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Outcome 2�Barriers and Opportunities to Translational Research�“talk to the hand vs Let’s Do This!”

W. Chad Spanos MD FACS

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Patient samples

  • Quality
  • Timing in relation to treatment
  • Correlation with outcome
    • Is your question feasible? E.g. pancreas biopsies on treatment/access
  • Institutional support
    • NIH pays to test samples, not acquire (your experience may vary)
  • Blanket consent vs finding cases
    • Who is going to consent at 545 am?
  • Annotated outcome related samples vs disconnected

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Annotated

  • Genomic profile
    • 5 years post stage IV breast cancer treatment no recurrence
    • Diagnosis of Diabetes, ALS, etc
  • Completely disconnected sample
    • Patient has the disease, no stage/outcome/etc

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Are we there yet?

  • Idea to application
    • Longer than we think/want: 1 year vs 20 years
    • Do no harm (assume improvement, history says two tails to the curve)
  • Who pays for this?
    • SBIR
    • Venture capital
    • Pharma
      • Competition with IP (risk/reward)

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Immature vs Mature field

  • Effective treatments?
    • Side effect profile may not matter as much as you think (HPV de-escalation)
  • Are all altruistic?
    • If someone’s lab and entire research career is based on one idea how easily will they pivot?
  • What do we incentivize?
    • Results?
    • Stories/narratives/mechanism
    • Moonshot (moon by 1969 vs safety/scientific exploration/etc)
  • Patent/profit potential vs repurposed drugs