First person profile: Ronald P. DeMatteo, MD

Abstract

During his fellowship in surgical oncology at the Memorial Sloan Kettering Cancer Center, Ronald P. DeMatteo, MD, stumbled onto a cancer that was new to him. His imagination was piqued, and this led to his study of the relatively uncommon and little investigated gastrointestinal stromal tumor (GIST). His investigation into the biology of the tumor paved the way to leading the first national trial, funded by the National Cancer Institute (NCI), to examine the benefit of a relatively new drug on the market as adjuvant therapy after surgical resection of the tumor.¹

The drug was imatinib, and the results of the trial (ACOSOG-Z9001), which showed significantly improved outcomes, led to the 2008 accelerated approval of the treatment regimen and changed the standard of care for patients with resectable GISTs.

He also led two additional national trials testing the benefit of imatinib as adjuvant therapy for patients with resectable GISTs. The US Food and Drug Administration granted full approval in 2012.

Fast-forward to today, and Dr DeMatteo is continuing his research into the biology of abdominal tumors while also serving as an academic surgical oncologist. He is currently chair of the Department of Surgery at the Perelman School of Medicine at the University of Pennsylvania, a position he has held since 2017. He maintains an active clinical practice, runs a research training program for young surgeons (funded by two NCI grants), and is in his final months as president of the Society of Surgical Oncology. In all these capacities, he cites the high reward in helping to shape the field of surgical oncology—from guiding the faculty and direction of a specific department to educating new surgical oncologists on how to perform research and ultimately to bringing all the training and expertise to bear on improving the lives of patients.

“Academic medicine allows you to do any or all of these jobs, and that is its big appeal,” Dr DeMatteo says. “That is what I find the most enjoyable, that you can eventually tailor the job to you and to what you like to do.”

From Dr DeMatteo’s accounting, the wish to tailor his career to suit his drive and purpose started at a very early age. In first grade, he decided that he wanted to be a surgeon. He did not know of any, but he liked to work with his hands—taking the lawn mower apart, building model airplanes—and somehow, he made the leap to the desire to take apart and put together the human body.

After a failed attempt at gaining access to an operating room as a seventh grader (he was allowed only outside the door to count sponges to ensure that the 10-packs used in surgery were accurate), he succeeded in getting into an emergency room at a local hospital, where he was given menial tasks to perform. His big break came while he was a premed undergraduate at the Johns Hopkins University, where he finally was allowed into the operating room at the Johns Hopkins Hospital, which he said was “fascinating and pretty cool.”

His drive to become a surgeon remained steady through medical school at Cornell University but was not fully formed until his surgical residency at the Hospital of the University of Pennsylvania, where he first thought that he would be a cardiac surgeon and then a transplant surgeon. As fate often dictates, his course to pursue surgical oncology came unexpectedly but swiftly with the arrival of a newly recruited surgical oncologist, Douglas L. Fraker, MD, at the University of Pennsylvania late in Dr DeMatteo’s residency. This was in the mid-1990s, and surgical oncology as a field was still in its infancy. It took only 1 week of working with Dr Fraker and seeing the variety of surgeries that he performed for Dr DeMatteo to be hooked. He wanted to do surgical oncology.

He left to complete a 2-year surgical fellowship at Memorial Sloan Kettering Cancer Center with the intention of returning to the University of Pennsylvania to work with Dr Fraker, but fate intervened again in the name of Leslie H. Blumgart, MD, a dentist turned surgical oncologist from South Africa who became a pioneer in liver surgery and inspired Dr DeMatteo with his singular focus on specific cancers (liver and pancreatic). Dr DeMatteo ended up staying at the Memorial Sloan Kettering Cancer Center for the next 20 years, the last 11 of which he served as the vice chair of the Department of Surgery, a position that he held until his return to the University of Pennsylvania to fill his current role as chair. In another twist of fate, he once again is working with Dr Fraker, who still practices at the University of Pennsylvania. It may have taken 20 years instead of 2, but the once mentor and mentee are again colleagues.

Dr DeMatteo’s contributions to shaping a new standard of care for resectable GISTs are based on his early work that gave insight into the biology of the tumor and on his efforts as a pioneer who led the field in understanding the immune response to GISTs. Other accomplishments include advancing our understanding of how specific types of oncogene mutations in GISTs correlate to clinical outcomes and the development of a tool for selecting patients for adjuvant molecular therapy via an online nomogram that can predict which patients are likely to experience tumor recurrence after a resection of a GIST.

Although he is possibly most known for his work in GISTs, his clinical practice extends to a wide range of abdominal cancers, whereas his laboratory (with 20 years of continuous funding from the National Institutes of Health) is focused on better understanding the immune environment of the liver and tumor immunology.

Dr DeMatteo became a member of the National Academy of Medicine in 2020. In 2016, he was awarded the Jeroen Pit Science Award by the GIST Life Raft Support Group. He received the Society of Surgical Oncology Clinical Investigational Award from 2008 to 2010, and he is regularly recognized as one of the top doctors by Castle Connolly America’s Top Doctors for Cancer, America’s Top Doctors, and Philadelphia magazine’s annual Top Docs issue.

When asked if his first-grade dream has been fulfilled, Dr DeMatteo says that he has far surpassed any dreams that he had as a simple first grader, and he muses, “You can’t dream that large when you’re that young.”