5 Questions for Kim Nichols, MD

This question-and-answer series explores the motivations, inspirations, and accomplishments of investigators at St. Jude. Kim Nichols, MD, is the Division of Cancer Predisposition director and a Department of Oncology member. She is the 2026 recipient of the George R. Buchanan Lectureship Award from the American Society of Pediatric Hematology/Oncology, which honors individuals with distinguished research, education and clinical expertise who are recognized as accomplished educators, dedicated mentors and leaders in advancing pediatric oncology.

1. What does receiving this award mean to you?

Receiving the George R. Buchanan Lectureship award was a true surprise and an incredible honor. I am so grateful to be recognized and receive this award. To give a lectureship in Dr. Buchanan’s name is both humbling and deeply meaningful, especially knowing the impact he had as a clinician, investigator and educator. I met Dr. Buchanan when I interviewed as a junior faculty candidate at UT Southwestern in 1999. He was the Children’s Cancer Fund Distinguished Chair in Pediatric Oncology & Hematology at the time, yet he personally picked me up from the airport and gave me a tour of Dallas. I remember thinking what a kind gesture that was, especially since I was so early in my career. From what I have heard after speaking with several of his prior trainees, that moment really reflects who he was. He was generous with his time and deeply committed to supporting trainees at every stage. Even from that brief interaction, it is clear why he left such a lasting impression on so many people.

2. What drew you to studying cancer predisposition and what are you trying to understand with your research?

What first drew me to studying cancer predisposition was my early experience as a hematology/oncology fellow and Instructor at the Dana-Farber Cancer Institute and the Children’s Hospital of Boston. At the time, I was carrying out research in a genetics lab that was screening for mutations in the breast cancer gene BRCA1 in women with breast and ovarian cancer. Although I was working on a different project, I began to see how genetic testing was transforming care for adults with cancer. Clinics were emerging where genetic information could be used to guide screening, treatment and prevention. After several years, I started to wonder whether we could do the same for children with cancer.  

In 1999, pediatric cancer predisposition programs were very limited, and there were many concerns, both ethical and practical, about testing children for hereditary cancer risk. Many providers questioned whether the information would be helpful or simply create anxiety for families. But I felt strongly that understanding a child’s genetic risk could answer some of the most important questions families and clinicians face, starting with why the child developed cancer in the first place.

Much of my early work focused on collecting evidence and addressing those concerns, demonstrating how genetic testing could be used responsibly and meaningfully in children. Over time, as we generated more data, the field began to shift, and pediatric cancer predisposition programs gradually expanded. Looking back now, it’s incredibly rewarding to see that this aspect of oncology has become a more routine part of care for children with cancer.

In terms of my research today, it spans two areas: a biology side and a clinical side. On the biology side, we’re focused on identifying germline genetic factors that contribute to childhood cancer. We know that we haven’t identified them all, so a major focus is on discovering new genes and variants that may underlie cancer risk. This information helps us think beyond the initial diagnosis. If we understand the genetic and molecular pathways driving a child’s cancer, we can use that information not only to guide treatment, including targeted therapies, but also to assess the risk of future cancers and implement early screening to detect new cancers at their earliest and most curable stages. On the clinical side, we’re working to help children and families understand their genetic test results better and what those results mean in terms of future cancer risks. That includes supporting families as they navigate care both at and beyond St. Jude, helping them find providers who understand these rare genetic conditions and ensuring they have the tools to advocate for themselves. Ultimately, the goal is not just to generate new knowledge but to ensure that this knowledge translates into meaningful support and better outcomes for patients and families with underlying cancer predisposition.

3. Was there anyone who inspired you or played a large role in your career?

I’ve been very fortunate to have worked closely with two mentors who truly helped to shape my path in a lasting way. The first was Brice Weinberg, MD, an adult hematologist I worked with as a medical student at Duke University. He studied how drugs that induce cell differentiation could be used to treat leukemia. My time working with him and others in his lab really sparked my interest in oncology research. Dr. Weinberg was incredibly supportive, gave me my own projects and fully trusted me to run with them. With his mentorship, I was able to publish two first-author papers and learn to present my work orally and in writing.

But most importantly, he made research enjoyable. He was kind, encouraging and genuinely invested in my growth. That experience laid the foundation for my career as a clinician-investigator studying cancer.  

The second mentor was Gary Koretzky, MD, PhD, who is currently vice provost for research at Cornell University. I worked with him early in my career as an Assistant Professor at the University of Pennsylvania Perelman School of Medicine and the Children’s Hospital of Philadelphia.

After years of doing basic genetics work as a hematology/oncology fellow, I had identified a gene important for regulating immune cell function, but I lacked the immunology background to study it further. Dr. Koretzky welcomed me into his lab at a time when I was expected to be independent but still had much to learn. He gave me the space, resources and support to gain my footing and develop my research direction.

What stood out most about Dr. Koretzky was not just his generosity but his enthusiasm for science. He instilled something in me that has stayed with me since then: Every discovery matters. Whether the outcome was big or small, he emphasized the importance of rigorous, meaningful research and celebrating progress along the way.

Those experiences and mentors have shaped how I approach my work today and how I try to mentor my own students and other trainees.

4. What type of impact do you hope to have at St. Jude?

At St. Jude, I hope to have an impact by making germline genetic testing available to every single patient who is accepted for care. Right now, we focus primarily on newly diagnosed cancer patients, but there is so much opportunity to expand into areas such as survivorship and pharmacogenomics. I’d love to build stronger partnerships across these and other groups, such as the Department of Hematology and the Pediatric Translational Neuroscience Initiative, so that genetic testing becomes a consistent part of care and more patients can benefit from it.

Beyond the walls of St. Jude, I would like to extend this work more broadly in collaboration with the Department of Pathology and the Department of Global Pediatric Medicine. The idea is to make genetic testing accessible to children all over the world.

On the research side, a big focus is continuing to identify new genes and improve how we screen for cancer risk. Ultimately, the goal is not just to understand predisposition, but to use that knowledge to guide treatment, and ideally, even prevent cancers from developing in children who are at higher risk. That’s the kind of impact I hope to have.

5. What advice would you give young physician-scientists seeking to excel in their careers?

There are three pieces of advice that I would give young physician-scientists:

1. Be open to opportunities, and sometimes you may even have to create them for yourself. Career paths aren’t always linear. Mine certainly wasn’t. It’s okay to change direction if something isn’t working, especially if it leads you to something that’s a better fit.
2. You need to work hard and be persistent. There will be ups and downs, so it’s important to keep a long-term perspective and stay focused on your goals. Enjoy the wins, but don’t get bogged down with the challenges. Use them as motivators to keep on going. Along the way, lean on mentors and colleagues who can help you identify where you can have the greatest impact and how to move your field forward.
3. Be sure to take time for yourself. It’s easy to get caught up in working hard, but burnout is real and can hold you back. Making time to rest and recharge isn’t a luxury; it’s essential to sustaining a meaningful and successful career.