Episode 48: Celebrating 20 Years of Precision Medicine

Karie Dozer  [00:00:05] I'm Karie Dozer and this is TGen Talks. This year marks the 20th anniversary of TGen's founding on what at the time was a relatively unknown idea outside the circles of academia and scientific research, precision medicine. The concept of using a person's own genome to diagnose and treat disease at an individual level, to move beyond the one-size-fits-all treatment plans that had dominated the medical landscape for decades, where drugs and therapies considered large groups of people with the same disease, and what worked for the majority.

A true public-private partnership, TGen came to fruition through the work of tribal leaders, CEOs, philanthropic trusts, foundations, individuals and university presidents all united toward an extraordinarily high-risk goal. Forming and funding this unique partnership based on the just completed Human Genome Project and placing it not in Boston, San Francisco or Washington, D.C., but in Phenix, Arizona. Four Governors and 20 years later, all this and more has come to pass, including an unprecedented positive economic impact on the growth of a knowledge based workforce in Arizona. Joining TGen Talks to discuss TGen’s beginnings, as well as its impact in terms of improved diagnostics and treatments, is none other than TGen’s founder, Dr. Jeffrey Trent.

Dr. Trent, thanks for sitting down with me today.

Dr. Jeffrey Trent [00:01:33] Delighted to be here.

Karie Dozer  [00:01:34] How was TGen born? How long did it take to go from an idea of yours to a business plan?

Dr. Jeffrey Trent [00:01:41] I spent the majority of my career in a traditional academic framework at universities, including most recently before I went to the National Institutes of Health, the University of Michigan and arriving at the NIH, being part of a project like the Human Genome Project, opened a window into envisioning how this information would truly change science and medicine. And it would it also would change it at a population level. And the excitement really, in my mind, was not in getting the genome completed. It was, how do we bring this to benefit the patients sitting in front of us today? I felt like the NIH was such a fan of the National Institutes of Health, a great place to do a common good project like the Human Genome Project. But people didn't want to work with the federal government to share their newest idea, their newest drug, their newest diagnostic. You need government approval, but you don't need the government directing that. It's really the. So that's when I began to think of a nonprofit as having being midway between industry, academia and government. And so taking that model, I went to, I worked with PricewaterhouseCoopers to develop a business plan that was presented to a series of states to try to decide whether we could get the kind of funding we needed to start teaching.

Karie Dozer  [00:03:21] Do you remember the first time you envisioned TGen when it was just an idea? Do you remember how what you saw when you when you thought about what it could be?

Dr. Jeffrey Trent [00:03:33] I think conceptualizing TGen early on was whether we could put an institute together to not focus on science, but focus on how to make a difference to the patients sitting in front of us today. It really was the chief operating principle of a research institute. Of course, that's what we call translational the focus, not on science for science sake, which is really important. Breakthrough technologies, breakthrough discoveries. But the idea that we could quickly move a new tool, a new technology, a new treatment from the laboratory into benefiting patients, I felt was an area that would distinguish what we do and make a difference for patients.

Karie Dozer  [00:04:20] You said you talked to other people, other states, so there was a possibility of TGen being someplace else. How real was that possibility?

Dr. Jeffrey Trent [00:04:28] Extraordinarily real. In fact, the last place I thought would likely be a home for TGen was Arizona, because there was so little on that, on the landscape that would suggest that there would be the kind of community support that there was. Plus, the other locations, particularly that I was serious in talking with, had either foundations or government support that was much higher scale than the individual contributions of the many people that ended up putting the funding together for teacher. So definitely at the start I would have given it a 1% probability and I was delighted now 20 years later, that the decision was made to come to Arizona.

Karie Dozer  [00:05:18] A lot of TGen scientists are right here in downtown Phenix in what's become known as the biomedical campus. Where else is teaching and research happening right now? You know, I think of it and you probably think of it as where you go to work every day, which is Fifth Street and Van Buren. That is one location of teaching. And where else is teaching conducting research right now.

Dr. Jeffrey Trent [00:05:42] And so we're so proud of the multiple areas that TGen scientists and investigators work. One of those is the TGen North group, the group that does pathogen and microbiome about 60 to 70 strong, incredible warriors. And the response for COVID. But, you know, they're engaged in the study of everything from Valley Fever to West Nile virus to things that are less on the top of people's mind today, but make a difference for four people in Arizona, and particularly, we have our rare childhood disorders clinic just down the street from where we are today. We have our physicians like Drs. Von Hoff and Sunil Sharma and Joe McHale, that all of those doctors that work at HonorHealth, we have, of course, collaborations across the valley with our university partners Barrow, Mayo, others. The City of Hope is where we have our affiliate and we're part of the City of Hope. And so we have some of our faculty that have labs there and work with teachers and scientists here. So, you know, it's multiple locations. And, you know, the heart of the organization sits with the research, which is done downtown. But a lot of the translation occurs across the valley and across the state and now across multiple states.

Karie Dozer  [00:07:23] Well, let's go back to the early years with the very little expense account and probably just a handful of people that you had on board with you. How did you begin? Where was the first office? Where was that first door that someone would have walked through?

Dr. Jeffrey Trent [00:07:39] Yeah. So APS gave us it was in the Compass Square Center here, gave us some office space. And Sonora Quest Laboratories had some empty lab space. And it started with a handful of individuals beginning the lab work, which at a site near the ASU campus and a handful of individuals that tried to put in place the infrastructure that would need for everything from hr. To finance to, you know, everything associated with research that you have to do.

Karie Dozer  [00:08:26] How quickly did you grow as you look back? Do you think, gosh, that took longer than I thought or wow, we got pretty big pretty quickly?

Dr. Jeffrey Trent [00:08:34] Yeah, we, we modeled it. So there would be about 300 people. That's that was the model with PricewaterhouseCoopers that if we and that would be about 30 faculty and we modeled it over approximately a five year period to get to that. But it was probably getting that first group of six or seven scientists to leave their academic positions. Dr. Berens leaving the Barrow Neurologic Institute. Dr. Von Hoff leaving the Cancer Center, directorship of the University of Arizona, two or three of the faculty, John Karp, uh, and others, leaving their positions at the National Institutes of Health, David Dugan and others. I invited about a dozen faculty to the Biltmore for a meeting to sort of conceive what this institute would look like, you know, scientifically, with the idea that if we were fortunate, some of these individuals would not just help create division, they'd actually want to be part of it. And in fact, that's what happened about ten of those 12 individuals ended up being part of TGen. And that was a major part of the start of the of our institute.

Karie Dozer  [00:09:48] Is that unusual for a new guy to arrive on the scene and to have researchers who are on board someplace else jump ship and join you? And how is that is it received well within your within your circles?

Dr. Jeffrey Trent [00:10:05] No. I mean, the reality is, is that positions like inside the federal government. So if you're a tenured so tenure within the academic system or is it's hard to root people out of these positions in the same way, with federal support that occurs every year, it's hard to get people to leave those positions. You know, one of those individuals I recently met last week at a cancer meeting in New Orleans, and he reminded me that the at the New Age, the individual ultimately became the NIH director for the past decade. Dr. Collins At the same time that I was trying to recruit this this young man, Dr. Collins wanted to retain him at the NIH and said, you know, John, you know, if you go, you know, you'll never be able to get a successful academic career. That gentleman spent 15 years here. Dr. John Carpten has gone on to lead a department at the University of Southern California to be appointed recently to the National Cancer Advisory Board that oversees the $20 billion of the National Cancer Institute. Is remarkable career and Dr. Collins said, he admitted that perhaps he was wrong. So I don't think anybody can map these things. I think that's a great story of John is that there's so many different paths to success. In our case, I continue to say it's because we focused on the patient sitting in front of us today.

Karie Dozer  [00:11:38] How has City of Hope made more things possible for TGen and what's the biggest difference since City of Hope and TGen have become one.

Dr. Jeffrey Trent [00:11:48] The extraordinary excitement of even the last six months. But that puts the City of Hope in perspective, where their decision to scale the sites that they had across California from a single site to about 40 sites, and then their decision to add hospitals in four other states, including one here and Phenix, through their acquisition of cancer treatment Centers of America, allow now studies to be and we're conceiving them and executing against them today where the 115,000 or so cancer patients that they see every year can now allow us to scale the studies we do in a previously completely unknown, unavailable way inside a single state or inside a single institution. And there are big, big hospitals, cancer hospitals. This is all cancer patients. None are bigger than now this national program. And I believe none probably have the breadth of the different areas, Atlanta, downtown Atlanta versus Chicago, Phenix, California. So I'd say a true national model. So the excitement in part is leveraging now what started out as a partnership with a great health care organization and now is looking at working with a great national health care organization.

Karie Dozer  [00:13:23] Obviously, those are exciting partnerships. And as you said in the last six months, that's what you're most excited about. What about as you look in the last five years, not so recent headlines, what are you most proud of that TGen’s been involved with?

Dr. Jeffrey Trent [00:13:36] Well, I do think that City of Hope has helped us anchor in Arizona. We bought the building that the city built for us and anchored TGen here. We have added faculty every year since we became part of City of Hope. We've had the opportunity to leverage research across both centers. We're close to opening our first clinical trials, where City of Hope has a unique manufacturing facility for taking cells from the human body and expanding them from a few million to a few billion that could be returned to a patient. And these type of immune treatments that where you can take cells that can go in and survey and kill just the cancer cells. These are unique resources never before available to our faculty and staff and have really made the last five years a goal towards making even more difference for the patients sitting in front of us today.

Karie Dozer  [00:14:38] That sounds like science fiction to people listening. That sounds like something made up.

Dr. Jeffrey Trent [00:14:43] Yeah. You know, the reality is that 20 years ago, this was this could not be almost this wasn't even conceived. The idea that the genome would truly be used to direct or therapy, the idea that we would know enough about our immune cells, that we could really take our own, the killer cells inside of us that are not doing their job, change their genetic information, expand them, and put them back into a body and see cures close to science fiction. But all of that is science fact. We treat patients now based on their genomics, their genetic information. We use the body's own defense mechanisms now, the ways we never been able to. And that's really been an exciting part of this journey.

Karie Dozer  [00:15:31] TGen’s economic impact has been measured, literally measured as more than $650 million every year. If TGen’s doing that at 20 years old, where do you hope TGen could be in another 20 years?

Dr. Jeffrey Trent [00:15:46] Yeah. So the audited financial estimation of our economic return of, you know, $650 million. So that's essentially like doing three Super Bowls every year. And certainly when you think about how this organization started in such an embryonic way to 20 years later, being able to bring a return to the community and that 650 million is around, you know, really what benefits the community with knowledge base? Workforce with jobs, with some opportunities in the education space, and with treatment options that really allow us to have local research benefit local patients first. It's a lot of what we're about.

Karie Dozer  [00:16:35] Anything that I've missed, anything that you want to include as Jen turns 20.

Dr. Jeffrey Trent [00:16:41] I think that one of the important parts to think about is, thank goodness TGen by no means has stood alone in the biomedical sciences and the development. When you look at the scale of what Mayo has planned and is planning, when you look at the medical school that sits directly behind TGen, that the University of Arizona now they're getting ready to build their second major research facility around tumor immunology. When you look at what is adjacent to us at ASU with their downtown campus and when you really begin to look at the measure of what is here in terms now of industries that are relocating like exact sciences and as and a series of these others you know it's been a major effort to have the community begin to appear on the map of biomedical and biotechnology hubs. But Arizona is getting there. So we're just pleased to be part of the horizon of the future in Arizona that's quite bright.

Karie Dozer  [00:17:53] Certainly a lot to celebrate. Thanks for taking the time to talk about it.

Dr. Jeffrey Trent [00:17:56] Thank you.

Karie Dozer  [00:17:58] For more on TGen’s research, go to tgen dot org slash news. TGen, the Translational Genomics Research Institute, part of City of Hope, is an Arizona based nonprofit medical research institute dedicated to conducting groundbreaking research with life changing results. You can find more of these podcasts at TGen dot org slash TGen Talks or on Apple Podcasts. For TGen Talks, I'm Karie Dozer.