American Cancer Society Honors Waun Ki Hong for outstanding clinical research

UT MD Anderson physician-scientist leads clinical trials that improve treatment, prevention

MD Anderson News Release 11/16/12

Distinguished physician, scientist, mentor and leader Waun Ki Hong, M.D., accepted the American Cancer Society 2012 Medal of Honor Award today in recognition of his novel, high-impact clinical research that has extended the frontiers of cancer treatment and prevention.

Hong, vice provost for clinical research and head of the Division of Cancer Medicine at The University of Texas MD Anderson Cancer Center, emphasizes teamwork and collaboration.

"I've been very lucky. I've been at the right place, working with the right people, with great support from my colleagues and this institution," Hong said. "I enjoy a challenge, and innovative clinical research requires perseverance, articulating an agenda and assembling the right team.

"And you must look at things from the positive side. There are pros and cons in any worthwhile project, but if you talk too much about the downside, you can't break through barriers to prolong and improve the quality of our patients' lives," he said.

Hong has mentored hundreds of oncologists and clinician-scientists and authored more than 685 scientific publications. In three major areas, he conceived, designed and completed clinical trials that enlarged the scope of life-saving possibilities.

"Ki Hong's creative, brave approach to clinical research has taken us beyond incremental advances in medical practice to new paths of inquiry and inspired others to follow," said MD Anderson President Ronald DePinho, M.D. "His clinical trials launched truly ground-breaking conceptual advances in organ-sparing cancer treatment, chemoprevention and targeted therapy - a remarkable, high-impact legacy."

Treating cancer, saving organs
As chief of medical oncology at the Boston Veterans Administration Medical Center in the early 1980s, Hong conceived and led a series of landmark clinical trials showing that patients with laryngeal cancer fared just as well when treated with chemotherapy and radiation as those who underwent surgery that ultimately resulted in removing the larynx and losing the ability to speak.

"This was a controversial notion at the time, when radical surgery was standard of care," Hong said. "This new model helped shift treatment toward organ conservation in other cancers, including anal and breast cancer."

"Cancer develops through a multi-step process," Hong said. "We identified precancerous lesions in the oral cavity and thought we could reverse the process with chemoprevention using a retinoid."

The subsequent MD Anderson clinical trial showed that chemotherapy could indeed block cancer development, but the high-dose retinoid had harsh side effects so couldn't be used preventively.

"We proved the principle of chemoprevention, that the course of cancer development can be reversed, and second primary cancers could be prevented," Hong said. The trial opened the field to other organ sites, leading to the use of tamoxifen and raloxifene to prevent breast cancer.

"As we increasingly understand cancer- promoting molecular targets and identify people who are at high risk for it, we can use targeted therapy to prevent cancer by blocking those pathways," Hong said.

Personalized targeted therapy
As cancer research increasingly revealed specific genomic changes that drive cancer progression, new therapies were developed to hit these targets. The need arose for a new type of clinical trial using biopsies to identify molecular targets and then match treatment to a targeted therapy.

Hong proposed such a trial for patients with advanced lung cancer. "It was difficult to convince peer reviewers of our grant application," Hong said. "They said it was a great idea, that the science was great, but their major concern was feasibility."

Would patients tolerate repeat biopsies? Would pharmaceutical companies allow their drugs to be used in such a study? Hong secured the participation of several drug companies and funding from the U.S. Department of Defense.

Patients did indeed consent to biopsies and MD Anderson's imaging-driven needle biopsies were performed with minimal complications. The Biomarker-Based Approaches of Targeted Therapy for Lung Cancer Elimination (BATTLE) trial demonstrated that a personalized approach was not only feasible, but highly promising.

The BATTLE II clinical trial is evaluating the same approach for combinations of drugs, and BATTLE III is applying personalized therapy as frontline treatment.

Hong came to MD Anderson in 1984 as section chief in head and neck medical oncology. He has led the Division of Cancer Medicine since 2001. Hong is past president of the American Association for Cancer Research (AACR) and served on the board of directors of the American Society for Clinical Oncology (ASCO). He has won numerous international awards as well as major honors from AACR and ASCO.

He previously was awarded an American Cancer Society research professorship and the organization's distinguished service award.

The American Cancer Society - the nation's leading voluntary health organization and largest non-governmental investor in cancer research - awards the Medal of Honor annually to those who have made outstanding contributions to the fight for a world with less cancer.