Chapter 15: The Office of Translational Research: Growth Areas

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Chapter 15: The Office of Translational Research: Growth Areas

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Description

Dr. Bast discusses projects that are expanding the impact of the Office of Translational Research. He first sketches the Clinical Investigator Program, started in 2009, that allows physicians to devote 75% of their time to research. He sketches the accomplishments of some of scholars who have completed this program. Dr. Bast then talks about how the Office develops the leadership potential of the translational researchers. Next, Dr. Bast shares examples to demonstrate the importance of keeping pace with emerging technologies to support translational research. Dr. Bast notes that his Office will focus on developing its educational initiatives in coming years. He mentions courses now under development now for the Graduate School of Biomedical Sciences.

Identifier

BastRC_02_20140724_C15

Publication Date

7-24-2014

Publisher

The Making Cancer History® Voices Oral History Collection, The University of Texas MD Anderson Cancer Center

City

Houston, Texas

Topics Covered

The University of Texas MD Anderson Cancer Center - Building the Institution; Education; On Research and Researchers; Understanding Cancer, the History of Science, Cancer Research; Discovery and Success; Technology and R&D; Mentoring; Leadership

Transcript

Robert Bast, MD:

Getting back, there’s one other area that we didn’t cover in terms of career development. And that was the clinician investigators. This is the flip side of the physician scientist program. And that’s a program for clinician-investigators. We’ve three times renewed a K12 grant from NCI to rain senior fellow and junior faculty members. Instead of being eighty percent in the laboratory doing clinically relevant research as physician scientists would be, clinician investigators spend seventy-five percent of their time doing clinical research. The endpoint here is to develop their own investigator-initiated clinical trials that ask a question so that no matter how the trial turns out, positive or negative, you get information that you need to plan the next trial, a so-called hypothesis-driven trial. Twenty-three scholars that have been part of this program. The K12 grand that funds them is from the National Cancer Institute, but that only pays about seventy-five K of the physician’s salaries. The difference from the actual salary, depending on your subspecialty, is huge, so that the institution really has picked up the difference to make seventy-five percent dedicated time for each of the clinicians who’ve been part of this.

Tacey A. Rosolowski, PhD:

How long has that program been in existence?

Robert Bast, MD:

Again, just about the duration of our office, fourteen or fifteen years. We’ve got five clinician-investigators currently in our program and eighteen graduates. Ninety-four percent have stayed in academe and one of the “drop outs” is actually founding a Phase I clinical trials unit for Sarah Cannon, which technically is a private group, but will be doing clinical trials. And most of these investigators have remained at MD Anderson. Seven are still assistant professors, and six have been promoted to associate professor, and four to professor. Seven are currently pursuing degrees and three have obtained either a master’s or a PhD. Altogether they’ve published more than 370 peer-reviewed publications and again with reasonable impact factors. Graduates have obtained $28 million in contract funding, but I think most importantly have had really productive careers in clinical research studying cancers at several different disease sites. The program has included medical, surgical and radiation oncologists. Clinician-investigators are crucial to translational science.

Tacey A. Rosolowski, PhD:

And I noticed I mean both among this group and the other training program you were talking about earlier a pretty high percentage stay at MD Anderson. Is that a surprise to you?

Robert Bast, MD:

No, it’s a great place.

Tacey A. Rosolowski, PhD:

Yeah. Well, and I’m curious. It certainly maximizes the investment.

Robert Bast, MD:

Increasingly too we have seen more senior people recruited away. When I first came to MD Anderson twenty years ago that didn’t happen nearly so often. But increasingly we’ve got really great people from MD Anderson who have become leaders at other institutions. You think of Roy Herbst and Lajos Pusztai are at Yale where Roy heads translational research and Lajos heads their breast cancer program. Fadlo Khuri is at Emory where he is currently head of their oncology department. Wadih Arap and Renata Pasqualini are now leaders at the New Mexico Cancer Center. Jean Pierre Issa now heads the Fels institute in Philadelphia. So we’ve got a number of people who have gone to other institutions in a good way, not because they were disgruntled with MD Anderson, but just because they had an opportunity to really lead something important at other outstanding institutions.

Tacey A. Rosolowski, PhD:

What about the leadership piece? Because you’ve talked about setting in place the planes of professional information that are needed simply to practice at the bench or to practice in the clinic and make the connections between the two. But what about emerging into a leadership role in the field? To what degree is this office involved in helping facilitate that in these careers?

Robert Bast, MD:

There are several answers. We just submitted a K12 grant renewal and one of the initiatives we’ve identified moving forward is to provide formal leadership training for the trainees. MD Anderson has two appropriate programs in which scholars can participate. We’re also developing what we have called a “Master Class” for the clinician investigators in the K12 program where senior leaders in clinical investigation at MD Anderson and elsewhere are invited to share their secrets and their wisdom about how they have made career decisions, deal with pharmaceutical companies, choose projects, how they got to where they are, and what problems they’ve overcome, and what they found most difficult or least difficult in all that. So we’re trying to do that as well. Scientific leadership is also important. For both physician scientists and clinician investigators the oversight committee has an annual committee meeting to review progress. I’ve found over the years that really wasn’t enough. So every four months or so I get together with each scholar individually and provide a second layer of mentorship. We have individual mentors both laboratory and clinical for each scholar. But it is important for someone to make sure that the physician scientists and clinician investigators are actually meeting with their mentors, that they’re getting their dedicated time and have clear goals and timelines for papers and grants. We’ve also helped to get small committees together to review grant applications or revisions to grant applications. I think that’s helped that as well. But increasingly in terms of mentorship we’ve become much more proactive in advocating for people as potential leaders to be sure that they meet other people in their chosen field. Also that we propose them for awards as soon as it’s appropriate, both for career development awards outside of the institution and actually. With Liz Travis [oral history interview] we’ve established an institutional committee to propose people for awards more aggressively. That’s actually paid off remarkably well. Also working with Helen Piwnica-Worms we’ve got another committee coordinated by Nancy Hubener in my office to try to increase our batting average in getting really prestigious career development awards for our faculty. Also working with Ki, and others, we have been successful in getting MD Anderson candidates elected to the American Society for Clinical Investigation, the American Association of Physicians and to fellowship in the AAAS.

Tacey A. Rosolowski, PhD:

What are next steps for this office? I mean I know you’re hanging on with the immediate steps. You’ve got a lot going on right now. But I mean in terms of planning for—

Robert Bast, MD:

Well, I think in terms of growth areas, clearly to keep pace with emerging technologies is going to be crucial to maintain state-of–the-art shared resources. New gene editing techniques for example have been developed with CRISPR-Cas9. One of our problems this week is try to figure out how to invest in new technologies most efficiently and most effectively. So there’s an ongoing process not just in keeping our current shared resources well managed but actually trying to identify what is the next frontier. And does shared instrumentation make sense? And also Alan McClelland has recently just taken on doing this with the Moon Shot platforms. Obviously each of the platforms does its own thing. But he’s providing a second layer of review if you will to be sure that there aren’t needs for the platforms that aren’t being met within the moon shots program. So that’s part of where we’re headed. In terms of our educational programs—we want to develop the Clinical and Translational Science program in the GSBS. And we need to be sure that both the graduate and post-graduate programs are optimal. But we’re going to have to have I think a substantial role in that. We also need to put together a new “Clinical Oncology” course for the second year as well.

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Chapter 15: The Office of Translational Research: Growth Areas

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