Vanderbilt-Ingram Cancer Center

The VICC.ORG Investigator Directory

Pierre Massion, M.D.

See also:

• Thoracic/Head and Neck Cancer Research Program
• Medicine: Allergy, Pulmonary, and Critical Care
• BRET: Biomedical Research Education & Training Faculty Listing
• PubMed Listing of Dr. Massion's Publications

Learn More About Pierre Massion's Specialties:

• Lung Cancer - Non Small Cell
• Lung Cancer - Small Cell
• Malignant Mesothelioma
• Thymoma and Thymic Carcinoma

Ingram Professor of Cancer Research
Professor of Medicine (Allergy, Pulmonary & Critical Care) and Cancer Biology
VICC Member
Pulmonary and Critical Care Medicine Doctor

Patient Contact Information:

615-936-2256

Healthcare Provider Contact Information:

Vanderbilt University Medical Center
Vanderbilt Ingram Comprehensive Cancer Center PRB 640
2220 Pierce Avenue
Nashville, TN 37232
615-322-3412

Profile

Dr. Pierre Massion is the Ingram Professor of Cancer Research. He is Professor of Medicine in the Division of Allergy, Pulmonary and Critical Care Medicine and Professor of Cancer Biology at Vanderbilt Medical Center. Dr. Massion has worked in the field of lung cancer biology, early detection and therapeutics for 16 years. He is the director of the Thoracic Program at the Vanderbilt Ingram Cancer Center and thereby overseeing and fostering a rich environment to translate science from the program to trials in the cooperative groups. He has over 80 publications in the areas of lung cancer development, role of oncogenes in the progression of lung tumor cells and innovative strategies towards the development of molecular biomarkers for early detection of lung cancer and intermediate endpoint biomarkers of response to chemoprevention. He served as Chief of the Pulmonary and Critical Care Medicine section at the Nashville VA Medical Center between 2007-2012. He is certified by the American Board of Internal Medicine in Internal Medicine and in Pulmonary and Critical Care Medicine. He is the principal investigator of the Vanderbilt SPORE in lung cancer and of the Vanderbilt Clinical Validation Center sponsored by the EDRN to validate candidate biomarkers of lung cancer. He is also co-PI of two DoD grants, one of which offers lung cancer screening across 12 VA and military hospitals to validate candidate biomarkers of risk and of diagnosis for lung cancer. Dr. Massion has mentored over 19 postdoctoral fellows, 11 graduate students and 20 undergraduate students. He is committed to pursuing innovative strategies to deepen the understanding of lung cancer development and progression. His laboratory applies novel genomic and proteomic technologies to biological specimens to address questions related to the identification and validation of molecular determinants of disease diagnosis, progression, prognosis, and intermediate endpoint biomarkers of response to chemopreventive strategies. He is the PI of 6 active clinical studies - http://www.clinicaltrials.gov. He is the Chair of the Lung Cancer Cooperative group in the EDRN and the Chair of the Scientific Advisory Board of the largest non-profit lung cancer foundation LUNGevity. He is a contributing member to the National Comprehensive Cancer Network related Non-Small Cell Lung Cancer Guidelines committee.

Research Specialty:

The laboratory of Dr. Massion emphasis is on lung tumorigenesis and on using genomic and proteomic approaches to identify molecular markers of lung neoplasia and to test those in multidisciplinary early detection strategies.

Research Description:

1. Role of chromosome 3q in lung cancer. Selection of candidate genes driving a genomic amplicon on Chromosome 3q. Focus on functional genomics for candidate driver genes on chromosome 3q such as p63 and PIK3CA. RO1 funded.

2. Proteomic approach to preinvasive lung cancer. Protein profiling of preinvasive lesions in bronchial biopsy and invasive lung cancer by MALDI MS; Identification of discriminatory proteins by LC-MSMS proteomics; Image analysis. funded by RO1 and SPORE in lung cancer.

3. Lung cancer biomarker discovery and validation. Identification of discriminatory proteins between lung cancer and controls after multidimensional mass spectrometry analysis of biological specimen and Phage-display recombinant antibody library (serum, plasma or pleural fluid). Funded by Vanderbilt SPORE in lung cancer, VA Merit review grant, ASCO research award and EDRN Clinical Validation Center (U01).

4. Inflammation and cancer. We are working on 3 proteins. PPAR delta in lung tumorigenesis (Pedchenko, 2008), Role of serum amyloid A in regulating apoptosis in lung cancer cells, and pIgR as a potential tumor suppressor gene in lung cancer (Polosukhin, 2007). Work supported by Damon Runyon Foundation and a Vanderbilt Discovery Grant.

Clincial Research Description:

Active Clinical Trials: Iloprost in Preventing Lung Cancer in Patients at High Risk for This Disease --This study is currently recruiting patients. http://clinicaltrials.gov/ct/gui/show/NCT00084409?order=2

Publications:

• Hassanein, M, Hoeksema, MD, Shiota, M, Qian, J, Harris, BK, Chen, H, Clark, JE, Alborn, WE, Eisenberg, R, Massion, PP SLC1A5 Mediates Glutamine Transport Required for Lung Cancer Cell Growth and Survival. Clin Cancer Res, 19(3), 560-70, 2013.
• Pecot, CV, Li, M, Zhang, XJ, Rajanbabu, R, Calitri, C, Bungum, A, Jett, JR, Putnam, JB, Callaway-Lane, C, Deppen, S, Grogan, EL, Carbone, DP, Worrell, JA, Moons, KG, Shyr, Y, Massion, PP Added value of a serum proteomic signature in the diagnostic evaluation of lung nodules. Cancer Epidemiol Biomarkers Prev, 21(5), 786-92, 2012.
• Ocak, S, Chen, H, Callison, C, Gonzalez, AL, Massion, PP Expression of focal adhesion kinase in small-cell lung carcinoma. Cancer, 118(5), 1293-301, 2012.
• Kikuchi, T, Hassanein, M, Amann, JM, Liu, Q, Slebos, RJ, Rahman, SM, Kaufman, JM, Zhang, X, Hoeksema, MD, Harris, BK, Li, M, Shyr, Y, Gonzalez, AL, Zimmerman, LJ, Liebler, DC, Massion, PP, Carbone, DP In-depth proteomic analysis of nonsmall cell lung cancer to discover molecular targets and candidate biomarkers. Mol Cell Proteomics, 11(10), 916-32, 2012.
• Ocak, S, Pedchenko, TV, Chen, H, Harris, FT, Qian, J, Polosukhin, V, Pilette, C, Sibille, Y, Gonzalez, AL, Massion, PP Loss of polymeric immunoglobulin receptor expression is associated with lung tumourigenesis. Eur Respir J, 39(5), 1171-80, 2012.
• Hassanein, M, Callison, JC, Callaway-Lane, C, Aldrich, MC, Grogan, EL, Massion, PP The state of molecular biomarkers for the early detection of lung cancer. Cancer Prev Res (Phila), 5(8), 992-1006, 2012.
• Su, Z, Dias-Santagata, D, Duke, M, Hutchinson, K, Lin, YL, Borger, DR, Chung, CH, Massion, PP, Vnencak-Jones, CL, Iafrate, AJ, Pao, W A platform for rapid detection of multiple oncogenic mutations with relevance to targeted therapy in non-small-cell lung cancer. J Mol Diagn, 13(1), 74-84, 2011.
• Deppen, S, Putnam, JB, Andrade, G, Speroff, T, Nesbitt, JC, Lambright, ES, Massion, PP, Walker, R, Grogan, EL Accuracy of FDG-PET to diagnose lung cancer in a region of endemic granulomatous disease. Ann Thorac Surg, 92(2), 428-32; discussion 433, 2011.
• Hassanein, M, Rahman, JS, Chaurand, P, Massion, PP Advances in proteomic strategies toward the early detection of lung cancer. Proc Am Thorac Soc, 8(2), 183-8, 2011.
• Polosukhin, VV, Cates, JM, Lawson, WE, Zaynagetdinov, R, Milstone, AP, Massion, PP, Ocak, S, Ware, LB, Lee, JW, Bowler, RP, Kononov, AV, Randell, SH, Blackwell, TS Bronchial secretory immunoglobulin a deficiency correlates with airway inflammation and progression of chronic obstructive pulmonary disease. Am J Respir Crit Care Med, 184(3), 317-27, 2011.
• Isbell, JM, Deppen, S, Putnam, JB, Nesbitt, JC, Lambright, ES, Dawes, A, Massion, PP, Speroff, T, Jones, DR, Grogan, EL Existing general population models inaccurately predict lung cancer risk in patients referred for surgical evaluation. Ann Thorac Surg, 91(1), 227-33; discussion 233, 2011.
• Polosukhin, VV, Cates, JM, Lawson, WE, Milstone, AP, Matafonov, AG, Massion, PP, Lee, JW, Randell, SH, Blackwell, TS Hypoxia-inducible factor-1 signalling promotes goblet cell hyperplasia in airway epithelium. J Pathol, 224(2), 203-11, 2011.
• Rahman, SM, Gonzalez, AL, Li, M, Seeley, EH, Zimmerman, LJ, Zhang, XJ, Manier, ML, Olson, SJ, Shah, RN, Miller, AN, Putnam, JB, Miller, YE, Franklin, WA, Blot, WJ, Carbone, DP, Shyr, Y, Caprioli, RM, Massion, PP Lung Cancer Diagnosis from Proteomic Analysis of Preinvasive Lesions. Cancer Res, 71(8), 3009-3017, 2011.
• Zhang, H, Liu, Q, Zimmerman, LJ, Ham, AJ, Slebos, RJ, Rahman, J, Kikuchi, T, Massion, PP, Carbone, DP, Billheimer, D, Liebler, DC Methods for peptide and protein quantitation by liquid chromatography-multiple reaction monitoring mass spectrometry. Mol Cell Proteomics, 2011.
• Kashikar, ND, Zhang, W, Massion, PP, Gonzalez, AL, Datta, PK Role of STRAP in regulating GSK3β function and Notch3 stabilization. Cell Cycle, 10(10), 2011.
• Grogan, EL, Weinstein, JJ, Deppen, SA, Putnam, JB, Nesbitt, JC, Lambright, ES, Walker, RC, Dittus, RS, Massion, PP Thoracic operations for pulmonary nodules are frequently not futile in patients with benign disease. J Thorac Oncol, 6(10), 1720-5, 2011.
• Ocak, S, Yamashita, H, Udyavar, AR, Miller, AN, Gonzalez, AL, Zou, Y, Jiang, A, Yi, Y, Shyr, Y, Estrada, L, Quaranta, V, Massion, PP DNA copy number aberrations in small-cell lung cancer reveal activation of the focal adhesion pathway. Oncogene, 29(48), 6331-42, 2010.
• Grogan, EL, Deppen, S, Pecot, CV, Putnam, JB, Nesbitt, JC, Shyr, Y, Rajanbabu, R, Ory, B, Lambright, ES, Massion, PP Diagnostic characteristics of a serum biomarker in patients with positron emission tomography scans. Ann Thorac Surg, 89(6), 1724-8; discussion 1728-9, 2010.
• Wehbe, FH, Brown, SH, Massion, PP, Gadd, CS, Masys, DR, Aliferis, CF A novel information retrieval model for high-throughput molecular medicine modalities. Cancer Inform, 81-17, 2009.
• Ocak, S, Sos, ML, Thomas, RK, Massion, PP High-throughput molecular analysis in lung cancer: insights into biology and potential clinical applications. Eur Respir J, 34(2), 489-506, 2009.
• Ocak, S, Chaurand, P, Massion, PP Mass spectrometry-based proteomic profiling of lung cancer. Proc Am Thorac Soc, 6(2), 159-70, 2009.
• Massion, PP, Zou, Y, Uner, H, Kiatsimkul, P, Wolf, HJ, Baron, AE, Byers, T, Jonsson, S, Lam, S, Hirsch, FR, Miller, YE, Franklin, WA, Varella-Garcia, M Recurrent genomic gains in preinvasive lesions as a biomarker of risk for lung cancer. PLoS One, 4(6), e5611, 2009.
• Qian, J, Zou, Y, Rahman, JS, Lu, B, Massion, PP Synergy between phosphatidylinositol 3-kinase/Akt pathway and Bcl-xL in the control of apoptosis in adenocarcinoma cells of the lung. Mol Cancer Ther, 8(1), 101-9, 2009.
• Groseclose, MR, Massion, PP, Chaurand, P, Caprioli, RM High-throughput proteomic analysis of formalin-fixed paraffin-embedded tissue microarrays using MALDI imaging mass spectrometry. Proteomics, 8(18), 3715-24, 2008.
• DeBusk, LM, Massion, PP, Lin, PC IkappaB kinase-alpha regulates endothelial cell motility and tumor angiogenesis. Cancer Res, 68(24), 10223-8, 2008.
• Xu, BJ, Gonzalez, AL, Kikuchi, T, Yanagisawa, K, Massion, PP, Wu, H, Mason, SE, Olson, SJ, Shyr, Y, Carbone, DP, Caprioli, RM MALDI-MS derived prognostic protein markers for resected non-small cell lung cancer. Proteomics Clin Appl, 2(10-11), 1508-17, 2008.
• Pedchenko, TV, Gonzalez, AL, Wang, D, Dubois, RN, Massion, PP Peroxisome Proliferator-Activated Receptor {beta}/{delta} Expression and Activation in Lung Cancer. Am J Respir Cell Mol Biol, 2008.
• Qian, J, Massion, PP Role of chromosome 3q amplification in lung cancer. J Thorac Oncol, 3(3), 212-5, 2008.
• Massion, PP, Zou, Y, Chen, H, Jiang, A, Coulson, P, Amos, CI, Wu, X, Wistuba, I, Wei, Q, Shyr, Y, Spitz, MR Smoking-related genomic signatures in non-small cell lung cancer. Am J Respir Crit Care Med, 178(11), 1164-72, 2008.
• Polosukhin, VV, Lawson, WE, Milstone, AP, Egunova, SM, Kulipanov, AG, Tchuvakin, SG, Massion, PP, Blackwell, TS Association of progressive structural changes in the bronchial epithelium with subepithelial fibrous remodeling: a potential role for hypoxia. Virchows Arch, 451(4), 793-803, 2007.
• Albert, JM, Gonzalez, A, Massion, PP, Chen, H, Olson, SJ, Shyr, Y, Diaz, R, Lambright, ES, Sandler, A, Carbone, DP, Putnam, JB, Johnson, DH, Lu, B Cytoplasmic clusterin expression is associated with longer survival in patients with resected non small cell lung cancer. Cancer Epidemiol Biomarkers Prev, 16(9), 1845-51, 2007.
• Yildiz, PB, Shyr, Y, Rahman, JS, Wardwell, NR, Zimmerman, LJ, Shakhtour, B, Gray, WH, Chen, S, Li, M, Roder, H, Liebler, DC, Bigbee, WL, Siegfried, JM, Weissfeld, JL, Gonzalez, AL, Ninan, M, Johnson, DH, Carbone, DP, Caprioli, RM, Massion, PP Diagnostic accuracy of MALDI mass spectrometric analysis of unfractionated serum in lung cancer. J Thorac Oncol, 2(10), 893-901, 2007.
• Taguchi, F, Solomon, B, Gregorc, V, Roder, H, Gray, R, Kasahara, K, Nishio, M, Brahmer, J, Spreafico, A, Ludovini, V, Massion, PP, Dziadziuszko, R, Schiller, J, Grigorieva, J, Tsypin, M, Hunsucker, SW, Caprioli, R, Duncan, MW, Hirsch, FR, Bunn, PA, Carbone, DP Mass spectrometry to classify non-small-cell lung cancer patients for clinical outcome after treatment with epidermal growth factor receptor tyrosine kinase inhibitors: a multicohort cross-institutional study. J Natl Cancer Inst, 99(11), 838-46, 2007.
• Stacy, DR, Ely, K, Massion, PP, Yarbrough, WG, Hallahan, DE, Sekhar, KR, Freeman, ML Increased expression of nuclear factor E2 p45-related factor 2 (NRF2) in head and neck squamous cell carcinomas. Head Neck, 28(9), 813-8, 2006.
• Massion, PP, Caprioli, RM Proteomic strategies for the characterization and the early detection of lung cancer. J Thorac Oncol, 1(9), 1027-39, 2006.
• Amann, JM, Chaurand, P, Gonzalez, A, Mobley, JA, Massion, PP, Carbone, DP, Caprioli, RM Selective profiling of proteins in lung cancer cells from fine-needle aspirates by matrix-assisted laser desorption ionization time-of-flight mass spectrometry. Clin Cancer Res, 12(17), 5142-50, 2006.
• Amann, J, Kalyankrishna, S, Massion, PP, Ohm, JE, Girard, L, Shigematsu, H, Peyton, M, Juroske, D, Huang, Y, Stuart Salmon, J, Kim, YH, Pollack, JR, Yanagisawa, K, Gazdar, A, Minna, JD, Kurie, JM, Carbone, DP Aberrant epidermal growth factor receptor signaling and enhanced sensitivity to EGFR inhibitors in lung cancer. Cancer Res, 65(1), 226-35, 2005.
• Haruki, N, Kawaguchi, KS, Eichenberger, S, Massion, PP, Olson, S, Gonzalez, A, Carbone, DP, Dang, TP Dominant-negative Notch3 receptor inhibits mitogen-activated protein kinase pathway and the growth of human lung cancers. Cancer Res, 65(9), 3555-61, 2005.
• Wardwell, NR, Massion, PP Novel strategies for the early detection and prevention of lung cancer. Semin Oncol, 32(3), 259-68, 2005.
• Shinohara, ET, Gonzalez, A, Massion, PP, Chen, H, Li, M, Freyer, AS, Olson, SJ, Andersen, JJ, Shyr, Y, Carbone, DP, Johnson, DH, Hallahan, DE, Lu, B Nuclear survivin predicts recurrence and poor survival in patients with resected nonsmall cell lung carcinoma. Cancer, 103(8), 1685-92, 2005.
• Rahman, SM, Shyr, Y, Yildiz, PB, Gonzalez, AL, Li, H, Zhang, X, Chaurand, P, Yanagisawa, K, Slovis, BS, Miller, RF, Ninan, M, Miller, YE, Franklin, WA, Caprioli, RM, Carbone, DP, Massion, PP Proteomic patterns of preinvasive bronchial lesions. Am J Respir Crit Care Med, 172(12), 1556-62, 2005.
• Anumanthan, G, Halder, SK, Osada, H, Takahashi, T, Massion, PP, Carbone, DP, Datta, PK Restoration of TGF-beta signalling reduces tumorigenicity in human lung cancer cells. Br J Cancer, 93(10), 1157-67, 2005.
• Gonzalez, Adriana L, Roberts, Richard L, Massion, Pierre P, Olson, Sandra J, Shyr, Yu, Shappell, Scott B 15-Lipoxygenase-2 expression in benign and neoplastic lung: an immunohistochemical study and correlation with tumor grade and proliferation. Hum Pathol, 35(7), 840-9, 2004.
• Massion, Pierre P, Taflan, Peter M, Shyr, Yu, Rahman, S M Jamshedur, Yildiz, Pinar, Shakthour, Bashar, Edgerton, Mary E, Ninan, Matthew, Andersen, Jeremiah J, Gonzalez, Adriana L Early involvement of the phosphatidylinositol 3-kinase/Akt pathway in lung cancer progression. Am J Respir Crit Care Med, 170(10), 1088-94, 2004.
• Lu, B, Gonzalez, A, Massion, P P, Shyr, Y, Shaktour, B, Carbone, D P, Hallahan, D E Nuclear survivin as a biomarker for non-small-cell lung cancer. Br J Cancer, 91(3), 537-40, 2004.
• Massion, Pierre P, Taflan, Peter M, Rahman, S M Jamshedur, Yildiz, Pinar, Shyr, Yu, Carbone, David P, Gonzalez, Adriana L Role of p63 amplification and overexpression in lung cancer development. Chest, 125(5 Suppl), 102S, 2004.
• Massion, Pierre P, Carbone, David P From clinical and pathologic to molecular staging of lung cancer. Am J Respir Crit Care Med, 167(12), 1587-8, 2003.
• Yanagisawa, Kiyoshi, Shyr, Yu, Xu, Baogang J, Massion, Pierre P, Larsen, Paul H, White, Bill C, Roberts, John R, Edgerton, Mary, Gonzalez, Adriana, Nadaf, Sorena, Moore, Jason H, Caprioli, Richard M, Carbone, David P Proteomic patterns of tumour subsets in non-small-cell lung cancer. Lancet, 362(9382), 433-9, 2003.
• Massion, Pierre P, Taflan, Peter M, Jamshedur Rahman, S M, Yildiz, Pinar, Shyr, Yu, Edgerton, Mary E, Westfall, Matthew D, Roberts, John R, Pietenpol, Jennifer A, Carbone, David P, Gonzalez, Adriana L Significance of p63 amplification and overexpression in lung cancer development and prognosis. Cancer Res, 63(21), 7113-21, 2003.
• Massion, Pierre P, Carbone, David P The molecular basis of lung cancer: molecular abnormalities and therapeutic implications. Respir Res, 4(1), 12, 2003.
• Massion, Pierre P, Kuo, Wen-Lin, Stokoe, David, Olshen, Adam B, Treseler, Patrick A, Chin, Koei, Chen, Chira, Polikoff, Daniel, Jain, Ajay N, Pinkel, Daniel, Albertson, Donna G, Jablons, David M, Gray, Joe W Genomic copy number analysis of non-small cell lung cancer using array comparative genomic hybridization: implications of the phosphatidylinositol 3-kinase pathway. Cancer Res, 62(13), 3636-40, 2002.
• Aliferis, C F, Hardin, D, Massion, P P Machine learning models for lung cancer classification using array comparative genomic hybridization. Proc AMIA Symp, 7-11, 2002.
• Godding, V, Sibille, Y, Massion, P P, Delos, M, Sibille, C, Thurion, P, Giffroy, D, Langendries, A, Vaerman, J P Secretory component production by human bronchial epithelial cells is upregulated by interferon gamma. Eur Respir J, 11(5), 1043-52, 1998.
• Massion, P P, Lindén, A, Inoue, H, Mathy, M, Grattan, K M, Nadel, J A Dimethyl sulfoxide decreases interleukin-8-mediated neutrophil recruitment in the airways. Am J Physiol, 271(5 Pt 1), L838-43, 1996.
• Yoshihara, S, Chan, B, Yamawaki, I, Geppetti, P, Ricciardolo, F L, Massion, P P, Nadel, J A Plasma extravasation in the rat trachea induced by cold air is mediated by tachykinin release from sensory nerves. Am J Respir Crit Care Med, 151(4), 1011-7, 1995.
• Inoue, H, Hara, M, Massion, P P, Grattan, K M, Lausier, J A, Chan, B, Kaneko, T, Isono, K, Jorens, P G, Ueki, I F Role of recruited neutrophils in interleukin-8 production in dog trachea after stimulation with Pseudomonas in vivo. Am J Respir Cell Mol Biol, 13(5), 570-7, 1995.
• Massion, P P, Hébert, C A, Leong, S, Chan, B, Inoue, H, Grattan, K, Sheppard, D, Nadel, J A Staphylococcus aureus stimulates neutrophil recruitment by stimulating interleukin-8 production in dog trachea. Am J Physiol, 268(1 Pt 1), L85-94, 1995.
• Massion, P P, Inoue, H, Richman-Eisenstat, J, Grunberger, D, Jorens, P G, Housset, B, Pittet, J F, Wiener-Kronish, J P, Nadel, J A Novel Pseudomonas product stimulates interleukin-8 production in airway epithelial cells in vitro. J Clin Invest, 93(1), 26-32, 1994.
• Inoue, H, Massion, P P, Ueki, I F, Grattan, K M, Hara, M, Dohrman, A F, Chan, B, Lausier, J A, Golden, J A, Nadel, J A Pseudomonas stimulates interleukin-8 mRNA expression selectively in airway epithelium, in gland ducts, and in recruited neutrophils. Am J Respir Cell Mol Biol, 11(6), 651-63, 1994.
• Jorens, P G, Richman-Eisenstat, J B, Housset, B P, Massion, P P, Ueki, I, Nadel, J A Pseudomonas-induced neutrophil recruitment in the dog airway in vivo is mediated in part by IL-8 and inhibited by a leumedin. Eur Respir J, 7(11), 1925-31, 1994.
• Massion, P P, Funari, C C, Ueki, I, Ikeda, S, McDonald, D M, Nadel, J A Parainfluenza (Sendai) virus infects ciliated cells and secretory cells but not basal cells of rat tracheal epithelium. Am J Respir Cell Mol Biol, 9(4), 361-70, 1993.

Education

• M.D. - Catholic University of Louvain
• Fellowship - University of California San Francisco Medical Center
• Internship - Saint Luc Hospital
• Post Graduate Training - Catholic University of Louvain
• Post Graduate Training - University of California San Francisco Medical Center
• Residency - University of California San Francisco Medical Center