On the Future of Medicine
Roger Perlmutter ‘73 transforms scientific questions into lifesaving treatments.
Every morning, somewhere in America, thousands of people walk into a clinical trial center, volunteering to test a compound that has never before existed in the universe. This extraordinary act of trust weighs heavily on Trustee and former Chair of the Board, Roger Perlmutter ’73. As a scientist, physician, and one of the pharmaceutical industry’s most successful leaders, he has spent decades developing new medicines, in the process registering dozens of drugs—in a field where skilled researchers can spend entire careers without moving a single drug into clinical trials.
“I feel the burden acutely,” he says. Volunteering for a clinical trial is “an almost spiritual act, because in most cases, those who volunteer recognize that the trial probably will not benefit them directly. Instead, they volunteer to help advance breakthrough medicines that will benefit someone else. We must take seriously the selflessness that motivates these actions.”
One of the breakthrough medicines that Roger helped bring from the lab into clinical practice was Keytruda™, an immunotherapy developed during his tenure at the biopharmaceutical company Merck & Co. The cancer treatment notably helped control metastatic melanoma in former president Jimmy Carter, who turned 100 in September of this year, a decade after he was first diagnosed with what would have previously been an incurable cancer.
For Roger, successful research requires that hypotheses be set up in a way that enables clear and reliable experimental results. “Rather than asking, ‘How does the brain work?’, one must focus on a specific aspect of brain function that can be measured reliably, building from such studies a more general understanding of brain function,” he says. This rigorous methodology, which he first embraced while a student at Â鶹¹ú²úAV, has led to many potent, lifesaving medicines.
Long before Roger was leading pharmaceutical companies, he was a teenager at Â鶹¹ú²úAV with broad interests in music, poetry, and mechanical engineering (including building a new type of gyrocopter). “If the measure of an education is the amount of change that it produces in one, then I got a great education at Â鶹¹ú²úAV: I began college thinking that I might become a poet and emerged a scientist,” Roger says, paraphrasing Mark Twain.
After Â鶹¹ú²úAV, he entered the Medical Scientist Training Program at Washington University in St. Louis, Missouri, earning both MD and PhD degrees. He pursued clinical training at the Massachusetts General Hospital and the University of California, San Francisco and served as a lecturer in biology at Caltech before moving to the University of Washington. There, he and his colleagues focused on mechanisms that permit diversification of immune receptors and the process whereby signals are communicated from these receptors, which reside on the surfaces of lymphocytes, into the interior of the cell.
Their discoveries, outlined in over 100 publications over many years, proved important to cancer biology, in which the same kind of signaling can stimulate unchecked replication of cancer cells.
Roger and his team then began to make synthetic compounds that could inhibit the signaling process. “It became clear to me that if we could turn down the thermostat on signal transduction, we would very likely be able to control a lot of pathological processes, and that set me off on a pharmaceutical career,” he says.
In the interim Roger had become the founding chair of the Department of Immunology at the University of Washington, which grew to include more than 300 scientists and trainees. But his belief in the importance of manipulating
molecular signals as a means to treat grievous illness led him to leave academia for the pharmaceutical industry, where over the next quarter century, he helped to direct both research and clinical development at Merck & Co. (1997–2001; 2013–2021) and at Amgen, Inc. (2001–2012).
Roger describes himself simply as a scientist, and takes credit only for having built truly excellent teams. He’s worked with specialists from diverse fields—each with unique concerns, challenges, and vocabularies. For example, “Every scientist is, both by nature and training, conditioned to be deeply skeptical,” he says. “You look at a graph and think, ‘why is that not true?’ Embracing this skepticism across all disciplines helps avoid superficial thinking about enormously complex biological processes.”
He explains that “to identify a new therapeutic candidate, and then to test it in the clinic, requires the best efforts of hundreds, sometimes thousands of people. No one person knows enough to execute the whole task. Drug development is unambiguously a team sport.”
For the past four years Roger has been engaged in building an even more diverse team of scientists and engineers with the goal of exploring the internal biochemistry of living cells non-destructively, and in real time. “Renowned physicist Eric Betzig, who shared the Nobel Prize in Chemistry in 2014 for the development of super-resolution microscopy, is fond of saying that if you want to study life, you ought to look at living things,” says Roger, “and that is exactly what we are doing.” As chairman, president, and CEO of Eikon Therapeutics, Roger and his colleagues have employed “single-molecule tracking,” which permits measurement of the behavior of individual proteins inside living cells through video recordings at over 100 frames per second, to identify novel drug candidates. What they’re discovering will rewrite textbooks, he says. And these discoveries offer the potential to develop highly targeted drugs to treat illness.
“Jimmy Carter’s longevity, enabled in no small part by scientific discoveries that led to the development of Keytruda, demonstrate what can be achieved if you have a bit of insight into the biological systems that control life on Earth,” Roger says.
For him, progress comes from turning big questions into testable ones, then bringing together the right minds to pursue the answers—an approach that has led to breakthrough treatments and continues to open new possibilities in medicine.
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