Dr Maura Lianne Gillison was a visionary trailblazer (Figure 1). Best known for her original discovery that a growing subset of head and neck cancers are caused by human papillomavirus (HPV), she continued over the brilliant arc of her career to transform this initial observation into further findings with impacts across oncology, epidemiology, public health, virology, genomics, immunology, and public policy.
FIGURE 1.
Maura Lianne Gillison, MD, PhD. This photograph is provided courtesy of the Symer–Gillison family.
An intellectual force with a prescient intuition, Dr Gillison was able to uniquely synthesize information from science, culture, humanities, politics, and conversations to crystallize a novel perspective on vexing questions that puzzled the majority. This made her the perfect communicator, advocate, and expert about the new disease entity that from the beginning seemed to engender complex scientific and policy controversies. In her research, she was not satisfied with simply sharing her forecasts or explanations; she rigorously demonstrated them. Paradigm‐shifting, her contributions revolutionized cancer research, treatment, and prevention worldwide.
Not surprisingly, findings that represent seismic shifts invite scrutiny. Dr Gillison welcomed that scrutiny and addressed questions head on with calm confidence that the data would speak for themselves. She was a firm believer that the truth is not political and therefore taught many of us to keep the conversation on the data, which would reveal the true story. Her doctoral thesis mentor at the Johns Hopkins Bloomberg School of Public Health, Keerti Shah, MD, PhD, was one of the first to identify HPV as a causal agent for cervical cancer. He imparted an early lesson that she described as the “secret to my success: an exclusive focus on the data helps one rise above the politics.” As she calmly explained concepts in the simplest and clearest way, she did so with compassion, confidence, and an “esprit de rire”—always finding a way to connect and move people forward. Once reassured that the connection was made and the concept was understood, she would flash her characteristic beaming smile.
She fostered community; built exceptional teams of collaborators and colleagues; and advocated strongly for those she believed were productively contributing, including communities of scientists, women, and believers in data—individuals whose commitment would result in progress for humanity.
After moving around for many years throughout Canada, Mexico, and the United States, Dr Gillison’s family settled in a suburb of Cleveland, Ohio. She attended Hathaway Brown School through high school and Duke University and Oxford University for undergraduate studies. She went on to Johns Hopkins School of Medicine for her MD degree and internship, and after completing her medical residency training at the Massachusetts General Hospital, she returned to Johns Hopkins for her clinical fellowship in medical oncology. She described her training period at Johns Hopkins as pivotal and idyllic, an environment where academic curiosity and rigor were promoted and inspiration abounded. It was there that she met her husband and intellectual partner, David Symer, MD, PhD.
She and her teams of trainees and colleagues made seminal discoveries that transformed the fields of head and neck cancer and cancer epidemiology, each of which spawned new lines of research and networks of collaboration. With each of these findings, which are now accepted as facts, there was initial resistance to the concepts because they were new, represented departures from prior understandings, and challenged the norms of the fields.
She was the first to provide definitive evidence, as part of her doctoral dissertation, in a retrospective case series that HPV, the most common sexually transmitted infection, is etiologically responsible for a distinct subset of head and neck cancers and suggested a distinct phenotype with better survival. While colleagues around the country wondered about this concept and asked why they were seeing more patients and younger patients with tonsil cancer, Dr Gillison went on to quell the uncertainty.
Building on this early case series, with characteristic scientific rigor, she performed a seminal prospective case–control study that furthered our understanding of the malignancy by showing that behavioral risk factors and biomarkers of exposure to HPV (i.e., oral HPV DNA) and oncogenesis (i.e., HPV‐16 E6 antibody) were strongly associated with the diagnosis of oropharynx cancer. In addition, HPV transcripts were found only in HPV‐positive tumors. Thereafter, Dr Gillison and her colleagues showed that the behavioral risk factors and unique phenotypes for patients with HPV‐associated head and neck cancer were distinct from those for HPV‐negative malignancy and overlapped with those for healthy individuals with oral HPV DNA.
Along with colleagues at the National Cancer Institute, she elucidated the dynamic epidemiology of head and neck cancer by detecting an epidemic of HPV‐associated oropharynx cancer surging in the United States and globally. They also projected that oropharynx cancer was overtaking cervical cancer. They established the impact of vaccination on oral HPV prevalence in a nationally representative cohort.
Dr Gillison led her trainees and multi‐institutional colleagues, using prospective, multi‐institutional data, to show the markedly better survival for HPV‐positive patients, which was reproduced by hundreds of other studies internationally. This work led to the concept of treatment de‐intensification, integration into national cancer care guidelines, and development of a distinct staging system for the disease. This laid the foundation for evaluating distinct therapies for patients with HPV‐positive cancers rather than treating all patients with head and neck cancers the same.
When immunotherapy was changing the treatment paradigm in lung cancer, she quickly recognized its relevance in head and neck cancer due to the neighboring anatomy, shared mucosa, and overlapping biological and molecular drivers. She partnered with colleagues to make the case to explore immunotherapy in trials of patients with recurrent and metastatic head and neck cancer, and for the first time in decades, there was an improvement in survival for patients with this previously recalcitrant disease.
Dr Gillison called for responsible de‐intensification of therapy for patients with HPV‐positive oropharynx cancers to ensure that favorable survival was not compromised for patients, which she demonstrated in a large cooperative group study. She was the leading authority whose work led to consideration of the anti‐HPV vaccine for prevention of oral, not only anogenital, HPV and a tireless advocate for the need to vaccinate. In her 2021 David A. Karnofsky Memorial Award lecture, “From Molecules to Populations: Elucidating Risk Across the Natural History of HPV‐Caused Cancers,” she warned that even with current vaccination and screening efforts, population growth means an estimated 1.3 million cervical cancer cases annually by 2069. HPV, she insisted, “remains a major cause of human cancers and is worthy of further study and investment.”
In her final scientific chapter, she devoted herself and her laboratory to the identification of genetic events leading to carcinogenesis, with the optimism that this would serve as the window to identification of new therapeutic targets. She also investigated tumor‐ and virus‐specific immune responses in patients with head and neck cancers. In the INVAX single‐arm, observational trial of patients treated with immune checkpoint inhibitors and intensity‐modulated radiotherapy, her laboratory comprehensively analyzed immune phenotypes in responding patients versus nonresponding ones. They asked what immune microenvironment factors correlated with immune response versus a lack of response. Her recent studies also are very likely to benefit patients with cancer in the future.
Throughout her career at Johns Hopkins, The Ohio State University, and the MD Anderson Cancer Center, Dr Gillison was an exceptional and devoted clinician. She listened intently to her patients, sought to understand their wishes, and looked for the most effective ways to care for them. She applied the same rigor, inquisitiveness, enthusiasm, and compassion to the clinic, where she served scores of patients alongside multidisciplinary colleagues and trained clinical fellows and residents.
Much of Dr Gillison’s work was completed with trainees and collaborators who became her close friends. Through these projects, they answered questions of significance to patients, families, and society, which is how Dr Gillson approached her work—it had to be important. There were interesting questions that could be answered, but she saw no need to spend her time on those. She was exacting as a mentor, scientist, and coauthor. She got into the details, ensured the fidelity of thought process, and made certain that each story was clearly told by both explaining its significance to eliminate ambiguity and foreshadowing what was coming next.
Dr Gillison accomplished much of her early work at a time when there were few women in the field. She later leveraged her impact and influence to create opportunities for all. She credited her clinical mentor, Arlene Forastiere, MD, who “worked very hard to support and promote promising young investigators, many of whom happened to be women. By promoting talented women, she changed the research environment of the head and neck cancer community at large.” Following her mentor, who initiated pivotal trials as chair of the Head and Neck Cancer Committee of ECOG–ACRIN from 1993 to 2006 and was an influential member of the SWOG Cancer Research Network and NRG Oncology, Dr Gillison collaborated with Barbara Burtness, MD (current chair of the Head and Neck Cancer Committee of ECOG–ACRIN), Quynh Le, MD (NRG chair and prior head and neck NRG chair), and Sue Yom, MD, PhD (current head and neck NRG chair), to design and conduct several landmark clinical trials through the cooperative setting. This likely contributed to head and neck cancer becoming the specialty in which women are most likely to serve as the lead author of a clinical trial in comparison with other specialties of oncology and head and neck surgery.
Dr Gillison mentored many whose contributions now continue to build on initial collaborations with her. She opened new doors to the story of HPV in epidemiology, early detection, and prevention. In an interview in 2024, she noted with satisfaction, “Today, the head and neck field overall has more gender equality than most subspecialties.” This was particularly important to her as the mother of two young women, whom she raised to be inquisitive, graceful, and kind, with encouragement to enjoy the arts and culture and follow their academic passions.
Her impact was recognized by the National Academy of Medicine; the American Association for Cancer Research (the Richard and Hinda Rosenthal Memorial Award); the American Society of Clinical Oncology (the David A. Karnofsky Memorial Award); and, most recently, the VinFuture Prize Grand Prize, an international scientific award recognizing discoveries that benefit humanity overall, which she received together with Dr Doug Lowy, Dr John Schiller, and her mentee Dr Aimée Kreimer, all of whom were longtime colleagues and friends.
She will be remembered for moving through the world with empathy, a deep and settled sense of her own purpose, and boundless pride in her family that literally lit her face up. She showed up every day with the kind of sincerity and vigor that reminded the rest of us why this work matters.
Her death has left an enormous void for so many. When she recognized that her days were numbered, she faced her fate with the same courage and the same clarity of thought that she had applied throughout her career by spending her last year focused on her highest priorities: family, friends, and science and medicine. She will be deeply missed. Her impact will endure for generations.
ACKNOWLEDGMENTS
The authors gratefully acknowledge David Symer, MD, PhD, for his editing and contributions.