Empowering Women's Health: GYN-COE's 20-Year Journey of Innovation and Impact

The Gynecologic Cancer Center of Excellence (GYN-COE) commemorates a 20-year journey of pioneering research, collaboration, and commitment to advancing women’s health and military readiness.

PENSACOLA, Florida (February 5, 2019 Lt. Cmdr. Leslye Green, staff obstetrician and gynecologist, Naval Hospital Pensacola (NHP), uses a model to discuss cervical cancer with a patient at NHP, Feb. 5, 2019. According to the Centers for Disease Control and Prevention (CDC), cervical cancer is highly preventable because screening tests for cervical cancer and vaccines to protect against human papillomavirus (HPV), which is the main cause of cervical cancer, are readily available. Cervical cancer is highly treatable and associated with long survival and good quality of life when it is found early. (U.S. Navy photo by Mass Communication Specialist 1st Class Brannon Deugan)
The GYN-COE works to identify molecular alterations in gynecologic cancers and develop novel strategies 
for prevention, early detection, and precision treatment of these diseases. (U.S. Navy photo by Mass 
Communication Specialist 1st Class Brannon Deugan)

May 23, 2024 by Vivian Mason

The Gynecologic Cancer Center of Excellence (GYN-COE) commemorates its 20th anniversary with a reflection on its enduring commitment to women’s health. Founded two decades ago, the Center remains steadfast in its mission to advance innovative research in the early detection of gynecologic cancers and to develop novel strategies for the prevention and precision treatment of those diseases, thereby ensuring military readiness.

The GYN-COE has established itself as a major asset to the Department of Defense (DoD) and the Uniformed Services University (USU), fostering collaborations nationally and internationally with leading research institutions. Military gynecologic oncologists, some of the pioneers of the specialty, uphold a tradition of leadership and engagement within the field. Notably, the program at Walter Reed National Military Medical Center is one of the oldest fellowship training programs in the United States. 

“Celebrating 20 years provides a great opportunity to recognize that the Center addresses the needs of our female active duty force and veterans who are vital to our readiness,” says professor of Gynecologic Surgery and Obstetrics at USU, and co-principal investigator of the GYN-COE,  retired Army Col. (Dr.)  G. Larry Maxwell.  “We owe it to women to provide the best care possible in preventive, diagnostic, and therapeutic ways.” 

Reaching back 24 years, Maxwell recalls joining the gynecologic oncology program at Walter Reed fresh out of his fellowship. There, he met two extraordinary pioneers: Dr. Craig Shriver, founder of the Clinical Breast Care Project, and Dr. David McLeod, founder of the USU Center for Prostate Disease Research, who both oversaw congressional special interest programs. With their mentorship, Maxwell put together a strategic plan for a GYN cancer program for the DoD. 

OB/GYN nurse residents train in the CRDAMC simulation lab. The 66G OB/GYN Nurse Resident Program, only offered at CRDAMC, focuses on OB/GYN nursing skills that include childbearing, high-risk and complicated pregnancy, newborn assessment and care and family planning gynecology. (U.S. Army photo by Gloria Montgomery, CRDAMC Public Affairs)
The GYN-COE has collaborated, both nationally and internationally, with the world's leading research
facilities. (U.S. Army photo by Gloria Montgomery, CRDAMC Public Affairs)

In 2004, Maxwell was introduced to a champion of cancer care improvement who would help him turn his plan into a reality: Congressman John P. Murtha. As the husband of a cancer survivor and as a senior appropriator for the DoD, Congressman Murtha looked for ways to improve early detection and prevention, provide more effective therapeutics, and decrease the escalating costs of cancer care. His support led to significant advancements, including the establishment of the Gynecologic Disease Center at the original Walter Reed Army Medical Center in 2004, and eventually the establishment of the GYN-COE at the Murtha Cancer Center at WRNMMC in 2010. Finally in 2011, the Women’s Health Integrated Research Center (WHIRC) became the foundational laboratory for the GYN-COE. 

Additionally, Murtha’s efforts led to the establishment of the U.S. Army Medical Research and Materiel Command’s Congressionally Directed Medical Research Programs that have provided more than $8 billion in cancer research funding since 1992.  

“I don’t think it could be more fitting than to have the Murtha Cancer Center named in his memory,” says Maxwell. 

Lt. Col. (Dr.) Neil Phippen, co-principal investigator of the GYN-COE, notes that the program has evolved over time. “We consistently compete for funding inside and outside of the DoD to supplement our reliable congressional support. Earning the Center of Excellence designation was a critical turning point for us, as has been the formation of strategic partnerships within the Murtha Cancer Center Research Program (MCCRP).” The MCCRP is a USU research center. 

The GYN-COE provides critical expertise to the MCCRP’s White House Cancer Moonshot APOLLO (Applied Proteogenomics OrganizationaL Learning and Outcomes) Program, and it works closely with The American Genome Center at USU. “I think these programs are enormously impactful for the readiness of our forces and the care of our medical beneficiaries, even those who are retired,” says Phippen. 

Addressing gynecologic diseases is a top priority for the GYN-COE because these conditions extract a substantial human, readiness, and economic toll on approximately 15‒20% of the female U.S. military, as well as nearly two million female veterans. Gynecologic cancers encompass ovarian cancer, vaginal cancer, cervical cancer, uterine/endometrial cancer, vulvar cancer, primary peritoneal cancer, and gestational trophoblastic disease. 

Through GYN-COE collaborations, the MCCRP’s White House Cancer Moonshot APOLLO Program, senior investigators at the WHIRC including Drs. Thomas Conrads, Kathleen Darcy, and Nicholas Bateman—as well as prominent collaborating physicians and scientists from multiple cancer centers across the United States, Australia, Canada, and the United Kingdom—recently published a deep proteogenomic profiling study of high-grade serous ovarian cancer (HGSOC) in npg Precision Oncology. These efforts highlighted the importance of investigating discrete cell populations from the tumor tissue microenvironment at a cohort scale and the opportunities to uncover new therapeutic opportunities for cancer patients using these types of approaches. 

Conrads, chief scientific officer for the GYN-COE, highlights the technical challenges and collaborative efforts driving the APOLLO Program’s success, explaining that “deployment of these techniques on a cohort scale within the APOLLO Program requires enormous systems development, quality assurance and quality control algorithms, and standard operating procedures,” but notes that “what really has been terrific through the years is how our USU cancer programs have synergized within the framework of the Murtha Cancer Center. The APOLLO Program has caused that force-multiplying dynamic to be further enhanced.” 

WHIRC from HJFMilMed on Vimeo.

Beyond cancer research, says Phippen, “we also collaborate with a number of departments within the university (e.g., immunology, pathology, surgery, etc.) and have also contributed in COVID-related research with USU and the Joint Pathology Center. There are numerous ways that we contribute to the overall ecosystem of the University’s research and clinical care. The Center continues to look for ways in which it can be more supportive of the university’s mission.”

As the GYN-COE celebrates two decades of groundbreaking research and care, Maxwell emphasizes a commitment to honoring the past while embracing the future. “It’s been a privilege to be a part of this outstanding organization during its first 20 years of ground-breaking research and caring. We’ve had significant milestones and hope to continue to accomplish much more. We embrace honoring the past while steadfastly looking to the future for more game-changing innovations.”