Chapter 02: Meeting Mary Lasker

Title

Chapter 02: Meeting Mary Lasker

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Publication Date

3-29-2006

City

Houston, Texas

Topics Covered

The Interview's Subject Story - Professional Path; Formative Experiences; The Researcher; Definitions, Explanations, Translations

Creative Commons License

Creative Commons Attribution-Noncommercial-No Derivative Works 3.0 License
This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 3.0 License.

Disciplines

History of Science, Technology, and Medicine | Oncology | Oral History

Transcript

Jordan Gutterman, MD:

OK. Well, let me give you a little history of that. Because Mary Lasker was really crucial there. So, I was doing exactly what I told you, and in 1973, J. Freireich and Evan Hersh told me that a woman was coming down here to visit MD Anderson by the name of Mary Lasker. Now I knew who she was, because Freireich had won the Lasker Award in 1972, and I knew about the Lasker Award. I still remember the day he got the phone call on -- what's today, I guess it would be fourth floor, I think it was the third floor, because my office was just down the hall from him when I heard the excitement in his office when he got the call in June. Late June of 1972. So I knew who she was.

Lesley W. Brunet:

Did you know who she was from even the '60s, because wasn't she in the heart cancer stroke?

Jordan Gutterman, MD:

Yeah, but I didn't know of her, I think, until -- I really didn't know -- I think I'd heard about it vaguely at Duke in training, but not much about it. But when I got here, I began to hear a little bit about this. And of course, when he won the award, that's when I really began to hear about it. But I still didn't know much about her. And then she was coming down to visit her good friend Michael DeBakey. And she was good friends with Lee Clark, because they had worked on the National Cancer Plan. Don't forget, the year I got here was when the National Cancer Plan went into action. And I will come back to all that later, because I had been in conversations with Mary about that. And she worked very closely with Lee Clark and Benno Schmidt and a few others.

Lesley W. Brunet:

Benno Schmidt?

Jordan Gutterman, MD:

Yeah. He was a big -- he was kind of the big benefactor of Sloan-Kettering. Benno Schmidt, Sr. I think he was an investment banker, if I'm not mistaken. But she worked very closely with Dr. Clark. To -- with the Nixon administration to get that thing through. And so, you know, I came here at a very propitious time, because the money for cancer research started on the upswing exactly the year I arrived. And so, Dr. Clark, it was from my recall and from what I was told, he selected eight people to meet with Mary Lasker, to give a five or ten minute brief summary of our work. And he picked what he thought were some of the visionaries of MD Anderson. For some reason, I don't recall Freireich being at that meeting. But Evan Hersh was there, and I was there.

Lesley W. Brunet:

Do you remember any of the other people?

Jordan Gutterman, MD:

I don't remember any of the others. And I don't know...

Lesley W. Brunet:

Let's see, 1975.

Jordan Gutterman, MD:

3. No, '73. This was '73.

Lesley W. Brunet:

'73.

Jordan Gutterman, MD:

I could go back and see if I have notes about that. One of the advantages of starting this, but it would be important to go back and see if I could remember.

Lesley W. Brunet:

It would be interesting to know.

Jordan Gutterman, MD:

Yeah, it would be really interesting.

Lesley W. Brunet:

It might be -- there may be something, a correspondence. I just don't remember offhand.

Jordan Gutterman, MD:

I don't think there was. I don't remember seeing it. But I don't know. Do we have access to Clark's records, or...

Lesley W. Brunet:

Well, we just sent them off to be duplicated. I have all of Clark's records. Everyone's records on microfiche.

Jordan Gutterman, MD:

Are they open?

Lesley W. Brunet:

We're just -- we're just about to formally open them, but I've been letting people use them with limitations. Depending on whether there's privacy, whether there's PHI and things like that.

Jordan Gutterman, MD:

Well, I still remember, we met in the conference room up there next to his office on the seventh floor, where Becker eventually took -- the big conference room over, the big table? And I remember she sat down on the -- as you're by the screen there, where the screen was, so she was down on the left side at the end, and Dr. Clark was there running the thing. So it was Dr. Clark. And I presented. And I presented the idea, and this is, I think, really, very, very important. Now what was different, what got her interested in talking to me, was that beyond chemotherapy -- and, by the way, just one year before, she had recognized 16 individuals in a very unusual Lasker Award, which, of course, I've been director now of those awards for several years, but she recognized, and we have a restriction of three. But she recognized, it was a special year, of 16 people who she considered -- who the jury considered, or the leadership at the time of Sidney Farber, 16 people who pioneered cancer chemotherapy.

Lesley W. Brunet:

I'm sorry, what did you say about Sidney Farber?

Jordan Gutterman, MD:

He was chairman of the Lasker jury at the time. And they recognized 16 people. Now Farber, if I -- I have to go back to verify this. Farber, I believe, had won previously a clinical award for methotrexate in acute leukemia. But this was the likes of Frei, Freireich, Pinkel, Gordon Zubrod, DeVita, Carbone, the list is there, I can get you the list. But anyway, 16 people were recognized, and of course, in part, I mean, clearly, I mean, I know how it runs when she was alive and afterwards, the jury is totally independent. But this had to be somewhat orchestrated, and it was probably in recognition of the fact that she got Congress to pass this plan to really rev up the money, and it was the whole idea of the Lasker Awards, in part not only is to recognize scientists, but to create public awareness of what's out there. Both for personal things -- hey, you can get chemotherapy for Hodgkin's now -- as well as for congressional support. We need more money. So, she used those -- I mean, the Lasker Awards, in part, was the publicity that surrounded them. So she came in that setting now down to MD Anderson in 1973, where chemotherapy was clearly in its plateau phase, in its -- you know, it was really the heart of it, because of the impact on childhood leukemia and Hodgkin's disease and so forth. And I presented a new idea, which I think she heard kind of for the first time, except for one person, and that was -- Edmund Klein was a winner. Issac Djerassi was a winner. Edmund Klein had done some immunotherapy of skin cancers. Not with BCG, but with other antigens that would react to the immune system. So she was not completely -- I mean, she was aware that the immune system -- and I'm going to come back to the fact the immune system is not the primary target of interferon. I thought it was at the time, but interferon wasn't discussed in '73. But I presented to her the ideas of Mattei, and of BCG, and there was a whole additional way of looking at cancer in addition -- I mean, you know, being a little redundant there. And that was immunotherapy. And we had data that the body does recognize AML cells as foreign, but not ALL. This is in paper. And then I presented some material with BCG both in early adults. And we had a paper in the New England Journal on that. I mean, that's a really major melanoma, and in acute myeloid leukemia. And to this day, I don't -- some of that was already published in both the New England Journal and Lancet, and to this day, I think BCG did clearly help patients with AML, prolonged their remission, and probably helped patients with early melanoma. I mean, Don Morton, who was at UCLA for many years, a surgeon, and now is at St. John's Hospital out there -- I think he's part of Irvine. Still, is using BCG with tumor vaccines 30 years later. He was kind of -- Don Morton's program, if you want to call it, was competition or parallel to what we were doing here. So I presented all of this material in a very brief way, and I remember her very well. She had a light powder blue suit on, and so forth and so on, and I was not intimidated by her, but I remember coming over -- she came up to me after the meeting and said to me in a very formal way, "Dr. Gutterman, I was very excited to hear about your work. I would like -- do you ever get to New York?" And I said, well, as a matter of fact, I've been invited -- because my work was starting to get some recognition. I've been invited, actually twice here in the next several months, one to give a talk at New York Hospital at Cornell, and then over at Sloan-Kettering. Lloyd Old has invited me and Bob Good had invited me over at Sloan-Kettering. She said please give me a call, I want to talk to you more about this work. And it was clear that I was singled out among this group. Of course, I was excited beyond get out.

Lesley W. Brunet:

You were the only one that she talked to personally?

Jordan Gutterman, MD:

Well, I think she was gracious to everybody, but -- and this created a bit of tension.

Lesley W. Brunet:

I could imagine.

Jordan Gutterman, MD:

With Evan Hersh particularly, because she didn't say anything much to him, she just was nice. But she say -- I mean, she came up -- she went over to the side of the room and said -- she didn't carry cards or anything like that. She just assumed...

Lesley W. Brunet:

That you'll know how to find her, right? I'm sure.

Jordan Gutterman, MD:

And she said just I want to talk to you more about your work and some other things. So I called her office and told her in early 1974, I believe this was -- and I could be wrong on this, we could try to verify this, this meeting occurred in the fall of 1973.

Lesley W. Brunet:

Oh, I'll try and find out.

Jordan Gutterman, MD:

But in early 1994, I gave this talk, and she came and sat right down in the first row of New York Hospital. And there she was. Plopped herself down, and I gave this talk on both tumor immunology and BCG. And again she came up to me and she said, you're coming back -- when are you coming to Sloan-Kettering? She says I'll be at the lecture, and why don't you come over to my apartment, and we'll have a -- we'll meet after the talk. So I returned to New York shortly thereafter, and this was kind of an early recruitment phase, which faded away when Bob Good got into all sorts of trouble after being on the cover of Time Magazine and they found out -- do you know that story?

Lesley W. Brunet:

No, I don't. And you mentioned another name besides Bob Good.

Jordan Gutterman, MD:

Lloyd Old. He was head of tumor immunology at -- and was quite an interesting -- that's another whole interesting story. He was very close to a woman named Helen Nauts, N-A-U-T-S. Helen's father was very famous, and to this day is well known among some people, his name was William Coley, C-O-L-E-Y. And he was a surgeon in New York, and in the late 1900s -- I'm sorry, late 1800s, early 1900s, we could verify the dates. Developed a thing called the Coley's Toxin. It was a mixture of bacteria, killed bacteria, where he vaccinated cancer patients.

Lesley W. Brunet:

What -- I never heard this one. When was this, late...

Jordan Gutterman, MD:

Oh yeah, this is really -- this was in the late 1800s, early 1900s. He was a surgeon. And it was a mixed bacterial toxin, basically. But -- it was Streptococcus and various bacteria. And he would immunize patients with different cancers. And he reported -- but it was very anecdotal, and that's why it was hard to accept it. He would report occasional remissions, because this comes back later on with the interleukin 2, which I never got into. I just -- the BCG was, in the sense, a part of this history, of activating the immune system, which myself -- and I'll come back to it later -- other than virus-associated cancers, I think that's not a direction that's going to pay off very much. I think, as a matter of fact, much later on, we'll talk about it. I think the work that I'm doing now clearly teaches me that the immune system is probably part of the whole problem of promoting cancer. But that's kind of a counter-intuitive and not a popular way of thinking about it. I think it's a mixed bag. I mean, I think some cancers do depend on a very vigorous immune system. We know that from transplant patients. And that had been known, that patients who get kidney transplants, for example, and are put on immunosuppressive therapy have certain cancers that have a higher instance. So, you can't generalize completely that the immune system is the cure-all and prevention for cancer. And you can't say that also that it's responsible for cancer. But there are certain cancers, particularly virus-associated ones like papilloma and a few others, EBV virus, where the immune system is important in defense against tumors. We know this from conditions like mononucleosis, which almost looks like a lymph cancer, and then it resolves due to the immune system. So, this idea of the immune system was very prevalent in the late '60s, particularly -- it was revived by Mattei's paper on BCG in the '70s. It was a major, major effort in activating the immune system. And it's had several ups and downs and the renaissance's back again with sophisticated vaccines, and some of that will work, but most of it won't, I think. But we can come back to that. So, Lloyd Old, an immunologist at Sloan-Kettering, was extremely passionate about this idea, about the immune system, because he had done studies with BCG in animals in the late '60s, about the same time Mattei was doing it, showing you can prevent cancers or get reduction of cancers. So he was excited about the work of Coley, which was, I think, done at Sloan-Kettering. But it was very, again, very anecdotal. It was very difficult to pin down, and because we've seen this, you know, almost a century later with interleukin 2, you occasionally get these really dramatic responses and nobody, to this day, really understands why. But it's not very common, it's not very consistent. Coley's daughter, Helen Nauts, took up the mantle and formed a foundation, I forget the name of it now. Could be the Coley -- well, I forget the name of it. I'm blanking. She died here a few years ago. And she went through every record of every patient that her father had treated, and she wrote many treatises. But they're all case reports. You know, 71-year old patient who had soft tissue sarcoma received the Coley's Toxin, you know, twice a week, da da da. And had a response. But it was all anecdotal. You had no denominator...

Lesley W. Brunet:

There's no comparison. No control or anything.

Jordan Gutterman, MD:

No, no. Nothing randomized, nothing -- you don't even have to be randomized, it was just impossible to say what the denominator was and so forth. But there's no doubt these things happen. And she compiled these in various reports. She was a lay person. Lloyd Old was very excited about this, and they became good friends, and she formed a foundation, and so when they started recruiting me in '74, they wanted me because I was really, along with Don Morton, a surgeon in UCLA, probably the only people really spearheading the use of so-called immunotherapy in cancer. I was pretty much of a loner along with Morton, and maybe a couple of others, but I was kind of leading the pack.

Lesley W. Brunet:

So you were recruited by Sloan-Kettering, or they started to, or...

Jordan Gutterman, MD:

Yeah, they started too. And Robert Good, I remember meeting with Robert Good up in the penthouse in '74. And that was going to happen. And Good himself was an immunologist. He was extremely interested in this. When this big controversy, this big thing happened with Summerlin -- do you know the Summerlin affair? Painting a mouse? He was interested in transplant -- I mean, in a way, Bob Good should have won a Nobel Prize, maybe twice. I mean, he really did the first bone marrow transplants, which eventually went to Thomas, which was well deserved, but -- and he won the Lasker Prize, and he was able to define that there were T cells and B cells. And what he was interested was transplantation, and he had this guy, Summerlin, a dermatologist from Louisiana, putting black skin on white mice and suppressing the immune system to get graft acceptance. And he would meet with these scientists early in the morning, when it was still dark out, up in the penthouse. And Summerlin came in one day with a cage of mice, white mice, which he said had accepted the graft based on the immunosuppressive types of therapy they were doing. But, in fact, it was all a hoax. He'd painted the white mice with black marking pen, and that got out -- I mean, I don't know who recognized it. Good had just been on the cover of Time Magazine. We can check that out. And when that broke, I mean, it was one of the first real -- you know, we know about these -- like the stem cell thing recently, these things happen. And this was big, big, big, because first of all, the last thing you want is to be on the cover of Time or Newsweek. Fortunately interferon, many years later, survived being on the cover of Time because it was a legitimate thing. But it was just a few months later. But Good was riding the crest of immunology, and Sloan-Kettering, clearly, was the place to be for tumor immunology and so forth. So I was very excited. But once that happened, it was chaos at Sloan-Kettering, and the whole thing fell apart as far as recruitment. I think eventually Paul Marks came in, but I think, I can't recall right now, there were some interim presidents after Good. I forget exactly how that happened.

Lesley W. Brunet:

And was there a reason that you were -- were you not happy here?

Jordan Gutterman, MD:

No. I was OK here. But it was exciting to be around Bob Good, who I thought was clearly going to -- I mean, he was a Nobel Laureate-type person. Lloyd Old was very enthusiastic and brilliant. And I just thought they had more of an infrastructure, of real, good, basic immunology, which they did. And so it wasn't being unhappy here. And I don't know if I would have accepted a position or not. I don't know what they would -- I was -- we never got down to offers. So.

Lesley W. Brunet:

Let me just pause here. END OF AUDIO FILE 3

Chapter 02: Meeting Mary Lasker

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