Roy Hertz, M.D. (1909-2002): the cure of choriocarcinoma and its impact on the development of chemotherapy for cancer.

Dr. Roy Hertz is one of two scientists credited with discovering the first medical cure of a solid cancer. This paper presents a biographical history of Dr. Hertz and discusses his roles in the discovery of a cure for choriocarcinoma and as a pioneer for future research in cancer chemotherapy. This biography not only serves as a testament to the pioneering individuals in the field of chemotherapeutics but also represents the unique blend of medical, pharmacological, and physiological histories that led to the profound discovery. The timing and significance of the work of Drs. Hertz and Li cannot be overestimated. Their discovery was a spectacular success, demonstrating proof of the principle that chemotherapy can cure metastatic cancer and that an almost uniformly fatal cancer in young patients could be cured with a single chemotherapeutic agent, which stands as one of the greatest achievements in cancer research.

Gestational choriocarcinoma.

The malignant transformation of trophoblast is interesting to contemplate, as trophoblast normally behaves in a manner that is interpreted as indicative of malignancy. First of all, trophoblasts show "controlled invasion" at the placental site as part of the normal process of implantation. Secondly, it is estimated that 100,000 syncytiotrophoblastic cells are deported to the maternal circulation daily and these are commonly identified in the pulmonary circulation of pregnant women (38). These trophoblastic cells do not ordinarily produce disease and presumably are rejected by the mother, unlike true metastases. When trophoblastic malignancy does develop, however, the trophoblast continues to invade and grow without limit, eventually metastasizing and ultimately leading to death. Choriocarcinoma is, therefore, unique in that it represents a malignant transformation of a tissue that inherently has "invasive" and "metastatic" properties. It is also the only tumor which contains DNA foreign to the host, as it is derived from a conception which contains paternal genetic material. Thus, choriocarcinoma is a complex neoplasm, and to study it, one must study and understand graft rejection, immunologic mechanisms and a multitude of genetic concepts in addition to the mechanisms of invasion and metastasis.