TCGA IN ACTION

Posted: July 28, 2015

RESEARCHER PROFILE: Compassion and Curiosity

Teagan Keating Kuruna

Image: Dr. William Kim, M.D.

William Kim, M.D., is motivated by two things: compassion and curiosity. Dr. Kim has taken these dual motivations and created a career in which he cares directly for patients and spearheads research that may lead to improved treatment options. "When I'm in clinic," he says, "I'm always thinking, 'How can we test this in the lab?' And when I'm in lab, it's always clear to me why we're doing this research. It should be clinically important; it should help improve patient outcomes."

Dr. Kim grew up watching his father, a urologist practice medicine and show deep dedication to his patients. Thinking he would pursue a different career path than his father's, he majored in economics at Wesleyan University. But by the time he was a junior, he found himself pulled toward biology. Ultimately, he felt that medicine would be a natural fit for him and pursued a career in oncology.

Dr. Kim was accepted as a Clinical Fellow in Hematology Oncology at Dana-Farber Cancer Institute. Prior to beginning the fellowship, his only research experience had been a single summer during medical school during which he worked with Jonathan Simons, M.D., a medical oncologist studying immunotherapy at Johns Hopkins. "He gave me my very first glimpse of cancer cells in tissue culture under the microscope," Dr. Kim says. "He was an incredible mentor. But, at the same time, my scientific knowledge was so miniscule that I don't think I appreciated the greater potential for what I was learning."

He began his oncology fellowship in 1999, which was at the dawn of the field of genomics and targeted therapies like imatinib. "I remember sitting in oncology grand rounds week after week, listening to physicians and scientists present high-level science. All of it went over my head!" he explains.  He quickly realized that if he didn't understand cancer genomics and novel therapies, he would likely spend his career mixing and matching drugs rather than making more precise therapeutic decisions.

At the end of his fellowship Dr. Kim was faced with choosing between pursuing laboratory work or clinical trial experience. He chose the lab. "I sensed that this was a new age for cancer therapy and our understanding of cancer biology," and he wanted to understand it. "I remember making the decision, thinking that even if I chose clinical trials research, understanding the genomics and biology underlying the cancers would make it so much more fulfilling. Otherwise, it would be like picking drugs out of a hat." He wanted to provide better treatment than that. He joined the lab of William Kaelin, Jr. M.D. at Dana-Farber as a post-doctoral fellow, where he spent six years studying kidney cancer. He describes Dr. Kaelin as being a formative figure in his development as a physician-scientist.  “Bill showed me how to think critically and continually challenged me to be my own worst critic.  That’s tough to do on a daily basis, but I’m so grateful for his guidance and inspiration.”    

After his fellowship, he moved on to the University of North Carolina Chapel Hill. "I was fortunate enough to get the opportunity to start my lab here at UNC, where I've had very good mentorship and a great cancer center—both of which allowed me to do translational research and get involved with TCGA," he notes. Dr. Kim served on both the Disease Working Group (DWG) and the Analysis Working Group (AWG) for TCGA's bladder cancer project. Being part of the early stages of the process, he used his expertise to help determine the types of samples and clinicopathologic data that would address clinically relevant questions. "This ensured that we prospectively collected meaningful data points that could then be integrated with the genomic analysis."

While part of the bladder cancer AWG, Dr. Kim continued to learn. Though his expertise lies in RNA analysis, being on teleconferences with other researchers in other areas taught him about  DNA methylation, somatic mutation calling, and other –omic platforms. "We all have deficits of knowledge," he says, “The AWG brought together people who might never have collaborated." He also valued the working group's collegial environment. "It was a community in which we talked and became friends. You're much more likely to ask questions and share ideas if you're on a friendly basis with everyone."

Dr. Kim has continued in this spirit of collaboration in his lab's work with David McConkey, Ph.D., at MD Anderson Cancer Center, and with members of the TCGA bladder cancer AWG. "We have found that there are patterns within RNA expression that can subdivide high grade, invasive bladder cancer into multiple groups that have both interesting biology and prognostic ability. We've used TCGA data to help define the RNA subtypes and have begun using RNA sequencing data to look at the state of immune infiltration of bladder tumors." Through this work, they are able to estimate the types of immune cells in a tumor." We're also looking at the diversity of the immune cells—if immune cells are present in a tumor, is it a diverse population or are the cells clonal and trying to attack the tumor?"

This is the research upon which Dr. Kim based his proposal for the Bladder Cancer Research Innovation Award. His project, "Immune Characterization of High-Grade Bladder Cancer," is supported by the Bladder Cancer Advocacy Network. This project is the beginning of "taking novel discoveries derived from TCGA and applying them to patient care" he explains.

"I really enjoy taking care of patients," he says. "If I were giving advice to a budding young researcher, I would remind them that no matter what you're studying in the lab, at the end of the day, the goal is to help people. You're not merely trying to advance our understanding of cancer or find a novel drug target for yourself, you are doing it for others, for all the patients out there with bladder cancer."