Health Care

At Children’s Mercy, a sharper focus on research; institute’s new leader arrives

“Academia and children’s hospitals in particular have an obligation to take the wealth of information they collect on their patients and use it for the benefit not only of those patients, but of all future patients that have a similar disease,” says Tom Curran, head of Children’s Mercy Hospital’s new Children’s Research Institute.
“Academia and children’s hospitals in particular have an obligation to take the wealth of information they collect on their patients and use it for the benefit not only of those patients, but of all future patients that have a similar disease,” says Tom Curran, head of Children’s Mercy Hospital’s new Children’s Research Institute.

Children’s Mercy Hospital suffered a setback in 2013 when Jackson County voters soundly rejected a new sales tax to fund health care research, with the largest share of the money — $20 million per year — set to go to the hospital.

But that hasn’t deterred Children’s Mercy’s drive to become a major medical research center. Last year, it created a Children’s Research Institute to coordinate the work of its scientists and physicians and to expand its research portfolio. The hospital announced this week that it has hired biologist Tom Curran, former deputy scientific director of Children’s Hospital of Philadelphia, to lead the new institute.

Curran, who still retains some of his Scottish brogue after decades in the United States, has a lengthy and distinguished resume in both academia and industry. His research has spanned molecular biology, cancer and neurobiology. Currently, his laboratory is focused on pediatric brain tumors, brain development and genomics.

Curran, 59, received his Ph.D. from London’s Imperial Cancer Research Fund Laboratories and University College in 1982, then studied as a postdoctoral fellow at the Salk Institute in San Diego.

After his academic training, Curran moved to the East Coast to work at Hoffmann-La Roche, a pharmaceutical company in New Jersey. And from there, he went to St. Jude Children’s Research Hospital in Memphis, Tenn., where he founded its department of developmental neurobiology. He moved to Children’s Hospital of Philadelphia in 2006.

Curran was just beginning this week to move into his Children’s Mercy office. His wife, Jessie Ng, also a research biologist, and 12-year-old daughter Ally will be joining him once Ally’s school year is over. The family already has gotten a look at Kansas City.

Curran was enthusiastic.

“People who never visited have no idea what it is like. You have all sorts of fantastic things,” he said. “We had a really enjoyable visit to the Kansas City Ballet. My daughter does ballet. You have an amazing ballet company. And the Kauffman Center: world class. You don’t really talk about yourselves that much.

“So I make the analogy: Children’s Mercy is like the Kansas City Royals. World champions, but who would know that? But now, people are beginning to recognize it.”

Curran spent a couple of hours with The Star for a wide-ranging discussion of his career, his thoughts about research and his plans for the Children’s Research Institute. His remarks have been edited for length and continuity.

How did you come to work on brain cancer?

I was in my lab at Hoffmann-La Roche and an Englishman came up and insulted me. I was telling him about what I was working on, and I’m Scottish, so this was really an insult. It almost came to fisticuffs. I was telling him about the work I was doing on cell signaling and cancer biology and he said, “Ah, why are you wasting your time doing that? You should be working on neurons.” I said “Why?” “Well,” he said, “it’s much more interesting and exciting.” And I said, “OK, let’s do it. Let’s collaborate.”

He was a neuroscientist and he thought the kind of work that I was doing could translate over into the brain with very different implications. He wasn’t studying brain cancer, he was studying how the brain works. It was such an interesting challenge, I thought, well, let’s try it. And we designed experiments together.

I started working on brain tumors (after moving to St. Jude) knowing absolutely nothing about brain tumors. So I gave myself a one-week rotation in the clinic. That was a very formative experience because I had never met children with brain tumors before and their parents. It was very tough because I had a young son at the time. It resonated with me what the parents were going through.

The kids were just very inspiring and very knowledgeable. Children who end up spending a lot of time in hospitals kind of learn fast; they actually know what they’re going through. (Meeting those children) completely changed my perspective. And so from that point, which was in 1995, I pursued my personal research goal, which was to deliver medicines to children that take advantage of the very latest science.

The biggest kick I got the last few years (was) hearing about the first patient who benefited from a drug I developed. He was actually a young adult. He had the disease for several years, multiple rounds of therapy, and now he had metastases all over his body, hundreds and hundreds of tumors. Initially, all the tumors disappeared. It was unbelievable. He wrote that he felt better than he had ever felt since he was diagnosed with this disease.

(The benefits) only lasted a few months because the tumor became resistant. He actually allowed the physicians to biopsy the resistant tumor, (pharmaceutical company) Genentech studied the tumor and they figured out why the tumor became resistant. And though his benefit was really short-lived, he actually helped move the field forward.

And that came from an idea where I knew nothing in 1995. It took 20 years (to develop) through the help of multiple collaborators, some in biotech companies, my clinical colleagues, and the multiple people who worked in the lab at different stages.

Why did you move from the pharmaceutical industry back to academia?

(After completing training in 1984) I had the feeling that science had progressed to the point that it was now going to significantly impact the discovery of new medicines. And I thought that transition would happen more rapidly in industry than in academia. Turns out I was wrong, but that was my thinking at the time. And I joined Hoffmann-La Roche.

I spent almost 11 years there, very successful. Ultimately, I was the director of the research institute that La Roche had. And then I was presented with a wonderful opportunity: I was fired. La Roche went through one of its regular downsizings, and although the institute had been very successful, they just decided to go in a different direction.

In industry, the profit motive was really pre-eminent, and that’s not always in direct patient benefit. And in particular, children are a neglected population. And children with brain tumors were an even more neglected population. Many of the leaders in industry, and they were quite honest about it, said we can’t make money selling medicines for kids with rare diseases.

I understand that, but someone has to do it; otherwise those children get left behind. That’s why I felt that academia and children’s hospitals in particular have an obligation to take the wealth of information they collect on their patients and use it for the benefit not only of those patients, but of all future patients that have a similar disease.

Well, things have changed and something very interesting happened in the last few years. Industry recognized that rare pediatric diseases were sometimes (amenable) to treatment with some of the modern approaches. In fact, there’s a collaboration between Children’s Mercy and my former institution, Children’s Hospital of Philadelphia, to treat pediatric leukemia with the very latest T-cell therapies where patients’ white blood cells are taken out, engineered in a test tube to attack the cancer, given back to the patients, and they eliminate the cancer.

This is kind of space-age stuff, even for me. I grew up with this field and even I am surprised at how well it works in some patients.

That program is supported by (the pharmaceutical company) Novartis. Novartis decided that the best indication to seek (Food and Drug Administration) approval for this really new technology was a pediatric leukemia. Children’s cancers are generally a little simpler than adult cancer because children have not been exposed to decades of environmental insults and toxins and additional mutations.

So in a relatively small trial, a smaller number of patients, industry can actually achieve very striking results because they are defining the patient population very carefully. So I think now that has kind of broken the barriers. Now industry is much more willing than before.

Why Kansas City?

I came to Children’s Hospital of Philadelphia in 2006 to try to apply some of the principles that I had learned specifically focused on pediatric brain tumors to the broader issue of pediatric medicine in a research hospital. And I spent years doing that and I believe that was very successful. I built programs that have done a lot of good.

My direction changed over the last couple of years and that started me thinking about what I really wanted to do. I think I have one big job left and where should I do it and how should I do it. I just continually came back to the issue of pediatric disease and the integration of science and medicine.

To achieve that integration, there’s an essential component. The hospital has to be excellent. I’m a bench researcher, a scientist. If I do studies and there’s (no one to receive them) on the hospital side, it’s kind of like a tree falling in the forest and no one notices.

What attracted me to Children’s Mercy, they have a fantastic hospital with really good people. You already have excellence in certain areas of research and what was missing was really somebody like me who has a background in building research structures integrating into a clinical research environment.

One of the things I’ve really tried to model over the years is the concept of teamwork, synergy, transparency, sharing of data. And surprisingly, although you would expect all these things to be very well-recognized and important in the research community, they sometimes get overshadowed by personal ambitions, structures, competition for grants from foundations, and awards.

The funny thing was I didn’t have to in any way explain that to the people at Children’s Mercy. They already got it. It was kind of like coming home.

What will be the role of the Children’s Research Institute?

There are several areas of excellence in research at Children’s Mercy. The pharmacology program is world class, for example. The genome center is making an enormous contribution. The idea is to be able to learn from those successes and build a structure that empowers every aspect of research that applies to pediatric disease and well-being.

The Research Institute provides a framework that makes all of this happen. For example, some areas of science, the individual scientist can’t do everything themselves. They need to rely on support structures, (facilities) that provide technological services that you wouldn’t be able to just develop in your own lab, you wouldn’t have the resources. The Research Institute provides a home for such kind of stuff.

Communications. Science and medicine are two sides of the same coin. But often, they’re separated by the lack of a common language or understanding. The Research Institute builds bridges across those sides.

Where will you look for funding, now that a sales tax is out of the question?

I’m familiar with that well-meaning but ultimately flawed approach to support research. The American population doesn’t resonate with more taxes. I think that’s been proven over and over again. It’s probably not the easiest sell.

On the other hand, there’s no one more generous than the American public in supporting research. It’s absolutely phenomenal. My former institution (St. Jude), a tiny hospital when I was there, it had about 60 beds, raised when I was there half a billion dollars per year. And actually, as I look around Kansas City, you have generous people here. You have a tremendous history of contributions to society, more so than many of the other places that I’ve visited.

I think industry is always best viewed as a partner as opposed to a source of funds. What industry did (for his cancer research) was to provide the drug and provide all the information associated with the drug development that allowed us to do clinical trials that brought it forward. They didn’t pour money on us.

Government grants are the coin of the realm. If you’re in research you need to be applying for grants from the (National Institutes of Health). It’s competitive. Sometimes children’s diseases don’t fare very well because you’re up against equally good grants that have a much larger affected population. So the Research Institute will work very hard to help people to get their NIH grants funded. But I don’t rule out any other kind of support whether it’s state or city.

What will your role be?

Probably the most important roles that I play won’t be apparent to anyone. Behind the scenes I have to make sure that things work and keep everyone on the right track and support the people who are really going to make a difference. I will, of course, continue my own lab, but my part is to really help other people achieve their goals more than my own personal ambition.

I’ve now got several decades of leadership experience. So if it’s possible to learn from mistakes, I must have learned a lot of lessons because over time, you know, nobody’s perfect. So I would like to take advantage of what I’ve seen, heard and experienced and create the ideal environment.

I’m not interested in making Children’s Mercy the second-best or the third-best hospital research environment. I want it to be the very best because I think we owe that to our patients. We owe them the latest science and technology. It’s not acceptable that children would have to wait until new approaches are pioneered or tested out on adults before they have access to those concepts and ideas.