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Dr. Deborah Dunsire, President and CEO of Millennium: The Takeda Oncology Company, is leading her company to achieve an audacious goal: curing cancer. We are what we repeatedly do…excellence, then, is not so much an act, but a habit.” This Aristotle quote is one of Deborah Dunsire, M.D.’s favorite expressions. As president and CEO of Millennium: The Takeda Oncology Company, Dr. Dunsire is drawing on more than 20 years of experience in the scientific, clinical, operational, and commercial aspects of the biological/pharmaceutical business, to foster excellence throughout the organization. At Millennium, she has created a corporate culture that is team-oriented, built on accountability and flexibility, strives toward innovation, and most importantly is passionately driven toward achieving the company’s stated goal of curing cancer. She acknowledges that this is a bold aspiration and one that guides her decision-making every day and in some interesting ways. “This means we’ve got to look for transformative therapies, not just incremental change; we need truly great leaps forward in science and medicine,” Dr Dunsire says. “Our mission guides us to focus on translational medicine and personalized medicine, which means understanding the genetics of a particular patient’s cancer to guide the combinations of therapies. It also drives us to prioritize our portfolio, and if a compound isn’t delivering a transformative benefit, we redirect resources to another product that can.” Millennium’s focus in drug development is on disease pathways — or processes — that cancer cells depend on to survive. The company has more than 300 projects under way and alsmost 20 drug candidates in its pipeline. Currently, the company develops and markets Velcade for injection, a first-in-class cancer therapy for the treatment of patients with multiple myeloma and relapsed mantle cell lymphoma. Passionate About Progress Dr. Dunsire’s passion to find a cure for cancer is partly driven by the reason she became a physician — to help people get better — and partly by an innate desire to find order and solve the big unanswered questions in medicine. “I want to work in areas that need transformation,” she says. “There are many of these areas in medicine — beyond oncology — such as Alzheimer’s disease, some of the inflammatory disorders, and diabetes. So I could certainly get passionate about being a part of solving these unmet needs. “I get excited about understanding why there is disorder,” Dr. Dunsire continues. “When we think about the human body and the billions of cells, which for the vast majority of the time all function perfectly, but then all of a sudden, for reasons that we don’t fully understand, some cells go awry and start to grow in an untethered way. It’s tremendously exciting to dig into an age-old problem and see the glimmer of light and start to understand the root causes of cancer and then figure out the solution.” For Dr. Dunsire, oncology is at the heart of understanding all of the -omics — genomics, proteomics, etc. — and how biology can turn diseased cells off. “This is exciting stuff; it’s intellectually very stimulating and addresses a huge unsolved need,” she says. “All of us know people or have family members who have been afflicted by cancer and I do say afflicted because it comes out of the clear blue sky. Most often it’s life-threatening. I want to be part of making the affliction go away.” Motivating for Results For the second year in a row, Millennium has been honored by Fortune magazine as one of the 100 best companies to work for in the United States. This honor is no doubt the direct result of Dr. Dunsire’s leadership and the innovative culture she has cultivated at the company, which allows every employee to make a difference and have a voice. “We’re passionate about our work because we care about progress, each other, and the patients we seek to help,” she says. “As a result, our culture is a blend of intensity and caring. We are really fortunate to have a group of people — from our bench researchers to our sales people to our finance folks to the people who work in strategic sourcing and reimbursements, to human resources, etc. — who want to make a difference in the lives of cancer patients. Each person wants to feel he or she is part of the whole, which is moving therapy forward to transform the lives of cancer patients.” Leading the company to its stated goal is a huge challenge and starts with the mission itself. “We are taking on the big, audacious goal of curing cancer, and we need every brain in the game,” Dr. Dunsire says. “To do that, I always look for people who want to come to work. My belief is that people want to have their work make a difference. So we start off with the premise that everybody is here to passionately drive toward the goal. We created a culture that allows for and encourages a lot of freedom. We expect great things, we expect great efforts, and we demand that a lot gets accomplished in a short period of time, but we give people freedom around how they do their jobs. I think giving people that trust and freedom allows them to make their best contributions. “We also have a culture that truly emphasizes respect; each person brings a different slant to the enormous challenge we’re facing,” Dr. Dunsire continues. “To me, the more complex the goal, the more it demands diverse points of view to try and solve the problem. We have people who have manifestly different backgrounds, training, and skills. And it’s not just about having diversity in skills; it’s also about having diversity in thought and approach, which can sometimes create innovative solutions to a problem. We also require a tremendous amount of specialization within each function. We need teams of people who can work together, with each bringing their own skills and knowledge to the problem.” As the company’s leader, Dr. Dunsire demands, drives, and insists upon a culture where respect between individuals is critical and is absolutely required of everybody. “Teams can’t be effective if people don’t listen and don’t truly respect that another person has value to add,” she says. “Driving the value of respect is very important as is a culture of listening, and is essential to Millennium’s success.” As a leader, Dr. Dunsire says she is considered fairly demanding in terms of delivery against goal. “If you tell me you’ll do something, you need to do it,” she says. “I hold people accountable. We set goals. We assess how we’re doing against goals. We investigate how we can improve each year. But I also listen very carefully to people. I’m a leader who demands that I understand the path or plan. My people tell me that I ask more questions than any boss they’ve ever had. This is probably true, but it’s because I need to follow the logic; I’m a very logical person. I go back over the plan until I understand what we’re trying to accomplish, how we believe we can accomplish it, and I can see why the plan will deliver on that goal. We can’t deliver on every goal; we’re experimenting all the time. There are things that don’t go as expected, and that’s understandable. I look to see if we had a clear and logical plan before we started, then if something doesn’t work the way we thought, we need to have a clear process to understand what went wrong and dig down so that we learn for the next time.” An Industry Perspective Dr. Dunsire’s desire to manifest significant change goes beyond just steering Millennium’s course, she is also vested in making sure the industry overall is driving toward scientific transformation and addressing unmet patient needs. “CEOs face many challenges; I think some of the most pressing ones are understanding the science and figuring out how to capitalize on that knowledge in a timely way, both from what the patients need and from a business sense,” Dr. Dunsire says. “Regulators are very focused on the safety of our medicines. We need larger patient populations and we need to figure out the equation that allows for the delivery of value. Trials are incredibly expensive; bringing a successful drug to market costs well more than $1 billion when the costs of all the failed drugs are factored in.” Dr. Dunsire admits that making the paradigm effective in order to address the diseases that are impacting lives, curtailing productivity, and creating enormous expense is challenging. “Changing the pharmaceutical investment model, figuring out how to advance personalized medicine at a faster rate, and get regulatory buy-in to conduct more narrow trials faster and being able to deliver enough data to assure efficacy and safety are the biggest nuts to crack.” Dr. Dunsire believes understanding how genes become disordered, why different mutations appear together, and what controls the switching on and off of different genes will lead to being able to change the manifestation of a tumor or a disease and its response to therapy. “We’ve peeled the onion, if you like, from just understanding the genome, to understanding the genetics of disease and all of the ramifications that are driven by those disordered genes,” she says. “This is a process that’s been going on for years now, but in some ways it’s still in its infancy. And it’s going to be this shift that will drive the future of medicine in the coming decades. This will translate into more diagnostic testing before therapies are used, so we can really understand which patients can benefit from which therapies and which patients are not appropriate for a therapy because the risk is too high and the benefit is too low. “We’ve been talking for a long time about the era of the human genome and what this is going to do for medicine, but I think it’s starting to come to fruition now,” she continues. “We’re probably at the bottom of a steep inflection of how genomics will truly transform medicine.” Dr. Dunsire believes in the next decade the advent of personalized medicine will come to maturation, not just in oncology, but truly across different therapeutic areas. “One of the things we know about medicines is that they don’t work in everybody as effectively as we would like,” she says. “Different people bear different levels of risk, so side effects manifest differently in different people. That occurs from hypertension to acid-related disorders to psychotherapeutics to oncology therapeutics. In every field of medicine understanding who can benefit and knowing for whom the risks are enhanced is the most critical advance. It’s this knowledge that will allow us to leverage therapies in the most effective way possible. This will also better leverage the available resources for delivering care.” Dr. Dunsire says the industry is in an evolutionary stage and there is a need to change the research, development, and commercialization models. “Things are really changing and they’re changing quite fast,” she says. “It’s very interesting; perhaps we are at the end of the beginning of the genomics revolution and now we can accelerate to the mainstream.” Deborah Dunsire, M.D. » Dr. Dunsire serves as President and CEO of Millennium: The Takeda Oncology Company. » She joined Millennium in 2005 from Novartis, where she helped increase the North American oncology revenue to more than $2.1 billion from about $50 million in 10 years. » Dr. Dunsire has earned many awards during her 20-year plus career, including the Healthcare Businesswomen’s Association (HBA) Woman of the Year in 2009; Doctor of Science, Honoris Causa, Worcester (Mass.) Polytechnic Institute; the American Cancer Society’s Excalibur Award; and the Creative Spirit Award from the Creative Center for Women. » She serves on several boards of directors, including the Biotechnology Industry Organization (BIO), Allergan Inc., the Museum of Science (Boston), CancerCare (New York), and the G&P Foundation for Cancer Research. » Dr. Dunsire earned her doctor of medicine degree from the University of Witwatersand, Johannesburg, South Africa. Dr. Dunsire is excited by the challenge of finding order among biological factors gone awry. CEOs face many challenges; I think some of the most pressing ones are understanding the science and figuring out how to capitalize on that knowledge in a timely way, both from what the patients need and from a business sense. PODCAST Dr. Deborah Dunsire Transformative Leadership