Collaborating to Cure
Academia and industry are often seen in stark opposition to each other—two warring titans with fundamentally different ideologies and ambitions. In health care, the division between research institutions and pharmaceutical companies has the potential to cause the next great discovery, from life-saving drugs to new therapeutic techniques, to slip through our fingers. Can we really afford that when the prospect of ending cancer is on the line?
Fortunately, The University of Texas MD Anderson Cancer Center is confidently bridging those two worlds. Realizing the untapped potential in combining the expertise of an academic medical center with the vast pipeline of resources of pharmaceutical leaders, they have spent the past several years forging alliances with industry partners. Nature Biotechnology, a monthly publication covering the science and business of biotechnology, recently published rankings of the most active institutions in terms of alliances and collaborations. With The University of Texas coming in second place overall and bringing in a total of eight deals—seven of those from MD Anderson—the importance of cultivating those connections cannot be overstated.
“This really conveys the great strides that MD Anderson has made as an institution,” said Ferran Prat, Ph.D., J.D., vice president of strategic industry ventures for MD Anderson. “ Biotech and Pharma companies have traditionally struck alliances with institutions on the West Coast or the East Coast, but now they are increasingly entering into significant deals with us. This helps to create a virtuous cycle where we conduct all types of research of different magnitudes, which will enable us to enhance these alliances.”
As the single entity with the most deals in the entire ranking, compared with institutions such as the University of California San Fransisco and Massachusetts General Hospital, MD Anderson is paving the way for research-driven discoveries that focus on benefitting individual patients.
“I’ve been a researcher for the past three decades, and the mission of what we do at MD Anderson is focused on improving patient care,” said Hagop M. Kantarjian, M.D., professor in the department of leukemia for the Division of Cancer Medicine at MD Anderson. “We believe that research is the only way to accomplish that. If we have outstanding clinical translational researchers, then we can design studies that are ahead of the game and can improve the survival of patients long before they become the standard of care.”
Kantarjian is the principal investigator in several studies stemming from one of MD Anderson’s most promising industry partnerships—a collaboration with Bristol-Myers Squib to advance our understanding of the role of the immune system in treating leukemia.
“Bristol-Myers Squibb has an extremely powerful pipeline in immunotherapy,” said Prat. “In leukemia, there haven’t been many immunotherapy drugs that have moved forward—that’s significant. Financial resources are just an enabler to actually conduct the research that will cure the disease. With this partnership, we have access to the full pipeline with all of those resources to find out the best combinations and the best patient populations.”
Forms of cancer, such as leukemia, that affect the blood, bone marrow, and lymphatic system—also known as hematologic malignancies—have poor outcomes compared to other cancer types, especially among elderly patients and those who have suffered multiple relapses. According to the American Cancer Society, someone in the United States is diagnosed with a form of blood cancer approximately every three minutes; someone in the U.S. dies from a blood cancer every 10 minutes.
“Aggressive hematologic malignancies represent significant areas of unmet need,” said Laura Bessen, M.D., head of U.S. Medical at Bristol-Myers Squibb. “Cooperation between industry and academia offers a tremendous opportunity to strengthen our scien- tific and clinical understanding of the role of the immune system in treating cancer. This collaboration will provide an efficient and comprehensive landscape of the potential of immunologic approaches to evaluate treatment options for leukemia and pre-leukemic conditions.”
Launching up to 10 clinical studies to evaluate the utility of immune-based approaches, as well as identifying optimal treatment approaches, the two organizations are leveraging their own unique strengths. MD Anderson will be leading the operational aspects of the studies, while a joint development committee will oversee any collaborative efforts.
“Our partnership with Bristol-Myers Squibb involves us taking their five immune-oncology drugs—what I call checkpoint inhibitors—and we proposed to investigate them across all leukemia and not just one particular disease,” said Kantarjian. “In fact, it allows us to combine investigations in these drugs because they all come from the same pipeline. You’re looking at many more tumors rather than one, so the chance of success will be higher, and the process is much faster. It’s a win-win situation where the cancer experts develop the concepts and propose the protocols.”
The traditional methodology that companies use to test out new drugs, which involves testing each compound one at a time, is frustratingly labor intensive and mired in bureaucracy. Driven by contract research organizations, which pharmaceutical, biotechnology, and medical device industries use to outsource their research, the opportunities to shine a light on successful therapies are slim.
“What we realized over time is that research has shifted from the experts— those at the academic and research cancer centers—to the companies,” noted Kantarjian. “It became not a partnership but a business model where people from the companies would say, ‘We have a drug, X, we want to test it out in a single cancer, Y, and that’s going to be our goal.’
“That form of company-driven research has drawbacks,” he added. “It’s a longer process. It’s much more expensive, because they use clinical research organizations with intermediaries and a lot of bureaucracy; it shortens the patent time; and it reduces their chance of success because they’re looking at one particular tumor rather than a spectrum of tumors.”
For researchers like Kantarjian, there had to be a different way of doing things. Through their approach, MD Anderson and Bristol-Myers Squibb have created a model that brings research back into the steady hands of cancer experts.
“In this partnership, we’re the ones actually driving those studies,” said Prat. “We’re really defining the best modalities of immunotherapy for a very underserved segment of the patient population. We just started enrolling patients, but we’re conducting all 10 of our clinical trials simultaneously. This is something that under the old model would have taken us three years just to get started, much less to get clinical results.
“By setting up this alliance, we’re going to learn a tremendous amount,” he added. “It’s a process that’s over ten times faster and over a much broader scope. Because you’re really boiling the ocean, the chances that you’re going to achieve a positive response are maximized. For the study modalities that don’t work, they merely get closed and substituted within the setting of the alliance—we actually have a much better chance of finding better combinations for particular segments of patient populations.”
With the studies ongoing, Kantarjian and his colleagues have already gained valuable insights on the mechanisms of how checkpoint inhibitors kill leukemia cells. Pending the success of these trials, MD Anderson
is looking to other companies with a similar partnership model in mind—an approach with the potential to reinvigorate research throughout the country.
“I think cancer research in the United States has led cancer research throughout the world,” said Kantarjian. “There’s no way that we will be ceding this leadership because we have great minds in the United States, we have great resources, we conduct high quality research, and we have a need to help patients with cancer. We have to disrupt the existing cancer research model, because it’s dying by thousands of bureaucratic paper cuts, high costs and a low success rate. The only way to move forward is by shifting the current model into something similar to what’s being attempted here—one that’s research driven and patient-centric.”
Ranked as the nation’s leading cancer hospital for 11 of the past 14 years, MD Anderson is distinguished, in large part, by the sheer scope of their ambition. With their Moon Shots program, a celebration of the drive and dedication necessary to put a man on the moon, they are seeking a similarly lofty goal with the same level of conviction—a dramatic 50 percent reduction of mortality across several major cancers. It’s a good thing they don’t have to do it alone.
“Cancer is a very, very complex problem,” said Prat. “It would be slightly arrogant to think that we can do it all by ourselves. We need a lot of help. And we fundamentally believe that industry partnerships are not a necessary evil, but an essential part of achieving our mission. They have a lot of smart people—many of whom come from academia—a lot of resources, and our goals are aligned. At a basic level, we all want to help cure patients.”