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The cancer care landscape is continually shaped and reformed by new drug discoveries, clinical guidelines, and therapeutic progress. Oncologic innovation is not in short supply, but it is constrained by practical implementation. The vision—the eradication of cancer—is clear, but the “how” continues to demand increasingly creative, diverse ways of thinking.
At the Hoag Family Cancer Institute in Newport Beach, California, the “how” drives every structural decision, every new care offering, and the Institute’s vision for the future. ACCC recently spoke with Dori Holnagel, MBA, vice president of the Hoag Family Cancer Institute, to learn how her team works tirelessly to fulfill their mission of delivering the most advanced, compassionate cancer care in Orange County.
Central to Hoag’s success is the dyad leadership model that drives many of its service lines. For many of Hoag’s institutes, including the cancer institute, a clinical and an administrative leader work in a close partnership to strategize, develop, and make decisions. “I believe dyad to be extremely important in complex diseases like cancer,” said Holnagel. “It’s essential to have that blend of clinical and administrative, and it’s a clear advantage to the Institute and to each of us.”
The Hoag Family Cancer Institute is made up of three hospitals, with one in Newport and two in Irvine, but leadership roles encompass the work of the entire institute. Holnagel described leadership as service- and institute-specific. “Our people and our policies and our processes are one,” she explained. Hoag prides itself on delivering the same excellent patient experience at each location, so patients can choose the most convenient location without compromising the quality of the care they receive.
Although some offerings are only available at one location, such as chimeric antigen receptor (CAR) T-cell therapy, the Institute has decentralized services as quickly as possible—including infusion, radiation, surgery, and research—in the interest of making the logistical aspects of cancer care as simple and convenient for patients as possible. This prioritization of the patient experience is reflected in Hoag’s various awards, including being ranked the number one hospital in Orange County for the ninth year consecutive year in 2026 by U.S. News & World Report.
This positive reputation is due in part to Hoag’s commitment to soliciting, thoughtfully considering, and implementing patient feedback. One way the staff does so is through a patient satisfaction survey via Qualtrics, which patients can easily complete online or on their phone. If a survey returns a satisfaction score below a certain level, the staff member assigned to that patient’s case immediately gets a notification prompting them to review the results. From there, they can quickly call the patient and address the issue. “We created a real-time feedback loop,” said Holnagel, “and it has gone a long way toward earning the trust and support of our community.”
Deeply attuned to the needs of its community, Hoag made it a priority several years ago to make CAR T-cell therapy and tumor-infiltrating lymphocyte therapy readily available to eligible patients. From the outset of developing the program, Hoag’s leadership quickly understood the need to hire a centralized nurse, Kristina Cloward, BSN, RN, Program Manager of Accreditation, to execute the vision successfully. In line with the structure of other institutes under Hoag, the Cellular Therapy Director works in a dyad partnership with Cloward—a model that allows them to incorporate best practices and the clinical expertise needed for safe and effective oversight of patients with highly specialized medical needs.
Cloward described the difficulty of building Hoag’s cellular therapy program piece by piece. “This endeavor was new to everyone here, not just me, so it was a challenge to find solid footing and know where to start,” she commented. Key to the success of this program was the enthusiastic buy-in and support from physicians, leadership, and staff from other departments.
“I’ve worked at organizations where change was considered daunting. Here at Hoag, every single department and physician was not only willing, but eager to help,” said Cloward. “Having that passion and trust from my colleagues was essential.”
Today, the Institute is one of only two providers in Orange County to offer CAR T-cell therapy for lymphoma and myeloma, and the first in the county to offer it for malignant blood and lymphatic cancers and for solid tumors through its robust clinical research program. Already, Hoag has seen firsthand the benefits of offering emerging therapies in a setting close to home. Holnagel shared that Hoag’s first CAR T-cell patient had opted not to go to the referral facility 40 miles away, instead waiting for Hoag’s program to be up and running so she could remain in her community. “That’s why it’s so important to have these offerings outside of academics,” said Holnagel. “Patients want to receive their cancer care close to home.”
She also shared that another CAR T-cell patient was so grateful for the care he received at Hoag that he immediately donated to the institute after finishing his treatment, so the program can continue to provide high-quality, compassionate care to its community.
Hoag’s Molecular Imaging and Therapy program, one of only 95 Radiopharmaceutical Therapy Centers of Excellence in the world, is helping to pioneer the most sensitive imaging methods to advance research and applications in molecular imaging and therapy. Two physicians were recruited to Hoag to develop this program, which comprises 80% research and 20% standard-of-care treatments.
Beth Thomsen, CNMT, Molecular Imaging and Therapy Coordinator, explained the supportive role Hoag’s leadership played in recruiting a knowledgeable and experienced medical director. “This was instrumental in building a foundation for the program, and it enabled our team to rapidly develop the necessary policies, procedures, and operational workflows,” she said.
Hoag was the first cancer center in Orange County to offer the two FDA-approved radioligand therapies, Lutathera® and Pluvicto.® In addition, Hoag offers 25 trials involving the development of isotopes for diagnostic imaging and radioligand therapies and serves as a site for several of these trials. Beyond these areas, Hoag also offers over 125 clinical trials capturing the full scope of precision medicine today.
“This allows patients in our community and the surrounding region to access new treatment options that might otherwise require travel to providers outside their local area,” explained Thomsen. “Receiving this high-quality care close to home significantly enhances the patient experience by reducing the burden of travel during treatment and allowing patients to remain near their support systems.”
For other programs considering or pursuing a molecular imaging and therapy program, Thomsen recommended connecting with cancer centers that have already successfully implemented these services. “In my experience, the molecular therapy community is highly collaborative and happy to share insights, best practices, and lessons learned,” she said. She also noted that recruiting a knowledgeable nuclear medicine technologist was key to navigating operational challenges, regulatory requirements, and clinical obstacles.
Amid a rapidly evolving clinical landscape, Hoag Family Cancer Institute demonstrates how innovation can be translated into meaningful, patient-centered care through intentional leadership and strategic program development. By embracing a dyad leadership model, investing in advanced cellular therapies, and pioneering research in molecular imaging and precision medicine, Hoag brings cutting-edge care closer to the community it serves.
Just as importantly, its emphasis on real-time patient feedback and consistent experiences across locations ensures that progress is measured not only in scientific breakthroughs but also in trust, convenience, and compassion. As cancer care continues to advance, Hoag’s approach offers a compelling example of how thoughtful structure, collaboration, and responsiveness can turn the vision of exceptional care into a reality for patients today.
Rachel Radwan is Associate Editor of Oncology Issues and Manager of Editorial Content at the Association of Cancer Care Centers in Chevy Chase, Maryland.
