That night, Pillarisetti saw a gene that was highly overexpressed in patients with multiple myeloma who were in a precancerous stage of the disease.
Despite very little information in the literature, he had a strong desire to investigate whether a therapy could be developed that would use that gene to intercept the cancer before it started or potentially stop it in its tracks if it already had.
“I still remember that exact moment when I thought, ‘Wow, this might work,’” says Pillarisetti, a scientist and discovery lead at Johnson & Johnson. It was, he adds, one of the most exciting points of his career. “The next morning, the first thing I did was run into my boss’s office to show him the data. When he looked as excited as I was, I knew we were on to something.”
Ten years later, Pillarisetti and a global team of employees across multiple functions have turned that novel molecule into a treatment that was approved by the U.S. Food and Drug Administration (FDA). While treatable, the disease is currently incurable and considered very difficult to manage because it almost always relapses.
“To take a drug from the lab to FDA approval is tough to do in 20 years,” says Pillarisetti. “Doing it in 10 is truly remarkable.”
For patients with later-line relapsed and refractory multiple myeloma who need additional treatment options, that progress mattered. Multiple myeloma remains especially challenging because it almost always relapses. But scientific advances have changed what may be possible, shifting Johnson & Johnson’s vision from managing the disease toward treating to cure.
Pillarisetti’s insights into gene expression in early-stage multiple myeloma laid the foundation for bispecific antibody treatments designed to bring immune cells and myeloma cells together, enabling the body to recognize and attack the cancer. As that work advanced, those learnings raised a new question: Could a next-generation therapy address more of the disease’s complexity by engaging multiple targets at once?
That question guided Pillarisetti and his team’s next area of research: a trispecific antibody designed to bind three targets—one on T cells and two on plasma cells—to explore whether engaging multiple disease signals could address myeloma’s ability to evolve and evade immune detection.
For Pillarisetti, the story of multiple myeloma innovation is also a story of scientific curiosity, persistence and teamwork. Learn more about his path into science, what drives his work and why he believes the field is moving closer to a future where cure may be possible.
Q:
Did a particular person in your life inspire you to study science?
A:
For as long as I can remember, I was interested in the subject. My inspiration is my father.
He was an agronomy professor who worked on rice crops—he studied how to improve rice production in drought conditions—so I always thought I’d go into plant sciences like he did.
I grew up in Hyderabad, India, which is where I also got all my education. Then, in my early 30s, I came to the U.S. for a conference and settled here after considering the opportunities for work. Around that time, I first learned about molecular biology and what it’s capable of doing. I was amazed and knew I wanted to pursue a career in that field.
Q:
What’s the biggest misconception people have about scientists that you’d love the chance to correct?
A:
Many people don’t realize how much effort and time is required to develop a drug—or how many people it takes. I would love it if there were more awareness around what goes into studying a new molecule and how many scientists have to think about the pros and cons of whether it will work as a treatment for patients.
As a scientist, this is something I’ve learned and experienced several times in my career: A small change in the experiment that may be tempting to ignore can turn out to be something really big.
As a scientist, this is something I’ve learned and experienced several times in my career: A small change in the experiment that may be tempting to ignore can turn out to be something really big.
I love the scientific discussions that happen when we’re studying a new molecule, especially when there are opposing ideas or suggestions. That’s what makes the process interesting—it prompts all of us to think differently and to come up with new ideas or new ways of thinking. As a team leader, I interact with many people from many different groups. It’s enlightening to see how people think in different ways.
Q:
What’s the best advice you’ve ever received?
A:
My mom always used to say, “Do the right thing.” If you think something is good and correct, just do it. Because even if you fail, it’ll be OK.
Q:
What’s the coolest thing about your work?
A:
My work helps patients, which I feel grateful for every day. Thinking that a patient might live longer thanks to one of the therapies that my team has developed is an incredible feeling. It really makes me take a step back and say, “Wow, I really contributed to something special.”
Q:
If we were talking 20 years from now, what innovation would you be excited to tell me about?
A:
I would love to see a cure for multiple myeloma. We’ve made tremendous progress, and today there are several treatment options that can help people live longer and better lives. But the ultimate hope is that one day patients could receive treatment for a defined period and then stop because they are free of both myeloma and ongoing therapy.
It would also be remarkable if the field could identify signals that indicate who may be at risk before multiple myeloma develops, opening the door to earlier intervention.
Q:
What advice would you give to young people in school or just starting out in the Science, Technology, Engineering and Mathematics (STEM) space?
A:
I would tell anyone in the science field—and especially those working at the bench in the lab—to analyze the data very carefully and to be on the lookout for subtle changes. Sometimes a very small change can surprise you in a big way.
As a scientist, this is something I’ve learned and experienced several times in my career: A small change in the experiment that may be tempting to ignore can turn out to be something really big.
Hearing from patients that they were able to live more days happily and spend more time with their grandchildren is what inspires me most—and motivates me to do even more.
Back in my early days at Johnson & Johnson R&D, when I was working on a different molecule, I noticed a result that initially seemed insignificant. But my team and I decided to look closer. At first, we thought we were chasing something inconsequential. But that small, seemingly insignificant result turned out to be an important biomarker for multiple myeloma that we used in 2013 to discover the molecule that would go on to become a breakthrough treatment.
It’s proof that scientists need to be very critical, especially when it comes to analyzing their own data.
Q:
What are your passions outside of work?
A:
I’m a family guy. I have two sons, and I like to go fishing with them. I also like gardening, cooking and I have a hobby of fragging coral, which involves cutting a small piece of coral from a larger “mother” colony and then relocating that fragment to grow elsewhere. I have a saltwater aquarium and give some of the corals to friends and family.
Q:
Who in your field—and outside your field—inspires you?
A:
In my personal life, it’s my wife. She inspires me and always supports me.
At work, I’m inspired when clinicians share news—good or difficult—about their patients with multiple myeloma. Hearing that a patient is recovering well, living longer and spending meaningful time with their family reminds me why this work matters. And when I hear that a patient has relapsed, it motivates me to keep asking what more we can do to improve outcomes.
But hearing directly from patients that they were able to live more days happily and spend more time with their grandchildren is what inspires me most—and motivates me to do even more.
This story, originally published on September 13, 2023, has been updated.
