New Post at MSK Offers Kantoff Another Platform for Leadership in GU Field

Philip W. Kantoff, MD

If he had to choose another career, Philip W. Kantoff, MD, said he’d really enjoy being in a classic rock band or playing professional basketball. “I love Led Zeppelin, the Grateful Dead, the Allman Brothers, AC/DC, Queen,” he said excitedly in a telephone interview. “I still go to concerts. One of the most fun things I ever did was when I took my son to London to see Eric Clapton at the Royal Albert Hall in London about three or four years ago.”

Leading and Pioneering

But Kantoff knows where his strongest talents lie. “I really enjoy music,” he said. “I play the piano— but with no proficiency. I also play basketball, tennis, and golf—again, with no proficiency. It’s a good thing I have my day job.”But musical skills aside, Kantoff has proved to be a rock star in that day job—as a giant in the field of prostate and genitourinary cancer research.

In November, Kantoff was named chairman of the Department of Medicine at Memorial Sloan Kettering Cancer Center (MSK) after nearly 30 years at the Dana-Farber Cancer Institute and Harvard Medical School.

“We are ecstatic to have been able to recruit Dr Kantoff to lead MSK’s already superb Department of Medicine,” said MSK’s Physician-in-Chief, Jose Baselga, MD, PhD, in announcing the appointment. “His astute leadership qualities and strong record of clinical and research experience will prove invaluable as we work together to usher this institution into the future and continue our tradition of excellence.”

Kantoff said he is excited about his appointment. “At MSK, we aspire to achieve a great blend of care and innovation. Our goal in the Department of Medicine is to deliver cutting edge patient-centric care, bring fundamental discoveries to the clinic to reduce the burden that cancer causes, and develop the next generation of leaders in the field of cancer medicine,” he said. Known for his work in identifying genetic markers of prostate cancer, Kantoff also has helped bring several prostate cancer drugs to the market, such as the chemotherapy mitoxantrone and the therapeutic vaccine sipuleucel-T.

At Dana-Farber, he served as director of the Lank Center for Genitourinary Oncology, chief of the Division of Solid Tumor Oncology, and the head of the prostate cancer program—all programs he developed from their infancy into the robust areas they are today, with about 20 physicians and scientists and many more postdoctorate candidates and fellows involved.

He also oversaw the prostate cancer SPORE (Specialized Program of Research Excellence), a multimillion dollar grant from the National Cancer Institute for the past 12 years that funds a number of different projects.

Such variety means Kantoff’s weeks are never dull. He typically spends about half his time on research activities, and divides the rest between administrative and clinical tasks. The time spent with patients, he said, is the most rewarding. Watching patients get well is “one of the great moments when you are an oncologist,” he said.

“Taking a very sick testicular cancer patient and curing them is one of the most remarkable feelings. It’s such a rewarding part of what we do.” Kantoff has also earned praise from others for his ability to teach and heal.

The Birth of a Molecular Biologist

“In addition to his brilliant research career, Phil embodies the finest attributes of a physician and mentor,” said Lee Marshall Nadler, MD, the dean for clinical and translational research at Harvard Medical School in Boston. “He also deeply cares about his colleagues, faculty, trainees, and staff. Everyone who works for Phil knows that he will treat them with respect, and remain loyal to them even when they leave his program. This has been true from the time he was a junior faculty member until today.”Kantoff’s interest in science and medicine sprouted as a child. He learned from his father, Sidney, who studied and taught entomology as a young adult before working in the clothing business, while living in Forest Hills, New York.

“My father had wanted to be a doctor but did not get a scholarship to go to medical school and as an orphan, couldn’t afford to go,” he said. “Instead, he studied insects, and spent a lot of time with me as a kid teaching me what he knew.”

Father and son pored over bug classifications, and soon, young Phil was hooked on molecular biology, reading books about early science and medicine such as Microbe Hunters and The Citadel. “These were fascinating accounts about people who moved from different fields like math or physics into biology and became early scientists who studied molecular biology, which led to the evolution revolution in biology.”

Growing up in the New York area, Kantoff also recalled a “fantastic, inspirational” seventh-grade biology teacher, Michael Krutoy, who inspired him to pursue a science career. He also spent a summer at the The Jackson Laboratory in Bar Harbor, Maine, studying mouse genetics, where Kantoff made an important decision. “That was the point where I said ‘This was for me. I want to be a scientist.’”

After high school, Kantoff attended Brown University for both college and medical school through a special 6-year program, and did his internship/ residency and chief residency in internal medicine at New York University/Bellevue Hospital.

Identifying a Passion

He focused on oncology because “it seemed to be the most molecularly approachable area when I entered the field 25 or so years ago,” he said. “I had wanted to apply molecular biological approaches to cancer, but it was very hard to do at the time. Not until the past 15 years has it been doable.”After medical school, Kantoff did a 4-year postdoctorate stint at the National Institutes of Health, researching gene therapy, and then joined Dana-Farber as a medical oncology fellow. While there, he saw an opening and went for it.

“Phil was a fellow when I was chief of medical oncology at Dana-Farber,” said George P. Canellos, MD, who is now the Institute Physician of Dana- Farber Cancer Institute and also the William Rosenberg Professor of Medicine at Harvard Medical School. “He did an excellent job as a fellow, but I thought he would return to the NIH where he previously worked on a new area of gene therapy. Instead, he shocked me by applying for an opening we had in the area of genitourinary oncology as the only staff member.”

Landing the job in 1988 set Kantoff on a new path. “I went into genitourinary oncology not because I was driven into that particular area of oncology, but mostly because there was an opportunity,” he said. “It was a great field for me to go into. On one hand, we have one disease, testicular cancer, where we cure people almost all the time. On the other hand, we also have prostate cancer, which has developed tremendously over my career, from a disease that no one was interested in to a disease that is very fascinating, both biologically and clinically. I’ve spent a lot of my career trying to understand the heterogeneity of the disease and develop better treatments.”

Prostate cancer has subtle issues of biology, heterogeneity, patient interaction, patient values, and psychology that Kantoff finds enthralling. “The whole mix makes the area a life’s work for me,” he said. “There’s so much to it—I enjoy studying the disease and taking care of patients. There’s so much there, and so much still that needs to be done.”

Kantoff’s devotion to growing the department and contributing to the research in the genitourinary field was notable. The department “started off with a bang, as there were much data on testicular cancer, which was a topic for compilation and investigation,” said Canellos. “The rest is history, as Phil slowly expanded the staff commensurate with the growth of the genitourinary patient volume. He was also successful in training and nurturing and expanding a set of experts in that field. His scientific experience allowed him to expand the scientific side of tumor biology related to genitourinary cancer.

“He began his career as a young man with great potential, which found a successful outlet at Dana-Farber Cancer Institute, and in the process contributed to its growth and distinction in the cancer research field,” Canellos added.

Growing and sustaining his relationships with others is, in fact, one of Kantoff’s guiding principles. “I try to create a work environment that’s respectful,” he said. “I’ve tried to create a horizontal environment here, where nurses, physicians, administrative assistants—everyone—feels part of the community and part of the mission. I’m very proud of that. And I’m very proud of the people I have trained through the years who have gone on to be outstanding clinicians and investigators here and elsewhere.”

These are attributes that Kantoff has tried to convey to his own children, who are in their 20s. He is the proud father of Aaron, who works in the venture capital field; Emily, who is studying to be a nurse practitioner; and Sydney, named in honor of Kantoff’s father and a student at Tulane University. And such traits have been lauded by others.

“Phil is more than a giant—he’s a gentle giant,” said Edward J. Benz, Jr, MD, president and CEO of the Dana-Farber Cancer Institute and the Richard and Susan Smith Professor of Medicine, Pediatrics, and Genetics at Harvard Medical School.

Transforming Cancer Treatment

“While it is true that his contributions to cancer and research are gigantic, it is who Phil is that makes him so special. He is caring and kind to his patients and their loved ones, supportive and loyal to those whom he leads, and a wonderful colleague, friend, leader and institutional citizen. He has built a world-class program for the care and study of genitourinary neoplasms, trained and mentored a generation of outstanding physicians, and scientists, and for thousands of patients, he has made their journey through cancer as good as it could possibly be.”Kantoff has witnessed many of the most significant changes in cancer treatment through the years. “When Gleevec was developed, it was a paradigm that we all felt was going to be the paradigm, that if we understand the genetics of a cancer, we’ll be able to cure cancer,” he said, referring to the drug approved by the FDA in 2001 for patients with chronic myeloid leukemia that was among the first molecularly targeted cancer therapies.

But that approach has been more difficult for solid tumors, both the ones Kantoff works with as well as solid tumors in general, he said. “While I still believe in genetics as a path to better treatments, I think immunotherapy is extremely promising as well. At the same time, focusing more on early detection and prevention for all cancers, but particularly prostate cancer, will also help reduce the number of patients with cancer,” he said.

It’s likely Kantoff will be on the forefront of such advances, or at least collaborate with others to help find new forms of treatment. “He has become one of a small group of international innovators in the study of genitourinary oncology and prostate cancer,” said Robert J. Mayer, MD, currently the faculty vice president for academic affairs at Dana-Farber Cancer Institute, and who served as the director of Kantoff’s medical oncology fellowship training program.

“He has the unique knack of being able to define the truly important research questions to ask and then bringing together colleagues from different disciplines to effectively address these challenging issues,” Mayer said.

In the future, Kantoff said he’d love to help patients live longer by using “multimodality therapy for early prostate cancer. I think within the next 5 to 10 years, we’ll be able to do it,” he said confidently. Most people who die from prostate cancer walk in the door with early disease, then die 10 to 15 years later. “There’s an opportunity there to use multimodality therapy to minimize the odds that people will relapse,” he said.

No matter what setbacks might occur, Kantoff said he’ll just keep looking forward. “I can’t remember not being knocked down,” he said.

“Whether it was patients who you take care of and become friends with, who pass away, and it drains the living soul out of you, or writing a paper or grant that gets rejected—just getting up and moving on and just saying OK.

“Defeat is part of this whole thing, but success is absolutely about being persistent,” he added. “The ability to keep on going, despite defeat, is part of the business of science and medicine. Anyone who tells you otherwise is deluding themselves.”