Apr 12, 2023
By Leah Lawrence
Peter C. Adamson, MD, FASCO, is the recipient of the 2023 ASCO Pediatric Oncology Award, which recognizes the career and achievements of an individual who has contributed outstanding scientific work—laboratory, clinical, or epidemiologic—of major importance to the field of pediatric oncology.
“Pediatric oncology is a small community and being recognized by one’s peers is always quite rewarding,” Dr. Adamson said. “Pediatric oncology, to me, is one of the most rewarding fields because everyone shares the same goals, and you don’t have to explain the mission. I am incredibly honored.”
Dr. Adamson is the Global Head of oncology development and pediatric innovation at Sanofi and emeritus professor of pediatrics and pharmacology at Perelman School of Medicine at the University of Pennsylvania.
Drawn to Pediatrics
Dr. Adamson always had a strong interest in science and pursued his undergraduate degree in physical chemistry. However, he decided that as much as he loved working in the lab, he wanted a career that provided more. He turned to medicine.
In medical school, Dr. Adamson was confident he would go into pediatrics, and in residency focused on pediatric oncology for several reasons.
“Pediatric oncology combines a number of things that I find rewarding,” he said. “First, when you care for children with cancer and their families, it is a long-term proposition. You get to know the child and the family. It is not a single visit; you have the privilege of watching to child grow and develop.”
Additionally, research is inherent to the subspecialty, Dr. Adamson said.
“Anyone who has been in the field for more than a decade has seen the results of their participation in clinical research, and outcomes continue to improve,” Dr. Adamson said.
Evolution of the Subspecialty
The subspecialty of pediatric oncology really grew as a result of its focus on research and collaboration.
“The dedicated physicians who established the subspecialty knew they couldn’t tackle the problem alone. They focused on working and collaborating,” he said. “When one looks at outcomes for children’s cancer from the late 1960s to the 1990s, every generation has seen improvements in outcomes.”
It is often assumed that these improvements are a result of innovations in drugs, but it is not, according to Dr. Adamson. Many of the drugs used today were developed and improved upon throughout the 1950s, 1960s, and 1970s.
“Instead, we have developed a better understanding that things we were calling a single disease—such as acute lymphoblastic leukemia—was actually heterogeneous, and we learned to tailor therapy and make progress,” Dr. Adamson said.
The other focus over the years has been not only to maximize the cure rate but to minimize both the short- and long-term effects of treatment.
“A mentor of mine, Dan D’Angio, said, ‘Cure is not enough. We have to return the child to full health,’” Dr. Adamson said. “This is where we have made progress that shouldn’t be understated.”
In addition, the more recent additions of immunotherapy and cellular therapy to the mainstays of chemotherapy, radiation therapy, and surgery, has been remarkable.
“These are historical advances in treatment that future generations will continue to benefit from,” Dr. Adamson said.
Dr. Adamson was modest in addressing his own contributions to the field of pediatric oncology. Dr. Adamson was appointed by President Obama to serve on the National Cancer Advisory Board and by then-Vice President Biden to serve on the Blue Ribbon Panel for the Cancer Moonshot initiative.
More recently, Dr. Adamson served as chair of the Children’s Oncology Group, an international consortium of more than 200 childhood centers with more than 10,000 members.
In his own words, many of Dr. Adamson’s contributions have been in helping to design trials that answer important questions as efficiently and quickly as possible.
“Most of my work has been in early phase trials and first-in-children trials, and from a clinical perspective, caring for children and families who have very few therapeutic options,” Dr. Adamson said. “Although our success rate is never what we want it to be, combining quality care with new therapies that we are studying has been extremely rewarding.”
Dr. Adamson, who is also a clinical pharmacologist, also works to help ensure that researchers and clinicians fully understand the adage “children are not just small adults.”
“We have to make sure we understand that when we give these potentially very toxic drugs to children that we are doing it in the most rationale way and maximizing the chance of benefit while minimizing the risk of toxicity,” Dr. Adamson said. “We have to apply that knowledge with every new therapy we develop.”
Future of the Field
In the next 5 to 10 years, Dr. Adamson hopes that pediatric oncology will continue to leverage the immune system to treat childhood cancers.
“When I think of the challenges we face today, we have to make sure the research structures are able to keep up with advances,” Dr. Adamson said, acknowledging that the challenges today pale in comparison to the challenges faced by those who began treating children with cancer decades ago.
“I want to learn how we can best harness the immune system, to better understand how the immune system of a developing child works, and how we can bring that to bear in improving outcomes,” Dr. Adamson said. “Lessening the toxicity of our therapies must remain on almost an equal plane to improving cure rates. Despite all our success, there is still an incredible amount of work that needs to be done.”