Franco Muggia, former head of CTEP and NYU cancer center, dies at 85

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Franco Muggia, a drug developer and former director of NYU Langone’s Perlmutter Cancer Center, died unexpectedly on Sept. 8. 

Photo courtesy of NYU Perlmutter Cancer Center

Muggia continued to practice literally till his final day.

Muggia went into oncology after hearing a Karnofsky lecture. Not the prestigious annual lecture the American Society of Clinical Oncology has named after David A. Karnofsky, but a lecture by Prof. Karnofsky himself, at Cornell Medical College.

“It was the first lecture we had in medical school as freshmen,” Muggia said in a podcast interview with Daniel F. Hayes, a breast cancer expert at the University of Michigan and a former ASCO president, who has recorded a series of interviews with oncology pioneers. “And in our 30th reunion, a few years later, I talked about Karnofsky, how he inspired me to think about the clinical matters in cancer and his performance status evaluation. I remember that very well. Nobody else did.

“I guess it resonated with me, but not with [others]—mostly surgeons in my medical school.”

Muggia’s life story is richer than most. Karnofsky gets a part, but so does Benito Mussolini. 

Muggia was born in Torino, Italy, on Jan. 2, 1936. His father was a pediatrician who taught at the university.

“He never joined the fascist party. In fact, he was best friends with the socialists that remained at that time,” Muggia tells Hayes. “Mussolini was brutal. He wanted everybody to become a fascist. And anybody who served at the university lost their jobs. 

“So that, plus the racial laws, which made Jews not be citizens, led to a big decision in the family. It was a phone call, whether we wanted to join an enterprise in Quito, Ecuador, in a pharmaceutical company. And my mother said, ‘I don’t know where the place is, but let’s go. So, that’s how it happened. So, in a matter of a few weeks, we were gone. 

“And I was three years old.”

During his career in oncology, Muggia worked on the pharmacology of bleomycin, nitrosoureas, taxanes, and platinum compounds. As an associate director of the NCI Cancer Therapy Evaluation Program, he helped to get these agents into academia, where they were tested and developed into treatment regimens. 

Muggia played a leading role in the Gynecologic Oncology Group, helped found the New York Gynecologic Oncology Group and the New York Phase I Trials Group, and led the Chemotherapy Foundation. For two decades, Muggia was the editor-in-chief of the NCI Physician Data Query Adult Treatment Editorial Board.

Muggia came to the U.S. in 1952 to finish high school. He went to Yale, then Cornell Medical College. He completed internship training at Bellevue Hospital, residency at Hartford Hospital, and a hematology-oncology fellowship at Columbia University. 

There, he trained alongside future giants in medical oncology, including Drs. Gianni Bonadonna and Joseph Fraumeni. He moved on to Einstein College of Medicine, then became one of the “Yellow Berets” at NCI, opting to sit out the Vietnam war in Bethesda, a move he eloquently describes in a podcast with Hayes: 

“Once I became a citizen, I actually became eligible for the draft. And that was the main reason why I ended up at the National Cancer Institute. So, it had a great effect on my career, that I actually volunteered for the Public Health Service in 1969, because Lyndon Johnson changed the rules for physicians. And if you hadn’t served, you had to serve up to age 35.

“So, I decided I should join, not head to Vietnam, like many of my classmates from Cornell. And it really was a career change for me.”

At the NCI Medicine Branch, Muggia worked in the laboratory of Vince DeVita and George Canellos, in a unit headed by Paul Carbone. He was later named associate director of CTEP. 

Muggia joined NYU School of Medicine in 1979 as professor of medicine and director of the Division of Medical Oncology. At that juncture, his focus turned to women’s cancers, especially gynecologic malignancies.

In 1986, he moved to the USC Norris Comprehensive Cancer Center, where he worked to optimize intra-peritoneal platinum and liposomal doxorubicin therapies for ovarian cancer. He returned to NYU in 1996, as director of the cancer center from 1996-1997. At the time, the institution was called Kaplan Cancer Center at NYU Medical Center. 

Muggia was later named head of the Division of Medical Oncology, a position he held until 2009.

After stepping down as division chief, he continued his commitment to clinical care, research and education of the next generation as a senior faculty member. 

Muggia is survived by his wife Anna, daughters Diana, Vickie, Paola, and Julia, and 10 grandchildren, who, until last year, took hiking in Italy. He is also survived by his older brother, Albert, a retired gastroenterologist.

Muggia remained scientifically relevant until his final day, colleagues say: 

James H. Doroshow
NCI deputy director for Clinical and Translational Research.

There aren’t many people who have done 600 or 700 clinical trials over their career, who have experience with the whole spectrum of drugs used to treat cancer from the beginning of oncology in the 50s and 60s through the 2000s. But he never got the credit he deserved, because he wouldn’t toot his own horn.

Daniel F. Hayes
Stuart B. Padnos Professor of Breast Cancer Research
University of Michigan Rogel Cancer Center

The field of medical oncology is relatively new, stretching back only 60 or 70 years, when courageous physicians, mostly from the hematology arena, began treating childhood leukemia and adult lymphomas with chemotherapy. 

These early advances led to demonstration of cures of childhood and certain adult leukemias as well as Hodgkins Disease, non-Hodgkins lymphoma, and testicular cancer.

I trained in the early 1980s. Thus, I and my contemporaries entered the field about halfway from its inception to the current time. During that period, we have seen remarkable advances in almost every corner of cancer diagnosis and treatment. We were luckier than our medical school colleagues who chose other diseases, in that we trained under, and got to know, the pioneers who were responsible for kickstarting the field of medical oncology.

Sadly, but not unexpectedly, we have begun to see these giants begin to pass away. Among others, Drs. Emil Frei, Emil Freireich, and James Holland, the trio responsible for the first cures by combining chemotherapy as opposed to sequential single-agent therapy, have all left us within the last few years. Likewise, Drs. Bernard Fisher and Gianni Bonadonna, who demonstrated the survival benefits of adjuvant chemotherapy in breast cancer, are also both gone.

This week, we lost another pioneer: Franco Muggia. 

I was first introduced to Franco when I was in the last year of my fellowship at the Sidney Farber Cancer Institute (now the Dana Farber Cancer Institute), by my Division Chief Dr. George Canellos, his good friend. Within minutes, Dr. Muggia was not only shaking my hand, he was asking me about my interests and research focus. We kept in touch through the years, and at each visit he remained as enthusiastic about listening to my droning on as he was at that first meeting.

Fast forward to 2018, when I was completing my term as president of the American Society of Clinical Oncology. With ASCO’s permission and help, I initiated a podcast series in which I have interviewed many of the folks who really set the stage for the rest of us to follow. One of the first interviews was with Franco Muggia. 

I, of course, knew of the role he played at the National Cancer Institute in supporting the early days of the cooperative groups and other clinical research initiatives. I also knew of his pivotal efforts to get cisplatin, now one of the most widely used drugs in all of oncology, into the clinical research community. 

Indeed, to close the circle, I became an oncologist, because of my experience as a third-year medical student at Indiana University assigned to the oncology ward. There, I witnessed Dr. Larry Einhorn demonstrate that 90% of men with testicular cancer could be cured with cisplatin—an accomplishment that might never have happened if Franco had not been an evangelist for the drug.

In my interview with Franco, in addition to stories about those early days, I heard another side of his life—his remarkable journey from fascist Italy to Quito Ecuador to escape Mussolini, and then his immigration to New York for education. But what I really heard was his enthusiasm and incredible passion for patient care, and for those patients for whom he cared. At the end of the interview, we chatted, but then he said, “Dan, I want to run a case by you…”

Franco Muggia will be missed dearly, by his family, by his friends and colleagues, by me, and by his patients. His was a life well lived.

Vincent DeVita
Amy and Joseph Perella Professor of Medicine and Professor of Epidemiology and Public Health at the Yale School of Medicine 
(via Twitter)

So sad to hear of the death of my good friend and longtime colleague Franco Muggia. We spent many years working together at the National Cancer Institute and beyond. Working with Franco was always a pleasure. Franco was a mainstay in Medical Oncology and cancer drug pharmacology. 

Margaret Foti
CEO, American Association for Cancer Research

Franco was an innovator and a true champion for improved cancer care. He dedicated his life to providing better treatments for patients through his impactful clinical research that transformed the standard of care, especially for ovarian cancer.

He was a pioneer in the early development of many new effective chemotherapeutic agents, most notably cisplatin, and his work was instrumental to the launch of clinical trials evaluating their efficacy and toxicity.

In addition to his long and fruitful research career, he remained fully committed to his activity as a clinician, and he cared deeply about his patients.

Franco was a thought leader in the cancer field, serving on committees and for organizations dedicated to the prevention and treatment of gynecologic and other cancers and supporting research on innovative therapies.

Franco was an active and long-standing member of the AACR. He served as an associate editor of Cancer Research in the 1980s and as a valued mentor for the Scientist↔Survivor Program held at the AACR Annual Meeting.

His legacy will live on through the remarkable achievements of the hundreds of medical oncologists he mentored and trained during his long career.

Photo courtesy of NYU Perlmutter Cancer Center.

James Speyer
Medical oncologist, Perlmutter Cancer Center at NYU Langone
Professor of Medicine, NYU Grossman School of Medicine

Franco Muggia was blessed with an extraordinary and infectious curiosity combined with a keen intellect, enormous integrity and an unswerving dedication to every one of his patients. These, coupled with his innate optimism, inspired generations of physicians to pursue careers in oncology.

Franco’s curiosity extended well beyond medicine. He was very much a renaissance man with command of many languages, a keen grasp of history and a deep appreciation of the arts.

There was never a lecture or scientific seminar where Franco was not found sitting in front rows, paying attention and carefully taking notes, often on the back of a piece of folded paper. And then he seemed to remember it all weeks or even years later. 

Franco simply loved learning. While he loved to travel and eat good food, his constant attendance at meetings at home and throughout the world was simply his way of connection with people and new ideas. He found scientific meetings a source of new inspiration and organized many of them in GYN oncology, platinum chemistry, clinical pharmacology including intraperitoneal therapy, chemoprevention against anthracycline induced cardiac toxicity and many new drugs. 

His taking the helm of the Chemotherapy Foundation after the departure of its founder Ezra Greenspan led it and its annual symposium to new heights as an important international forum for new developments in cancer treatment.

Franco had an enormous reservoir of optimism. Even when the data from a clinical trial appeared negative to many, he would end his reviews with statement that there were observations presented that warranted further pursuit. 

There was always something positive to find, even in the most mediocre presentations. In a similar way his interactions with colleagues were usually focused on their assets or potential rather than their faults. He rarely had something negative to say about other people. And I never, over decades, heard anybody say something negative about Franco Muggia the man.

His curiosity and positive approach as well as his humanity guided his approach to his patients.

Every patient was a unique human being with unique challenges. He was always seeking new treatments to help each one of his patients while at the same time leading clinical trials and data reviews that would improve the care of all patients. While an approach might seem unorthodox at times it was guided by scientific facts gained in a lifetime of learning.

He would use it to inform the treatment of the individual patient and think about how to create trials or laboratory collaborations to determine the validity of an approach. 

Besides his font of knowledge and dedication to his patients, Franco was one of the finest clinicians and diagnosticians with whom I and my colleagues have had the privilege to know and work. His observations and ability to tie together facts and patient based observations often led us to a clearer understanding of the problem at hand.

His greatest professional achievement is embodied by the countless physicians in the field of oncology who say: ‘If it were not for Franco, I would not be who I am and where I am today.’

James Speyer

Simply put, it was exciting and stimulating to work with Franco Muggia, whether you were a medical student, a brand new trainee or a colleague of many years. It was never dull.

This rare combination of curiosity, intellect, honesty, skill as a clinician and dedication to each individual patient and optimistic search for improvement in the care of every patient is what inspired so many people over the past 60 years.

His absolute integrity and optimism were unparalleled and they rubbed off on his colleagues and trainees.

There is a generation of physicians at NYU Langone’s Perlmutter Cancer Center and across six continents that point to Franco Muggia as the reason they went into oncology, often pursuing careers as clinical investigators with the enthusiasm and knowledge gained from him.

His teaching and mentoring never stopped—iIt was part of him. Right up until the time of his death, he was actively involved in a number of projects, some on a national or international scale and some with individual medical residents considering a career in oncology. You could always go to Franco with a difficult case or problem and he would do the same. On his last day, he came in to see a patient who was ill and then wanted to talk about three cases of AML in patients with ovarian cancer who had received a PARP inhibitor.

Yes, he was a man of many achievements. In my view, his greatest professional achievement is embodied by the countless physicians in the field of oncology who say: “If it were not for Franco, I would not be who I am and where I am today.”

Photo courtesy of NYU Perlmutter Cancer Center.

Victoria Shields
NCI PDQ Adult Treatment Editorial Board Manager.

We were so privileged to have Dr. Franco Muggia, a pioneer in oncology, chair the National Cancer Institute’s Physician Data Query (PDQ) Adult Treatment Editorial Board for more than 20 years. Under his leadership, the board curated over 280 evidence-based cancer treatment summaries for health professionals and patients in English and Spanish. 

Over the years, he thoughtfully reviewed literature for the gynecologic and rare tumor summaries, recruited bright and talented members, and encouraged the Board’s careful critique of the evidence. He took pride in mentoring other oncologists and will be remembered not only for his brilliant mind but also for his humble and generous spirit. 

On a more personal level, I am grateful to have had the opportunity to work alongside Dr. Muggia since he joined the board in 2000. As a practicing oncologist, he understood the value of evidence-based summaries for clinicians and patients and was a strong advocate for PDQ. And he was always so kind and modest that it was easy to forget that I was working with one of the leaders in oncology.”

Michael G. Rosenberg
President, Chemotherapy Foundation.

The board and medical directors of The Chemotherapy Foundation of New York, mourn with profound sadness, the unexpected passing of Dr. Franco M. Muggia, our esteemed longtime chairman, friend, colleague, and a tireless champion, architect and originator of some of the most innovative treatments of cancers in use today. 

Franco was a giant in the field, whose contributions and work loomed large, influencing the world’s leading physicians and patient treatment worldwide. 

He touched and saved countless lives, provoked thought and inspired researchers at universities, private and public institutions and shaped direction at leading pharmaceutical companies and the therapies they brought to market. 

His leadership of the Chemotherapy Foundation and many years heading the annual Chemotherapy Symposium in New York City, was conducted with intellect and humility and as was the gentle manner he brought to treating thousands of patients who he selflessly cared for over a lifetime. 

Muggia presenting at the EORTC Symposium on New Approaches to Cancer Therapy in Madrid, Oct. 2-3, 1980. 
Photo courtesy of NYU Perlmutter Cancer Center.

Abraham Chachoua
Associate director, Cancer Services, Perlmutter Cancer Center at NYU Langone

Jay and Isabel Fine Professor of Oncology, Department of Medicine at NYU Grossman School of Medicine

A lot has already been eloquently said about Franco by my colleagues; rather than repeat all the well-deserved accolades and tributes, I want to tell you about Franco Muggia, how this brilliant, talented, yet understated man molded my career: 

“I think your training will make you an ideal candidate to build our AIDS program at NYU.” 

Franco travelled so much that there was a running joke: ‘What’s the difference between God and Franco?’ God is everywhere and Franco is everywhere except at NYU.

Abraham Chachoua

With these handwritten words Franco reached out to me across the ocean in Australia and instilled in me the desire and ambition to help build a program; me just finishing training, I felt that this was a rare honor even though at that time there was little understanding about this disease and there was so much fear.

It exemplified Franco’s ability to inspire with just a few words. This letter was followed by a phone call from Michael Green, another Australian who was working with Franco at the time: 

“You will get to learn from one of the most brilliant men I have ever met. You will work with a master clinician and an amazing researcher. Sitting with him you will get to hear all these ideas that will change your life.” 

That is how my decades-spanning relationship with Franco began. That is how I got to learn from one of the true giants of oncology.

I quickly discovered that Franco knew EVERYONE, and everyone knew him; he travelled extensively in his quest to learn and teach. I got to work with many talented “super fellows,” who came to NYU from all over the world to learn from Franco. 

Many have gone on to illustrious careers of their own. 

Franco travelled so much that there was a running joke: “What’s the difference between God and Franco?” God is everywhere and Franco is everywhere except at NYU.” 

Please do not misunderstand; we just wanted Franco for ourselves.

The weekly tumor board with Franco at the head of the table and master of ceremonies was an inspirational learning experience, 

“You should measure serum chromogranin;” “Maybe try measuring tumor markers in CSF;” or “I read about this in a lab study, maybe you should try it.” 

These pearls of wisdom would just keep coming, and to this day I can still hear him say these things to me.

It was through watching Franco that I began to appreciate that medicine, and particularly oncology, is a mixture of factual knowledge and the art of applying this knowledge for the maximum benefit of patients. Franco had encyclopedic knowledge, but he was also the ultimate artist when it came to treating cancer. If I am a fraction of this today, it’s because of Franco.

Listening to Dr. James Holland speak one day about the evolution of modern oncology, he described the oncology generals (including Franco) who came out of the NCI to lead the army in the war against cancer. 

So, to Franco: My general, I salute you. I will miss you, but you will live on in the hearts of the countless soldiers in your army. 

1985 NCI Consensus Development Conference on Adjuvant Breast Cancer Treatment. Pictured top, from left: Franco Muggia, Bernard Fisher, Gianni Bonadonna. Bottom, from left: Paul Van Nevel, Sandra Swain, Frank Cummings, and George Canellos.
Photo courtesy of  NCI.

Rosemary W. Mackey
Managing Partner, Mackey Krakoff Healthcare Consulting

Franco influenced my career.

We first met in 1974, when I was hired by one of his partners, Juden Reed, M.D. at Tenbroeck Medical Associates, a private practice associated with Albert Einstein College of Medicine in the Bronx. 

Juden was also a medical oncologist, and my initial role was to work with him as a medical assistant. That quickly evolved into my working with Franco who had recently broken his leg as a result of being thrown from a horse and was on crutches. 

Members of the PDQ Adult Treatment Editorial Board at the 2010 NCI Director’s Award Ceremony. Pictured from left: Barry Kramer, Margaret Beckwith, Giuseppe Giaccone, Victoria Shields, Franco Muggia, and Harold Varmus.
Photo courtesy of  NCI.

Even on crutches, he was always in a hurry—it was hard to keep up with him.  He was passionate about finding new clinical trials through the Eastern Cooperative Oncology Group that might help his patients. He and Juden were quintessential, dedicated physicians who seemed to work day and night.  They often saw their patients in the hospital well into the wee hours of the morning.

In 1976, Franco was recruited by Vince DeVita, the director of the National Cancer Institute in Washington, to head the Cancer Therapy Evaluation Program at NCI and while I would have loved to continue working with him, a move with two small children and a husband with a career in New York made that impossible. He did, however, trade one Ms. Mackey for another, Elise Mackey became his right-hand person in D.C.

We always stayed in touch. Seeing one another at ASCO annual meetings and watching each other’s children as they grew. 

Time passed, and then, in 1999, when the NYU Cancer Center where he had moved after the NCI was in danger of losing its core grant, and also hadn’t moved with the times and lacked an inpatient oncology unit or an ambulatory cancer center, Franco suggested to the dean at that time, Robert Glickman, that my husband, Irv Krakoff and I might be helpful in leading a strategic analysis and implementing the steps necessary to return the cancer center luster to NYU.

In concert with Terry Bischoff, the president of NYU Medical Center and with Franco’s support, that was achieved, and the NYU Cancer Center has grown from strength to strength. Franco returned to what he did best, teaching and mentoring medical students, residents and fellows, caring for his patients and travelling the world to attend cancer meetings and give lectures. 

Along with the late Dr. Joe Burchenal, I owe Franco an enormous debt for nurturing my career in cancer research and administration.

Omid Hamid 
Chief of research/ immuno-oncology, The Angeles Clinic & Research Institute
Co-director, Cutaneous Malignancy Program, Cedars-Sinai Cancer

Franco Muggia’s passing hit me hard. There aren’t many people in my life like Franco.  There aren’t many people left in the world like Franco. 

My memory is not sterling, but I cherish all of the talks that we had. Those have not faded. We met at USC where he shaped my view of medicine and oncology. 

Our last time together was walking the halls at ASCO 2018, but it seems like yesterday—the apprentice hanging on every word from the master, hoping the hallway would never end. He made everyone feel special, individual, important. He ensured that we felt like equals.

I read Twitter this week and noticed the same sentiment. We all rushed to share our loss, claim our place as one of his students, move on together. There were more talks to be had, one more lesson to learn.

Franco Muggia was authentic to who he was every day. He was a healer and teacher. I was not surprised to hear that he had clinic on the day he passed. Service was part of his identity.

When you read the resume, it doesn’t do justice to the man. It does set a bar of service that we should all strive to reach daily. Our talks ended with a smile and a hug, I will miss that. His memory is a gift.

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