Sidney Farber

Farber's research was primarily focused on diseases in children and infants. His work at Children's spanned many areas, including cystic fibrosis, celiac disease, infant hyaline membrane disease, Eastern equine encephalitis, eosinophilic granuloma, meconium ileus, and sudden infant death syndrome.[2][5] As a result, Farber is now known as a founder of pediatric pathology.[5]

Through the mid- to late-1940s, childhood acute lymphoblastic leukemia was almost inevitably fatal and little was known about the mechanisms of the disease. Only basic forms of treatment were available, including red blood cell transfusions and antibiotics, leading to survival rates of merely weeks to months after diagnosis. Despite general pessimism in the scientific community towards efforts to cure cancer, Farber became dedicated to the battle against childhood leukemia in 1947 during his assistant professorship at Children's Hospital and Harvard Medical School.[1]

Farber discovered that folic acid plays a key role in the proliferation of cancer cells in leukemias. Realizing this, he attempted to use a folate antagonist, aminopterin, to block the function of folic acid in patients with leukemia in hopes of achieving remission.[6] In 1947, Farber conducted a clinical trial on aminopterin on 16 children, 10 of which eventually achieved temporary remission.[7] While many practicing physicians responded to these results with enthusiasm, many scientists expressed disbelief and resistance against the new drug since Farber, a young pathologist at the time, was viewed as presumptuous. However, Farber's discovery marked a breakthrough in cancer research since no drugs had previously been found effective against tumors of the bodily fluids.[7]

While working at Harvard Medical School on a research project funded by a grant from the American Cancer Society, he carried out both the preclinical and clinical evaluation of aminopterin (synthesized by Yellapragada Subbarow). He showed for the first time that induction of clinical and hematological remission in this disease was achievable.[4][8] These findings promoted Farber as the father of the modern era of chemotherapy for neoplastic disease, having already been recognized for a decade as a founder of modern pediatric pathology.[1]

Throughout the 1950s and '60s, Farber continued to make advances in cancer research, notably the 1955 discovery that the antibiotic actinomycin D and post-operative radiation therapy could produce remission in Wilms' tumor, a pediatric cancer of the kidneys.[7][9] The antibiotic, derived from Streptomyces parvulus, was originally offered for free by the Eli Lilly Pharmaceutical Company.[9] Farber and his colleagues published their results on the efficacy of actinomycin D in 1960, and further development of treatment protocols by the National Wilms Tumor Study Group resulted in a 90% survival rate in children with Wilms' tumors by the end of the century.[9]

In 1939, during his appointment at the Children's Hospital, Farber worked with colleague Jerome S. Harris to publish a classic description of the transposition of the great blood vessels in the heart.[1] This work played a major role in the development and advancement of pediatric cardiac surgery.[2]

In 1952, Farber described a lipid storage disease that was subsequently named Farber disease.[10]

Farber began raising funds for cancer research with the Variety Club of New England in 1947. Together they created the Children's Cancer Research Foundation (CCRF), which was one of the first nationwide fundraising efforts to take full advantage of modern media, such as a broadcast of the radio show Truth or Consequences. On May 22, 1948, one of the CCRF's first patients to respond to Farber's antifolate, a twelve-year-old boy named Einar Gustafson, appeared on the show. Despite having Burkitt lymphoma, rather than leukemia, Gustafson (nicknamed 'Jimmy' for publicity purposes) became an inspiration for all pediatric cancer patients and triggered the renaming of the CCRF to the Jimmy Fund.[1]

The success of the Jimmy Fund led Farber to realize the importance of marketing in the scientific advancement of knowledge about diseases. For the remainder of his career, Farber would extend far beyond his identity as a pathologist and oncologist, becoming not only a clinician but a public cancer research advocate too. This personal transition reflected the shift in society's attitude towards cancer as well; bringing cancer into the public spotlight propelled funding and awareness for cancer research for the remainder of the century and beyond.[4]

Beginning in the early 1950s, and continuing until his death in 1973, Farber became a star presenter at Congressional hearings on appropriations for cancer research.[1] A compelling speaker, he was very successful in his efforts. With Mary Woodard Lasker, a longtime advocate of biomedical research, famed surgeon Michael E. DeBakey, Senator J. Lister Hill of Alabama and Congressman John E. Fogarty of Rhode Island, Farber led the drive for a massive expansion in federal spending for cancer research.[1] Between 1957 and 1967, the annual budget of the National Cancer Institute, the government's primary funder of cancer research, jumped from $48 million to $176 million.[11]

In 1974, Farber's CCRF was renamed the Sidney Farber Cancer Center, and again in 1976 to the Sidney Farber Cancer Institute. Long-term financial support by industrialist Charles A. Dana and his foundation was acknowledged by the building of the Charles A. Dana Building in 1978 and the establishment of the Institute's present name of the Dana–Farber Cancer Institute in 1983.[1]