INTERVIEW

VIEW Interview A Transformative INTER Time for Cancer Research An Interview with Dr. Laurie H. Glimcher, President and Chief Executive Offi cer, Dana-Farber Cancer Institute

Over the past fi ve years, Dana-Farber has fi gure out how we can make 100 percent of had its fi ngerprints on half of the new cancer patients who have those particular tumors drugs. respond to immunotherapy. There are also When you look at the advances taking many tumors that don’t respond to immuno- place at Dana-Farber, should there be more therapy, so we have to fi gure out how to har- optimism that we’re going to achieve the ness the in those patients so Laurie H. Glimcher results needed to cure cancer? that, someday, 100 percent of all patients will It’s an incredible and transformative time respond to immunotherapy. EDITORS’ NOTE Immediately prior to assum- for cancer research. The history of innovation It will take basic and translational research ing her current post, Dr. Laurie Glimcher at Dana-Farber is well-known. Sidney Farber at many different institutions, both in academia served as the Stephen and Suzanne Weiss was the fi rst person to use chemotherapy to and in the private sector, to fi gure things out. I’m Dean and Professor of Medicine at Weill cure acute leukemia, so we have a long history optimistic about success and eventually making Cornell Medical College in New York City, and of innovation. cancer a chronic disease. I hesitate to use the Provost for Medical Affairs at . The checkpoint inhibitor drugs currently word “cure” but, when we think of HIV/AIDS, From 1991-2011, Glimcher was the Irene being marketed are based on research done that disease was lethal and it’s now essentially a Heinz Given Professor of Immunology at the in part by one of our faculty members who chronic disease because of combination therapies. Harvard School of Public Health, where discovered the PD-L1 gene. A 20-year-old diagnosed with HIV today she was director of the Division of Biological There are two major revolutions that have has virtually a normal lifespan. If we could say Sciences, and Professor of Medicine at Harvard taken place in the past decade. One of them the same for even some tumors, that would be Medical School. Dr. Glimcher received a bache- is precision medicine and the realization that a big success. I believe we will get there, and lor’s degree, magna cum laude, from Radcliffe every patient’s tumor is unique in that it has it’s going to require that we take advantage of College and a medical degree, cum laude, from different genetic alterations and that one can precision medicine and targeted therapies and . develop specifi c drugs that can target those immunotherapy. mutations in the tumor. We are the only can- At Dana-Farber, the patient-fi rst men- ORGANIZATION BRIEF Since its founding in 1947, cer institute that offers every patient that comes tality is embedded in the culture. How criti- Dana-Farber Cancer Institute (dana-farber.org) across our threshold the opportunity to have cal is that, and how is it driven throughout in , Massachusetts, has been committed to their tumor sequenced and their genetic altera- the institution? providing adults and children with cancer with tions identifi ed. People often ask me what has impressed the best treatment available today while devel- The information we have garnered from me the most since I started at Dana-Farber, and oping tomorrow’s cures through cutting-edge sequencing patient tumors has infl uenced the I tell them that it’s the amazing quality of the research. kind of therapy we put patients on about 70 patient care I see delivered here. It’s uniformly percent of the time. This has been a major thrust delivered at a level that I have never seen any- What have been the keys to the strength of research at Dana-Farber and elsewhere. It’s where else. and leadership of the Dana-Farber Cancer exemplifi ed by some of the targeted drugs that Every week, I get e-mails and letters Institute? are currently available today that have been from patients or their families who are so Dana-Farber is a unique cancer institute very effective in treating diseases like chronic grateful for the quality of patient care. They because there is an equal balance between myelogenous leukemia. tell us that, from the parking attendant to the research and clinical care that other cancer The second revolution is immunotherapy. janitor to the physical therapist to the nurses research centers don’t have. Dana-Farber has been a leader in that starting and doctors, everyone formed a team around Ninety percent of our clinicians also have from discovery of costimulatory receptors and them and made them feel they were part of research interests, and this allows us to imple- inhibitory receptors. a family. ment a very seamless interaction between the Checkpoint blockers, for example, were I had a woman confi de in me that her doc- bench and the bedside. fi rst utilized in melanoma patients. There are tor told her that her breast cancer was essen- Our clinicians and researchers are inter- a substantial number of melanoma patients tially cured and she didn’t need to come back ested in working together to go from very basic who were at death’s door but are alive today, for more visits. She said that she had made so research in cancer at the cellular and molecular 10 years later after treatment, with checkpoint many friends at Dana-Farber that she wanted to level to very translational research, where we inhibitors. come back every six months to see everyone have a very successful pipeline that stretches This is just the tip of the iceberg – there again. from an initial discovery in a laboratory to cre- are six or seven different tumor types that are I hear that over and over again. I don’t ating a small or large molecule compound that immunoresponsive but, still, only a minority of think I’ve had a single complaint from a patient can be tested for proof of principle in preclinical individuals who have those tumors respond to in the 10 months I’ve been here. animal models. checkpoint inhibitors. Dana-Farber is known for the incred- In many instances, it is this model that is While the progress has been amazing on ible care it delivers and it is a reputation that is attractive for partnering with the private sector. those tumors, we still have much left to do to well-justifi ed. 148 LEADERS POSTED WITH PERMISSION. COPYRIGHT © 2017 LEADERS MAGAZINE, INC. VOLUME 40, NUMBER 4 When it comes to the talent you’re hiring, is cultural fi t just as important as experience? It is absolutely vital. One bad apple can spoil the whole bin, and everyone from our vol- unteers to our clinicians are an amazing group of committed and dedi- cated people. It’s true that people here live and breathe the mission of Dana-Farber, which is to offer the very best quality clinical care we can for our patients and, at the same time, do the transformative research that can lead to new treatments for cancer. How critical is it that the diversity in your patient base is mirrored throughout your workforce? That is really knit- ted into the fabric of Dana-Farber. I have spent my career mak- ing sure that we take advantage of the brains The Yawkey Center for Cancer Care at the Dana-Farber Cancer Institute in Boston, Massachusetts of the 50 percent of our population who are women. I’ve been hospitals and primary care clinics to provide When you ask if I’m worried about the devoted to supporting and promoting talented training and education to treat patients with future of the pipeline outside of what I’m see- women within the organization and pro- many different kinds of cancers. ing at Dana-Farber, there are perhaps institu- moting those underrepresented in medi- We’re well-known not only throughout tions that aren’t as prominent as ours that might cine and science. New England, but nationally, because we have have some issues, but we have a remarkable We are committed to serving every patient established a lot of these partnerships through- pipeline. who comes through our door. We reach out to out the country. Sometimes when I contemplate the down- the community with our clinics, and we treat There is so much discussion today ward pressure on healthcare reimbursements, every person who comes to us for help with no about the changes occurring in healthcare. the fi nancial constraints of government funding exclusions. Do you worry that the next generation of for research and how we’re going to support Dana-Farber also plays a strong leader- leaders is not going to enter the industry our healthcare system, the job can seem frustrat- ship role within the community. Will you because of the high cost of medical school ing. That’s’ when I ask my secretary to schedule discuss this effort? and the challenges in the industry? a meeting for me with one of our junior faculty. Ninety percent of oncology care is It’s a legitimate concern, but when we look Once I have met with them for 20 minutes or so, delivered locally, and most people want to at the young people who are coming in, they my optimism returns, and I become very excited stay and be treated within their communi- are amazing. They’re coming into medicine about where we are both in treating cancer and ties. Complex cases need to come to our main and oncology for the same reason that previ- in discovering new cancer treatments. campus, but we have four satellites and we’re ous generations of students have chosen to do As an institution, every day there are working on a fi fth, spread across Massachusetts so. I spend a fair amount of time with medical challenging events that occur, but there and New England. This is very important to us students. My eldest son is now a cardiothoracic are also many wins. Are you able to take in that we can help them stay in their local surgery fellow, and I remember asking him moments to appreciate the wins? communities and receive their care there. We when he came home from college what he was It’s critical to have those moments. are also spreading our training, education, and going to do next. He had considered becoming Being a doctor and a scientist in a challeng- knowledge to local communities. a lawyer, but then he told me that he wanted to ing healthcare environment makes this very One example of that is access to clinical go to medical school. When I asked him why, important in avoiding physician burnout, so trials. About 20 percent of patients at cancer he said it was because he would never have we do celebrate our wins all the time because centers are put on a clinical trial, but in the com- to wonder in the morning why he was going we have such a committed and passionate fac- munity, that number is 2 to 3 percent. It’s our into work. ulty and staff. We celebrate whenever one of belief that every patient for whom there isn’t We have the best hematology/oncology our faculty members wins an award or when an adequate standard-of-care treatment should fellowship program in the country and the we come up with a new small molecule that have access to a clinical trial if they are eligible quality of our fellows is unbelievable. I wish looks promising in treatment in animal mod- for it. We’re working hard to put in the infra- we could keep all of them, but we don’t have els or when we do a clinical trial and it turns structure that will allow clinical trials to be done room for everyone. These are extraordinary out to have a very positive outcome. We get in communities. young people and they inspire me and give together and we celebrate because there are In addition to our satellites, we are also me much hope about the next generation of amazing things going on today in the fight establishing partnerships with community medical professionals. against cancer.• VOLUME 40, NUMBER 4 POSTED WITH PERMISSION. COPYRIGHT © 2017 LEADERS MAGAZINE, INC. LEADERS 149