5 Questions for Swati Naik, MBBS

This question-and-answer series explores the motivations, inspirations and accomplishments of investigators at St. Jude. Swati Naik, MBBS, is a physician-scientist in the Department of Bone Marrow Transplant and Cellular Therapy.

1. What drew you to pediatric hematology/oncology clinical research?

I grew up in a family of physicians, so it was an obvious choice for me to go into medicine. I knew early on that I wanted to work with children, but I didn’t know what I wanted my specialty to be. Then, in my first year of medical school, one of my classmates was looking at her own bloodwork, which led to her self-diagnosis of leukemia. She had a very rare type of leukemia called chronic myeloid leukemia (CML), for which it was recommended she be treated with bone marrow transplantation. Unfortunately, she did not have a familial donor match, so her only option was to enroll in a clinical trial in the United Kingdom (UK) that was studying a drug called a tyrosine kinase inhibitor. Thankfully, that approach worked very well, and she was one of the first few patients in the world to be treated with a drug that revolutionized outcomes for this disease. To be a first-hand witness to the impact of that work made me want to contribute to the advancement of medicine in a similar way. I realized oncology was a young field with discoveries waiting to happen, and I loved the idea of using precise, targeted approaches instead of broad chemotherapies.

I’ve always been drawn to complex medicine. As I was going through my rotations in medical school, I fell in love with the transplant unit because it combined all the complexities of medicine with immunology — another great love of mine. My training at Baylor College of Medicine — where they were conducting some of the earliest immunotherapy trials — introduced me to the practice of targeted therapies which harness the immune system. Therapies that use the patient’s immune system, like chimeric antigen receptor (CAR) T–cell therapies, made me excited to work in this space where there was much to learn and so much promise for patients.

2. What motivates you in your current areas of research?

My main area of research focuses on acute myeloid leukemia (AML) and discovering how we can best tailor CAR T–cell therapies to the specifics of this pediatric blood cancer. AML has limited treatment options, so it is exciting to translate a treatment approach from the lab to the clinic. It feels like chartering unknown territory. That’s especially the case for CAR T–cell products being used in the context of AML, because they’re new and we are constantly learning. Even shifting the needle a little is a huge achievement.

I also study graft engineering for haploidentical transplants combined with immune effectors given after transplant, which is a more targeted approach to transplantation that is very exciting to me. I am committed to expanding current boundaries with new, promising treatments, and working with pediatric patients and their families only highlights the urgency for more effective and safe treatments.

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

There are two people that come to mind. The first is Malcom Brenner, MD, PhD, because he really pioneered the field of CAR T-cell therapy at a time when no one thought this type of medicine was possible. His vision and conviction that this was a medical possibility was inspiring to me — he was able to see the future of this potential therapeutic approach when it did not yet exist. Beyond pioneering the field, he also trained a whole generation of cell therapists. It’s been incredible to see how that conviction and mentorship has changed the field over the past 20 years.

The second is Stephen Gottschalk, MD, the Bone Marrow Transplantation & Cell Therapy chair here at St. Jude. I joined his lab at Baylor when I was finishing my fellowship because I wanted to understand how CAR T–cell therapy worked. He gave me that first opportunity, and he is the reason I am at St. Jude now. He has been a selfless and dedicated mentor over the past 14 years and continues to mentor me to this day.

But above all, it’s the patients. I had the opportunity to stay in the lab, and while I love the research, I equally love the patients. The ability to be a physician scientist, where I do both research and clinical care, is of utmost importance to me. The patients are the reason to keep going.

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

I would like to work toward a cure for patients with high-risk hematological malignancies. If we can cure AML with CAR T–cell therapy, that would be amazing. But on the way to a cure, enabling patients to safely reach remission without high doses of chemotherapy would be a major achievement. In terms of my transplantation research, my goal is to maximize the cure rates with the rational combination of immune effectors to allow for a targeted approach, avoiding radiation and chemotherapies to make transplantation safer and more tolerable to patients.

5. Is there any advice you would offer to clinician scientists who are embarking on their own journeys?

Embarking on this type of work requires resilience and staying in touch with the part of you that remembers why you are doing this. When you remember that why, the path opens automatically, and staying on the path becomes easier. Try to view setbacks as challenges rather than failures and find the lesson in the challenge. More importantly, remain curious, never stop learning and recognize there is always more to do. As Steve Jobs said, “Stay hungry, stay foolish.”