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    Dr. Entrepreneur

    "We're going to kick cancer butt," says incoming M.D. Anderson prez Ron DePinho

    Clifford Pugh
    Jul 28, 2011 | 3:02 pm
    • Dr. Ron DePinho at a Town Hall meeting at M.D. Anderson Cancer Center in June.
      Photo by F. Carter Smith
    • Dr. Ron DePinho, left, shakes hands with current M.D. Anderson Cancer Centerpresident Dr. John Mendelsohn
      Photo by F. Carter Smith
    • Dr. Ron DePinho
      Photo by F. Carter Smith

    Dr. Ron DePinho doesn't become head of the University of Texas M.D. Anderson Cancer Center until Sept. 1, but he's already raring to go. "I think Houston is going to be the place where cancer is tamed," he said during a recent interview. "We're going to kick cancer butt."

    DePinho, who is leaving his position as director of the Dana-Farber Cancer Institute's Belfer Institute for Applied Cancer Science in Boston, has made weekly trips to Houston throughout the summer, where he has met with hundreds of employees across all levels of the institution to better understand how it works.

    "I've been down here at least a dozen times (in the past) to give lectures, but to really look under the hood and see the inner workings of the institution, it's very exciting. I don't think that there is something of this magnitude and this depth that exists elsewhere," he said.

    He was drawn to the fight against cancer after his father died of the disease in 1998. "That transformed my career from one of thinking about the science and publishing high-profile papers to one (of believing) that it only counts if the science actually ends up getting into the clinic," he said.

    As only the fourth permanent president in Anderson's 70-year history, DePinho says one of his chief goals will be to translate the latest scientific research into effective clinical trials, targeting specific cancers with specific new drugs that show high promise to cure or curtail the disease and get them to market.

    "M.D. Anderson is the best cancer hospital on earth. For it to remain in that premier status it must embrace and incorporate today's brilliant science fully into the fabric of how we do clinical medicine. That science is really going to enable us to change the course of this disease in a most fundamental way," he said.

    As an entrepreneur who has founded several biotech companies, he also sees building relationships with the private sector as a big part of his role.

    "One of the deficiencies in Houston is the biotechnology community needs to be better developed," he said. "My experience in building a half-dozen companies over the past decade is going to help me with that activity."

    "One of the deficiencies in Houston is the biotechnology community needs to be better developed," he said. "My experience in building a half-dozen companies over the past decade is going to help me with that activity. Houston's got great resources. It's got a phenomenal talent pool and work force. It's got the infrastructure and the space. The only thing that it's missing is gifted managerial leadership with a lot of experience in biotech. That, I think, can be fixed."

    His groundbreaking work on reversing the aging process has drawn a lot of attention, including an appearance on The Colbert Report in January where he matched wits with host Stephen Colbert.

    "I love to educate and communicate," said DePinho, 56. "I thought it would be a great forum to educate the public about what's going on in the aging sciences and what the challenges are."

    Being in the public eye will be "one of my key jobs" at Anderson, DePinho said. "I am the face of the institution. This position here in the most important cancer enterprise on earth demands that you be engaged with the public, the government and the scientific and clinical community at large."

    Here are some excerpts from our conversation.

    CultureMap: What factors attracted to you to M.D. Anderson?

    Ron DePinho: It has a lot to do with where we are in the history of cancer medicine. We're finally at a point where there is a confluence of genomics, computational firepower, the ability to manipulate genes at will, to engineer living organisms with precisely the same mutations that enable us to identify the best targets and the best drugs for those targets. I think the rubber is going to meet the road in bringing those scientific discoveries to clinical end points.

    M.D. Anderson has already done the hardest part of that equation, which is to get the best cancer medicine and the most powerful translational cancer medicine programs on the planet. The challenge now is to bring all of that newfound knowledge into the clinical arena. Historically it's been very difficult to bridge that chasm. In the past couple of years that has changed completely because our ability to conduct science in the clinical arena is now possible. It's a remarkable opportunity.

    CM: How is this big institution going to change under your leadership?

    RD: All institutions that are focused on cancer are going to have to change and M.D. Anderson is no exception. While we know a lot, we don't know enough yet to cure this disease. And so every few years we are humbled by our ignorance. It's clear that cancer is extraordinarly complex and we need to understand it more. So under my leadership we are going to be strengthening multiple aspects of the science. Where we will stay the course is in maintaining our leadership position in the clinical arena. We are going to keep our eye on the clinical ball.

    There's an enormously high rate of failure in cancer drug development — a 95 percent failure rate. Over 50 percent of those failures occur at Phase III clinical trials. Let's think about ways to reduce the rate of failure. Our clinical trials often fail because we don't know where the gene is important or which patients we should apply that drug to. So what I hope to develop is a goal-oriented continuum of activites that responsibly takes discoveries from these very early stage observations to highly validated targets.

    CM: Are you going to put more resources into research?

    RD: We have a lot of headwinds here. We have contracting state budgets, decreasing pay lines from the NIH, research is more expensive. We have diminishing clinical revenues as a result of reimbursement for managed care. All of these forces are conspiring to reduce our resources. So we're doing lots of things to enhance our resource position. I will work tirelessly to inspire our community to support us.

    Another component is to enhance the science so we're more competitive in securing grants and attracting the finest trainees to this instiution. I'm going to put a lot of effort into enhancing the graduate program, the young physician scientists, the clinical fellows to attract the best and the brightest and once they're here educate them so that they achieve their fullest potential.

    CM: What has surprised you about what you've seen?

    RD: The enormity — 18,000 people (work at Anderson). One of the things that has been a really pleasant surpise has been the excellence of the science. The clinical and translational activity here is so world leading and so powerful that I don't think the science gets as much respect as it deserves. To see the collective talent that exists in the basic science department has been refreshing and quite impressive.

    More broadly, the Houston macro environment is something I've been pleasantly surprised with. I was born in New York. I think one of the really pleasant surprises of Houston is its progressive nature. Its culture is quite impressive. The restaurants here are fantastic. I'm having to redouble my efforts in the gym. Not a surprise has been the warmth and hospitality of the community. I've seen this at all levels.

    CM: What is the largest number of people you have managed?

    RD: I manage currently a couple of hundred at the Belfer Institute. I think what's positioned me best to run (Anderson) is not any single effort that I have organized or run but the collective experience I have had.

    I've run a large lab in basic and translational science. I've run an institute which developed this new construct for applied cancer science at Harvard. I have two of the most significant academic corporate alliances in history that have helped me build productive relationships between academia and industry. I've started and founded and help direct several biotechnology companies. That taught me a lot about business and how to develop drugs. And I've been a physician. I love clinical medicine.

    It's the diversity of these experiences. I feel very comfortable talking to the business guys, because I know a P&L. I can talk to the physicians because I can diagnose chest pain as well as they can. And of course, I know a lot about basic science. One of the critical things I'm interested in in Houston is to actually build more productive relationships with the private sector.

    CM: Sometimes it's hard to convince executives to come to Houston because of the city's perceived negatives. Was there any issue with your family?

    RD: Everyone has prejudices. Once I learned the facts I was shocked at how great it was at every level. You've got fantastic schools, a great economic advantage, the cost of living for a city of this size and sophistication is extremely reasonable. My kids were thrilled to learn they can now bike in the winter. And then the whole cultural side of things is great.

    Also, it's a very diversifed economy. I've been an entrepreneur so I really enjoy business in general. This is obviously a capital for many different businesses. It has a very diversified base. I find that to be very vibrant and exciting. This is the biggest macro environment for life sciences in the United States.

    (Note: DePinho's wife, Dr. Lynda Chin, will also join the Anderson faculty. She is currently the scientific director of the Belfer Institute for Applied Cancer Science at the Dana-Farber Cancer Institute. The couple has three children.)

    CM: What is the greatest weakness this insitution has?

    RD: I don't think it has any significant weaknesses. It's No. 1 for a reason. Its weaknesses will emerge if we do not fully embrace the science. We must have the courage and conviction to be able to bring the best science towards the clinic. And I think the institution has that. I have confidence in that.

    CM: What was the Colbert experience like?

    RD: I didn't know who Colbert was. I got an email from his producer that I deleted, but my secretary was cc'ed and then my lab found out and they all marched into my office and said, "You have to do this." There was no prep. It was completely ad hoc. Everyone was really frightened that I was going to get eviserated. But my New York upbringing prepared me. It was a fun experience. I was determined to have fun and to stay on message. It certainly penetrated a (younger) demographic I don't normally speak to, which is why I did it.

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    A crucial big 4-0

    Your heart in pictures: Methodist images provide a stark reminder of how quicklyheart disease strikes

    Heather Staible
    Jul 30, 2011 | 10:47 pm
    • Doctors use an imager to see where blood flow is weak. This image of an abnormalheart shows weakness in blue or black.
    • This is what a normal, healthy heart looks like.
    • The heart is enlarged in this image, showing a bypass graft, indicated by thesquiggly line.
    • This is what a heart with normal blood flow looks like.
    • This aorta shows evidence of a an aneurysm, a widening of the blood vessel. Thewhite line points to the aneurysm.
    • These images compare a normal abdominal aorta to an abdominal aortic aneurysm.

    It's easy to dismiss heart disease as a health problem only affecting older people, or those with a family history of the deadly disease. The reality is, coronary heart disease is the number one cause of death in America for men and women of any ethnic background.

    As the average age of people diagnosed with heart disease creeps lower, lifestyle changes are crucial to hitting the big 4-0 without having a cardiologist’s number saved in your iPhone.

    The Methodist DeBakey Heart & Vascular Center shared images with CultureMap, giving us an up close and personal look at how that cheeseburger, lack of sleep and stressed-to-the-max life can increase your risk of heart disease. The American Heart Association (AHA) encourages people to quit smoking, lose excess weight, eat a healthful diet, control blood pressure and keep cholesterol levels in check to maintain a healthy heart.

    Pictures of an abnormal heart show blood flow is weak across certain areas of the heart (blue or black). Information about blood flow helps doctors diagnose what ails a heart, and also help them decide how to approach surgery.

    Two in three men and one in every two women are at risk for cardiovascular heart disease at the age of 40. If it’s hard to imagine what that looks like, consider a series of images of the same heart, as the imager moves in three dimensions. Each pair of rows is a different dimension. Red shows where blood is flowing the most.

    Pictures of an abnormal heart show blood flow is weak across certain areas of the heart (blue or black). Information about blood flow helps doctors diagnose what ails a heart, and also help them decide how to approach surgery.

    The aorta is the largest and most important artery in the body taking blood from the heart, extending down to the bottom of the abdomen. The appearance of an aneurysm, a widening of the blood vessel, is usually the result of a weakening in the blood vessel wall. If left untreated, aneurysms can rupture, leading to internal bleeding and possibly death.

    Cardiologists treat coronary artery disease with a bypass graft. The grafted blood vessel is taken out of a patient's leg, then surgically attaching it to the heart and the aorta. A bypass gives blood a clearer path, allowing it to flow more easily from the heart.

    Other courses of treatment include mechanical heart valves commonly used by surgeons at the Methodist DeBakey Heart & Vascular Center. Surgeons insert a replacement heart valve by moving the device up the aorta, from the leg to the heart, avoiding open-heart surgery.

    The same everyday choices that endanger the heart can also help it. The AHA suggests positive self-talk, deep breathing, counting to 10, smiling, doing things you enjoy and relaxation exercises as ways to tame the stress in life.

    Even if you only smoke in social situations, cut it out. That is especially poignant for people between 25 and 44 — the age range with the highest percentage of people who smoke. Cigarette smokers generally have higher blood pressure which stretches arteries, causing scarring. Bad cholesterol, called LDL, often gets lodged in the scar tissue and combines with white blood cells to form clots. Good cholesterol, called HDL, helps keep the LDL from sticking and building up.

    Consistent exercise is another heart-healthy choice and a mere 30 minutes a day can do wonders for the heart. Eating at least four and a half cups of fruits and vegetables plus a minimum of two three and a half ounce servings of oily fish, like salmon, tuna, mackerel, herring and trout, weekly are also encouraged by the AHA.

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