Filling the gaps for daunting public health challenges

Physician scientist. Cancer doctor. Problem solver. Relationship builder. Servant leader.

Each phrase describes Dr. Ethan Dmitrovsky, director of the Frederick National Laboratory for Cancer Research (FNLCR) and president of Leidos Biomedical Research, Inc., which operates the laboratory for the National Cancer Institute (NCI).

But looking at these descriptions together paints a fascinating picture of a man well-suited to lead a national laboratory dedicated solely to biomedical research.

“Our mission is to do all that we can to combat three major public health challenges: first is cancer, the second is HIV/AIDS, and the third is emerging health challenges, like COVID-19,” Dmitrovsky explained. “We have been working in this sphere for 50 years with an admirable record of success.”

Dmitrovsky’s career prepared him to take the helm of FNLCR over four years ago. He began his oncology training at the NCI and just prior to joining FNLCR, he served as provost and executive vice president of the MD Anderson Cancer Center, a top-ranked cancer center in the United States.

With considerable experience working around the globe in challenging conditions, Dmitrovsky most recently led the FNLCR team through a global pandemic—COVID-19.

Not long after COVID-19 became part of the world’s vernacular, remdesivir became a source of hope to treat this frightening virus. The FNLCR team was asked to facilitate the first clinical trial for remdesivir at sites in America and internationally. In partnership with the National Institute of Allergy and Infectious Diseases (NIAID), the team completed a double-blind, placebo-controlled, randomized trial of remdesivir in over 1,000 patients in less than three months working with 70 institutions worldwide.

As a result, “remdesivir was the first drug approved by the FDA to combat COVID-19,” Dmitrovsky shared. “I’ve never in my career seen such a complex trial completed so quickly.”

The scientists at FNLCR and NIAID also helped determine when monoclonal antibodies are best suited to improve outcomes for COVID-19 sufferers.

Dmitrovsky commended Dr. Ligia Pinto’s leadership in launching the NCI Serological Sciences Network for COVID-19 (SeroNet) with the NCI and leaders in the extramural community. This multi-institution consortium is designed to study the immune response to COVID-19 and increase the nation’s antibody testing capacity. SeroNet serves as a great example of science serving the public interest. Simultaneously, it allows scientists to share their findings to rapidly move the field forward.

Bringing public health solutions to challenging environments around the world

The collaboration behind SeroNet is just one example Dmitrovsky cited of how the laboratory is advancing the public’s health.

“We fill the gap…we do work that could not readily be done in an academic sphere or biopharmaceutical company,” he explained.

The laboratory’s structure gives it a distinct ability to bring together local, national, and international organizations. This expertise is especially useful in militarily or politically unstable parts of the world.

For example, FNLCR successfully facilitated with NIAID and other partners a clinical trial in the Democratic Republic of the Congo that identified two drugs that markedly improved survival of Ebola patients.

FNLCR manufactured one of them for the NIAID trial. Both drugs were ultimately approved by the U.S. Food and Drug Administration (FDA).

“I find it incredibly rewarding to do work that could not otherwise be done as easily elsewhere,” Dmitrovsky highlighted.

Dmitrovsky’s passion for serving global communities began early in his career when he served as a medical volunteer in Thailand for the International Rescue Committee shortly after the end of the Vietnam War.

He was tasked to work in the Khao-I-Dang refugee camp, where “we took care of survivors of the Khmer Rouge regime and provided them emergency medical services. That camp was located three kilometers in from the Cambodian border, which was then militarily unstable due to clashes between the opposing Vietnamese and Thai forces,” he explained.

“It taught me a lot about conducting work in resource-constrained areas that I've sought to continue and build on throughout my career.”

From medical volunteer to published researcher

After volunteering overseas and completing his residency at New York Hospital and Memorial Sloan-Kettering Cancer Center, he joined NCI as a medical staff fellow. At the NCI he cared for cancer patients and worked in the laboratory studying oncogenes, or cancer-causing proteins, related to leukemia. He discovered that introducing a certain oncogene to leukemic cells could prevent them from differentiating, thus promoting their malignant behavior. This discovery was published in Nature, which helped launch his career.

“Here’s the backstory,” he added with a smile. “I was never told until I published this work in the journal Nature that all other postdoctoral fellows before me were offered this project but declined to take it on because they thought it was too risky. But then I hadn’t enough research experience to know this. So I took it on without knowing it was risky.”

Dmitrovsky’s first faculty position was at Memorial Sloan Kettering Cancer Center, where he focused on developing differentiation therapy with retinoic acid to treat a rare form of human leukemia called acute promyelocytic leukemia, or APL.

This treatment received FDA approval, and now over 90% of the people afflicted with APL are cured with retinoic acid-based therapy. Dmitrovsky published the first American trial with retinoic acid for APL in the New England Journal of Medicine. When he began this research, only 20-25% of people afflicted could be cured. With Dr. Ronald Evans at the Salk Institute, he went on to clone the genetic cause of APL and published that work in the journal Cell. Dmitrovsky patented and published in the Proceedings of the National Academy of Sciences the companion diagnostic test for APL.

Today, Dmitrovsky has shifted his research focus to lung cancer—the most common cause of cancer deaths for both men and women—and wants to see what targeted therapies can be developed at FNLCR to combat this public health threat.

Dmitrovsky shared more examples of the groundbreaking contributions that FNLCR made to science and public health, including helping to secure the nation’s blood supply against HIV contamination early in the epidemic and a multinational, Zika vaccine trial to prevent the infection that causes severe birth defects in children.

“We have a substantial record of accomplishment,” he noted. “So that is why I came here—to do work like this to improve the public’s health.”

As inspired as he is by the Frederick National Laboratory’s mission, it’s hard not to consider Dmitrovsky himself an inspirational example to the next generation of scientists.

“What I would say to a young scientist in training is follow what is your passion, follow an idea until it doesn’t make sense to follow it,” he advised. “Follow what drives you, but don’t be afraid to take an informed risk.”

Excellent advice and a sound reminder of the value of science that can lead to life-changing–and life-saving–discoveries.