Stephen P. Hunger, MD, has received numerous honors throughout his decorated career. However, winning the George R. Buchanan Lectureship Award from the American Society of Pediatric Hematology/Oncology (ASPHO) had particularly special meaning to the chief of the Division of Oncology and director of the Center for Childhood Cancer Research at Children’s Hospital of Philadelphia.
Recognized internationally in the field of pediatric leukemia clinical care and research, Dr. George R. Buchanan— past president of ASPHO and a renowned pediatric hematology physician-researcher — was very supportive of Dr. Hunger early in his career.
“I was both flattered and honored,” Dr. Hunger said of the distinction. “He helped me to get established nationally.”
Dr. Hunger accepted the award at the ASPHO Conference in May, where he personally thanked Dr. Buchanan and presented the lecture “Improving Survival for Children and Young Adults With Acute Lymphoblastic Leukemia.”
Can you briefly describe the lecture you gave at the ASPHO Conference?
I was encouraged to give a talk that would be accessible to the whole audience, which included everyone from trainees and fellows in pediatric hematology/oncology to people who have worked in the field for decades. I opened with a general overview of how the field has changed over the past 60 or 70 years. The most common cancer in children, acute lymphoblastic leukemia (ALL) was incurable until the early to mid-1960s. Then, I showed how clinical trials have led to steady improvements in survival, focusing on trials within the Children’s Oncology Group where I chaired the ALL Disease Committee for eight years. I concluded by providing my perspective on future research opportunities.
Where do you see future research heading?
A lot of gains have been made through optimizing how we use chemotherapy drugs that kill cells somewhat nonspecifically. They certainly kill cancer cells, but they also kill and damage normal tissue, which leads to side effects. My perspective for the future is that we will have more targeted therapies that have a better therapeutic index — much more specificity in terms of leukemia cell killing while sparing the normal cells. You move from dropping bombs to using targeted missiles. Also, certainly there is a great hope about the opportunity to incorporate immunotherapy into ALL treatment, hopefully leading to better cure rates and potentially allowing us to do away with some aspects of current therapy.
What inspires you to conduct research on leukemia?
Early in my career, I was a pediatric resident trying to decide what sort of specialty I wanted to do. I found I really enjoyed taking care of leukemia patients, and when I started the research components of my career, I began to do laboratory research in the basic genetic features of leukemia. Those two things merged: I liked both the research aspects and the opportunity to have long-term longitudinal relationships with patients and families.
With all the advances being made with leukemia, you must have such a strong sense of satisfaction when working with these patients and their families.
It is rewarding. I think the main thing that families want to know is we have treatments, and I try to consistently tell them that our goal is to cure people, not to just make them live well for a longer period of time.
What are the next steps for you? Do you have any big research projects in the works?
My research has gone along a couple routes. I’m still engaged in collaborative studies trying to improve the understanding of the genetic underpinnings of acute lymphoblastic leukemia, and in particular, how those can be used to refine therapies. I’m also exploring the role of new immunotherapies in treating leukemia. I’m not the driver of those, but I’m in a position where I can try to help young investigators conduct the studies to find where these therapies belong in the toolbox of treatments we have.
You have a strong reputation as a role model for trainees, junior faculty, and other investigators. Why is this so important to you?
People helped me to get established early in my career. I think the way you pay that back — besides thanking them — is trying to do the same for others when you’re in a position to do so.
Besides helping others, what do you love most about your work?
Collectively, over the years and decades, we have changed the landscape for how curable some of the common pediatric cancers are. I have always focused on acute lymphoblastic leukemia. The way I personalize it is the most common age to be diagnosed with ALL is between 3 and 5 years old. If I were diagnosed with ALL in the early 1960s, I wouldn’t have lived. But now, we can tell patients that overall we can cure about 90 percent of cases. That’s a big change over somebody’s lifetime.
What advice do you have for people just starting their medical careers?
People can be good at things they’re not really excited by, but very few can be great at something that doesn’t excite them. Find out what’s your passion. That’s most likely where you will make the most impact and derive the most personal satisfaction.