Chapter 15: The Zayed Institute for Personalized Cancer Therapy, Part II
Dr. Mills returns to the story of the Zayed Institute in this chapter. He begins by talking about the new Zayed Building, designed to facilitate collaborations. Next he talks about the Institute's role to promote personalized medicine. One arena of promotion involves supporting the next generation of physician-scientists with this translational mindset. He then turns to another facet of this role: provide mechanisms to deal with the "big data" emerging from Systems Biology research and leveraging this into clinical applications. He discusses a project run by Funde Merick-Berstam, the PODS Program [Precision Oncology Decision Support], which is a web based support system for clinicians that Systems Biology and the Zayed Institute run over the last two years.
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The University of Texas MD Anderson Cancer Center - Building the Institution; Building the Institution; On Research and Researchers; Understanding Cancer, the History of Science, Cancer Research; Research, Care, and Education; Research; Building/Transforming the Institution
Tacey Ann Rosolowski, PhD:Shall we go back to the story of the institute?
Gordon B. Mills, MD, PhD :Sure. Yes. What story would you like about the institute?
Tacey Ann Rosolowski, PhD:Well, we were talking about kind of shepherding it, moving it through and kind of getting connections with the institution, and just wanted to ask, kind of what are the newer developments. We've got a new building.
Gordon B. Mills, MD, PhD :The building is named after the people who donated the funds. The proportion of the building that is dedicated to the institute is actually quite small.
Tacey Ann Rosolowski, PhD:Oh really? Okay.
Gordon B. Mills, MD, PhD :The great news was, is those funds were used to build this incredible facility, and it is truly an incredible facility, and that many of the things that will happen in the building are related to the goals of the institute. But the actual institute space, physical space for people who work directly related to the institute, is quite small.
Tacey Ann Rosolowski, PhD:I didn't realize that. And just for the record, this is the Zayed Building. What's so amazing about the facility?
Gordon B. Mills, MD, PhD :There are several things. First, this is the last current, new space, available for research, in the institution. I've been here twenty-two years. This is the first time there is not a construction crane on the property in twenty-two years. This is the only new building that we're going to be able to put new researchers in, reorganize space, probably for the next five or six years. There are plans for more buildings, but it's going to take time for those to come to fruition, and so this is an incredible opportunity to bring in new people, new ideas, and also in some places, to move people to give better contingencies to others. So it's not necessarily that everyone who comes into the building will be new, but the space they release will allow us to expand and bring in new people. One of the other pieces that will happen is we have old facilities that have to be vacated, they're just no longer viable. So, built at a time when they just did not have the ability to plan this far in the future, for the flexibility that's needed, and they just need to come down and be replaced.
Tacey Ann Rosolowski, PhD:What kind of features does the building have to facilitate the kind of research that you folks need to do?
Gordon B. Mills, MD, PhD :The building was designed with the concept of collaboration in place. Just talk about a couple of physical things first, that make it a neat place to work. The first one is, is the ceilings are a foot higher, and there is this feeling of openness that comes with that. Massive amounts of glass, again, openness that comes with that, and those are really two very important aspects. The building was also designed to, as much as possible, in an environment of research, to facilitate and encourage collaborations. So the first is, is there are four towers, but every tower is connected to the other by a large interaction room in the middle, where people going from their offices to the towers will have an opportunity to run into others and develop collaborations and interactions. There is nothing like bumping into someone, talking, and making something happen. Now, I'm not saying that that's working as well as was hoped, because people are very busy with their own things right now and the amount of information and challenge and stress with grants and the rest, has restricted some of that free time to interact and talk. The other is, is that all of the labs are open, they're glass, well they're open in two ways. There's no walls in each wing. Basically, the whole lab or the whole wing, is one open area, again designed to facilitate interactions and flexibility. Then, the walls, all of the rooms, on the outside, are glass, so people can walk by and look in and say ah, there they are, I can go talk to them, or this is what's going on there or here's a piece of equipment. The idea is again, to foster the idea of openness, sharing, collaborations, interactions. We will see how well that works over time. Right now, there's only a very small amount of the facility occupied, in what's called phase one. Phase two and phase three and supported to start very soon. The funds are available and so they will begin. There are some design processes that are being put in place, in that the fire marshal rules changed from when the building was planned, to when people have come into the building, resulting in a need to re-plan some of the ways in which different parts of the building will work to deal with the worries about flammables and explosions. That's in process now and we're excited, because we're going to get new space in that expansion.
Tacey Ann Rosolowski, PhD:Now, you said that the other occupants of the building are going to be related to the activities of the institute. What do you mean by that?
Gordon B. Mills, MD, PhD :Well, related. One of the things, the Zayed family, or the Foundation, has supported both the Institute for Personalized Cancer Therapy and pancreatic cancer research specifically related to the disease that brought them in touch with MD Anderson. So, the Pancreas Cancer Research Group is one floor below us, and we do interact with them. I'm not sure that proximity is as important as it was five years ago. The ability to communicate at a distance, through the Internet, through Skype, through others, I think has taken down a little bit, the need for physical proximity, although knowing people makes those distance communications easier. I have multiple Skype meetings with people around the world, but most of them I knew before we start that process, and so once you know someone it's easy to collaborate. Interacting with them will help and, you know, we share agents, we share equipment, and so those are working. The others is that most of the groups at MD Anderson have, over the last ten or fifteen years, evolved, partly because of opportunity, partly because of this convergence we talked about, and partly because the National Cancer Institute demands evidence that what you are doing can help patients. That's their jobs, since it's a national cancer institute, not the National Science Foundation, which is a little different concept. With that in mind, the translational aspects are much more prominent, I think in most people's minds here, so the people that come into the building will, in most cases, have a goal of translating things through to the patient, which is what the institute is all about. Now, one of the major roles that the institute serves is as an advocate for different things across the institution. This institution is big and it's hard for people to have an impact with ideas and concepts, and drive directions of the institution, and so the institute has very much taken on the role of saying we are the advocates for personalized cancer therapy and all the things that go with this. What we are doing now, in one of our major programs, is to attempt to recruit and support the next generation of scientists that are going to benefit from the concepts and precepts that we have helped put in place. We don't have as many outstanding young physician scientists that are going to be the next generation as we would like to have, and so John Mendelsohn has taken a personal charge to find, recruit and support those people. Now, young here can be assistant and associate professors, not just trainees, but people who can come in and help build this program more broadly. So I think that this is one of the other legacies that will come out of the institute and its support. One of the other pieces of evolution that has happened, and I think that this was not something we thought about at all when we started this program, is that the average physician has very few tools to help them deal with the amount of information we can now generate for patients. And so the concept of what's called decision support, providing useful approaches to take all of the stuff that is being generated in pathology and lab medicine, in our group, in other groups, and say how do I take that information to Mrs. Green's particular circumstance and help her, is one of our big programs. This is headed by Funda MericBernstam, again, and it's our decision to support the program.
Tacey Ann Rosolowski, PhD:How does that work? What sort of support is being put in place?
Gordon B. Mills, MD, PhD :Well, it comes in many levels. One is, is we've developed a website, which is a user friendly website, that website is used worldwide. We make everything we can, as much as we can, we make it publicly available to all, to help all. There's an internal website that is a little more directly linked to the results that you would get from molecular testing on a patient here, and then we had a PODS program where, by email or by phone call, an individual can call and say I've got this abnormality in a patient, what do I do? Giving direct feedback to help. With that process started and built, we were able to get a CPRIT grant, we being Funda, to move that further along, and also to make it available to everyone across Texas.
Tacey Ann Rosolowski, PhD:Wow, wow. I remember Dr. Mendelsohn telling me just about the data management challenges now, and one end is for the researchers, managing -- how do you keep abreast of all the research that's coming out and understand all the data that's coming out, but then on the other hand for clinicians, how do you process and integrate so you can apply.
Gordon B. Mills, MD, PhD :So how do you take the thousands of papers that exist and distill the key points that you need. The website that we've developed goes everywhere from very superficial to this is the name of the gene, this is what you might do, down to direct links to a paper about the most minutia point about, this is a particular change in that gene and this is what you would do because of that one change. So the idea here is that the physician determines the amount of information that they want back.
Tacey Ann Rosolowski, PhD:Who designed the website?
Gordon B. Mills, MD, PhD :Funda.
Tacey Ann Rosolowski, PhD:Okay, and did she have a team of people?
Gordon B. Mills, MD, PhD :Our PODS program. I don't know how many people she has working on this but there's a team to help her make that happen.
Tacey Ann Rosolowski, PhD:And I'm sorry, the PODS program.
Gordon B. Mills, MD, PhD :Yeah, I knew you were going to ask.
Tacey Ann Rosolowski, PhD:I've never heard of it before, so I can be excused.
Gordon B. Mills, MD, PhD :No, I can't remember. It's Physician Oncology Decision Support, I think.
Tacey Ann Rosolowski, PhD:Oh, okay.
Gordon B. Mills, MD, PhD :But let me find out for sure.
Tacey Ann Rosolowski, PhD:I can look it up too.
Gordon B. Mills, MD, PhD :I doubt you can, because I can't.
Tacey Ann Rosolowski, PhD:Interesting.
Gordon B. Mills, MD, PhD :Here it is, I hope. I knew when I said that, I was going to regret it.
Tacey Ann Rosolowski, PhD:Well, it's actually pretty important, I mean this and --
Gordon B. Mills, MD, PhD :Precision Oncology Physician Support.
Tacey Ann Rosolowski, PhD:Precision. Great, thank you. And when was that set in place, do you remember approximately the year for that?
Gordon B. Mills, MD, PhD :The various aspects of it have been being built over the last three to four years. Becoming highly useful would be the last two years, give or take. Funda herself and her husband, Elmer Bernstam, are two of the leading medical informatics people around. Elmer is at the University of Texas, Houston, and medical informatics is the process around medicine. This is one aspect of that process. They have multiple grants in this area. It's a little hard to say, I'm not sure we can say, how many or how much of what we've done, based on philanthropic funding, has been necessary, integral, required, for leveraging of grants and other funding support. It's very hard to track, but these are some clear-cut examples of funding in these areas, that would never have happened without the institute.
Tacey Ann Rosolowski, PhD:Wow. So this PODS program started with philanthropic dollars?
Gordon B. Mills, MD, PhD :Oh, yes.
Tacey Ann Rosolowski, PhD:Oh wow, that's amazing. Well, it sounds really, really exciting.
Gordon B. Mills, MD, PhD :Again, like most high risk, high yield, not sure where it's going to go programs, you have to start with philanthropy, and once you get it to a stage where it's more concrete, you can bring in grant support.
Tacey Ann Rosolowski, PhD:We're almost at four. Would you like to stop for today?
Gordon B. Mills, MD, PhD :I've got to do some other work.
Tacey Ann Rosolowski, PhD:Yes, makes sense. Okay, so I want to thank --
Gordon B. Mills, MD, PhD :And I don't want to cough in your face any more.
Tacey Ann Rosolowski, PhD:It looks like it's coming on a little stronger. I wanted to thank you for your time today.
Gordon B. Mills, MD, PhD :Good.
Tacey Ann Rosolowski, PhD:I'm turning off the recorder at about three fifty-two.
Mills, Gordon B. M.D., Ph.D. and Rosolowski, Tacey A. Ph.D., "Chapter 15: The Zayed Institute for Personalized Cancer Therapy, Part II" (2016). Interview Chapters. 74.