Ushering in a New Era in Personalized Medicine

Waun Ki Hong, MD, changed the landscape of patient care through pioneering research and biomarker-driven clinical trials.


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There is nothing more gratifying than looking into the face of a patient who may have lived because of something I did. At the end of the day, that is what really matters.

—Waun Ki Hong, MD

When Waun Ki Hong, MD, and his pregnant wife, Mihwa, made the journey from Korea to Manhattan in 1970, he had just $451 in his wallet, and the only job he could get was as an intern in Bronx-Lebanon Hospital Center, a community hospital in the Bronx. The work was grueling—24-hour shifts every 2 nights—and his lack of proficiency in English made it difficult to communicate clearly with his patients and hospital staff. The experience was so difficult and frustrating, and it was not the life he had been expecting when he decided to move to the United States. Today, looking over a nearly 50-year career as a physician/scientist whose pioneering research has resulted in three groundbreaking contributions in cancer medicine, Dr. Hong said he has achieved the American Dream.

Born on August 13, 1942, in a town 30 miles outside of Seoul, while Korea was still under Japanese colonial rule, Dr. Hong said his early years were relatively peaceful despite the occupation. It wasn’t until the Korean War between North and South Korea was declared in 1950 that life for Dr. Hong and his seven siblings became difficult.

“We had to leave our home and settle with the North Korean refugees,” said Dr. Hong. The experience, however, instilled in him a lifelong sense of stoicism and perseverance that enabled him to overcome the challenges of pursuing his education during wartime, serve 3 years in the Korean military, and then emigrate to the United States—where he became one of the country’s leading experts in head and neck and lung cancers.

A Brother’s Inspiration

Dr. Hong credits his older brother, Suk Ki Hong, MD, PhD, who made significant scientific contributions in renal physiology and diving medicine, with influencing his choice of a career in medicine. He died in 1999. “My brother was a physician/scientist, and I was inspired by his behavior. He was more than a mentor to me; he was like another father to me, and I decided to follow in his steps and go to medical school. I can never thank my brother enough for everything he did for me,” said Dr. Hong.

Dr. Hong received his medical degree in 1967 from Yonsei University College of Medicine in Seoul and was promptly drafted into the Korean Air Force. He served as a flight surgeon and was responsible for transporting wounded soldiers from battles in Saigon in Vietnam to Clark Air Base in the Philippines and then to the city of Daegu in South Korea for medical care.

Although the years from 1967 to 1970 were tumultuous ones for Dr. Hong, they also presented him with life-altering opportunities. He met Mihwa in 1968, and they married the following year. And then in 1970, Dr. Hong and Mihwa became the beneficiaries of a change in U.S. Immigration and Naturalization Act of 1965, also known as the Hart-Celler Act, which abolished an earlier quota system from the 1920s that was based on national origin and established a new immigration policy that created preference visa categories focusing on immigrants’ skills and reuniting immigrant families.

Forging a Landmark Career

In 1971, with his internship at Bronx-Lebanon Hospital Center nearly completed, Dr. Hong applied to hundreds of hospitals looking for a residency position in internal medicine. Finally, he received an offer from the Boston Veterans Affairs (VA) Medical Center, where Dr. Hong found his calling in oncology.

“When I was at the Boston VA Medical Centerm, I saw so many patients with head and neck and lung cancers and felt a responsibility to do something for them, which inspired me to pursue medical oncology as a subspecialty,” said Dr. Hong.

After deciding to specialize in oncology, Dr. Hong was accepted into a fellowship program at Memorial Sloan Kettering Cancer Center (MSKCC). With effective treatment for cancer still in its infancy, Dr. Hong saw many of his patients die, including Chicago Bears running back Brian Piccolo from a mediastinal germ cell tumor in 1970. It was while at MSKCC that Dr. Hong developed a passion for research and academia—two professional loves that would become the cornerstone of his work.

After finishing his fellowship in 1975, Dr. Hong returned to the Boston VA as Chief of Medical Oncology. There Dr. Hong launched his landmark career in oncology. Disturbed by the many cases he saw of head and neck laryngeal cancers and determined to improve patients’ quality of life, he designed and led the VA cooperative prospective randomized larynx preservation trial1 with Gregory T. Wolf, MD [now Professor Emeritus in the Department of Otolaryngology-Head and Neck Surgery at the University of Michigan Health System], which showed that cisplatin-based chemoradiation was an effective alternative to the standard of care at the time (total laryngectomy and postoperative radiation). The study results changed the way the disease is managed and has served as a model for organ preservation in many other cancers. “I learned that larynx preservation technique from my mentor at MSKCC, Robert E. Wittes, MD [former Physician-in-Chief of MSKCC], so I have to give him credit,” said Dr. Hong.

Launching a New Era in Precision Medicine

Nine years later, Dr. Hong was recruited by Irwin H. Krakoff, MD, Head of the Division of Medicine at The University of Texas MD Anderson Cancer Center and Dr. Hong’s mentor during his fellowship training at MSKCC, to join the staff of MD Anderson. He stayed at MD Anderson for the next 30 years, serving as Chair of the Thoracic/Head and Neck Medical Oncology Department; Head of the Cancer Medicine Division; and Vice Provost for Clinical Research. It is at MD Anderson that Dr. Hong achieved his next two major accomplishments in cancer care.

In 1986, Dr. Hong established a large multidisciplinary research program that included Scott M. Lippman, MD [now Director of the UC San Diego Moores Cancer Center], which focused on the chemopreventive potential of 13-cis-retinoic acid in the aerodigestive tract. Dr. Hong and Dr. Lippman and their colleagues later published results from a study showing that high doses of retinoic acid were effective in reversing oral precancerous lesions and in preventing second primary tumors in head and neck patients.2 Their work helped define a new discipline in cancer prevention.

In 2004, Dr. Hong and his colleagues developed a new paradigm of personalized cancer therapy in solid tumors with his work on the landmark BATTLE (Biomarker-Integrated Approaches of Targeted Therapy for Lung Cancer Elimination) trial, which ushered in a new era of biomarker-driven targeted therapy in drug testing.

“Coming to MD Anderson was the best career decision I ever made, because I was only doing clinical research at the Boston VA, but MD Anderson gave me the opportunity to do very sophisticated translational research as well as clinical research,” said Dr. Hong.

Paying It Forward

Two years ago, Dr. Hong announced his retirement as Head of the MD Anderson Cancer Center Division of Cancer Medicine. However, he is still active at the cancer institution, training and mentoring young physician-scientists accepted into the Advanced Scholar Program, an immersive learning program in academic research in oncology, and overseeing fellowship programs at the Sheikh Khalifa Bin Zayed Al Naghyan Institute for Personalized Cancer Therapy.

Having benefited from the mentoring he received from his brother, Dr. Hong said he feels an obligation to replicate that experience for other young physician/scientists. Over his career, he has trained several hundred medial oncology fellows nationally and internationally, as well as hundreds of postdoctoral fellows, which he counts among his greatest accomplishments.

“Mentoring is my passion,” said Dr. Hong. “My era will soon be gone. You have to bring up the next generation of scientists and have a strong pipeline of talented people to succeed you and that comes from mentorship.”

In Appreciation of a Stellar Career

Dr. Hong has been recognized for his career achievements with numerous awards, including the Medal of Honor for Clinical Research from the American Cancer Society, the Raymond Bourgine Award and the Claude Jacquillat Award from the International Congress on Anti-Cancer Treatment in France, and the Ho-Am Prize from the Samsung Foundation in Korea. He has served as President of the American Association for Cancer Research and received the organization’s Joseph A. Burchenal and Rosenthal Foundation Awards and was appointed by President George W. Bush in 2008 to serve on the National Cancer Institute’s National Cancer Advisory Board. Dr. Hong is the recipient of ASCO’s David Karnofsky Memorial Award and the ASCO/American Cancer Society Award as well as served on ASCO’s Board of Directors. Dr. Hong is also an elected member of the National Academy of Medicine.

A Life Well Lived 

Dr. Hong credits his family, his wife, Mihwa, and their two sons, Ed and Burt, with providing the support he needed to pursue his medical career as a young physician/scientist and relishes the time he now has in semiretirement to spend with his three grandchildren, Elizabeth, 12; Daniel, 9; and William Ki Hong, 2.

Now 73, Dr. Hong said his life experience of coping with the casualties of war as a child and young adult and the havoc it wrought on Korea gave him the patience, stamina, and focus to endure and overcome the language and cultural challenges he faced as a young immigrant to this country, trying to maneuver a complex medical system and build a career and raise a young family.

“Once you experience an underprivileged life, you can overcome challenging issues. The opportunities I found in this country no other country can match. I’m awed and humbled by my body of work and deeply honored to have been able to make some contributions that change the way we treat cancer and that move the world a bit closer to eliminating the disease. As a boy in Korea dreaming of coming to the “land of opportunity,” I never could have imagined I would achieve so much.

“There is nothing more gratifying than looking into the face of a patient who may have lived because of something I did. At the end of the day, that is what really matters.” ■

Disclosure: Dr. Hong reported no potential conflicts of interest.

References

1. Induction chemotherapy plus radiation compared with surgery plus radiation in patients with advanced laryngeal cancer. The Department of Veterans Affairs Laryngeal Cancer Study Group. N Engl J Med 324:1685-1690, 1991.

2. Lippman SM, Heyman RA, Kurie JM, et al: Retinoids and chemoprevention: Clinical and basic studies. J Cell Biochem Suppl 22:1-10, 1995.



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