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Q&A with Medical Oncologist Gilberto Lopes, M.D.

Gilberto Lopes, M.D., chief of the Division of Medical Oncology at the Miller School and associate director for global oncology at Sylvester Comprehensive Cancer Center

Sylvester physician and researcher believes access to care is as critical as developing new treatments.

When oncologist and cancer researcher Gilberto Lopes, M.D., tackles development of much-needed new drugs for lung cancer and other solid tumors, he doesn’t consider his job done when a new treatment is approved for use in the clinic.

The next step for Dr. Lopes, associate director of global oncology at Sylvester Comprehensive Cancer Center, part of the University of Miami Miller School of Medicine, is patient access. He feels a strong obligation to ensure that patients worldwide benefit from his work and that of his colleagues. The impact of Sylvester’s research, he believes, is not limited to patients and countries who can afford the high cost of new cancer drugs.

Dr. Lopes also co-chairs the Access to Oncology Medicines (ATOM) Coalition, a global initiative led by the Union for International Cancer Control to improve access to oncology treatments in low-income countries.

We must ensure that we serve our patients to the best of our ability, be it those we can cure or patients we can help in other ways. – Dr. Gilberto Lopes

Balancing roles in patient care, drug development and global oncology may be a lot to take on, but Dr. Lopes is equally driven to serve patients in South Florida and worldwide. We recently chatted with Dr. Lopes, a professor of clinical medicine at the Miller School, to learn more about his work and what motivates him. His answers have been lightly edited for length and clarity.

I’m a medical oncologist, so I’m a physician specializing in treating cancer patients, and I’m also a researcher with two main focus areas. One is the development of new drugs. I was the main investigator on a trial that showed that an immunotherapy drug called KEYTRUDA® helped patients with lung cancer live longer and with better quality of life, leading to FDA approval of the drug.

I’ve also worked on a number of medications that are targeted to specific molecular changes in tumors. The latest that was approved is called pralsetinib, which works for patients with lung cancer, thyroid cancer and other solid tumors that have a mutation known as an RET fusion.

Dr. Gilberto Lopes seated at his desk
Dr. Gilberto Lopes works with the ATOM Coalition to improve access to cancer drugs in low-income countries.

The other part of my research agenda is to make sure that everything we do in high-income settings also applies in settings where resources are more limited. That involves working with policymakers, governments and international entities to help countries develop their cancer systems.

It may take up to 20 years after a new cancer drug is developed for patients in low-income countries to get access, and we’re working with the ATOM Coalition to try to change that. Right now, we’re mainly working in three countries: El Salvador, Zambia and Mongolia. But we plan to expand to the 40 lowest-income countries.

It’s really about the cost of the medications. Often, new treatments can exceed $100,000 a year, and that’s not affordable in low-income settings. It’s sometimes not even affordable in high-income countries for patients who don’t have insurance. The cost comes from the cost of drug development, and it’s estimated to cost up to $3 billion to develop a new cancer drug.

Through ATOM, we’re trying to create different mechanisms for access. We work with pharmaceutical companies to donate medications and then work with our partner, the Max Foundation, to get those donated medications to low-income countries.

Other ways of improving access include voluntary licensing. We recently got a license for nilotinib, a drug for chronic myeloid leukemia, from Novartis that we can make available in certain countries. We’re also encouraging pharmaceutical companies to set lower prices according to what individuals and countries can afford.

Cancer researchers like me are responsible for developing these new drugs that become very expensive and are accessible in the U.S. but are not accessible in a lot of other countries, including countries we come from. I’m from Brazil, and even though we have universal health care, the cost of these medications means many are unavailable to patients in the public sector.

Both my parents were orphaned at young ages, my dad at 14 and my mom at 17. Both their mothers died of cancer. That certainly made me think about medicine at a young age. As a teenager in high school, I really loved biology and the scientific aspects of medicine truly fascinated me.

We must ensure that we serve our patients to the best of our ability, be it those we can cure or patients we can help in other ways. It’s a privilege to serve the South Florida community, in no small part because it is such a diverse community. It also teaches us many ways of serving the global community.

Tags: Access to Oncology Medicines (ATOM), Dr. Gilberto Lopes, Health Equity, healthcare access, Sylvester Comprehensive Cancer Center