October 9, 2010 - 2:10pm
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Chancellor Addresses 230th Class at Induction into American Academy of Arts and Sciences

UCSF Chancellor Susan Desmond-Hellmann signs the American Academy of Arts and Sciences Book of Members, a tradition dating back to 1780, as she and three other UCSF faculty members were inducted into the academy at a ceremony on Oct. 9, 2010.

Chancellor Susan Desmond-Hellmann, MD, MPH, who was inducted into the 230th Class of Scholars of the American Academy of Arts and Sciences on Oct. 9, called on the scientists to “set the bar high” to speed the translation of discoveries into treatments so that patients “can live a full life without pain and suffering.”

Desmond-Hellmann was among the world’s most distinguished scholars, artists and institutional leaders inducted into the academy at a ceremony in Cambridge, Massachusetts, where she was one of five to address the 210 new fellows and foreign honorary members. She focused on today’s unprecedented opportunities to understand human biology and improve human health.

“The health care dialogue that we are having in our country today is especially resonant for those of us who have chosen careers as physicians,” she said. “Health care is a right. Access to care, especially preventative care, is essential.”

Three other UCSF faculty also were named as fellows in the ceremony: Samuel H. Barondes, MD, director of the UCSF Center for Neurobiology and Psychiatry; Howard L. Fields, MD, PhD, principal investigator in the Ernest Gallo Clinic and Research Center; and Deepak Srivastava, MD, director of the UCSF-affiliated Gladstone Institute of Cardiovascular Disease. They join more than 50 UCSF faculty members who previously have been named as fellows in the past.

Founded in 1780, the American Academy of Arts and Sciences is an independent policy research center that conducts multidisciplinary studies of complex and emerging problems. Current academy research focuses on science and technology policy, global security, social policy, the humanities and culture and education.

The academy’s work is advanced by its 4,600 elected members, who are leaders in the academic disciplines, the arts, business and public affairs from around the world.

Here is the chancellor’s entire speech.

It is truly an honor for me to stand here today and speak for my class in the Biological Sciences. I’d like to talk about a topic I am very passionate about: The unprecedented opportunity that we have today to better utilize our rapidly expanding knowledge of human biology to improve human health.

The health care dialogue that we are having in our country today is especially resonant for those of us who have chosen careers as physicians. Health care is a right. Access to care, especially preventative care, is essential.

We certainly need to emphasize the adoption of appropriately-tested and proven prevention modalities such as childhood vaccinations, smoking cessation, exercise and a healthy diet. But we can’t stop there.

I would also argue that our goal of improving human health cannot be achieved solely through disease prevention. We must continue to push ourselves to do everything we can to capitalize on the ongoing explosion of scientific knowledge in order to innovate and, ultimately, decrease the pain and suffering of those who, despite best efforts, are diagnosed with maladies for which we still don’t know the cause or have a preventative intervention. The list of such ailments is long and includes breast and prostate cancer, lupus, multiple sclerosis, Alzheimer’s disease, Parkinson’s disease and Type I diabetes mellitus. And the suffering of those affected is substantial.

In the early 1990s, I spent several years working as a community oncologist. My experience treating cancer patients at that time taught me that there were some forms of breast cancer that were too aggressive to cure and some forms of lymphoma for which the toxicity of the therapy so greatly outweighed the benefits that “watch and wait” was the standard of care for many patients, despite knowing that the disease would ultimately progress and debilitate the patient. Every time I had to tell a patient, “I’m sorry, you have this disease and we have nothing to treat it”, it felt like a personal failure.

And then everything began to change. The biotechnology industry was maturing and molecules which had started out as brilliant early stage research experiments conducted by visionary scientists in the 1970s and 1980s who were determined to solve the mysteries of human biology were now showing promise in a clinical setting and, ultimately and wondrously, providing hope for thousands of patients.

In the five years between 1997 and 2001, several breakthrough cancer therapies were approved by the US Food and Drug Administration. These therapies uniquely sprouted from our expanded comprehension of these biological puzzles and uniquely targeted specific protein or receptor abnormalities in cancer cells. Finally, physicians were able to tell patients with certain types of cancer, “You have this disease – and we have something for it, perhaps even hope for a cure.”

No longer was cancer therapy solely dependent on drugs that broadly targeted the most rapidly dividing cells in the body, which included malignant cells as well as healthy human tissue, such as precursors of blood cells, hair follicles, and the lining of the gut and intestines. The substantially deeper understanding of the biological basis of disease pathogenesis and cellular biology had suddenly made several fatal conditions controllable and even potentially curable.

The hope of “personalizing” or targeting our cancer therapy using molecular biomarkers to select those patients most likely to benefit was also becoming a reality. While these therapies aimed against specific targets in cancer cells were not without side effects, we were able to avoid common side-effects most feared by patients including hair loss and nausea. We now had remedies in our arsenal that allowed us to offer a more promising future with less pain and suffering to our patients and their families.

Where are we today, almost a decade later? Additional dramatic scientific breakthroughs continue to occur that further expand our knowledge of human biology. However, potential barriers are also multiplying that can limit our ability to translate magnificent scientific discoveries into therapies that offer a greater benefit without attendant unacceptable risk.

Concerns exist about conflicts of interest between industry and academia, potentially increasing barriers to beneficial and necessary collaborations. Required clinical trials for regulatory approval are growing in complexity and expense. The increasingly high regulatory hurdles create unpredictability of the approval process and engender frightening labels in drug development, such as the “valley of death,” which diminish investors’ willingness to finance new life sciences innovations. The reality is that today it is more challenging than ever to translate scientific breakthroughs into transformational medicines with evidence sufficient to allow for US Food and Drug Administration approval. These are the challenges faced daily by individuals we call “translational, clinical, and regulatory scientists.”

In the face of these challenges, it is essential for scientists at academic medical centers to push ourselves to innovate in translational science by increasing our ability to predict what will happen in the clinic, in clinical science by designing more efficient and effective clinical trials that provide us with greater confidence in our ability to measure clinical benefit, and in regulatory science, by using novel approaches to ensure that we have greater confidence in “safety and efficacy” and can more effectively communicate our findings to the public. In each of these areas, I want to challenge us to set the bar high - to imagine what's possible - and then to make it happen.

Patients are waiting. These patients and their families deserve our sense of urgency around using all of our scientific and medical knowledge to allow each human being the best chance possible to live a full life without pain and suffering. 

Photo by Martha Stewart