Rita Lawrence was running out of options. It was 1988 and the 38-year-old, who had been diagnosed with lymphoma four years before, had endured multiple rounds of chemotherapy so grueling she thought it might kill her before the disease did. Now, after only two years of remission, the cancer was back ― and the treatment she was getting at home in Illinois couldn’t keep up with her swiftly growing tumors.
When she learned about a clinical trial in Seattle that she thought might offer hope, she made the hard choice to leave her husband and two children at home while she put her life on hold to be the fifth patient on the trial.
She knew that the treatment she’d be receiving ― a type of cancer-targeting radiation called radioimmunotherapy ― was highly experimental. But she was confident it was going to work ― partly because of her spiritual faith, but also because the doctor who’d be guiding her treatment was unlike any other doctor she had ever met.
His name: Dr. Oliver Press.
Then, Press was a young physician-scientist ― like Lawrence, in his 30s with two kids at home ― who had already gained a reputation among the senior faculty at Fred Hutchinson Cancer Research Center for his quick mind and determination in overcoming obstacles. For Lawrence, the young doctor “had a way about him,” she remembers, that made her feel like he truly understood what she was going through.
Today, Press is internationally known for his expertise in lymphoma and other blood cancers, so widely respected that patients clamor to be seen by him, early career scientists compete for his mentorship, and his word is so trusted that a recommendation from him once got one of his trainees an offer for a job she didn’t even apply for.
In January, Press took medical leave from faculty positions at Fred Hutch and the University of Washington to focus on his own health after he was diagnosed with a brain tumor in 2015.
“I look at myself like I look at my patients. I think I’m very realistic about it, treating myself the same, and thinking about myself the same, and realizing I have the same limitations,” Press said. “It gives me a little more, I think, insight and perspective into how it really feels [to have cancer].”
Press, now 64, has played a pivotal role in the development of targeted cancer therapies, particularly radioimmunotherapies like the one Lawrence received under his care 30 years ago. Those who know him best say he’s a tireless worker and transparent leader with high expectations (particularly for himself). At the same time, they say, he is also a down-to-earth guy who makes jokes at his own expense and radiates joy when he spots a favorite orchid in the woods.
For all his reputation today as a skilled physician, Press didn’t originally set out to be a doctor, let alone a blood cancer specialist. His first love was lizards, and fish, and frogs, and, in fact, anything he could catch in the parks around his boyhood home in St. Louis.
“I was a total curiosity to [my parents],” said Press, grinning at the memory of the creatures he would house in shoeboxes in his bedroom whenever he had the chance.
Press would have been just as happy a biologist as he is a cancer doctor, he said. In college, he chose a medical career path, partly influenced by the draft deferment offered to medical school students during the Vietnam War, but also because he saw medicine as a way to apply his love of biology to helping people.
“To me, it’s seamless. I think most people see people” ― he gestured to his left ― “and animals” ― he gestured to his right ― “To me, it’s a continuum.”
Press spoke about his life and career as he sat in the Fred Hutch office of his wife, Nancy, filled with pictures of their family of four. Nancy Press, a medical librarian by profession, is the Press Lab’s research administrator, a relatively recent role that formalizes the couple’s decades of unofficial collaboration behind the scenes.
They met as college students in a study-abroad program in Germany and got married eight years later, the day after Press’ M.D./Ph.D. graduation, in June 1979. (Press’ graduate adviser forbade his students from marrying any earlier.) By then, Nancy had steered her career toward medical librarianship as a complement to his once it had become clear that their lives would be intertwined.
“We were in this together,” Nancy said. At 18, she flushed marrow out of mouse bones for his Ph.D. research. Later, she painstakingly programmed a computerized catalogue of his publications with the punch-card technology of the day. Throughout the years, she’s edited his grant applications, helped him search the scientific literature, and assisted in countless other ways even as she pursued her own career at other organizations.
“My wife deserves at least half the credit for staying with me and dealing with my fanaticism,” Press said.
Across the hall from Nancy Press’ office is Press’ own. Besides the medical textbooks and piles of papers that are common in scientist workspaces throughout the Hutch, his features his tank of Korean fire-bellied toads, $4 each at the pet shop but so beloved to him that he once spent $1,000 on a last-ditch surgery to try to save the life of one of his favorites.
That relentless effort to help others, whether creature or human, is innate in him, say those who know him.
“He cared about the patients,” said Lawrence, the woman with lymphoma Press treated in the 1980s. “I wasn’t just a number to him. And I think he’s probably like that with a lot of people ― I think that’s just who he is.”
One of the shelves in Press’ office holds a Christmas card from Lawrence and her husband, now grandparents of five living in Arizona. The couple has sent yearly cards to Press’ family ever since that early radioimmunotherapy trial, which ― unknown to Press at the time ― would be the fuse that launched his career.
In radioimmunotherapy, a radioactive isotope is glued to a cancer-targeting antibody ― precision molecules produced by immune cells that have been enlisted in many contemporary cancer therapies. When a radioimmunotherapy is infused into a patient, the antibody finds its way to cancer cells, delivering its radiation payload straight to its target, while sparing the many healthy cells that fall victim to traditional, less-targeted radiation therapies.
That trial was supposed to be a starting point, something the team could build on for the future. So when the results started rolling in ― huge, widespread tumors that disappeared from scans just a week after an infusion of the experimental therapy ― “it was astonishing,” Press said.
Lawrence was one of the 84 percent of 19 participants whose cancers went into complete remission on the trial. She was also among the subset of those whose cancers never came back. “I’m just very grateful I got the chance to do this,” she said.
That trial was only the beginning of what became Press’ career-long dedication to developing radioimmunotherapy for cancer. Hundreds of patients, Press estimates, have now received radioimmunotherapy products created in his research labs, and the trial Lawrence participated in helped pave the way for the FDA’s approval, years later, of the strategy in treating cancer. In fact, trials Press has led of high-dose radioimmunotherapy in conjunction with blood stem cell transplant have demonstrated some of the best long-term outcomes ever seen in certain kinds of blood cancers.
Over the decades, Press’ team has worked on ways to make radioimmunotherapy more effective, even more targeted and, he hopes, easier to use. (To Press’ frustration, the strategy so far has had limited use outside of the specialized academic centers that have radiation-safe facilities and experts trained in the drugs’ use. “It scares people away,” Press said. “People do the [therapy] that’s easy, that only lasts a year or two, rather than doing stuff that lasts 30 years. That’s been a little maddening.”)
Press has also made fundamental contributions to other kinds of targeted therapies for blood cancers, such as genetically engineered, cancer-killing immune cells called CAR T cells, a headline-grabbing strategy still in development by researchers at Fred Hutch and around the country.
“He’s a pioneer in those areas. He was working with antibodies back in a time when antibodies weren’t big business, and with CAR T cells when they weren’t the most promising thing ― they were kind of a pie in the sky, or at least that’s what people thought,” said Fred Hutch colleague Dr. David Maloney, who has also played a major role in the development of these therapeutic strategies.
Press sees much of his work as the “base of the pyramid” for today’s cancer immunotherapies, and he’s proud of what he’s done to help push the field of cancer therapy forward.
For example, in 1987, Press and colleagues published the very first trial of an antibody specifically targeting a molecule called CD20 on B cells as a treatment for patients with lymphoma. This trial, said Maloney, demonstrated that it was safe to target CD20-positive cells with an antibody, an important foundation for the trials that Maloney later led of the anti-CD20 antibody drug rituximab, now a mainstay of treatment for certain blood cancers.
Press’ research spans the lab and the clinic, from tests of new therapeutic strategies in petri dishes to clinical trials in patients, and he has led the development of multi-institutional cooperative trials that have changed standards of care for cancer.
It’s unusual for a researcher to make such a powerful impact over the entire bench-to-bedside spectrum, let alone have the reputation Press does as a physician as well, said Dr. Steve Forman, an internationally known blood cancer expert at the City of Hope cancer center in California who has known Press for years.
“There are very few people that can say they’ve made major lab-based contributions and clinical contributions in part derived from their work, and Ollie is really the poster child for doing that,” Forman said.
If you’d come into the Hutch’s clinical research building any given Saturday morning through much of his career, you’d likely find Press in his office, working. His family knew they could always expect him home for dinner, but that he’d often head back into the office afterwards, where he’d sometimes stay until the wee hours, frequently sleeping less than six hours before getting up again. A favorite story among his colleagues concerns an incident nine years ago, when he suffered a dangerous blood clot in an artery of his lung while working late one night on a grant application. After getting himself to the hospital, he sat on a gurney in the ER with his laptop and kept working.
For more than three years, through November of 2016, Press served as the Hutch’s acting senior vice president and the acting director of the Hutch’s Clinical Research Division, the institution’s largest scientific division. When Hutch leaders asked him to take on that role they didn’t expect for the temporary position to last nearly as long as it did. Yet, Press plowed ahead with its responsibilities until a permanent head was found ― even when he was diagnosed with cancer ― while maintaining all his other responsibilities as a researcher and physician.
Despite everything else on his plate, for his entire career, he has continued to go into the clinic, two days a week at least, and see patients. In fact, after he had brain surgery one Friday in October 2015 ― after being diagnosed with a grade 3 glioma just four days earlier ― he was back in the clinic on Monday with his patients.
Press said it fulfills him to see how his patients are doing, even years after their treatment, understanding what problems crop up for them and offering them new experimental therapies he was developing, when appropriate.
They've also become his friends: Patients and former patients often take him out to lunch, they introduce him to their families, they keep up with him over the years. (Press also holds the first David and Patricia Giuliani/Oliver Press Endowed Chair in Cancer Research, bestowed on him and named in his honor by a patient and her husband, who are also friends.) And for him, those friendships, and the continuity of caring for people over the course of years, is one of the most rewarding things about his job, he said.
Both Lawrence and Andy Firpo, another former patient and a Hutch employee, say that they might never have guessed how busy Press was: When he was in the exam room with them, he talked with them and answered all their questions as if he had all the time in the world.
“He cares. And that really comes through,” said Firpo, a survivor of Burkitt lymphoma. “He listened to me. And knowing all the things, on paper, that Ollie was responsible for when he was head of the Clinical Research Division ― I have no idea of the other 50 bazillion things on his mind ― but none of that came through. He was focused on me. I appreciated that.”
Press prides himself on the attention he provides to patients, and for the better-than-average outcomes he can help them achieve by keeping his focus on the ultimate goal ― a long, cancer-free life ― throughout all the rough side effects of an aggressive treatment. Half of Press’ patients last year he’d had for at least 15 years, many of them in continuous remission.
“I should probably turn some of the patients loose, because they’re cured,” he said with a shrug, “but both for me and for the patients, it’s been rewarding to see the continuing benefit.”
In the evenings, Ollie and Nancy Press pour themselves glasses of wine and stroll through their garden, their hands automatically slipping together. In the dark Seattle winters, the two wear headlamps as they walk, trailed by their cats. They always take the same path.
They talk about their family, their days, their work, the plants. A big Douglas fir, right on the property line, is one of Press’ favorites. His neighbors wanted to cut it down, but he saved it by promising them he’d take responsibility for it.
Throughout their life together, Nancy has shared closely in her husband’s joys and frustrations, and she has seen his worries firsthand. Sometimes, worries keep Press up at night. And, invariably, she said, he’s worrying about the people for whom he feels responsible ― especially the next generation.
Press has been widely recognized for his mentorship of early career scientists and doctors. He received a 2016 Mentorship Award from the UW Department of Medicine, and in February, Fred Hutch unveiled the “Oliver ‘Ollie’ W. Press Award for Extraordinary Mentorship,” which was created by Press’ colleagues to honor his impact on patients and on cancer research.
“The young people are the future,” Press said. “My day is over. To continue with success, you need young people who are bright and motivated and dedicated.”
Over the course of his career, he has mentored more than 70 people at all stages of their careers. For 15 years, he also was associate director of the University’s M.D./Ph.D. training program, which he once graduated from himself, and, since 2014, he has led the University of Washington/Fred Hutch Cancer Consortium’s training program for new oncologists (of which he was also a product).
The magnitude of his impact is apparent in the superlatives former mentees use to describe his influence: “He has transformed my life,” said one former mentee, Hutch faculty member Dr. Damian Green. Choosing to work with him “is probably the best decision I’ve ever made in my life,” said Dr. Elizabeth Budde, now at City of Hope.
He taught them how to choose a research project, how to write grants, how to approach patient care. But has also taught them the importance of balance in life, by modeling it in his own. When his son Michael played soccer and rugby in college, Press would often fly down to L.A. for home games ― working on the plane, meeting his son for lunch, cheering enthusiastically on the sidelines during the game, and then catching up on work while flying home. His mentees’ family became his, too, and Green remembers fondly the time that Press set Green’s daughters up with everything they needed to rear their very own fire-bellied toads.
The Presses are empty-nesters now, other than their cats. Their two sons are grown and moved away ― Maximilian, now 30, is a geneticist at UW, and Michael, now 33, is a lawyer in Boston. Looking back, the two men can trace their dad’s influence on who they are today.
Their love today of the outdoors was nurtured by their father on family trips to the San Juan Islands, fishing trips and walks in the woods, said his two sons. Day to day, he always expected them to be diligent at their schoolwork, and as teenagers, that sometimes became a point of conflict. They both remember draft essays for school that would come back from their father marked up from top to bottom. (For fun, they sometimes needled him with purposefully incorrect grammar, one of his pet peeves.) Nevertheless, when Michael was staying up late to do an assignment that was due the next day, he knew he could wake up his dad at 2 a.m. to read through the draft and give his critique ― even if his father knew many of his edits would be ignored, again.
“He was the perfect dad for me … There were times where it didn’t feel that way at the time, but looking back now he was,” said Michael, who credits those high-school critiques, in part, for his skill in the daily writing his profession demands. “He was very consistent throughout the years about what he thought was important ― being a good person, a good student ― and through that everyday consistency, it was very powerful in terms of shaping how I made myself.”
Though Press has stepped away from his professional responsibilities for a time to focus on his own health, his influence echoes on through the next generation, say his colleagues.
“I think his biggest contribution is going to be his dedication as a mentor for trainees. I think the work he’s done has been very important but I think that the work that his trainees will do will magnify that and expand it,” said Dr. Fred Appelbaum, deputy director of Fred Hutch, a former mentor of Press’ and a long-time research collaborator.
In January, Press won a Fred Hutch award honoring his patient care. At the award ceremony, he made a surprise announcement that he was donating the prize’s cash award to Green, who is about to launch a trial of a next-generation version of the radioimmunotherapy approach that cured Lawrence three decades ago. The funds will serve as seed money toward the costs of developing and manufacturing the experimental therapy, which is not covered by Green’s grant funding.
In just months from now, Green anticipates, the trial will open.
Talk about this story on Facebook.
Susan Keown is an associate editor at Fred Hutchinson Cancer Research Center. She has written about health and research topics for a variety of research institutions, including the National Institutes of Health and the Centers for Disease Control and Prevention. Reach her at firstname.lastname@example.org or on Twitter @sejkeown.