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Department of Medical Oncology

The Department of Medical Oncology provides compassionate clinical care for patients with cancer; conducts transformative basic, translational, and clinical research; and provides leading education, training, and mentorship in cancer medicine.

Clinical, Research, and Educational Activities

Patient Care

Integration of clinical care and research, with a personalized and multidisciplinary approach to oncology medicine

Basic research focused on blood and solid tumors, molecular and cellular oncology, and population sciences

The department coordinates hematology and oncology fellowships at Brigham and Women's Hospital, Dana-Farber, and Massachusetts General Hospital, and offers clerkships in hematology/oncology at Harvard Medical School.

Medical Oncology By the Numbers

• 300+ Harvard Medical School (HMS) Faculty 
• 360+ Clinical and Research Fellows
• $280M+ Research dollars awarded to our investigators in 2022

Our Patient Care

• 14 Clinical divisions led by Internationally recognized leaders in their fields
• 290,000+ outpatient visits in 2022
• 190+ average inpatient daily census

Our Research

• 3 Research divisions creating academic communities of investigators with similar interests
• 80+ highly collaborative research labs
• 637 Clinical trials in Fiscal Year 2022

Medical Oncology at Dana-Farber

Trace the remarkable growth and development of medical oncology at Dana-Farber – from its early roots to today’s mission-driven commitment to excellence in research, care, collaboration, and training.

Research and Care Within — and Across — Disease Boundaries

The Department of Medical Oncology integrates outstanding basic cancer research and clinical oncology within the same department. Clinician-scientists within Medical Oncology provide substantial expertise within their specific programs, as well as interdisciplinary areas such as cancer genetics and prevention, early drug development, and population sciences.

Clinicians in the department have deep understanding of the genetics and biology of cancer and engage in clinical research with deep correlative scientific studies. Nearly all basic scientists in the department are clinically trained and are motivated to link the implications of laboratory findings to potential clinical impact, and to take clinical observations as the inspiration for laboratory studies. Nearly all laboratory-based principal investigators also see patients in a clinical division, and many attend on inpatient services. And most clinical investigators have ties to one or more research or disease programs within Dana-Farber/Harvard Cancer Center (DF/HCC).

All of our faculty collaborate with external institutions and serve on national and international oncology committees and steering groups. Faculty actively contribute service and leadership, providing an open two-way conduit for expertise that benefits the Institute and the broader oncology and health care communities. Faculty perform cutting-edge basic and clinical research, and provide education and training to the next generation of physicians and scientists who are focused on the biology and treatment of cancer.

Support Our Cancer Research

To learn more about the many ways you can support Dana-Farber's research initiatives with a philanthropic gift, please email Rebecca Shortle or call 617-632-4215

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Researchers in the hsci cancer program are working to establish the crucial differences between normal stem cells and their cancerous counterparts..

The goal of the program is to develop therapies that can eradicate cancer cells – and their entire lineage – without harming healthy tissues. This ambitious goal demands a profound understanding of how, precisely, a normal stem cell becomes a cancer cell. Some of the world’s foremost cancer researchers are collaborating across Harvard's schools and hospitals to do just that.

• Identify the critical genes and pathways that distinguish cancer from normal stem cells.
• Pinpoint which of these – in what combination – could serve as candidate targets for therapy.

What we have achieved so far:

HSCI Cancer Program scientists have:

• Isolated normal stem cell populations from intestine and colon tissue, and characterised their molecular profiles extensively.
• Identified and investigated key pathways operating in lung-tumor-propagating cells.
• Demonstrated what factors are required for leukemia stem cell development and survival.
• Clarified the role of a specific mutation that controls signaling in tumor-propagating cells in human pancreatic tumors.
• Developed imaging technologies for visualizing single tumor-initiating stem cells in the laboratory.

Program Leaders:

Carla F. Kim, Ph.D.

Mario Suva, M.D., Ph.D.

Get the latest hsci research news, related news, mutant protein switches sides in melanoma, kara mckinley named packard fellow for science and engineering, kara mckinley receives nih director’s new innovator award, hsci faculty member appointed the inaugural regenerative biology endowed chair at boston children’s hospital.

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that provides shared resources and a collaborative environment for over 1,100 cancer researchers at 7 Harvard institutions.   Learn more about DF/HCC here

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September 24, 2024 –  Announcements

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NCI is requesting applications for the Early Career Cancer Clinical Investigator Award (ECIA). The ECIA recognizes and supports outstanding early career clinical investigators who are committed to building a career as an…

September 24, 2024 –  Cancer Disparities

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Faces of Faith is on exhibit September 23 - November 1; In-Person RECEPTION: OCTOBER 15, 2024 | 4:00 PM EST

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We are pleased to announce that Nareg Grigorian has been named as the new Director, Office of Data Quality supporting clinical research across Dana-Farber/Harvard Cancer Center. Nareg’s many years of service, and his…

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To assess a smoker’s lung cancer risk, think years — not packs.

Jeffrey Yang with patient Albertha Gethers, who was treated for lung cancer at Mass General Hospital.

Photos by Jodi Hilton; Illustrations by Liz Zonarich/Harvard Staff

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Far more cases get caught when screening guidelines consider duration of habit regardless of intensity, study finds — especially among Black patients

When deciding who to screen for America’s deadliest cancer, should a person who has smoked a pack a day for 20 years get priority over someone who has smoked fewer cigarettes over the same amount of time?

That’s the question tackled by  Harvard Medical School  and  Massachusetts General Hospital  researchers in a recent study that showed that lung cancer screening guidelines set by the U.S. Preventive Services Task Force — requiring the equivalent of a pack a day for 20 years — miss a large proportion of cases and fail to close a screening gap between Black and white patients. That gap means lung cancer among Black patients is too often caught later in the disease’s course, leading to higher mortality.

The researchers, whose work was published earlier this year in the  Journal of Clinical Oncology , suggest switching instead to a simple measure that would recommend annual screening for anyone who’s smoked for 20 years, regardless of how many cigarettes they smoke a day. Both guidelines also require the individuals be between ages 50 and 80 and either be current smokers or having quit within the last 15 years. The simplified guideline would widen the pool of those who qualify for lung cancer screening and, according to the study, both increase the proportion of cancer cases that are caught and virtually eliminate racial disparities in lung cancer screening eligibility.

“We found that it completely eliminated the racial disparity in the proportion of lung cancer patients who would have qualified among both people who currently smoke as well as people who formerly smoked,” said  Alexandra Potter , the study’s first author, clinical research coordinator at Massachusetts General Hospital, and president of the  American Lung Cancer Screening Initiative .

Smoking duration vs. intensity and risk

The 20 pack-year threshold can be difficult to use and inaccurate, said senior author  Chi-Fu Jeffrey Yang , associate professor of surgery at Harvard Medical School and a thoracic surgeon at MGH. That’s because the equivalent of smoking a pack a day for 20 years could mean smoking half a pack daily for 40 years, two packs a day for 10, or any other permutation that results in the required combination of smoking intensity and duration. In addition, most people who smoke have smoked different amounts at different times of their lives which, decades later, can be difficult to recall. Plus, while it may make intuitive sense that someone who smokes more intensely has a higher risk of developing lung cancer, studies have not shown that the risk due to smoking intensity is equivalent to the risk from smoking duration, as the pack-year standard implies, the authors said. 

White patients tend to smoke more each day

In the work, supported by the National Institutes of Health and the Agency for Healthcare Research and Quality, researchers applied both the current screening guidelines and the proposed simplified guidelines to participants in two studies: the Southern Community Cohort Study, which included both Black and white subjects receiving care at community health centers in the U.S. Southeast, and the Black Women’s Health Study, whose study population was limited to Black women. Both included data on subjects’ health and smoking history. 

Researchers first applied the current screening guideline and found that, of those who developed lung cancer in the Southern Community Cohort Study, just 58 percent of Black patients and 74 percent of white patients would have qualified for screening. In the Black Women’s Health Study, just 43 percent of those who developed lung cancer would have qualified for screening.

By contrast, applying the simplified 20-year smoking duration guideline would capture over 80 percent of both Black and white participants who developed lung cancer in the Southern Community Cohort Study, and 64 percent of lung cancer patients in the Black Women’s Health Study. That would not only significantly increase the percentage of lung cancer cases eligible for screening, it would virtually eliminate the racial disparity in eligibility.

That racial disparity, the authors said, largely stems from the fact that current guidelines include the pack-a-day measure of smoking intensity, which varies between Black and white individuals. White individuals smoke significantly more each day, lowering the bar for screening eligibility. That has been seen in previous studies and was apparent in Potter and Yang’s research as well. Research has identified several possible explanations for differences in smoking intensity and lung cancer risk, including differences in nicotine metabolism between Black and white people who smoke. However, there are also an array of social and cultural factors still unexplored, the authors said. 

“We showed that the median number of cigarettes smoked among Black patients with lung cancer was almost half of that among white patients with lung cancer,” Potter said. “Even though they smoke similar durations, intensity was really the driving factor in the difference between them.” 

Other screening barriers

The debate over who should get screened and when is just one part of lung cancer’s dismal landscape. Smoking is its leading cause, accounting for 85 percent of cases. It is one of the most aggressive cancers, Yang said, meaning it can spread rapidly if not caught early. It kills more people annually — in both the U.S. and the world — than colon, breast, and prostate cancers combined, and is expected to kill 125,070 Americans in 2024, according to statistics from the American Cancer Society. 

Despite lung cancer’s deadly record, a recent study by the American Lung Association showed that more than 80 percent of those who qualify for screening don’t even know it is an option. Further, only between 5 percent and 19 percent of those who qualify actually get screened for lung cancer.

“It pales in comparison to breast cancer, colon cancer, and cervical cancer screening, where 70 to 80 percent get screened,” Yang said. “There’s a huge gap.”

Of those who qualify for lung cancer screening don’t even know it’s an option

Of those who qualify actually get screened for lung cancer

Of lung cancer cases are caused by smoking

Americans are expected to die from lung cancer this year

In addition to lack of awareness, part of that gap may be due to additional requirements placed on those seeking a lung cancer screening, Potter said. Unlike a mammogram, which a patient can schedule themselves, lung cancer screening has to be scheduled in conjunction with a visit to a healthcare provider. While it’s not bad to have a provider involved, Potter said, it is an extra step and one required by many insurers before they’ll pay for the procedure.

“Out of lung, breast, colon, and cervical cancer, lung cancer is the only one where it’s required to have this formal documentation of a shared decision-making visit,” Potter said. 

The screening itself is straightforward, noninvasive, and takes just minutes, Yang said. Patients can stay in their street clothes and lie on a table for a CT scan that takes a series of X-rays to create an image of the lungs, revealing any tumors that might be present. 

Yang said a recent patient’s case highlights the situation. She smoked lightly — just three cigarettes a day — but for many years. The light intensity of her habit put her at just 8.4 pack-years, not enough to qualify for lung cancer screening. Fortunately, she was able to get screened through an ongoing clinical trial, called INSPIRE, that Potter and Yang are leading to investigate lung cancer screening in high-risk Black women. The scan showed three small, aggressive cancerous nodules that Yang was able to remove surgically. 

“She’s doing very well right now, but she’s 69 and without the screening this would certainly have come back in her 70s as stage IV lung cancer with a very, very different outcome,” Yang said. “We’re hoping that people take a good look at pack-years and whether this is really the best measure overall and the best criterion for Black cancer screening eligibility.”

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Tuesday, September 24, 2024

New cancer diagnoses did not rebound as expected following pandemic

Cancer incidence trends in 2021 largely returned to what they were before the COVID-19 pandemic, according to a study by researchers at the National Institutes of Health (NIH). However, there was little evidence of a rebound in incidence that would account for the decline in diagnoses in 2020, when screening and other medical care was disrupted. One exception was breast cancer, where the researchers did see an uptick in diagnoses of advanced-stage disease in 2021. The study appears Sept. 24, 2024, in the Journal of the National Cancer Institute.

A previous study showed that new cancer diagnoses fell abruptly in early 2020, as did the volume of pathology reports, suggesting that many cancers were not being diagnosed in a timely manner. To determine whether these missed diagnoses were caught in 2021, possibly as more advanced cancers, researchers from NIH’s National Cancer Institute (NCI) compared observed cancer incidence rates for 2021 with those expected from pre-pandemic trends using data from NCI’s Surveillance, Epidemiology, and End Results Program .

A full recovery in cancer incidence should appear as an increase over pre-pandemic levels (also known as a rebound) to account for the missed diagnoses. The researchers looked at cancer overall, as well as five major cancer types that vary in how they are typically detected: through screening (female breast and prostate cancer), due to symptoms (lung and bronchus and pancreatic cancer), or incidentally during other medical procedures (thyroid cancer).

Cancer incidence rates overall and for most specific cancers approached pre-pandemic levels, with no significant rebound to account for the 2020 decline. However, in addition to an uptick in new diagnoses of advanced breast cancer in 2021, the data also provided some evidence of an increase in diagnoses of advanced pancreatic cancer. Also, new diagnoses of thyroid cancers in 2021 were still below pre-pandemic levels.

The researchers concluded that 2021 was a transition year that was still affected by new variants and new waves of COVID-19 cases, which continued to impact medical care. They said the findings highlight the need for ongoing monitoring to understand the long-term impacts of the pandemic on cancer diagnoses and outcomes.

Nadia Howlader, Ph.D., Division of Cancer Control and Population Sciences, National Cancer Institute

“ Impact of COVID-19 on 2021 Cancer Incidence Rates and Potential Rebound from 2020 Decline ,” appears September 24, 2024, in the Journal of the National Cancer Institute.

About the National Cancer Institute (NCI):  NCI leads the National Cancer Program and NIH’s efforts to dramatically reduce the prevalence of cancer and improve the lives of cancer patients and their families, through research into prevention and cancer biology, the development of new interventions, and the training and mentoring of new researchers. For more information about cancer, please visit the NCI website at cancer.gov or call NCI’s contact center, the Cancer Information Service, at 1-800-4-CANCER (1-800-422-6237).

About the National Institutes of Health (NIH): NIH, the nation's medical research agency, includes 27 Institutes and Centers and is a component of the U.S. Department of Health and Human Services. NIH is the primary federal agency conducting and supporting basic, clinical, and translational medical research, and is investigating the causes, treatments, and cures for both common and rare diseases. For more information about NIH and its programs, visit www.nih.gov .

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