First Leader

Paul P. Carbone, MD

Early in his career, Paul Carbone felt honored to be invited to speak at ASCO's first meeting, presenting his "Contributions of Cytogenetics to Chronic Myelogenous Leukemia." ASCO's initial gathering, held during the 1965 American Association of Cancer Research (AACR) conference, drew attendees from across the U.S. and Canada. "We met in a single room; about 65 of us could all get together," Dr. Carbone recalls. "It was then very difficult to present papers at the American Society of Hematology--they weren't really interested in cancer papers--and hard for a clinical researcher to become an AACR member. That was the genesis of ASCO," explains Dr. Carbone, whose main focus has been laboratory and clinical research. "In its early years, ASCO was a very good way of gathering clinical researchers to present their findings."

As the ninth ASCO President (1972-1973), he strove to preserve the Society's clinical research aspects, trying "to maintain and develop the AACR relationship, as long as I could. Then ASCO became so big, it was like the tail wagging the dog. The decision to become independent was because the baby grew up," reflects Dr. Carbone, who also served as AACR president while the groups were still affiliated (1979-80). "ASCO is now the much larger organization. I think it was good to have its members recognized by AACR for their research."

As ASCO evolved, it added a large educational component to its Annual Meeting. "Many people at meetings are not researchers any more but interested in what's going on." Dr. Carbone calls the current direction "a large CME approach," adding, "Community physiclans are involved, as well. I think it's important to have them participate." He usually attends the ASCO Annual Meetings, enjoying the President's dinner there.

The winner of ASCO's 1995 Distinguished Service Award for Scientific Achievement began his impressive career at the National Cancer Institute in 1960, where he became head of its Medicine branch. Noting such colleagues as Emil Freireich and Emil "Tom" Frei, he comments, "It was a great place to be." Moving to the National Institutes of Health (NIH), he worked on the first use of white-cell transfusions and the demonstration of transfusion-induced transplantation and explored eliminating the Philadelphia chromosome with chemotherapy. By 1971, Dr. Carbone was Chair of the Eastern Cooperative Oncology Group (ECOG), which was conducting clinical trials in 300 hospitals and medical schools. The University of Wisconsin, one of the first comprehensive cancer centers, drew Dr. Carbone because he thought it was a good place to continue his clinical research. He became head of Medical Oncology there in 1976, Chair of the Department of Human Oncology in 1977, and Director of its cancer center from 1978 to 1997. He is now the center's Director Emeritus and Professor of Medicine Emeritus.

To Dr. Frei, Physician-ln-Chief Emeritus at Dana-Farber Cancer Institute, Dr. Carbone's main accomplishments include central roles in developing a curative treatment for Hodgkin's disease (MOPP) and in defining chronic myelogenous leukemia as a multilineage disease. He also points to other valuable contributions. "As Chairman of the Breast Cancer Task Force, Paul was involved in research, decisions, and support for the initial studies of successful adjuvant chemotherapy for breast cancer. With [ECOG], he implemented research on a number of fronts and provided national leadership. It was a big group; Paul made it the best group. He's known as an outstanding clinician, teacher, and administrator in addition to his scientific contributions," he adds.

Adding to that sentiment is another oncologist, David Carbone, a medical oncologist at Vanderbilt University Cancer Center and son of Dr. Paul Carbone. "Working in Uganda in his early career and later in Taiwan, as well as his leadership in ECOG, are examples of his total dedication to improving the lives of patients with cancer everywhere," says David. Dr. Paul Carbone's work at the Taiwan Academy of National Sciences led to the development of the medical oncology training program there. In addition, as a Visiting Professor at the National University of Singapore, he helps plan cancer programs for citizens and lectures at Seoul National University Cancer Center's clinical trial workshops.

"Working in Uganda in his early career and later in Taiwan, as well as his leadership in ECOG, are examples of his total dedication to improving the lives of patients with cancer everywhere." David Carbone, MD

He is proud to have served on the first certifying committee of the American Board of Internal Medicine for Medical Oncology. "We helped write the first exam and definitions of medical oncology, when there were no accredited medical oncologists," recalls Dr. Carbone, who has published more than 350 papers. He is also gratified to have trained so many American oncologists at NIH and Wisconsin. In Taiwan, Dr. Carbone "trained 13 oncologists who became leaders in oncology and now train others, as heads of departments there."

"Partially retired" since 1998, Dr. Carbone's two new NIH grants for phase III clinical trials in preventive chemotherapy for bladder cancer and skin cancer each involve more than 330 patients. "It's been exciting to be involved in [working on] advances in cancer prevention. At the NIH, we developed some important drugs, like vincristine, BCNU, and hydroxyurea."

Dr. Carbone's enthusiasm for his work was felt at home too. While David followed his father into oncology, two other of the seven Carbone children also became physicians. He and Mary, his wife of 47 years, have 16 grandchildren and enjoy living in Madison. Commenting on his father's impact in the oncology community, David says, "Everywhere I go, I run into people he has trained, mentored, or supported in some way, and very often I hear that he did so when he didn't have to and didn't stand to personally benefit."

Carol Milano


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