As a physician-scientist, Dr. John Lee keeps one foot in the lab and the other in the clinic. He works to bridge the worlds of science and medicine and speed basic discoveries into patient care.
Because he knows that, sometimes, the pace of progress is not fast enough.
A few years after med school, Lee was exploring the genetics of prostate cancer as a research fellow. Halfway through the fellowship his mom was diagnosed with an advanced form of bladder cancer.
Today, immunotherapy drugs called checkpoint inhibitors are revolutionizing cancer care. They are used to treat some of the sickest patients, including those with the same disease Lee’s mom had.
But six years ago those drugs had barely left the laboratory. Lee’s mom didn’t go on the handful of clinical trials that were testing them.
One year after her diagnosis, she died.
“Sometimes I wonder: If she got a checkpoint inhibitor, would she be one of those patients who had a durable, long-term response? It’s possible,” Lee said. “But everything happens for a reason. So I use it as fuel, as motivation.”
That fuel helps power several research projects he’s spearheading. In the lab Lee hunts for the molecular and cellular drivers behind the most aggressive prostate and bladders cancers. He knows vulnerabilities lurk somewhere in that genetic chaos — targets he one day might exploit to help treat the patients he sees in the clinic. To go after those Achilles’ heels, Lee is engineering immune cells to recognize and attack cancer and testing experimental drugs that can disrupt molecules critical to cancer’s growth.
When he finally leaves the lab, he’s off to treat patients with advanced bladder and prostate cancers in the clinic. Lee has been bouncing between the two worlds for years, ever since he decided to hit pause on his education halfway through medical school.
“I realized I was getting too far away from the lab,” Lee said. So he took a year off, spending it as a research scholar at “Disneyland for scientists” — aka the National Institutes of Health. He returned to school, got his MD … and didn’t set foot in a lab for another six years.
“That’s the goal: Do the work in the lab to ultimately benefit patients.”
Today he’s found a better balance between the bench and the bedside.
“There’s no greater challenge than taking care of people and trying to understand what goes wrong with their biology,” he said. “At this point I get to do what I love, which is science, but then I get to apply that science and try to help patients in the clinic.”
Lee marvels at the scientific advances that have helped transform patient care since his mom’s diagnosis. But we’re just scratching the surface of cancer’s complexity, Lee says. “Cancer is usually the sum of multiple events that accumulate over time. But the way we currently approach personalized cancer treatments is to look for one gene abnormality and try to target that with a drug.”
Figuring out a better way is why he keeps traveling back and forth between the lab and the clinic. It can be exhausting, he admits. And it can be hard to treat patients who, like his mom, won’t benefit from the advances that are happening right now in the lab.
His young kids help keep him grounded. “They allow me to wipe all the science away for the day and enjoy them without having to worry. To them I’m just dad, not a scientist or physician.”
But he wears both hats outside his home, forever trying to shrink the distance between science and medicine.
“That’s the goal: Do the work in the lab to ultimately benefit patients,” he said. “If I can hand off an idea to my clinical collaborators, and if it’s successful in patients, then I’ve done my job. If you can do that repeatedly in a career, then you’re blessed.”