By Saphia Suarez
When the Association of Community Cancer Centers (ACCC) selected Roy Herbst, MD, PhD, as their 2020 Clinical Research Award recipient, they honored not only his recent research and clinical work but also his legacy. For 25 years, Herbst has been a pioneer of personalized medicine and immunotherapy, working to identify biomarkers and bring novel treatments to patients.
Herbst, Ensign Professor of Medicine (Medical Oncology) and Professor of Pharmacology and chief of medical oncology at Yale Cancer Center, is recognized for his clinical trials work, bringing the science from the lab to the clinic, community outreach, and working to bring the best therapies to all populations.
When Herbst went into lung cancer research in 1994, the disease was a death sentence. “No one wanted to work in lung cancer,” said Herbst. “But my advisor, Emil (Tom) Frei at Dana Farber—a 1948 Yale School of Medicine graduate—told me, ‘Work in lung cancer, Roy, because there’s so much that needs to be done. And, if you bring science to bear on the problem, maybe you’ll see some results.’ He was right.”
Nearly three decades later, Herbst is chief of the Section of Medical Oncology within the largest department at Yale School of Medicine and has many fellows eager to train with him. “So many of my fellows want to work in this area because science and clinical care have come together,” said Herbst. “And that’s really what it’s all about: clinical investigation, bringing what you learn in the lab to the clinic and making it work.”
Herbst has spent his career doing exactly that—bringing science and clinical care together to revolutionize lung cancer therapy. He has taken new drugs from pathway development to Phase 1 trials and has run Phase 3 trials that have resulted in the approval of drug therapies. One such trial study was published in The New England Journal of Medicine just last October.
“We looked at drug therapy in patients post-surgery—so, in the earliest stages of disease—who had specific mutations in the epidermal growth factor, and the result was phenomenal,” said Herbst. That drug therapy was approved by the U.S. Food and Drug Administration in September 2020.
Herbst also works on cancer policy, including preventative measures such as tobacco cessation. “Of course, that work highlights disparity—and the issue that clinical trials are not easily available to all groups,” said Herbst. “If you look at minority accrual to clinical trials, it is often less than 5 or 10 percent.”
Herbst said that is often because patients of color do not even get into the hospital system. “I have tried to make sure that both prevention and treatment trials are available throughout the community,” said Herbst. “But, given the history of unethical medical testing in Black and Brown communities, there is a lot of distrust of clinical trials.”
To help address this problem, Herbst worked with Beth Jones and Sakinah Suttiratanaat at the Yale Cancer Center to launch the Bristol Myers Foundation-funded Firewall Project, which helps patients navigate the hospital system. “We hired people to go out into the community and meet with patients and community leaders,” said Herbst. “And make them aware of what we're doing so that there's more trust in the clinical trials program.” From education to transportation, Firewall Project navigators help patients participate in valuable clinical studies through which they receive the best possible care and access to the latest treatment options while contributing to the fight against cancer. With the COVID-19 pandemic, Herbst’s navigator project pivoted to help collect samples and investigate the pathogenesis of the virus in diverse cancer patients. And in New Haven, where 50 percent of COVID-19 patients have been people of color, he found an opportunity to talk about access and trust.
As a board member of the American Association for Cancer Research (AACR), Herbst is also working with colleagues to develop a teaching and mentorship program for investigators of color. “Another reason there might be fewer people of color enrolling in our clinical trials may be that our workforce doesn’t represent the population we’re caring for,” said Herbst. “The best way to develop trust and bring trials to a more diverse population is to have nurses and oncologists who are part of the community, or who can identify with the community.”
As Herbst continues his work, he recognizes the strength of the mentorship he has received and now imparts, not only in the careers of future generations of physician-scientists, but also in increasing access to the quality healthcare he has spent a lifetime advancing. “I’ve been very fortunate,” said Herbst. “I worked with great mentors. Now my goal is to be a good mentor to others, so that they will be able to do the same.”
Yale’s Section of Medical Oncology is renowned for its ground-breaking clinical and translational cancer research; excellence in training and education of the next generation of clinicians and clinician-scientists; and exceptional clinical care.