First person profile: Alex A. Adjei, MD, PhD

W asked by a mentee what his secret to success was, Alex A. Adjei, MD, PhD, answered, “Focus on doing the work, and the rest will work out.” The career of Dr Adjei attests to living those words. As current chair of the Cleveland Clinic Taussig Cancer Institute, he leads a network of multidisciplinary specialties focused on caring for patients with cancer and conducting research to advance that care. He also coordinates and oversees cancer care across the large regional expanse of the Cleveland Clinic, including its 18 hospitals and primary care centers. As with many leaders, prior training and a litany of accomplishments paved the way for Dr Adjei to be ready to steer the helm of such a large enterprise. Born and educated in Ghana, he left the country after earning his medical degree to pursue a PhD in pharmacology in Canada. He completed his internal medicine residency at Howard University in Washington, DC, and clinical and research fellowships at Johns Hopkins University in Baltimore, Maryland, and, just before his current position, oversaw oncology drug development and led lung cancer research and treatment at the Mayo Clinic in Rochester, Minnesota, where he also co-led the developmental therapeutics program. During his tenure at the Mayo Clinic, he earned recognition for his work in phase 1 clinical trials and lung cancer research. He received the first American Society of Clinical Oncology Drug Development Research Professorship from 2012 to 2017 for conducting work in cancer drug development and mentorship, and in 2020, he received the inaugural International Association for the Study of Lung Cancer Adi F. Gazdar Merit Award for Distinguished Service and Mentorship in Lung Cancer. He also received the European Society for Medical Oncology Lifetime Achievement Award in 2021. He has served on numerous society and National Institutes of Health committees and is currently a member of the National Cancer Institute Board of Scientific Counselors. He is editor-in-chief of both the Journal of Thoracic Oncology and JTO Clinical and Research Reports, the latter of which he launched for the International Association for the Study of Lung Cancer in 2020. Dr Adjei is amazed at the vast improvements in cancer care over the course of his career; the high number of patients who currently respond to targeted therapies and immunotherapies was unheard of just a decade ago with older systemic therapies. He also notes the advancements in surgery and radiation therapy, as well as imaging, that lead to earlier diagnoses, offer patients less aggressive treatments, and help to improve quality of life. He does, however, point to the challenges that accompany these accomplishments. Although he says that up to 70% of patients treated with targeted therapies respond to treatment, that leaves 30% who do not. Given the noncurative nature of these new drugs, the 70% who do respond will eventually relapse. How to treat both patient populations is an ongoing challenge, Dr Adjei says. In addition, he emphasizes that not all populations have access to these drugs (e.g., those in rural or underresourced areas). “We have exceptional care in this country, but not the whole population can avail themselves of it,” he adds. Improving the prevention and detection of early disease is another ongoing challenge, he notes. “As a healthcare system, we focus so much on people with disease. We need to spend a lot more time on screening and early detection so that we can prevent people from getting advanced cancer,” he says. For people with advanced disease for whom treatments no longer work, Dr Adjei believes that more work is needed to expand palliative care, but he is pleased with the progress in including palliative care experts on the oncology team to help with quality-of-life and end-of-life care.