How a Breakthrough Idea Transformed Retinoblastoma Treatment

An Idea Sparks Innovation

When David Abramson, MD, became the founding Chief of the Ophthalmic Oncology Service at Memorial Sloan Kettering Cancer Center (MSK) in 2004, he imagined his team would be “an exotic, rare, and unusual group.” MSK was the first cancer center to establish a dedicated service for ocular (eye) cancers, and it remains the only one today — but with more than 15,000 patient visits each year, the rare and unusual has become everyday work.

Dr. Abramson and his colleagues have gained an unmatched depth of experience caring for people with eye cancers. Their expertise — combined with MSK’s strong research infrastructure — has led to first-of-their-kind breakthroughs that have revolutionized care. No example is more striking than the insight that has transformed how physicians worldwide treat retinoblastoma, the most common eye cancer in children.

As good ideas often do, this one came to Dr. Abramson while he was doing something else: swimming laps, a habit preserved from his teen years when he was a candidate for the U.S. Olympic swim team. At the time, retinoblastoma was treated with systemic chemotherapy and, in advanced cases, surgery to remove the eye. While curative, both approaches had lifelong repercussions. “I was doing laps and dreaming about how we could get chemotherapy just into the eye,” Dr. Abramson remembers.

It wasn’t a small challenge. The eye is fed by a single artery, “but it’s less than half the width of a penny and it’s in the skull, behind the eye, underneath the brain,” Dr. Abramson says. A subsequent conversation with an electrician working in Dr. Abramson’s home sparked a solution. “If he could run a wire anywhere in the house, I could do the same inside the body,” he says.

“The World Was About to Change”

Less than a year later, in 2006, Dr. Abramson asked for a family’s consent to deliver the first-ever dose of intra-arterial chemotherapy (IAC) to their infant with retinoblastoma. He threaded a catheter thinner than a piece of angel hair pasta through a major artery in the groin all the way up to the tiny vessel that brings blood to the eye, delivering a potent dose of chemotherapy directly to the tumor. “In three weeks, the cancer was gone, and we knew the world was about to change,” he says. The shift was titanic. “In 2003, we were sparing about 4% of children from surgery, and by 2019, we were able to preserve the eye 95% of the time and still cure 99% of our patients.” IAC, an outpatient procedure with few or no side effects, is now the standard of care for retinoblastoma around the world.

In an unusual twist, Dr. Abramson notes that IAC was first tried in the clinic, foregoing testing in laboratory models. This approach was possible only because he was using drugs that were already FDA-approved for retinoblastoma. Years later, researchers at MSK and elsewhere conducted laboratory studies of IAC, all of which, surprisingly, failed. “The experiments showed that the levels of drug that would reach the eye would not be high enough to cure the cancer,” he says. “If we had followed the usual process, I wouldn’t be here telling you this story.”

Recognizing a Lifetime of Achievement

Dr. Abramson was honored with the 2026 Helen Keller Prize for Vision Research from the BrightFocus Foundation and the Helen Keller Foundation in recognition of his significant contributions to vision science and advancements in the treatment of childhood eye cancers. Dr. Abramson has developed pioneering treatments that have transformed the management of eye cancer worldwide.

Established in 1994, the Helen Keller Prize for Vision Research recognizes excellence demonstrated through multiple significant research contributions to vision science or a single contribution of exceptional impact. Recipients are selected by an international panel of biomedical physicians and researchers.