The Real Key Faculty: Those Who Develop A Treatment

By

Leonard Zwelling

For the past twenty years or so, the key to faculty success at MD Anderson has been excelling in the rather traditional metrics of academia—papers, grants and awards. Most of the emphasis has been placed on scientific accomplishment and much of that has had its origins in the laboratory. Nothing wrong with that. I built my career on this strategy and it worked. But, did it really?

When I step back and look in my professional rearview mirror, I am impressed most by what it lacks. My research never helped any cancer patient. Ever. Oh, I tried here and there to turn a discovery into a clinically useful application, but I never did. But then again, how many of us ever do? Few.

But some do.

And MD Anderson was and is blessed with a large number of people who have actually developed treatments. Some have done it with discoveries in the lab, but far more have realized the utility of a basic insight and applied it to the treatment of a specific disease entity with remarkable success. This is the major goal of all of cancer research and used to be the most honored endeavor at Anderson.

Lately, the powers that have led Anderson have rewarded the accomplishments of more lab-based researchers than those doing the much harder clinical research. That’s too bad.

The clinical investigators were and are my heroes. Perhaps it is because they do well what I did so poorly. Perhaps it is the awe in which I hold anyone who can actually apply knowledge to the problem of human cancer and make an impact. Regardless, these men and women are the standouts in our field and their work ought to be more lauded than it is.

But we have arrived at a juncture where this sort of work can come to the fore again.

If the new leadership of MD Anderson puts clinical research first and rewards those who toil to discover at the bedside as well as those who discover at the bench, there is a real chance that MD Anderson may uniquely ascend to its rightful place as the foremost institution for experimental cancer care.

This will require a massive effort.

Clinical research is expensive. It is resource intensive and personnel of great skill are required all along the pathway from basic science discovery to successful clinical application.

The infrastructure required for clinical research is Byzantine at best due to intense federal regulatory scrutiny. An institution can make that administrative burden easier or harder. The only real significant contribution I ever made to cancer care was trying to establish an efficient infrastructure for clinical research. Some thought I did this well. Others not so much. I understand. But I did try.

Finally, the pharmaceutical industry is dominating this field of endeavor. They have the molecules and they have the money. It takes great skill to find the path to success in academic clinical research having to negotiate regulatory, contractual and scientific hurdles. The best clinical investigators manage to do it. These people ought to be the heart and soul of Anderson and they ought to be led by someone who has done clinical research with success and led and managed with great skill.

The next president of MD Anderson ought to be someone who has developed a successful treatment for cancer. If he or she is, there likely will be more successful cancer treatments to come.

Test tubes are great. Mice are helpful. But what happens within the confines of an IRB-approved protocol on an FDA IND is what really matters to cancer patients. It should matter the most at MD Anderson, too.

Leonard Zwelling