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Embattled Cancer Center Chief Plans New Approach

Ronald DePinho's first two years as president of MD Anderson Cancer Center have been marked by distractions and growing unease as much as by lofty aspirations. He said he has learned from his missteps and is making changes.

Ronald DePinho, president of the University of Texas MD Anderson Cancer Center, visiting labs on the south campus in Houston on Sept. 30, 2013.

HOUSTON — Ronald DePinho, the president of the MD Anderson Cancer Center, part of the Univeristy of Texas, becomes animated when he talks about his ambitious plans in leading the institute’s efforts to combat the disease.

In two weeks, Depinho plans to give a public report on the first year’s progress of MD Anderson’s “moon shots” program. An ambitious cross-disciplinary effort fashioned after the Kennedy-era space efforts, its aim is to dramatically reduce mortality rates of a group of cancers — breast, ovarian, lung and prostate cancer, multiple types of leukemia, and melanoma.

But the tenure of DePinho, who has been president since 2011 and is the fourth in the institution’s 72-year history, has been marked by distractions and growing unease as much as by lofty aspirations. Most recently, a survey of clinical faculty members found that a majority of respondents believed that the program’s demands were having an impact on patient care and MD Anderson’s clinical reputation.

With pressure mounting from University of Texas System leaders, DePinho acknowledged that his hard-charging style might have resulted in some missteps. He said he has learned from his experiences and is making changes.

“I have stumbled,” DePinho said Monday during an interview in his office. “It comes from running really fast.”

Born and raised in New York, DePinho moved to Houston with big ideas after 14 years in Massachusetts at the Dana-Farber Cancer Institute and Harvard Medical School. His wife, Lynda Chin, a renowned cancer genomics researcher, came with him, as did most of the employees of his Boston lab, to help establish the new Institute for Applied Cancer Science.

He soon encountered financial pressures.

“The reality is that all academic institutions are going to have to find ways to increase the quality of care and the numbers of patients they see, and do so with less support,” DePinho said, citing the advent of the Affordable Care Act and the erosion of federal research financing, among other factors.

But the demands of such ambitious efforts and financing challenges are taking a toll.

In 2012, clinical departments were asked to increase revenue targets by 5 to 10 percent. This year, austerity measures, including salary freezes, were announced.

A clinical faculty survey conducted in September indicated that deep concerns are taking root.

Of nearly 550 clinical faculty members who participated — out of about 850 total — a majority indicated that they had at least considered other job opportunities. More than 56 percent of respondents agreed that demands for increased clinical productivity have had an impact on patient safety.

DePinho said patient safety and care remain MD Anderson’s top priorities, and he takes such concerns seriously.

“If there is any veracity to those claims, we want to find out and we want to open up the lines of communication,” he said, adding that the survey has sparked “healthy dialogue where people are now focused on good discussion, trying to come together and think about what the solutions might be.”

The survey, the latest in a series showing declining morale, was presented during a faculty senate meeting last month that was attended by University of Texas System Chancellor Francisco Cigarroa.

Members of the executive committee of MD Anderson’s faculty senate declined to comment further on the matter this week.

In a statement, Cigarroa described his discussions with faculty as “very productive.”

“We identified several areas that we felt needed immediate attention as it related to better communication, compensation, reviewing how funding mechanisms are currently used to support clinical operations and research, involving faculty in decision-making and planning, and a better balance of near-term needs and long-term goals,” Cigarroa said.

He added that he is working with MD Anderson leaders to address faculty concerns and believes they can forge “a constructive and successful path forward.”

In addition to malaise among the faculty, the last two years have featured some controversy.

In 2012, questions were raised when the Cancer Prevention Research Institute of Texas bypassed the standard approval process in issuing a $20 million grant to a project co-directed by Chin at the Institute for Applied Cancer Science. CPRIT was the subject of legislative hearings and an administrative overhaul. A UT System review found no conflicts of interest related to the grant.

Given recent budget constraints, a nearly $550,000 price tag for office renovations approved by the UT System as part of the effort to attract DePinho and Chin also caused heartburn among some faculty.

DePinho’s ties to Aveo Pharmaceuticals, a Cambridge company he co-founded with Chin, have also been scrutinized. In 2012, he appeared on CNBC in his capacity as president and touted a renal cancer drug developed by the company. He later apologized for doing so. Though there had been internal discussions about troubling test results within the company, DePinho has said he was not aware of them at the time.

At the end of last year, DePinho resigned from the Aveo board and two other companies with which he had retained ties. He also put his investments into a blind trust.

But Aveo has continued to create headaches. The Food and Drug Administration rejected the renal cancer drug in June. Less than a month later, the Securities and Exchange Commission launched an investigation into the company.

According to an SEC filing, the company has been informed that the action “should not be construed as an indication that any violations of law have occurred or that the SEC has any negative opinion of any person, entity or security.”

DePinho said these episodes have been instructive. “I think they’ve been really good lessons that one has to be a lot more proactive in managing the information so that perceptions don’t build,” he said.

He said he intends to adopt a more inclusive approach to planning and to step up the dissemination of information to encourage data-driven decision-making. “We have an extraordinary faculty and a phenomenal staff,” he said, noting that they shared common motivations.

“The thing we all agree on is that we hate cancer,” he said. “And we agree that patients come first.”

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