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Dana-Farber CEO: Collaboration is essential for next cancer breakthrough

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Dana-Farber Cancer Institute Inc. President and CEO Laurie Glimcher

Source: Dana-Farber

The Dana-Farber Cancer Institute's culture of collaboration — internally and with the private sector — has led to treatment breakthroughs.

Technology like artificial intelligence and machine learning helps Dana-Farber personalize medicines and treat future patients.

➤ Several new targets for cancer show promise, but there is still work to be done.

Dana-Farber Cancer Institute Inc. President and CEO Laurie Glimcher spoke with S&P Global Market Intelligence about ongoing work at the nonprofit treatment and research center, the challenges of running successful cancer programs and the future of treatment in the space. The interview has been condensed and edited for publication.

S&P Global Market Intelligence: Research collaboration is a big part of the Dana-Farber story. What is your approach to finding the right people and groups to work together and knowing when that synergy will lead to advances in the field?

Laurie Glimcher: Dana Farber has an incredibly unique culture and the path between basic scientists, translational researchers and our clinicians is really seamless. I haven't actually seen that at any other institution, and it may be because we are really 50/50 half of our faculty are researchers and half are clinicians, and there really isn't any boundary.

In your collaboration with biotech and pharmaceutical companies looking to develop treatments based on Dana-Farber research, how does that conversation begin and how does it evolve over time? What do you look for in a partnership?

We're very eager to work with the private sector because it's better for our patients and things just get done faster in a commercial setting. Often we reach out to a variety of pharmaceutical partners to say, this is what we have so far, and you guys are probably better at building a molecule that can actually go into humans. Our mission is always, how do we get our basic research discoveries into patients as fast as we can?

I think what's critical is that there are teams at both places. There's a Dana-Farber team and there's a pharma team that are dedicated to the product, and we are in constant communication. That there's really heartfelt commitment on both sides of the table, that we're essentially one team working together. It has to be completely transparent. I had an experience years ago with Merck & Co. Inc. working on bone, and that's the way it went. It's a natural partnership, and you can do it much more quickly and cheaply with a partner like that.

Can you discuss some of the ways Dana-Farber is using artificial intelligence and large databases and where that might lead in the future?

Every patient that comes to Dana-Farber, we sequence their tumor and see what their genetic mutation is, but now we've added on to that and we're sequencing their immune tumor microenvironment at the same time. And if you do it on enough patients, we would be able to predict ahead of time what drug that patient should be on. So let's just consider, what are the buckets of information that we need and that we need to use AI and machine learning technology to understand? Genomics, immune microenvironment, pathology and radiology are the first four. Then there's the microbiome and metabolism in general — so if you know what that metabolics neighborhood looks like, that's number five.

The most important bucket is the medical record connecting all of those data pieces with the outcome of the patient. How did this patient do on this drug or that drug? You're going to need several thousand patients for each tumor, but once you assemble all that, we're structuring the data in our medical records with an algorithm that one of our faculty members, Deborah Schrag, has developed called Prism. This is taking the medical records and saying, this patient presented with the following symptoms, their tumor has this genetic mutation, here's what the immune system looks like in this person, here's what the radiology looks like, here's what the pathology slides look like — and here was their outcome when we put them on this drug.

This is my dream, that within a few years we will be able to do this if we utilize the latest technologies, which we are doing at Dana-Farber.

Are you working with specific companies or institutions to facilitate that?

Right now, we collaborate with the Broad Institute for the sequencing, but we're looking at ways to do this with the private sector because it's so expensive to do, and it's not paid for by insurance companies, so we're paying for it ourselves, millions of dollars a year. We're lucky to have some grateful patients and some generous donors, but we want to expand it even more, and we are in conversations with a couple different pharmaceutical companies. We want to make it available to everybody.

We've done extremely well in genomics, and we have the [American Association for Cancer Research] alliance that we run out of Dana-Farber and Memorial Sloan Kettering Cancer Center called GENIE. We share our genomic data with each other. Let's say we detected a rare mutation that's present in 2% of patients with lung cancer, and there's a new drug that Pfizer Inc. or Bristol-Myers Squibb Co. wants to put into clinical trials, and we have maybe six patients at Dana-Farber with the mutation. But maybe Memorial has seven people with the mutation, and Johns Hopkins and Penn also have a few patients, we can see who else has this rare mutation and now that'll give us 20 to 25 patients and we can do a phase 1 trial with this drug and get dramatic results. That's how [Pfizer and Merck KGaA's] Xalkori was approved. If you had tested it in all patients, it never would have been approved. We would like to do that with immunology as well.

What would you hope to see in cancer research from a conference like the European Society of Medical Oncology's this week?

I'd love it if there were more immunotherapeutic agents that are close, and there are some. We've been waiting for several years now for additional immune therapy drugs, and I must say I would've thought we would've come up with one by now. So many companies and biotechs are working on that, including Dana-Farber, and we're looking for that next drug. We have a lot more work to do in immunotherapy and I really think it's the tip of the iceberg here.

I would like to see some progress on pediatric tumors, which are very different and require targeting of the epigenome and the proteins that govern the expression of genes.

Another area I'm excited about is therapeutic cancer vaccines. We were very excited when Cathy Wu, chair of our department of transplanted cell therapies, created a personalized melanoma vaccine that has undergone phase 1 trials and has been really successful in patients with metastatic melanoma, which is a lethal disease. In six patients with a personalized melanoma vaccine, all of them are still in remission after five years. She now has a kidney vaccine, and she's working on a glioblastoma vaccine and an ovarian cancer vaccine.

We need to continue to make this progress because although the survival rate for people with cancer has improved over the last quarter-century, the incidence rate of cancer is skyrocketing.