{"id":12640,"date":"2026-03-24T21:27:35","date_gmt":"2026-03-24T21:27:35","guid":{"rendered":"https:\/\/magazines.uthscsa.edu\/mission\/?p=12640"},"modified":"2026-04-06T20:53:03","modified_gmt":"2026-04-06T20:53:03","slug":"a-legacy-of-discovery","status":"publish","type":"post","link":"https:\/\/magazines.uthscsa.edu\/mission\/a-legacy-of-discovery\/","title":{"rendered":"A legacy of discovery"},"content":{"rendered":"

How a clinical trial patient helped reshape pancreatic cancer treatment<\/em><\/span><\/h4>\n

\u00a0<\/strong><\/p>\n

Content provided by Susan Anasagasti<\/strong><\/p>\n

Author’s note:<\/strong> At this year\u2019s Practical Applications of New Agents in Oncology conference, hosted by UT Health San Antonio\u2019s Mays Cancer Center, keynote speaker Daniel Von Hoff, MD, reflected on a breakthrough that began in San Antonio. <\/em><\/p>\n

 <\/p>\n

In the early 1990s at San Antonio\u2019s Audie L. Murphy Memorial Veterans\u2019 Hospital, a pancreatic cancer patient had somewhere to be.<\/p>\n

\u201cYou\u2019re late again, Dr. Von Hoff,\u201d the patient\u2019s wife told the young oncologist. \u201cI need to get my husband across the street to Kentucky Fried Chicken.\u201d<\/p>\n

Weeks earlier, he could barely eat. After enrolling in a phase 1 clinical trial, he had gained 15 pounds and was thinking about fried chicken \u2014 the first batch, hot from the fryer.<\/p>\n

For a patient with a disease that often steals appetite long before it claims life, the craving was striking.<\/p>\n

\u201cIf you listened to him, he was actually pain-free,\u201d said Daniel Von Hoff, MD, who led drug development at the Cancer Therapy & Research Center (CTRC), now the Mays Cancer Center.<\/p>\n

What he saw wasn\u2019t on a scan. It wasn\u2019t in the data. It was human.<\/p>\n

He pushed for a larger trial.<\/p>\n

\u201cYou expect us to spend $2 million on a phase 3 study based on one patient eating Kentucky Fried Chicken?\u201d an executive asked.<\/p>\n

\u201cYeah, that\u2019s about it,\u201d Von Hoff replied.<\/p>\n

They did.<\/p>\n

\"\"
Daruka Mahadevan, MD, PhD<\/figcaption><\/figure>\n

What began as a bedside observation led to a randomized study of 126 patients and, ultimately, the approval of gemcitabine, the first drug shown to extend survival and improve quality of life for patients with advanced pancreatic cancer.<\/p>\n

\u201cToday, that same philosophy \u2014 listening closely to patients, observing remarkable responses in a phase 1 trial and moving promising therapies quickly into phase 2 trials \u2014 continues to shape the work at UT Health San Antonio,\u201d said Daruka Mahadevan, MD, PhD<\/a>, director of the Institute for Drug Development at Mays Cancer Center.<\/p>\n

More than 25 years later, Von Hoff returned to San Antonio \u2014 not to a clinic, but to a meeting, where more than 200 oncologists and hematologists gathered to hear him speak.<\/p>\n

Leading a legacy of discovery<\/strong><\/span><\/h4>\n

\u201cIt\u2019s great to be back in San Antonio,\u201d Von Hoff said at the 2026 Practical Applications of New Agents in Oncology (PANAO) conference. \u201cMuch of the work that led to gemcitabine began here, with colleagues and collaborators in this room.\u201d<\/p>\n

In the audience, the next generation of drug developers sat, quietly listening. Von Hoff did not begin with statistics. He began with instruction.<\/p>\n

\u201cThe best translational investigators are those who really embrace patient care,\u201d he said. \u201cYou need to spend as much time as possible with patients and their families, because if you listen, they will teach you. It\u2019s not artificial intelligence. This is real intelligence.\u201d<\/p>\n

Von Hoff returned to a question that has shaped decades of cancer research: Where, exactly, are tumors most vulnerable?<\/p>\n

Cancer cells, he told the audience, live under constant biological stress, dividing rapidly and adapting to therapies designed to destroy them. That pressure, he said, may also expose their weaknesses.<\/p>\n

\"\"
Lei Zheng, MD, PhD<\/figcaption><\/figure>\n

\u201cBecause of stress on the tumor cells, they\u2019re actually on the verge of collapsing,\u201d Von Hoff said. \u201cThe question is how to push them over the edge.\u201d<\/p>\n

Over the course of the two-day conference, researchers shared findings that reflect how quickly the field is evolving. Presentations highlighted new approaches, from antibody-drug conjugate therapies targeting resistant tumors to artificial intelligence tools helping researchers find new cancer targets faster and match patients with targeted therapies.<\/p>\n

\u201cThat progress reflects a broader shift in oncology,\u201d said Lei Zheng, MD, PhD<\/a>, executive director of the Mays Cancer Center. \u201cOur focus is not only to develop better therapies, but to detect cancer earlier and intervene when treatment can have the greatest impact for patients.\u201d<\/p>\n

Building early-phase research at UT Health San Antonio<\/strong><\/span><\/h4>\n

Von Hoff\u2019s connection to San Antonio stretches back decades. In 1979, the National Cancer Institute recruited him to help expand the research mission at the CTRC, then a small radiation clinic founded in 1974 to serve local patients.<\/p>\n

The need was urgent. South Texas carries one of the nation\u2019s heaviest cancer burdens. Researchers at the CTRC set out to change that by bringing new treatment options to patients in the region who often had few.<\/p>\n

\u201cBy 1988, the CTRC was investing nearly $8 million each year in cancer research,\u201d Zheng said. \u201cThat investment helped launch a phase 1 clinical trials program, enrolling 40 patients in its first year. It was an early step in establishing San Antonio as a proving ground for new cancer therapies.\u201d<\/p>\n

Out of that momentum came the Institute for Drug Development, launched in 1991 with Von Hoff as its founding director. The program helped bring new cancer drugs into early testing, including gemcitabine.<\/p>\n

The CTRC eventually evolved into what is now the Mays Cancer Center at UT Health San Antonio, the region\u2019s only National Cancer Institute\u2013designated Cancer Center.<\/p>\n

\u201cWhen we started, we were trying to build something that didn\u2019t really exist yet,\u201d Von Hoff said. \u201cBut the spirit that defined those early years has remained the same.\u201d<\/p>\n

Since then, UT Health San Antonio has grown with new research programs, expanded facilities and a new cancer-focused hospital<\/a> serving patients across the region.<\/p>\n

Von Hoff has mentored dozens of physicians, many of whom returned for the conference. Others now lead cancer programs around the world, including Lillian Siu, MD, president of the American Association for Cancer Research and Manuel Hidalgo, MD, PhD, a leader in oncology drug development. Both trained as clinical research fellows at UT Health San Antonio.<\/p>\n

\u201cOur time working together at UT Health Science Center San Antonio and the CTRC was special because of the people in San Antonio who made so many good things happen,\u201d Von Hoff said. \u201cThere were no egos \u2014 just doctors, nurses and an incredible staff focused on helping patients and advancing new treatments.\u201d<\/p>\n

Currently a Distinguished Professor at the Translational Genomics Research Institute in Arizona, Von Hoff shows no signs of slowing down. \u201cWe\u2019re still bringing two new agents every week to consider for therapy,\u201d he said. \u201cThere\u2019s still so much work to be done. Every new trial is another step toward better options for patients.\u201d<\/p>\n

A legacy still in motion<\/strong><\/span><\/h4>\n
\"\"
John Sarantopoulos, MD<\/figcaption><\/figure>\n

In many ways, PANAO reflects that legacy \u2014 a gathering of investigators still asking the same question that shaped those early trials: Which new therapies might change what happens next for patients?<\/p>\n

\u201cEarly-phase trials are where possibility begins,\u201d said John Sarantopoulos, MD<\/a>, a Mays Cancer Center medical oncologist and PANAO conference co-chair. \u201cWhat you see across these presentations is how many different approaches scientists are pursuing at once.\u201d<\/p>\n

Nearly three decades after its founding, PANAO remains a place where scientific ambition meets clinical urgency, where new ideas are tested, challenged and refined in the search for better cancer care.<\/p>\n

While many breakthroughs begin in a laboratory, others begin at the bedside. And some may even emerge from a patient\u2019s craving for fried chicken.<\/p>\n

 <\/p>\n","protected":false},"excerpt":{"rendered":"

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