Fred Hutch Phase 1 Program director, Dr. John Thompson, retires

Patients, clinicians and researchers have much to thank John A. Thompson, MD, for when he retires at the end of 2024 after 40 years of service at Fred Hutch Cancer Center. But he’s the one exuding gratefulness. 

“I have such gratitude for the environment that my predecessors put together both at Fred Hutch and the University of Washington, making this a place that values science and research and also values good clinical care,” said Thompson, medical director of the Phase 1 Clinical Trials Program and professor in the Clinical Research Division at Fred Hutch and the Division of Hematology and Oncology at the University of Washington School of Medicine. “It’s been a fantastic place to work.”

A medical oncologist, Thompson co-directed the melanoma clinic for many years and built the melanoma program with surgeon David R. Byrd, MD, who retired earlier this year. Thompson also co-chaired the National Comprehensive Cancer Network (NCCN) melanoma guidelines committee and is chair of the NCCN guidelines committee on management of immunotherapy-related toxicities. He received the 2019 Marvin Turck Award at UW and the 2020 Rodger Winn Award from the NCCN for his teaching and clinical contributions.

From immunotherapy’s early days to the checkpoint revolution

Thompson came to Fred Hutch in 1985, after completing specialty training in oncology at UW Medicine. Interested early on in the potential for the immune system to treat cancer, he joined a group of Fred Hutch investigators including the late Martin (Mac) Cheever, MD, and Alex Fefer, MD. Rather than focusing on a single type of cancer, the three were exploring opportunities to learn more about the relationship between the immune system and cancer broadly and to develop and test new immunotherapy approaches.

“Some of that early work involved testing interferons in various cancers, including hairy cell leukemia, which is a very rare leukemia, but it turns out it could be put into remission with interferon. That was a big breakthrough at the time,” said Thompson. 

In the decades since, immunotherapies have transformed the treatment of many cancers, including metastatic melanoma. 

“I was fortunate to persist long enough in the field to go through what we call the checkpoint revolution,” he said, referring to the development of immune checkpoint inhibitors. “It’s phenomenal what has happened in the course of my lifetime in terms of our understanding of the basic biology of cancer but more specifically the role of the immune system and how that can be harnessed to treat patients.”

Getting novel therapies to more people

Thompson led and participated in many innovative immunotherapy trials and brought many of these trials to the Pacific Northwest, said Shailender Bhatia, MD, who chose Thompson as his research mentor almost 20 years ago. Bhatia now directs the melanoma and renal cancer team at Fred Hutch. He is a professor in the Clinical Research Division at Fred Hutch and the Division of Hematology and Oncology at the UW School of Medicine. 

Since the Phase 1 Clinical Trials Program was established in 2008 to test new therapies for solid tumors, Thompson has been at the helm. Before then, Phase 1 studies were being done at Fred Hutch by various disease groups. But the challenges of conducting these trials, which can be time consuming and cumbersome to execute, were limiting the organization’s ability to make promising treatments available to patients. Centralizing Phase 1 trials made sense because many of the trials intersected with multiple disease groups. The Phase 1 Program has allowed Fred Hutch to conduct many more of these early studies and enroll many more people.

“He developed the Phase 1 Program basically from nothing, nurturing it and turning it into the large and very successful program that it is now,” Bhatia said of Thompson. “This means there are so many more options available to our patients who are desperate for novel therapies.”

Mentoring with enthusiasm

After benefiting from the mentorship of colleagues like Cheever and Fefer, Thompson evolved into a mentor himself — for Bhatia and numerous other faculty members and providers over the years. It’s a role that Thompson said came easily because he’s so enthusiastic about what’s happening in the field and happy to pass that enthusiasm on. 

“His mentorship style is very unique and thoughtful,” said Bhatia. “He has been there to support and guide, to facilitate things, but without micromanaging. I always felt like he would have my back if I needed it, but I also had the freedom to venture out in new directions.” 

Thompson applied a similarly skillful approach to soothing distressed patients, leading his colleagues in the melanoma group and interacting with staff in every role throughout Fred Hutch, said Bhatia. “He’s just such a nice human being — and his sense of humor is exceptional.”

A steady presence for patients

Marikay Coyer was a patient of Thompson’s until he transitioned out of seeing patients in clinic about two years ago. She was diagnosed in 2012 at age 53 with melanoma that started under her thumbnail and spread to her lungs. In more than a decade of treatment, she’s been through many ups and downs, including successful surgeries to remove part of her right lung as well as a painful, fast-growing tumor on her liver, and trials of medicines that didn’t work well against her disease. In 2018, she started on pembrolizumab, a type of immunotherapy, and her cancer currently appears stable.

Through it all, Coyer appreciated Thompson’s steady demeanor, describing him as her rock.

“In my first meeting with him, he said, ‘Look, we really have to wait a few months to see if these lung nodules grow, and until that time, let’s be hopeful and partner and see what happens.’ That was what I needed because I’m kind of an emotional person, and it was obviously a very emotional time for me,” she said.

He consistently explained anything she wanted to understand about her disease and treatment, Coyer recalled, and was responsive to her concerns, building a strong physician-patient relationship.

“You really have to relinquish all of your trust to your care team — which doesn’t mean you don’t raise questions because there are lots of times I’ve had questions. But whenever I had an intuition or felt weird about something, Dr. Thompson and his team supported me and investigated it. If I called him and said, ‘I’m feeling this strange thing,’ he’d say, ‘OK, let’s get you in.’”

Beyond treating her disease, the two had points of personal connection, like sharing pictures of their first grandchildren, who were born within a short time of each other. 

Thompson looks forward to spending more time in retirement with his grandchildren, children and wife, Dianne Thompson, MD, a retired dermatologist, whom he met at Fred Hutch. Early in her career, she worked as a technician in Cheever’s lab and as a research coordinator for Fefer. 

“Not only did Fred Hutch and UW give me a rich place to play, so to speak, in science, but it also introduced me to my wife,” said Thompson. “And I think that's probably the more important thing.”