The Long Game: A Conversation about Surgical Oncology, Collaboration, and Perseverance in Research with Dr. Todd Bauer

A Q&A with Dr. Todd Bauer, MD, PhD

Article written by William Lain

In the second installment of VJM’s Expert Q&A series spotlighting exceptional surgical faculty and surgeon-scientists, we spoke with Dr. Todd Bauer, Professor of Surgery and Chief of the Division of Surgical Oncology at UVA. A nationally recognized expert in pancreatic and hepatobiliary cancers, as well as soft tissue sarcomas, Dr. Bauer combines high-volume clinical practice with a thriving translational research program. His work bridges patient care, bench science, and institutional collaboration, aiming to advance our understanding and treatment of aggressive cancers.

Dr. Bauer earned both his undergraduate and medical degrees at the University of Pennsylvania, where he also completed his General Surgery residency and a postdoctoral research fellowship. He went on to train in Surgical Oncology and conduct additional research at the University of Texas MD Anderson Cancer Center, one of the world’s top cancer institutions. Now at UVA, he leads a robust research lab focused on pancreatic and colorectal cancer, with an emphasis on tumor-stroma interactions, chemotherapy resistance, and personalized approaches to therapy using patient-derived xenograft (PDX) models. Specifically, these patient-derived xenograft (PDX) models and multi-omic approaches are used to identify drivers of metastasis and resistance to treatment.

From childhood hospital rounds with his father, a general surgeon, to national leadership in cancer surgery and research, Dr. Bauer’s path is a story of long-term vision, scientific rigor, and an unshakeable commitment to advancing care for patients with some of the toughest cancers in medicine.

On Choosing Surgery:

"I knew from a young age I wanted to be a surgeon."

Dr. Bauer’s earliest inspiration came from shadowing his father on the weekends during hospital rounds. He saw the patient connection, the problem-solving, and the impact that his father had on his patients, and that resonated with him. Then, as a medical student, he enjoyed all of his rotations as he finally felt like he was contributing to the team and making a difference. However, his time spent working with the general surgery team was particularly fulfilling and confirmed his preconceptions. During residency, the complexity, beauty, and challenge of major abdominal cancer operations further guided his career and inspired him to pursue a fellowship in Surgical Oncology.

"I grew up joining him while he made rounds on his patients on the weekends and on trips to the ER in the evenings to see consults, and I loved being in the hospital and around the patients. I knew he worked long hours, but it was always evident how much my father loved what he did.”

On Research:

"During my General Surgery residency at Penn after my third clinical year, I spent two years in the lab as a postdoc doing research, as is customary in most academic General Surgery residency programs... This was my first experience doing basic and translational science, and I loved it!”

That lab experience changed everything. It gave Dr. Bauer his first taste of what a career in research could look like and confirmed three goals: pursue a Surgical Oncology fellowship, work at an academic medical center, and one day run his own research lab.

Today, his lab now focuses on pancreatic and colorectal cancer. They are interested in identifying the drivers of tumor progression, metastasis, and chemotherapy resistance. The lab has also established an IRB-approved human GI cancer tissue bank, which includes patient demographics, tumor stage, treatment history, survival data, and multi-omic sequencing. These tumors are then propagated as PDXs and used in orthotopic and splenic injection models of metastasis in mice. Dr. Bauer’s group also performs in vivo CRISPR screening experiments, targeting transcription factors and epigenetic regulators to study chemotherapy resistance and metastatic behavior.

They have analyzed the tumors in terms of gene mutation status, RNAseq, ATACseq, and growth and metastasis behavior in mice. With these patient-derived xenograft (PDX) tumors, they have developed sophisticated mouse models of orthotopic growth and splenic injection models of liver micrometastasis.

“…We are performing CRISPR screening experiments (targeting transcription factors and epigenetic regulators) in mice treated with and without standard of care chemotherapy to identify mechanisms of tumor metastasis and epigenetic regulators of chemotherapy resistance… We have several ongoing collaborative projects with other labs, such as: 1) mutant RAS pathway activation of DRP1 and its effect on mitochondrial function, tumor metabolism, and the tumor microenvironment, 2) the role of lipid metabolism in colorectal cancer growth and metastasis, 3) the role of epithelial-mesenchymal transition (EMT) in pancreatic cancer.”

On Collaboration:

"Trying to do it all yourself? The science won’t be as strong—and it won’t be as fun.”

For Dr. Bauer, collaboration isn’t a bonus. It’s the backbone of research success. His team partners with investigators across specialties, seeking out collaborators with established expertise in areas like genetics, epigenetics, tumor metabolism, and computational biology, recognizing that the science is often better when done together. He also shares his own resources with other researchers, contributing cell lines, mouse models, and expertise to help others advance their work

“When approached by other investigators who have projects in need of my expertise, I have almost always offered to collaborate with them and share my cell lines, PDX tumors, and conduct mouse experiments, etc.”

This culture of reciprocal collaboration, he says, has strengthened not only his own lab but also the wider research environment at UVA.

On Mentorship:

"Honesty and integrity are imperative in scientific research.”

When it comes to mentoring, Dr. Bauer values character just as much as capability. He looks for mentees and collaborators who bring a strong work ethic, dependability, and collegiality, noting that these values are central to UVA’s research culture. He sees them as foundational to any productive mentorship or collaboration.

On the Road Ahead:

Dr. Bauer encourages students to develop comfort with complexity and humility in the face of evolving knowledge. He believes interdisciplinary fluency—knowing how to communicate across scientific domains—is increasingly critical for success.

"Science is difficult in that many assays can be finicky, cell lines can adapt or behave inconsistently, and outcomes for repeat experiments can be variable.”

But for Dr. Bauer, funding is even more challenging. With NIH grant funding rates often below 10%, the reality is that most submissions (at least 90%) are rejected, despite years of work.

“After that huge time investment and the major blow to your ego after the grant rejection you still need to find the funding somehow.”

His advice? Stay focused on what matters.

“Given the challenges of conducting science and acquiring funding, it is imperative that you are passionate about conducting research, that you enjoy the field you are studying, and that you are doing research for the right reasons – to advance the field, improve human health, and train the next generation of researchers. In the end, if you 1) address important questions with your research, 2) conduct good, solid science, and 3) persevere with conviction, you will be successful – the science will advance, and you will find a way to keep it funded and will have fun doing so.”

Final Thoughts:

Dr. Bauer’s career is a testament to scientific rigor, humility, and shared progress. His path reminds us that surgical research isn’t a sprint—it’s a long game of persistence, precision, and purpose. From CRISPR screens in chemotherapy-resistant tumors to mouse models of micrometastasis, he leads with a vision rooted in service to patients and collaboration with peers, building tools that others can use, teams that can grow together, and science that lasts. For students and early researchers, his message is clear: lead with integrity, collaborate generously, and stay committed to the work that matters most, even when it’s hard and unforgiving.

Stay tuned for more interviews from our Expert Q&A series, where we spotlight faculty across surgical specialties working at the cutting edge of surgical care, research, and education.

Interested in reading more from Dr. Bauer? Check out some of his recent works!

Perez, I. C., Bigelow, A., Shami, V. M., Sauer, B. G., Wang, A. Y., Strand, D. S., . . . Buerlein, R. C. D. (2024). Comparative accuracy of four guidelines to predict high-grade dysplasia or malignancy in surgically resected pancreatic intraductal papillary mucinous neoplasms: Small nuances between guidelines lead to vastly different results. Annals of hepato-biliary-pancreatic surgery. doi:10.14701/ahbps.24-049
Brown, B. A., Myers, P. J., Adair, S. J., Pitarresi, J. R., Sah-Teli, S. K., Campbell, L. A., . . . Lazzara, M. J. (2024). A Histone Methylation-MAPK Signaling Axis Drives Durable Epithelial-Mesenchymal Transition in Hypoxic Pancreatic Cancer. CANCER RESEARCH, 84(11), 1764-1780. doi:10.1158/0008-5472.CAN-22-2945
Rane, A., Jarmoshti, J., Abdullah-Bin, S., Adair, S., Torres-Castro, K., Honrado, C., . . . Swami, N. S. (2024). Dielectrophoretic enrichment of live chemo-resistant circulating-like pancreatic cancer cells from media of drug-treated adherent cultures of solid tumors. LAB ON A CHIP, 24(3), 561-571. doi:10.1039/d3lc00804e
Alaimo, L., Moazzam, Z., Lima, H. A., Endo, Y., Ruzzenente, A., Guglielmi, A., . . . Pawlik, T. M. (2023). An attempt to establish and apply global benchmarks for liver resection of malignant hepatic tumors. SURGERY, 174(6), 1384-1392. doi:10.1016/j.surg.2023.08.024
Ali, L. R., Lenehan, P. J., Cardot-Ruffino, V., Dias Costa, A., Katz, M. H. G., Bauer, T. W., . . . Dougan, S. K. (2024). PD-1 Blockade Induces Reactivation of Nonproductive T-Cell Responses Characterized by NF-κB Signaling in Patients with Pancreatic Cancer. CLINICAL CANCER RESEARCH, 30(3), 542-553. doi:10.1158/1078-0432.CCR-23-1444