Everett Vokes1, Jin Ye Yeo2
1Section of Hematology/Oncology, Department of Medicine, University of Chicago Medical Center and Biological Sciences, Chicago, IL, USA; 2TLCR Editorial Office, AME Publishing Company
Correspondence to: Jin Ye Yeo. TLCR Editorial Office, AME Publishing Company. Email: editor@tlcr.org
This interview can be cited as: Vokes E, Yeo JY. Meeting the Editorial Board Member of TLCR: Prof. Everett Vokes. Transl Lung Cancer Res. 2025. Available from: https://tlcr.amegroups.org/post/view/meeting-the-editorial-board-member-of-tlcr-prof-everett-vokes.
Expert introduction
Prof. Everett Vokes (Figure 1) is the John E. Ultmann Distinguished Service Professor; Chair, Department of Medicine, Physician-in-Chief at the University of Chicago. He earned his MD from the University of Bonn Medical School, West Germany, in 1980. A clinical and translational investigator, Prof. Vokes focuses on the biology and treatment of lung and head and neck cancers and the interaction of chemotherapy and radiation and integration of targeted and immune-based agents. He established the intellectual and clinical basis of national trials investigating concomitant chemoradiotherapy and other approaches to providing multispecialty care and leads clinical and translational investigations both at the university and nationally.
Figure 1 Prof. Everett Vokes
Interview
TLCR: What initially drew you to oncology and subsequently focus your research on lung, head, and neck cancers?
Prof. Vokes: I have been in the field of oncology for all of my medical career. I grew up in (then) West-Germany and went to the University of Bonn Medical School. It is a small town with a longstanding academic and university tradition (and the Capital of West Germany at the time). The medical school was of high quality, but oncology in Germany was still underdeveloped. There were good clinical trials, particularly for hematologic malignancies. However, oncology for solid tumors was not yet an established specialty. While in Medical School, I did a rotation in Australia for 2 months at a community hospital that was linked to Sydney University, and they had an oncology unit. Patients, mostly with lymphoma, were treated with systemic chemotherapy. It made sense to me that cancer would frequently be a systemic disease, not just a local problem. For that, you need to treat the body as a whole, and back then, that meant chemotherapy. There were emerging curative regimens for some lymphomas and leukemias, so the idea that we could use drugs for systemic cancers very much intrigued me. During my medical residency in Chicago, I again observed that patients who were treated with systemic approaches could sometimes do very well. That intrigued me, and I thought that oncology would be a field for me. I wanted to conduct research on curative treatments for solid tumors but also saw the challenge given the limits of available therapeutics. Thus, combinations of available treatment modalities were imperative. Foundational to my work has been the interaction of chemotherapy and radiation and the integration of new drugs into those paradigms.
As an Assistant Professor at the University of Chicago, I was able to lead clinical trial approaches to head and neck cancer, frequently in collaboration with Ralph Weichselbaum (Chair of Radiation and Cellular Oncology). This included trials of neoadjuvant chemotherapy regimens or concomitant chemoradiotherapy focused on survival and/or organ preservation. I gained insights into these approaches and realized I could apply the same concepts to lung cancer.
TLCR: Your career has been marked by an innovative approach to integrating chemotherapy, radiation, and immune therapies in cancer treatment. What were some of the key moments in your career that led you to explore these multidisciplinary treatment approaches?
Prof. Vokes: There was a trial we did in the late 1980s to early 1990s in head and neck cancer. Chemotherapy and radiation given concomitantly were already being done, but more frequently than not, chemotherapy was given at mini-doses. In general, we want chemotherapy to do two things: one is to make the radiation more effective in the radiated field, and the other is to have a systemic effect against micrometastatic disease so that both local and systemic control can be improved. For that to work, you need to give chemotherapy at the systemic doses. Hence, we designed a regimen for head and neck cancers that allowed us to give radiation and full doses of chemotherapy and were able to show that we were curing patients while allowing organ preservation. This laid the groundwork for today’s curative intent regimens, which are based on systemically dosed chemotherapy.
TLCR: Can you share some of the most significant discoveries from exploring these multidisciplinary treatment approaches and how you see these combinations changing the future landscape of cancer treatment?
Prof. Vokes: We laid the foundation for the concurrent administration of full-dose chemotherapy with radiation that is curative and now a standard in several types of solid tumors. This applies not only to head and neck cancer, where it can now cure a majority of human papillomavirus (HPV)-related tumors and a significant number of patients with alcohol and tobacco-related disease.
The same principles of systemic-dose chemotherapy and radiation also apply to stage III lung cancer. A recent trial that I was directly involved in established that cisplatin and pemetrexed, which is the preferred 2-drug combination for stage IV non-squamous non-small cell lung cancer, can be given at full doses with radiation therapy. This regimen remains foundational to current trials integrating chemoradiotherapy with immunotherapy.
TLCR: As Chair of the Department of Medicine at the University of Chicago, you have had the opportunity to mentor many young researchers and clinicians. What do you consider the most important traits for aspiring oncologists and researchers in this highly competitive field?
Prof. Vokes: Aspiring oncologists and researchers need to have a mentor or a mentoring committee who can give advice and lead them to promising research directions. Ultimately, it is the inherent drive of the mentee that allow him/her to be successful. What is needed is intellectual curiosity and engagement. They need to know what they are interested in and what problems they want to help solve and then pursue them with determination and energy.
TLCR: What has been the most rewarding aspect of your work as both a clinician and a researcher in the oncology field, and what keeps you motivated to continue pushing the boundaries of treatment options?
Prof. Vokes: I believe most clinical and translational researchers will ultimately be motivated by their patients. That is certainly the case for me. I still have a busy practice, seeing both head and neck and lung cancer patients. It is clear that there is a lot of work to be done, but there are many rewarding moments when outcomes are good or when we see that a new drug works.
Inspiring moments in my career have been the major successes that have occurred in our field over recent years. First, it was supportive care, particularly anti-nausea and growth factor support agents. The targeting of driver mutations by tyrosine kinase inhibitors was revolutionary in lung cancer. Recently, various types of immunotherapy research have also improved outcomes and further linked oncology to basic science and biology.
A place like the University of Chicago has other departments with young trainees that want to collaborate. The overall environment supports collaboration, and there are few departmental barriers to training and working with one another, so the environment has also been very rewarding to be a part of.
TLCR: Looking ahead, what are some of the key challenges and opportunities in the treatment of lung, head, and neck cancers, and how do you think the research community can address them in the future?
Prof. Vokes: Lung cancer has seen a lot of progress. For early-stage disease, chemoimmunotherapy, given neoadjuvantly or sometimes perioperatively, has led to improved survival. In that setting. I think the biggest challenge is to know who is truly benefiting from the treatment, how long the treatment should be given, and whether we have endpoints other than survival, which we do not establish until many years have passed. It is about prognostic and predictive indicators and better ways to assess treatment. At the other end of the spectrum is stage IV disease. We now know how to use tyrosine kinase inhibitors and when to use currently available immunotherapy, but there are many remaining questions. There are new immunotherapy drugs and bispecific agents that are coming along, as well as some of the antibody-drug conjugates.
In the middle, you have stage III disease, and that is about combined modality therapies. This area is where my focus has been for many years. It has become clear that giving immunotherapy concurrently with chemoradiation is not the way to go. In fact, it seems to be detrimental in both small cell and non-small cell lung cancer. In stage III and unresectable disease, neoadjuvant chemotherapy has been underinvestigated. If it works in stage I and II diseases, I think it is highly possible that it would work in stage III disease when given before chemoradiotherapy, and such trials should be conducted.
TLCR: As an Editorial Board Member, what are your expectations for TLCR?
Prof. Vokes: The journal is focusing on an area in lung cancer that should drive the future, which is translational research that has clinical relevance but signifies some of the underlying principles derived from biology. I think the niche and the overall sphere of lung cancer research is a very good one. Ultimately, it depends on interesting our readership and having articles that are meaningful and influential to the field.