POP: People with cancer come to a place like Dana-Farber in hopes of getting the newest drugs or experimental treatments. Is that what's happening?
Nadler: More and more, that is the case. We would like to make Dana-Farber the "go-to place" where pharmaceutical companies are eager to bring their newest drugs for testing. We want to conduct their first trials. To make this a reality, though, we need to be more sensitive to their goals. We must make it easier for a drug company to launch a clinical trial here. The obstacles now include the time it takes to open and complete a trial, as well as our ability to provide them with the tissue specimens necessary to evaluate whether the drug works.
POP:Your goals require many changes, not all of which can be accomplished quickly. What are the first steps you would take to improve translational research at the Institute?
Nadler: First, we need infrastructure. We must improve our system for handling patient samples — blood serum, live cells, and other tissues — that are crucial for clinical trials. We need a world-class laboratory to receive human specimens from our adult and pediatric clinics and inpatient floors, process and store them, and get them to more than 100 collaborating laboratories eager to do research. No institution does this well.
George Demetri, MD (right), and Jonathan Fletcher, MD, were among the Dana-Farber investigators who helped spearhead the use of Gleevec for treating the stomach cancer called gastrointestinal stromal tumor (GIST).
We definitely need an oncology outpatient clinical research center. This would be a unit dedicated to clinical trials, staffed by a multidisciplinary team that specializes in carrying out complex research protocols. Such a center would not only be a draw for industry but would improve the care of our patients and the safety of our trials. Equally urgent is the need for a laboratory to measure whether our drugs are hitting their targets. This is the heart of true translation and represents our biggest challenge.
Once we have the right infrastructure, we will need to work on the team. It is essential that we develop a plan to train the next generation of translational investigators. We have a chance to be the model. Today, very few of our trainees are willing to embark on this slow and high-risk career pathway. We must find a way to make them successful. They need institutional commitment, the right mentors, protected time to do research, and academic rewards.
Finally, we need individuals on the team who have experience in developing novel therapeutics and diagnostics. They have to understand biology, clinical trials, industry, and the current complex regulatory environment.
POP: How will we know whether our efforts are succeeding?
Nadler: We will know we're the best in translational research when the pharmaceutical industry works with us as partners, both bringing its best ideas here and taking our best ideas and developing them with us. Second, we will see our faculty leaving here to lead programs elsewhere after being trained to be the best translational researchers in the world. Finally, and most importantly, we will measure whether our translational approaches change the standard of practice in oncology to ease suffering and save more lives.
