CHICAGO — Research is the backbone of the medical field. Through research, breakthroughs are made to discover how and why diseases develop and how to treat these conditions. For Sissy M. Jhiang, PhD, a professor in the department of physiology and cell biology at The Ohio State University College of Medicine, her work on thyroid cancer research has helped push the field forward, particularly in terms of genetics, thyroid tumor development and radioiodine therapy.
Sissy M. Jhiang
It is no coincidence that Jhiang has dedicated her professional career to thyroid cancer research. Through her biomedical training and work with several mentors, Jhiang was able to single out the condition and make it her passion. Her success in the field earned her the John B. Stanbury Thyroid Pathophysiology Medal from the American Thyroid Association this year.
Jhiang spoke with Endocrine Today about her biomedical education roots, her path to thyroid cancer research, the developments she has helped discover and her thoughts on what is next for the field.
What was the defining moment that led you to your field?
For my PhD training with Austen Riggs, PhD, at the University of Texas at Austin, I studied molecular evolution of globin genes and provided evidence that vertebrate globin characteristic gene structure has been conserved for at least 600 million years.
Thereafter, I was introduced into cancer research by Harris Busch, MD, PhD, at Baylor College of Medicine to characterize a proliferation-associated nucleolar gene as a possible target to attack many types of cancer.
After joining Ernest Mazzaferri, MD, at The Ohio State University, I was inspired to work on one disease — thyroid cancer. Mazzaferri often asked me, “Is there a way to identify which patients will develop fatal disease and would these patients be saved with more aggressive therapeutic regimen at his/her early stage of disease?” Mazzaferri’s passion for his patients was contagious and the quest to achieve personalized medicine for thyroid cancer patients quickly became my personal goal for life.
I started my thyroid cancer research with two approaches: characterize RET/PTC oncogene to uncover molecule events underlying thyroid tumor development, and clone and characterize the human iodine pump that mediates radioiodine delivery to follicular-derived thyroid cancers with the goal to further improve radioiodine therapy.
What are you currently researching , and how do you foresee that research developing?
To date, studies have largely focused on tumor mutations associated with different stages of disease, as tumor mutations enriched or specific in advanced disease stages may provide prognostic value and/or serve as novel targets to intervene in disease progression. However, I believe that germline variants contributing to intrinsic differences in tumor microenvironment and/or immune surveillance also play important roles in tumor progression and therapeutic responsiveness. Thus, my current research is focused on identifying molecule profiles of tumor mutations and germline variants unique to patients who developed progressive disease and were not responsive to current therapeutic regimen.
In addition, anatomic and functional imaging reflects real-time tumor dynamics that integrate interaction between tumors, tumor microenvironment and systemic immune surveillance. We are currently developing necessary tools to conduct close-up and longitudinal image analysis to assist prognosis prediction and clinical decision. I foresee integrating big data of genetics, images and clinical outcomes is the key to finding ways to achieve personalized medicine for thyroid cancer patients.
Have you ever been fortunate enough to witness or to have been part of medical history in the making? If so, please explain.
I was fortunate to witness or take part in recent advancements made by our thyroid cancer scientific community to continuously improve patient’s care in differential clinical managements for thyroid cancer patients stratified by their clinical presentations as well as tumor mutations profile; re-differentiation of radioiodine non-avid thyroid cancer with small molecule inhibitor(s) to increase radioiodine delivery; and small molecule inhibitor(s) with or without immunotherapy to prolong progression-free survival for patients with advanced disease.
What advice would you offer a student in medical school today?
Ask big questions, stay focused but remain connected with others, one patient at a time.
What do you think will have the greatest influence on your field in the next 10 years?
Integrating big data of genetics, images and clinical outcomes is the key to stratifying patients for differential clinical management. Novel drug discovery and development to allow a multi-pronged approach for therapeutic intervention. Innovative strategies preventing or minimizing therapeutic adverse effects.