This Time It Was Avoidable      May 11, 2013

By Leonard Zwelling

            In
the coming days it is likely that MD Anderson faculty and employees will, once
again, be explaining to friends and family why the private business activities
of the institution’s president are coming under public scrutiny. This follows
previous questions being raised about the conduct of the president and his wife
and the troubles the previous president had in the business arena.

            Unlike
the concerns raised by the previous president’s activities on the Enron and
ImClone boards, this time this outcome was totally predictable. Once the
University of Texas System, the Board of Regents and the Executive Vice
Chancellor allowed flagrant conflicts of interest to remain in place for both
Dr. DePinho and Dr. Chin and then took no public action when Dr. DePinho
promoted his own stock on national television, it was only a matter of time
before the business entanglements would prove an embarrassment. Now, they have.

            Another
week and another issue of the Cancer Letter delineates problems at MD Anderson.
This time it appears that the only drug product in clinical development by
Aveo, the company started by the DePinhos and on whose board Dr. DePinho served
until December 31, 2012 and on which Dr. Chin still serves, had a serious
setback when the FDA rejected the company’s application to get the drug to
market. At least in the case of ImClone, the poorly done registration trial
with Erbitux was correctable and the drug eventually found a niche in the treatment
of cancer. This is not likely in the case of tivozanib, the Aveo drug.
According to the Cancer Letter, the results of the trial were available 6 days
before Dr. DePinho inappropriately touted the drug on national television. The
Cancer Letter quotes DePinho as stating that he was unaware of the FDA’s
reluctance about the trial when he appeared on CNBC. This is despite the fact
that both he and his wife were still on the board and this was the major
product of the company they founded.

            The
questions are clear. When did Dr. DePinho become aware of the trial’s poor results
and did he trade on that knowledge before it was widely available to investors?
And perhaps of greatest concern, couldn’t all of this have been avoided if Dr.
DePinho and Dr. Chin divested themselves of all drug company stocks and seats
on boards prior to starting their service to the people of Texas? This was what
most of us familiar with the Anderson’s conflict of interest rules and the
possible cost of waiving them had assumed would occur.

            The
Chronicle has not weighed in on this yet, but undoubtedly it will very shortly.
It is reasonable to assume that if the Cancer Letter was able to put these
pieces together, others will, too.

            The
leadership of the UT System now has a very difficult choice with regard to its
tolerance for conflicts of interest and self-dealing among its academic
leaders. Namely, can this go on any longer? What is so upsetting to many of us
is that this was precisely why we objected to the waivers that were eventually
granted to Dr. DePinho on October 10, 2012 according to the Cancer Letter.

            The
concept of conflict of interest is that since you can never fully know why
someone does something, it is best to eliminate outside and competing financial
interests for leaders and key decision makers of academic institutions and for patient
caregivers if it might be perceived by others that the actions of these
individuals were affected by any interest other than that of their fiduciary
role in administration or patient care. Here, Dr. DePInho’s appearance on
television increased the value of his stock. Since then, and especially
following the FDA decision, the value has plummeted.  Was all the DePinho stock in a blind trust and beyond his
reach? It appears not yet even though that promise was made.

            I
cannot say how this will turn out. It depends whether federal or state
authorities believe some of these activities are worthy of investigation under
current policy or law. Suffice it to say, this is likely to once again take up
the time of the MD Anderson president and the faculty and staff at a time when
all of our efforts should be put into detecting, treating and preventing
malignant disease.

            While
this seemed to be a minor side show previously, it is now moving into the main
event arena where it can divert everyone’s attention from the goal of fighting
cancer. This was all avoidable. All we had to do was follow our own
policies—without exception.