Found in translation
Despite much progress in the quality of healthcare and therapeutics over the past few decades, much of the research that shows promise in the lab never makes it to patients or providers. While some of this is certainly due to challenges both in terms of efficacy and efficiency of scaling up, Gabriela Apiou, an assistant professor at Harvard Medical School, was certain there was more to it.
Apiou, also the director of the Wellman Center for Photomedicine's Translational Research Core and director of Strategic Alliances at the Mass General Research Institute, believed much of this unmet promise could be solved long before the commercialization stage through increased collaboration earlier in the research process. Working with her team in the Office of the Scientific Director at Mass General, she is guiding multi-disciplinary research groups in the healthcare development field, developing innovative and long-term collaborations between academic researchers, clinicians, and industry.
She initiated that role in an earlier iteration at Mass General ten years ago, determined to bring about a cultural change and, today, retains that determination. "We are very focused on the model of innovation through collaboration," says Apiou. "In order to solve today's healthcare challenges more effectively, we need to find a better way for academia and industry to work together." To that end, Apiou and her colleagues work to build new initiatives and facilitate collaboration between scientists and industry at every step of the research process.
After 15 years of experience in biomedical engineering and the pharmaceutical industry, where she performed and directed research on inhaled therapeutics and delivery devices, Apiou was convinced that the dearth of partnerships between academia and industry was due for a much-needed paradigm shift.
"This was something I'd been discussing with colleagues for quite some time," she says. "The idea of bridging academia with industry came about because we believed that in order to get our discoveries to clinical practice, to patients in need, we needed to collaborate with industry. As scientists, we need partners to develop our technologies, to bring them to the market."
As one example, Apiou cites her colleague Clemens Alt, an instructor at Harvard Medical School and investigator at the Wellman Center for Photomedicine who worked on developing a detecting technology for traumatic brain injury (TBI) but could not find partners for his project. Apiou's translational team said, "Okay, what about bringing the clinicians on board?" and set up a discussion session with several neurologists. The result was eye-opening: "Why TBI?" asked the neurologists. "We would love to have something like this for our multiple sclerosis (MS) patients because we think it's an inflammatory process. Right now we have nothing that works to detect it." And, as Apiou notes, with TBI, there are already several technologies trying to address it. "So we totally changed the orientation of Alt's program, and, since then, he has been extremely successful, writing grants and collaborating with the clinicians to develop and test relevant technology to diagnose and monitor MS patients. It was an important shift, and it changed a career."
In making that shift, Alt joined one of the problem-driven, thematic programs leveraging the biology, technology, and clinical expertise across multiple labs at Mass General, focusing on better understanding how neuroinflammation may drive neurodegeneration and exploring a possible a cure for diseases such as Alzheimer's. "Alzheimer's is a huge problem," says Apiou. "There is no treatment, and many of my colleagues say this is a tsunami coming for our healthcare system. If neuroinflammation is a driving mechanism of this disease, we need to detect this inflammation in the brain early. To do so, technologies embedded in photomedicine, optics and photonics — such as Alt's — have great potential."
That willingness to listen and switch gears drives Apiou's collaborative work, a necessity in today's healthcare environment. The challenges that people are facing in healthcare today are complex: they require something bigger than the one-lab, one-company model that's been traditionally relied on, or one researcher, toiling in a lab to create an innovative solution that may not address a clinical need or have a market. The idea, says Apiou, is to structure a collaboration around a healthcare problem from its earliest stages. First you dentify the problem, and then build the collaboration between academia and industry by bringing scientists and business specialists together in order to develop medical solutions that are relevant, affordable, and reach patients more efficiently and quickly.
With a cohesive team in place, comprehensive teamwork can be implemented after early discussions around questions such as "What is the problem we are trying to solve?" "What is the knowledge gap?" "What would be the product?" "What about the market?" "Who would pay for this?" "What about the regulatory strategy?" "We start to think about these elements at an early stage, together," says Apiou. "That way, we can also orient the research team in terms of the experiments that they perform."
Ultimately, she says, the goal is to engage in long-term collaborations; that shared level of investment invariably leads to deeper and more impactful partnerships. "So we have a translation piece, academically speaking, between different disciplines, such as engineering and physics, but we also bring the clinicians on board early in the process. We bring industry in very early on as well so that they can inform the research we are doing and build a relationship with us. They can guide the scientists in how to work toward a viable commercial product."
As part of her role, Apiou has also led two successful pilot programs with a particular focus on training and education, one for fellows and one for faculty. "This was a broad mission," she says. "How could we roll out a new model of innovation through collaboration and convince our scientists to engage in long-term, more productive collaborations with each other and with industry?"
One outcome of that inquiry was the SPIE-Franz Hillenkamp Postdoctoral Fellowship which has been running since 2018. The Fellowship, which supports post-graduate positions that are 80 percent research and 20 percent focused on learning how to bring research outcomes to patients, is not just about translating research into medical application and industry. It's also, notes Apiou, about training young scientists to approach their work a certain way: ideally, a new generation of faculty will buy in to this translational, collaborative approach as a viable and necessary way forward. "Hillenkamp Fellows are potential future faculty. At this early stage they are in academia, but they also learn how to reach out to their industry peers so that they can solve problems together."
The Bridging Academia with Industry Educational Program for Faculty, a program that Apiou directs with Robert Tepper, founder and partner at Third Rock Ventures, provides a systematic way of training junior faculty. "We bring in leaders from academia and industry to teach why it is important for academia and industry to work together, as well as to teach the language that is needed to engage in relevant dialogue," Apiou explains. As part of the program, speakers who have had the experience of bringing new diagnostic or therapeutic technologies and products to patients are invited to share their experiential stories. "Our faculty trainees learn through these stories. It's not just about how to do translational research — we are very focused on the model of collaboration, of building a robust, usable model that will offer new opportunities for academia and industry to work together."
Pursuing this kind of collaborative work is now key for current and future healthcare solutions. "We need to move beyond our silos," says Apiou. "There's a real disconnect in the academic environment where clinicians and basic scientists — physicists, biologists, etc. — don't talk enough to each other, or they talk at a very late stage and lose the opportunity to inform each other's work. That's what we're trying to change. When you have a compelling case and you have the biomedical optics faculty and the clinical faculty together, talking as partners, saying, ‘We need this because our patients need this,' the impact of that discussion and work is so much more powerful. Because they all have the patient's well-being in mind — and because they are looking at it together."
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