By Jonathan Cheng, MD, senior vice president, and head of Oncology Development


The move to treat early: Seeking to transform the treatment of cancer in earlier stages of disease

March 23, 2023     
By Jonathan Cheng, MD, senior vice president, and head of Oncology Development

Decades ago, when I was a medical oncology fellow training to be an oncologist, we had relatively few tools in our toolbox, mainly older chemotherapy agents, to try to help patients with their cancer. Fast forward to today with the approval of not only more effective chemotherapies and hormone therapies, but also novel antibodies that disrupt important cancer targets, antibody drug conjugates, small molecule inhibitors of genetic drivers, plus the emergence of immune checkpoint inhibitors across multiple indications. The innovations in immunotherapy in metastatic disease have been revolutionary for many patients and their families.

Moving treatment to earlier stages of cancer

Bristol Myers Squibb has a long history of leading the immuno-oncology field and introduced three checkpoint inhibitors that have had a significant impact on the treatment of cancer. By understanding the scientific underpinning of checkpoint inhibition in treating metastatic cancer, we aim to translate that knowledge into clinical studies that evaluate the benefits of immunotherapy in earlier stages of cancer and to try to prevent the disease from ever coming back. This group of patients is at high risk of recurrence after surgery and are often less well studied in this potentially curative setting.

As a medical oncologist who still practices today, I see the stress of uncertainty in making decisions based on the risk of recurrence, as the stakes are very high. Patients worry about their disease returning and being metastatic. It’s an emotional toll that patients, along with their loved ones, constantly carry as we talk about their treatment options after surgery, with their worry etched on their faces. This is why moving cutting edge cancer treatment earlier as a preventive concept is important, as it may offer additional treatment options and the potential to lessen the burden of cancer to not completely overshadow one’s life moving forward. 

The scientific rationale for treating the cancer earlier in the potentially curative setting, is that by administering immunotherapy before the disease has widely spread, particularly when the immune system is largely intact and hence may be more responsive, it might substantively reduce the risk of a cancer returning. Research led by BMS aims to demonstrate that immunotherapy can be a strong tool for the treatment of cancer in this setting and has the potential to make a significant impact for patients both before and after surgery.

Bristol Myers Squibb is continuing its commitment to bring important medicines to settings where there is potential to transform outcomes for patients. Our research in melanoma, lung, gastric/esophageal, and urothelial cancer has been geared towards understanding how we can best serve patients earlier in the course of their disease.

Looking ahead

Cancer is unfortunately all too common, and almost all of us have loved ones, family members, or even ourselves, that have been deeply impacted by this disease. The courage of my own family members, and the heroism of the patients and families that I treat, continues to inspire and motivate me to develop new and better therapeutic approaches. 

To face this common foe requires a village, to contribute, dialogue, and understand the latest research as presented in the literature and at congresses, as well as through social and digital channels. Maintaining active relationships with advocacy organizations and discussing new datasets with colleagues are wonderful ways to keep advancing the field and fighting for our patients.  

Treating cancer is a team effort to provide the best care to our patients and their families. There can be complex nuances of the disease, and considerable coordination required to identify which patients are most likely to benefit from which treatments. I am most humbled and honored to be a part of this wider medical community, dedicated to providing the best care to our patients and their families.

Jonathan Cheng, MD

Senior Vice President and Head of Oncology Development

Jonathan Cheng, MD, SVP, and head of oncology development, details how immunotherapy earlier in the course of disease may help prevent recurrence and improve outcomes for patients.


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Bristol Myers Squibb is a global biopharmaceutical company whose mission is to discover, develop and deliver innovative medicines that help patients prevail over serious diseases. As global citizens, we work sustainably and responsibly to create a positive impact in the communities where we live and work.