Emory Report

September 25, 2000

 Volume 53, No.5

The Doctor is in

By Eric Rangus

Like any good teacher, Jonathon Simons is a whiz at explaining difficult concepts to lay people.

Concepts like his job.

Actually, it's not his job that's so tough to ascertain. That part's pretty easy; Simons is the director of the Winship Cancer Institute. It's the background he brings to his job and the manner in which he goes about it that may leave all but the few fortunate to have a medical background scrunching their eyebrows.

Until he explains it.

"Translational research," said Simons, prefacing a definition of his work, "is taking new scientific understanding and seeing if it can actually help a patient. You have to be both a scientist and a clinical scholar in the same person. It's a new generation of cancer researchers who are heavily trained in the basic sciences but actually have medical degrees and care for patients."

Specifically, Simons is a genomics-based cancer pharmacologist, but even that title can be simplified. "Most people say 'gene therapist," he said. "The idea is to take our understanding of genes that cause cancer and make medicines that prevent or treat cancer because we have a new, rational, gene-based understanding of a cancer's soft underbelly for attack. Part of the job here is to find the connections between emerging science and great doctors, and start to build the bridges for clinical trials."

Perhaps another definition would help here-that of genomics, and its relationship to genetics. "Genetics is the science of knowing genes-brown eyes, sickle-cell anemia," Simons said. "Genomics is the science of using the information of the genes and coming up with a new treatment or a better way to detect cancer before it spreads."

Simons, an internationally known researcher and prostate cancer specialist, was an associate professor of both oncology and urology at Johns Hopkins Uni-versity in Baltimore, as well as director of the Molecular Pharmacology Program and Cancer Gene Therapy Laboratory at the Hopkins School of Medicine until he was hired to head Winship in February.

He moved to Atlanta in July, and his office in Emory Clinic B still resembles a half-decorated loft apartment. Several boxes remain unpacked behind Simons' desk, and a host of three-ring binders and textbooks line the room's perimeter.

"It takes a while to wind things down in one place and build things in another," Simons said. And he had quite a foundation in Baltimore. Not only was the Washington, D.C., native a member of the Hopkins faculty and staff since 1991, but he also earned his medical degree there.

"At Hopkins, Jonathan took hold of the program that translates cancer research from the laboratory to the bedside and led it to new heights," said Michael Johns, executive vice president for health affairs. Johns was medical dean at Hopkins when Simons joined the faculty. "I have known him and watched his career for the past decade. He has all the qualities and the many skills to lead the Winship Cancer Institute into a new era of world-class research and patient care."

Simons has written for many publications, and he also has appeared on several network and cable news shows; one of the most interesting was when he discussed gene chips accompanied by several survivors of prostate cancer such as entertainer Robert Goulet, New York Yankees manager Joe Torre and former Sen. Bob Dole for an episode of CNN's "Larry King Live" that focused on the disease.

While at Hopkins, scientists trained by Simons cloned new genes, developed new strategies for gene therapy of prostate cancer and identified three new treatment pathways for metastasis. The Food and Drug Administration approved early clinical testing of four different strategies of prostate cancer treatment, all discovered and developed by the Simons team. He also led the early teams that treated patients with these modalities.

In most instances, past and present, that sort of a research-to-bedside-treatment process has been performed by several teams of scientists and doctors. The translational science practiced by Simons, however, incorporates all those responsibilities into one doctor.

"Translational science is not private practice medicine. You must focus on a subspecialty to remain a good clinician. But in principle, you can help 10,000 patients by caring for and studying 10 at a new molecular level of understanding," Simons said. "The idea is to take excellent care of patients and at the same time go home knowing more about the disease. What is going to be different about the Winship Cancer Institute is it's supposed to create a culture that advances the standard of care, not just practices it."

Another important part of translational science is that humans are the test subjects.

"With this revolution in biomedical research, the most relevant species for cancer research are Homo sapiens with cancer. Now a patient's own cancer can be analyzed very quickly," Simons said.

Those patients give their consent, of course, and translational scientists do not use humans exclusively. Mice, flies and worms are also test subjects; in fact, in his own laboratory Simons has created "transgenic" mice-mice who have received pieces of human genes.

Simons' vision of Winship's future includes not only making it a center of translational research, but also a leader in cancer genomics and in new drug development and experimental therapeutics, which is bringing new kinds of medicine to cancer treatment in early clinical trials.

"In the last five years, we've learned more about prostate cancer genomics than we've ever known," Simons said. "There are many new targets, including the possibility of making entirely new vaccines that are not like chemotherapy-you won't lose your hair or throw up. They would actually activate your own immune system against your cancer. That's not science fiction; many now do that for a research living.

"After seeing the birth of my children and after my marriage, the most wonderful experience is to see somebody with cancer receive treatment that you helped develop," Simons said. "It means that you took new science to try and solve an age-old ploblem."

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