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Three interview sessions conducted in summer and early winter of 2014
Total approximate duration, 4 hours and 50 minutes
Interviewer: Tacey A. Rosolowski, Ph.D.
For supplementary materials:
Please contact, the Historical Resources Center, Research Medical Library:
Javier Garza, MSIS, email@example.com
About the Interview Subject:
Dr. Bast came to MD Anderson in 1994 to head the Division of Cancer Medicine, at which time he also joined the faculty as Internist and Professor of Medicine in the Department of Experimental Therapeutics. Dr. Bast was Division head until the year 2000, when he became Vice President for the Office of Translational Research, a position he occupies today. Dr. Bast’s research has focused on ovarian and breast cancer. He has made advances in identifying biomarkers for early detection, drug sensitivities, monoclonal antibodies, the CA125 biomarker, and the significance of the ARHI tumor suppressor gene. Very early in his career he developed a translational approach and he has been instrumental in developing the capacity of institutions to support and promote translational research.
Major Topics Covered:
Personal and educational background
Career prior to MD Anderson recruitment
Research: the early detection and prevention of ovarian cancer; studies of cell growth regulation (ovarian and breast carcinomas); research into imprinted tumor suppressor genes; the manipulation of cancer autophagy and tumor dormancy; and research into the modulation of taxane sensitivity.
Translational Research: thought processes and working strategies
Strengthening MD Anderson’s research programs, especially translational research
The Office of Translational Research and its impact on science at MD Anderson.
The Moon Shots Program
Training requirements for physician-scientists
Challenges of financing multi-disciplinary research
Regarding the Transcript and Audio Files
In accordance with oral history best practices, this transcript was intentionally created to preserve the conversational language of the interview sessions. (Language has not been edited to conform to written prose).
The interview subject was given the opportunity to review the transcript. Any requested editorial changes are indicated in brackets [ ], and the audio file has not correspondingly altered.
Redactions to the transcript and audio files may have been made in response to the interview subject’s request or to eliminate personal health information in compliance with HIPAA.
The views expressed in this interview are solely the perspective of the interview subject.They are not to be interpreted as the official view of any other individual or of The University of Texas MD Anderson Cancer Center.
Interview Session One: 7 July 2014
Early Opportunities to Focus on Research
Chapter 01 / Educational Path
Integrating Research and Clinical Practice
Chapter 02 / Professional Path
A Review of MD Anderson Research in the Early Seventies and a Discussion of Clinical Trials
Chapter 03 / The Researcher
Studies of C. Parvum and a Screening Test for Ovarian Cancer
Chapter 04 / The Researcher
Developing Tools to Monitor and Screen for Ovarian Cancer
Chapter 05 / The Researcher
Increasing Patients’ Sensitivity to Taxol; Understanding the Function of ARHI (DISRAS3) and Autophagy
Chapter 06 / The Researcher
Rapidly Changing Science and the Pressure to Publish in High-Impact Journals
Chapter 07 / The Researcher
Research to Develop a Big Picture of Ovarian Cancer; Creating a Collaborative Laboratory Environment
Chapter 08 / The Researcher
Experience at Duke and Coming to MD Anderson to Build Research
Chapter 09 / Joining MD Anderson/Coming to Texas
Interview Session Two: 24 July 2014
The Office of Translational Research: Building Collaborations
Chapter 10 / Building the Institution
Training Physician-Scientists at MD Anderson
Chapter 11 / Building the Institution
The Moon Shots Program and a Model of Translational Research
Chapter 12 / Overview
The Moon Shots Program; Genomic Medicine
Chapter 13 / Overview
Working with Pharma; Supporting Innovation; Attracting Philanthropic Dollars
Chapter 14 / Building the Institution
The Office of Translational Research: Growth Areas
Chapter 15 / Building the Institution
Thoughts about Training as a Physician-Scientist; A Review of Good Colleagues
Chapter 16 / A View on Career and Accomplishments
Interview Session Three: 18 December 2014
The Multi-disciplinary Research Program
Chapter 17 / Building the Institution
As Head of the Division of Cancer Medicine: Building MD Anderson’s Academic Programs and Research Focus
Chapter 18 / Building the Institution
The Culture of Research at MD Anderson
Chapter 19 / MD Anderson Culture
Accomplishments as Division Head and Observations about Leadership and Mentoring
Chapter 20 / The Administrator
John Mendelsohn and Ronald DePinho
Chapter 21 / Key MD Anderson Figures
The Moon Shots Program and Its Impact
Chapter 22 / Building the Institution
Writing a Guidebook on Translational Research
Chapter 23 / The Researcher
Establishing a Habit of Translational Thinking
Chapter 24 / MD Anderson Culture
Photography, Basketball, and An Advisor to the V Foundation for Cancer Research
Chapter 25 / Personal Background
Interview Session One: 7 July 2014 (listen/read)
Interview Identifier (listen/read)
Chapter 01 (Educational Path)
Early Opportunities to Focus on Research (listen/read)
Dr. Bast gives an overview of his early introduction to the researcher’s life and work.
He begins with brief comments about his family background and good educational opportunities, including chances to participate in medical research at the age of fifteen or sixteen. He describes the research methods he was exposed to, a precursor to translational research. He talks about his respect for data (even if it negated an initial hypothesis) and his scientific integrity.
Next, Dr. Bast explains why he went to Wesleyan College (BA 1965) to major in biology with a minor in religion. He was interested in a liberal education. He also describes the research project he undertook in the pathology laboratory at Massachusetts General Hospital, where he “learned enough about reading slides to be dangerous.” He then talks more about his undergraduate experience which established his “life-long learning approach to life.” Dr. Bast then comments on his habits of lateral thinking and 3-D visual thinking.
Chapter 02 (Professional Path)
Integrating Research and Clinical Practice (listen/read)
Dr. Bast explains how his desire to integrate research into his clinical practice evolved in medical school, internship and residency.
He attended Harvard Medical School (MD 1971) for six years because he spent two years conducting pathology research, integrating his clinical and research practices. Dr. Bast explains how working with patients and seeing the minute-by-minute progress of disease enhanced his research.
Next Dr. Bast explains his focus on cancer research, noting that he was influenced by Bill MacFarlane’s early interest in immunology and cancer. He focused entirely on cancer when he took a research internship at the National Cancer Institute (1972 – 1975) and gained experience with microbacterial approaches. He explains that he studied the successful effects of Bacillus Calmette-Guerin on tumor control and metastasis in guinea pigs. He believed that there could be analogous results in humans.
Chapter 03 (The Researcher)
A Review of MD Anderson Research in the Early Seventies and a Discussion of Clinical Trials (listen/read)
Dr. Bast begins this chapter by noting that, in the mid-seventies he wrote a review of research on BCG and cancer for the New England Journal of Medicine and included comments on the poor quality of research at MD Anderson. He gives further context, noting the controversies over randomized clinical trials and the bias at MD Anderson for conducting single arm trials. Dr. Bast next explains why today studies of targeted therapy can be productively advanced by single-arm trials, though they require final confirmation by randomized trials to win FDA approval for any drugs or procedures.
Chapter 04 (The Researcher)
Studies of C. Parvum and a Screening Test for Ovarian Cancer (listen/read)
Dr. Bast describes the research that grew from his belief that BCG could be injected into tumors to control growth and metastasis.
During his residency at Brigham and Women’s Hospital and a fellow at the Dana-Farber Cancer Institute, he looked for ways to apply intravenous tumor injection to other cancers. He explains how ovarian cancer appears in the body and talks about a study of how injected C. Parvum inhibited ovarian cancer in animals by increasing macrophages.
He then talks about translating the results to human treatment. In women, the injected C. Parvum produced a great deal of inflammation, but resulted in a 30% response rate. Dr. Bast explains the next step in the research involving the monoclonal antibody OC125, resulting in an ovarian cancer screening test and an assay for CA125. Results were published in 1983 in the New England Journal of Medicine. The procedure is still used for monitoring.
Dr. Bast then talks about uses of OC125 for early detection.
Chapter 05 (The Researcher)
Developing Tools to Monitor and Screen for Ovarian Cancer (listen/read)
In this chapter, Dr. Bast notes the tools being developed for to screen for and monitor ovarian cancer.
He begins by describing a study of auto-antibodies. Next he describes the SQUID detector (superconducting quantum interference device) that his laboratory is studying to fine-tune detection of presence of ovarian cancer cells. Funding comes from a SPORE grant. The project is part of the Moon Shots program.
Chapter 06 (The Researcher)
Increasing Patients’ Sensitivity to Taxol; Understanding the Function of ARHI (DISRAS3) and Autophagy (listen/read)
In this chapter, Dr. Bast discusses two other important areas of his research.
He begins with a sketch of his work on reducing patients’ resistance to Taxol by manipulating the overproduction of certain kinases.
Next Dr. Bast talks about his work on the gene ARHI or DIRAS3. Reexpression of this gene inhibits cell proliferation and also induces autophagy of cancer cells as well as their dormancy. Dr. Bast explains autophagy, a process that provides energy for starving cells. He also explains that after surgery and chemotherapy, some ovarian cancer cells remain. His laboratory is currently looking at drugs that can promote autophagy to rid the body of these cells. Dr. Bast goes on to explain other animal studies in progress to reveal other mechanisms of DIRAS1, DIRAS2, and DIRAS3.
Chapter 07 (The Researcher)
Rapidly Changing Science and the Pressure to Publish in High-Impact Journals (listen/read)
Dr. Bast begins this chapter by observing that science is changing so rapidly that it’s “almost always continuing medical education.” He praises the wide array of specialized scientists at MD Anderson who can contribute their expertise to research.
Next he observes that it is difficult to publish translational research in high-impact studies and that the mechanistic studies that are given the most respect don’t necessarily take into account the variety of ways that studies effects can manifest in patients in the clinics. He notes that in today’s very competitive environment, graduate students and fellows need high-impact publications to compete for a limited number of jobs. Graduate and post-graduate training programs are generating more scientists than there are positions.
Chapter 08 (The Researcher)
Research to Develop a Big Picture of Ovarian Cancer; Creating a Collaborative Laboratory Environment (listen/read)
Dr. Bast describes the final area of research underway in his laboratory: collating studies of ovarian cancer to develop a big picture of the disease to identify the molecular/genetic studies required to further develop the fine details.
He sketches the themes emerging from this study and their implications for targeted therapy.
Dr. Bast talks about the strategies he has used to develop his laboratory. He also notes that it has been very collaborative, participating in many multi-author and multi-laboratory studies. He lists key people in the laboratory and notes the “stellar” students who have embarked on strong careers. Dr. Bast also describes how he tries to identify students who have a future in research and who will take the knowledge acquired by working in a translational setting to other institutions or back to their countries of origin.
Dr. Bast then talks about different activities held in the lab to build collaboration and sharing of ideas.
Chapter 09 (Joining MD Anderson/Coming to Texas)
Experience at Duke and Coming to MD Anderson to Build Research (listen/read)
Dr. Bast begins with an overview of the administrative experience he gained at Duke University, where he was hired to modernize and build rigorous science because of his focus on monoclonal antibodies.
Dr. Bast next explains that he arrived at MD Anderson to take over leadership of the Division of Cancer Medicine from Irwin Krakoff. He then describes the research scenario and explains that MD Anderson had always been “great clinically,” but was not strong in basic science and translational research, though Dr. Krakoff built a good infrastructure for the continued growth of research.
Dr. Bast talks about the opportunities he saw on arriving, noting the “anything is possible” spirit at MD Anderson, which he observes may be due to Texas culture. He notes his mission to build translational research, strengthen MD Anderson education and training.
Interview Session Two: 24 July 2014 (listen/read)
Interview Identifier (listen/read)
Chapter 10 (Building the Institution)
The Office of Translational Research: Building Collaborations (listen/read)
In this chapter, Dr. Bast talks about the roles of the Office of Translational Research: submitting applications for Core Grants that fund the shared resources critical for MD Anderson’s translational research projects. He explains how the first application for comprehensive cancer center status, a status required to receive Core Grants. He describes many of the shared resources in place then and others that have evolved in the last fourteen years.
Dr. Bast sketches the increases in grants awarded to MD Anderson. He lists the departments/divisions involved in translational research. He explains that his Office receives and integrates all information about the institution’s translational project to help foster collaboration. Dr. Bast also explains that the Office created a system for presenting faculty CVs on a single platform.
Chapter 11 (Building the Institution)
Training Physician-Scientists at MD Anderson (listen/read)
Dr. Bast explains the efforts his Office has undertaken to build training and support for physician-scientists.
He first talks about the success in bringing SPORE grants to the institution. Next he talks about MD Anderson funding for scientists who want to collaborate and start up translational projects.
He then describes career development programs that target physician-scientists (the Physician-Scientist Program and a course in development on translation approaches).
He comments on medical education and describes a plan for a patho-biology course offered at the Graduate School of Biomedical Sciences that takes a whole-body view and reverses the traditional trend.
Dr. Bast goes into more detail about the training course for Physician Scientists. He then talks about the role that pharmaceutical companies currently serve in funding and driving research. Academic medicine has a role to play, he explains, in identifying biological processes that pharmaceutical companies can target in developing new drugs.
Chapter 12 (Overview)
The Moon Shots Program and a Model of Translational Research (listen/read)
Dr. Bast begins with general observations about how translational research has evolved at MD Anderson under Dr. Ronald DePinho’s leadership as president. He notes that Dr. DePinho’s Moon Shots Program is the most direct application of the translational approach. As an example of how research can be optimally organized, Dr. Bast focuses on advances being made through the Moon Shots for treatments for breast cancer and ovarian cancer. He also explains that the patients involved in the Moon Shots trials are providing tissue for the study of nine different diseases. Dr. Bast notes that his own work on the mechanisms of autophagy in ovarian cancer (see Session One) connects to this Moon Shot.
Chapter 13 (Overview)
The Moon Shots Program; Genomic Medicine (listen/read)
Dr. Bast first responds to some of the criticisms leveled at the Moon Shots Program. He explains that some individuals were skeptical that additional investment in research could bring big rewards. He then sketches advances that have been made since the National Cancer Act was passed in the seventies. He then lists some key administrators who have been working to build greater support for the Moon Shots.
Next, Dr. Bast defines genomic medicine, summarizes the perspective of the Genomic Institute, and notes that this field is addressing the challenge of how much gene sequencing to conduct at MD Anderson. He concludes that the most important genes to sequence are those for which we have drugs.
Chapter 14 (Building the Institution)
Working with Pharma; Supporting Innovation; Attracting Philanthropic Dollars (listen/read)
Dr. Bast begins with a description of a pilot project designed to further research by establishing effective collaborations with pharmaceutical companies. He describes several points of difficulty in setting up these relationships: negotiating intellectual property agreements, aligning the workflow processes of MD Anderson with those of each individual pharmaceutical company, and dealing with differences in company cultures.
Next Dr. Bast talks about grants the Office of Translational Research provides to support development of drugs and devices. He then talks about the private philanthropy that supports MD Anderson faculty research. Dr. Bast notes that private funds are very important in the current economic climate, where government and industry funding is very risk averse and the expectations of return on investment are very high.
Chapter 15 (Building the Institution)
The Office of Translational Research: Growth Areas (listen/read)
Dr. Bast discusses projects that are expanding the impact of the Office of Translational Research. He first sketches the Clinical Investigator Program, started in 2009, that allows physicians to devote 75% of their time to research. He sketches the accomplishments of some of scholars who have completed this program. Dr. Bast then talks about how the Office develops the leadership potential of the translational researchers.
Next, Dr. Bast shares examples to demonstrate the importance of keeping pace with emerging technologies to support translational research.
Dr. Bast notes that his Office will focus on developing its educational initiatives in coming years. He mentions courses now under development now for the Graduate School of Biomedical Sciences.
Chapter 16 (A View on Career and Accomplishments)
Thoughts about Training as a Physician-Scientist; A Review of Good Colleagues (listen/read)
Dr. Bast begins with a review of his own training as a physician scientist. He notes many advantages he had, but stresses he could have had more rigorous training in how basic scientists think. He also notes that he has faced some challenges in balancing the clinical, scientific, and administrative arenas of his career.
He then mentions the people he has worked with at the Office of Translational Research.
Interview Session Three: 18 December 2014 (listen/read)
Interview Identifier (listen/read)
Chapter 17 (Building the Institution)
The Multi-disciplinary Research Program (listen/read)
In this chapter, Dr. Bast sketches the history, aims and successes of the Multi-disciplinary Research Program.
He explains the origins of the program ten years ago and its importance as funding from other sources has diminished. He explains that MD Anderson has invested $8.7 million via the Program and seen $136 million in grant money awarded. He explains how the Office of Translational Research identifies promising research and also provides coaching services and templates that investigators can use to create successful grant applications. He comments on the idea that grantors are more conservative today and explains that what is needed now are grants specifically targeted toward discovery projects. He notes that the Office of Translational Research is contributing to a strategic plan to address this issue at the institution.
Chapter 18 (Building the Institution)
As Head of the Division of Cancer Medicine: Building MD Anderson’s Academic Programs and Research Focus (listen/read)
Dr. Bast begins this chapter by reviewing his reasons for leaving his role as head of the cancer center at Duke University in 1994 to take over as Head of the Division of Cancer Medicine at MD Anderson. He sketches the restructuring of divisions at the time he arrived and explains why this helped bring good leadership to departments.
Dr. Bast then talks about his work building MD Anderson’s educational programs, focusing in particular on preparing physicians to get involved in research throughout their careers, even if they are in community practice. He talks about the types of research that can be conducted in community settings and explains why MDs may leave academic medicine and avoid conducting research. He lists specific indicators that show a stronger research focus among fellows.
Chapter 19 (MD Anderson Culture)
The Culture of Research at MD Anderson (listen/read)
Dr. Bast begins by noting that the strong department leadership created when Divisions were restructured helped bolster the institution’s research focus. He notes that at MD Anderson, Duke, and the Farber Cancer Center, patient care is the primary value and that research is emerging as a primary value. He notes Dr. John Mendelsohn’s [Oral History Interview] influence on this process. He also notes that his work as head of the Division of Cancer Medicine led naturally to his role as Head of the Office of Translational Research. Dr. Bast notes that he was unable to centralize many activities because of the very independent leadership exerted by department heads. He also observes that he might have been more effective had he spent more time building trust with department heads.
Dr. Bast observes that he was successful in raising awareness about the importance of translational research. He compares Dr. David Hone’s perspective on finances with Dr. John Mendelsohn’s.
Chapter 20 (The Administrator)
Accomplishments as Division Head and Observations about Leadership and Mentoring (listen/read)
Dr. Bast begins by noting that, as Head of the Division of Cancer Medicine, he was able to build connections between people across departmental lines. He credits Dr. Waun Ki Hong [Oral History Interview] for his leadership in building appreciation for administrative personnel and staff people. He comments on how a leader can be “feared and loved.” He notes that he has been inspired by the faculty and their contributions to patient care and research, but regrets the amount of time he had to spend on conflict resolution. He summarizes why he enjoyed his time as division head, specifically citing the opportunities he had to mentor people.
Next Dr. Bast summarizes his approach to mentoring and sets it in the context of MD Anderson culture, where relationships with other people are a form of “currency.” He also notes how inspired he has been by fellows who see patients.
Chapter 21 (Key MD Anderson Figures)
John Mendelsohn and Ronald DePinho (listen/read)
Dr. Bast first comments on Dr. John Mendelsohn and his success at expanding MD Anderson during turbulent financial times. He also notes that Dr. Mendelsohn created connections with the Houston community, expanded the role of the Board of Visitors, and created a vision for the institution. Though he brought in strong clinicians and physician scientists, Dr. Bast says, he faced challenges recruiting basic scientists.
Dr. Bast next observes that Dr. Ronald DePinho has underscored how important basic science is for a number one cancer center and he has been successful in putting together a “great team.”
Dr. Bast also notes that he is gratified to see that Dr. Mendelsohn and Dr. DePinho have both supported Dr. Elizabeth Travis and the Office of Women Faculty Programs.
Chapter 22 (Building the Institution)
The Moon Shots Program and Its Impact (listen/read)
Dr. Bast begins by commenting that Dr. DePinho’s Moon Shots Program is one of the “most important projects undertaken at MD Anderson.” He sketches why he believes this is so and notes some of the impact the Program is already having on patient care. He also explains that Dr. DePinho is using MD Anderson as a “pulpit” to effect national changes in how cancer prevention and detection is approached. He talks about how research is conducted under the Moon Shots model. He explains that it has been challenging to convince clinicians that they have as much ownership over the Moon Shots research as basic scientists. He explains resistance to the model and how to address these problems.
Chapter 23 (The Researcher)
Writing a Guidebook on Translational Research (listen/read)
In this chapter, Dr. Bast talks about a book he is writing for young researchers interested in conducting translational research. He describes the sequence of chapters. While discussing his aims for the book, Dr. Bast touches on several subjects. First he talks about MD Anderson’s Apollo Program that aids in diagnosis. He explains how important it is to bring academia and Pharma together in research project. He gives examples of chasms to overcome and explains that it’s important to bridge the gap because pharmaceutical companies fund so much research. Dr. Bast also notes that his book aims to increase the pool of physician scientists.
Chapter 24 (MD Anderson Culture)
Establishing a Habit of Translational Thinking (listen/read)
Dr. Bast explains that one aim of MD Anderson’s graduate programs is to provide an environment where young scientists will develop a translational habit of thinking. He explains the input of the faculty into this process and the variety of approaches it demands.
Chapter 25 (Personal Background)
Photography, Basketball, and An Advisor to the V Foundation for Cancer Research (listen/read)
In this chapter, Dr. Bast talks about his leisure activities. He is a photographer, is “addicted” to lectures by the Teaching Company and Duke University Basketball. He also talks about his work with the V Foundation for Cancer Research, an organization that funds young investigators. He serves on the advisory board.
This three-session interview with Robert C. Bast, MD takes place in summer and early winter of 2014. (Total duration, approximately 4 hours and 50 minutes.) Dr. Bast’s research has focused on ovarian cancer: for example, he is known for establishing that the protein CA-125 can be used to screen for the disease. Very early in his career he developed a translational approach and he has been instrumental in developing the capacity of institutions to support and promote translational research. Dr. Bast came to MD Anderson in 1994 to head the Division of Cancer Medicine, at which time he also joined the faculty as Internist and Professor of Medicine in the Department of Experimental Therapeutics. Dr. Bast was Division head until the year 2000, when he became Vice President for the Office of Translational Research, a position he occupies today. The interview sessions take place in Dr. Bast’s office in the Office of Translational Research in Pickens Academic Tower on the Main Campus of MD Anderson. Tacey A. Rosolowski, Ph.D. is the interviewer.
Dr. Bast attended Wesleyan University in Middletown, Connecticut, receiving his BA in Biology in 1965. He then went to Harvard Medical School in Boston, Massachusetts, where he received his MD in 1971. From 1971 to 1972 he was a Medical Intern at Johns Hopkins Hospital in Baltimore, Maryland. From 1972 to 1975 he held a position as a Research Associate in the Biology Branch of the National Cancer Institute in Bethesda, Maryland. From 1974 to 1975 he served as Research Scientist at this institution. From 1975 to 1976 he returned to Boston for a Clinical Fellowship in Medicine at the Harvard Medical School. During this same period he was also an Assistant Resident Physician at the Peter Bent Brigham Hospital in Boston. From 1976 to 1977 Dr. Bast held a Fellowship in Medical Oncology, Sidney Farber Cancer Institute in Boston. He joined the faculty of Harvard Medical School as an Assistant Professor in 1977, advancing to Associate Professor in 1983. In 1984 Dr. Bast was recruited to Duke University Medical Center in Durham, North Carolina, where he co-directed the Division of Hematology-Oncology. He also served as Director of Clinical Research Programs at the Duke Comprehensive Cancer Center from 1984 to 1987. In 1987 Dr. Bast became Director of the Duke Comprehensive Cancer Center. He was recruited to Head the Division of Cancer Medicine at MD Anderson in 1994.
In this interview, Dr. Bast sketches the path of his research and his impact on MD Anderson through his administrative roles. He discusses his areas of research: the early detection and prevention of ovarian cancer; studies of cell growth regulation (ovarian and breast carcinomas); research into imprinted tumor suppressor genes; the manipulation of cancer autophagy and tumor dormancy; and research into the modulation of taxane sensitivity. During these discussions, Dr. Bast provides insight into the thought processes and working strategies of translational researchers. He adds depth to this discussion when he talks about his work as Head of the Department of Internal Medicine: his main mission was to strengthen MD Anderson’s research programs and commitment to translational research. He also speaks in depth about the mission of the Office of Translational Research and its impact on the shape of science at MD Anderson. In the process he talks about Dr. Ronal DePinho’s Moon Shots Program, sketches the special training requirements for physician-scientists, and provides insight into the struggles of financing multi-disciplinary research.