From Cancer to COVID, Boston to Beirut

Short abstract

The COVID‐19 pandemic has highlighted health and vaccine disparities. Lessons from the collaborative development of targeted therapies for lung cancer and their impact on survival show that there is a better path forward.

The arc of any life is a singular one, but many of those arcs have a shared trajectory. Over the course of this last year, that which unites us has become clearer than ever before.

The week of February 14 to 21, 2021, was a momentous one personally. On February 12, 2021, I returned to the campus of the American University of Beirut (AUB) after almost 2 months in the United States. It was the latest of many desired and undesired firsts over the last year, and that return would turn out to be a remarkable one. Since emigrating (unknowingly at the time) in 1982 back to the United States, the country of my birth, I had never spent more than 3 consecutive months away from its shores, not even after becoming AUB's 16th president in 2015, when my trans‐Atlantic trips became ever more numerous. Yet I stayed in Lebanon and at AUB for almost 10 months in 2020, the longest I had been away from America in 38 years.

On the other hand, since my academic, clinical, and leadership career picked up momentum in 1997, I had never had the good fortune to share the same house with my wife Lamya continuously for more than 6 consecutive weeks. Such are the joys and travails of life in the academic fast lane. However, before my return in this case, I had the great joy of staying with my wife, sharing virtually every meal together for 11½ consecutive months, our longest stretch since we were married almost 30 years ago. This has been by far the happiest consolation of the great plague that has been the coronavirus disease 2019 (COVID‐19) pandemic, which has cost so many of us loved ones, including Lamya's mother last November. I will never willingly return to my previous travel schedule, as the year has shown me and others, if indeed we needed showing, what and who really matter most in our lives.

Back to the week of February 14, 2021. On Valentine's Day in a beleaguered and despairing Beirut, 3 academic hospitals, 2 private and 1 public, led by the AUB Medical Center, piloted the Lebanese national COVID‐19 vaccination program. Together, we vaccinated more than 1000 patients, navigating through the repeated collapse of the Ministry of Public Health electronic vaccine registration platform, just one of many obstacles in a country where only 44% of those surveyed have indicated a willingness to be vaccinated. Along with France, Croatia, and Serbia, that is among the lowest rates in the world. Yet the vaccinations were launched, and in 2 weeks, despite a cynical campaign to undermine it, the vaccination drive saw the number of individuals registering to be vaccinated double from less than 400,000 to more than 800,000. This is not nearly enough in a country with almost 7 million inhabitants, but it is an important step in the right direction.

Meanwhile, in the United States, the last 3 months have seen the number of vaccinations given rise above 100 million. Yet in Boston, city of my birth and postgraduate medical training and home to a booming biotech industry that includes Moderna, one of the main developers of messenger RNA–based vaccines, the process has gone slowly enough that friends of mine in their 80s had to wait months before receiving their first vaccine doses in America's medical Athens. Moreover, vaccine nationalism keeps rearing its ugly head, whether in disputes between Great Britain and Europe or elsewhere.

The other monumental personal undertaking for the week of February 14, 2021, was my participation in the 20th Targeted Therapies of Lung Cancer Meeting of the International Association for the Study of Lung Cancer (https://ttlc2020.iaslc.org/), this year held virtually. Twenty years ago, as a 37‐year‐old ingenue at the first such meeting, in the midst of my annus mirabilis at MD Anderson, I was the only individual selected to give 4 different scientific talks on 4 different compounds in development. It was a thrilling time in my career. However, this time I had a vastly different role to play as the eminence grise, the experienced “veteran” on the final panel of the first day of meetings, tasked with giving perspective on a much more exciting panoply of compounds nearing the clinic, all of which were being developed by folks several years, or in some cases decades, my junior.

I am delighted to announce that the conference itself was in marked contrast to the vaccine wars. Previously undisclosed information, collaborations on the development of new compounds, discoveries and debates about their possibilities and limitations, unpublished data—all were shared openly and collegially. It was a remarkable breath of fresh air at a time when we all badly needed it. The meeting was an example of what can be accomplished when we pool our resources and share our hopes, doubts, and fears. The evidence that this collaborative approach works was there for all to see last summer when an article in The New England Journal of Medicine showed that lung cancer survival has improved since the dawning of targeted therapies for the disease. ¹

From Boston to Beirut, the lessons are both evident and abundant, if only we will heed them. We will all do much better when we share knowledge, medicines, and causes.

In his poem “For Whom the Bell Tolls,” the great English poet John Donne wrote the following:

No man is an island,

Entire of itself.

Each is a piece of the continent,

A part of the main.

If a clod be washed away by the sea,

Europe is the less.

As well as if a promontory were.

As well as if a manor of thine own

Or of thine friend's were.

Each man's death diminishes me,

For I am involved in mankind.

Therefore, send not to know

For whom the bell tolls,

It tolls for thee.

These words are as true today as they were in John Donne's far more challenging era. Cancer, as much as COVID‐19, shows us what is possible when we keep the concept of a shared destiny firmly in mind.

Funding Support

No specific funding was disclosed.

Conflict of Interest Disclosures

The author made no disclosures.

Khuri FR. From cancer to COVID, Boston to Beirut. Cancer. 2021. 10.1002/cncr.33538