Where did you grow up?
I was blessed to grow up in a small, oceanside town (San Juan de Marcona) in the southern part of Peru. It was an easygoing existence with no stress – that’s what happens when you live by the ocean, I guess. I was the youngest of seven children. My father worked for the Marcona Mining Company for many years, and my mother was at home taking care of all of us.
Did you always know you wanted to go into medicine?
I can trace that decision to one distinct memory: I was around 5 years old when I was burned by hot water on my face, arm, and leg. I was taken to the hospital and I stayed there for several weeks. I spent a lot of time talking with the doctors, nurses, and nurses’ assistants, and I started thinking, “This is cool.” That’s when my passion for medicine began.
When I was older, that interest continued to grow, helped by a visit from one of my uncles who was studying medicine. During his visit, he shared with me what he was studying and showed me some of his textbooks. That’s when I decided I wanted to be a physician.
What was your first job?
My first job was at Federico Villarreal Medical School in Lima, Peru, when I was a medical student in 1982. I was learning more about biochemistry and immunology, and Juan Falen, MD, PhD, a professor in the Department of Biochemistry asked me to help him in the department during my free hours. Initially it was unpaid, but they eventually gave me a stipend, so I must have done a good job.
I have had influential mentors at every step in my career, and Dr. Falen was the first. He was incredibly stringent, but also kind. And he really was responsible for sparking my love of science and immunology.
Did you ever consider pursuing another career besides medicine?
If I hadn’t gone to medical school, I would have liked to study economic policy and would probably have been an economist. They are two very different fields, but my twin interests have always been policy and medicine.
What advice do you offer young hematologists/oncologists?
First, I teach the “three Ps”: Passion, positivity, and persistence. Any success I have had is attributable to following those principles.
Second, I share something I learned from Robert C. Gallo, MD, the scientist who co-discovered HIV. When I was a junior scientist in Lima, he told me, “Broad base, big focus.” In other words, learn a lot. In my case, focus in cancer immunology. However, to make an impact in that area, I need to have a broad understanding of what is happening in the entire immunology field.
As a curious young scientist, it’s natural to want to do everything, but you need to focus on the area where you can advance the field, even marginally. And, as a leader, you need to strike a balance; you cannot kill innovation, but you want to guide scientists to their areas of strength.
Sometimes, of course, we can be biased. As we take on more leadership roles and become more senior, we may become dogmatic. Junior faculty might propose – in our opinions – crazy ideas. If the junior faculty is passionate, positive, and persistent, we can be proven wrong. As mentors, we can’t force them to change their passions or ignore their instincts.
I learned this early in my career when I was fortunate enough to work in the laboratory of
Diana M. Lopez, PhD, a professor of microbiology and immunology at the University of Miami in Florida. This was during the late 1980s, when she was one of only a handful of investigators who were working in the areas of immunology, immunotherapy, and cancer. The most exciting investigative work at that time seemed to be in the field of identifying oncogenes and tumor suppressor genes or studying signaling pathways. Now, of course, immunotherapy is a huge topic, but years ago, people were just starting to dream that, someday, cancer immunology would be an important element of cancer treatment.
Dr. Lopez, though, was persistent and positive – two qualities that I admired greatly. She said, “Cancer immunotherapy is going to make it big.” And, as we all know now, she was right.
How has the field of hematology changed since you were a young medical student in Peru?
It is night and day. When I started my career, we had limited treatment options for patients with hematologic malignancies, and our biggest questions were whether to start chemotherapy or palliative care. Fast-forward to 2017, and the knowledge of targeted therapy and immunotherapy has exploded to the point where we are within reach of cures for some of these cancers.
For example, the U.S. Food and Drug Administration recently approved antibodies against PD-1, an immune checkpoint molecule, as frontline therapy for patients with metastatic non-small cell lung cancer whose tumors express its ligand, PD-L1. If someone had told me 30 years ago that we would one day be able to treat lung cancer patients without chemotherapy, I would not have believed him. But it’s happening!
Another major shift in medicine is how quickly these advances and new knowledge spread globally. Ten or 20 years ago, immunotherapy may not have made it to medical students in Peru and other parts of the world as rapidly as it does now, but the interconnectivity we have today means knowledge is disseminated in the blink of an eye.
What accomplishments in your career are you most proud of?
I am incredibly proud of my initial contribution to the field of tumor immunology – or how cancer affects the body’s immune cells – that I made during my training with Hyam Levitsky, MD, and Drew M. Pardoll, MD, PhD, at Johns Hopkins University. While I was there, our research group was able to demonstrate that cancer cells have a strategy to avoid detection by the body’s immune system. This was pioneering work and, years later, we observed the interaction between tumors and T cells and identified the mechanisms behind this interaction. This helped research groups, including ours, develop therapies to overcome the tumor cells’ evasive strategies. We were helping to define the experimental basis for what we now know as T-cell immunotherapy.
After completing my training at Johns Hopkins in 1999, I moved to the Moffitt Cancer Center in Tampa, Florida, which was a small center at the time. Now it has grown to be one of the largest cancer centers in the nation. Joining Moffitt after training at a large institution like Johns Hopkins was certainly a transition. People at the time might have said, “Why would you go? You should stay in a big place. Moving to a smaller center is too high-risk.” My thought was, “It’s high-risk, but high-reward. If I can help to make Moffitt a better institution, then that is what I am going to do.” I was proud to be a part of the team that helped build Moffitt, and we could not have done that without the leadership of William S. Dalton, MD, PhD, who was the chief executive officer for more than 10 years. Bill taught me about being humble and having big ideas, as well as the drive to follow those big ideas.
I very much enjoy being part of a team and building on others’ discoveries and contributions. As a junior scientist, it was great to be part of a big team; now, as director of a cancer center, I enjoy helping those junior faculty work through their ideas. Our young faculty have so much energy and are brimming with ideas – they want to conquer the world! I was in their shoes many years ago and now I am happy to be able to support them in the fight against cancer.
What is one thing people would be surprised to learn about you?
People might be surprised to learn that I was shy growing up. I didn’t want to ask questions; I preferred to just listen. Now I think that people would say I’m engaging, so I don’t know what happened. I would still say that I enjoy being a supporting actor rather than the star. It’s interesting though, because life has tended to push me in the direction of taking more of a central role. However, what I enjoy most about being the director of a cancer center is putting people together to attack a problem, whether immunologists, engineers, clinicians, surgeons, social workers, computational scientists, or anthropologists – anyone who can help.
What do you do in your off hours?
Like I mentioned earlier, my interest in politics and policy has never left me. And, I have recently become a wine collector. I was introduced to wine collecting when I was at Moffitt, where several faculty were already in the habit of collecting wines. Then that interest turned into taking trips with my wife, Maria, to Napa Valley and buying wines to enjoy with friends and family. That passion has now extended to food. When Maria and I travel, we enjoy seeking out new restaurants.
We have been married for 27 years. We met in medical school in Lima and she is now a dermatologist practicing at GWU. We have two children: Mariana, who works at NBC News here in Washington, DC, and Eduardo Jr., who is a sophomore at New York University. It is too early for him to decide what he wants to do, but he is interested in art business. I just want him to be passionate about whatever he does.
If you could have dinner with one person from history, who would it be?
I would love to speak with William Coley, a pioneer of cancer research and immunotherapy. In 1891, he produced the first cancer vaccine by injecting bacteria into a patient with a sarcoma tumor. He was so far ahead of his time, and his contemporaries might have rejected his ideas, but this marked the beginning of cancer immunotherapy.
I would love to show him how far the field of immunotherapy has come, to the point where we are now using immunotherapy to successfully treat several types of cancers. And I would love to know his thoughts after seeing his ideas becoming a reality almost 120 years later. It would be an incredible conversation.