trying to be able to better classify the stroma from pancreatic cancer in humans,” Biffi said. The stroma is mixed in with the cancer cells, all around and in between clusters of cells.

The results with mice, however, suggest that approaching cancer by understanding the molecular signals from fibroblasts could offer a promising additional resource to a future treatment. In a 10-day study of mice using a specific inhibitor involved in the pathway of inflammatory fibroblasts, Biffi saw a reduction in tumor growth.

If Biffi can figure out a way to affect the signals produced by fibroblasts, she might be able to make the stroma and the cancer cells more accessible to drugs. One potential reason other drugs failed in mouse models is that there’s increased collagen, which is a barrier to drug delivery. Drugs that might have failed in earlier clinical efforts could be reevaluated in combination with other treatments, Biffi suggested, adding if scientists can manage to target the inflammatory path, they might mitigate some of this effect.

A native of Bergamo, Italy, which is near Milan, Biffi earned her doctorate at the Cancer Research UK Cambridge Institute. Biffi lives on a Cold Spring Harbor property which is five minutes from the lab.

When she was young, Biffi wanted to be a vet. In high school, she was fascinated by the study of animal behavior and considered Dian Fossey from “Gorillas in the Mist” an inspiration. When she’s not working in the lab, she enjoys the opportunity to see Broadway shows and to hike around a trail on the Cold Spring Harbor campus.

Biffi started working on fibroblasts three years ago in Tuveson’s lab. “I really wanted to understand how fibroblasts become one population or the other when they were starting from the same cell type,” she said. “If they have different functions, I wanted to target them selectively to understand their role in pancreatic cancer to see if one might have a tumor restraining role.”

A postdoctoral researcher for over four years, Biffi is starting to look for the next step in her career and hopes to have her own lab by the end of 2019 or the beginning of 2020.

When she was transitioning from her doctoral to a postdoctoral job, she was looking for someone who shared her idealistic view about curing cancer. Several other researchers in Cambridge suggested that she’d find a welcome research setting in Tuveson’s lab. Tuveson was “popular” among principal investigators in her institute, Biffi said. “I wanted to work on a hard cancer to treat and I wanted to work with [Tuveson].”

Biffi hopes that targeting the inflammatory pro-tumorigenic fibroblasts and reprogramming them to the potentially tumor-restraining population may become a part of a pancreatic cancer treatment.

She remains optimistic that she and others will make a difference. “This can be a frustrating job,” she said. “If you didn’t have hope you can change things, you wouldn’t do it. “I’m optimistic.”

Biffi points to the hard work that led to treatments for the flu and for AIDS. “Years back, both diseases were lethal and now therapeutic advances made them manageable,” she explained in an email. “That is where I want to go with pancreatic cancer.”