Sanford Lorraine Cross 2018 goes to blindness researchers
SIOUX FALLS, S.D., Dec. 4, 2018 — For their work in creating a path for genetic treatments for blindness and other devastating diseases, Drs. Katherine High and Jean Bennett won the inaugural $1 million Sanford Lorraine Cross 2018 at a ceremony in Sioux Falls, South Dakota.
“I want to thank my research partner,” High said of Bennett. “Her deep understanding of this and her commitment were keys to seeing this through. One day we would be able to turn genes into medicines. But as you heard today, it took a tremendous amount of work in the laboratory. I want to thank the Sanford Health system for rewarding innovation. There were many days we were discouraged, so it’s so wonderful for an award to be given for people who made it across the finish line.”
“Ditto everything that Kathy said,” Bennett said. “I also want to acknowledge that Jim Wilson and Brian Kaspar have been heroes of mine, and collaborators and inspirational. I have been honored to go through this nomination process with them.”
The black-tie event brought together the finalists, and supporters and leaders of Sanford Health, including and philanthropist Denny Sanford; former Speaker of the U.S. House of Representatives Newt Gingrich; Monsignor Trafny, head of Science and Faith Department of the Pontifical Council for Culture of the Vatican; and CBS News medical correspondent Max Gomez. It opened with music from Grammy and Tony-award winning “Hamilton” performer Leslie Odom Jr. and was emceed by Shankar Vedantam, host of National Public Radio’s “Hidden Brain.”
Learn more about the award: $1 million for a transformative medical breakthrough
‘True innovation is very difficult’
But the real celebrities of the evening were the nominees:
- Bennett and High, whose gene therapy Luxturna cures an inherited form of blindness;
- Brian Kaspar, whose work seeks to cure spinal muscular atrophy (SMA), or floppy baby syndrome; and
- James Wilson, who created the vector that carries the gene therapies.
Their stories are all similar: Setbacks. Some major, some just annoying. Hard work. A single-minded pursuit.
“There’s a common theme,” Vedantam said. “True innovation is very difficult. It’s difficult and very lonely. Once you find the light switch, everything seems obvious.”
But before that moment, it was still dark.
The Sanford Health Lorraine Cross Award seeks to illuminate the darkness by rewarding innovation and research. Sanford Health executive vice president Micah Aberson announced that the award had reached $10 million in donations, halfway to the goal of $20 million, which would fund the biannual award in perpetuity.
“We all come together in this, to do something bigger than ourselves,” Aberson said.
For Kelby Krabbenhoft, CEO and president of Sanford Health, the work is more personal. He shared the story of his father’s blindness and his brother’s paralysis.
“People are suffering. And in the time it takes to get things approved, people die. And I don’t like it, and I know you don’t either. We’re going to embrace failure. Because when you take risks, sometimes there’s failure. And we’re going to embrace that,” he said.
“What an unbelievable task we had at hand today,” said Andy North, president of the Sanford International Board, which decided the winner. “Today was an amazing day that we will never forget. There were tears in there today. A lot of laughter. A lot of hope.”
Members of the Sanford International Board gathered on the overcast December day, the low winter light reflecting on the snow outside, to hear presentations from the finalists. They met at the Sanford House, a building in Sioux Falls, South Dakota, that tips its hat to Mr. Sanford, the philanthropist whose giving helped catapult Sanford Health into a major player in health care in the upper Midwest.
Those around the table knew that progress can take years, decades. That obstacles can feel insurmountable. That the only thing that pays off is a pathological need to make a real, measurable difference in people’s lives.
They heard three presentations.
Two men. Two women.
One field: Gene therapy.
Later, a deliberation, votes, a winner.
But first, they heard stories of perseverance.
James Wilson: ‘We only have one life.’
James Wilson was barely seated before he began talking.
“I grew up the oldest of four kids in a suburb of Detroit,” he began, and the board settled back to hear his roots. He went to Catholic school and loved to play sports — and was competitive enough to know he wanted to break with tradition and go to the public high school, which was larger and offered more opportunity for sports.
He did, and you get the impression that Wilson usually is able to persuade people of things.
But in the next story, he showed he’s able to learn, too: “I was ready to accept a Division II scholarship, but my dad said, ‘Son, you’re too slow to make it to the pros, so you might want to rethink this one.’”
The room laughs, and so does Wilson.
Wilson says he listened to his dad and went to a different college, realizing he could channel that competition into academics. He went on to study the molecular base of diseases, particularly in childhood diseases.
“It was an incredible time, but I realized the work I was doing wasn’t going to help them. If I was going to spend my life in science, I wanted it to be directed at therapy. I wanted it to be treatment.”
It was a turning point for Wilson, who left practice to begin his work in research, calling his last day at Mass General Hospital one of the saddest in his life.
“I was pretty good at science and probably a mediocre doctor,” he laughs.
For the rest of the hour, though, he talked about that phase: About this drive to solve problems, and the global responsibility he feels to make solutions accessible. He rattled off a list of phrases that begin with the obvious and end with the profound: Knowledge is power. Science self-corrects. The truth prevails, no matter what you think it may be.
And this: Science should be available to everyone.
You could follow these phrases to trace his career.
He went back in time again — to the turn of the century, when gene therapy was hot. “Everyone was riding the wave,” Wilson says. “There were many clinical trials, and none of them were working.”
Patients died, or developed cancer. The stock market tanked. Enthusiasm for the field evaporated.
“This was about a young man who had volunteered to participate in this. We had to figure out what happened,” Wilson says.
It was time to reinvent, and Wilson came back to what he knows: science. Science is the answer.
“That was the easy part,” he says. “Don’t point fingers. Take responsibility. Talk about resolve to getting it right — I resolved to get it right.”
The board members who would decide the winner nodded, beginning to ask questions. They wanted to know about collaboration. About roadblocks. About what keeps him up at night.
“How do you push forward but not make it so fast?” asked Robin Smith.
“It is getting ahead of itself,” he replied. “They call it Wilson’s warning. I wish they called it something else.”
He laughed, but there it was: The ever present comment on his past, on that story he tells as a warning and an inspiration to get it right. He doesn’t shy away from it, faces it head on.
“I say look, this is how I am,” Wilson said in his direct way. “You’re going to hear everything I worry about, not how I want it to be. Anything we’re doing now is not how we are going to be doing it in 10 years.”
The room looks ahead.
“With all your success, you’re still dreaming,” said Manny Ohonme, a member of the Sanford International Board.
Wilson is. He spent the rest of the discussion talking about the responsibility he feels to the world.
“One thing I enjoy is traveling to different parts of this planet and meeting families and patients. This is the physician in me,” Wilson said. “And they’re all the same. And we can cure those diseases in my lifetime. We just have to figure out how to do it. But it’s not going to be just me.”
Brian Kaspar: ‘It takes decades of work.’
Brian Kaspar talks about Falls Park, home to the Sioux Falls, South Dakota, namesake waterfalls. He drove through the park the night before to admire the holiday lights with his family.
“It’s 100 percent decorated, and it’s just beautiful,” he said, before launching into a description of how he watched the lights go on in his work. He used gene therapy to treat a deadly pediatric disease called spinal muscular atrophy, or SMA.
He reviewed his history, and his work at Ohio State University and Nationwide Children’s Hospital, before founding Avexis in 2015.
“I’ve been in gene therapy for over two decades,” Kaspar said. He talked about Novartis, which acquired the company, and how that relationship developed.
“Novartis recognized that this is something that we had moved the needle on,” Kaspar said. “When they acquired Avexis, they said, ‘We like the miracles you’re doing each and every day. We consider you the speedboat. We’re the big steamship of Novartis, but when you need to come back and fill up with fuel, pull up.’”
He laughed, and so did people in the room. But everyone knew funding matters, and getting therapies approved matters. These are the steps that need to be taken before something can be treated or cured.
Most common genetic killer
And for Kaspar, it always comes back to that.
Children born with SMA don’t live to see their second birthdays.
“We’ve worked diligently throughout my career to change these diseases,” he said, and then he credited Wilson, a fellow award finalist, as a pioneer in the field.
Kaspar showed slides of babies who couldn’t hold their heads up.
“These may be hard to watch,” he said. He described SMA and said it doesn’t have any ethnic boundaries. “This happens around the entire world. I’ve heard the same stories in China. In Argentina.”
It’s the most common genetic cause of infant death. He calls it a childhood version of Lou Gehrig’s disease, so they’ll understand.
It’s a death sentence.
He used a gene replacement therapy, starting in mice, then pigs and, eventually children.
It’s a one-time administration into the blood, and the human clinical trials at first made people uncomfortable. “We would receive phone calls saying, ‘Don’t do this,’” Kaspar said. “This is the largest amount of gene therapy in a human. This is scary.”
The procedure takes about an hour. The child sleeps, or rests in a parent’s arms.
These children are still alive. Some are turning age 5. They’re sitting up on their own. He showed more videos.
“These kids are eating normally,” Kaspar marveled. “One of these has achieved a milestone I haven’t: They’re bilingual.”
Credits his team
It’s clear he loves what he does and knows why he does it. And he spent as much time crediting his team as he did the science itself.
“We’ve broken the barrier of giving the world’s largest amount of gene therapy safely,” he said. “But how do you scale this?”
It’s the same driver: Make it accessible.
For Kaspar, that means making a test for SMA part of the standard battery of tests in a newborn screening. It’s a blood draw.
“I’m blessed to have two healthy children and a healthy wife,” Kaspar said. “But you see how fragile that is. And you see that we are not superhumans.”
Jean Bennett and Katherine High: ‘We were lucky we were naive’
Jean Bennett and Katherine High said they faced dozens of challenges on the way to discovering the first and only approved gene therapy for inherited disease in the United States — and creating a path for genetic treatments for blindness and other devastating diseases.
They began their presentation with a slide show.
And the facts.
“Let me tell you about this disorder,” said Bennett, her long hair falling out of her barrettes as she gestured, pulling the room into a conversation, not a presentation. High sat next to her, letting Bennett talk about how people with this inherited form of blindness slowly lose their sight.
They show a video of a boy holding his parents’ hands as he walks down the hallway, unable to see enough to navigate the space. Next, he was 9 years old and riding a bike. Then, he was 18 and he picked up his date for prom. In a car he drove himself.
This was the result of their work.
To deliver a correct copy of a gene for some of the 3,000 people in the United States with this form of blindness.
They started in animals. Moving to humans created a list of obstacles.
‘Bewildering array of problems’
There was no path for pediatric drug development. They needed to figure out how to document clinical meaningfulness — the test of reading an eye chart wouldn’t work. These patients couldn’t even see the eye chart. They had to come up with an obstacle course for patients to navigate — to measure changes in functional vision.
They did. Then, they had to come up with dozens of configurations so people couldn’t memorize it.
It was just one setback, creating the test, in what High called a “bewildering array of problems.”
That included the rarity of the disease, the lack of natural histories of it, and what would be the controls in a trial. And then, of course, the funding.
“We were getting great results, but we realized we wouldn’t be able to assemble everything we needed to move this across the finish line,” High said. “So in 2013 we started Spark Therapeutics.”
Bennett is a scientific founder but has no financial stake in the company. This was to protect conflicts of interest for her.
The conversation switched as High explained the company and the why: Bringing this treatment to a commercial level, who could help, how to solve issues of access and reimbursement.
They figured it out, just like they had been doing together for years, and in 2017 Luxturna was approved.
“This is how we felt,” High laughed as she showed a slide of fireworks.
‘You own all the problems’
The board asked about their early work. Bennett talked about working with gene therapy. They talked about their families. High discussed working in internal medicine and hematology. They found each other at the right time.
High wanted to focus on gene therapy but she was told it couldn’t be only in hematology. She liked Bennett’s work.
“No two people can do this alone,” Bennett said.
High reflected on how to move faster.
“If I didn’t believe the clinical guidelines would shorten, I couldn’t come to work every day,” she said. “I believe that every time somebody does a trial, more problems are solved and the timelines are shortened.”
They knew this was their path, and it will be for others, too.
“We chose a good target, and we executed,” High said. “We solved the problems in our path. For young people, if you want to get across the finish line, you own all the problems. Not just the ones that will lead to a good journal article, but the ones that are boring and need to be done. No problem is too small.”
Sanford Health created the prize, which it will award every other year, to be one of the top five most lucrative awards celebrating transformative breakthroughs in medical care and the people who dedicate their lives to the work of health and healing.
Candidates were filtered through nominations from the public and a computer algorithm that sifted through medical publications in search of great discoveries. An interdisciplinary scientific advisory board identified top areas of innovation and the candidates were narrowed down to the top four.
The award is named after the Lorraine Cross, a symbol recognized around the world for those who take action for their passions. Sanford Health uses it to symbolize innovation in health care.