A Glimpse into the Journey of an Oncology Icon: Manmeet Ahluwalia

Manmeet S. Ahluwalia, MD

Last year, Manmeet S. Ahluwalia, MD, was given the title of Oncology Icon by Targeted Oncology^TM, a recognition of his lifelong dedication to patient care and groundbreaking contributions to oncology.

In an exclusive interview, Ahluwalia, chief scientific officer, chief of medical oncology, deputy director, and Fernandez family endowed chair at Baptist Health Miami Cancer Institute, and chief scientific officer for Lynn Cancer Institute, reflects on the significance of this award, attributing his success to the support of mentors, colleagues, and mentees.

Ahluwalia explained the pivotal role cutting-edge technologies and clinical trials have in advancing patient care and discussed his hopes for the future. Specifically, he noted the importance of initiatives like President Biden's Cancer Moonshot Program which is helping to promote early cancer diagnosis, equitable access to care, and more.

In the interview, Ahluwalia provided insights into his personal career and goals and the transformative potential of oncology.

Targeted Oncology: What does being an Oncology Icon mean to you?

Ahluwalia: First of all, I was extremely humbled, honored, and privileged to have received the inaugural Oncology Icon award. For me, it was a testament to the mentors I have been lucky to have in my life, the colleagues that I worked with, and the mentees who drive me to strive harder. More importantly, I was happy for my institution for the recognition it got. Since I took this role over 3 years back, 1 of our aspects was to put Miami Cancer Institute on the map nationally and internationally. Awards have a meaning if they serve a purpose, and our purpose is, how are we serving our patients with cancer to the best of our ability? What that truly means is offering the greatest and latest in technologies, innovations, and clinical trials for our patients, because for patients [with cancer], this means it is a second chance to beat a devastating diagnosis.

What impact has your own work had on the lives of patients in the community oncology setting?

First, 1 of the points I want to highlight is that 70% to 75% of patients with a cancer diagnosis are treated in a community setting. When I joined Miami Cancer Institute, it was on its journey starting out as a hybrid cancer center, but more importantly, in its journey to being more academic, in terms of what those roles are. I think those lines are getting increasingly blurred, because a lot of community-based hospitals or community-based cancer centers, if they are doing cutting-edge research, are as good as any academic cancer programs out there because when patients come to get treated, their number 1 goal is how can they get the best therapy, whether that is standard of care, or if it is not available as standard of care, through a clinical trial. Whether they get that clinical trial at an academic cancer center, a comprehensive cancer center, or their community cancer center, it does not matter. What matters is the highest and the best in terms of innovation.

Miami Cancer Institute is [on its way] to becoming a nationally and internationally recognized cancer program because truly, we do want to serve the patients in South Florida and beyond. We have a large footprint just beyond even South Florida. We treat a number of patients from the Caribbean, as well as Latin America, because Miami is the gateway to Latin America. For us the biggest joy and purpose is how we serve our patients with the latest and greatest therapies.

What unexpected challenges have you encountered over the course of your career?

My desire to become a cancer doctor was because my grandmother, who was my primary caregiver, was diagnosed with cancer. Unfortunately, she succumbed to the disease. As a 12-year-old who was living with her at that time, I said I would go to the [United States] and cure cancer. Now I only get humbled and inspired by my patients every day. But also, if I am able to give back to a patient or their loved ones, it is a way for me to pay back to my grandmother. I could not take care of her, but I can take care of someone else's grandmother.

We have had a number of challenges, but I see every challenge as an opportunity.

Now, how do we transcend that obstacle or challenge that we have to make it through and deliver that therapeutic for someone else? I am also a brain tumor expert, and I would love to have more therapies for my [patients with] brain tumors. Nothing would give me more joy than to be involved in something that will change the standard of care for [patients with] glioblastoma. We have done well with our patients [with] brain metastases in the last decade or 2, which has been a satisfying and fulfilling journey, but we would love to have more therapies for glioblastoma. Although we have challenges like everyone else, we are excited about the future of innovation, future of research for our patients, and the potential of what we can do for them.

What excites you the most about the future of oncology, especially in the context of the community setting?

We are fans of President Biden and his Moonshot Program. It is an aspirational program that hopes to target to decrease the cancer mortality by 50% for the next 25 years. What that truly means is cancer screening, early diagnosis, advancing research and innovation, decreasing the differences in equity of care. We do know that there is a tremendous difference in people in terms of outcomes, based on where they are in terms of whether they are a minority or not, but also, more importantly, the zip codes that they live in. We have a lot of work to be done in front of us.

We are excited that now we are probably living in the greatest era of development, or transformation in mankind's history ever. The amount of innovation that is happening in cancer, what we are learning about the biology of the disease, how many therapeutics are coming down the pipeline. We are doing more research and more innovation in a single year than we did in a decade, we are doing more than a decade than we did in the entire century. I could not be more excited as a cancer physician, physician, scientist, or a researcher about the premise of offering better treatments for our patients, and I think we will cure a lot more of our patients going forward.

Because of President Biden's Moonshot Program, we will start recognizing people earlier in the stages of their diagnosis, which basically means greater likelihood of cure. As I said, 70% to 75% of the care is given in the community, and that is where a lot of this action needs to happen. For most community cancer centers, this is a huge opportunity to serve their patients, right where their homes are.

One of the important things to remember is when people have a cancer diagnosis, yes, they can always travel to Boston to get read at Dana-Farber [Cancer Institute], or go to Houston to MD Anderson [Cancer Center] or Memorial Sloan Kettering [Cancer Center] in New York, but that is the last place you want to go when you have a cancer diagnosis so one can live closer to [their] family and support group. Obviously these institutions have a great role to fulfill when people run out of options. [Patients] are willing, and should be, able to go to these tertiary care cancer centers, but for regular diagnosis, for most of the patients that we treat, we should have those resources and access closer to home. That is what our goal is at Miami Cancer Institute, and Baptist Health Cancer Care, is how to give the community of South Florida the best care possible in terms of clinical trials or traditional treatments close to home.

What resources are most beneficial for community oncologists to effectively integrate targeted therapies or new research practice?

I have so much respect for the community oncologist because I am daunted by the amount of innovation and new drugs we are having and which are coming down the pipeline every month. It is challenging to keep up with the research and innovation. That is why I think I am a big fan of not only the [American Society of Clinical Oncology Annual] meetings, but also educational programs that are being put together, because that creates an opportunity for community oncologists to mingle with a speaker.

We started a precision oncology meeting in solid tumors at Miami Cancer Institute last year. It was a successful meeting where we had experts from all over the country come and present on various topics. It gave opportunities to our cancer doctors or medical students who want to go into oncology and [gave] an opportunity to interact with these speakers in a more intimate manner. Those kinds of opportunities are important.

[Including National Comprehensive Cancer Network] guidelines, there are several resources available on the web [that] are good resource[s]. [Also speaking with] colleagues is smart. I have relationships with several. I am a brain tumor expert, and whenever they need my help, they will reach out to me via email or a text or a phone call. We always want to serve the patients whether we see them or we do not. them. That is what unites all of us, to improve the outcomes for patients with cancer.

What advice do you have for aspiring oncologists interested in pursuing a career in community oncology?

What I would tell people is, it is always nice to develop a focus. As a fellow, to develop an area of interest, even if you are going to go into community oncology and treat all the tumors, it is always nice to do some kind of research because it develops an aptitude for innovation. If you are an oncologist, it is a lifelong learning, because as I said before, we have so many new drugs being approved every year that it is highly exhilarating and exciting as an oncologist for what we can do for our patients. But also on the flip side, it can be challenging as a community oncologist to keep up with all the research or new drugs that are coming through.

Make sure that you are connected and formulate a group of go to experts. If you treat everything, it is nice to know someone who has expertise in breast cancer, lung cancer, brain tumors, so that if you have a patient who is complex, or someone who has failed a couple lines of therapy, what is the best drug or clinical trial to offer to your patients, and whether you are able to do it at your place or are able to refer them to the next closest cancer center, which is able to give them that innovation. We all want to give the best treatment to our patients.

What keeps you motivated to make a difference in the lives of your patients?

It takes a village to take care of patients [with cancer], so no single person can ever do everything. At Miami Cancer Institute, we want to serve our patients, and we are growing. We have made some tremendous strides in the last few years. We have been here in the community to serve our patients. I think the thing that excites me most is the premise of helping someone get a second chance, because cancer is not only a diagnosis for a patient, but it is a diagnosis for the whole family because it impacts the whole family. If we can help a patient, we can help a family. The premise of making a difference in someone's life is like nothing else. The opportunity to help someone is a gift, and we take that with a lot of gratitude [and] a lot of pride.

We are excited about this being in the greatest era of human innovation ever where we can do more for our patients, whether it is in terms of screening or something else. I think the next 5 to 10 years is going to be transformative in terms of cancer screening. We have a number of blood-based biomarkers coming, which will, hopefully, help identify patients earlier in this stage of the disease. We have therapies coming through the pipe like no other new drugs, which are helping ensure greater cures for our patients. Also, I think I have been lucky in my career as I have had some phenomenal mentors who helped pave the path for what I am able to do today, in terms of serving my patients. I am excited to work with a number of mentees here, whether they are students, fellows, or young faculty at Miami Cancer Institute, or all my mentees throughout the country where I can help them reach the next stage of their life. The students and fellows of today are going to be the doctors and physicians of tomorrow. Someone needs to take care of us as we get older as well, so it is an investment in the future.

All these aspects of working at a large tertiary care cancer center is exciting because it fulfills several of what I would love to do in life, which is take care of patients, be involved in research and innovation, but also educate the next generation of physician leaders. I am so lucky that my job has helped, and is able to help me with opportunities to do all of them.

Awards like this help a long way, not only for me, but they also serve as an inspiration for my younger colleagues to strive for better and higher things in life. Ultimately, all of this will help us take care of our patients because ultimately, it is only about the patients, nothing else.