Patient-Centered Discovery

reprinted from Issue 13, Fall 2011 of Frontiers of Medicine (PDF)

Dr. Elliott Sigal, chief scientific officer and president of research and development for Bristol-Myers Squibb, visits a pediatric HIV clinic in Lesotho created through a grant from the pharmaceutical company.

Elliott Sigal, MD, PhD, vividly remembers the first patient he admitted to the hospital as a UCSF intern in 1981. “In retrospect, he was a young man with HIV/AIDS,” says Sigal. “It was before AIDS had a name, before we knew it was a virus. Yet it was clear to us that we were somehow witnessing medical history. We were all waiting for the response of the modern medical enterprise.”

After completing additional training in pulmonary medicine and research at UCSF and serving on the faculty, Sigal went on to create part of that response. After working at several biotech companies, he joined Bristol-Myers Squibb in 1997, where he oversaw development of a protease inhibitor used as part of a cocktail of drugs to slow the spread of HIV in the body.

“The biomedical enterprise… changed AIDS from an acute, lethal disease, to a chronic, manageable condition,” says Sigal, now the chief scientific officer and president of research and development for Bristol-Myers Squibb. Under his leadership, the company has brought to market more than a dozen new medicines representing major advances for patients with serious diseases, including the first and only new medicine to extend the lives of patients with metastatic melanoma, as well as breakthrough therapies for head and neck cancer, thrombosis, hepatitis B, organ trans-plantation, and rheumatoid arthritis.

“UCSF helped provide a great foundation for what I’m able to do,” says Sigal. In particular, he recalls how former Chair of the Department of Medicine Lloyd H. “Holly” Smith, Jr., used to walk on the wards with trainees. “After listening to a case, he was able to put medical treatment in a historical context from his vast experience, and discuss how medical care has evolved,” says Sigal.

Professor Jay Nadel, MD, who headed pulmonary research, encouraged him to collaborate with biochemists at UCSF to apply molecular research to lung disease, which at the time was a new approach. “Jay also gave me a real sense of helping more junior people in their careers, which I’m doing a lot of now,” says Sigal.

Joining Science with Medicine

Prior to medical school at the University of Chicago, Sigal earned a PhD in industrial engineering from Purdue University, studying computer simulation and a mathematical approach to decision-making. He found that the pharmaceutical industry was a great place to combine his medical training with his quantitative background.

“I certainly enjoyed helping people one at a time at UCSF,” says Sigal. “Now I envision helping tens of thousands of patients in a different way by helping teams that are making medicines for the future. It requires understanding the science, and also knowing where the field of medicine is going.”

Sigal says his experience caring for patients shapes his work today. “It’s so important in pharmaceutical medicine to keep the patient at the center when you’re thinking about disease treat-ment, the need for new therapeutics, and safety and risk benefit,” says Sigal.

He maintains this patient connection by inviting clinical trial participants to tell their stories to his teams. “The patients often want to thank the researchers, because many of these are debilitating conditions, like severe rheumatoid arthritis, or hepatitis or stroke,” says Sigal. “There’s not a dry eye in the house…You realize that everybody has a story of a family member, friend or acquaintance that makes things very real.”

Since 1999, Bristol-Myers Squibb has committed $150 million to address the HIV/AIDS epidemic in Africa. Sigal recently visited pediatric HIV clinics in South Africa and Lesotho created by some of these funds, and remembered his internship experience 30 years ago. “I think of that one patient, and then all the research that’s come out of our company and others – I am very proud of the people I work with, and the impact they’ve had on disease,” says Sigal.

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