Progressnotes chats with Craig Lockhart, Division Director for Hematology and Oncology

Since joining MUSC in the summer of 2021, A. Craig Lockhart, M.D., MHS, has donned many hats: he is the division director for hematology and oncology within the Department of Medicine of the College of Medicine, associate director for clinical sciences within the MUSC Hollings Cancer Center, and ICCE Chief for Oncology Services within MUSC Health. Prior to joining MUSC, Lockhart served as chief of the Division of Oncology and associate director for regional and strategic research affiliations at the Miami Sylvester Comprehensive Cancer Center. He specializes in gastrointestinal cancers and has an impressive research portfolio spanning more than 100 Phase I/II and III clinical trials.

He recently sat down with Progressnotes to share more of his story.

What brought you to the Medical University of South Carolina?

My wife and I have been visiting Charleston since as far back as 1997, and we’ve always really enjoyed it. Throughout my career I’ve learned a fair amount about MUSC and have kept track of what was happening here. I was looking for the opportunity to create a destination program at an institution that already had a good regional and national reputation, and MUSC was just the place. We have great teams here as well as the resources to really make positive changes. I’m thrilled to be leading and building programs with an organization that I already know well and in a city that I like.

How did you discover your passion for medicine and research and decide to pursue both as a career?

From a young age I was very interested in research with sharks and marine animals, and I originally wanted to be a marine biologist! But when I was in college I was drawn to medicine because it allowed me to study science as well as help people in what is still considered a noble profession. During my residency I did a rotation in oncology, and I really valued the relationships that oncologists built with their patients during the very difficult time of undergoing cancer treatment. Oncologists teach patients about their illness, explain their therapy options, and guide them through the treatment process, and they have such an impactful role in people's lives.

That led to my oncology fellowship at Duke, where my mentor, Herbert Hurwitz, led the phase I program in drug development. He involved me in clinical trials to evaluate early drugs that inhibited tumor angiogenesis, or the way that tumors make blood vessels, which was a hot topic at the time. We did some research into monitoring the way that blood vessels grow even while patients are taking medications — using both animal experiments and clinical trials with patients — and it all clicked for me. I was very engaged with that process and just knew that it was where I belonged.

After that fellowship I worked on research on gastrointestinal cancers, and I've now been running gastrointestinal cancer trials for 22 years and counting.

What kind of perspective do you bring to MUSC, and what areas do you prioritize?

Within my role as a division chief, I want to make sure that we have faculty in place who can provide excellent patient care, but I also want faculty who are inclined not only toward the prevailing standard of care but also toward conducting ongoing research in their specialties. Whether they treat patients with lymphoma, lung cancer or any other cancer, I want my team to bring novel therapies and state-of-the-art care to the patients at MUSC Hollings Cancer Center, and this includes access to novel clinical trials and research strategies for all citizens of Charleston and South Carolina.

I'm particularly interested in early-phase clinical trials, where drugs are being examined in patients for the first time or being used for certain disease types for the first time. There are about 20 drugs for the care of cancer patients that are approved by the FDA every year. I've been working in that field for over 20 years, and I will continue to build on it to make sure that the Hollings Cancer Center stays at the forefront of the drug development process. One tangible step toward that goal is that we are building a clinical trials unit that will give us a dedicated space for early-phase clinical trials.

Finally, since we reside in a state where there are a lot of disparities surrounding the delivery of cancer care and many patients who live in areas without enough medical resources, we need to continue to refine our statewide hub-and-spoke model. In this model, Charleston is the main institution, or the center of the wheel, but we also provide top-quality care wherever our patients live. In some cases, part of our clinical trial portfolio is available outside of Charleston, including places like Florence, Orangeburg or Murrells Inlet. There are still some special procedures and studies that require travel to Charleston, but the goal is to deliver the best care possible across the state, no matter where somebody resides.

What's been changing in oncology in recent years, and what excites you about the future of the field?

It's not a new concept anymore, but we're getting better at precision oncology. We’re taking the characteristics, genomics and molecular changes within the tumor — and also some of the genetic and genomic components of the patient — and trying to find the best therapy for them. And with the new arsenals of drugs being approved every year, we have more and more pharmaceutical options for these patients that are based on the particular molecular patterns of their tumor or even their own genetic characteristics. And we know so much more about the immune system and about how it interacts with cancers. By learning to harness it, whether that's through pharmaceutical approaches or through things like CAR-T and cellular therapies, we’re finding ways to train the patient's immune system to actually wipe out the cancer.

What are some of the challenges you face and how are you working to address them?

Delivering state-of-the-art care in a state that is medically underresourced is always a challenge. And even with the best care available at present, if somebody comes to us with a newly diagnosed pancreatic cancer that has spread and we can’t give them a good prognosis, that’s unacceptable to me. We have to do better than that, which is where clinical trials come in. They provide patients with top-notch care and access to novel therapies, and in some cases they may help patients live longer than currently expected.

And then there are always challenges as political and economic landscapes shift, so we need to remain nimble and strategic so we can always deliver the best care possible to all our patients. That’s the ultimate goal, to provide health and well-being for all the citizens of South Carolina and beyond who need our care.

Finally, when you’re not working, how do you enjoy spending your time?

There are so many things to do in Charleston! I love dining out, running and walking near the water. And since marine biology has always intrigued me, I love just simply observing the natural beauty of our marine environment.