Curiosity and Compassion Propel Lung Cancer Pioneer Ramalingam to TIME100 Health 2025 List

Suresh S. Ramalingam, MD, FACP, FASCO

As a resident in internal medicine in the early 1990s—during a time when cancer therapies were scarce—one patient with lung cancer changed the narrative and career trajectory for Suresh S. Ramalingam, MD, FACP, FASCO, who has since worked tirelessly to propel research in this field.

In May 2025, Ramalingam was recognized on the TIME100 Health 2025 list for his contribution to groundbreaking research, particularly in evaluating EGFR TKIs for the treatment of patients with EGFR-mutant non–small cell lung cancer (NSCLC).^1,2

“The past 10 years have been remarkable. Immunotherapy came into the treatment of lung cancer, and now we're using immunotherapy for practically every stage of lung cancer,” Ramalingam said during an interview with OncLive®. “We're curing more patients with early-stage disease with immunotherapy and extending the lives of patients with advanced-stage disease.”

In the interview, he highlighted his journey of becoming a medical oncologist, his experience in the oncology industry during a pivotal time in the lung cancer landscape, and his contributions toward identifying the EGFR pathway and developing EGFR TKIs. He also offered advice to incoming physicians looking to break into the oncology space.

Ramalingam is the executive director of Winship Cancer Institute of Emory University and associate vice president for cancer of Woodruff Health Sciences Center, both in Atlanta, Georgia.

OncLive: What inspired you to become a medical oncologist, and what was your journey of becoming one?

Ramalingam: When I was pursuing internal medicine during my residency, I had the opportunity to take care of patients with cancer, particularly lung cancer. One specific case I still remember involved a situation where a very young patient was diagnosed and hospitalized for a fairly advanced form of lung cancer. For me, that resulted in interactions with the oncology team, where I learned about lung cancer and realized there were very few therapeutic options for patients with lung cancer. In the early 1990s, that could be said for a lot of cancers. To me, that was the moment I felt that there was a lot to be done in this area. [There were] many opportunities for research and [to make] a difference in people’s lives by providing care. All of those factors firmed up my interest in oncology. Ever since I entered the field and completed my fellowship, I realized that pursuing research to generate new knowledge and develop new ways to treat patients with cancer was very exciting and personally rewarding. In addition to taking care of patients, I started working on clinical and translational research, and throughout my career, that quest for new knowledge has driven my work. I have been fortunate to work with many exceptional colleagues who have helped me do what I do well, and these partnerships continue to be [relevant].

How has the lung cancer field evolved since you started practicing?

One of the major things is how much the field has changed in the past 15 to 20 years. When I started 25 years ago, there was no targeted therapy for lung cancer; there was no immunotherapy. Chemotherapy and radiation therapy were the mainstays of treatment. A very small number of patients were even able to undergo surgical resection. Median survival for stage IV disease was a matter of months—6 to 8 months, to be precise. Now we are in a place where personalized treatment is helping improve outcomes. We've seen major innovations in the management of early-stage lung cancer. Detecting lung cancer early through screening is possible, and even advanced-stage lung cancer is treatable, and long-term survival is possible. I would say the scientific advances that have happened in the past 10 to 15 years have completely changed how we approach this disease.

I also think about the EGFR TKI journey. The first third-generation drug was FDA-approved in 2015; this year marks the 10th year of osimertinib [Tagrisso] as an approved therapy in the United States for patients with lung cancer who have an EGFR mutation. This is another drug that has made a remarkable difference in the lives of people who have this mutation.

I also have looked at emerging ways to detect minimally residual disease by just doing a blood test. This is going to revolutionize how we identify the risk of recurrence, even in patients with early-stage disease. This has the potential to decide who needs more therapy vs less therapy, longer duration vs shorter duration of therapy, and how we know if a patient is cured within a few months of treating the localized disease. All of these possibilities are truly exciting.

The second point I would make is how advances that have been made in the fight against lung cancer have inspired research in other cancers. The treatment paradigms we're seeing in lung cancer are being modeled for the treatment of other cancers. That makes me feel very happy to personally be at this place, because 25 years ago, lung cancer was not where people were looking for answers or solutions. I would emphasize the point that we are at an incredibly exciting time, and we are continuing to invest in research and the development of innovative approaches. Building on the platform that we have put together over the past several years is very critical.

What research that you have contributed are you most proud of?

I have been very fortunate to work on the subset of lung cancers that harbor the EGFR mutation, which is seen in approximately 15% of the patients with lung adenocarcinoma in the Western population. I have participated in research that included therapeutic options for patients with EGFR-mutated lung cancer. For the past 12 years, I have worked closely with the development of third-generation EGFR TKIs, which have now become the standard of care, not just for stage IV disease, but for stage III unresectable disease, and even for patients with early-stage lung cancer for delaying or avoiding recurrence of disease. Through all of these, we have learned a lot about how to develop precision therapies for lung cancer, how to manage acquired resistance, and how to improve the quality of life by using very targeted approaches for patients.

That line of research is something I have been a part of, and I take immense pride in it. I've also had the opportunity to work with world-renowned immunologists, like Rafi Ahmed, PhD, at Winship Cancer Institute, who have shared greater insights on the use of immunotherapy in lung cancer and other cancers. We are interested in improving outcomes for patients who are candidates for immunotherapy by bringing in new ways to enhance the effectiveness of PD-1 inhibitors, which is another line of research that I'm excited about.

Regarding your research in EGFR-mutant NSCLC, what future directions do you look forward to seeing?

Based on the work that's already been done, the key considerations for patients whose tumors harbor driver mutations are managing acquired resistance and understanding the mechanisms of acquired resistance. Developing novel approaches that are directed against the mechanism of resistance is also key. [We also want to determine if we] can avoid or prevent the mechanism of resistance from emerging if we knew beforehand.

In the immunotherapy world, it's the same story. Patients respond well initially, but the cancer recurs. How can we improve the effectiveness of immune checkpoint inhibition? One example we have published on the fact that when we give patients PD-1 blockade, we see a significant proliferation of the T cells that can quell the tumor. However, the quality of these T cells is still not what they are fully capable of. Therefore, how can we improve the quantitative response and the quality of response? That is going to be key, and that's something our group is focused on. Certainly, those are not the only areas where research is advancing, but I just bring these two up as examples of things that we're interested in.

What advice do you have for incoming physicians in the oncology space based on your own experience?

Oncology is a very exciting field to be in, and it is a personally rewarding field [to contribute toward]. When I say rewarding, I'm not talking about monetary terms—it's about the satisfaction I get from being able to make a difference in the lives of people who are fighting this dreaded disease. The research opportunities are vast in oncology, and it's also a highly collaborative community that you will be entering when you take up cancer research or cancer care as your career.

The nation's goal of reducing the deaths related to cancer by 50% by the year 2047 is eminently reachable, and we have various tools [at our disposal]. The evolution of artificial intelligence is also going to make things even more exciting. Oncology is already one of the most sought-after fields within medicine, and it's going to get even more sought after because of all of these things. My experience that I would like to share is that while we are excited about all of these aspects, it's all about taking care of patients and making sure that we are committing ourselves to finding every solution possible for our patients to facilitate their ability to live long and live well.

References

1. TIME100 health 2025. Time. Accessed June 6, 2025. https://time.com/collections/time100-health-2025/
2. Suresh Ramalingam: a breakthrough against lung cancer. Time. Accessed June 6, 2025. https://time.com/collections/time100-health-2025/7279582/suresh-ramalingam/