Chapter 19: Overview of Administrative Roles; The Moon Shots; Translational Research and the Future of Targeted Therapy
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Description
Dr. Podoloff covers several topics in this segment.
He first sketches his role as Director of Clinical Research and his related work on the Institutional Executive Research Committee. He then sketches his role as Director of Clinical/Translational Research for the Division of Diagnostic Imaging (role assumed in 2010).
Dr. Podoloff then sketches the evolution of translational research under Dr. Ronald DePinho and gives his impressions of the Moon Shots program. He talks about early data produced a multi-disciplinary group of diagnostic studies conducted within the Lung Cancer Moon Shot.
Next Dr. Podoloff reflects on the evolution of cancer care. He then talks about how the genetic mutability of cancer tumors in relation to tailored therapies and the Moon Shots.
Identifier
PodoloffD_02_20150423_C19
Publication Date
4-23-2015
City
Houston, Texas
Interview Session
Tacey A. Rosolowski, PhD, Oral History Interview, April 23, 2015
Topics Covered
The Interview Subject's Story - Overview; Overview; The Researcher; Cancer and Disease; Discovery and Success; Understanding Cancer, the History of Science, Cancer Research; The History of Health Care, Patient Care; Research, Care, and Education
Transcript
Tacey A. Rosolowski, PhD:
What are the immediate next steps that you see for CABI? What are you hoping to work on?
Donald A. Podoloff, MD:
Well, they’re going to have to replace me, because I’m eventually going to retire. Don’t put that in the article, please, because I haven’t made up my mind when I’m going to do that.
Tacey A. Rosolowski, PhD:
All right. Well, you’ll have to look at the transcript and see if you want to take that out. But you can of course.
Donald A. Podoloff, MD:
We need to—it’s a very tangible thing and I’m uncomfortable talking about it because it has to do with the contract. In order for a cyclotron to be positive cash flow, it must sell radiopharmaceutical to its nuclear medicine department. All the successful cyclotrons in the United States do that. And that’s the major way they survive. We have a contract with PETNET that—
Tacey A. Rosolowski, PhD:
I’m sorry. What’s the name?
Donald A. Podoloff, MD:
PETNET.
Tacey A. Rosolowski, PhD:
Oh, PETNET.
Donald A. Podoloff, MD:
It’s a Siemens operation but it’s a different company now. That’s where it came from though. Ninety percent of our routine radiopharmaceuticals have to be purchased under contract from PETNET, for which we get a very nice discount. But when that contract is over in 2017 we need to renegotiate, because in order to make our cyclotron successful we need to start producing a fair quantity of our own radiopharmaceuticals from the cyclotron.
Tacey A. Rosolowski, PhD:
I see. Interesting.
Donald A. Podoloff, MD:
I don’t know if I want any of that in the article, because I’m not sure I should be telling it to you.
Tacey A. Rosolowski, PhD:
OK. Well, like I said, when you—
Donald A. Podoloff, MD:
There may be legal issues.
Tacey A. Rosolowski, PhD:
Absolutely. Well, when you get your transcript, you can say that you would like that redacted. Or you could say it should be sealed until a later date. You have all those good choices.
Donald A. Podoloff, MD:
OK.
Tacey A. Rosolowski, PhD:
Yeah. So not to worry.
Donald A. Podoloff, MD:
But that’s an immediate next step. We are exploring now the possibility of doing inpatient and interventional radiology over here. The driver for that is that—
Tacey A. Rosolowski, PhD:
Now when you say over here do you mean at CABI? OK.
Donald A. Podoloff, MD:
Yeah. Because we can do them in certain places on the main campus, but we have unique imaging capabilities here. The driver for that is this personalized medicine. You really need live-time biopsy and it’s not convenient to do an image over here and then take the patient somewhere else for a biopsy. So we’re exploring that. We just started that effort yesterday actually. I met with people to lay out the strategy about what we want. They do see inpatients, a small number of them, at the proton facility. And that’s what got our investigators. Well, if they do it at the proton, it’s right across the street, why can’t you guys do it? Well, right now if we have a catastrophic cardiac event we call 911, because we don’t have access to the Blue Team like they do on the main campus. And that’s part of the reason that the original decision was made, no inpatients and no pediatrics here. So we’re looking at that. And that’ll have a huge impact if we change that policy. I don’t know whether we will or we won’t, but that’s the idea. And I guess once we have been—we just did the McCombs Report. That was a big milestone.
Tacey A. Rosolowski, PhD:
What’s that?
Donald A. Podoloff, MD:
Well, we had a five-year report to do.
Tacey A. Rosolowski, PhD:
OK, for the—
Donald A. Podoloff, MD:
Basically hi guys, we gave you a lot of money, what did you do with it? Well, it turns out we didn’t really get all that much money from McCombs. He used his money for other reasons. This building was not paid for by the McCombs—
Tacey A. Rosolowski, PhD:
Really.
Donald A. Podoloff, MD:
Yeah. The state of Texas built this building.
Tacey A. Rosolowski, PhD:
So the combination of funding sources for CABI was partially McCombs, state of Texas, other philanthropy?
Donald A. Podoloff, MD:
Yes.
Tacey A. Rosolowski, PhD:
OK. MD Anderson itself made a financial commitment?
Donald A. Podoloff, MD:
They have underwritten us, yeah, right. So it’s clinical care last, because that’s the thing that we—clinical imaging last. Before that it was philanthropy, state of Texas. The medical school was supposed to put up some money but they changed their mind and instead became tenants rather than joint owners.
Tacey A. Rosolowski, PhD:
Interesting.
Donald A. Podoloff, MD:
And we basically get our money like the institution does, from the same sources. We don’t have a printing press either.
Tacey A. Rosolowski, PhD:
Right. But I imagine that there are certain individuals like Red McCombs who are very very interested in specifically research.
Donald A. Podoloff, MD:
I’m not sure about that. We don’t have that much individual donor money. It’s very hard in imaging to get sponsorship from donors, because they can’t see any immediate benefit, like if I save your life with a drug with prostate cancer. We don’t have an equivalency there in imaging. So it’s a very difficult donor support thing. A lot of PET cameras and cyclotrons in the beginning got supported by people who had brain tumors, and they got this marvelous image of the whole body that they’d never seen. That turned them on. But that’s not common. It’s hard to get philanthropic support for purely research studies. For instance the phase I study that I’m doing, what we’re trying to find out is how much of a dose of something can we give this patient before we give him or her so much that we might be damaging organs. That’s not a very easy sell for recruitment purposes. You basically have to tell the patient flat out, “This is not going to help you. It can’t. But it may help somebody in the future.”
Tacey A. Rosolowski, PhD:
Right, so it’s altruism.
Donald A. Podoloff, MD:
And that altruism really runs through so many of our patients. It’s remarkable that they’re willing to donate their bodies if you will to this kind of research.
Tacey A. Rosolowski, PhD:
Well, I derailed you, you were talking about the McCombs Report and how that was leading to thinking about next steps.
Donald A. Podoloff, MD:
Yeah. So the next steps, the ones that I’ve already outlined for you, are really the most important things that we have to do over the next couple years. My runway is a little too short for a five-year plan. I will be spending a fair amount of time mentoring people to take over this job when I do retire. It used to be when and if I retire, now it’s when I retire.
Tacey A. Rosolowski, PhD:
Well, that’s a good thing.
Donald A. Podoloff, MD:
I don’t know. My dad retired and died three days later. (laughter)
Tacey A. Rosolowski, PhD:
Yikes. (laughter) Well, you don’t have to repeat the past.
Donald A. Podoloff, MD:
Yeah, hopefully not, that’s right.
Tacey A. Rosolowski, PhD:
Oh my gosh. Well, would you like to talk about some of the other roles? Though I didn’t ask you specifically the scope of your responsibilities and some specific examples of your role as medical director of CABI.
Donald A. Podoloff, MD:
It’s pretty ill-defined in that there’s no job description for it. I’m basically responsible for the medical activities that occur in the Imaging Center.
Tacey A. Rosolowski, PhD:
That’s pretty broadly defined.
Donald A. Podoloff, MD:
Yeah, exactly. And I think it was done that way purposely. It’s like the medical director of the Emergency Center. I’m the go-to person if the nurses or the techs have a problem when I’m here, and I’m here more than I’m not, I don’t travel that much anymore. I report to Dr. Hicks, who is the acting center director for administrative purposes. And my other role is as director of clinical/translational research for the Division of Diagnostic Imaging, and I report to Dr. Piwnica-Worms for that role.
Tacey A. Rosolowski, PhD:
And what is the scope of your responsibilities in that position?
Donald A. Podoloff, MD:
Major activity that I do right now is I help Sujaya Rao, who is the clinical/translational manager, if she has problems that she can’t solve. She and I, I think we meet every two weeks. I also am responsible for—and I delegate a lot of this—I’m responsible for every protocol in the institution to determine whether or not it has imaging as part of it and whether or not we need a radiology collaborator on the project. So I basically see or my staff sees every protocol that comes out of MD Anderson with that question in mind. A lot of it is handled electronically by e-mail. But it takes some time every week, really every day.
Tacey A. Rosolowski, PhD:
When did that become a part of the evaluation of protocols at the institution?
Donald A. Podoloff, MD:
I want to say seven eight years ago. It’s relatively new.
Tacey A. Rosolowski, PhD:
I thought that might be the case. Now what was going on seven or eight years ago that made people think OK, we need to do this now?
Donald A. Podoloff, MD:
We were getting a lot of protocols that were coming through that needed a radiologist but didn’t have one.
Tacey A. Rosolowski, PhD:
And the PI didn’t know or wasn’t really aware that they needed a radiologist.
Donald A. Podoloff, MD:
Right. Yes.
Tacey A. Rosolowski, PhD:
Interesting.
Donald A. Podoloff, MD:
And we’re also seeing a lot of—while there are—in the protocol it says tumor measurement is going to be done. Who’s going to do it? I’ll do it. That’s the PI speaking. OK. What’s your training? What’s your background? I know you’re the PI but do you know how to measure tumors? Oh yeah, I’ve been doing it all my life. Well, where’s your quality control? So that’s what led to QIAC, the Quantitative Imaging Analysis Core, that Dr. Piwnica-Worms is running. That’s going to mean that in the future what I’m doing won’t be necessary anymore, because it’ll all be done through QIAC.
Tacey A. Rosolowski, PhD:
Oh, interesting.
Donald A. Podoloff, MD:
And it’s going to take some time to transition that obviously. I sit on the institutional executive research council because of that role. It’s just another administrative job that I have.
Recommended Citation
Podoloff, Donald A. PhD and Rosolowski, Tacey A. PhD, "Chapter 19: Overview of Administrative Roles; The Moon Shots; Translational Research and the Future of Targeted Therapy" (2015). Interview Chapters. 747.
https://openworks.mdanderson.org/mchv_interviewchapters/747
Conditions Governing Access
Open
