Overcoming Adversity and Achieving the American Dream in Cancer Care

A researcher at heart, Robert F. Ozols, MD, PhD, has been at the forefront of platinum chemotherapy development in advanced ovarian cancer for nearly the entirety of his career, establishing carboplatin plus paclitaxel as the gold standard regimen in this space. Ozols, who was named a 2023 Giant of Cancer Care inductee in the gynecologic cancer category, faced many significant obstacles on the path to success. Growing up as an immigrant undoubtedly shaped his path, instilling a drive to succeed, an appreciation for the opportunities he encountered, and a sense of humility regarding his own achievements.

“Here’s a guy who barely survived his family’s escape from communism, who went into the American education system barely knowing any English …He is now [a pioneer in his field],” said Ozols’ longtime friend and collaborator at the National Cancer Institute (NCI) and Fox Chase Cancer Center, Robert “Bob” C. Young, MD. “It’s a great story of the American dream.”

Ozols has served as a leader at both the National Cancer Institute (NCI) and Fox Chase Cancer Center. He has also received several commendations from the US Public Health Service for his work at the NCI and a myriad of awards for his work in developing the standard platinum chemotherapy regimen for ovarian cancer. These include the Bristol Myers-Squibb Award for Distinguished Achievement in Cancer Research in 2002, the International Gynecologic Cancer Society Award for Excellence in Gynecologic Oncology in 2010, and the American Society of Clinical Oncology Distinguished Achievement Award in 2012.

Life in Latvia

Ozols was born in the summer of 1944 in Latvia. “At that time, World War II was ending and the Russians were invading Latvia. We barely escaped. My mother was separated from the family when she went into labor as the Red Army advanced rapidly through the countryside. My father, with a few bottles of vodka as bribes and a great deal of luck, was able to rescue me and my mother and bring us to Riga, Latvia’s capital, which was better
defended,” said Ozols.

Ozols’ mother and father, a dentist and teacher, respectively knew that to stay in Latvia under Soviet occupation would mean complete loss of freedom and a high likelihood of deportation to Siberia. They made the decision to flee Latvia for Germany in the fall of 1944, when Ozols was only 3 months old. At the time, Nazi Germany was only a few months away from capitulation. His father had relatives in Western Germany, and the Ozols family managed to join them there. Consequently, the family found themselves under the control of the United States when the war ended. They spent the next 6 years in a crowded displaced persons’ camp not knowing when and where they could start to resume a more normal life.

The family immigrated to America in 1950, which came with its own set of hardships. Immigration laws at the time required sponsorship for all immigrants by an employer or relative. The Ozols’ journey was sponsored by a farm near Rochester, New York. Ozols’ father worked at the farm for 6 months before he was finally able to move his family to the city.

“It was a very difficult time for all of us, but the American people were incredibly hospitable and helped us. I remember the first Thanksgiving, [our neighbors brought] a big turkey to the door. Things like that, you remember.”

Although his parents were unable to continue their previous professional careers in America, Ozols said, they successfully raised 3 children and had a comfortable, happy life.

“[My parents] came [to America] with about $100 in their pocket, and [their kids] all wound up going to school, going to college, and having [successful] careers,” said Ozols. “My parents never [were able] to work the jobs they had in Latvia, and that was always a hardship for them, but we had to look forward. They loved America and the way that we were able to have a good life.”

Educational Journey

Ozols’ parents were highly educated and stressed the importance of hard work and education. Ozols said he and his siblings took this to heart.

After obtaining his bachelor’s degree in chemistry from the University of Rochester in 1966, Ozols was accepted into the university’s PhD program in biochemistry. Ozols enjoyed taking didactic courses alongside medical students and soon began to consider a career practicing medicine.

During medical rotations of his residency at Dartmouth Medical School, Ozols found great fulfillment in working with patients with cancer. At that time, the body of research in oncology was still relatively nascent and was brimming with potential opportunities and underinvestigated niches. By pursuing a career in oncology, Ozols combined his passions for both research and clinical practice.

“I knew I wanted to be in research, but I really enjoyed the work with cancer patients. I felt that the best way to think of combining a career in research and medicine would be in cancer. Things were taking off then in cancer research, so I thought, well, there’s an opportunity there to do both.”

While still attending medical school, Ozols applied for and was accepted into a fellowship program in the Medicine Branch of the National Cancer Institute (NCI)’s Public Health Service. Upon completion, Ozols became a senior investigator and attending physician in the NCI’s Medicine Branch.

It was there that he met and began working with Young, a 2021 Giant of Cancer Care inductee in gynecologic cancer, on clinical and laboratory studies. Young would serve as a mentor, collaborator, and friend to Ozols throughout their careers.

“It’s hard to overestimate the relationship we had and have,” Ozols said. “Back in 1976, when I first met him, I was just a clinical associate and Dr Young was chief of the Medicine Branch at the NCI. We continued to do the same work [together] throughout our careers, and we had an outstanding collaborative relationship.”

Initially, Ozols was focused in testicular cancer research and helped develop an aggressive 4-drug combination for patients with poor prognosis. After about 2 years, he shifted his focus to work in Young’s laboratory. They and their colleagues identified a severe dearth of national clinical trials within ovarian cancer and sought to bring structure to existing studies in this space through a more rational approach.

“At that point, ovarian cancer was usually treated by gynecologic oncologists,” Ozols said. They primarily used surgery and a couple of drugs like melphalan, but they did not routinely stage patients.”

Ozols and Young were inspired by the work of Lawrence H. Einhorn, MD, a 2013 Giant of Cancer Care recipient and professor at Indiana University School of Medicine. Einhorn’s demonstration of the curative effect of cisplatin on ovarian cancer germ cell tumors provided the basis for the team’s interest in developing more effective ovarian cancer treatments.

“When Dr Young and I began our collaborative studies, little was known about the biology and clinical behavior of epithelial ovarian cancer,” Ozols said. “I felt that the best way forward was to better understand biological mechanisms associated with oncogenesis, disease progression and spread, and sensitivity/resistance to chemotherapeutic agents.”

Together with his team, Ozols began conducting laboratory investigations into ovarian cancer.

“We [had a] 2-pronged approach,” Ozols explained. “First, [we began] to develop model systems of ovarian cancer so we could study the disease in the laboratory. At the same time, we started to develop clinical trials [using] some of the information we gained from the laboratory studies.”

Their work vastly improved the accuracy of surgical staging and subsequent identification of patients with advanced disease using laparoscopy.

In addition to staging advancements, the team established the first human ovarian cancer cell lines, which became a worldwide standard in ovarian cancer research. With the contributions of renowned researcher Thomas Hamilton, PhD, they also developed novel xenograft mice models of ovarian cancer. These tools were used to evaluate novel chemotherapy agents coming down the pike, including carboplatin and paclitaxel. The team began investigating these agents in combination in the late 1990s.

In 1984, Ozols was elected to the American Society of Clinical Investigation and was appointed head of the Experimental Therapeutics Section in the Medicine Branch at the NCI.

“The NCI was a spectacular place, and always has been a wonderful place to train and work,” he reflected. “It still continues to be one of the premier institutions in the world.”

The Move to Fox Chase

After 12 years at the NCI, Ozols changed things up. In 1988, Ozols accepted a position as chief of medical oncology at Fox Chase Cancer Center in Philadelphia, Pennsylvania.

Soon after he joined, Young accepted a role as the president and CEO of Fox Chase Cancer Center. Ozols saw this as an exciting opportunity to reunite with his friend and colleague and continue their collaborative relationship.

“Some people think that Bob Young got there first and recruited me, but it was quite the opposite,” Ozols added. “I got there, and I told all the people [about him]. They probably would have recruited him anyway, but I was eager to [work with him] on a team at Fox Chase.”

Once again, Ozols, Young and their colleagues set their sights on implementing large-scale research programs for ovarian cancer and building up one of the highest-ranking cancer programs in the country.

“They used to refer to us as ‘The Bobs,’” Young joked.

Overall, Ozols found Fox Chase to be an exciting and fulfilling place to work.

“Fox Chase was an excellent place. We were able to increase our research funding and develop the ovarian cancer [program]. There was no ovarian cancer program when we got there, and we made it into a very large-ranking cancer program.”

A Platinum Pioneer

With their prior experience in ovarian cancer research at the NCI, Young and Ozols quickly recognized the potential for using platinum compounds to treat patients with epithelial ovarian cancer (EOC). A prior Gynecologic Oncology Group trial had demonstrated the superior efficacy of cisplatin plus paclitaxel vs the previous standard of cisplatin plus cyclophosphamide in patients with advanced EOC, so Ozols and Young investigated the use of cisplatin-based regimens. Despite encouraging long-term efficacy, toxicity limitations led the 2 researchers to focus more
on carboplatin.

Their findings demonstrated carboplatin and paclitaxel could be combined at full therapeutic doses with area-under-the curve dosing.

These data supported the inception of a landmark phase 3 study demonstrating the efficacy and tolerability of paclitaxel and carboplatin for previously untreated patients with advanced ovarian cancer. The study, completed in 1999, revolutionized the treatment landscape in ovarian cancer by establishing this regimen as a new standard of care.

“Since 2003, there hasn’t been a better chemotherapy combination than paclitaxel and carboplatin, [although] we initially thought it was going to be better than it turned out to be.…It has become the standard against which new treatments are still being evaluated.”

Ozols spearheaded several other important research efforts in EOC at Fox Chase, including investigations of high-dose therapy with stem cell transplants, the intraperitoneal administration of anticancer agents, and other novel combinations. Ozols also improved the identification and scientific understanding of platinum resistance mechanisms and developed several strategies for overcoming such resistance.

“It was clear cut-what the problem was…the cells had a variety of ways to try to overcome chemotherapy effectiveness, and we were able to develop individual drugs and targets that looked promising.”

Yet this achievement was not without its challenges regarding practical application.

“It’s been a formidable task,” Ozols admitted. “We did perform some clinical trials, and the downside was that none of them ever turned out to be a way that we could reverse [immediate] platinum or [paclitaxel] resistance.”

He remains optimistic about the future of this research area.

“Some of the same issues still [exist with novel therapeutics], but we have a much better understanding of the plasticity of the genome and how we could perhaps attack it in the future.”

A Look Back at "The Bobs"

The partnership between Ozols and Young continued for the remainder of their careers, resulting in an incredibly deep and meaningful 35-year friendship that continues to bring them great joy and fulfillment.

"Many times, there are people who start to work together, mentors and their trainees, and then they split because jealousy develops. There never was any jealousy or animosity [between us]. It was just a really continuing collaboration for over 35 years.”

Young emphasized that Ozols is a paragon in his own right, and that his contributions to gynecologic oncology extend to his own skills as a mentor and leader in the field.

“On a personal level, having worked with him in many capacities for 30 years. He’s an extraordinary leader. He’s quiet, competent, never provocative, and always willing to collaborate.…It’s been a joy for me to work with him over the past couple of decades.”

The personal relationship has continued to flourish in their retirement, with both families attending each others children’s weddings and other major family events. Before Young moved to Ohio, the two would often meet for breakfast at an IHOP in Pennsylvania.

With both men now becoming Giants of Cancer Care, Ozols feels that his peers have truly recognized the importance of their relationship and their work together.

“This was a big award, and it spans everything we’ve done. It shows that the scientific community, our peers, recognize how important our work was and what was accomplished. And it was accomplished by both of us.”

“It’s been a real honor to work with him and it’s one of the relationships that I treasure immensely,” Ozols added.

Professional Retirement, Personal Reasons

Ozols retired after more than 2 decades at Fox Chase Cancer, though he served as chief clinical officer emeritus and professor emeritus at the institution from 2010 to 2013.

Ozols still resides in New Hope, Pennsylvania, with his wife, Jeanne. The two have always been supportive of each other’s endeavors, though their life together was not without hardship. In 1988, Jeanne experienced a critical traumatic brain injury while working as the director of Congressional, State and Local Affairs for Chief Justice Warren E. Burger when he was serving as Chairman of the Commission on the Bicentennial of the US Constitution. Brain surgery was life-saving but she was left with permanent disabilities and requires life-long treatment. Although it has been a long road to a partial recovery, Jeanne has worked hard to regain her mobility, showing incredible optimism and determination.

“She never returned to work, but is able to walk…swim, and travel with accommodation. She participates in all our family activities and has been an inspiration to our family and all who know her,” Ozols emphasized.

He and Jeanne enjoy spending time with their 3 children and 4 grandchildren. They often have all the family over to swim in the pool and play tennis. The family frequently vacations together and sports are always part of the trip.

Ozols, an avid golfer, plays at his local course several times a week and has been on golf outings to Ireland and Scotland, often with children and grandchildren. The family enjoys sport fishing for tuna and striped bass and Ozols have fly fished frequently with his son, Rob for trout in the West, and salmon in Alaska and Canada.

He is also an avid supporter of his 14-year-old grandson’s goal of becoming a professional soccer player, and attends many of the boys’ matches in the United States and abroad.

Ozols has been an avid outdoorsman since he was a child, and nature has always served as a source of calm and rejuvenation. He credits this passion to his grandparents, who were farmers in Latvia and maintained many gardens when they emigrated to America. Ozols now cultivates his own fruit and vegetable garden and donates the fresh produce to local food pantries. He is also raising several native tree species to promote biodiversity and restore the natural environment.

“There’s so much more to life. It’s digging in a garden planting stuff and watching these trees grow in the yard...watching the environment unfold in front of you slowly over the years. It’s sort of magical."

Between cruises in the Arctic, trips to Hawaii, and occasional golf journeys, he and Jeanne are extensive travelers. Together, they have traversed all 7 continents and visited all 7 wonders of the modern world.

“I did play hard and work hard. You must make time for significant enjoyment and vacation.…I work as hard as I can, but you have to recharge your batteries, and you really have to have fun.”

Ultimately, Ozols continues to express a great joy for life and a deep appreciation of the people, opportunities, and hard work that got him to where he is today.

“When I was a young kid [dealing with] hunger and hand-me-down clothes, I never dreamed that someday I could travel the world and have a car and all these things. I exceeded everything I thought I could have then.”