Taking Science from Bench to Bedside
Bench science – new biomedical knowledge extracted and verified in exacting and disciplined laboratory experiments – is vital to advancing clinical care. This scientific march from laboratory bench to patient bedside and back is the first step for virtually all treatment, prevention and understanding of disease, the genesis of nearly all cutting–edge medical breakthroughs.
Translation of the findings of promising laboratory discoveries into therapies, drugs and devices to treat or cure sick people is the desired outcome that motivates researchers at Georgetown University Medical Center (GUMC).
Situated in Washington, D.C., GUMC is at the crossroads of government, policy making, and scientific discovery. Proximity to key federal agencies such as the National Institutes of Health, the Food and Drug Administration, and the National Science Foundation provides significant advantages for scientific collaboration.
The three missions of research, education and clinical care that propel work at GUMC further are edified by the guiding Jesuit principals of service to others and cura personalis, or care of the whole person.
“We have an imperative because of who we are and where we are located. At the end of the day, we want Georgetown research to lead to improvements in human health,” says Robert Clarke, PhD, DSc, GUMC’s dean for research and professor of oncology, “We want our work to impact individual human lives for the better.”
At the core of GUMC’s academic research is what Clarke wryly refers to as “the 800 pound gorilla of the medical center.” Georgetown’s biomedical graduate research organization is sometimes casually referred to as the research enterprise.
No matter the moniker, GUMC accounts for nearly 80 percent of Georgetown University's extramural research funding. More than $141 million in peer-reviewed federal grants, distributed over five years and ranging from a low of $6.4 million to a high of $38 million, measure the scope of current, active awards to GUMC researchers from the National Institutes of Health, United States Agency for International Development (USAID), and the Substance Abuse and Mental Health Services Administration (SAMHSA).
Among these grants is the Georgetown-Howard Universities Center for Clinical and Translational Science (GHUCCTS), established with a $38.2 million Clinical and Translational Science Award (CTSA). Funded by the National Institutes of Health, this CTSA will transform laboratory and clinical research into a more dynamic process that translates biomedical advances into new, results-oriented medical treatments for patients.
“More than 9 out of 10 grant [applications] are turned down, so we have done very well compared with many of our competitors,” says Clarke, who recently was awarded a five-year, $7.7 million from the National Cancer Institute to apply a systems biology approach to study endocrine resistance in breast cancer. Clarke studies how hormones, growth factors and drugs affect breast cancer cells, and how breast cancers become resistant to treatments.
In 270,000 square feet, including five research buildings and a number of off-campus scientific facilities, the GUMC research enterprise houses four non-cancer, basic science departments, and 17 clinical departments.
The biomedical graduate research also directs the medical center’s 16 masters’ and doctoral programs, educating the next generation of scientific investigators as well as government and industry leaders. These terminal degree programs keep pace with changing needs and technologies, including:
• Biohazardous Threat Agents & Emerging Infectious Diseases;
• Complementary and Alternative Medicine; and,
• the Special Master’s Program in Physiology. Since 1975, this program has been available to college graduates to strengthen their credentials before applying to medical school.
The research enterprise has 410 faculty, 202 of whom are on the clinical track, and 650 graduate students. There are nearly 10,000 graduate alumni, including residents and fellows.
The basic science faculty teaches first and second year students at Georgetown School of Medicine while clinical faculty from the research enterprise and from Georgetown University Hospital (GUH) teaches third and fourth year medical students.
GUMC research scientists push the most promising basic science forward to tackle diseases. They work aggressively and strategically to expand knowledge of fundamental biological, chemical and physical processes and principles. Strategic priorities include reducing health disparities, global health, neuroscience and cancer research, a series of significant health areas that continue to challenge the scientific and medical communities.
Now, more than ever, scientists and physicians are able to anticipate and define the future of medicine and health care amid new approaches to the thorniest of medical mysteries
They are unlocking how the basic processes of life, death, wellness and disease work, what factors are involved and how they interrelate. Understanding these fundamentals from the molecular level up yields insight to what “healthy” looks like and how disease destroys the “norm.”
To ensure that scientific discoveries do not languish in the lab, Georgetown fosters innovation and nurtures the entrepreneurial approach to research:
• The Office of Planning and Enterprise Development seeks out new partnerships and funding opportunities with industry, government agencies and the larger scientific community.
• The Office of Technology Commercialization (OTC) manages invention disclosures, patenting and licensing activities and material transfer agreements. Since creation of the OTC in 2002, GUMC has received 55 U.S. patents.
Georgetown investigators have made outstanding contributions to biomedical research, helping to shape both medical education and health care delivery. Clarke, for example, is an internationally renowned breast cancer researcher who developed a series of hormone-resistant breast cancer models used world-wide in breast cancer research.
Widely-used GUMC laboratory bench discoveries that were translated into patient therapies or disease prevention include research by Raymond L. Woosley, MD, PhD, former chairman of Georgetown’s Department of Pharmacology, that lead to the discovery of fexofenadine, now marketed under the brand name Allegra®. Allegra® was approved by the Food and Drug Administration (FDA) in 1996.
Ten years later, the Food and Drug Administration approved Gardasil®, the world’s first cancer vaccine. The vaccine's technology was generated by a team of Georgetown University researchers led by Richard Schlegel, MD, PhD, professor and chair of pathology, in the early 1990s and licensed for commercial development. Scientists believe the vaccine could eliminate most new cases of cervical cancer worldwide and, potentially, anal and head and neck cancers.
And there is more to come from Georgetown and other research-driven academic medical centers, where scientists work hand in glove with physicians who partner with patients in clinical trials.
“When dealing with the toughest diseases, when there’s no where else to go, hope resides here for cutting-edge, life-saving medicine,” Clarke says. “We make long and deep strides because we aren’t here just to run the race; we’re here to win it.”
By Victoria Churchville, GUMC Communications