Dr. Lawrence Fong: Transforming Cancer Treatment

reprinted from Issue 24, Spring 2017 of Frontiers of Medicine (PDF)

Lawrence Fong, MD

Lawrence Fong, MD, led some of the first clinical trials of immunotherapy, and continues to be a pioneer in this rapidly advancing field.

For oncologist and immunotherapy pioneer Lawrence Fong, MD, cancer is personal. His father died of lymphoma when Fong was in college, inspiring a lifelong focus on cancer.

“I became really intrigued by the complexity and power of the immune system, and one of my medical school professors was interested in cancer immunotherapy,” said Fong, now the Efim Guzik Distinguished Professor in Cancer Biology. “That really planted the seed of thinking about using the immune system to treat cancer.”

Fong, a San Francisco native, grew up in the Russian Hill neighborhood. He received his medical degree from Stanford University School of Medicine, and completed internal medicine residency at the University of Washington in Seattle and medical oncology fellowship and postdoctoral fellowship in pathology at Stanford. In 2002, Fong joined the UCSF faculty, collaborating with other researchers who shared an interest in tumor immunology.

Fong worked closely with Eric J. Small, MD, now the chief of the Division of Hematology and Oncology, Doris and Donald Fisher Distinguished Professor in Clinical Cancer Research, Stanford W. and Norman R. Ascherman Endowed Chair, and deputy director of the UCSF Helen Diller Family Comprehensive Cancer Center.

Fong, Small and their colleagues brought some of the first immunotherapy drugs from the lab to the clinic. They identified a protein called prostate acid phosphatase, using it as a target for a prostate cancer vaccine called sipuleucel-T or Provenge – now approved by the U.S. Food and Drug Administration (FDA) for treatment of prostate cancer. They also led firstin- human trials of ipilimumab, also known as Yervoy, now an FDA-approved immunotherapy for melanoma. It works by lifting immune system “brakes” associated with CTLA-4, enabling the immune system to aggressively pursue cancer.

Persevering through Lean Times

Although the potential of cancer immunotherapy has intrigued physicians for more than a century, its clinical usefulness has only recently been demonstrated. “I joke that four or five years ago, the field of cancer immunotherapy was a little bit of a support group for people who were diehards, thinking this approach would really work,” said Fong. “It was a very difficult time, not only because of cynicism from our peers, but because it was very difficult to get grants from the NIH [National Institutes of Health]. I certainly would not have predicted that we’d be treating so many different cancers with immunotherapy, and that companies would have invested billions of dollars to develop immunotherapy drugs.”

Today, Fong is the co-leader of the UCSF Cancer Immunotherapeutics Program, and directs its Cancer Immunotherapy Clinic, where patients can access the latest new drugs through clinical trials. The program also includes a cancer immunotherapy laboratory, which rigorously studies patients’ responses to novel agents.

“The program has been an outstanding success, and is a testament to Larry Fong’s skills both as a researcher and a clinician,” said Alan Ashworth, PhD, FRS, president of the Helen Diller Family Comprehensive Cancer Center and E. Dixon Heise Distinguished Professor in Oncology. “It allows UCSF to provide patients with access to new treatments, and to do it at scale.”

“It’s such an exciting time,” said Fong. “As a family member of someone who died from cancer, I want to be able to offer effective treatments to patients. The pace of development has really accelerated, and we can go from ideas to actually treating patients with some of our concepts in not that long a period of time.

“I have some of the most fulfilling relationships in my life with my patients. We tend not to talk about the mundane, but rather about pretty significant questions. You learn a lot about a person in that context, and I’m privileged to help guide patients through their disease.”

Outside of medicine, Fong enjoys mountain biking and spending time with his family. He is married to Nina Loh, MD, a radiologist with the Palo Alto Medical Foundation. Together they have three children: Grant, Mara and Alana.

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