Three years after stepping down from the top job at Entergy Corp., New Orleans' lone Fortune 500 firm, Wayne Leonard's retirement took a bad turn.
Driving back to New Orleans from Baton Rouge, he blacked out on the Bonnet Carre Spillway in early 2016 and crashed his Bentley head-on into the bridge. Emergency responders initially assumed the driver was dead. But by a stroke of luck, Leonard not only survived but walked away from the wreck with only a few scratches.
But weeks later, Leonard blacked out again. His doctors ran tests that revealed his lungs were filled with fluid. He was diagnosed with stage 4 lung cancer.
"My only question (to his doctor) was, 'Where do I go from here?' " the soft-spoken, 67-year-old Leonard, a lifelong runner and non-smoker, recalled in an interview. "She said, 'You need to get the best oncologist you can get,' and so that was kind of how I came to where I am."
Leonard was referring to Ochsner Medical Center on Jefferson Highway, where he is involved in a new initiative designed to tailor a cancer patient's treatment to information found within their tumor's genetic profile. That information can be used to match patients with early-phase clinical trials and enable them to participate in innovative therapies still under development.
Leonard now is a firm believer in the approach, so much so that he recently donated $1 million to Ochsner's Precision Cancer Therapies Program.
"It just seems like that's the way cancer therapy should be done anyway, particularly across different boundaries and different disciplines," he said.
In 2017, Ochsner joined the Strata Precision Oncology Network, a group of more than 50 hospitals that work in tandem to accelerate the development of precision medicines by offering no-cost genetic sequencing for advanced cancer patients.
The company behind it, Strata Oncology, aims to collect sequencing data from 100,000 patients as part of an observational study. The idea is to build a patient population large enough to remove the bottleneck that exists in developing precision oncology drugs by identifying potential candidates for such therapies.
Ochsner, the state's biggest nonprofit health care system, is the only hospital in Louisiana offering no-cost genetic profiling for tumor and lymphoma patients.
The testing reveals detailed information about specific genes in cancer cells, which can provide clues for doctors charting a patient's course of treatment.
"Based on the genetic information that we gather, we can figure out what genes are driving the cancer and then we can figure out how to attack the cancer," said Dr. Marc Matrana, medical director for the Ochsner Precision Cancer Therapies Program.
In many ways, finding an alternative treatment for some forms of cancer is akin to finding a needle in a haystack.
As an example of how it can work, Matrana recalled a recent patient diagnosed with advanced colon cancer, whose genetic sequencing showed a rare mutation typically related to lung cancer. That revelation led doctors to weigh a treatment that showed positive signs for combating lung cancer.
In another case, Matrana recalled a patient diagnosed with bladder cancer, whose genetic testing steered doctors to a medicine more typically used for treating breast cancer.
"We would've never thought to try this therapy," he said.
By taking advantage of precision medicine, treatment decisions are increasingly based not on the type of cancer or its origin, but on the actual genetics that are causing it to grow.
For hospitals, Matrana said, offering early-stage trials and genetic testing is "extremely expensive" — typically a money-loser; in this case, Strata Oncology at least covers the costs for the sequencing test.
However, in the long run, knowing in advance which treatments are more likely to work could speed up treatment and ultimately reduce health care costs, experts say.
"It should also mean that you're not wasting six months or two months doing the test that doesn't work before you get to the one that does work, and so people are getting cured faster," said Walter Lane, an associate professor at the University of New Orleans who studies health care economics.
So far, about 125 patients have signed up with Ochsner to move ahead with the genetic testing, and roughly 50 are participating in a clinical trial.
The eligibility process is complicated, Matrana said, and each study has its own criteria.
"The great majority of these patients, they would have no options," he said. "These are patients who otherwise would have no treatment, and many of them would go to hospice and succumb to their disease fairly quickly."
At Entergy, Leonard started as chief operating officer in 1998 and rose to CEO a year later. Over more than a dozen years, he developed a reputation as a careful leader and a skilled motivator, whether it was encouraging others to support his vision for the company or backing issues close to him, such as combating climate change or poverty.
Before signing on with Ochsner, Leonard met with a handful of other doctors, but he felt that he developed a good rapport with Matrana. He's also being treated at MD Anderson Cancer Center in Houston.
Leonard, who has undergone multiple rounds of chemotherapy, feels fatigued but said he's generally OK, though he's lost about 25 pounds.
Knowing that his cancer was inoperable, Leonard said, "The goal was to make it a chronic disease, not a terminal disease, and so what that means is you have to just keep living long enough for the next drug or the next breakthrough.
"Hope is a self-fulfilling prophecy here, and individuals who maintain hope and maintain the belief that they can survive or they can survive longer always do better than people who have the attitude that 'I'm doomed and there's nothing I can do about it, and there's no way out.' "
Likewise, Matrana said that the prognosis for Leonard is better now than it would have been in the past.
"Stage 4 lung cancer, a few years ago, that was a death sentence that happened pretty quickly," he said. "Today, we make that into a chronic disease, so although he has terminal cancer, his cancer is responding very well to therapy, and I fully hope that he's going to be around for quite a while."