Always Wanted to Be a Doctor

Desmond-Hellmann didn't set out to be an oncologist. But, growing up in Reno, Nevada, she did know she wanted to be a doctor. Her father co-owned the local Keystone Owl Rexall drugstore, and her mother was an English teacher. Desmond-Hellmann and her six siblings were brought up to value education. "There was a lot of emphasis on being a good student, on studying, and discussion about science and about medicine," she says. "When I was growing up, I was very much the nerdy student. I admired people who were smart."

Working as a bookeeper at the pharmacy, she listened to her father talk with patients about their illnesses. She and her brothers and sisters were also inspired by their physician and family friend, Dr. Smirnoff. (Today, he's 101.) The early influences took root. Four of the seven children now work in health or science.

She planned to work in sports medicine, but something clicked the first time she went to the cancer wards of the Veterans Administration Hospital. "My first rotation was with an oncologist, Dr. Stephen Hall," she recalls. "He was such a good doctor—and the patients had such difficult medical problems. It was just a one-month rotation, but it was the first time I was in the hospital as a medical student, and I was inspired to try to do something. After that, I switched to focusing more on internal medicine, and then oncology."

By 1982, she had begun an oncology residency at the University of California, San Francisco, where she met her husband, Nicholas Hellmann, a fellow resident who was treating patients in the new and terrifying AIDS epidemic. She took a master's in public health at Berkeley, doing a research project on the epidemiology of patients with Kaposi's sarcoma, a disease that sits at the intersection of AIDS and cancer. In 1991, the Rockefeller Foundation invited the couple to conduct AIDS research and teach at Makerere University in Kampala, Uganda.

"Taking care of patients in the beginning of the epidemic, I felt so overwhelmed with the sense that young people were dying and there was so little to do," says Desmond-Hellmann, who watched medicine transform AIDS into a chronic managable condition. "That challenges us working in other fields to ask, 'How could it work for us? How can we have the kind of molecular breakthroughs that were seen in HIV?'"

The couple returned to the United States in 1993 as changed people, and settled into private practice in Lexington, Kentucky, where Nicholas grew up. Desmond-Hellmann was working in a two-person oncology practice, and her husband was one of the few doctors that treated AIDS patients in the region.

"It was a difficult time," says Desmond-Hellmann. "There weren't as many therapies to treat patients with HIV and AIDS. My husband and I would commiserate about the conversations that no physician wants to have with a patient—about their impending demise or their suffering or their pain." She pauses. "Fifteen years later, oncologists still have those conversations."

Within a few years, Desmond-Hellmann was ready to try something new. It was hard to keep working when so many conversations with patients ended, she remembers, with "I'm sorry, we don't have anything else to try."

So when Bristol-Myers Squibb called her husband in 1993 to work in its HIV division, she went along and became the project team leader of Taxol (paclitaxel). Her mother, Jennie, would later take the drug in her successful battle against breast cancer. Taxol became one of the biggest chemotherapy drugs ever developed for cancer. But even a blockbuster success could not quiet her misgivings about traditional chemotherapy.

Vision Finds a Home

"What's exciting to me about the future of cancer therapy is that some of the most feared side effects—hair loss, nausea and vomiting, bone marrow suppression—aren't part of the new targeted therapies," says Desmond-Hellmann. "That's good for patients."

It was a project related to side effects that brought Desmond-Hellmann to Genentech. It was 1995, and researchers at the company had just identified thrombopoietin as a key mediator in making platelets. The drug had an obvious potential use in cancer—treating chemotherapy-induced anemia. But Genentech had a series of disapointments over oncology drugs in the clinic, and was still very much focused on cardiovascular and growth hormone drugs.

"At the time, Genentech had no presence in oncology whatsoever and wasn't necessarily guaranteed to make inroads," says John Park, MD, who spent time as a visiting scientist at Genentech, but is currently an associate professor of medicine at the University of California at San Francisco, where Desmond-Hellmann still teaches epidemiology and statistics.

Just a few months after Desmond-Hellmann arrived, Arthur Levinson replaced Kirk Raab as CEO. Levinson, who had worked on the early research that would lead to understanding HER2 and launching Herceptin, reinvigorated the oncology program. He invested 50 percent of revenues into R&D, promoted Desmond-Hellmann to vice president of medical affairs, and less than two years later, to chief medical officer.

"When she became head of clinical affairs, the company kicked it up a notch further and made a full-court press toward oncology," says Park. "She really oriented the company toward thinking about the best ways to develop new drugs for oncology, and in some cases, somewhat creative ways."