How do we know when cancer treatment works?

How do we know when cancer treatments work and when they don’t? And how can we improve diagnostic technology and interpret the results so that every patient gets the right treatment at the right time? 

For Christopher Hourigan, those questions get to the heart of precision medicine.

Hourigan, an oncologist and physician-scientist who directs the Fralin Biomedical Research Institute’s Cancer Research Center in Washington, D.C., will open the 2026-27 Maury Strauss Distinguished Public Lecture season with “Why Measure?” at 5:30 p.m. Sept. 17 in Roanoke.

His answer to that question has been shaped by treating patients with cancer and by years spent studying what happens when an apparently successful treatment fails.

“As a physician, you never forget that behind every sample that we test in the laboratory was a person who desperately wanted to know whether their cancer treatment had worked and what their future would hold,” Hourigan said. “Their doctors could only give them partial answers and consequently often missed the chance to intervene. That information gap and opportunity to do better is what motivates our work.”

Hourigan’s research focuses on patients with acute myeloid leukemia, a rare and aggressive blood cancer. Most adults treated for AML initially enter remission, yet the disease frequently returns. His laboratory develops highly sensitive genomic tools to find tiny traces of leukemia that remain after treatment and uses that information to better understand who is at risk for relapse and who might benefit from additional therapy tailored to their specific situation.

The research aligns with an approach taking place across the institute. “Precision medicine is about moving beyond a one-size-fits-all approach to cancer care,” said Michael Friedlander, executive director of the Fralin Biomedical Research Institute at VTC and Virginia Tech’s vice president of health sciences and technology. 

“By giving physicians a clearer picture of each patient’s disease and response to treatment, research like Dr. Hourigan’s can help guide the right care at the right time, while sparing patients from therapies they may not need,” Friedlander said. “Dr. Hourigan is one of the world’s foremost clinician-scientists who is bringing the science of modern molecular medicine out of the laboratory and into the service of cancer patients. We are very fortunate that he has joined the FBRI and that he plays a key leadership role in Virginia Tech’s growing presence in cancer research.”

Systematically improving measurements so that they work for all patients is critical. “Precision medicine depends on building a solid foundation so that these powerful technologies can be used responsibly,” Hourigan said. “Our ability to improve outcomes for those suffering from cancer is limited by the quality of information available to make clinical decisions, and we can and must do better.”

That philosophy underpins his work on measurable residual disease, or MRD, cancer cells hidden among healthy cells at levels too low to be detected through traditional assessments. Rather than simply accepting that a patient is in remission, MRD testing seeks a more precise answer: How much disease, if any, remains?

The distinction can be important. Hourigan’s team has shown that sensitive DNA-based tests can help identify patients more likely to experience cancer recurrence after apparently successful treatment. The laboratory is also working to determine which genetic markers provide reliable information and how such tests can be standardized for use across cancer centers.

A recent study led by a researcher in Hourigan’s laboratory illustrates both the promise and limitations of measurements. Researchers examined MRD test results from 131 U.S. testing centers involving more than 2,500 patients with AML. They found substantial variation in how well commonly used multiparametric flow-cytometry test results predicted outcomes. The takeaway? The value of the results depends in part on how and where the test is performed.

The findings reinforce a challenge Hourigan has emphasized: Better technology and good ideas are not enough. Testing also needs to produce information clinicians can trust, interpret consistently, and act upon. The study called for more standardized and sensitive approaches, a challenge being met by Hourigan’s national MEASURE initiative. The program is working with 18 major U.S. cancer centers across the United States to prospectively validate advanced approaches to AML MRD testing.

That bedside-to-laboratory perspective will be central to Hourigan’s lecture. Trained first as a research scientist and later as a practicing oncologist, Hourigan approaches translational research in what he describes as the reverse of the familiar “bench-to-bedside” path. His team starts with problems encountered in patient care and takes them back to the laboratory, developing tools to understand why treatments work for some individuals but fail for others.

Hourigan joined Virginia Tech in 2024 after serving as a tenured senior investigator at the National Heart, Lung, and Blood Institute at the National Institutes of Health, chief of its Laboratory of Myeloid Malignancies, and founder and co-director of the trans-NIH Myeloid Malignancies Program. The White House recognized his work with a Presidential Early Career Award for Scientists and Engineers in 2015.

He previously trained and practiced clinically at Johns Hopkins Hospital and earned his medical and research doctorates at the University of Oxford. At Virginia Tech, he is founding director of the Fralin Biomedical Research Institute’s Cancer Research Center in Washington, D.C., where basic, translational, and computational researchers work across disciplines to develop new approaches to cancer.

His lecture continues a recent tradition of opening the Maury Strauss series with scientists from within the Fralin Biomedical Research Institute. Computational neuroscientist Read Montague opened the 2023-24 season, followed by neurobiologist Friedlander in 2024 and cardiovascular scientist and biomedical entrepreneur Robert Gourdie in 2025. Those talks have offered the public an inside look at research underway at Virginia Tech while continuing a series that brings leading scientists and health innovators to Roanoke.

“Why Measure?” begins at 5:30 p.m. Thursday, Sept. 17, at the Fralin Biomedical Research Institute at VTC, at 2 Riverside Circle in Roanoke. A reception begins at 5 p.m. The event is free and open to the public and also will be available via Zoom.

The lecture series is named for the late Maury Strauss, a longtime Roanoke businessman and community benefactor whose support helped sustain the institute’s free public seminars.