Channeling His Creativity Into Oncology: A "Renaissance Man" Makes a Mark in Lymphoma Research

OncologyLive, November 2011, Volume 12, Issue 11

Andre Goy, MD, MS, treats lymphoma patients at New Jersey's largest cancer center, Goy, 54, is also a translational researcher widely known for his work showing the first-ever evidence of activity of bortezomib.

Andre Goy, MD, MS, celebrates with cancer survivors and loved ones at Liberty State Park, New Jersey, in September.

When you can effortlessly whip up a meal for a resort crowd of 200 people, paint well enough to have your art displayed in the window of New York City’s Bergdorf Goodman, and figure skate your way to the top of a national competition, it can be hard to choose a direction in life.

Some might imagine that Andre Goy was faced with too many options.

Yet Goy knew by the time he had finished high school in Entremont, a village in the French Alps, that he wanted to be a physician. He enjoyed using his talents to lift people’s spirits, but he was driven to save their lives.

In the 35 years since, Goy, MD, MS, has accomplished that again and again. A physician who treats lymphoma patients at New Jersey’s largest cancer center, Goy, 54, is also a translational researcher widely known for his work showing the first-ever evidence of activity of bortezomib, a proteasome inhibitor, in mantle cell lymphoma (MCL).

He built on that discovery by serving as coprincipal investigator on the PINNACLE trial that led to the FDA’s 2006 approval of the compound, known by the brand name Velcade, for a defined group of patients with the aggressive form of non-Hodgkin lymphoma. The approval brought patients the first treatment ever indicated for relapsed or refractory MCL.

At the John Theurer Cancer Center (JTCC) at Hackensack University Medical Center in New Jersey, where he was named chairman and director this year, Goy continues to research a wide range of novel treatment approaches for lymphoma, including immune-based and targeted therapies.

“We definitely have a greater understanding of the diversity of cancer at the molecular level,” said Goy. “Just in lymphomas, we know of more than 65 subtypes, and likely more if you take into account some of their molecular features.

“In addition, within one subtype itself, there are differences as well again at the molecular level, reflecting the heterogeneity of the disease. Some of these differences translate into differences in outcomes. Ongoing studies are looking at ways to simplify these molecular signatures, so they could potentially be used to customize therapies.

“I think it is one of the most fascinating aspects of oncology currently and one that wakes me up at night,” he said.

Filling a Prominent Role at JTCC

Goy joined JTCC in 2005, excited about his chance to help shape an up-and-coming cancer care and research program.

To bolster the institution’s ability to contribute to personalized medicine, he founded and has helped to develop a Tumor and Tissue Repository there. The samples allow researchers to “look at some of the molecular differences among patients,” the doctor said, and offer greater possibilities for collaboration with other researchers, as well as trying to define biomarkers to predict outcome or response to therapy.

In addition to developing JTCC’s fellowship program, Goy heads the center’s translational research program and its lymphoma division, which he developed, and which has grown to include 3 full-time attending doctors who see about 600 new lymphoma patients each year.

Those responsibilities add up to a busy existence for Goy. In an “ideal world” he would spend about one-third of his time seeing patients, one-third attending meetings and conducting administrative duties, and the rest overseeing his own lab and the center’s clinical research program, which typically has more than 200 studies in progress. He also squeezes in opportunities to lecture around the world.

“I wish I had more time—I run around a lot,” Goy said. “But I’m never bored, as you can see. I never feel like I’m working, and that’s really essential. You have to follow your gut and your passion into this field as well as any other field. If you don’t, you’ll never become good, because it then takes too much time and energy.”

Amid all his other commitments, Goy finds time to teach doctoral students at the University of Medicine and Dentistry of New Jersey, focusing on oncology, lymphoma, and personalized medicine. He also emphasizes some philosophical points that he hopes the students will carry with them into their working lives.

“I tell them to work hard, to be curious, bold, and passionate, and to learn by doing,” Goy said. “I encourage them to be supportive and respectful to the staff, because they are absolutely essential to everything we do....Bedside manners are also very critical, obviously on a purely ethical level, but they also matter for the success of our patients. If you don’t have a good relationship with your patients—if they’re scared of you—it really will affect their treatment.”

Andre Goy, MD, MS, At a Glance

  • Lives by the saying “Just do it.” “I don’t like people who postpone or whine,” he said. “Jump in and do it—it’s true for everything.”
  • Enjoyed the movie Tell No One, a French film about the disappearance of a physician’s wife. “It’s a thriller, and usually the French are good at that,” he said.
  • Considered becoming a veterinarian but decided he’d rather treat people.
  • Believes that US regulatory agencies, industry, scientists, and clinicians should work more collaboratively to ensure that research into personalized medicine is funded.
  • Considers it critical to include eligible patients in clinical trials whenever possible, in order to speed up the trial process and make it less costly. The average 3% rate at which US cancer centers enroll patients in trials, he said, is much too low.

From the Alps to Oncology

Goy grew up among relatives who built chalets and owned hotels, where he worked as a chef cooking gourmet meals for large crowds. He was also skilled at drawing, and considered becoming an architect.

What swayed Goy toward becoming a doctor was his interest in biology and science, but also in human beings from the time he spent with his father—for 40 years, a small-town mayor—visiting older people, volunteering for the local church, and taking care of community landmarks.

“I was interested in science and in helping people, so medicine was a very obvious choice,” Goy said.

Goy received his initial medical training at the Université Joseph Fourier, Grenoble, France, and completed an internship and a residency at Grenoble University Medical Center. After spending a year as a hospital fellow in the French navy in Paris— fulfilling the military service required of doctors studying in France—he earned his medical degree in 1984.

He decided to pursue oncology because he anticipated it would be everchanging and, thus, always interesting.

During the next several years, Goy, hungry for more knowledge about his field, earned a certificate and a master’s degree in immunology, as well as a master’s degree in experimental oncology. Simultaneously, he served as an oncology fellow at Albert Michallon University Medical Center of Grenoble, where he was in the top 5% of students.

And that was when his mother became his first patient.

“I diagnosed her with end-stage ovarian cancer,” Goy recalled. “My peers at the time felt she was too advanced. After the initial exploratory surgery, they told me it was too late—that she was going to die very quickly. I said that I wanted to give her chemotherapy, which we did. She then had a second look to remove potential residual tumors. After the intensive chemotherapy, they found no more tumors. She was in remission.”

Tackling Lymphoma

With his mother’s restored health came a new chapter in Goy’s career. He moved to America—something he had dreamed of as a teenager— to complete a fellowship in hematology-oncology at Memorial Sloan-Kettering Cancer Center, New York, New York. Afterward, he stayed on there as an attending physician specializing in lymphoma.

Once in New York, the doctor also made his mark in art and athletics. His oils, described in New York magazine as “symbolic paintings of trees in landscapes,” were featured in 12 shows between 1994 and 2004, the first in the Christmastime window of the Bergdorf Goodman luxury department store. During the same years, Goy, who had honed his skiing and skating skills as a child, also won a national adult competition as a solo figure skater.

Since then, Goy has had time only for solving the puzzle of lymphoma.

His biggest “aha” moment came when he was the first to demonstrate that bortezomib was effective against relapsed/refractory MCL, which is commonly resistant to chemotherapy.

The injected drug, marketed in the United States by Millennium Pharmaceuticals, Inc, works by inhibiting the action of 26S proteasome proteins within cancer cells, causing the cells to die.

“When I first worked on this, there was some reluctance to try this new drug in lymphomas, but I was convinced, and pretty early on, the activity in the first few patients was so obvious that it became easier,” Goy recalled.

In clinical trials, data from an analysis of archived tumor samples tested prespecified biomarkers for their association with time to progression and response to treatment with Velcade in patients with relapsed MCL. The results supported the usefulness of NFkB-p65, PSMA5, p27, and Ki-67 protein levels in predicting the outcome of MCL and its responsiveness to Velcade, according to a Millennium statement.

Goy is working on a number of novel therapies in lymphoma, especially MCL. He also has developed a database of 185 patients with MCL from which several papers already have been published, including the results of Rituximab- HyperCVAD versus R-CHOP in MCL, as well as the role of PET scan in MCL, and methylation profiling differences among patients with MCL.

As a leading MCL researcher, Goy was appointed as a member of the prestigious Mantle Cell Consortium and a member of the Lymphoma Research Foundation’s esteemed Scientific Advisory Board. He recently convened the first Mantle Cell Lymphoma Symposium for physicians, patients, nurses, and other healthcare professionals.

Participants at the conference were joined by physicians and patients in 13 countries on 3 continents, reflecting Goy’s commitment to make information about MCL transparent to physicians, patients, and caregivers alike, and his philosophy about empowering and partnering with patients.

“We can continue to develop better treatment options by collaborating with our patients,” Goy said. “This will help them better understand and manage their diseases to help move our clinical research forward.”

In addition to his leading and transformative work in MCL, Goy is also actively engaged in work focusing on stem cell transplantation, immunology, and new prognostic markers, as well as novel therapies in other lymphomas. Goy’s awardwinning research is funded by several pharmaceutical companies, foundations, and the FDA. He is regularly invited to speak around the world and is a journal reviewer for 9 publications.

Considering Needs of Patients

As he considers new ways to treat patients, Goy likes to take a holistic approach.

Known by colleagues as “the renaissance man” because of his artistic talents, the doctor was involved in designing JTCC’s new building, which for the first time houses all of its 14 divisions under one roof. He worked with an interior design firm to create an environment that supports the psychological and emotional needs of patients, as well as their physical care.

Goy also invested a lot of time in devising an additional way to provide emotional support to thousands of patients.

Inspired while treating a patient who worked as curator of the Statue of Liberty, Goy launched an annual cancer survivor event titled “Celebrating Life and Liberty” in 2009. That first year, more than 700 survivors gathered at Ellis Island and the Statue of Liberty to offer each other support. Last year, having outgrown Ellis Island, the event included 1500 survivors at nearby Liberty State Park. This year, 2200 attended.

Goy made it happen, he said, simply “because someone had to do so—it was so obvious how patients appreciated this event from the start.”

“Run by and for patients, it gives them a chance to inspire and support each other,” the doctor said. “This year, John Theurer staff members were invited, too. It was good for them to be able to mingle with their patients, whom they see all year round in the clinic. It is a very uplifting event for patients, caregivers, and all care providers as well.”