MD Anderson Cancer Center

MD Anderson Cancer Center A Global Perspective to Eliminate Cancer Hilario E. Mata, PhD, MBA Director, Global Academic Programs

The mission of The University of Texas M. D. Anderson Cancer Center is to eliminate cancer in Texas, the nation, and the world through outstanding programs that integrate patient care, research and prevention and through education for undergraduate and graduate students, trainees, professionals, employees and the public.

We shall be the premier cancer center in the world, based on the excellence of our people, our researchdriven patient care and our science. We are Making Cancer History #1 Cancer Center in the U.S.A. Ranked No. 1 U.S. cancer hospital for 10 out of 12 years

The Texas Medical Center

MD Anderson Campuses at the Texas Medical Center North Campus Cores Sequencing and Microarray Research Animal Support* Genetically Engineered Mouse Facility* Small Animal Imaging* Tissue Biospecimen and Pathology Resource* Flow Cytometry* Patient-Reported Outcomes Biostatistics Bioinformatics Clinical Trials Support Clinical and Translational Research Center shrna and ORFeome ehealth 15.3 millions gross square feet in operation South Campus Cores Chemistry Research Animal Support* Genetically Engineered Mouse Facility* Small Animal Imaging* Tissue Biospecimen and Pathology Resource* Characterized Cell Line Core Electron Microscopy Flow Cytometry* Monoclonal Antibody Reverse Phase Protein Array TALENs

North Campus Facilities Mitchell Basic Science Research Building Clark Clinic Cancer Prevention Building Alkek Hospital & Lutheran Pavilion Mays Clinic LeMaistre Clinic Pickens Academic Tower

North Campus Aerial View

South Campus Facilities Research Building 3 Research Building 1 Research Building 2 Research Building 3 Smith Research Building

MD Anderson Strengths Largest freestanding cancer center in the world - nearly 30,000 employees, faculty, trainees, & volunteers Delivers the highest standard of cancer treatment and care - unprecedented breadth and depth of clinical oncology data and knowledge Tremendous expertise due to the large numbers of cancer patients treated in care centers - 120,000 a year, 1/3 rd new patients Performs the greatest number of cancer clinical trials in the world each investigating new therapies >1,000 trials Receives the highest level of peer-reviewed National Cancer Institute funding among all US universities - $182M in federal grants/year An extensive track record of research milestones and setting standards of care for cancer

Resources TOTAL OPERATING REVENUE FY2013 = $4,135,238,891 $3,178.9 Net patient revenue 76.9% $505.1 Restricted grants/contracts, philanthropy 12.2% $154.6 State-appropriated general revenue 3.7% $40.7 Auxiliary income 1.0% $75.6 Other income 1.8% $180.4 Investment and other non-operating income 4.4%

Research Expenditures FY2013 External Funding Federal Grants & Contracts $182,970,502 Private Industry Grants & Contracts $65,579,036 Philanthropy & Foundation $101,642,898 Total $350,192,436 State & Internal Funding State-Appropriated General Revenue $11,776,785 Tobacco Settlement Receipts/LEER Funds $5,837,249 CPRIT $24,262,525 Hospital Operating Margins $182,770,342 Institutional Grants $95,730,271 Total $320,377,172 Total Research Expenditures $670,569,608

Clinical Divisions Radiation Oncology Pathology and Laboratory Medicine Cancer Medicine Pediatrics Cancer Prevention and Population Sciences Quantitative Sciences Internal Medicine Surgery Anesthesiology and Critical Care Diagnostic Imaging Pharmacy Nursing

Multidisciplinary Care Centers Designed to treat specific types of cancer by disease-site that has become MD Anderson s trademark Built on team approach that bring together surgeons, medical oncologists and radiation oncologists The Method: Research driven patient care, evidence based, performed in a multi-disciplinary setting

Multidisciplinary Care Centers Brain and Spine Breast Cancer Prevention Endocrine Gastrointestinal Genitourinary Head and Neck Gynecologic Leukemia Lymphoma and Myeloma Melanoma and Skin Pediatrics Sarcoma Stem Cell Transplant Thoracic

Ambulatory Care Building

Specialty and Treatment Centers Cancer Prevention Cardiopulmonary Integrative Medicine Internal Medicine Dermatology Orthopedic Pain Management Proton Treatment Radiation Treatment Reconstructive Surgery Supportive Care Stem Cell Transplant and Cellular Therapy

Proton Therapy Center

Survivorship Clinics Breast Childhood Cancers Colorectal Genitourinary Gynecologic Head and Neck Lymphomas Melanomas Stem Cell Transplants Thyroid Nutrition, psychosocial, energy balance, side effects, follow-up medical care, networking with other survivors

Cancer Prevention Building

Basic Science Departments Biochemistry and Molecular Biology Cancer Biology Genetics Molecular Carcinogenesis Immunology Molecular and Cellular Oncology Veterinary Medicine and Surgery Veterinary Sciences

Basic Science Research Building

Institutes Institute for Applied Cancer Science Institute for Personalized Cancer Therapy Institute for Basic Sciences Centers: Biological Pathways, Bio-molecular Structure and Function, Cancer Epigenetics, Environmental and Molecular Carcinogenesis, Genetics and Genomics, Inflammation and Cancer, Stem Cell and Developmental Biology Duncan Family Institute for Cancer Prevention and Risk Assessment Center for Translational and Public Health Genomics Institute for Cancer Care Excellence McCombs Institute for Early Detection and Treatment Centers: Advanced Biomedical Imaging Research, Cancer Immunology, Molecular Markers, Metastasis, Proton Therapy, RNA Interference and Non-Coding RNA, Targeted Therapy

Institute for Personalized Cancer Therapy (IPCT) MD Anderson will be the leader in implementing Personalized Cancer Therapy, based on an analysis of each patient s cancer that will integrate information across DNA, RNA, proteins and metabolomics in the context of the tumor in its microenvironment, the patient s immune system and the patient s own genotype.

Patients Accrued (1000 s) Patients Accrued (1000 s) Clinical Research Activity 2008-2012 Interventional Protocols Non-interventional Protocols 14 12 10 8 6 4 2 Industry Institutional Ext Peer National 35 30 25 20 15 10 5 27,305 27,422 29,351 26,348 0 2008 2009 2010 2011 2012 Fiscal Year 0 2008 2009 2010 2011 2012 Fiscal Year o Institutional protocols accounted for >50% of interventional enrollment o Of 399 industry-sponsored interventional protocols in FY2012, 130 (33%) were authored by or significantly influenced by MD Anderson investigators o Non-interventional protocol accruals include bio-specimen collection, ancillary and correlative studies and observational cohorts

Specialized Programs of Research Excellence (SPORE) Robert Bast P50 CA083639 Ovarian Cancer Colin Dinney P50 CA091846 Genitourinary Bladder Cancer Elizabeth Grimm P50 CA093459 Melanoma Gabriel Hortobagyi P50 CA116199 Breast Cancer Jean-Pierre Issa P50 CA100632 Leukemia Scott Lippman P50 CA097007 Head and Neck Cancer Chris Logothetis P50 CA140388 Prostate Cancer Karen Lu P50 CA098258 Uterine/Endometrial Cancers Robert Otlowski P50 CA Myeloma Jack Roth P50 CA070907 Lung Cancer Anas Younes P50 CA136411 Lymphoma Alfred Yung P50 CA127001 rain Cancer

Recent Notable Publications RISK Hepatocellular Carcinoma Risk Prediction Model for the General Population: The Predictive Power of Transaminases Chi-pang Wen Xifeng Wu, J Natl Cancer Inst 104:1599-1611, 2012 BASIC SCIENCE ERK1/2-dependent phosphorylation and nuclear translocation of PKM2 promotes the Warburg effect Weiwei Yang Zhimin Lu, Nat Cell Biol 14:1295-1304, 2012 TRANSLATIONAL Oncogenic NRAS signaling differentially regulates survival and proliferation in melanoma Lawrence N Kwong Lynda Chin, Nat Med 18:1503-10, 2012 CLINICAL Ponatinib in Refractory Philadelphia Chromosome Positive Leukemias Jorge E. Cortes et al, N Engl J Med 367:2075-88, 2012 SURVIVORSHIP Identification of the molecular basis of doxorubicin-induced cardiotoxicity Sui Zhang Edward T H Yeh, Nat Med 18:1639-42, 2012

Moonshot Program An strategic initiative to apply current knowledge & technology in order to accelerate declines in mortality for several major cancer types within the next 5-10 years. The selected inaugural programs were: Acute myeloid leukemia / Myelodysplastic syndrome Chronic lymphocytic leukemia Melanoma Lung cancer Prostate cancer Triple-negative breast cancer

MD Anderson Global MDACC Sister Institutions Co-Branded Institutions

MD Anderson Madrid - Spain Opened October 15, 2000

Banner MD Anderson Cancer Center Phoenix Opened September 26, 2011 6692 appointments Scheduled through 1/31/12 688 Initial Consults 684 Infusions 997 Follow-up appointments 916 Radiation treatments

GAP Rationale 1. MD Anderson has the determination, values and tools to play a leading role in eliminating cancer on a global scale 2. We are expanding the reach of our mission by building relationships with premier academic, health care and government that share our vision and can help enhance the international dimension to our academic programs 3. As a leading academic cancer center, it is our obligation to share our best practices and exchange research and training with premier cancer programs throughout the world 4. Many key research and epidemiologic questions in cancer can only be answered with international collaborations

GAP Objectives 1. Expand the availability and improve the quality of cancer care worldwide by sharing guidelines and pathways while also providing advice on case management. 2. Broaden the portfolio of basic, clinical and translational research, which has the potential for advancing diagnostic and therapeutic services that can provide worldwide benefits. 3. Build significantly on the global talent base of clinicians and researchers in the field of oncology.

The Sister Institution Network The GAP team oversees MD Anderson's Sister Institution relationships and the broader GAP network including institutions linked to us via memoranda of understanding. It is the largest such network dedicated to the fight against cancer in the world, including relationships with over 30 leading regional cancer fighting institutions in 21 countries throughout North and South America, Asia, Europe, Australia and Africa.

Sister Institution Network Worldwide

Sister Institutions Affiliations Australia 1. Peter MacCallum Cancer Centre, Melbourne Brazil 2. Hospital Israelita Albert Einstein, Sao Paulo 3. Hospital Do Cancer, A. C. Camargo, Sao Paulo 4. Hospital Do Cancer de Barretos Chile 5. Clinica Alemana, Santiago Colombia 6. Instituto de Cancerología Las Américas, Medellín

Sister Institutions Affiliations (cont.) China 7. Fudan University Cancer Hospital, Shanghai 8. Peking Union Medical College Cancer Institute, Beijing 9. Sun Yat-Sen University Cancer Center, Guangzhou 10. Tianjin Medical University Cancer Institute, Tianjin 11. Chinese University of Hong Kong, Hong Kong France 12. Institut Gustave Roussy, Villejuif Germany 13. German Cancer Research Center, Heidelberg

Sister Institutions Affiliations (cont.) India 14. All India Institute of Medical Science, Delhi 15. Tata Memorial Center, Mumbai Israel 16. Sheba Medical Center, Tel Aviv Japan 17. Kyoto University Graduate School of Med., Kyoto 18. Tokyo Oncology Consortium, Tokyo Jordan 19. King Hussein Cancer Center, Amman

Sister Institutions Affiliations (cont.) Korea 20. Yonsei University Medical Center, Seoul Lebanon 21. The American University of Beirut, Beirut Mexico 22. National Cancer Institute, Mexico City Norway 23. Norwegian Cancer Consortium Stavanger University Hospital, Stavanger Norwegian Radium Hospital, Oslo Cancer Registry of Norway, Oslo

Sister Institutions Affiliations (cont.) Poland Polish Cancer Consortium Sweden Karolinska Institute, Stockholm Turkey Hacettepe University Institute of Oncology, Ankara Taiwan China Medical University Hospital, Taichung United Kingdom Imperial College of London, London

Signing Ceremony

Academic Activities Basic, translational and clinical research collaborations Education exchanges: fellowships, training, observerships, MD/PhD programs, etc. Scientific symposia Medical education by Internet, videoconferencing or satellite broadcasting

Symposia

Videoconferences

Research Collaborations Tissue and tumor banking Immunology Gene therapy Bronchial airway research Microarray research and technology Traditional Chinese medicine Endocrinology Radiation and surgical oncology Leukemia, breast, thoracic, genitourinary, hepatobiliary colorectal, gastric and head & neck cancers

Sister Institution Network Fund (SINF) Funding mechanism to continue enhancing collaborations in research and education within the Sister Institution Network Eligibility: only projects developed in collaboration between faculty/staff at MD Anderson and one or more collaborating institutions are considered for funding Funding: up to $100,000 over one or two years for MD Anderson investigators. Funding levels and mechanisms for investigators at collaborating institutions to be determined by their home institution.

SINF - up to date 61 projects 3 RFAs (FY11/12/13) 36 collaborating institutions 23 countries MD Anderson: $6.1M Network: $6.4M Total: $12.5M Collaborate Globally & Fund locally Clinical Basic 10+ cancer types broad range of research http://bit.ly/sinf_vis_ipad First Papers Coming Out Nature (2); NEJM; Cell; Mol Cell; Nat Cell Biol; JBC (2) First Grants NCI (4); CPRIT (2); foundation

GAP Activities Research (publications) Collaborative publications co-authored with Sister Institution Faculty SINF started Many of the top institutions we co-author with are part of the Sister Institution Network DKFZ (German Cancer Research Center) is affiliated with University of Heidelberg GAP started Data obtained from SciVal Experts - www.mdanderson.org/scival

GAP Activities: Research (clinical trials) In 2011 gathered an inventory of the capabilities of 17 of our Sister Institutions regarding clinical trials shared this internally with clinical investigators Instituto De Cancerologia, Clinica Las Americas, Medellin, Colombia: *Conservative surgery for women with low-risk, early cervical cancer *Laparoscopic approach to cervical carcinoma: a phase III randomized clinical trial of laparoscopic or robotic radical hysterectomy versus abdominal radical hysterectomy in patients with early stage cervical cancer Fudan University Cancer Center, Shanghai, China: External qigong therapy for women with breast cancer prior to surgery Pilot study of Huachansu in patients with hepatocellular carcinoma, small cell lung cancer or pancreatic cancer (Phase I) *Huachansu and gemcitabine in pancreatic cancer (Phase II) Sheba Medical Center, Tel Hashomer, Israel & University of Heidelberg, Germany: A phase I, open-label, dose escalation study to evaluate the safety, tolerability and pharmacokinetics of INNO-406 in adult patients with Imatinib-resistant or intolerant Ph+ leukemias Institute Gustave Roussy, Paris, France: A phase II trial of the multitargeted kinase inhibitor E7080 in advanced radioiodine (RAI) refractory differentiated thyroid cancer (DTC)

SciVal Experts Track your own pu A directory of research expertise to find collaboration within your institution and the Sister Institution network Track publications and identify experts and publications Increasing visibility across the research community Identify potential collaborators and discover new relationships Find funding opportunities and connect authors to sponsors

Annual GAP Conference Provides a forum for faculty from MD Anderson and our Sister Institutions to develop collaborations and exchange research results and ideas Sessions are formed around topics of interest to the members of the SI Network The event is held at MD Anderson in odd years and is hosted by a Sister Institution in even years GAP 2014 Conference, Seoul, Korea May 1 3, 2014

Annual GAP Conference

GAP Strategy Expand the Sister Institution network by creating regional clusters with similar missions, economic, social and cultural backgrounds. Develop programs in line with MD Anderson s vision, driven by faculty interest and commitment that benefit all participants Encourage and support multi-institutional collaborations, primarily in clinical research to generate high-impact breakthroughs which impact cancer care worldwide

The Worldwide Innovative Networking (WIN) Consortium WIN Consortium in personalized cancer medicine was created in 2010 by MD Anderson and IGR to accelerate pace and reduce costs of translating novel cancer treatments through worldwide clinical trials and research projects Goal: to make an impact on personalized cancer therapy by increasing the number of patients having access to innovative, global clinical trials in the area of genomic-based cancer therapeutics Aims: to initiate research projects each year in a global consortium guided by an independent scientific advisory board

SI Iberoamerican Summit Nov. 2012 Galvanize on the potential of the SI Network by recognizing commonalities and identifying opportunities: Clinical and translational research 1. Conservative Surgery for Women with Low-Risk, Early Stage, Cervical Cancer 2. A Phase III Randomized Trial of Laparoscopic or Robotic Radical Hysterectomy vs. Abdominal Radical Hysterectomy in Patients with Early Stage Cervical Cancer Cervical cancer is much prevalent in Colombia Outstanding contribution by IDC - to date, they remain the center with the highest and fastest accrual in both studies Prevention / Training & education 3. Integrative Epidemiology Global Training Program

Integrative Epidemiology Global Training Program Preeminent, and sustained training in contemporary & translational epidemiologic approaches across the lifespan of cancer care continuum, including: Integrative Epidemiology Integrative Prediction Model Cancer Registry & Population Sciences Biomarker Discovery Computational Epidemiology & omics Integrative Risk Models

Global Prevention Initiatives Nov. 27, 2012 LOI signed by the Commission of National Institutes and High Specialty Hospitals of Mexico, the National Cancer Institute of Mexico and MD Anderson Cancer Center Oct. 15, 2013 LOI signed by the Government of the City of Medellin, the Instituto de Cancerologia Clinica las Americas and MD Anderson Cancer Center, for: The development of community-based tobacco use prevention and control pilot programs for children and adolescents The development of formalized prevention and control programs, including programs related to public health policy, education for the public and professionals, clinical and community services, comprehensive initiatives, research endeavors; and other public health and academic programs The implementation, evaluation, refinement and dissemination of prevention and control programs.

Mexico Texas Tobacco Control Initiative

Thank You