March-April 2011

Breaking Down Barriers between Labs, Peoples’ Lives

URMC research building focuses on fast-tracking tomorrow’s therapies

This spring, more than 600 scientists, physicians, nurses, statisticians, research administrators and support staff will move into the 200,000-square-foot Saunders Research Building. We sat down with Thomas Pearson, M.D., M.P.H., Ph.D., director of the Clinical and Translational Science Institute (CTSI), to learn how the new facility will accelerate scientific discoveries into new ways to treat, prevent and cure diseases.

Pulse: Let’s jump right in. What’s the vision behind this new building?

Pearson: This facility is all about translation. The word literally means “to bring across,” and that’s the entire purpose of our CTSI, and this new building: to identify the most promising lab discoveries – insights into the cellular mechanisms of disease, for instance – and help “bring them across” to a place where they can make a measurable difference for real patients.

Pulse: Doesn’t that happen already? I mean, isn’t that the point of medical research?

Pearson: It is the point, but it occurs far less often than you might think. I’m a cardiologist by training, practicing for almost 30 years now, and I can assure you – in any given field, it’s rare to have a blockbuster therapy arrive on scene. The development of statins – cholesterol-lowering drugs – is one of the few great translational research triumphs I’ve witnessed in my career. If success stories like this were commonplace, Michael Brown and Joseph Goldstein wouldn’t have won a Nobel Prize for their pioneering work for statins.

“Our medical school is steeped in the legacy of founding dean George Whipple, himself an iconic translational scientist. Our new Saunders Research Building is an integral element of the Medical Center’s strategic plan. It will serve as a conduit for rapidly bringing basic science discoveries to everyday patient care.”

– Bradford C. Berk, M.D., Ph.D., CEO of URMC

The reality is, research tends to get stuck. It can take 25 years for a finding to move from an idea in the lab to actual therapeutic use – say, a new drug or device – in humans.

Pulse: What barriers stand between a lab breakthrough and changed lives?

Pearson: There are a great number of things. Of course, lab insights must be translated into a testable candidate drug, device or technique – but that’s only the first hurdle. Next come studies of safety, effectiveness – first in animals, then in humans; in small groups, then in large ones.

Undoubtedly, important “comparison” questions arise. It’s not simply a matter of “does drug X help disease Y,” but does drug X do so in a way that improves upon existing therapies – either by conferring less risk, fewer side-effects, etc.? Or, does drug X help males more than females? African-Americans more than Hispanics? Children more than adults? Researchers must carefully design trials to assess these variables and discern which therapies hold most promise for a given population. Of course, to carry these trials out, investigators must secure funding, submit designs for ethical review, and overcome volunteer recruitment challenges.

Pulse: That sounds like a lot of work!

Pearson: It is. And even if a drug or device secures FDA approval, “translation” isn’t finished; researchers must find ways to actually implement it into the flow of care. This gives rise to another whole field of study known as “implementation research.”

Take aspirin, for instance. More that 155,000 people have participated in studies that collectively show taking aspirin daily could reduce one’s risk for heart attack and stroke by about 25 percent (mind you, heart disease and stroke kill one in three Americans). Still, too few heart disease patients take aspirin daily – even though it’s been widely studied, proven safe, is available over the counter and costs just pennies a day. The big question now is how to actually change behavior and get patients to take it.

Needless to say, translation can be a long and complicated process – but it’s incredibly important. If a finding doesn’t translate completely, it can’t produce change. And change is the whole point.

Pulse: How will the Saunders Research Building hasten the translation process?

Pearson: To start, the building will house a host of support services – experts in bio-informatics, technology transfer, regulatory affairs, human subject protection, trial recruitment and retention. Each of these groups provides critical intelligence necessary to keep research progress on track, supporting clinical investigators along every step. These services will be interspersed throughout the facility – in many cases, with their offices situated right next to an active research program.

Pulse: So, looking at a floor plan of the new facility, I see that heart researchers are sharing a floor with biostatisticians. Is this sort of unexpected “neighbor” arrangement all part of the plan?

Pearson: Yes, that’s part of the beauty of this building – its very design promotes spontaneous collaboration. Shared break rooms for all groups located on a given floor encourage informal networking. Clusters of chairs in wide hallways – or the healthy café on the ground floor – inspire impromptu discussions with colleagues. Glass walls along perimeter offices – and low dividers separating central cubicle workstations – ensure that there’s a sense of community, synergy, momentum. We’re actually planning to measure how the layout increases our productivity, and perhaps more importantly, our creativity.

Pulse: It sounds like this could prove to be a great model for future clinical research facilities.

Pearson: It could be. As it stands, we’ve had more interest in the space than we had room to accommodate. Clearly, we’re excited about the chance to work together as never before.

For more about the Saunders Research Building – including panoramic inside views, plus details on its energy efficient and environmentally conscious design – click here.

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