Maura L. Gillison, MD, PhD
When The ASCO Post asked physician-scientist Maura L. Gillison, MD, PhD, where she was from, she answered, “North America.” Actually, she was born in Canada, but her father worked for a large international company, so the family moved regularly through Canada, the United States, and Mexico.
“I grew up in a situation not unlike a military brat, only I was a corporate brat. Although it sounds tough on a kid, it actually wasn’t, because it made me comfortable with change. We moved so frequently that I never grew roots deep enough to make moving a bad experience. You learn pretty quickly that, yes, you’ll miss the friend you’ve just made where you’ve been for a year, but a new best friend is right around the corner at the next move. Kids are very welcoming,” said Dr. Gillison.
Medical Training Unfolds
Dr. Gillison, who would eventually become one of the leading experts on head and neck cancers caused by human papillomavirus (HPV), noted that she could not remember ever wanting to be anything but a doctor, stressing that a career in science and medicine had been her vision since childhood. After graduating high school, her decision for undergraduate work was influenced, somewhat, by the weather.
“When I finished high school, we were living in a 200-year-old farmhouse with no insulation, and I was tired of being chilled to the bone all the time. I asked my college admission counselor where I could get the best education possible and be warm at the same time, and she said, ‘That would be Duke University.’ So that’s where I went. I’d actually gone to a precollege program at Duke between my junior and senior years and loved it. It was my first choice, and that’s where I went. It was a wonderful experience—lots of smart people, but there wasn’t any elitism,” said Dr. Gillison.
Although becoming a doctor was never a question, I did struggle a bit with whether to center my career on research or patient care.— Maura L. Gillison, MD, PhD
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Asked about her interest in research, Dr. Gillison replied, “I began working in laboratories in high school. One of the great things about Duke is that the medical center is immediately adjacent to the campus. So, I worked in the Duke laboratories throughout college. Although becoming a doctor was never a question, I did struggle a bit with whether to center my career on research or patient care. I wanted my research to be directly applicable to the human condition, but when I was in the clinic, I felt that individual patient care didn’t have any broader impact beyond that one patient,” said Dr. Gillison.
She continued, “I spent most of my undergraduate career trying to figure out this conundrum. I went to England and was reading biochemistry at St. Peter’s College, Oxford, pondering whether I should go straight to a PhD, which would fit in with my research aspirations. But I was also reading philosophy with a medical ethicist, tackling different issues about medical decision-making, and that caused me to question my decision, because I wanted to have a direct connection with human health. So I returned to the United States and applied to medical school.”
Dr. Gillison noted that Johns Hopkins was her first choice of medical schools. “Hopkins has a very cool tradition. During the application process, you interviewed with other medical students, and after a couple of weeks, one of the medical students would call and let you know if you’d been accepted. I found that really impactful—that the students were helping to make these tough decisions and they were so actively involved in the process. I’d also applied to another well-known medical school, and when I asked if I could visit, the admission’s office said that I was welcome to visit, but they left it at that.”
I had an epiphany, realizing that if I studied the relationships between viruses and cancers, all my research could be conducted directly on human subjects.— Maura L. Gillison, MD, PhD
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She continued, “In contrast, Hopkins rolled out the red carpet, hosting me for 4 days. During my visit, a young man who’d been shot in the heart was admitted, and the ER attending told me to stand at the foot of the bed as he cracked his chest and did cardiac massage. I had 96 hours of being embraced by a group of people who loved what they did. I was hooked, and I got a medical education at Hopkins that could not have been topped by any other institution.”
Research Career Calls
Throughout her medical school training, Dr. Gillison said she was still struggling with how she could connect her love of research with a career that also had a direct impact on patients. After earning her MD degree from Johns Hopkins, Dr. Gillison did her internship there as well. Afterward, she was accepted for a residency program at Massachusetts General Hospital, where she had a career-changing experience.
“I was doing grand rounds and was assigned to the journal club. I picked a paper that had just come out in Science, which was by a couple, Chang and Moore, who had discovered the Kaposi sarcoma herpesvirus, which causes Kaposi’s sarcoma.1 During that journal club session, I had an epiphany, realizing that if I studied the relationships between viruses and cancers, all my research could be conducted directly on patients. And identifying the relationship between a virus and a cancer offered innumerable opportunities for disease intervention. That’s when I decided to go back to school for a PhD in epidemiology or clinical investigation, so all of my research could have immediate applications to prevention and public health.”
Dr. Gillison completed her medicine residency and entered The Johns Hopkins School of Hygiene and Public Health to work toward her doctorate. “I was offered a spot in their public health program, where the school would pay for my PhD training. The experience I had at the school of public health was just as rewarding as medical school. It was fantastic to be surrounded by such bright people dedicated to worldwide public health.”
She continued, “Hopkins had a strong program that was beginning to tease out the relationship between HPV and cervical cancer. It was at the beginning of the doctoral program that I met my mentor, Keerti Shah, who was at the center of that work. We began research on a therapeutic vaccine project, and Keerti and I discussed observations he had made about HPV in head and neck cancer. He’d read a case report in which HPV was found in an oral cancer, and he wanted to investigate whether this was a one-off fluke or something more common. He was in the process of collecting head and neck tumor samples when I became involved, which ended up being the focus of my PhD thesis and a 2000 article in the Journal of the National Cancer Institute (JNCI) that showed a strong association between HPV and head and neck cancer.”2
Dr. Gillison said that leading up to the groundbreaking discovery, she immersed herself in the complete library of literature on HPV and cervical cancer. “I worked nonstop, but I was having fun doing research that literally fascinated me. Every time I did an experiment in the lab, it provided more compelling evidence that the presence of HPV in these head and neck tumors was real. Where others had done cursory work in this area, we took the time to do multiple examinations. I stayed up late every night doing a huge number of chart extractions to categorize patient age, gender, smoking history, and so forth. When we compared the characteristics of patients with and without HPV, we discovered a clinically defined subset. When we looked at the impact on survival, it was startling. Although the 2000 JNCI paper changed my whole career, I was having so much fun that I didn’t realize its implications.”
Inspired by an Iconic Oncologist
Asked when she first realized the weight of her findings, Dr. Gillison responded, “One day at Hopkins, I was walking through an underground tunnel that connected the facilities, and I ran into the Johns Hopkins Kimmel Cancer Center Director, Martin Abeloff. He asked me what I was up to, and when I told him about my preliminary data, it stopped him in his tracks. Now I’m six-foot-two and Marty was about six-five, and he looked down at me—one of the few people who actually could—and said ‘Wow, tell me more.’ That was the first hint that led me to believe what I was doing was truly important. Marty was not only an incredible Director, but also a warm and concerned human being.”
Shortly after her encounter with Dr. Abeloff, Dr. Gillison began an 8-year endeavor to convince others in the field about the significance of the HPV connection with head and neck cancer. “What ended up persuading others in the field was an article I published in TheNew England Journal of Medicine in 2007,3 which was right before Marty stepped down as Director of the cancer center because he had leukemia. His last act as Director was to write me a note saying how proud of me he was, along with a small amount of grant money. It was a beautiful thing, sort of coming full circle, since years before, he was the first person to help me recognize the value of my work,” said Dr. Gillison. She added, “It was especially meaningful that he took the time to reach out to me when his life had turned upside down.”
An Opportunity to Expand Her Work
In 2017, Dr. Gillison joined The University of Texas MD Anderson Cancer Center to continue her research into HPV-caused cancers. She also began investigating the genetics underlying how HPV causes human cells to become cancerous.
Asked to describe her current work, Dr. Gillison replied, “I wear several hats here at MD Anderson. I run the head and neck medical oncology group, which is composed of a large number of junior faculty who I have the great opportunity to mentor—something that is very important to me, considering how much mentors helped my career. I’m also one of the leaders of the HPV
Although the 2000 JNCI paper changed my whole career, I was having so much fun that I didn’t realize its implications.— Maura L. Gillison, MD, PhD
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Moonshot effort, trying to coordinate HPV research across all HPV-associated cancers. Moreover, MD Anderson is so large that we see many rare HPV-associated cancers, such as anal and penile cancers. It provides an opportunity to identify common targets for therapies across these cancers, which would mean these therapies could be effective for about 5% of all human cancers.”
Dr. Gillison also runs her own research program. She explained that the first 10 years of her career were focused on epidemiology, simply because convincing people in the field that a virus causes cancer was in the traditional sphere of epidemiology. “The second decade of my career centered on the clinical implications of the diagnosis, during which we worked on the prognostic and therapeutic implications,” she said.
“Now I’ve returned to the roots of my early career, when I was more of a molecular biologist,” she continued. “I actually did a 2-year molecular biology post doctorate between medical school and my residency. I’m now doing more of a deep dive into the pathogenesis of HPV-related cancers, in order to fully understand the secondary genetic events that are necessary for cancer to develop, which gives us insight into whether they’re targetable.”
Reinvention Staves Off Burnout
Asked about physician burnout, Dr. Gillison said, “A lot of people focus their expertise on one area of work. I think what’s kept me from burnout is that I’ve changed lanes a lot in my career and have reinvented myself accordingly. And most importantly, I love what I do, so I don’t really feel stressed out at all. There’s a difference between being challenged and being stressed. There are so many interesting areas of research into preventable virus-associated cancers. It’s an exciting time to be in the field.” ■
DISCLOSURE: Dr. Gillison has served in a consulting or advisory role for BioMimetix, Bristol-Myers Squibb, EMD Serono, Genocea Biosciences, Merck, and Roche and has received institutional research funding from Bristol-Myers Squibb and Genocea Biosciences.
REFERENCES
1. Chang Y, Cesarman E, Pessin MS, et al: Identification of herpesvirus-like DNA sequences in AIDS-associated Kaposi’s sarcoma. Science 266:1865-1869, 1994.
2. Gillison ML, Koch WM, Capone RB, et al: Evidence for a causal association between human papillomavirus and a subset of head and neck cancers. J Natl Cancer Inst 92:709-720, 2000.
3. D’Souza G, Kreimer AR, Viscidi R, et al: Case-control study of human papillomavirus and oropharyngeal cancer. N Engl J Med 356:1944-1956, 2007.
