When I ask a new patient about expectations, they invariably say ‘quantity and quality,’ and I say as long as you keep up the fight, I’ll be there with you, because that’s my goal, too.
— Daniel D. Von Hoff, MD, FACP
Internationally renowned clinical investigator Daniel D. Von Hoff, MD, FACP, attended grade school in a one-room schoolhouse on the rural outskirts of Oshkosh, Wisconsin. Polio was a scourge at the time, and Dr. Von Hoff recalled lining up with his skittish classmates to get the newly developed Salk vaccine. “It had a lot of meaning for me because my friend had polio and was hospitalized in an iron lung. I visited him and even though I was in a strange environment, I remember thinking that the vaccine I’d been given prevented the same disease that had made my friend so sick. I had an inkling that medicine might be for me, and that some day there might be a lifesaving vaccine I could work on,” Dr. Von Hoff said.
Inspired by Dedicated Teachers
Dr. Von Hoff, who received ASCO’s 2010 David A. Karnofsky Memorial Award, credits the dedication of his early teachers for much of the academic fuel that launched his medical career. “The one-room schoolhouse experience was terrific; all the grades were taught within earshot of each other, so I could listen and learn the more advanced lessons,” Dr. Von Hoff said.
Dr. Von Hoff’s academic excellence continued, culminating in a full scholarship to highly regarded Carroll College (now Carroll University), which was known as a proving ground for students bent on medicine. “If you got through biology at Carroll, you had a good chance of getting into medical school. Being a small college, we had one-on-one access to professors who were unflinching in their standards, placing the highest value on rigorous research,” Dr. Von Hoff said.
On his advisor’s recommendation, Dr. Von Hoff decided to go to an out-of-state medical school. He applied to Columbia University College of Physicians and Surgeons, 1,000 miles away from home in the daunting big city. However, Dr. Von Hoff was president of his fraternity at Carroll, and a prior fraternity president who was also a Columbia alumnus offered Dr. Von Hoff a hand, helping out with the airfare, hotels, and even the interview process.
“Besides a few awkward moments over regional accents, being in New York City at Columbia was a rich learning experience. I studied alongside many of the medical luminaries of the day,” Dr. Von Hoff said. “I spent a lot of time with Houston Merritt, MD, the founding father of neurology; I followed him around like a puppy. He always pulled the diagnostic rabbit out of the hat, and by using the power of keen observation he saw what others didn’t. It was a great learning experience.”
A Stepping-stone into Oncology
Dr. Von Hoff did his internship at the University of California, San Francisco (UCSF), where his last name acted as a serendipitous stepping-stone into oncology. “UCSF had one of the nation’s first cancer units, called the Cancer Research Institute. Because my name began with a V, the cancer unit was my first rotation; nobody else wanted to go. We did UCSF’s first bone marrow transplant when I was an intern. I remember the patient very well—her name was Charlotte. Transplantation was in its infancy and I called the leader in the field, Dr. E. Donnall Thomas, for advice. He actually got on the phone to help me through some difficult issues, such as graft-vs-host disease. Dr. Thomas went on to win the Nobel Prize, but he was a doctor first, always willing to do anything that benefited the patient.”
Dr. Von Hoff liked all aspects of medicine—especially surgery, although he felt he didn’t have the requisite skills. It was a fellowship opportunity at the NIH, however, where he was fortunate to work with the giants in the emerging field of cancer research, that sealed the deal for his career path. “Dr. Vincent DeVita, my attending physician, was one of the best internists I’ve ever worked with. He told me to get patients feeling better so they can make clear decisions about their treatments,” Dr. Von Hoff said.
From NIH, Dr. Von Hoff was recruited to the University of Texas at San Antonio (UTSA) to launch a new therapy unit. “Once again,” he continued, “I was blessed with a great teacher, Charles A. Coltman, MD, a world-class oncologist and one of the country’s best clinical trialists. An ASCO Past President, Dr. Coltman also led the Southwest Oncology Group for many years. He, and many others at UTSA, inspired my clinical oncology career. I was at UTSA for 20 exciting years.”
Precision Medicine: The Next Step in Cancer Treatment
Then a telephone call from an old friend and mentor once again changed the course of Dr. Von Hoff’s career. “Sydney Salmon, MD, who was Director of the University of Arizona Cancer Center (UACC) called and immediately said, ‘Dan, I’ve got pancreatic cancer. Would you help keep my dream alive? I want you to come to Arizona and take over as the Cancer Center’s Director.’ Despite the hardships on my family, I told him that I would. My wife Ann was Syd’s friend also, and I credit her resolve and flexibility for helping make the hard transition that much easier,” Dr. Von Hoff said.
Despite early trepidation over the difficult administrative activities in his new role as Director, the experience was yet another rewarding stretch of road in Dr. Von Hoff’s oncology journey. “After almost 5 years at UACC, a patient of mine asked about the next step in cancer treatment. We spoke about starting a new research institute called Translational Genomics Research Institute (TGen), which I was planning to join in the capacity of Physician-in-Chief,” Dr. Von Hoff said. His current work at TGen focuses on “precision medicine,” which seeks to unearth new genetic markers and their corresponding targeted therapies for treating cancers.
“My goal is to develop therapies that best help the individual patient sitting in front of me,” Dr. Von Hoff said. To that end, Dr. Von Hoff and his team are currently investigating 26 new compounds in phase I trials.
No End in Sight
Asked if TGen is where he will hang his lab coat for the duration of his career, Dr. Von Hoff dismissed the idea of permanence when it comes to scientific exploration, preferring to let the work, such as his groundbreaking research in pancreatic cancer, guide his path. Despite much progress, cancer care is beset by relentless mortality issues, but Dr. Von Hoff remains eternally optimistic, focusing on one patient at a time.
“When I ask a new patient about expectations, they invariably say ‘quantity and quality,’ and I say as long as you keep up the fight, I’ll be there with you, because that’s my goal, too.”
What does Dr. Von Hoff—who stresses that he cannot “divorce” himself from patient care and research—do in his brief leisure time? “I have model trains, lots of them. In fact, two rooms in my house are full of trains,” Dr. Von Hoff said. ■
Disclosure: Dr. Von Hoff reported no potential conflicts of interest.