Early cancer drugs killed indiscriminately, going after the body’s healthy cells as relentlessly as its cancerous ones. Today, hundreds of anticancer drugs target the specific genetic mutations that drive cancer. Pinpointing those mutations and pairing patients with targeted drugs has become standard at Smilow Cancer Hospital at Yale-New Haven, thanks in large part to the work of Thomas J. Lynch Jr., M.D., the Richard Sackler and Jonathan Sackler Professor of Medicine.
According to the National Cancer Institute (NCI), nearly 41 percent of Americans will be diagnosed with cancer in their lifetimes. Growing up in New Jersey as the son of a hematologist, Lynch says, “I knew even as a kid that I wanted to make [addressing] that my life calling.”
Lynch received his bachelor’s degree from Yale College, and his medical degree and his start in cancer research at the School of Medicine. As an undergraduate he worked in the lab of John S. Lazo, Ph.D., associate professor of pharmacology, studying a drug for head and neck cancer. “Seeing the applicability of what happens in the lab and how it impacts patients got me really excited about the research angle of what we do,” he says.
Lynch’s forays into personalized medicine took place in Boston. He completed his internship and residency at Massachusetts General Hospital (MGH) and a fellowship in medical oncology at the Dana-Farber Cancer Institute. In 1993 he joined the faculty at Harvard Medical School (HMS), where he progressed to professor of medicine and chief of hematology/oncology at MGH Cancer Center.
Lynch specialized in the biggest cancer killer in America: lung cancer. When he began researching the disease, it was a death sentence. In the early 2000s he was giving his patients a drug called Iressa. The drug worked in 10 percent of patients and did virtually nothing for the other 90 percent.
Then came a turning point. A colleague, Daniel A. Haber, M.D., Ph.D., professor of oncology at HMS and the director of MGH Cancer Center, found a mutation in the epidermal growth factor receptor gene in nearly every one of Lynch’s patients that responded to Iressa. Lynch now had a test that could identify the patients who would respond to a specific drug. Personalized medicine in lung cancer was born.
Lynch returned to Yale in 2009 as director of Yale Cancer Center (YCC) and physician-in-chief at Smilow Cancer Hospital. He has overseen the standardization of molecular profiling in cancer patients, the establishment of an early drug development unit, and the re-designation of YCC as a comprehensive cancer center by the NCI. He has also worked to narrow the gap between research and patient care.
“Yale always had great clinical care and great basic science. But it lacked that translational connection between the laboratory and the clinic,” says Lynch, who has recruited top translational scientists to build programs that link the clinical care offered at Smilow—where patient satisfaction scores are high—with the innovative research occurring in Yale’s labs.
Lynch is also committed to advancing treatment by improving patients’ access to clinical trials. Today YCC has 200 open clinical trials, and Lynch has established 10 Smilow Care Centers around Connecticut to bring greater access to patients. Citing progress made in breast cancer and melanoma outcomes, he hopes these trials will someday lead to cures.
“It’s a daunting challenge,” Lynch says, “but unless we make that our goal, we’re never going to get there.”