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Dr Waun Ki Hong Reflects on Career Milestones in ASCO 2018 Interview

Gina Columbus @ginacolumbusonc
Published: Friday, Jan 04, 2019

Waun Ki Hong, MD

Waun Ki Hong, MD

Pivotal clinical trials in oncology that laid the groundwork for organ preservation, chemoprevention, and precision medicine can be traced back to pioneering medical oncologist Waun Ki Hong, MD.

Hong, who was the former head of the Division of Cancer Medicine at The University of Texas MD Anderson Cancer Center, passed away on January 2, 2019. He was most recently recognized by OncLive as the 2018 Giant of Cancer Care® in Head and Neck Cancer.

Throughout his career, Hong held an essential role in the development of larynx-sparing treatments for patients with head and neck cancer through the VA Cooperative Group for Laryngeal Cancer Study, results of which demonstrated that induction chemotherapy and radiation had noninferior survival outcomes to standard laryngectomy and radiation. Additionally, 64% of patients who received chemotherapy had their larynx preserved.1

Additionally, Hong was a senior author on the prospective, randomized BATTLE trial, which demonstrated the feasibility of a biopsy- and biomarker-driven approach for patients with advanced non–small cell lung cancer.2 The late physician also advocated for the development of chemoprevention.

In an interview with OncLive during the 2018 ASCO Annual Meeting, Hong reflected on his career milestones in head and neck cancer and how his pioneer initiatives continue to make inroads across malignancies.

OncLive: You were recognized as a 2018 Giant of the Cancer Care® in Head and Neck Cancer. What does this peer-nominated award mean to you?

Hong: This is a wonderful, incredible honor—something I never expected at all. It was a total surprise. I don’t think I belong in the category of the [Giants of Cancer Care®], and when I received an email [about it], I didn’t believe it. It is such a great honor.

You have had a number of notable achievements throughout your career. What stands out to you?

I am a first-generation immigrant of this country. I came to this country in 1970 and, in fact, [this year] is 48 years of my immigration to the United States. I have had a wonderful career and started my medicine training at Veterans Affairs (VA) Medical Center in Boston, and then at Memorial Sloan Kettering Cancer Center, where I did my oncology fellowship. Then, I went back to Boston Veterans Administration Medical Center as chief of medical oncology and then moved to The University of Texas MD Anderson Cancer Center in 1984.

When I started my career in mid-1970s at Boston Veterans Administration Medical Center, I ended up seeing a lot of patients with head and neck cancer, especially the patients who had radical surgery and lost their voice box from total laryngectomy. It was really devastating to see that kind of disfiguring in these patients with head and neck cancer.

I was fortunate to have chemotherapy [available] at the time, which was cisplatin and bleomycin and induction chemotherapy followed by radiation treatment. We treated a small number of patients and found [that patients] who had sequential induction chemotherapy followed by radiation achieved excellent local control and, at the same time, spared the larynx. That was a very intriguing finding; many other people observed the same findings.

[We wanted to prove it]; you had to develop a randomized study. One group received the chemotherapy and radiation treatment, and the other group had standard treatment, which was total laryngectomy and radiation. There was a huge challenge, I must tell you, in the late 1970s. I tried to get research grants from the National Cancer Institute (NCI); it failed.

Then, finally, I [began the] VA Cooperative Group for Laryngeal Cancer Study along with my partner Gregory Wolf, MD, who is a head and neck surgeon from the University of Michigan. That proposal was approved with the funding. That was a really dramatic trial initiated in 1980; there were 332 patients [with] 166 patients in each arm. Results showed equal survival [between arms], but the patients who received chemotherapy/radiation treatment had their human voice box spared. This was considered one of the major advances in cancer treatment in the 1990s. That paper was published in 1991 in the New England Journal of Medicine.

That was the organ preservation concept and it expanded to other sites, such as breast conservation in patients with breast cancer, and anus preservation in anal cancer, and bladder conservation in bladder cancer. I was very fortunate to be in the right place and right time, and worked with the right people and, simply, I was very fortunate. That is the larynx preservation concept.

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