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71 December 2018 EW MEETING REPORTER ophthalmology has with industry, he said. Within Novartis, Mr. Tamboow- alla said, it is a more complicated question. He mentioned that Lu- centis (ranibizumab, Novartis) was launched from a partnership. But he said that the company does not benchmark what it does internally vs. externally. Mr. Shams noted that Santen does not have an internal discovery engine and is therefore dependent on its licensing and partnerships. This will hopefully change over the next 3–5 years, he added. Mr. Romano added that Regen- eron has only one ophthalmology product (with many expanded in- dications). Of the company's seven approved products, he said that all seven were approved in the last 10 years, and 100% of these were inter- nal efforts. EW Editors' note: The speakers at OIS@ AAO have financial interests with the companies they represent. on acquisitions and innovation and included panelists Naveed Shams (Santen, Osaka, Japan), Carl Romano (Regeneron, Tarrytown, New York), Robert Dempsey (Shire, Lexington, Massachusetts), Mr. Frinzi, Andrew Stewart (Allergan), and Jehan Tamboowalla (Novartis, Basel, Switzerland). The panel discussed innova- tion and how it is handled both internally and externally. Dr. Link asked panelists to think about the last decade and how many product launches their company did that were sourced internally and how many were sourced externally. Mr. Frinzi said that over the past 10 years, Johnson & Johnson Vision has had 58 product launches, 70% of those internal and 30% external. Shire, Mr. Dempsey said, is in a bit of a different situation, and over the last 5 years has had one prod- uct launch, which was an external acquisition. They had to launch the franchise, he said. This goes back to the relationship industry has with ophthalmology and the receptivity toma. Retinoblastoma is the most common eye cancer in children, he said, and when left untreated, it is universally fatal. However, when treated, survival rates in the U.S. are greater than 95%. Dr. Daniels noted that retinoblastoma affects both eyes about half the time. Many eyes are saved with IV chemotherapy; however, IV che- mo has poor rates of globe salvage success for more advanced disease. There are also side effects, including immunosuppression, transfusions, hair loss, and more. Intra-arterial chemo is an alternative option, Dr. Daniels said, which helps to avoid some of the side effects related to IV chemo. However, this method has its own problems, as melphalan, which is used in intra-arterial che- mo, is toxic to the retina. So even though the eye can be saved, the patient could still lose vision. Dr. Daniels spoke about his research efforts to find drugs that are just as effective as melphalan but that can also save sight. This involves targeting specific tumor pathways. He mentioned research with a small animal model in rabbits of intra-arterial therapy. He said that research so far has been successful, with multiple classes of drugs that appear promising. Utilizing eye-targeted therapies increases treatment success and reduces systemic complications, Dr. Daniels said. He noted the forma- tion of the treatment model, the tumor model, and the assessment platforms to develop and test new drugs in vivo. He has also identified a new class of targeted therapeutics with high efficacy and low toxicity. Building a strong pipeline through acquisitions and innovation A panel moderated by William Link, PhD, San Francisco, focused doctor and the practice staff. But if it could be done at another office or at home, it could be an opportunity to expand the product's scope. You also have to think about "how much," Dr. Roberts said. Is it something that is going to cost the doctor money or increase the cost of medical care? If it increases the cost of medical care, it could be a harder value proposition, he said. During the panel, Mr. Speares also commented on collaboration between industry and practitioners. He noted that there's often foun- dational knowledge built along the way that can be leveraged when launching a new technology. But sometimes, there's still a gap in insti- tutional knowledge. Mr. Speares said that to address this, there needs to be a "more holistic type event" to help further understanding as commercial enti- ties launch new technologies. In addition, he suggested collab- oration among associations. Even in areas that may not seem related, you have to recognize that there cannot be enough education and informa- tion as technologies are launched, Mr. Speares said. Blindness prevention research A session focused on Research to Prevent Blindness, with Brian Ho- fland, PhD, president of Research to Prevent Blindness (New York), speaking about some of its efforts to preserve and restore vision by supporting research to develop treatments, preventives, and cures for all sight-threatening conditions. Founded in 1960 by Jules Stein, the organization today focuses on early stage research and supports early career researchers. Also during this showcase, sev- eral presenters shared their current research. Anthony Daniels, MD, Nashville, Tennessee, highlighted his research in curing retinoblas- View videos from the OIS@AAO: EWrePlay.org Yari Mitchell discusses the IC-8 small aperture IOL.

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