Chapter 06: Funding Interferon Research through Connections and Industry

Title

Chapter 06: Funding Interferon Research through Connections and Industry

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Identifier

GuttermanJ_02_20060518_C06

Publication Date

5-18-2006

City

Houston, Texas

Topics Covered

The Interview Subject's Story - The Clinical Provider; Fiscal Realities in Healthcare On Pharmaceutical Companies and Industry The Business of MD Anderson -- The Institution and Finances Definitions, Explanations, Translations; Cancer and Disease; Understanding Cancer, the History of Science, Cancer Research; Donations, Gifts, Contributions; Fundraising, Philanthropy, Donations, Volunteers; On Philanthropy and Volunteerism

Creative Commons License

Creative Commons Attribution-Noncommercial-No Derivative Works 3.0 License
This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 3.0 License.

Disciplines

History of Science, Technology, and Medicine | Oncology | Oral History

Transcript

Lesley W. Brunet:

Why were you criticized?

Jordan Gutterman, MD:

Oh, because I didn't do it the way chemotherapists do it. They'll treat...

Lesley W. Brunet:

The worst first?

Jordan Gutterman, MD:

Absolutely. And I said no. Because I want this to succeed. I mean, if you treat 20 patients who are terminal, and it doesn't work, it still doesn't mean anything about what it might do in earlier stages of disease. And this -- I knew this idea would die if we didn't see something very soon, because there was no way to raise money. We only had Mary Lasker's money at that point. Yeah. So I'm very proud of how I did it.

Lesley W. Brunet:

So, where would you get the criticism from? From within your department, or from the surveillance committee?

Jordan Gutterman, MD:

No, not so much within the department, but around the institute, within whatever it was -- the developmental therapeutics, within the division. I mean, I'm jumping way ahead. But much later, I'm just going to mention an example. I still remember this very clearly. We had good evidence. We probably even had a published paper, or close to one, on the activity in breast cancer, but much more significantly in myeloma and lymphoma. And I was called to the clinic to see a patient with chronic lymphocytic leukemia. Walked in, the lady probably -- if she weighed 90 lbs, it would have been lucky. She was gray, she was jaundiced. And this doctor was very, very critical of me. It was a woman doctor who -- and I came out and I said, we still had limited amounts. And I said this patient was not eligible. She said oh, is that because the patient's not rich enough for you? I said no. If we had a patient who we felt comfortable asking that they could pay for the interferons so we could have extra interferon to treat more patients, we would do it. I mean, we had no choice. It was a very -- we should come back to this issue of how I dealt with the money issue, because it was all donations. Because there weren't many wealthy people. Some would give money, some would not.

Lesley W. Brunet:

Are you talking about the patients?

Jordan Gutterman, MD:

The patients, yeah. And I'd get calls from wealthy people. And even there, I would not necessarily accept money. They would say, well, I'll pay for the interferon if you just treat it. And even that, I had to be careful about, simply because...

Lesley W. Brunet:

(inaudible)

Jordan Gutterman, MD:

Yeah. There's -- you had to be really careful. We should come back to this issue. I don't think this has been discussed at all by anybody, of how those decisions were made. Because it was somewhat of an unusual...

Lesley W. Brunet:

That didn't come through to (inaudible).

Jordan Gutterman, MD:

No. And I don't want to get distracted, you know, I just -- I'm the one that got off on a tangent, but I won't forget this issue. There's probably multiple subtexts to talk about, if you have the time, I'd like to explore with you, because there's so many facets -- the interferon story is such a prototype, a microcosm for so many issues. Deals with government -- I mean, I don't know many sessions we're going to have, because I got to be a little bit careful getting too detailed with this, because my mind is wandering of all the stuff that is coming here. You know, my tie with Mary Lasker and Washington, and just the whole thing around money.

Lesley W. Brunet:

(inaudible) (break in tape)

Jordan Gutterman, MD:

Sure. OK. Thanks. All right. So...

Lesley W. Brunet:

So you were talking about the...

Jordan Gutterman, MD:

So we had these breast cancer patients, and initially, I think we treated about eight patients before we went on to the tumors that I thought were going to be more sensitive. But we needed to do about eight patients. Now. At that stage, Mary Lasker was getting quite excited. I would keep her posted almost on a daily basis of what was going on with the patients, and it was clear that she began to strategize. Because she would think big. How can we move -- assuming that this is -- I mean, she trusted me. She had Strander working on, now, maybe three patients with myeloma, and there was this suggestion that these osteosarcoma patients, bone sarcoma patients, that he had treated post-surgery that he suggested way back in '75 that giving interferon after surgery delayed or prevented the recurrence of sarcoma. That's how the clinical stuff kind of got started. It was not advanced disease, he was using it as a preventative. Which was the logical thing to do. And the irony is no one has attempted to repeat those studies, which it kind of gets back to the whole point of, you know. So when later people tried to treat advanced terminal osteosarcoma patients, the interferon didn't work. It doesn't mean anything. Doesn't mean anything. It's like trying to treat a hypertensive who's had the disease for 20 years, and the blood pressure now has climbed to 240 over 120, and they have a stroke, and they're sitting there, unable to talk, and now you want to go in there and treat their blood pressure. Well, you need to get it down, but the point is, you can't reverse the damage. Any more you can reverse those mutations, and all the things of osteosarcoma. It's the same principle. So the fact that anti-hypertensive may be able to lower the blood pressure, but would not reverse any of the damage. Mutations and all of the damages that evolve during cancer, once they occur, you're not going to reverse them. If there are too many. So -- but that principle was -- Strander's work has never been appreciated or, for that matter, really, with interferon. But back to the story. So Mrs. Lasker began to strategize. How can we move this forward. Now, I was new at this, now I -- so, she began to talk to a lot of people. And she had two strategies. She had pretty much given up on the National Cancer Institute, saying they were hostile to the idea of this, which they were. So she felt that the only way we could do this is go directly to Congress to force it down their throats to get more money put in designated for interferon. Number two, the pharmaceutical industry. And number three, the private sector. Other private donors, and then specifically, the American Cancer Society. So she had a three to four pronged approach. Number one. Private. She called me after hearing about maybe five or six patients. And said, "I had lunch today with Dick Rauscher, Frank Rauscher, who was head of the ACS. A virologist. And being a virologist, being a PhD in virology, he certainly was familiar with interferon. I told him about your results, and he said, for you to write a grant, that they had extra money. They were looking for new avenues for their money, and this sounded like something that would be very attractive to the ACS." I'm sure -- and there's nothing wrong with this, by the way -- I'm sure he was thinking the ACS a unique profile. I'm sure -- in fact, I know that he heard from Mary that the NCI is sitting on their hands or hostile to it, and there were some competition. Rauscher had been the director of NCI, if I'm not mistaken, prior to taking over the ACS job, so there must have been some competition there. And so, I started to put together a grant. And Rauscher's recommendation is, based on the cost of interferon, that I put a grant in for $2 million. To expand -- to confirm, expand these studies in breast cancer, and by the time I start talking to him, we began to get some preliminary results in myeloma and lymphoma as well. So I began in the spring of '78, began to put a grant together, under the naive thought that -- well, it turned out OK, but under the naive thought that the money was coming to MD Anderson. Mary suggested that we suggest -- that we write it so that the money would be shared with one other institute, which was actually a great idea, so the work would be confirmed, and I suggested a place like Sloan-Kettering. In part, because -- in large part because Mathilde Krim, who had organized that meeting of all those basic scientists that set up a big interferon research laboratory, they had a team of basic scientists, so the environment there, I think, would have been very hospitable -- very favorable towards interferon. I mean, at the time, don't remember when Bob Good was -- I guess he was let go. I don't know if Paul Marks was in president -- but that's not important. The important thing is that the environment there, I think, would have been pretty good. So, secondly, she called a friend of hers at Hoffmann-La Roche, and I'll get back to the ACS, because it all converged at one time. She suggested that we needed to really get the pharmaceutical industry, because that was explained to her that now recombinant DNA had become a reality. To go back, I mentioned that it was discovered by Cohen and Boyer and Paul Berg all at Stanford -- well, Paul Berg was at Stanford. Stanley Cohen was at Stanford. Not working together directly. And Herb Boyer, in 1976, was the co-founder of Genentech. He was at UC San Francisco, I think. And then in April the 7th, 1976, Genentech was formed. By the way, I find these dates interesting...

Lesley W. Brunet:

Just wondering how you remembered all these dates.

Jordan Gutterman, MD:

Well, it's embedded -- and this is not just rote, but the thing is, I do kind of look at things -- I mentioned to you last time, one of my really favorite topics, it's kind of non-scientific. But that my father passed away on April the 7th, 1974, because I went back to the unveiling a year later around the Passover time. I was on the East Coast when Freireich called and Clark called to go to this meeting. Nobody wants to go from here, you're the closest. And so, the same date, again, one year later, April the 7th, is Genentech was formed. Cetus had been formed, that was the first company, and they also were working on interferon, we won't get into that. So, Genentech was formed. So, in 1978, when Mary and I were talking, I told her that the supply problem -- if this was going to continue to work, eventually we're going to get to an insurmountable problem. But, and still, there was no publicity, so there was very little activity outside of the Finnish Red Cross and Mathilde Krim working with the Swiss Red Cross trying to produce interferon in a more economical way. But I remember talking to her and saying that recombinant DNA may be a ways. So therefore, she said, we got to get into the drug industry. Don't forget now, biotech, in 1978, consisted of Genentech, Cetus which was eventually bought by Chiron, and maybe a couple of other companies.

Lesley W. Brunet:

Can you spell that?

Jordan Gutterman, MD:

Cetus? C-E-T-U-S. This was a company formed in 1970, and it never really made it, although it was bought out eventually by Chiron. They did work on beta-interferon eventually. Anyway, so, she called up -- Mary called up her friend in the late spring was I was writing up this grant, at Hoffmann-La Roche, John Burns. She had gone to Burns after hearing a talk on L-DOPA, for Parkinson's disease many years previously, and urged Burns, who was head of research and was one of the co-founders and idea visionaries forming the Institute of Molecular Biology at Hoffmann-La Roche. The only -- as far as I know, the only one of the rarer ones of its kind, they had an institute devoted to the burgeoning science of molecular biology within the drug companies. Pretty -- see, there's no biotech industry, so cloning genes was still kind of a foreign thing for companies. And also, since genes make proteins, proteins outside of insulin really wasn't much part of the big pharmaceutical industry. Proteins come out of biotechnology. But Roche had the vision. There's a guy named Sidney Grunold, I think his name was, or something like that, I could think of it. And John Burns. So anyway. Burns was the head of pharmacologists, and Mary said I have another idea for you. Well it turns out that Dr. Burns, John Burns, who's in the National Academy of Sciences, told Mary that in fact there was an interferon program at Roche already in place, trying to purify interferon. They were having a problem, John told Mary, in getting raw material, i.e. white blood cells, to get enough interferon to try to purify it. Nobody could purify -- nobody knew what the structure was. So Mary arranged for a meeting, the annual Lasker Awards were, and they still are, in the middle of June. And I was coming up from my first year to be on the jury, which was a great honor. And so we arranged a meeting to go over to Hoffmann-La Roche in Nutley, New Jersey, and I believe -- the dates -- I have the dates at home if they're not in the letters. Around the 15th of June of 1978. So, to back up just for a second, about two weeks -- no, actually about a month before in May, I finished, completed the application to the American Cancer Society for the treatment of breast cancer, myeloma, lymphoma, asking for $2 million. Sent that off to Rauscher. And it's ironic that the day before the Lasker jury meeting, we went to Roche. The following day, Rauscher got a group of ten scientists from ten different cancer centers to review the grant and discuss it. So he brought them all into New York. The day we actually were meeting for the Lasker Awards, around the 16th of June. So all of this converged very fast. All of this converged with Mary pushing it.

Lesley W. Brunet:

Did you have any trouble getting the grant publication out of MD Anderson? Were things being fed through a research office (inaudible) or through...

Jordan Gutterman, MD:

Not that one. I'm trying to remember. Now, this was -- Clark was still here.

Lesley W. Brunet:

(inaudible).

Jordan Gutterman, MD:

Yeah. Later on, I had big problems. Two separate ones. I can give you names and stuff later. But, I don't think that particularly one had a problem. Now, I just want to, as an aside, I probably mentioned this, and I fail to do so, but I have extensive notes. Extensive. From 1977, '78, through up to '85, '86. And what is not in your thing -- and I've written this all up, and I have almost like a daily log, because I would drive to work with a Dictaphone, and my secretary at the time would type all this stuff up. I mean, totally uninteresting, but I mean, just random thoughts, you know. The grant went -- I mean, boring things, but you know, it's not boring, because I can read it real fast and get the gist, and really trigger the memory. And I'm finding even today, and I'm -- a point like that, I'm not 100% sure about that one. But there's a lot of things that stand out. I probably, if I had a problem, I would remember it, because there were others with the Clayton Foundation that -- I mean, I'm not going to get into now, but the Clayton Foundation here in Houston came into this within a year, and there was an individual, absolutely blocked my application. The money was already approved to get people too, because the trials were getting bigger. Come back to that later. The guy would deny in the...

Lesley W. Brunet:

(inaudible) somebody within the institute?

Jordan Gutterman, MD:

Well, he's retired now. I see him from time to time, he's got a lab still up here. And he acts my -- like, for 20 years, my best friend, and he would deny it.

Lesley W. Brunet:

[Redacted]

Jordan Gutterman, MD:

You got it.

Lesley W. Brunet:

(inaudible).

Jordan Gutterman, MD:

What's that? BRUNET: [ That's what I've (inaudible).

Jordan Gutterman, MD:

Yeah. We'll talk about it. Yeah. He put a granite -- he just put my grant in the drawer and [sent a grant in?]behind me to the Clayton Foundation. Of course, they were outraged about it. By that time, LeMaistre was here, and it was all just -- oh, you know. We had a committee that looked at this, and Dr. Gutterman's grant is -- was found to be inferior -- there was no truth to any of it. [Redacted] Stupid. Anyway, it was taken care of, but to me it was just unbelievable. But, on this one, I don't think so. But Clark was still here. (laughter) And, nobody was paying attention (inaudible). After -- these all came later, when all the publicity and -- but right now is all -- that's why, just as an aside, on the work I'm doing now, which is actually, frankly, is potentially much more explosive. I'm...

Lesley W. Brunet:

Very quiet.

Jordan Gutterman, MD:

Very quiet. So I can get the work done. There'll be a time, and then I can get it out there. But we're not ready yet, because there's no advantage. Yeah, I could probably raise some more money, because, you know, people like to know, and that's -- I've had some problems. But I'm too old for this. (laughter) I don't want to go through this again. It's very exciting. And Mary's not alive, I don't have a fairy godmother here helping me out. OK.

Lesley W. Brunet:

Hold on just a minute. END OF AUDIO FILE 7

Jordan Gutterman, MD:

I'll do it again. She knew the foibles of man. She knew that institutes, you know, the higher up, the more problems there are going to be. Including then, you know. The power game. I mean, she always felt that -- there were so many wise things that she said. And one of them -- we'll touch on all of them. The ones I remember. But one is that she always felt that women were much more sensitive to research and healthcare needs, because -- and she said the answer is because most women take care of children -- grow up children, and they're the ones who get up in the middle of the night, in general, don't forget, she lived in a different time. But women are the ones that get up and take care of the colic and the otitis media in the ear, and the screaming and the yelling and all that. And so, they're sensitized to pain. In her mind, certainly up until her death, and again, the prime of her life was at a different time. Men just weren't sensitive to it. It's not maybe they weren't built that way, it's just their roles in life. And she -- and I always found this to be true. And you'll see this as time goes on. Almost always, but not always, we'll find out as we go through this saga, that people who really came up at the bat were women. It's a great -- another subplot. We might even write those subplots...

Lesley W. Brunet:

What was the last thing you said?

Jordan Gutterman, MD:

About women.

Lesley W. Brunet:

Another...

Jordan Gutterman, MD:

Another subplot. Yet another subplot. No, I think, as we're talking, I can -- you said something really profoundly exciting to me about -- I hadn't thought about that, of -- besides what I've written, recapitulating it with you, where the memory may not be quite the same, and we're going to have to -- I'll compare notes. I mean, this is all accurate. But I may be forgetting a few things. What I'm telling you, but it's just am I leaving anything out. Probably it's good I'm leaving a few things out, because we could be here forever.

Lesley W. Brunet:

And we want to get this to Olson.

Jordan Gutterman, MD:

Yeah, I know, so let's get going. But I think there are several -- whether he will do anything with it, it's not the relevant thing, he probably won't, because of this big thing at MD Anderson. But for me to think about these subplots in terms of what are the lessons we learned about how things get done in society, and there are some wonderful stories here. I'm having lunch a week from Tuesday with someone I introduced to her who is a powerhouse of a lady, Sherry Lansing, I don't know if you know the name. She was head of Paramount Studios. [Redacted] And we became good friends. She was very close to Armand Hammer, who's also a friend of Mary's. And Sherry's quite interested in cancer research and health research and stem cells and all that. And she's so typical compared to a man, and Mary recognized in her. She had great possibilities. But almost without exception, women are the ones who came to the forefront.

Chapter 06: Funding Interferon Research through Connections and Industry

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