Professorfor Research in Cancer and Professor of Surgery, Duke University; Director of the Duke Comprehensive Cancer Center.
Professor H. Kim Lyerly, M.D., FACS. He serves the editorial board of 12 scientific journals. Dr. Lyerly has been appointed a member of the National Cancer Advisory Board by President George W. Bush. He is also a member of the scientific advisory committee on the Susan G. Komen for the Cure Foundation and the Burroughs Welcome Fund, and he has served as chair of the executive committee of the integration panel of the Congressionally Directed Medical Research Programs in Breast Cancer. Dr. Lyerly is a member of advisory boards for the M.D. Anderson Cancer Center and the Universities of Michigan, Chicago, and Wisconsin. He co-directs the NCI sponsored workshop of cancer clinical trials and is the scientific chair of the Southwest Oncology Group Molecular Therapeutics Committee.
So I guess you’re asking if the physician to a practicing medicine are impacted by the Noble Prize, or the science behind the prize that is worth it? So I think the Nobel Prize is very important, they highlight major scientific changes that often have an impact on medicine either because they have a direct relationship to a human condition, or they develop tools for scientists to study human health and diseases. So it’s often a balance of a direct observation, or tools, or inside of fundamental process.
That’s a very good question. I think in medicine，there are something , in which the medical solution is very good , I think that’s very helpful. And a doctor should practice that, are very effective. There aresomething in medicine that the success is very poor, sometimes for example the management of patients with advanced cancers, the outcome to the patients remains poor. So there’re many things to do research on. But those physicians, who would like to improve what we do today, have to be involved in research. So I don’t think anyone wants to have a poor outcome, and spend their whole life repeating of poor outcome for the next patient and the next patient. So research allows them to have a hope for the future, not only for their own interest, but a hope to improve the outcomes for patients, that hope could be an understanding of new treatment, or new diagnoses, but sometimes it comes into new understanding of the disease. So the Nobel Prize was awarded a few years ago for understanding of the virus infection causes cancer of the cervix, so now the development of a vaccine to prevent that infection. So rather than a new surgical tool, or new medicine to treat cervical cancer, the hope would be that we always prevent cervical cancer by preventing the viral infection that causes that. So I think that’s an example where research, you know, really does have both impact on understanding the disease, and then hopefully the future would be improved outcomes, or maybe elimination of the disease itself.
- No Chinese-born medical scientist has won a Nobel Prize in the field of medicine. From your experience and knowledge regarding China’s medical industries, would you please communicate to our perspective audience one existing advantage or disadvantage in any of Chinas present medical atmospheres?
Well, I think there is one very large advantage in China. And that is a very large number of people, and the health care system that is evolving to provide care for all those people. Because our ability to understand medical outcomes depends on the number of events that occur in a population. And so let’s say something that occurs commonly, that you would like to see a number of events occur. And you would like to compare that to another situation. You also want to look for a number of events that can occur, if you have very large numbers of patients, the time for those events to occur could be much more rapid than a situation where you have few people. So, for example, the study for a new therapy could actually occur in china in a way that would allow people to understand very quickly, that something is working or not working. The key thing about how new therapies are developed is that it is a process; some trial, we don’t like to say this, but sometimes there are some errors, and then you learn and you advance quickly. So the idea that the testing could occur in a population where you would know more quickly the outcome, and then you learn from that, and then move to the 2nd step or 3rd step or the 4th step. You can see that there might be enormous advantage in China in which the uniform application of rules and regulations and the health care system would allow someone to learn very quickly what’s the right form of therapy or right strategy or new medicine for that condition. So, that could be extremely powerful and enormous opportunity for china in the medical establishment.
- On May 8th in Beijing, the NPLS organizing committee will officially announce the Nobel Prize Star (NPS) award winners. The NPLS organizing committee awards the NPS award to encourage innovative medical thought for the creation of new medical ideas.Considering your position today in the medical science field and your scientific forefather’s experiences in the past, the public could assume that medical leaders and/or medical professionals have used your experiences, discoveries, work, or knowledge to assist in fighting human disease. If you could share one interesting instance or experience related to your professional and/or personal growth, while in seek of your own scientific endeavors, what would it be?
Professor Lyerly: Well, I think that the important thing that would be useful to share is the fact that, you know, an environment that allows people to question what exists, and to challenge what we think we know is really important.I think a good example from my own personal experience was that I was working in a cancer research laboratory, as young scientist, and there were many medicines that had been developed for cancer that were found to be ineffective, and so they were put on shelves in storage. And during that time there was a new disease that was emerging in the United States and around the world, which was the infection of humans with a virus, a new form of human infection called Human Immunodeficiency virus, or HIV. Now the HIV virus used a form of replication that was different than what most people expected life forms to take. Most life forms went from a DNA, which is the back bone of the genetic information for us. DNA is made into RNA and RNA is the blueprint to make the building blocks of life, proteins, and so forth. Retroviruses went backwards, they went from RNA to DNA, and then went and completed their lifecycle. When HIV first emerged it was a devastating disease. People thought there would be an elimination of a significant percentage of mankind. People began to look at stopping HIV infection and they began to explore the use of old chemotherapy agents that were not very effective. So, people developed screening strategies where the process of reverse transcription, this backwards form of life was tested in test tubes, and identified a drug called AZT that seemed to block that process and in fact that was subsequently tested in the laboratory, and found that it could inhibit the HIV virus and subsequently these new medicines which were actually old failed medicines were tested in people that had HIV infection and were shown to be effective. And this foundational piece failed chemo-therapy and the reverse of the lifecycle led to the development of the anti-retroviral medications that have proven so effective in the abatement and treatment of the HIV infection in the United States, around the world and so forth.So that would be my sense, that if we had believed that a failed drug wasn’t going to work anymore or if we believed that there was only one way of life, that could occur, we’d never would have put together the opportunity to develop new therapies, you know that directly impacted people all over the world.
Justin: Was that in the 80’s or 90’s?
Professor LyerlyIn the 80’s
Justin: I was born in 1980’s.
Professor Lyerly: Yes, I was a medical student and people were just discovering HIV, I was a medical student at UCLA, so the young people would come in and they would die in front of us, so we spent a lot of time on antiretroviral sciences at that time.
- In your own opinion, what major advantages would you make use of that is existing in China’s medical industries that could potentially attract Chinese-born medical scientists and/or mandarin-speaking practitioners living abroad, to return to China for the fight against human disease?
Lyerly: Well, I think there are many things that motivate people. But I do think people who have an interest and passion in improving outcomes, look for opportunities, and those opportunities could be in the development of programs that are specific to fight diseases of interest to them, whether that’s cancer or autism or all kinds of disease. The ability to have organizational structure and pathways of success, for that, that’s clearly one.Then also I think an investment in the scientific resources and infrastructure that’s necessary to be, an active and productive scientist. So currently the investment by the central Chinese government in biomedical research is growing every year, which is fantastic. But still, it is a very, very small fraction of the investment that the U.S. makes every year. The U.S. investment has been stable in accounting for inflation that has actually been dropping off for the last few years which always makes it a very difficult. If we born young people, there is no room for them because the biomedical infrastructure is not growing. So, the best opportunity for China is, to try to, I think, to promote the opportunities for young scientists to develop and blossom, and the mature in a Chinese biomedical establishment.
Justin: O.k., so you would say it would branch off of many outside investments and internal investments too, right?
- For Chinese Continuing Medical Education graduates, who are currently overseas, and having at least 4 years of organized medical research and being unable to acquire a medical residency, for whichever reason, would you encourage those medical investigators to pursue their professional medical careers in China? Why or why not?
Well, the reality of being a biomedical researcher is that you have a life where your foot is in two worlds, one as a physician and a practitioner, and the other is a scientist. So I think the opportunities is for any tradition scientist, if they can find that right balance, I think it would be a very interesting opportunity to pursue. If any one of those opportunities is limiting. For example, if you’re a high-quality physician but you don’t have any opportunity to do research, that imbalance is not very useful. Or, if you’re a great researcher and have research activities but the practice of medicine is not appropriate, then that becomes a challenge. I think one example of that, is the Oncology field in which the translational part or the application of your science into human care is an important part of that. So, if you think that you have insight into treating cancer, then you develop a therapy that you think will either improve the treatment or reduce toxicities, then it’s a very important thing to try to move that idea and to test it into people, what we call translational research. If there are structural limitations, for example, new medications are not available, or there is regulatory pearls, the testing new medicines, then I think some of the best scientists, in my opinion, that would like to see their basic research translated to improvements in human health, they may seek opportunities that really allow that to happen. And that may be something for leaders and policy makers to consider as they’re thinking about building the biomedical research capacity in parts of the world.
- Would you please offer a few words of advice that could help inspire our young audience of medical scientists working to make a difference in China’s general public health status?
I think the important thing about medicine is that it continues to change. When I was in medical school, there was many things that I was taught, that are now proven to be, wrong. And these things have important implications for care of many common diseases. So, I think for those people that are young, that are caring for people, the idea that they can improve the care of the population, they can take opportunities to learn fundamental science that can improve the care of people, but they can also think about improving the application of care, or improving systems that deliver care, all of those things are important and I think balancing individual’s interests, and the opportunities, that will lead to, I think a meaning of their passion and their life and the outcomes of that meaning, you know contributions to society that will have lasting effects. So, again, I think people who have the opportunities in China to make a difference. I think the emerging recognition that difference can be made from policy, to clinical research, to basic research is encouraging and I think the ongoing investments that are being made are really creating enthusiasm for people, that they really do see the potential to have the opportunity, to have all of that, in a career in china.