Lung Cancer Is Personal: Interview With Lee James
Each November marks Lung Cancer Awareness Month in the United States. Lung cancer is the leading cause of cancer deaths in the country, taking more lives than breast, colon and prostate cancers combined.
Lee James, MD, PhD, vice president of U.S. Medical Oncology at Bristol Myers Squibb, and a medical oncologist with experience in both the academic and community health settings, shares more about our commitment to the lung cancer community and ongoing progress to advance treatment for non-small cell lung cancer (NSCLC).
Q: What are the main goals of observing Lung Cancer Awareness Month (LCAM)?
James: LCAM provides a meaningful opportunity to raise awareness about lung cancer and its impact on patients and their loved ones. It’s a month that I’m especially passionate about, having worked in lung cancer research and directly with patients throughout my career. It’s also an important time to shed light on the unmet needs that still exist for many lung cancer patients, and identify steps that are necessary to meet those needs.
Q: Although advances have been made in lung cancer treatment, what are some challenges we still face?
James: Most patients with lung cancer have NSCLC and are often diagnosed at an advanced stage – meaning, after it has metastasized or spread to other parts of the body – which makes it more challenging to treat. These patients need treatment options that may offer them more years of life and time with their loved ones. Then there are patients whose lung cancer is discovered early, before it has spread, and can have it removed with surgery – but they face challenges too, as the risk of the disease coming back after surgery can still be high. For these patients, treatment options that can reduce the risk of recurrence are key.
This is why it’s vital that we continue efforts to bring innovative treatments to all patients with lung cancer and support the endeavors of patient advocacy groups to provide education and support to people impacted by cancer. One great example is the work of the Lung Cancer Awareness Month Coalition, a global coalition of cancer and related organizations bringing voices together to amplify the conversation around lung cancer, specifically during LCAM in November.
Q: How has immunotherapy research changed what it means to be diagnosed with lung cancer? What role has Bristol Myers Squibb played in this progress?
James: Immunotherapy research has led to important progress that has changed the way lung cancer is treated and continues to transform the treatment landscape. It’s incredible to think that immunotherapy may help the body’s own immune system fight cancer. This was a distant goal when I was a young scientist working in lung cancer research 15 years ago, and today it’s already a reality.
Bristol Myers Squibb has played a role in bringing options to patients with lung cancer for nearly a decade. Thanks to continued research and commitment to developing innovative treatments for patients, there are several immunotherapy options available that give me hope across stages of the disease.
Q: What excites you about lung cancer research?
James: Everything. Today we have a clearer understanding than ever before of how lung cancer functions and the unmet needs that exist for lung cancer patients. This, in turn, helps inform everything we do – from developing more targeted therapies, to studying treatments across stages of lung cancer, to providing patient support where it’s needed most. The more we learn about lung cancer, the better we can help patients – and we are learning more every day.
A great example of this is the role of PD-L1 in advanced lung cancer. There was a time not too long ago that lung cancer was considered one singular disease and treated as such. But today we know that the presence of a protein called PD-L1 in a patient’s tumor may impact their response to treatment. In metastatic or recurrent lung cancer specifically, patients whose tumors don’t express PD-L1 experience worse outcomes when treated with current standards of care compared with patients whose tumors do express PD-L1. The enhanced use of biomarker testing and the continued understanding of PD-L1 levels has led to the development of a more personalized approach for lung cancer. This is very exciting.
Q: What aspects of lung cancer research keep you up at night?
James: What keeps me up at night is thinking about all the unmet needs that still exist. While understanding these needs is critical for future treatment development, the realities of patients' experiences are never far from my mind. If first- or second-line treatment doesn’t work, people with advanced lung cancer are left with very limited treatment options, which can be a devastating situation. This often includes those whose tumors don’t express PD-L1. And patients with early-stage lung cancer who are treated with surgery often still need routine scans to see if their cancer has reoccurred. This can cause so much anxiety for patients and their loved ones.
About three years ago, I had a close family member who was diagnosed with NSCLC. I helped her navigate her treatment options and advocated for her in her decision-making. After a while her treatment was no longer working. The decision was made to re-evaluate her goals of care. Ultimately, she transitioned to hospice where she passed away just recently.
So, while there is an amazing amount of progress being made in this space, there is more to be done and it’s very personal to me.
Q: Can you talk about health disparities in lung cancer and the company’s advocacy work in this area? What’s important about this work? What inspires you?
James: Early on in my career, I joined a small private practice in Queens, New York, as the partner focused on clinical trials, with a goal of bringing more options to underserved populations. Working in this practice showed me first-hand how patients in medically underserved communities have different access to groundbreaking medicines, including clinical trials, and different perceptions of treatment.
Many disparities in lung cancer diagnosis and treatment sadly exist today, with race being an important factor. Lung cancer is the number one cancer killer among Black men and women in the U.S. When compared with Caucasians, Black Americans are 18% less likely to be diagnosed early, 23% less likely to have surgery and 9% more likely to go without treatment.
Other social determinants of health impacting equitable access to quality healthcare and medical innovations include poverty and health literacy. One of my patients in Queens repeatedly refused treatment for his lung cancer because of a preconceived notion he had about the medication. Every week, I tried to educate him about the treatment and its potential benefits, and every week he’d refuse, citing misinformation he’d learned in his community. Within two months, he passed away.
At BMS, we are committed to helping advance health equity: the assurance that everyone has a fair and just opportunity to achieve optimal health outcomes. Our goal is not to just provide appropriate treatment options but to help bring these innovative therapies to all patients. We do this, in part, by supporting efforts that raise awareness of lung cancer in at-risk communities and diversify enrollment in lung cancer clinical trials. A perfect example of this work is our support of Stand Up To Cancer’s campaign with award-winning artist, actor and activist, Common, which raises awareness of lung cancer’s impact in the Black community and educates about the importance of clinical trials. Since launching in November 2021, this campaign has reached millions of people across United States.
This year, we also announced grants supporting lung cancer patient advocacy organizations: GO2 Foundation for Lung Cancer, American Lung Association, Día de la Mujer Latina and LUNGevity Foundation. These grants will fund projects designed to increase lung cancer screening, reduce health disparities and improve patient access within underserved communities.
Q: What do you hope the treatment landscape for lung cancer looks like 40 years from now?
James: Imagine a world in which we can halt the course of lung cancer, prevent the cancer from returning and offer patients with metastatic disease a real chance at a longer life. A world where everyone has equal access to innovative lung cancer treatments and education to make informed decisions and achieve optimal health outcomes regardless of race, ethnicity, gender, socioeconomic status, income, disability status and geographic location. That’s my hope for the future, and what we're working to achieve.