The first time Chad Pecot saw cancer cells under a microscope, he was mesmerized. They were round and packed together tightly like “a cobblestone street,” he says.
It was 2009, and the then 29-year-old was working on his residency in internal medicine at Vanderbilt Medical Center — and had previously never spent any time in a lab space. In fact, until that very moment, he was convinced he hated research and was on track to become a private practice oncologist. But the next step in his career was an oncology fellowship. And having research on his resume would help him land one.
“The idea of research was boring,” he confesses. “And I thought I was going to have to lie through my teeth that I wanted to become an academic and do research.”
Pecot’s feelings about research stem back to the early 2000s, when he was an undergraduate student majoring in biomedical engineering at the University of Miami. At the time, he was helping a PhD student create a medical device for a thesis project.
“I thought he would use the device to get data and then publish the results, but he never tested it,” Pecot says. “So I thought most research didn’t go anywhere, and I never had an interest after that.”
Fast-forward to that day in the lab in 2009. Pecot was there with the late pulmonologist Pierre Massion, an internationally known expert in the early detection and prevention of lung cancer.
“Pierre was so jazzed about his research,” Pecot says. “He was trying to understand the different proteins in the blood of patients and whether that determines if someone has lung cancer. I was intrigued.”
Pecot had to beg his training program for an extra two weeks of residency to work in the lab alongside Massion’s team. He ended up spending two months there, coming into the lab after 30-hour shifts and on weekends to log more hours and develop a poster of his data.
“I was trying to learn all the techniques, and I made a lot of mistakes, but I couldn’t stop coming in,” he says. “The team was really encouraging. From the very first day when they showed me what cancer cells looked like in a flask, I was just enamored.”
Today, Pecot is a practicing oncologist for UNC Health, as well as a professor, cancer researcher, and biotech CEO. He cares for patients with lung cancer, studies how various types of ribonucleic acids (RNA) drive cancer, and is engineering RNA to target tumors and protect healthy cells — a therapeutic method he’s since patented via his startup company, EnFuego Therapeutics.
He also directs the UNC RNA Discovery Center, launched by the UNC Lineberger Comprehensive Cancer Center in 2022 and comprised of 40 faculty members and over 150 researchers studying everything from RNA structure and biology to protein regulation to therapeutics.
“When I think about the perfect medicine and about cancer being the most complicated disease, I think of two things,” he says. “One is the medicine needs to get rid of the problem, and two, the medicine needs zero side effects. It’s intriguing to understand how cancer cells utilize some types of RNA for their advantage, and then how we can also engineer RNA as a therapy to get rid of them.”
Engineering to healing
When Pecot was a kid, he could often be found rifling through his parents’ junk drawer. He’d pull out old answering machines and broken telephones and disassemble them to learn how they worked — and if he could fix them.
“My parents even got me a book for Christmas called, ‘The Way Things Work,’ which was really cool,” he remembers. “It was basically how all kinds of things work, from telephones to telescopes to nuclear fission and how planes fly.”
So it was no surprise that he chose to major in biomedical engineering in college.
“I loved it: all the calculus and physics and early engineering courses. It was definitely a great fit for me,” he says. “Then my second year of college came — and I got cancer.”
In the fall of 1999, Pecot was diagnosed with stage II testicular cancer. While his surgeon believed he could eliminate all the cancer cells by removing the infected testicle, a follow-up scan showed the cancer had spread to Pecot’s abdomen.
“That’s when the floor fell out from under me,” he says.
Within about a month of his surgery, Pecot began an intense course of chemotherapy treatments. For nine weeks, he lived with his mom at the American Cancer Society Hope Lodge next to the hospital in Miami and continued to attend college full time to finish his degree.
While Pecot’s oncologist, Pasquale Benedetto, told him there was a 90% chance that chemotherapy would eliminate his cancer, he quickly recognized this wasn’t the outlook for most of the other patients living alongside him at Hope Lodge.
“I got to know and befriend several people who, shortly after, passed away,” Pecot shares. “That’s where it changed for me. I was sick, but they were sicker. And just being surrounded by all these people I realized I wanted to be their doctor.”
Mentors and molecules
Just as Pecot was wrapping up his chemo treatments in January 2000, he applied to a fast-track program for medical school at the University of Miami. When his interviewers asked him why he wanted to become a doctor, he pointed to his head — which had the tiniest bit of peach fuzz on it — and shared his story.
“And the reason I didn’t apply anywhere else was because Dr. Benedetto was the program director for the oncology fellowship at the University of Miami,” he says. “So my doctor became my mentor through all four years of med school.”
Pecot credits his mentors for the path he’s on today. Benedetto was an excellent teacher and oncologist, while Massion was a passionate and prolific researcher.
In 2010, after working in Massion’s research lab at Vanderbilt, Pecot went on to pursue a fellowship at the MD Anderson Cancer Center in Houston, Texas. He worked in the lab of Anil Sood, a gynecologic oncologist who was studying how small ribonucleic acids called microRNAs control cancer-related genes.
“These microRNAs amazed me and showed me that RNA could even be repurposed as a therapeutic if we could figure out how to engineer and deliver them back to cancer,” Pecot says.
RNA innovations
Present in all living cells, RNA is a molecule that contains the body’s instructions for making proteins, controlling genes, and supporting chemical reactions. It is the intermediary between DNA and proteins.
Scientists began studying RNA in the late 1950s, discovering messenger RNA in 1961 and conducting research that would lead to first RNA-based therapeutic in 1978. By the 1990s, researchers were testing multiple RNA-based vaccines on animal models and today they’re being used to treat everything from COVID-19 to cancer.
But about 98% of RNA never gets turned into proteins. These are called noncoding RNA. In cancer cells, noncoding RNA can become dysregulated and drive tumor growth. Pecot works to understand this process and make therapeutics from something that can combat it: more RNA.
Many current treatments work by killing good cells alongside the bad ones as they move throughout the body, and some cancers have mutations that don’t respond to these medications. Pecot and his team have engineered RNA and proteins that bind to the cancer cells and silence the genes that cause them to mutate.
“We can tune this process and control how long it takes for the body to clear these RNA therapies,” Pecot says. “So theoretically it’s only hitting the mutated RNA target in the tumor, not the rest of the body. In theory, it shouldn’t cause much toxicity, and we’re hoping it creates other therapeutic options.”
Pecot thinks RNA therapies are the future of medicine. They have the potential to treat more common problems like diabetes, high blood pressure, and cholesterol and can be customized for an individual patient.
Pecot’s engineered RNA and proteins are fueling his startup company, EnFuego Therapeutics, which he founded in 2019. He hopes to spend the next year conducting safety testing for this technology and to start clinical trials in 2026.
“Having cancer really stoked the fire in me, and EnFuego captures that idea,” he says.
He also wants to continue to build out the UNC RNA Discovery Center, which he created in 2022 to bring together scientists across campus working on RNA research. The goal is more collaboration, more funding mechanisms for this type of research, and more bench-to-bedside medicine here at Carolina — meaning the work of basic scientists studying RNA gets translated into treatments that are eventually delivered directly to patients by clinicians like Pecot at UNC Hospitals.
“It’s a very exciting time to be studying RNA biology and therapeutics,” Pecot says. “And I’m lucky I get to do both.”