I am interviewed for this article on pioneers in healthcare social media.

The big question in the drug industry is why nobody seems to be able to invent any new drugs. Big Pharma is going to lose billions of dollars to patent expirations over the next five years, but fewer products are emerging from drug company labs, and those that reach the market are not selling as well as they used to. What has gone wrong?

One surprising answer: It may be that companies' tendency to keep their research under wraps is holding them back. Secrecy leads companies to race down the same blind alleys, to miss opportunities and to understand biology less than they otherwise might.

Now former executives from companies including Merck and Genentech are pushing to open up many stages of drug development, from basic science to human research, in the hopes of ending this drought.

At Sage Bionetworks in Seattle, former Merck vice-president Stephen Friend is trying to pool data from drug companies and academics to create predictive models of the body's chemistry. Merck has signed up for one project, and Pfizer for another, with both of them providing data to the effort. Two years after the collaborations begin, the companies will make their data available through Sage's database. The idea is that sharing data in this way will lead to a better understanding of biology, and to better drugs.

Friend says that companies will continue to keep their individual drug compounds secret, because they can still invent medicines faster than their rivals. But in biological research, he argues, there is increasing evidence of "the absurdity of how data is not shared." He adds: "It's not just industry, it's academia. If patients ever came to an understanding of how people do not share  data in academia, they would revolt."

GlaxoSmithKline is opening up its libraries of chemical compounds to fight malaria. It is allowing outside researchers access to its technology, intellectual property and chemical libraries in the hopes of creating anti-malarial drugs. If a use were to turn up outside malaria, Glaxo would keep the rights.

In cancer, drugs may increasingly have to be studied in tandem, or in combination. M.D. Anderson Cancer Center looked at four different lung cancer drugs being developed by separate companies: AstraZeneca, Roche, Onyx Pharmaceuticals and Eisai. The idea was to use blood tests to try and predict which patients would respond to which drug. Early results were promising. Until now, it was unusual for so many yet to be marketed medicines to be tested together in one study.

A similar effort is occurring at the University of California, San Francisco, where researchers are studying four different experimental drugs in a study of 800 women. They are using specially designed blood tests to try and pick the right drug for the right patient and prevent bad decisions.

"All companies today are concerned with the sustainability with the way we've done research and development over the years. We hear it everywhere," says Susan Desmond-Hellmann, a former Genentech executive who is now UCSF's chancellor. "The question is can you give up the secret nature that is your competitive advantage because you gain so much participating in a process like this?"

It's possible that a more open-source approach could have averted some of the drug industry's biggest controversies. Take the diabetes drug Avandia, from GlaxoSmithKline, which critics say is linked to an increased rate of heart attacks. In the first half of this decade, drugs like Avandia that worked by triggering cellular master switches called peroxisome proliferator-activated receptors (PPARs) were a hot area. The hope was that these pills could lower both blood sugar and cholesterol.

Companies started tests of 50 drugs targeted at the PPARs between 2000 and 2006, but not one of these medicines made it to the market. They seemed to cause side effects, including heart and liver risks, with some regularity. Pooling the results of all those studies as they were conducted might have led drug companies to use their money more wisely. It might also have shed more light on whether there is a problem with Avandia. Traditionally, drug companies don't share data with each other as studies progress. Increasingly, it seems that might be a mistake.

Check back tomorrow morning for more on how secrecy has hurt drugmakers, and how they are changing by opening up.

A new study of women with the earliest form of breast cancer offers clues into which patients may need aggressive therapy and who can be spared unnecessary treatment.

Researchers from the University of California, San Francisco, tracked nearly 1,200 women who were diagnosed with ductal carcinoma in situ, or D.C.I.S., which is often referred to as precancer because the risky cells haven’t moved outside the milk duct. With increased use of mammography, the diagnosis of D.C.I.S. is on the rise, yet most of these women are at low risk of ever developing an invasive cancer. Because doctors have no way to identify which lesions pose the greatest threat, most women treat the problem aggressively, undergoing a combination of lumpectomy and radiation or opting for mastectomy.

The researchers collected data on 1,162 women who had been diagnosed with D.C.I.S. from 63 San Francisco-area hospitals and followed their progress for an average of eight years. They identified three specific “biomarkers” that predicted higher risk of invasive cancer. When all three of these markers were present, or positive, a woman had a 20 percent individual risk of developing invasive cancer over eight years. When all the markers were negative, her risk of invasive cancer was only 4 percent, according to the report published online today by The Journal of the National Cancer Institute. About 28 percent of the women in the study fell into the high-risk category. Today, women with breast cancer are not typically tested for these markers, called p16, COX-2 and Ki67.

“At this point in time we’re probably over treating people and under treating people,” said Dr. Karla Kerlikowske, professor of medicine, epidemiology and biostatistics at the UCSF Helen Diller Family Comprehensive Cancer Center. “If we can define a woman’s risk a little better then we can personalize what they want to do.”

The study also determined that when D.C.I.S. is detected by breast exam rather than by mammography, the woman also is at higher risk for developing an invasive breast cancer within the next five to eight years.

Several breast cancer experts not involved in the study said the findings mark an important step toward more personalized cancer treatment, but they are not likely to change practice anytime soon.

“It’s a great study and a good example of how we can decrease overtreatment by identifying markers which can tell us which lesions are the good ones versus which are likely to become invasive and deserve more aggressive treatment,” said Dr. Susan Love, clinical professor of surgery at the David Geffen School of Medicine at the University of California, Los Angeles.

An accompanying editorial said the study was both “thought provoking” and “mystifying,” because the “triple positive” biomarker predicted risk for invasive breast cancer but did not predict increased future risk for recurrent D.C.I.S.

The study also is limited by its relatively small size as well as the fact that the women studied received only lumpectomy with no other therapy, which is not the standard treatment for women today. Typically, women with D.C.I.S. get lumpectomy and radiation or mastectomy.

“This is not practice changing,” said Dr. Jennifer Litton, assistant professor in the department of breast medical oncology at the University of Texas M. D. Anderson Cancer Center. “But it’s certainly very exciting to start to give us more clues as to what might be the underlying biology of less aggressive or more aggressive tumors.”

ucsf study is the subject of this article

By RON WINSLOW

When 37-year-old Kerry Landreth discovered a lump in her breast last April, she was told it would take three weeks to get a doctor's appointment to have it checked.

"I don't do three weeks," she recalls saying. "How about today?"

By the end of the day, she had talked her way into a doctor's appointment, a mammogram and a biopsy to determine whether the suspicious lump was a tumor. A few days later came the diagnosis: stage 2 invasive ductal breast cancer, a particularly aggressive form of the disease. When a surgeon recommended a double mastectomy, she decided to consider other options.

Now, Ms. Landreth, a vice president at the San Francisco office of a Wall Street investment bank and the mother of two young children, is among the first participants in a novel clinical trial that is similarly impatient with the status quo in cancer treatment.

The trial, called I-Spy 2, employs several innovative approaches to improve the notoriously slow and inefficient process of developing new cancer drugs. Using the latest advances in genetics, I-Spy 2 aims to match experimental drugs with the molecular makeup of tumors most likely to respond to them. And it tests multiple drugs at once, with the intent of getting the most effective ones into late-stage trials more quickly.

The goal is to reverse a dismal record, in which 60% to 70% of late-stage cancer studies fail, and to dramatically reduce the time and cost required to get promising new drugs to the market. Currently it can take $1 billion, thousands of patients and more than a decade to gather the evidence necessary to approve a new cancer drug.

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Misha Gravenor for The Wall Street Journal

Kerry Landreth just finished her final round ofchemotherapy.

"Predictability is the Holy Grail here—being able to identify promising drug candidates early and figuring out who they might work in," says Janet Woodcock, director of the Center for Drug Evaluation and Research at the U.S. Food and Drug Administration.

The new trial draws from a growing body of research showing that the genetic makeup of tumors varies widely even among patients diagnosed with the same cancer. Some of these molecular traits, called biomarkers, make a tumor vulnerable to a specific medicine, while others may thwart a drug's effect.

A big part of the problem with conventional trials is that they essentially take all comers. Researchers know many participants won't benefit from the treatment. Those who don't respond can cause a drug to fail even though a significant minority of patients might benefit.

"Unless we do something different, people are going to give up on doing trials" for cancer, says Laura Esserman, director of the breast-care center at University of California, San Francisco, and co-leader of I-Spy 2.

The study focuses on women with aggressive breast cancers that have not spread to other organs. It aims to collect information about experimental drugs that would then enable drug companies to design leaner, faster late-stage trials that enroll only patients whose tumors had a high probability of responding to the treatment. Those trials, called phase III trials, provide critical data used in determining whether a drug will be approved.

 

"The vision is a 300-patient phase III trial instead of a 3,000-patient trial, with better results," says Don Berry, head of Quantitative Sciences at M.D. Anderson Cancer Center in Houston and co-leader of the study.

I-Spy 2's effort to bring much higher standards of productivity to cancer-drug development is inspired partly by Dr. Esserman's experience at business school. In addition to her surgical training, she has an MBA from Stanford University, where she learned about the rapid pace of innovation in high-tech industries. She was particularly influenced by the idea of what Intel Corp. chairman Andrew Grove calls "knowledge turns"—breakthroughs that have led to annual advances in microchip technology and an ongoing revolution in the performance of products like personal computers.

In the development of cancer drugs, by contrast, "knowledge turns" may take 10 or 15 years. Typically treatments are first studied in metastatic patients—for whom cancer has spread from the original tumor site to other parts of the body—who didn't benefit from standard therapies. Even when drugs succeed, benefits often are limited to a few extra weeks or months of life. Then it takes several more years to test successful drugs in early-stage patients, for whom effective treatments could mean a cure.

"We have 45,000 women dying each year of breast cancer," Dr. Esserman says. "We should be compelled to move faster."

About 3½ years ago, she joined forces with Dr. Berry at M.D. Anderson, an expert in a new approach to clinical trials called "adaptive design," to plan I-Spy 2. Unlike conventional trials, in which no one sees results until the end, "we look at the data right away," Dr. Berry says. What is learned in the early going helps to determine which drugs are assigned to patients later in the study, speeding the emergence of winners and losers.

Misha Gravenor for The Wall Street Journal

Dr. Laura Esserman, co-leader of the I-Spy 2 study.

 

The trial incorporates other new approaches. It's currently testing five drugs at once from three different companies. As compounds graduate to phase III studies or are winnowed out for lack of significant benefit, new candidates are cycled in, sparing the cost and time to mount separate trials. Up to 12 candidates will be screened over the course of the study.

In addition, participants get a six-month course of chemotherapy before having an operation to remove their tumors. In many studies, surgery is performed first, followed by chemotherapy and radiation, reflecting a long-standing preference to quickly remove tumors before beginning drug treatment. As a result, it can take three to five years to determine whether a drug is working, as researchers wait to see if the cancer recurs. Whether surgery occurs before or after chemo does not affect long-term outcomes.

In I-Spy 2, researchers use an MRI to evaluate a tumor's response to a drug early in the trial and get a definitive answer at surgery. "All of a sudden I've taken a five-year learning curve and shortened it to six months," Dr. Esserman says.

Ms. Landreth's ordeal began with a heavy sensation in her left breast that led her to discover the lump. It seemed to come out of nowhere and felt as big and hard as a marble. The news that she had cancer came while she was on a business trip to Los Angeles. "It was a shocker," she says.

She didn't reject out of hand the surgeon's recommendation of a double mastectomy, but as she and her husband, Creighton Reed, cast a net among friends for advice, Dr. Esserman's name kept coming up. They were taken with her on their first meeting.

"She sweeps into the room like this Fleetwood Mac figure," Ms. Landreth says, referring to Dr. Esserman's resemblance to the group's singer Stevie Nicks. "There's no B.S. She cuts completely to the facts. She gives you a hug at the end. You leave thinking, 'All right, I can do this.'"

A key feature of the study is a molecular analysis that determines whether the participants' tumors are positive or negative for estrogen, progesterone and the Her2 protein—the basis for putting patients in one of 10 biomarker categories.

Every patient gets 12 weekly treatments with the standard chemotherapy taxol, followed by four biweekly infusions of the standard drugs Adriamycin and Cytoxan. A precursor study called I-Spy 1 showed that 30% of patients who got that regimen saw their tumors disappear completely.

About 80% of patients are also randomly assigned to one of five experimental agents (from Abbott Laboratories, Amgen Inc. and Pfizer Inc.), given with the taxol treatments. Each drug targets a different molecular pathway affecting the growth and proliferation of tumors.

Tumor response is assessed from MRIs and at the time of surgery after chemo is completed. The associations between tumor response and patient biomarkers among the early participants will influence how subsequent patients are assigned to the treatments.

"The goal is to pair drug and biomarker signatures and graduate them into a small phase III trial that has gotten rid of the subset of patients that don't benefit," says Dr. Berry.

There are challenges. Though biomarkers are a promising predictor of a drug's effectiveness, tumor response to a drug can vary widely despite biomarker status. Doctors say that more evidence is needed linking biomarkers to long-term outcomes.

Eric Winer, the director of breast oncology at Dana-Farber Cancer Institute in Boston, is not involved with I-Spy. He calls it "a very good trial," but he wonders if the bar is set too high. "We have to be very careful not to toss away drugs prematurely based on their failure to pass this screen," he says.

The bar is high, Dr. Esserman acknowledges, but the study isn't after incremental improvement. "This trial will say who are the big winners," she says.

Even if I-Spy 2 succeeds in showing that compounds have a high probability of success in small late-stage studies, it isn't clear yet whether or how the FDA's regulatory system would then enable faster drug approval. "That's our next step," Dr. Esserman says.

The study, to cost $25 million over five years, is sponsored by the Biomarkers Consortium, a public-private partnership managed by the Foundation for the National Institutes of Health. It includes representatives from the National Cancer Institute, the FDA and the pharmaceutical industry. Funders include the Safeway Foundation, UCSF, Quantum Leap Health Care Collaborative and several drug companies. So far, about 20 patients are enrolled, with the expectation that about 800 will participate at some 20 medical centers across the U.S.

Ms. Landreth was assigned to one of the experimental drugs and began treatment on May 18. By the second week, a physical check of her tumor suggested it had shrunk notably after just a single treatment. In one of what became weekly email updates to friends, she wrote: "I have always liked to get good grades, so the nerd in me was fully flourishing when the cancer nurse said she was 'over the moon' about how I'm responding to the drugs."

 

Misha Gravenor for The Wall Street Journal

Dr. Hope Rugo, above, is Kerry Landreth's oncologist.

 

The next Tuesday, as she awaited her third round of chemo, she wrote: "I got in trouble with my chemo nurse for trying to tough it out this weekend. I didn't think that a 70 min walk, 18 holes of golf (I broke 100) and a little too much heat + a total failure to use the nausea drugs would cause a problem.... oops!" The result, she wrote, was almost unremitting vomiting for 36 hours.

But, she added, the tumor had shrunk dramatically again.

Later that week, an MRI confirmed the progress. After just three weeks, her tumor had shrunk more than 50%, a strong predictor, Dr. Esserman told her, that the tumor would be gone by the end of chemotherapy.

Still, the cumulative effect of the chemo exacted a toll on Ms. Landreth. She lost her hair, shaving it all off just days before her 37th birthday. Frequent nausea posed a persistent challenge to her energy and appetite. At one point, Hope Rugo, her oncologist, warned that she'd lost too much weight, information she disclosed in an update titled, "Bring on the guacamole."

By week eight, her tumor was the size of a watermelon seed, compared with a golf ball the day she enrolled. At week 12, it was the size of a sesame seed. Her medical team was ecstatic. "There's nothing like hearing them cheer," she says.

Not everyone sees tumors melt away. Inne Harry-Ogaree, 54, who entered the trial at about the same time as Ms. Landreth, had her tumor grow despite treatment with taxol and an experimental drug. She was switched to a more standard regimen, which has shrunk the tumor by more than 50%. "It hasn't been easy," Ms. Harry-Ogaree says. "But I have a positive attitude toward my treatment and my care."

Ms. Landreth's final chemo session was last Tuesday. Under the study protocol, she'll undergo surgery in November. The actual status of her tumor won't be known until then.

Three weeks into the trial, she got the results of a test for mutations in the BRCA1 and BRCA2 genes. Dr. Esserman suggested the test because of a family history of ovarian and prostate cancers. The test was positive for BRCA2, putting Ms. Landreth's lifetime risk of another bout with breast cancer as high as 85%; for ovarian cancer, it's 30%.

She knew immediately what her surgical plan would be: the double mastectomy that she had initially resisted. She plans to have her ovaries removed as well.

Ms. Landreth's results will go into the trial database and could affect which other patients are assigned to the drug. If it turns out, as Dr. Esserman expects, that her tumor is gone, she is unlikely to need radiation.

In her email update early this week, she expressed "high hopes" that surgery would reveal her to be "cancer-free." Reflecting both the challenge of the surgery ahead and the battle she has already fought, she wrote: "I have to remember that after 16 rounds of magic poison it is going to take awhile to bounce back, no matter how fierce my determination. Churchill apparently said, '[If] you are going through hell, keep going!'"

Write to Ron Winslow at ron.winslow@wsj.com

Susan Desmond-Hellmann’s life of science is filled with milestone numbers: Ninth chancellor of UCSF, the second of seven children, millions of lives saved at

Genentech Inc. by shepherding development of the breast cancer drug Herceptin.

Just don’t call her the first woman chancellor of the

University of California, San Francisco.

Not that Desmond-Hellmann minds being a role model, she said — it’s just that her career is marked by … well … not being marked. “In the simplest way, I’m the chancellor,” she said. “I am who I am.”

So while Desmond-Hellmann is a clinical researcher who spent two years in the early 1990s studying HIV in Uganda, she labels herself an optimist. She became chancellor in August — at the height of the UC system’s financial struggles — and yet she invites tough decisions. And, yes, she is a woman, but even as one of the few women in scientific management as head of product development at Genentech, she largely eschewed “women’s things” like lists of women leaders.

“I’m not so easy to put into one of those compartments,” said the woman known around UCSF’s four campuses at Parnassus, Mount Zion, Mission Bay and Laurel Heights simply as “SDH.”

In the end, Desmond-Hellmann said, it’s about equal opportunity at achievement.

“What I want for women and for men — for all people — I want them to believe that anything is possible and to not feel constrained by the scope of what they dream about.”

‘Immediate best friends’

UCSF’s leadership ranks include the top women in science education and research — School of Pharmacy Dean Mary Anne Koda-Kimble, retiring School of Nursing Dean Kathleen Dracup, nationally known breast cancer surgeon Laura Esserman and aging expert Cynthia Kenyon, to name a few.

“It’s less and less a gender issue and more about the best people with the right qualities,” Koda-Kimble said.

Within weeks of Desmond-Hellmann taking over as chancellor, UCSF professor of biology and physiology Elizabeth Blackburn shared the Nobel Prize for physiology or medicine for her work on how chromosomes are protected as cells divide.

“For future chancellors: If you come to UCSF at a really tough time — and it is a tough time, economically — and are worried about morale, have someone win the Nobel Prize,” Desmond-Hellmann joked at her first “town hall” meeting in October. “Thank you, Liz.”

That gee-whiz humor, mixed with scientific acumen, awe, common sense and a quick smile, is the cornerstone of Desmond-Hellmann’s leadership style. It also serves as an inspiration to aspiring women scientists and managers.

“People look at things that are easy to see, like a Nobel laureate and a chancellor,” Blackburn said when asked about the chancellor’s potential impact on women at UCSF. “When it happens to be women, that’s great. It sends a message that it is possible — rather than one token.”

Indeed, said Koda-Kimble, women at UCSF are inspired by Desmond-Hellmann’s chancellorship. Koda-Kimble recalls her first meeting with Desmond-Hellmann, when the two women immediately hugged each other. That made Koda-Kimble more comfortable, and demonstrated to her that Desmond-Hellmann has the ability to “respect everyone’s comfort level.”

“We were immediate best friends,” Koda-Kimble said. “It’s not male or female — some are touchy-feely and some are not.”

Comfortable as role model

Still, Koda-Kimble said, the new chancellor recognizes that she is a model for women.

“She brings hope,” Koda-Kimble said.

But there was a time — not so distant — when Desmond-Hellmann wanted little to do with being a role model, a mentor. While at Genentech, she and another woman in a leadership position were asked to be on a panel of women leaders.

Desmond-Hellmann rolled her eyes.

But her thinking has “evolved,” she said, to believing that “under-represented people” can share their learning and inspirations and serve as role models.

UCSF Chancellor Dr. Susan Desmond-Hellmann is profiled as one of San Francisco's 'most influential women" in the Business Times.

Susan Desmond-Hellmann, the daughter of a Reno pharmacist, helped develop some of the top cancer-fighting drugs. Her work on Taxol, Rituxan, Herceptin, Tarceva and Avastin, which have saved countless lives, made her a millionaire hundreds of times over.

But at 52, Desmond-Hellmann, the former head of product development at Genentech, has stepped into a new challenge: serving as the ninth chancellor and first woman to lead UC San Francisco, a medical, research and academic institution with a $3 billion annual budget, 4,493 students and 22,196 employees. It is the second-largest employer in San Francisco after the city and county.

She took over in August with a sentimental allegiance to UCSF. It is where she met her future husband on the first day of their medical residencies in June 1982. And she has arrived with a calculating mission: to relentlessly uncover the key drivers of cancer.

Desmond-Hellmann, a reluctant female role model who chose career over kids, disdains tokenism and thrives on merit. In several interviews, she spoke of the development of certain cancer drugs - the heartbreaking failures, the breakthrough moments - as if she were a parent talking about her child's ups and downs.

"The period from 1997 to 2001 was an amazing time in oncology," she said, ticking off notable drugs, including Rituxan, Herceptin and Gleevec. "It was a special time because there was such an unmet need."

Drawn to the field

Desmond-Hellmann was drawn to the field of oncology because of the courage of patients, and has since seen her mother and sister undergo treatment for breast cancer. She spent two years early in her career working as a medical oncologist in private practice.

"It's a life-changing moment for someone to be told they have cancer," she said. "So I've always felt this incredible commitment to being a part of something that can help them."

She is also driven, friends and colleagues say, by a mix of perfectionism, intellectual hunger and a kind of moral principle formed in her close-knit Catholic family.

"We need to make drug development faster, cheaper and more predictable," said Desmond-Hellmann, who will be honored by Bay Area college and university presidents at a dinner Thursday at Mills College. "We need to get to the point where when a patient hears the words, 'You have cancer,' the patient also hears, 'And here is what we have for you.' "

Bob Cohen, a senior oncologist at Genentech who has known Desmond-Hellmann since 1985, said the new chancellor has a "sense of obligation that runs deep."

"Sue has made oodles of money and doesn't have to work," he said. "I think she has always loved UCSF, and she also has deep spiritual beliefs. She's also brilliant. A quick study. And she never disappoints."

'We took a chance'

Lloyd "Holly" Smith, who was chair of UCSF's Department of Medicine for 21 years, said, "I remember Sue as an intern. We had hundreds of applicants from Ivy League schools, from Stanford. Sue came from the University of Nevada, an institution we hadn't had any experience with. We took a chance on her because the university had written these letters filled with superlative descriptions. They said they had not seen a student like her.

"When she got here, she quickly stood out in a very elite group."

Sitting in her office at UCSF's Parnassus Campus, Desmond-Hellmann is skilled at staying on message. She has her party lines ("Coming to UCSF means I'll be associated with excellence and a deep commitment to human health") and her favorite quotes ("If we all did the things we are capable of, we would literally astound ourselves" - Thomas Edison).

While her new role makes her something of a public figure, she only reticently opens up about her private life.

Shedding her naivete

Nicholas Hellmann, who runs clinical and research efforts at the Elizabeth Glaser Pediatric AIDS Foundation, said of his wife of 23 years: "She is still the same sweet and warm person, but when I met Sue, she was very naive about the world. Now she is very savvy about the world."

Her childhood in northwest Reno was defined by parochial school, sports, after-school jobs and lively discussions around the dinner table. Both parents were keenly interested in their kids' educations. Frank Desmond, whose parents moved to San Francisco from Ireland, ran the Keystone Owl Rexall drugstore. Jennie Desmond, whose parents were from Yugoslavia, taught English before staying at home to raise the seven children.

"Sue loved school and was competitive, whether in family Scrabble games or school sports," said Frank Desmond, 79. "I suppose you become competitive in a big family."

Laughing, he recalled: "What is kind of funny is Sue and (her older sister) Judy were in parochial school, and one of the sisters said something to Sue about how come you are not as docile as your sister. Sue shot back, 'I'm not my sister, Sister.' "

Pharmacy work

All of the Desmond children spent time working at the pharmacy, doing bookkeeping and making home deliveries. By high school, Sue wanted to become a physician. The University of Nevada had just opened a medical school.

Of his daughter's success, Frank Desmond said, "Sue is someone who needs challenges. From the beginning, she kind of just went forward, and she has kept moving forward."

He shared another story: "When my wife, Jennie, was getting chemo in 1998, she was in one of those lounge chairs. A woman a few chairs over was back because she had a relapse. The doctor told her, 'We're giving you this incredible new drug called Herceptin.' And, pointing to my wife, he said, 'You can thank the daughter of the woman over there for helping get this drug to you.' "

Desmond-Hellmann's path to Genentech was unconventional. From UCSF, she and her husband moved to Uganda for two years, from 1989 to 1991, to study the heterosexual transmission of HIV. That was followed by two years in private practice in Kentucky before joining Bristol-Myers Squibb in 1993, where she designed the studies that got Taxol to market. (Taxol was the chemotherapy drug that her mother received.) She joined Genentech in 1995.

"We recruited Sue to Genentech to work as a clinical scientist," said Bob Cohen. "Oncology wasn't a giant part of our business. But Sue and I got to talking about cancer, and I told her I think we can have real successes in this area."

Art Levinson, one of Genentech's first scientists and the company's former CEO, said, "Sue came in as a clinical scientist, but every six to 12 months, I was promoting her. Her instincts were excellent."

Cohen said Desmond-Hellmann had to look at all of the drugs in the pipeline and make the crucial, billion-dollar decisions of which ones had the potential to succeed. "She used all she knew to develop a portfolio of oncology drugs," Cohen said. "She was a gifted manager of people and resources, and she bet on the right horses and was able to get them to the finish line."

Frank McCormick, head of cancer research at UCSF, calls Desmond-Hellmann the "god of drug development" and has high hopes for what she will bring to UCSF.

"She really oversaw the development of some of the top drugs that have had a major benefit to a huge number of cancer patients," he said. "It doesn't get much better than that."

When Desmond-Hellmann left Genentech in 2009 to take the job of UCSF chancellor, the company had become the nation's No. 1 producer of anti-cancer treatments, and Herceptin was the first "personalized" medicine, targeting a specific mutation rather than wiping out the good cells with bad ones.

"Herceptin for me was an amazing experience," Desmond-Hellmann said. "Before Herceptin, there were no treatments for HER2-positive breast cancer. (HER2 is a protein that encourages the growth of cancer cells.) It was a death sentence for most women. After Herceptin, the risk of cancer returning was reduced by 52 percent, and three years later, 85 percent of patients had no tumor recurrence."

Desmond-Hellmann's office is a few floors down from where she met her husband in 1982. A handful of family photos lines shelves above her desk, and a black-and-white photo of her favorite place - Donner Lake near Truckee, where they have a home - adorns a wall. Of her decision not to have children, she says, "My husband and I made the decision early on that we wouldn't have kids. It wasn't a pull for me. I definitely enjoy the life we have."

In those rare moments when she's not working, she loves to exercise listening to NPR, and to read listening to country music. She is a master of the "five-minute meal," whipping dinner together in no time, according to her husband.

'I'm very grateful'

She never loses sight of the success and blessings of her life - of the fact that her grandparents worked as maids and coal miners, and that her parents on both sides were the first in their families to graduate from college. (Her mother started grammar school speaking only Slovenian and graduated college as an English major.)

"I'm very grateful for a lot of things," she said. "I was born into a great family, not a wealthy one, but a family where our parents cared about our education and paid extra money for us to go to a good school. Then, being in Uganda really was life changing. I saw how spoiled we are."

Her happiest times are simple ones, she says.

"I like to go skiing, to be off somewhere with my husband," Desmond-Hellmann said. "I have my fears just like anyone else. I have a wonderful husband. I fear something could happen to him as he travels around Africa."

Heading off to her next appointment in a day packed with meetings and events, Desmond-Hellmann said, "I have this great and big job as chancellor. It's really interesting and complicated and challenging. I love being around brainiacs. And, most of all, I do have this strong sense of what I expect from myself and what I want to give back."

E-mail Julian Guthrie at jguthrie@sfchronicle.com.

This article appeared on page A - 1 of the San Francisco Chronicle

UCSF's Chancellor makes front page news of SF Chronicle.
Here's one of my favorite lines from the article:
"Sitting in her office at UCSF's Parnassus Campus, Desmond-Hellmann is skilled at staying on message."

Dr. Laura Esserman, director of the Carol Franc Buck Breast Care Center at the University of California at San Francisco, said there were limitations to screening. “Where it is very clear that the benefits outweigh the risks is for women ages 50 to 75,” Esserman said, noting that the recommended interval varies between one and two years.

UCSF's Chief of Breast Cancer Surgery is featured in the New York Times.

Dr. Shelley Hwang, a breast surgeon at UC San Francisco, says DCIS strikes almost 70,000 American women annually and accounts for about one-fifth of all new diagnosed breast cancers. "The prognosis of someone with DCIS is excellent," she says. "There's only a one-percent chance of anyone with this diagnosis would die of breast cancer.

UCSF's star breast cancer surgeon is featured in People.

Navratilova has breast cancer: report

NEW YORK

Wed Apr 7, 2010 9:43am EDT

 

 

 

 

Former tennis player Martina Navratilova of the U.S. speaks at the Foreign Correspondents' Club of Japan in Tokyo March 11, 2008.

Credit: Reuters/Kiyoshi Ota

   

NEW YORK (Reuters) - Martina Navratilova, one of the finest female tennis players of all time, has been diagnosed with breast cancer, she has told online magazine People.

 "I cried," the report quoted Navratilova, 53, as saying about the moment in February when a biopsy came back positive after a routine mammogram revealed a cluster in her left breast.  

"It knocked me on my ass, really. I feel so in control of my life and my body, and then this comes, and it's completely out of my hands."

Wednesday's report said she would begin six weeks of radiation therapy in May following minor invasive surgery called a lumpectomy and the prognosis for survival was extremely good.

She was diagnosed with a non-invasive form of breast cancer, the report said, called ductal carcinoma in situ, or DCIS, which in her case had not spread to the breast tissue.

"It was the best-case scenario you could imagine for detecting breast cancer," Mindy Nagle, a good friend of Navratilova, told the magazine.

Shelley Hwang, a breast surgeon at UC San Francisco, said DCIS strikes almost 70,000 American women annually and accounts for about one-fifth of all new diagnosed breast cancers.

"The prognosis of someone with DCIS is excellent," she told the magazine (www.people.com). "There's only a one percent chance anyone with this diagnosis would die of breast cancer."

The nine-times Wimbledon champion, who still plays tennis and ice hockey and competes in triathlons, said she was lucky, as she had not been getting regular check-ups.

"I went four years between mammograms. I let it slide. Everyone gets busy, but don't make excuses. I stay in shape and eat right, and it happened to me. Another year and I could have been in big trouble."

Czech-born Navratilova, who became a U.S. citizen in 1981, won 18 grand slam singles crowns.

(Writing in London by Jon Bramley)

Sports

UCSF's Shelley Hwang is quoted in this Reuters article.