Cancer biology and cancer cures: reflections of a clinical investigator: presidential address.

Basic biological principles in cancer biology can be learned from laboratory experiments as well as the clinic. The clinical investigator may be able to uncover cancer biology and clinical cures, an exciting possibility. Clinical trials can and should be designed to discover biological principles as well as to test one option of surgery or drug combination versus another. During the past 20 years, a variety of clinical research programs in patients with myeloma, chronic myelogenous leukemia, lymphoma, and breast cancer have led to the discovery of important biological principles. These include contributions leading to the origin of myeloid and lymphoid cells in the marrow, the discovery of immunoglobulin D myeloma, the development of effective combination chemotherapy in Hodgkin's disease, and the concept of adjuvant therapy in breast cancer. These studies also have led to improved or new therapy for these diseases. Future research and cancer cures will undoubtedly be facilitated by close collaboration between the clinical and the laboratory investigator.