Chapter 13: The Zayed Institute for Personalized Cancer Therapy, Part I
In this chapter, Dr. Mills begins the story of his role in managing the The Zayed Institute for Personalized Cancer Therapy in 2006/2007. He notes that he was first asked to manage the Institute with pilot funding. He talks about the first efforts to hire an Institute director leading to the decision that he and John Mendelsohn would serve as co-directors. Next, he talks about developing a plan for the Institute's growth, relying on significant philanthropic support. [the recorder is paused]
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Tacey Ann Rosolowski, PhD:Do you want to go on to the Institute for Personalized Care?
Gordon B. Mills, MD, PhD :Sure, why not?
Tacey Ann Rosolowski, PhD:Were you in the ground floor of getting that all…?
Gordon B. Mills, MD, PhD :No, I wasn't.
Tacey Ann Rosolowski, PhD:So tell me about when you came in and why.
Gordon B. Mills, MD, PhD :The Institute for Personalized Cancer Therapy had been developed by John Mendelsohn, with a clear understanding that this was an important are to move forward, that at that time, it looked like our greatest opportunity to have a major impact on patients and patient outcomes; matching the therapies to the underlying genomic aberrations that were present in the tumor.
Tacey Ann Rosolowski, PhD:Now, your involvement came in 2010, but remind me, when was the institute actually started?
Gordon B. Mills, MD, PhD :Probably 2006 to 2007, was the inception and implementation, and in that time period, they had initially asked Dr. Stan Hamilton and Dr. Waun Ki Hong, to manage the program. Their approach was very much to use pilot funding support to say can people build and develop, with small amounts of funds, a program that would then lead to improved outcomes based on these precepts.
Tacey Ann Rosolowski, PhD:These were philanthropic funds at the time?
Gordon B. Mills, MD, PhD :These were philanthropic funds. It's been driven primarily by philanthropic funds, at least initially. After a few years, it became clear that that perhaps was not the most efficient way to move the program forward, that the idea of a more top down, broad development program, would make sense. The institution then went out and started a search process, to find somebody who would potentially run the program, interviewed a lot of people, both internally and externally, and I think because the direction of the program was not clearly articulated and indeed, I think that Dr. Mendelsohn and a number of people hoped that the person they would recruit would articulate that direction, but if it's not articulated, do you recruit the right person, was this circular problem. They decided to again, to disband the committee and look at additional candidates, and one of the candidates that they brought in said to John Mendelsohn, "Why are you talking to me? You've got the right person here already." And so Dr. Mendelsohn came to me and said, "Would you consider this?" How do you say no?
Tacey Ann Rosolowski, PhD:Well you can but you didn't, so why didn't you?
Gordon B. Mills, MD, PhD :That's the story. In general, with my Canadian background, if you are asked by your boss to do something, you do it, and unless you feel that you are absolutely the wrong person and not able to do it, you would do it. It's not really a question, it's an order.
Tacey Ann Rosolowski, PhD:So in 2010, you took on that role. Did you shed some other roles in the process?
Gordon B. Mills, MD, PhD :Should have. No, not really. So there's a little more to the story. At that point in time, I was asked, by Dr. Ray DuBois and Dr. John Mendelsohn, to put together a program that would take what we had been doing in the Kleberg Center, which they were modeling this on, the fact that we'd been successful in that process, and take this another level. And so I was putting that together when, one day I got a call to come and see Dr. DuBois and Dr. Mendelsohn, to talk about this, which was fine. They wanted me there at eight in the morning, that was no problem, and then at the end of that discussion, Dr. Mendelsohn said, "I need to talk to you." Okay, when? I was on my way out of town on a trip and he says, "Today." Okay. When do you have time here? Okay, I will change my flights, I'll be there, and I come in and he says, "What do you think about me stepping down as president of the institution and running the institute with you?" So, that was kept very quiet for a number of reasons, because there was potential conflict of interest, he could not play any role in anything to do with this if he was going to play a role as co-head later on. So, it took a lot of work, a lot of time and a lot of planning and process, to where he stepped down, and we have been co-directors of the institute since.
Tacey Ann Rosolowski, PhD:How did you go about collaborating to develop that? What did you want to achieve?
Gordon B. Mills, MD, PhD :There are two ways to move an area forward. One of the things, at that time, is there really was a very strong philanthropic support for the institution, and a pretty significant bankroll to make this happen. We looked at this and said, instead of asking for RFAs and small projects, let's take on some big questions, bring together an advisory board, but very much in the way that I like to see things happen. Get a small group of people together, build a plan, put that plan in place, and then ask others to say how should we modify this, is this something that makes sense? And took that book to internal advisory boards, external advisory boards, and said here is what we want to do, but we're going to do this big. That led to much more of a centralized planning group, but once that general process and concept was in place, we had Dr. Mendelsohn, myself, we recruited Kenna Shaw, who had been running the Cancer Genome Atlas, which I talked about, because of its scale and scope and outstanding scientific administrator who is not just an administrator, she is an active player. And then, in order to implement on the clinical side, we brought in Funda Meric-Bernstam, who was a surgeon, to help as medical director of the program, with the idea that I had worked with her and there was no one that I knew who was more able to deliver on making things happen, and we needed to do that.
Tacey Ann Rosolowski, PhD:Could you repeat her name please?
Gordon B. Mills, MD, PhD :Funda, F-U-N-D-A. Meric, M-E-R-I-C, dash, Bernstam, B-E-R-N-S-T-A-M.
Tacey Ann Rosolowski, PhD:Thanks.
Gordon B. Mills, MD, PhD :She is now also, in addition to being medical director of the institute, the chair of our phase one program, and that actually came very much out of her success in the institute, as showing that she could deliver in this area. So, it's been, I think very useful for her career development also, but very much so, the direction was driven by the four of us sitting and planning, and putting processes together and then checking, improving, checking, improving, rather than necessarily, a process of whole group in the middle, people in a room and brainstorming. We felt that putting together a plan first, and then using that to have people organize and improve, would be the way to go, and that's how we've worked the program ever since. We get lots of input from EABs and IABs and advisors, but it's been much more of a use of funds at a, to do things big that you can't do as individuals. Again, this idea of team science, collaborations, and most of what we do is support the efforts of others, but in a big manner.
Tacey Ann Rosolowski, PhD:Now, how do those collaborations work, because I remember when I was talking to Dr. Mendelsohn about this a few years ago, at that point he was talking about the need to reach out and invite people to basically make institute projects an extension of their research. So how has that process proceeded or progressed since then?
Gordon B. Mills, MD, PhD :I think that the way I would describe this is a little bit differently than Dr. Mendelsohn did. We put in place an infrastructure and resources. I mean you've sort of heard this from me before, facilitating, for example, molecular testing for cancer patients, thousands of cancer patients, that then our physicians could use that information in treating the patients, obtaining drugs, doing trials, moving things forward in their own studies. But rather than saying, You need to come and work with the institute, just go ahead and do your work, we're going to help make that happen. I think that it was much more of an infrastructure basis. Now, we also recruited some outstanding people who wanted to work in that environment and were collaborative, interactive, and used this, and we assigned or we selected or we worked with and found a representative of each of the different departments to function as a liaison who would come to our meetings, who would in theory, go out to their department members and make sure that the technologies were available, the processes were available, the information was available. So, I think rather than soliciting projects, which I think Dr. Mendelsohn would have liked to have seen, we actually instead, built an infrastructure and let others use it. It's sort of this, if you've got some big funds, do something big, rather than if you've got some big funds, do a lot of little things. I think we pushed very hard to try and do things that were big and I think that there's little question in the community, that the MD Anderson Cancer Center led much of what has happened, because if the IPCT. In terms of the implementation, identifying the challenges, and to some degree trying to find solutions for those challenges. Excuse me for a second.
Tacey Ann Rosolowski, PhD:Sure, let me pause. [The recorder is paused.]
Mills, Gordon B. M.D., Ph.D. and Rosolowski, Tacey A. Ph.D., "Chapter 13: The Zayed Institute for Personalized Cancer Therapy, Part I" (2016). Interview Chapters. 72.