St. Jude’s $11.5B, six-year plan aims to improve global outcomes for children with cancer and catastrophic diseases

Small dreams have no power to move hearts, and in a new six-year strategic plan, St. Jude Children’s Research Hospital is thinking very big.

What would it take to drastically increase cure rates for childhood cancer worldwide?

St. Jude’s answer: $11.5 billion and an additional 1,400 jobs.

To get a rough sense of scale, work it out with a pencil:

Spread over six years—at $1.916 billion each year—it’s just under a third of the NCI’s annual spend, fourfold this year’s projected revenues of the American Cancer Society, and more than seventyfold the budget of the World Health Organization’s International Agency for Research on Cancer.

“It’s a broad and ambitious plan that will allow the institution to grow at an almost 8% compound annual growth rate,” James Downing, president and CEO of St. Jude, said to The Cancer Letter. 

“At a global level, we also want to see identifiable increases in cure rates. We are watching those very carefully. Our goal is to move toward cure rates of 60% for diseases like acute lymphoblastic leukemia, Hodgkin’s lymphoma and Wilms tumor,” Downing said. “As we look at a global population, survival rates hover around 20%, and we’d like to see those go up year by year. 

“A lot of our efforts are based on implementation science, looking at what works and what doesn’t work. Workforce, drug distribution and true advancements in cure rates are what we’re seeking over the next six years.”

The plan, rolled out on April 27, calls for an acceleration of research and treatment globally—not just for pediatric cancer, but also other illnesses, including blood disorders, neurological diseases, and infectious diseases.

Not surprisingly, this amount represents the largest investment the Memphis, Tenn. hospital has made in its nearly 60-year history. The previous strategic plan, the largest expansion in the institution’s history, resulted in $7 billion in investments (The Cancer Letter, May 19, 2017).

The multi-phase expansion plan is funded almost entirely by steadily increasing donor contributions generated by ALSAC, the fundraising and awareness organization for St. Jude.

” It is an ambitious plan. But we’re going to have lots of new personnel, new investments, new technology and new partnerships. We have formal partnerships with many U.N. associate agencies and organizations around the world.”

James Downing

Within the past six years, St. Jude has advanced fundamental, clinical, and translational research, Downing said.

“Two years ago, we began strategically looking at the most pressing issues in the field of pediatric cancer,” Downing said. “As we developed the strategic plan over those two years, there were many ideas we critically assessed, and we often said, ‘It’s not really best for St. Jude to pursue that.’ 

“In the end, we aligned on goals that collectively bring the prospect of remarkable benefits to the field of childhood cancer, and to children with cancer everywhere.”

On campus, St. Jude accepted nearly 20% more new cancer patients; increased faculty by 30% and staff by 23%; and embarked on several large-scale construction projects.

The new strategic plan focuses on five areas: fundamental science, childhood cancer, pediatric catastrophic diseases, global impact, and workforce and workplace culture.

“We’re coming out of a six-year strategic plan in which we increased our number of cancer patients by 20%, with 30% new faculty, 23% more staff, many large-scale construction projects,” said Charles Roberts, executive vice president of St. Jude and director of the hospital’s Comprehensive Cancer Center. “And we’re now going into a new strategic plan that is 60% larger than our prior plan.”

Under the plan, St. Jude will hire nearly 70 new faculty members, plus supporting laboratory staff, to work in basic, translational, and clinical research across 22 departments. 

These investigators will have the freedom to pursue the type of conceptually driven research that leads to tomorrow’s clinical advances.

“As we launch a strategic plan, we’ve identified the most exciting opportunities and challenges at that point in time,” Roberts said to The Cancer Letter. “However, we fully realize that we don’t know what’s coming next. New discoveries will be made, and new opportunities will emerge. Via the blue-sky process, we’ve set aside substantial funds every year to invest in the pursuit of emerging opportunities suggested by faculty and staff.  

“Part of what brought me here from Boston was the last strategic plan, and it’s so exciting to be a part of this. But just looking at the numbers, 1,400 new positions, average salary of $90,000. Six hundred and forty of those positions are in research, 266 are in clinical, 100 are in global pediatric medicine, and 394 in support. 

“Those are the kinds of numbers that you need to make these things real, and I think it’s exciting for St. Jude and for the field of cancer research, as we bring in all of these new folks.”

During the next six years, St. Jude will invest more than $250 million to expand technology and resources available to scientists and clinicians in their search to understand why pediatric catastrophic diseases arise, spread and resist treatments. These investments will include:

• Creating a Cryo-Electron Tomography Center to determine the atomic structure of molecules in their native states within human cells,
• Establishing a Center of Excellence in Advanced Microscopy to build the next generation of microscopes that explore cells in ways previously unimaginable,
• Expanding data science staff and the digital infrastructure necessary to become a world leader in the application of data science to biological discovery in normal and disease states; and 
• Creating a brighter future for children with cancer.

St. Jude will invest $3.7 billion during the next six years to expand cancer-focused research and related clinical care. These efforts will center on raising survival rates for the highest-risk cancers and for children with relapsed diseases, while simultaneously improving quality of life for pediatric cancer survivors. The investments will include:

• Accelerating preclinical and clinical testing of new therapeutic agents so the most promising agents can rapidly move from clinical investigation to standard of care
• Expanding large-scale, collaborative trials to reach more childhood cancer patients across the U.S. and around the world
• Creating a new Translational Immunology and Immunotherapy Initiative (TI3)—an inter-departmental collaboration focused on expanding the use of cellular-based cancer immunotherapy as curative treatments for pediatric solid tumors and brain tumors
• Finding cures and saving children everywhere

In the U.S., more than 80% of children diagnosed with cancer will be cured. In contrast, 80% of children with cancer live in limited-resource countries, where a mere 20% survive their disease. To address this, St. Jude will more than triple its investment in its international efforts coordinated through St. Jude Global and the St. Jude Global Alliance during the next six years. 

This represents an investment of more than $470 million. Global initiatives include:

• Expanding educational programs to train the workforce needed to treat childhood cancer worldwide; strengthening the health care systems required to deliver that care; and bolstering regional and global programs to create the research infrastructure necessary to continually improve the quality of care in resource-limited settings,
• Creating seven international operational hubs staffed by St. Jude workers to effectively manage the St. Jude Global Alliance, a network of more than 140 institutions across 50-plus countries; and
• Developing a multimillion-dollar Pediatric Cancer Global Drug Access Program—in collaboration with WHO, other U.N. agencies and international organizations—to distribute an uninterrupted supply of anti-cancer drugs for childhood cancer treatment in low- and middle-income countries.

Under the plan, St. Jude will expand research and treatment programs to advance cures for childhood catastrophic diseases. The $1.1 billion, six-year investment includes work in nonmalignant hematological diseases, such as sickle cell disease; a new laboratory-based research program in infectious diseases that affect children worldwide; and a new research and clinical program to better understand and treat pediatric neurological diseases.

The plan outlines several strategies to encourage teamwork, and internal and external collaboration. These will include:

• Expanding the St. Jude Research Collaboratives program from funding five to 11 teams of scientists worldwide through a more than $100 million investment,
• Enriching future biomedical research pipelines for potential employees by creating experiences for high school and college students in science,
• Expanding the established St. Jude blue-sky process, which solicits mission-related, game-changing ideas outside of the strategic plan, by $180 million,
• Building and supporting best-in-class environments that help employees advance the institution’s life-saving work and offer patients and their families a home away from home; and
• The $1.3 billion in new construction and renovations will include completion of The Domino’s Village, a family housing facility with one-, two- and three-bedroom units; Family Commons, a quality-of-life space with patient family services from school to tech support; and the Advanced Research Center—and construction of outpatient, clinical office and administrative buildings and parking garages.

It is estimated that 87% of funds to sustain and grow St. Jude over the next six years will come from public donations. 

Patients at St. Jude do not receive a bill for treatment, travel, housing or food—a model established by ALSAC and St. Jude founder Danny Thomas, who believed in equal access to medical care and driving research advances.

“There are an incredible number of donors across the United States who support St. Jude,” Downing said. “This carries a great responsibility for us to seek the maximum possible impact to improve outcomes for childhood cancer.”

Downing and Roberts spoke with Matthew Ong, associate editor of The Cancer Letter.

Matthew Ong: Congratulations on the official launch of St. Jude’s second six-year strategic plan. Could you briefly walk us through what’s in it?

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Source: The Cancer Letter