Naji Gehchan: Hello, leaders of the world. Welcome to “Spread Love in Organizations”, a podcast for purpose-driven healthcare leaders, striving to make life better around the world by leading their teams with genuine care, servant leadership, and love.
I am Naji, your host, joined today by Fabrice Barlesi CEO of Gustave Roussy, a Leading Cancer Centre in Europe, ranked third world’s best oncology hospital and first outside the United States. Fabrice is a lung cancer specialist and a major contributor to research in the field of novel oncological therapies. He was appointed CMO then CEO of Gustave Roussy since 2020. Fabrice is a Professor of Medicine at the University of Aix-Marseille and joined Paris Saclay University in 2022. He has been head of the Multidisciplinary Oncology and Innovative Therapies Department of the Nord Hospital in Marseille and the Marseille Centre for Early Trials in Oncology (CLIP2) which were established by him. Fabrice is also co-founder of the Marseille Immunopôle French Immunology network. Fabrice is the author and co-author of some 400 articles in international journals and specialist publications. In 2018, the European Society of Medical Oncology (ESMO) and the International Association for the Study of Lung Cancer (IASLC) awarded him the prestigious Heine H. Hansen prize. He appears in the 2019 world list of most influential researchers.
Fabrice, it is a pleasure to see you again and have you with me today!
Fabrice Barlesi: Thank you, Naji. It’s a great pleasure to bewith you and to make this podcast with you.
Naji Gehchan: I would love first to learn more about your personal story. Why did you choose medicine, oncology, and now leading one of the most renowned cancer institutions in the world? What is the story behind this incredible journey?
Fabrice Barlesi: I think it’s, uh, quite a simple story. In fact, um, I, I have been, uh, interested to medicine by a neighbor of my parents who was, uh, a gp.
And in fact, uh, when I grew up, I was discussing with him, he was, uh, showing me or explaining me what he was doing, the patients he was seeing, what he was doing with the patients. And, uh, and then I, I, I became passionate by, by medicine and by. Doing six for others, I will say. Then, uh, I started, um, the School of Medicine and, uh, and I have to confess that during, uh, my training, uh, uh, at least I will say during the theoretical training because in France we have six years of, uh, theoretical training and we have students at the hospital, but we are not in responsibility of patients during that time.
And, uh, I was really not And even it’s the contrary. I was quite sure that I was not made for oncology and In fact why because I believe that when you look at oncology on the theoretical point of view, you know you are learning a lot of Classification a lot of different treatments But you are not seeing the other face of oncology beyond medicine and beyond science That is the patient that is the humanity of the patient that is saving life And, uh, it’s, it was during my first, uh, uh, resident, uh, uh, stay, I would say it was in a, in a small hospital in the, in the, the suburb of, uh, of Marseille.
And, uh, I was, I remember, I will always remember, it was, uh, an old patient. She was, uh, diagnosed with an ovarian cancer. And she was here at the beginning of, uh, of this, uh, this training and, uh, I was discussing with these patients, uh, while I was seeing also a lot of lung cancer patients. But I remember this patient because she was, you know, she was so, uh, courageous regarding, uh, regarding her disease, et cetera.
And in fact, she was waiting for her grandchildren and she was waiting for the visit and that came for Christmas. And I saw her for the last time on the 24th of December. The grandchildren came on the 24th in the evening, and on the 25th she died. And I, uh, it’s for me the example of what we should do for those patients.
We should try to make them having the life they want to have, to support them during the disease. I would say now find new treatment in order to cure those patients. But I always remember because this example is showing what is oncology for me. Oncology for me, it’s the perfect mix between science and human.
Naji Gehchan: Wow. Thank you so much, Fabrice, for sharing this. I think all of us who’ve done rotations or went to oncology, this, this human side that you described is so powerful. And we really see. How courageous as you said those patients are and what it means actually to add even a day when when a day means so much emotionally for patients.
You moved from being a clinician and I feel your passion as a clinician and researcher to leading now an institute as the chief executive officer. Can you share with us your learning And challenges probably through this transition and how you
Fabrice Barlesi: go with it. In fact, um, you know, um, when I was, uh, based in Marseille, uh, I had the chance to lead, uh, I would say a large, uh, uh, departments of, I would say.
General oncology, but also the early phase drug development center. And it was really exciting, but I would say Gustave Roussi was, uh, was always for me like a model, you know, and when I was in Marseille, I was saying, I want to make the Gustave Roussi of Marseille. Uh, at Gustave Roussi, I had a lot of friends with Jean Charles Soria, with Benjamin Bess.
And then we had a lot of exchanges and with Jean Charles, we were resident at the, at the same time. And, uh, I would say we always add collaborations through the large clinical trials like the SAFIR trial, but also some of the projects like the biomarker France project that we, uh, we ran together. And, uh, and in fact, I came.
In Gustave Roussy beside the admiration I had for this institution to join Jean Charles and Jean Charles asked me to come early in 2020 when he came back from the U. S. to take the head of Gustave Roussy and at that time I came as a CEO and also leading the clinical research organization and I would say for me what I discovered in Gustave Roussy is something that was even more amazing and Fascinating, uh, than than expected because of not of the size of the institution that you made, uh, realized from from outside, but because of, I will say the extreme dedication of all the people here, you know, both the, uh, the, the nurses, the, uh, the, the researchers, the, uh, the MDs, everybody is, uh, Doing things with a lot of patience that they want really and really the the mindset here is to say Everything we are making is to cure more patients today and to cure more patients tomorrow through the research we are, we are carrying out.
And, uh, clearly it’s, uh, it’s something that is, that you may see every day, uh, and, uh, every day of the year. And, uh, uh, it’s, it’s what I see here. Uh, it’s also a place that was a leader for many innovations in oncology, uh, but a place also where we can still try to, uh, to improve our activities, our organizations, because we know that this organization and the needs of the patients and the expectation of the, the society are still Moving, uh, for one and we need to to adapt ourselves to this new world Both regarding the expectation of the patients, but also the expectations of our professionals and we know how much it changed after the covet crisis and I really believe that in gustavo c giving Our hospital, giving the research centers, giving also the other pillars that make Gustavus Union unique.
Our education, we have a large part of education, more than 300 programs that are dedicated to all the professionals. But also our international activities, and we are taking care of more than 1, 500, 1, 500 patients, uh, international patients every year. And we are going to, uh, to open some, uh, facilities outside, uh, France, but also, uh, our spin off, Gustave Roussi Transfer.
That is. Clearly trying to make what has been made very nicely in, uh, in the U. S. And especially in Boston, that is transforming the product of our research into new drug, new devices or new pathways. And the idea is that it’s all we really want to have associated impacts with our research and change the life and the future of the patients.
That is awesome.
Naji Gehchan: And really, you’re taking what’s been there and you’re expanding this and exploring even beyond. I love this idea about also drug development, as you said, and how you can expand those, uh, globally. Um, I want to go back to this moment where you came to Gustave Gosset as you shared in the early 2020 and obviously you came and COVID crisis hit.
Um, you shared the dedication and the devotion of your people. So I’m interested to learn what was your biggest leadership learning during those times of tough moments for your patients and also health care providers going through this crisis.
Fabrice Barlesi: Uh, the big lessons I will say is the, uh, is probably the, um, adaptability of the people when they are facing a huge crisis. Uh, I would say that, uh, we are lucky that, uh, No one of, uh, of us in our generation had to face, uh, a war, uh, at least I would say in, uh, in, uh, in Europe. And, uh, but I would say the COVID crisis was like, uh, a small and of course, quote, uh, uh, smart, uh, war against the virus.
But, uh, it was really, um, uh, the adaptability, the capacity of the people to work 24 hours in order to take care of patients, uh, finding new solutions. And the leadership, uh, during this crisis, I would say was quite, I would say, easier, I would say, because all the peoples We are dedicated to one goal. We want to take care of those patients, whatever they are coming from, and even what is really special in Gustav Rossi for the first time we had in our intensive care unit patients without any cancer.
It was the first time in the story of Gustav Rossi in more than 100 years. And it was really a special moment, but it was quite easy. And what was really important at that time, it’s important every time, but at that time was really to Capture the information that we are coming from all around the world regarding the epidemiology, the knowledge about the virus, the knowledge about the treatments, the knowledge about how we can protect ourselves and protect our people, but also the patients, how we can continue to treat our cancer patients.
Even in this special situation, then we adapted the, uh, the institution and, uh, and finally, uh, the, uh, the, all the, uh, the importance of the vaccinations and how we can go back, uh, to a, to normal life. Uh, I would say not very rapidly, but we wanted to, uh, to, uh, to be able to provide our patients and our, uh, employees with quite a normal life, even if the Covid was still there and through the different waves of the, of the Covid.
Naji Gehchan: So thinking, thinking now forward, uh, we’re at another, uh, what like. We’re at another incredible moment in time, right? And oncology, I’m sure you would agree where innovation, um, will be at this tipping point to cure even more patients with some cancers. We thought we would never be able to tackle or to treat, um, thinking about.
Gene therapy, AI, immuno oncology, a lot of those that are ongoing that will help us really cure patients. So I’m, I’m intrigued. How do you think about the future of oncology for the patients you serve and also for your care teams? Who is treating them daily.
Fabrice Barlesi: Yeah, you’re absolutely right. And, uh, I cannot imagine another work that is more fascinating than oncology as of today.
Uh, it’s really amazing how we change in the last 20 years, I would say, and even more rapidly in the past decade. Um, what, uh, how we foresee the future of oncology is first I would say oncology will not only be dedicated to cancer patients, but also to subjects at high risk of cancer. Then we should also try to prevent the occurrence of cancer by a more dedicated, more precise prevention, but also we should progress to have more.
compliance with screening, then diagnose patients very early. And because it’s one of the way to cure more cancer patients. The second is to be more precise. Also, in the early stages of the disease, I would say in the past. We were sometimes simply saying, okay, the patient has been operated on, then he’s or she’s cured, and then it’s done.
We know that now we have some aggressive disease, even in the early stage, then we should use what we learned in the precision medicine field. And to, uh, uh, apply it for, um, for early stages. And it’s what we do, uh, for, for, uh, patients regarding the, the advanced stage it’s also, I believe that, and we believe in Gustavo C that probably we should be more smart in using local treatment, surgery, radiotherapy, international radiology, even in the advanced stage, uh, or I would say Oligo metastatic disease to say to to use a word that is easily understandable.
And we believe that we may be able to cure, uh, more patients, uh, with the use of this, in using this new, this type of technology, even in metastatic stages. Beside that, regarding, uh, medical treatment, medical strategies. We believe that there are two different big ways. The first one is, uh, to better understand, uh, all the, the, the molecular profile of, of the tumors finding on oncogenic addictions, but also how co molecular alteration are jeopardizing the, uh, the activity of targeted drugs and we can try to combine it in order to overcome the potential resistances, uh, uh, driven by these co molecular alterations.
Thank you. It’s all the work that we should do in this field of precision medicine. The second one is, of course, immunotherapy at a large sense, then saying that the use of checkpoint inhibitors, the one that we have in our hand, but also to develop new drugs, how we should combine it with the new, uh, uh, I would say, uh, strategies that are coming and we are developing in Gustavus Uh, department that is called the immune cell and answer, then we don’t want to, to, to discuss about just, uh, target the cell therapy, I would say, but saying that we could manipulate the immune system and the immune environment with the many type of drugs that are on development or.
For some of them already available, and we believe that it will generate the new strategy for for the patients. And finally, regarding this, uh, this, uh, medical oncological treatment, we believe that we cannot anymore be, uh, have built our strategy on Um, that’s empirical decision. We believe that patients are waiting for more objective decisions.
It’s why we are developing, uh, both biological and digital avatars for our patients in order to be able at the lab, uh, to test, uh, different therapeutic strategies being more and more precise, uh, uh, over the time, uh, with this kind of strategies, just in order at the end to be able. In the time frame, uh, that that will be a turnaround time that would be, um, uh, compatible with the queue of patients, uh, being able to clearly define what will be the strategy with the highest probability of activity in a given patients at a given stage of the disease.
And we believe that this. Ultra precision of the treatment is a part of our future. And finally, the final part of our development and what we foresee is the fact that we will cure more patients. And when we see the data that we have for the moment, we know that we are curing more and more patients, I would say, over the time.
But we want to give these patients back to a normal life. And we have to understand what are the patients with long lasting adverse events with sequelae from the treatment and probably in some of them we, we can go to de escalation of the, uh, of the therapeutic strategy. Then we are, I would say, enlarging the activities and the research in order to, uh, fulfill of this, uh, uh, I would say field of research.
Uh, in order to be, uh, to be more precise for our patients, more potent and cure more
Naji Gehchan: patients. Thank you Fabrice for this great overview and certainly gives hope for, for many of us as caregivers or potential patients. Um, I want now to move to a section where I will give you a word and I would love your reaction to it.
So the first word is leadership.
Fabrice Barlesi: It’s, uh, take the blame and give the credit.
Well, I love that. Can
Naji Gehchan: you, can you share a little bit more? Because I remember also a discussion where you shared your thoughts about what’s your job as a leader and CEO of an organization, and you talked about people and talent. So I’d love to dig a little bit more here.
Fabrice Barlesi: Uh, I believe that the, the, for me, the, um, One of the most important things regarding, uh, the leader in an organization like Gustave Roussy is to be able to attract talents and, uh, attracting talents means that You have the good facilities, you have the good projects, you have, in fact, it’s the, just the final, uh, demonstration of the, the rightness of the decision that you took before, in fact, and, uh, I believe that you, you, you may be able to attract talent only if you have, all the other things.
Then for me, uh, it’s really important to, to discuss with young people to, uh, to know what are their expectations regarding the research, what are their ideas, all the, but also how they want to live. What are the expectations regarding both their professional life, but also the personal life and try to make the good mix in order to have to have the best institution and not, uh, I would say, uh, just trying to, uh, to set up an organization, an highly efficient organization like that, things that were not in the past, regarding the, uh, the efficiency of the companies or things like that.
The second word is
Naji Gehchan: precision medicine.
Fabrice Barlesi: Precision medicine is, um, is first the, the DNA of Gustave Roussy, uh, with the, uh, and I say the validation of an idea that came more than 20 years ago, that was the idea to use the techniques that were used for research in the labs and transfer this technique to patients. And demonstrate the value of the use of these new techniques.
In, uh, in clinical trials. And then, uh, I would say everywhere. And, uh, it’s what we did, uh, when, uh, uh, what the leaders of Gustave Roussy did at that time, supported by, uh, by Professor Tures, who was the, uh, the CEO of Gustave Roussy at that time. It was clearly to transfer the genotyping of the tumors that was done only at the lab for patients.
In a turnaround time that was, uh, uh, that may be used for the, for the management of patients. Then we set up a new generation of clinical trials, the SAFIA trial for breast, for lung cancer, etc. Demonstrating the use, the efficiency. Of this strategy and then participating to the development in the, uh, in France of the, uh, the network of, uh, of, uh, uh, genotype genotyping platforms in order to provide all of the patients with this kind of strategy.
Then it’s the DNA of precision medicine is the, is clearly the Roussel. And we are trying both to improve what we did in the past, but also To find what are the new technology from coming from the research that we should transfer to the patient and it’s what we are trying to do with a single cell and spatial mix in order to build these biological but also digital avatars of our patients.
Naji Gehchan: And this work for our listeners has really transformed care for patients. So, thanks for all the work that you guys have
Fabrice Barlesi: done. Yeah, clearly, when, when we look, you know, I remember as a lung cancer specialist, when I, when I started, in fact, it was, you know, in the, in the middle of the nineties. In fact, I would say the, the life expectation for stage four lung cancer was like six months.
Now, I have patients that I’m following for more than 12 years, then clearly it changed a lot. And even we have patients that were treated just at the beginning of the era of immunotherapy through clinical trials that are still alive after 10 years with a stage 4 disease, then clearly it changed a lot.
We still have a lot of things to understand both regarding the biology of the tumors and the, uh, how we, we, we made, uh, modulate the immune system, but, but clearly it changed the life of the patients clearly.
Naji Gehchan: Yeah. And as we said, we still, we still have a lot to do, but it’s great to see the road that’s been on and hopefully we will, this is why we wake up every morning to, to make sure that we can cure more patients and help them out.
The third word is health equity.
Fabrice Barlesi: It’s, uh, it’s a huge issue, you know, you know, because, um, when you are leading a big centers like Gustavus here, but I would say it’s also true probably when, when you are leading a research group or even a small hospital, you are always trying to improve what is happening in your immediate environment.
But if you are trying to look a little bit, uh, uh, uh, in the future, you realize that it’s absolutely impossible to imagine that the progresses you, you are making. Are just dedicated to the small number of patients that will come to your institution, then it’s really important. And it’s clearly something we are discussing every day in Gustavus.
It’s how the progresses we are making will be disseminated across the country, but also internationally. And the first step for that is education. It’s why we set up Gustave Roussier education with both national and international programs. Because without the knowledge about the innovations, you may not disseminate innovation.
The second is the clinical research. And we set up some very simple, pragmatic trials that maybe run everywhere in the world, but that are set up in order to answer a very simple question. You know, like the lung art trial that we did in, uh, in the past. Should we do radiotherapy in stage into lung cancer or not?
Something very simple, but we have a lot of example like that. And also some, a part of this trial will be dedicated to de escalation. Can we de escalate? I would say, uh, the dosage of immunotherapy or the length of immunotherapy as an example, something that is simple that may be done everywhere. And, uh, and also it’s also the reason why we set up our alumnis.
The alumnis are not only, I would say, like a club where people are happy to meet one time a year during the ESMO meeting, but it’s also. A way to run clinical research everywhere in a large number of countries and, uh, making the possibility for some patients everywhere to accede to molecular genotyping, some strategies regarding research.
And the last one, the last, I would say, uh, uh, pillar for, uh, health equity is also when you are developing. Uh, therapeutic strategy or diagnosis strategy. It’s also to say, okay, I want something that is quite simple and that may be done everywhere at a price that would be affordable for all the patients.
And it’s what we try to do, you know, even when we are developing, uh, very, um, sophisticated tools after that, we move to say, okay, how can we simplify? And, uh, being sure that we may reach the same results because, uh, there is no future for techniques that will be dedicated only, uh, to, to, uh, highly privileged peoples, uh, uh, or some specific centers in some specific countries, we should make progress is available for, for everyone in the world.
Naji Gehchan: I can’t agree more. The last one is spread love and organizations.
Fabrice Barlesi: Um, I would say, it’s, uh, what is important for me is, um, uh, is to, to build organization that, uh, that, um, that, that are, that, that are always, um, dedicated to the, to the largest, uh, I would say institutional interest, I would say. Uh, what is important is that everybody should be aligned with the, uh, with an organization that is serving patients and the patient’s research, education, and the strategy of the, uh, of the institutions, and no one, even the CEO is more important than the institution, and it’s what we try to do, we try to, uh, educate our fellows like that, we, uh, and we have always huge leaders, I would say, in Gustave Roussy, as you cannot find people that are more interested with the institution than people that are working here.
And I can cite, I would say, not all of them, but, you know, Caroline Robert, Karine Kizazi, Benjamin Bez, Fabrice André, uh, it’s a big stars in the field of oncology and I’m sitting only people working in the field of, uh, Technical research because they are very well known everywhere, but we have also basic researchers like Florent Gineau, Olivier Bernard, etc.
And, uh, all of them are really everyday thinking to the institution, what we can do for the institution, how can we attract talent, what are the projects we can fight for, etc, etc. And clearly for me, the organization is, uh, is serving the strategy of the institution. And, uh, and should be both flexible regarding the expectation and the need of the researcher we should be, uh, you know, you should give researchers some freedom in order to think and to develop the, the, the hypothesis they have, but also with always the alignment with the strategy and our strategy regarding, uh, especially research is to say, we want to have a societal impact.
And we, we want to, to, uh, to, uh, conduct a research with associative impact. We want to change the outcome of the patients in a, in a, in a close future.
Naji Gehchan: Any final word of wisdom Fabrice for healthcare leaders around the world?
Fabrice Barlesi: Uh, the first one is, um, I would say we know that we are in a big competition and, uh, clearly, uh, all the countries, the institutions are trying to, uh, to do their best in order to find a new generation of treatment and to develop a new generation of drugs or pathway or devices.
But at the end, and it’s, uh, the strengths of all of these academic centers, I would say, We know that we are clearly strong together, uh, by also sharing our knowledge through, I would say, the international societies, the different meetings that we have, and clearly aligning both this competition and this collaboration.
They are not the opposite. They are just the two faces of the same coin.
Naji Gehchan: Well, thank you so much, Fabrice. It’s an incredible chat. Thank you also for what you do as a CEO and for all Gustave Roussy’s team. The social impact is more than clear and obvious through all the years and hopefully even more exciting innovations for the years to come, coming from you.
Thank you so much for joining me today.
Fabrice Barlesi: Thank you, Naji. It was a great pleasure.
Naji Gehchan: Thank you all for listening to SpreadLove in Organizations podcast. Drop us a review on your preferred podcast platform
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