At several key moments in a career spanning more than a half-century, Jaffer A. Ajani, MD, determined that the options available to him were simply insufficient. Whether yearning for more opportunity, more knowledge, or more research progress, this innate drive has propelled him from boyhood in a poor town in India to becoming one of the world’s top experts in gastric and esophageal cancers. He stands now at the pinnacle of his profession, with a resume that includes more than 700 peer-reviewed papers, but such success was far from guaranteed when he was growing up.

His parents had fourth-grade educations. His mother tended Ajani and his 5 siblings, while his father cobbled together a living running a shoe shop, selling mangoes and oranges from a sidewalk stall, or renting out a tiny fleet of hand-pulled rickshaw carts.

The cultural expectation was that Ajani would do the same, he said.

“I was raised to believe that you’re not supposed to leave the town where you were born. You’re supposed to do the family business. How can you leave your family?” he said in an interview from his office at The University of Texas MD Anderson Cancer Center in Houston.

Yet his father had a friend, a physician who made house calls on a motorbike. The young Ajani was entranced by this tall, striking man who zoomed from household to household and earned the respect of everyone in town.

At age 23, Ajani moved to the United States to begin work at a clinic in Altoona, Pennsylvania.

“For no other reason, I decided to become a doctor,” he said, laughing.

India was in desperate need of physicians when Ajani was young and the government heavily subsidized medical school fees, so even a poor man like his father could afford the tuition. Ajani left home for a city 35 miles away to begin his medical studies when he was just 17.

However, he eventually determined that while he could learn medicine there, he couldn’t actually practice it—at least not in the manner he had envisioned.

The struggling government hospital had a single electrocardiogram machine for 600 patients, and the time-consuming process to get authorization for use was absurd. Moreover, practicing medicine was often a pointless exercise. He had the tools and training to diagnose a child’s ear infection, for instance, and he could prescribe antibiotics, but he knew the parents could never afford the medicine.

“It was very painful,” he recalled. “It was very clear early on that there was no future for me there. I was looking for bigger things. I had to run from there.”

The United States beckoned as a place for a better future. In 1974, he accepted a clinical residency in Altoona, Pennsylvania, a small Rust Belt city in the Allegheny Mountains. Ajani grew up in the equatorial plains of central India where summer temperatures routinely hit 117˚ F. Now picture him, desperately homesick without a car, trudging to work through the snow during grim Northeastern winters. “Culture shock” barely begins to describe the experience.

Ajani with Jeff Netzer (tan suit), president of the Stupid Strong Foundation, and his laboratory team. The foundation has been a strong supporter of Ajani and his research over the years.

Making matters worse, Ajani had been advised to postpone his dream of going into orthopedics to pursue family medicine. The advice, while well intentioned, was a bad fit for him. He was on call every third night and found the work uninspiring.

In some ways, “it was a good experience,” he now concedes. “But in hindsight, I could’ve done without it.”

Turning his back on the chance to go into private practice in Altoona, he applied for an orthopedic surgery residence at Albert Einstein College of Medicine in New York, New York. At the interview, however, he discovered that all applicants had to train in general surgery first, with no guarantee of being allowed to specialize in orthopedics.

The gamble seemed too risky: What if he couldn’t pursue orthopedics after finishing his training? Instead, he contemplated what he’d enjoyed most about working as a family practitioner—the challenge of making a diagnosis—and switched to internal medicine.

Tulane University in New Orleans, Louisiana, offered him a residency, and there he got his first taste of oncology. He began in the field of cancers of the blood, but soon realized it simply wouldn’t be interesting enough for him. His teachers, although brilliant, spent their days bent over microscopes. He wanted to treat patients as well as research cancer cells.

“Scientific thinking about the disease was limited to how the cells looked under a microscope. The field has grown tremendously, but at the time, it was very boring,” he said. “I said to myself, ‘That’s not enough.’”

“That’s not enough.” The refrain once more drove his choices.

By 1980, just 6 years after arriving in Altoona, he had secured a fellowship at MD Anderson. He’d found his professional home. He was offered his choice of 2 slots: one in breast cancer and one in the gastrointestinal (GI) division. The breast cancer group was chock-a-block with veteran researchers; the GI division had just one.

“I thought, ‘This is a really good chance to see a lot of patients and do a lot of research,’” Ajani recalled of his decision to pick the GI position. He’s now a professor in the Department of Gastrointestinal Medical Oncology.

Soon he narrowed his focus even more, specializing in gastroesophageal cancers.

Gastroesophageal cancers are cruel diseases that have been painfully slow to relinquish their secrets. These can be treated effectively if caught early, but the symptoms are vague and often dismissed as minor irritants like heartburn or indigestion with or without weight loss.

Ajani with his then 4-month-old granddaughter, Maya.

Removing the entire esophagus is obviously not an option. Resecting part of the organ, then stretching stomach tissue into the chest, is a possibility, but that tactic is burdensome even when successful, said Crystal Denlinger, MD, senior scientific officer for the National Comprehensive Cancer Network (NCCN) and also a specialist in the esophageal cancer field.

“It’s a life-altering surgery. You’re never going to eat the same way,” Denlinger said. “And eating is underappreciated: Not only is it nourishment, but it’s also how you socialize with people, a way to take care of somebody.”

Gastroesophageal cancers affect about 46,000 Americans annually, but they are even more prevalent in Ajani’s native India, situated in the East Asian esophageal cancer “belt.” Furthermore, it is an orphan disease, and attracting research funds is an ongoing struggle.

Ajani with his daughter and son-in-law, Emilie and Cameron Howitt, and their daughter, Maya.

Nevertheless, Ajani spent much of the 1990s and early 2000s running a series of clinical trials for chemotherapy drugs administered in many different combinations with surgery and radiation. Progress, as measured by survival rate, was slow.

“For a very long time, our benefits were measured in weeks, not months,” said Denlinger.

“There have been times when I’ve been discouraged, and Jaffer was too. And we’ve slogged through,” said Wayne L. Hofstetter, MD, one of Ajani’s longtime research partners who is a professor in the Department of Thoracic and Cardiovascular Surgery and director of the Esophageal Surgery Program at MD Anderson.

However, very recently—just in the past 2 years— physicians have begun to see the needle move on treatment success. Ajani has served as a major investigator for 3 trials that have provided some much-needed bright spots.

Results from the phase 3 RATIONALE 302 trial showed that tislelizumab (BGB-A317), a novel humanized immunoglobulin G4 anti–PD-1 antibody, improved the rate of overall survival compared with chemotherapy as a second-line therapy. In September 2021, based on findings from RATIONALE 302, Novartis filed a biologics license application seeking FDA approval for tislelizumab in patients with people with advanced or metastatic esophageal squamous cell carcinoma who had received prior systemic therapy.

In 2020, Ajani served as one of the leading authors for the CheckMate 577 and 648 trials. Investigators took the novel approach of using a checkpoint inhibitor, nivolumab (Opdivo), as adjuvant therapy for patients with resected esophageal or gastroesophageal junction (GEJ) cancer who had previously received neoadjuvant chemoradiotherapy. Nivolumab doubled median disease-free survival compared with placebo (22.4 vs 11.0 months).

Based on these results, the FDA approved nivolumab in May 2021 for use in patients with completely resected esophageal or GEJ cancer with residual pathologic disease who had received neoadjuvant chemoradiotherapy.

CheckMate 577 “blew my socks off,” said Geoffrey Y. Ku, MD, an assistant attending physician at Memorial Sloan Kettering Cancer Center, speaking at the European Society for Medical Oncology Virtual Congress 2020. “It [was] absolutely a game-changer.”

The esophagus, a foot-long tube that would seem no more complex than a sausage casing, actually has cellular heterogeneity. Ajani and his associates recently found the same holds true for metastatic gastric tumors. By analyzing 45,000 individual tumor cells from 20 patients, they found 2 distinct cell subtypes, gastric-like and intestine-like, with the gastric-like cells much more aggressive. The team then developed a gene signature that could better predict patient survival.

These days, Ajani is most excited about the work that is the result of a decision he made years ago to begin collecting tissue samples from all his patients. It was originally suggested by a colleague, who convinced a skeptical Ajani to start the collection by telling him, “If you don’t do it, someone else will.” At the time, Ajani had no idea how he would ever use the samples. The hope is that the insights gained will lead to the production of individualized treatments. colleague, who convinced a skeptical Ajani to start the collection by telling him, “If you don’t do it, someone else will.” At the time, Ajani had no idea how he would ever use the samples.

Ajani at the 3-day Awa Odori Festival in Tokushima, Japan. He says the main dance is “fairly easy” for novices to learn.

The hope is that the insights gained will lead to the production of individualized treatments.

“Moving forward, we would like not to just try the next medicine on everybody,” Ajani said. “It has to be personalized, but it has to be on the basis of interrogation with a patient’s blood or tissue or something else.”

Outside the lab, Ajani’s efforts have helped secure a new pipeline of research funding for this oft-neglected cancer. His timing is good, unfortunately. Esophageal cancer is the eighth most common cancer and the sixth-leading cause of cancer death worldwide. Gastric cancer is the fourth most common cancer and third-leading cause of cancer-related deaths globally.

Ajani worked with patient advocacy groups to convince Congress to include gastric cancers among those for which the US Department of Defense allocates research funds. He even traveled to Capitol Hill to lobby legislators directly. That funding stream resulted in Ajani and his MD Anderson colleagues receiving roughly $10 million in grants since 2016.

Ajani with, from left: an older cousin; his sister-in-law, Laila; and youngest sister, Parveen; at a market in Katol, India.

Ajani serves as chair of the NCCN’s esophageal/ gastric cancers panels—the only chair the panel has had since its inception in 1997. He oversaw the drafting of new clinical practice guidelines in 2022.

Despite the behind-the-scenes procedural chores, Ajani said he relishes the panel’s meetings. He views them as his own personal continuing education seminars “You couldn’t learn more [anywhere else] in the couple of hours we spend [together] every few months,” he said.

Coworkers call Ajani by his first name (Jaffer rhymes with “suffer,” as he puts it) and describe a gentle man who almost never talks about himself. Denlinger, a member of the NCCN panel, calls him a careful listener who elicits opinions from everyone.

Trim and with a boyish face that belies his 71 years, Ajani says that if he’s in Houston, he’s likely in his office. Even on Saturdays and Sundays, he’ll go in for a few hours. On weekdays, he works “nonstop.” Hofstetter said his colleague doesn’t even pause to eat lunch, choosing instead to eat just 1 meal, dinner, each day.

Whenever he contemplates retirement, Ajani realizes he can’t leave right when the field is on the cusp of incredible breakthroughs. “He could have decided to retire 15 years ago,” Hofstetter said. “But he feels he still has work to do.”

Aside from his various clinical, research, administrative, and leadership duties, Ajani finds time to review submissions for nearly 3 dozen professional journals. Others might view this as a chore, but Ajani sees it as a way of getting a sneak peek at new research.

He also relishes doing his own writing. “I love to write. I don’t know where it came from,” he said. “But the things I love to write [most] are grants— you have to basically convince your peers that your idea is really good. I need to get better.”

He has a knack for catchy article titles. He published “It’s the poison that killed him, you say!” in 2003, and “Celebrate or calibrate? We say calibrate” came out in 2011, both in the 

If it sounds like Ajani has a lot on his plate, that’s what he prefers at this stage of his life. He does regret traveling as much as he did when his 2 daughters were little; he knows he missed a lot of their childhood milestones, but he found the travel “thrilling.”

“I think it was a mistake, but at the time I wasn’t smart enough to say no,” Ajani said.

At an age when he could begin to dial it back and take it easy, that isn’t happening. His mantra of “That’s not enough” applies to treatments as well. The man who left his homeland “looking for bigger things” wants that for his patients, too.

Jaffer’s dedication is legendary. Denlinger once accompanied him on a weeklong trip to Nigeria to discuss efforts to standardize treatment protocols for patients in sub-Saharan Africa. They spent their days discussing gastric cancer treatments, then met for informal dinners. Did he tell funny travel stories? Gossip about colleagues? Perform karaoke songs? No, Denlinger recalled. They talked about esophageal cancer

“He keeps saying, ‘We need to be thinking bigger,’ ” said Denlinger. “‘We need to be thinking more.’ ”

Articles

Jaffer A. Ajani, MD, has an unyielding drive that has resulted in breakthroughs in a deadly, but often overlooked, disease.

The Desire to Always Do More 

Glance at her résumé and you might assume that Nancy E. Davidson, MD, has an outsized personality that commands the spotlight the moment she walks into a room.

After all, she is 1 of only 7 people to have been president of both the American Society of Clinical Oncology (ASCO) and the American Association for Cancer Research. She has run groundbreaking international clinical trials, contributed to more than 380 papers, and served on the advisory boards for 10 National Cancer Institute (NCI)–designated cancer centers.

Yet, such success is due in large part to her secret superpower: She’s an introvert.

Davidson has a natural aversion to drawing attention to herself. As a young researcher, she had to be advised by her mentor that when attending a conference, she should, “sit in the front row and ask a question.”

Yet quietly, subtly, she accomplishes what she’s set out to do, in part because of that very willingness to share the stage with others.

“She has that basic decency of listening to others,” said Marc Lippman, MD, professor in the departments of oncology and medicine at Georgetown University Medical Center and the mentor who gave her that “front row” advice.

That introversion, however, can prove frustrating when she feels it gets in the way of conveying her ideas, Davidson said. Still, she knows it is a powerful asset when convincing others to join her team.

“It allows me to draw others out so that they contribute and shine,” she said.

Collaboration is valued in modern-day cancer research, yet easier said than done when dealing with hard-driving intellectuals who each have turfs to protect. In such a milieu, think of Davidson as The Oncologist Whisperer.

She is now at the pinnacle of her career, having amassed an admirable record of her own research breakthroughs in breast cancer as well as leadership that boosts the work of others. She is now at Fred Hutchinson Cancer Research Center, 

where she is a senior vice president and director of the clinical research division. She also has leadership roles at Seattle Cancer Care Alliance, the center’s nonprofit treatment arm, and the University of Washington.

When asked which of her research findings she views as the most significant, she cites the phase 3 ECOG 5188 clinical trial that established the benefit of endocrine therapy for premenopausal women with early-stage, hormone-responsive breast cancer.

The study tested the conventional wisdom that young patients wouldn’t benefit from adjuvant hormonal therapy. “There wasn’t any clarity that it would work in younger women,” she said. “We decided to challenge that.”

One lingering memory that encouraged her to go down that path was of reading the original article from 1896—yes, 1896—in 

by the pioneering Scottish oncologist and surgeon Sir George Thomas Beatson, MD, MB, in the stacks of Welch Medical Library at Johns Hopkins University. His revolutionary technique of treating breast cancer by removing the patient’s ovaries signaled the dawn of an antihormonal approach to the disease.

That article, along with her own preclinical laboratory studies, helped Davidson realize that pathways of endocrine response are not age dependent, she said.

ECOG 5188 was a 3-arm, randomized, national trial that compared chemotherapy alone; chemotherapy followed by ovarian suppression with the luteinizing hormone–releasing hormone agonist, goserelin; and chemotherapy plus goserelin and tamoxifen.

It took years to complete, by design. Davidson wrote the study the year her son, Kevin, was born and published the findings the year he left for college.

When caring for younger patients with breast cancer, she noted that it isn’t particularly helpful to tell a 30-year-old her chances of living to 32. The trial followed patients for nearly a decade. The timeline was also lengthened due to the difficulty of enrolling premenopausal participants when the median age for receiving a breast cancer diagnosis was 63.

The results showed adding adjuvant tamoxifen to chemotherapy significantly improved time to relapse and disease-free survival compared with chemotherapy alone at 9 years of follow-up. The findings helped rewrite the rulebook for treating 

premenopausal breast cancer. (And yes, she was one of the people who actually rewrote ASCO’s clinical practice guidelines.)

Davidson was the first to describe epigenetic regulation of the 

gene, uncovering a pathway through which some endocrine receptor–negative breast cancers could be made to reexpress the estrogen receptor and resensitize those tumors to endocrine therapy. Further, she was part of the team that demonstrated the value of using trastuzumab (Herceptin) along with chemotherapy for treating early-stage HER2-positive breast cancer.

Lippman noted that Davidson’s research is of immense value but that her bigger achievement is getting—and keeping—her fellow investigators on task for lengthy studies.

That is quite a feat, particularly given the size of some of the egos involved. “She has the ability to work in large, contentious, and often narcissistic groups of doctors and [get them to] behave,” he said. “Some of them I couldn’t be in the room with for 10 minutes.”

And in one-on-one settings, Davidson is friendly and engaging, with a ready laugh.

“How would I describe her style? I would say it takes a while to get close to her,” said Steffi Oesterreich, PhD, an expert in lobular breast cancer whom Davidson recruited to UPMC. “But once you are close to her, you will never leave her inner circle again.”

The daughter of 2 geologists, Davidson was born in Colorado and moved to Maryland with her family when she was a teenager. As a girl, she fancied becoming an archeologist, until her father gently set her straight.

“He said, ‘That’s a nice idea, but what are you going to do to earn a living? I don’t think you can support yourself being an archeologist,’” she recalled.

She came of age just as many of the Ivy League universities went coed, expanding her choices for where to study molecular biology. Both her parents had liberal arts degrees, and her mother had attended a women’s college. So perhaps it was no surprise that Davidson ended up at Wellesley College in Massachusetts.

Halfway through her studies, she sought more exposure to laboratory work at the nearby Massachusetts Institute of Technology. She laughs when she recalls a simpler era, void of voracious competition and lightning-fast internet applications. Her technique? She talked to her boyfriend’s fraternity brother, who worked in a laboratory.

That lab focused on liver cancer research, which she said got her thinking about cancer in general. Upon graduation, she went to Harvard Medical School.

The summer after her first year of medical school, she went back to Maryland to save money and applied for summer work at the nearby National Cancer Center (NCI). When breast cancer research titan C. Kent Osborne, MD, called with a job offer, she recalls bluntly asking, “Does it pay? He said yes, and I said, ‘I’m in.’ ”

Seeing the interplay between laboratory research and its “bench to bedside” potential that summer hooked her.

After graduation and internal medicine residency, Davidson was a medical staff fellow at NCI for 3 years and then moved to Johns Hopkins University School of Medicine, where she was a faculty member in the Department of Oncology from 1986 to 2009 and served as director of the breast cancer program from 1994 to 2009.

In 2007, she began a term as president of ASCO. Leading the world’s largest professional oncology organization broadened her perspective. She realized that the exciting progress she’d witnessed in breast cancer was occurring in other cancers as well.

“I thought, ‘Wow, cancers like melanoma and kidney cancer, which were therapeutic deserts for medical oncologists, were now areas that were really up and coming with a lot to investigate,” she recalled. “That year made me decide that I wanted to think about all types of cancer. And I wanted to do it in a way where I’d have a larger leadership role.”

Overseeing research in those areas would mean becoming a director of an NCI-designated cancer center. Even today, there are only 71 such facilities in 36 states and director-level jobs are rare and highly coveted. Furthermore, taking such 

a job would mean relocating, and Davidson and her husband, Thomas Kensler, PhD, also a cancer researcher, felt it would be unfair to uproot their then-teenagers while in high school.

Her opportunity to lead an NCI-designated center came in 2009, when the University of Pittsburgh had an opening. From 2009 through 2016, Davidson was director of the UPMC Hillman Cancer Center as well as a professor of medicine at Hillman and associate vice chancellor for cancer research at Pittsburgh. Hillman is one of 51 NCI-designated comprehensive cancer centers. The NCI recognizes comprehensive centers for their leadership and resources, as well as their depth and breadth of research and commitment to transdisciplinary research that bridges scientific areas.

The timing was good because her 2 children, Caroline and Kevin, had finished college—and Davidson and Kensler had promised them the family wouldn’t move until after they graduated. Of the handful of open leadership jobs, Davidson found Pitt the most appealing because it was routinely among the top recipients of National Institutes of Health funding and its health system was the dominant provider of care across western Pennsylvania. In addition, Pitt actively recruited her husband, who joined the faculty of the Department of Pharmacology.

There, she spent a lot of time recruiting talent, building up the center’s breast cancer laboratory science, bolstering an already-strong immunology group, and beefing up the cancer epidemiology team.

There was still time in her career for one more move, and with it, the chance to fulfill a lifelong wish to return to the West, where she was born. She was already serving on the advisory board at Fred Hutchinson Cancer Research Center in Seattle, Washington, when they called to tell her about a job overseeing clinical research and care that she might find intriguing.

The job appealed to her because she could expand her own knowledge of cancer treatment. She’d focused on solid tumors in her career, but Fred Hutch, as it is colloquially known, has an international reputation as a leader in investigating and treating blood cancers and conducting transplantations. Davidson talks with obvious relish about the chance to learn about those fields in almost the same way a top chef would talk about learning a new ethnic cuisine.

“I knew it was going to be a growth opportunity for me,” she said.

She still sees patients a half-day each week. She finds it gives her a taste of the challenges her colleagues and patients face. Converting to electronic records has a very different feel in the examining room than in the CEO’s corner office.

“It’s useful to put your boots on the ground now and then,” she said.

Davidson’s curriculum vitae overflows with stints on advisory boards, national cancer charities, and NCI research committees. With a finger in so many pots, she noted that “one of the challenges of being a leader is when you go home at the end of the day, sometimes you’re not quite sure what you did.”

“She is so busy,” said Oesterreich, whose research Davidson had encouraged even before they became colleagues at Pittsburgh. “Yet if I want something—advice, guidance—her door would be open.”

Davidson said her secret is setting priorities by sometimes saying “No” or a brilliant variation of that: “Not now.” That allows her to fold new activities into her schedule when others reach their natural conclusion.

That’s how she thrived in her career while married to another hard-working investigator and raising 2 children in an era that wasn’t always supportive of working mothers. One welcome change over the years has been seeing childcare become a family issue instead of a woman’s issue. Her advice to both women and men: “You can do everything. You just can’t do it all at once.”

She also makes time for vacations that truly take her far from the world of cancer. That childhood fascination with archeology has persisted: She and her family have visited all 7 continents, as well as toured major historic sites such as Machu Picchu, Angkor Wat, and the Taj Mahal. She has trekked in Tibet and gone on safari in Africa.

Oesterreich said Davidson’s penchant for travel represents a conscious approach to self-care in a field whose demands can be unrelenting: “She told me, ‘It’s really important to forget about breast cancer for a while. It’s not an easy job.’ ”

A subtle superstar, Nancy E. Davidson, MD, is as adept at conducting
groundbreaking research as she is at treating patients and corralling investigators.

Giants of Cancer Care Award in Breast Cancer Goes to Nancy E. Davidson, MD: The Introvert in the Front Row

In the dark days of World War II, a 12-year-old boy dodged the Japanese soldiers who occupied his neighborhood in Hong Kong, slipping around corners and into alleys to sell cans of kerosene he’d converted from diesel oil to support his widowed mother.

When the occupation was over, he learned English in night school and rented a typewriter so he could make money exporting cheap toys to the West. Eventually, his import-export venture did well enough that he could afford to buy the typewriter outright.

Six decades later, his son, internationally recognized oncologist and investigator Tony S.K. Mok, MD, keeps that same typewriter in his office. Mok calls it his daily reminder to follow his father’s example of “entrepreneurship and diligence.”

Mok’s groundbreaking research into treatment options for lung cancer subtypes that are driven by genetic mutations is credited with producing a paradigm shift in fighting the world’s deadliest malignancy.

One look at his resume hints at a curiosity that compels him to seek out experiences not in the average oncologist’s day: He’s not just a world-renowned cancer investigator and clinician, but he’s also the host of several seasons of televised food shows, and he’s written a news-paper column for the past 14 years.

His face is so familiar in Hong Kong that an elderly patient, meeting him for the first time, assumed he was just an actor. “Are you a real doctor?” she asked skeptically, Mok, 60, recounted with laughter. How does he make time for it all?

“When an opportunity comes along, 2 things come to my mind: Am I going to like it? And am I going to make a positive contribution to the community? If the answer to both questions is ‘Yes,’ I find the time,” he said.

He was born Shu Kam Mok. When his parents enrolled him in an English-speaking secondary school, the school insisted he take a Christian name. A tutor picked “Tony” and the name continued to make sense for the next chapter of his life, when his parents sent him to college in Canada at age 16. He received his fellowship training in medical oncology at Princess Margaret Cancer Centre in Toronto, Ontario, having chosen oncology because it seemed to be a field on the cusp of major new developments.

In 1995, he took a tour of the Prince of Wales Hospital, the main teaching hospital of the Chinese University of Hong Kong. At the end of the tour, the head of oncology surprised him with a job offer.

Hong Kong was starting to experience a “brain drain” of physicians worried about the impending transfer of the British colony to China. Mok’s credentials as a seasoned oncologist who spoke Chinese made him an attractive candidate, despite his lack of research experience.

Accepting the offer would mean giving up his comfortable life in Canada and taking a big financial hit. On the other hand, he’d get to work with Chinese researchers and he was enchanted by “the charm of uncertainty.” Staying in Toronto meant his life would follow the very predictable path of a suburban physician.

He took the plunge and accepted the offer. He was 36, older than most of his peers, he didn’t have a single publication to his name.

Mok noticed that few investigators in Asia were looking lung cancer. The lethality of the disease was discouraging, and its mysteries seemed impenetrable. Where others saw a brick wall, however, Mok saw opportunity.

“One of the reasons to go into a field where little is known is because that is exactly the field where you’ll learn more and create more,” he said. “I thought, ‘This is a great area where there is going to be great progress.’ ”

His early research tackled a grab bag of topics, including pancreatic, colon, and lung cancers, as he tried to catch up with his colleagues. Much of his research has focused on the role of the EGFR gene mutation in non–small cell lung cancer (NSCLC). Mok was the lead researcher for the pivotal phase 3 IPASS trial. Investigators randomly assigned 1217 previously untreated patients with advanced lung cancer in East Asia to gefitinib (Iressa) or carboplatin plus paclitaxel.

For patients with the EGFR gene mutation, gefitinib was clearly superior to standard chemotherapy; for patients without the mutation, chemotherapy was superior.

e in September 2009, remade the world of lung cancer treatment and remains 1 of the most cited publications in the field. Based on that data, physicians would test patients with newly diagnosed lung cancer for genetic mutations before choosing a treatment. Lung cancer, so slow to relinquish its secrets, had entered the age of personalized medicine.

While Mok is accessible and friendly by nature—and funny, as well—colleagues say that beneath that convivial exterior is a serious intellect. His presentations at professional conferences are known for delivering not just the latest developments in research, but for put-ting that research into a broader context that every attendee can grasp, even those outside the immediate field of lung cancer.

He’s also a wine connoisseur and foodie who makes it a point to know the best restaurants in every major city. At the American Society of Clinical Oncology (ASCO) Annual Meeting, Mok traditionally arranges a big dinner with friends where shop talk is discouraged.

All his activities—the university teaching, the columns in the Hong Kong Economic Times, his work in the clinic, and his research—make for a very full plate. He wouldn’t have it any other way, explaining that being busy fits into his philosophy of life.

“The way I see life, the way I define a happy life, is this: At the end of the day, how many happy moments have I collected? So if I collect enough moments, I can call this a happy life,” Mok said.

Tony S.K. Mok, MD's, early research tackled a grab bag of topics, including pancreatic, colon, and lung cancers, as he tried to catch up with his colleagues.

Kathleen O’Brien

Articles

The Desire to Always Do More

Giants of Cancer Care Award in Breast Cancer Goes to Nancy E. Davidson, MD: The Introvert in the Front Row

Embracing the Charm of Uncertainty in Lung Cancer Research