On the Path Toward Targeted Therapies

Dr. Richard Van Etten has dedicated his career to discovering what prompts normal cells to become cancerous.

When Richard Van Etten was a sophomore at the Massachusetts Institute of Technology, a seemingly random event occurred that changed the course of his career. One October morning in 1975, American biologist David Baltimore—who was on the MIT faculty—won the Nobel Prize for his discovery of reverse transcriptase, an enzyme that tumor-causing viruses use to hijack the DNA in the cells of their hosts.

Instead of giving the planned lecture that morning, Van Etten’s biology instructor explained to her class what Baltimore had done and the significance of the discovery. Baltimore’s finding marked the start of a new era in cancer research because it gave scientists a tool to decipher the biological underpinnings of this dreaded scourge.

“I was hooked,” says Van Etten, who switched majors from physics to biology and is now the director of the UC Irvine Health Chao Family Comprehensive Cancer Center. A hematologist who specializes in blood cancers like leukemia, myeloma and lymphoma, Van Etten has dedicated his career to figuring out what prompts normal cells to become cancerous. His overall goal is to move beyond today’s blunt-force chemotherapies and devise targeted treatments that turn fatal illnesses into treatable conditions.

An Architect of Change

“Today’s new targeted therapies and immunotherapies are really amazing game changers because they can put people into remission,” he says. “But they all stemmed from basic research that took 20-odd years to bring forward.”

Van Etten was one of the architects of this sea change. After completing a combination MD and PhD program at Stanford University, he spent three years as a post-doctoral fellow in David Baltimore’s lab at MIT, which he recalls as “one of the most amazing and productive periods in my life.”

While there, he started researching a genetic abnormality that produced an aberrant protein. He and his colleagues published papers showing that when lab animals expressed this abnormal protein in their bone marrow cells, they got a disease similar to chronic myeloid leukemia (CML). “That was convincing evidence that this protein was the direct cause of this leukemia,” Van Etten recalls.

His research inspired experiments and the discovery of a compound that thwarted the action of the abnormal protein. That compound eventually became Gleevec, a miracle pill that transformed chronic myeloid leukemia into a controllable illness.

“Today’s new targeted therapies and immunotherapies are really amazing game changers because they can put people into remission.”

Virtually overnight, five-year survival rates jumped from about 30 percent to nearly 90 percent, as long as sufferers took daily doses of these pills. Introduced in 2001, this breakthrough drug helped pave the way for the targeted treatments of today. “This changed the whole paradigm of cancer medicine,” recalls Van Etten.

A World-Class Cancer Institution

In the years since, Van Etten has been at the forefront of high-profile research at Harvard and Tufts universities, searching for clues to the genetic basis for relapsing or hard-to-manage blood cancers. What prompted him to move from Boston to Orange County in October 2013 was the opportunity to direct a National Cancer Institute (NCI)-designated comprehensive cancer center. There are only 47 NCI-designated comprehensive cancer centers in the country, and each one has undergone a rigorous peer-reviewed process conducted by the NCI and the National Institutes of Health to earn its highest designation.

“It’s a very tough road to get that designation, and it’s a very big deal that is reserved for the crème de la crème,” says Van Etten. “I saw a huge upward potential for UC Irvine.”

He is steering the Chao Family Comprehensive Cancer Center into a world-class institution that serves the needs of Orange County’s economically and ethnically diverse community. Orange County has the biggest Vietnamese community outside of Vietnam and a large Hispanic population.

He ticks off areas of concern. “Female breast cancer is 25 to 30 percent higher than the national averages, and we don’t know why that is,” he says. “Melanoma incidence is almost twice that of other regions in California or elsewhere in the country. In the Asian community we see a lot of liver and stomach cancers, while in the Hispanic community there is a high incidence of cervical cancer.”

Van Etten hopes to meet those challenges with a broad research program to uncover why the rates of these cancers are so high and by recruiting the best and the brightest scientists from across the country. He’s in the process of fashioning one of the largest early-phase clinical research programs in Southern California so patients can have access to promising experimental medicines well before they become available elsewhere. And he’s emphasizing community-based prevention and screening programs that can catch cancers at their earliest and most treatable stages.

“I can see a clear way forward,” he says, “to making this the best cancer center in Southern California.”