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Thursday, December 17, 2015

Screening, Tests, Informed Consent and an Story About Leadership

Last couple of days have seen lots of tests, the clinical trial informed consent, and a story about leadership.  

As you may remember I'm being treated at the City of Hope which houses one of the foremost investigators in the area of CLL research--Dr. Steve Rosen.  Here are a few of Dr. Rosen's titles:
  • Irell & Manella Cancer Center Director’s Distinguished Chair
  • Director, Beckman Research Institute of City of Hope
  • Provost and Chief Scientific Officer
  • Professor and Director, Comprehensive Cancer Center
  • Professor, Department of Hematology & Hematopoietic Cell Transplantation
One would think that such a person would be disconnected emotionally and socially at best but one finds in experiencing him and talking with his staff (often the best test of one's leadership is the perception of one's subordinates) that Dr. Rosen actually maintains a striking humility, grace, and respect for others as he moves about his various professional orbits.  One physicians' assistant I spoke to made it clear that Dr. Rosen's respect for colleagues (even saying "thank you") was not the norm among physicians.

I've been teaching about leadership for several years now and one of the models of which I've been enamored is "Servant Leadership".  The following quotes summarize this theory of leadership.
“Good leaders must first become good servants.”
― Robert K. Greenleaf
"True leadership must be for the benefit of the followers, not to enrich the leader."
― John C. Maxwell
"Servant-leadership is more than a concept, it is a fact. Any great leader, by which I also mean an ethical leader of any group, will see herself or himself as a servant of that group and will act accordingly."
― M. Scott Peck
"A new moral principle is emerging which holds that the only authority deserving one's allegiance is that which is freely and knowingly granted by the led to the leader in response to, and in proportion to, the clearly evident servant stature of the leader. Those who choose to follow this principle will not casually accept the authority of existing institutions. Rather, they will freely respond only to individuals who are chosen as leaders because they are proven and trusted servants. To the extent that this principle prevails in the future, the only truly viable institutions will be those that are predominantly servant-led."  ― Robert K. Greenleaf

R. Greenleaf's work did much to solidify the Servant Leader theory in management leadership.  I remember writing in my Life Mission statement that one of my life aims was:  exercising leadership such that people are served, encouraged and developed into synergistic interdependence. I am about using power and authority with purity toward noble social and spiritual goals, striving to always be mindful of the overriding importance of right principles.

It's refreshing to see that others are striving toward this goal as well.  What if all the leadership authority we were given was used exclusively to serve, encourage and develop others?  Cudos to Dr. Rosen and others exemplifying Servant Leadership for showing us how it's done.

Looks like my next clinical trial will likely begin December 30. For those with an interest in the details:  A Randomized, Multicenter, Open-Label,Non-Inferiority, Phase 3 Study of ACP-196 Versus Ibrutinib in Previously Treated Subjects with High Risk Chronic Lymphocytic Leukemia.

The next event is being "randomized" which will tell me whether I'm in the AB-196 arm or the Ibrutinib arm.
 

Saturday, December 5, 2015

It Looks Like Another Clinical Trial is in My Future

I had two meetings this week with CLL experts.  Turns out the remission was neither as robust nor as longlasting as I had hoped.  I had what's called a "partial response" to the clinical trial (which is better than adverse reactions or "no response") but is a bit disappointing.

I'm really not experiencing significant symptoms beyond some lymph node enlargement which is unfortunate because my work is requiring me to do a bit of on-camera work (whine, whine, whine).

Another change is that I'm becoming a "City of Hope guy" rather than a "Moores Cancer Center (UCSD) guy".  UCSD does a great job; I'm opting for COH due mainly to the logistics (COH is an hour closer to my home).  Both facilities have renowned CLL experts.

My wife and I are attending a workshop Saturday which is likely very relevant to whatever clinical trail I end up utilizing.

The most likely option at this point appears to be a randomized trial comparing Ibrutinib (an approved drug for CLL) with ABT-199.  ABT-199 has shown great promise but is only in a Phase III trial.  Being who I a am, I'd prefer the newer drug but the trial is randomized so if I enroll in that trial, I need to be okay with whatever assignment I get.

Expect another post around 12/12 (the day of the workshop) if I don't get lazy.  Thanks for all the interest in my CLL adventure.

By the way, the bottom line is that this continues to be a "chronic" disease which suggests I may have a good while left and it is very cool that I have access to the best of the best in terms of research and clinical quality professionals.