The Bernard Sachs Award honors an outstanding teacher and scholar of international status who has conducted leading research in neuroscience with relevance to the care of children with neurological disorders, an apt description of this year’s recipient of this prestigious award, Dr. Scott Pomeroy. A highly effective teacher, scholar, administrator, and leader within the field of child neurology, his primary focus is the field of pediatric neuro-oncology.
Scott entered the world in Cincinnati, where he spent his childhood and adolescence. His grandfather was a civil engineer; his father a chemical engineer; his first brother a mechanical engineer; and his second brother an industrial engineer. Born into such a solid family of engineers, one might have thought that Scott’s destiny would be engineering as well. But young Scott’s interest was biology, and he recognized in himself, early on, a passion for human interaction and desire to help people. Thus, by the time he was in high school, he had set himself on a course toward the “human engineering” of medicine.
Throughout his high school and college days, Scott volunteered at the Cincinnati Children’s Hospital, where, thirsty for knowledge, he went on rounds with the great developmental pediatrician, Dr. Jack Rubenstein, and one of the founders of the field of teratology, Dr. Josef Warkany. These pediatric luminaries exposed Scott to the world of neurodevelopmental disorders and propelled him toward a career in child neurology.
Scott’s formal education included college at Miami University of Ohio, an MD-PhD from the University of Cincinnati, Pediatrics residency at Boston Children’s Hospital, Child Neurology residency at St. Louis Children’s Hospital, and a postdoctoral fellowship at Washington University School of Medicine. In the course of this education, he encountered three special mentors whose lessons shaped his thoughts and career forever.
The first of these influential mentors was Dr. David Nathan, a giant figure in the field of pediatric hematology-oncology at Boston Children’s Hospital. As a pediatric resident, Dr. Pomeroy spent much time with this mentor, who inspired in Scott the perspective that science, conducted at a high level, could truly solve medical problems and that a practicing physician can find synergy by bringing research and clinical practice together. Dr. Pomeroy applied these lessons throughout his career as he focused his laboratory skills and his clinical efforts jointly on the target of neuro-oncology.
His second important mentor was Dr. Phillip Dodge, Chief of Pediatrics at St. Louis Children’s Hospital and namesake to the CNS Young Investigator Award, which Dr. Pomeroy would later win (1989). For Scott, Dr. Dodge was the consummate role model, as he demonstrated how to be both a compassionate physician and an effective leader. Phil taught the value of addressing with humanism not just neurologic issues, but all aspects of a patient’s life. Further, Phil showed that a physician leader can make the greatest strides by focusing not just on one’s own career, but on the careers of those he or she leads. Dr. Pomeroy would later enact these lessons in humanism and leadership with his own patients and as Chairman and Neurologist-in-Chief at Boston Children’s Hospital.
Dr. Pomeroy’s third important mentor was Dr. Dale Purves – a highly influential pioneer in the field of developmental neurobiology and Scott’s postdoctoral mentor at Washington University in St. Louis. From Professor Purves, Scott learned that effective scientists doubt themselves, double- and triple-check their results, and are skeptical of their own conclusions. Only by pursuing the truth with care and rigor can scientists make true progress. Scott took this lesson to heart as he successfully sought to uncover important facts in pediatric neuro-oncology. Dr. Purves further taught the importance of discriminating writing, a lesson that Scott would later employ in his many publications and as Associate Editor of the Annals of Neurology and co-editor of Bradley’s Neurology in Clinical Practice.
With such excellent mentors, combined with his innate drive and abilities, Dr. Pomeroy has emerged as a foremost leader in the field of neuro-oncology and child neurology. Dr. Pomeroy chose to enter the field of neuro-oncology because of an abiding interest in the biology of cancer and because he realized that the study of brain tumors would allow him to find synergy in his research and clinical work, as he transitioned back and forth between the laboratory and his patients’ bedside.
Dr. Pomeroy’s goal is to understand brain tumors from a neurodevelopmental perspective. He has been intrigued by the well-known, but unexplained, fact that certain tumors occur only in children and not in older people. This implies that there must exist certain cells in the developing brain that are susceptible to oncogenesis and that they lose this susceptibility to form cancers as development progresses. If one could understand these developmentally determined susceptibility factors, then one might understand what causes cancers and perhaps how to attack the tumors.
As a first step toward identifying susceptibility factors in central nervous system neoplasms, Dr. Pomeroy discovered that medulloblastomas express a particular neurotrophin, neurotrophin-3, and its receptor, TrkC. He discovered that high levels of trkC expression independently predict more favorable outcome, and later found that trkC is a biomarker of the Sonic hedgehog subgroup of tumors. This study began his journey of discovery regarding the cellular and molecular factors that control susceptibility to pediatric brain tumors. He has since identified the importance of multiple genes, proteins, growth factors, receptors, signaling pathways, and stem cell populations in determining the biological characteristics of multiple brain tumor types, especially medulloblastoma and other embryonal tumors.
One key to Dr Pomeroy’s scientific success has been his ability to form fruitful collaborations. As Scott notes, “I have been successful, in large part, because I made a lot of great collaborations.” One example of a fruitful collaboration was his study of neurotrophic factor signaling. In the early 1990’s, he and two close colleagues realized that no one understood how activation of a neurotrophic factor receptor at a nerve terminal could produce a survival signal in the cell body as far as one meter away. Dr. Pomeroy confronted this issue by combining his expertise in cell biology with his two collaborators’ expertise in signal transduction and neurotrophins. Together, they discovered that the neurotrophic factor and its receptor form a complex that is internalized within the nerve terminal and very rapidly transported within a coated vesicle along the axon back to the cell body.
Dr. Pomeroy’s research in pediatric brain tumors has occurred not just in the laboratory, but in clinical practice, as well. He has been very active in the Pediatric Oncology Group and the Children’s Oncology Group, where he has helped to establish treatment protocols for children with brain tumors. His work was recognized in 1999 with the inaugural Kenneth B. Schwartz Center Compassionate Caregiver Award and in 2017 election to the National Academy of Medicine.
In addition to his success as a physician-scientist, Scott is a family man. He and his wife, Marie, have five children and five grandsons, with whom they engage in frequent outdoor activities, including hiking, biking, and kayaking. Dr. Pomeroy considers himself to be fortunate to have so many varied and wonderful blessings, and is most grateful for being chosen to receive the 2019 Bernard Sachs Award.
Dr. Pomeroy’s research in pediatric brain tumors has occurred not just in the laboratory, but in clinical practice, as well. He has been very active in the Pediatric Oncology Group and the Children’s Oncology Group, where he has helped to establish treatment protocols for children with brain tumors. His work was recognized in 1999 with the inaugural Kenneth B. Schwartz Center Compassionate Caregiver Award and in 2017 election to the National Academy of Medicine.