Levi Garraway: Transforming Oncology Through Precision, Resilience And Heart

“I owe a lot to mentors,” says Levi Garraway, MD, PhD, a pioneer in oncology whose impact on precision cancer medicine has been profound. “Phil Kantoff was one of the first people who believed in me. When I was still a medical student, he made the first calls to connect me to oncology faculty. Everyone needs mentors like Phil.”

The respect is mutual. When I asked Phillip Kantoff whom I should interview next, he didn’t hesitate: “Levi Garraway.”

Garraway’s path to medicine was shaped early on by family influence. “Both of my parents had PhDs—which was quite unusual in the 1970s,” he recalls. “Their commitment to education was unwavering. They set high standards, not only academically, but in how we lived and treated others.”

Science was in his blood. His father, a plant biologist, fueled his fascination with research, while two uncles—both surgeons—introduced him to medicine. One of them, Levi Watkins Jr., a famous cardiothoracic surgeon at Johns Hopkins, became a personal role model.

“Watching him succeed inspired me,” Garraway reflects. “Initially, I wanted to follow his path as a leader in academic medicine. That dream never left me.”

But it was a personal tragedy that anchored his course firmly in oncology.

“When I was in graduate school, my father was diagnosed with aggressive prostate cancer,” he shares. “Before then, I hadn’t really thought much about cancer. But watching him go through treatment, relapse, and eventually progression consumed our family.”

Evenings found him pouring over cancer literature in the library, desperate to find something—anything—that might help his father. The frustration was immense.

“There had been so many discoveries—oncogenes, tumor suppressor genes—but almost none of it was reaching patients yet,” Garraway says. “It felt unacceptable. That experience gave me clarity: I wanted to dedicate my career to bridging the gap between scientific discovery and clinical care in oncology.”

Building a New Era in Precision Oncology

Levi Garraway’s academic training reads like a blueprint for excellence: MD and PhD degrees from Harvard, a residency in internal medicine at Massachusetts General Hospital, a medical oncology fellowship at Dana-Farber Cancer Institute, and service as a chief resident at Mass General.

Yet it was during his post-doctoral fellowship at Dana-Farber, under the mentorship of Bill Sellers, that his career trajectory accelerated.

“We were applying emerging technologies to cancer genomes,” Garraway explains. “We discovered a new cancer-causing gene in melanoma—that was a pivotal moment.”

When he started as a tenure-track faculty member at Dana-Farber, Harvard Medical School, and the Broad Institute, another critical inflection point arrived.

“At the time, sequencing even a single gene across many samples was expensive,” he says. “We needed a more cost-effective way to profile the relevant areas of cancer genes.”

Garraway and his team developed a method to rapidly and affordably sequence actionable portions of the genome—a concept that would eventually become foundational to precision oncology.

“We started finding actionable mutations in places we didn’t expect. And it hit me: oncologists everywhere might want this information to guide treatment decisions.”

That realization sparked the creation of Foundation Medicine, a groundbreaking company that helped usher precision oncology into the clinic.

“It started small—just trying to solve a technical problem in the lab, trying to gather relevant genetic information from a subset of cancer genes—faster, cheaper. But it became part of a global shift toward personalized cancer care.”

Navigating Crisis: Lessons in Resilience

Success wasn’t without struggle. Levi Garraway recounts one of the hardest moments of his career.

“We launched a clinical study to apply genomic characterization at scale. But once we began, the process was overwhelming. The complexity, the volume of data—we just couldn’t keep up.”

Progress ground to a halt.

“I called an all-hands meeting. We had to confront the truth: the project was failing.”

It was a painful decision, but they suspended the study temporarily to regroup.

“We owned the failures, got creative, and addressed the bottlenecks. It forced us to ask hard questions about what truly mattered—and to focus our resources where they could have the most impact.”

Ultimately, the project was rescued—and completed successfully.

“Adversity can refine your vision,” he says. “It teaches you to see clearly what matters most.”

The Source of Inspiration: Family and the Next Generation

Today, what drives Garraway forward is both deeply personal and profoundly outward-looking.

“My family—especially my kids, nieces, and nephews—inspires me,” he says. “Helping them find their path, learning from the principles that guided me, keeps me grounded.”

He also finds hope in the next generation of physician-scientists.

“They’re resilient. They’re optimistic, even amidst adversity. It’s important to carve out time to mentor them, because the future of oncology is in their hands.”

Principles That Endure

Garraway’s life philosophy is rooted in a few unshakable ideas.

“First, find work you love—and do it really well,” he emphasizes. “Don’t get distracted worrying about the next opportunity. Focus on excelling at the task at hand.”

Hard work is non-negotiable. “There’s no shortcut,” he says. “You have to be willing to put in the hours, but also to find time to rejuvenate.”

Character matters as much as skill.

“Treat people well. Collaborate. Build community. Success isn’t just about what you achieve—it’s about how you achieve it.”

And finally, he stresses the importance of mentorship.

“No one gets there alone. Find mentors who embody the kind of success you aspire to—and let them guide you.”

A Legacy of Transformation

Asked how he hopes to be remembered, Garraway offers a simple but profound aspiration:

“I would hope people remember that my work enabled new cancer treatment paradigms and brought new medicines that together made a transformative impact on cancer care around the world.”

It’s a legacy already taking shape—with far more still to come.

Foundation Medicine: From Laboratory Insight to Global Impact

What began as a pragmatic lab exercise evolved into a revolution.

The idea was deceptively simple: create a single, comprehensive test that could detect actionable genetic alterations across many types of cancer at once, empowering oncologists with better tools for treatment decisions.

But turning that idea into reality required a different kind of expertise.

“I knew I couldn’t do it alone,” Garraway says. “So, I reached out to Matthew Meyerson, Todd Golub, and eventually Eric Lander at the Broad Institute.”

He vividly remembers presenting his first business plan to Lander.

“Eric said: ‘Great idea. You have no idea how hard it’s going to be. But I want to help.’ And he knew people who could help.”

Within weeks, Garraway and Lander were dining with Mark Levin, Bob Tepper, and Neil Exter, partners at a leading venture capital firm. What followed was a year and a half of weekly meetings.

“Every Tuesday night, over dinner—usually from the same restaurant—it was my job to order the food,” Garraway smiles. “But they were patient with me.”

Together, they wrestled with every foreseeable challenge: scientific, regulatory, logistical. Finally, they had a plan robust enough to build something enduring.

The result was Foundation Medicine—a company that would eventually become part of Roche and help transform cancer precision medicine globally.

“More than a million patients have now had a Foundation test as part of their care,” he says. “And related tests are available worldwide. It’s gratifying to know this helped open the door to a new era of precision oncology.”

The Global Oncology Landscape: Progress, But Unfinished Business

Today, Garraway serves as Chief Medical Officer of Roche and Genentech, among the world’s most influential forces in oncology. Despite the progress, he is keenly aware of the work still ahead.

“Yes, we’ve made major advances in targeted therapy and immunotherapy, and other therapies,” he says. “But cancer remains one of the leading causes of death globally. Clinics are still full. Waiting rooms are still crowded.”

The reasons are sobering.

“Resistance is a major challenge—some tumors don’t respond at all, others relapse. Our understanding of tumor biology has improved, but significant gaps remain. And even when treatments exist, they’re often expensive and inaccessible.”

Early diagnosis, Garraway stresses, is another frontier.

“If we could intervene earlier, we could cure more cancers,” he says. “But access and affordability for everyone remain global challenges.”

What Sets Roche Apart

When asked what differentiates Roche’s approach, Levi Garraway outlines a unique ecosystem.

“We’ve invested heavily in oncology for over six decades,” he notes. “Today, we have more than 30 novel agents in development—across small molecules, biologics, gene therapies, immunotherapies, and more.”

Beyond therapeutics, Roche’s integrated diagnostics division is a major advantage.

“It means we can support the entire patient journey—from screening and diagnosis to treatment and monitoring.”

Finally, he highlights Roche’s balanced portfolio.

“We have near-term opportunities—like new trials in breast, lung, and hematologic cancers—and longer-term bets like allogeneic cell therapy and new therapeutic classes like cyclic peptides, which we’re doing in collaboration with Chugai, which is a Japanese company that’s part of the group. That breadth positions us to keep driving advances for years to come.”

Levi Garraway with Stefan Frings, MD, PhD, Deputy Chief Medical Officer at Roche. Photo by Philip Wartena.

Advice to the Next Generation: Ruthless Focus, Deep Joy

Garraway’s advice for young scientists and physicians is both practical and inspiring.

“First—hang in there,” he says. “This is a special field. Advances that change the world are possible—and sometimes closer than you think.”

Second, he urges focus.

“You have to be ruthless about prioritizing the most important work. Say no to things that are ‘nice to have’ but not ‘must have.’ That frees you to do the work that really matters—and to make time for the people and passions that enrich your life.”

Finally, he circles back to a familiar principle.

“Find work you love. Do it well. If you do that, opportunity will find you—you won’t have to chase it.”

The Books That Shaped His Thinking

Garraway is quick to recommend three books that deeply influenced him—none of them directly about cancer.

• Good to Great by Jim Collins: “It taught me the behaviors of leaders who take organizations to unprecedented achievement.”
• The Power Law by Sebastian Mallaby: “It reframed how I think about transformative impact—not just in business, but in medicine.”
• The Years of Lyndon Johnson (especially Master of the Senate) by Robert Caro: “It showed how navigating complex systems—and unexpected people or events—can change history.”

Each, in its own way, reinforced the lessons of resilience, vision, and strategic patience that Garraway lives by.

If Not Medicine, Then Teaching

Had he not chosen medicine and science, Garraway knows exactly where he would have found fulfillment.

“Teaching,” he says without hesitation. “Helping the next generation think critically and originally.”

Who Should Be Interviewed Next?

When asked whom he would recommend for the next OncoInfluencers interview, Garraway smiles.

“Charles Sawyers or Arul Chinnaiyan,” he says. “Both have incredible stories that would inspire.”

The Moments That Keep Him Going

Before concluding, Garraway shares one last reflection—perhaps the most personal of all. “There’s nothing quite like seeing survival curves separate because of a new treatment you helped bring forward,” he says. “Knowing that someone got one more Christmas with family, or lived to see a child’s wedding—that never gets old.”

The setbacks, he acknowledges, can be brutal. “But the successes—the ones that change lives—those are worth everything.”

The Power of Mentorship: Giving Back, Moving Forward

Garraway credits an entire constellation of mentors for shaping his path.

“It would take two slides to name them all,” he laughs. “From my PhD advisor Steve Beverly, to postdoctoral mentor Bill Sellers, to career shapers like John Potts, Phil Kantoff, and Ravi Thadhani.” He also honors his industry mentors—Sue Mahoney, Laurie Glimcher, and many others.

“The common thread?” he says. “None of them had to help me. They chose to. And to the extent that we can each pay that forward—to a trainee, a colleague, anyone who asks—that’s how we make the world of biomedical science stronger.”

For Levi Garraway, real triumph is not in headlines, but in one more Christmas, one more goodbye delayed.