St. Jude Children's Research Hospital has been a leader in treatment and research for childhood catastrophic diseases since the doors opened in 1962. Since then the cure rate for all cancers has gone up to 75 percent, and leukemia has gone from less than five percent to 90 percent, a vast improvement, but there is still much work to be done. Cancer is still the leading cause of death by disease in children. St. Jude director and CEO William Evans, explains the strategic plan for the research hospital and where they are concentrating their efforts for the future.

 

With greater technology, scientific talent and maintained focus on treating and preventing these diseases in children, St. Jude is poised to increase that cure rate, and help others around the world do the same.

 

We're about halfway through a five-year strategic plan that we launched in 2006 and going into that plan, we realized that we needed to stay focused on what we thought were the most compelling problems under the rubric of childhood catastrophic diseases.

 

Where we have expertise and momentum are childhood cancer, infectious diseases in children (children with cancer-suppressed immune system) HIV infections in children and respiratory infections such as influenza. The third area is non-cancer blood disorders like sickle-cell.

 

What we do best is research and integrating that into new treatment protocols. The largest piece of that pie is cancer. That's probably 70 percent of what we do. Another 15 percent would be sickle cell and other blood disorders and the other 15 percent is the infectious diseases.

 

We will continue to deploy the most modern technology around genomics and there's a next generation of DNA sequencing so the ability to sequence the DNA of an entire tumor is moving very fast. It's getting faster and cheaper. We're looking at differences in disease risk. Can we find genetic differences in children who develop leukemia and those who didn't?

 

We're now able to look inside a white blood or leukemia cell, at the DNA, to see what's different between that and a normal person. That's leading us to clues about what caused the cancer in the first place and how better to treat it. 

 

In 2005 we started a new department called chemical biology and therapeutics and it's an enterprise within St. Jude that's not that much different than what you'd find at Merck or Glaxo or Pfizer that's using modern technology, robotics, high put-through screen systems that find a drug that hit a target that causes the disease. Scientists at St. Jude discovered these hits that caused childhood cancers were different than the hits that cause adult cancers. 

 

We realized the old paradigm of taking anti-cancer drugs developed for adult cancers and making them work for kids was not likely to continue to be the way forward in the next decade. Now that the world is migrating toward targeted therapies, we realize that the targets are different in childhood cancers. 

 

We don't want to become a drug company. What we want to do is find the molecules that look promising, take them through the laboratory tests and animal testing in mice to prove that they work, and then partner with somebody, perhaps license them to a startup biotech company.

 

We do collaborate locally with UT, some with U of M, increasingly we're collaborating with regional players, some overlap with Vanderbilt. We are also developing increasing collaboration with Oak Ridge labs.

 

We do some of our treatment protocols with other centers throughout the U.S. where we hand pick them and say 'we want to try this new leukemia treatment, we think it has great promise, would you want to work with us?' That allows us to move our protocols faster. 

 

Our international outreach program and Cure4Kids Web site is really more of a humanitarian and educational effort. What we're doing is sharing this information so that if we can teach a team of doctors and nurses and pharmacists in Guatemala how to treat childhood leukemia, you can almost overnight increase the cure rate from 30 percent to 65 percent. You don't necessarily teach them how to give 2009 treatment, you teach them to give what they can give. 

 

This is just St. Jude looking at how we can fulfill Danny Thomas' vision that to cure one child in Memphis is to cure 1,000 children worldwide. The impact of our discoveries and our innovations and treatment, and just our know-how, can touch thousands of kids that never set foot on this campus.

 

The genomics piece; we are definitely focused on bringing in the newest technology so we can accelerate the rate of that science. We're also working very hard to put together a new group on campus called Computational Biology, which are information science types who also understand biology, who would work with our cancer biologists and clinical faculty to try and put together this overwhelming amount of data we can generate overnight on every single patient at the DNA level. 

 

A child's ability or inability to metabolize a drug; we can now diagnose that from their DNA and avoid that drug. So we're increasingly moving toward individualized medicine. If you're going to try to cure 95 percent or even 100 percent, you're going to have to exploit every piece of data that is possibly available to make those decisions. We think that's doable. It's bringing the right people and technology on campus.