A Discussion About a Hematology Career in Industry With Drs. Benjamin Kim and Mark Chao

Q: Describe your interests during fellowship and how they led you to consider an industry position. How have your mentors guided your transition from academia into industry?

BK: I have always been interested in caring for individuals while also thinking about ways to improve the lives of populations. Concurrent with my hematology/oncology fellowship at University of California, Los Angeles (UCLA), I pursued graduate studies in health policy analysis at the Pardee RAND Graduate School through UCLA’s Specialty Training and Advanced Research (STAR) program. With the clinical skills gained in treating patients with nonmalignant hematologic disorders and research methodologies learned through analyzing large datasets, I began my academic career as an assistant professor at University of California, San Francisco (UCSF), with a focus on hemostasis/thrombosis comparative effectiveness research. I also had the good fortune of participating in ASH’s Clinical Research Training Institute, through which I met two great mentors, Drs. David Garcia and Mark Crowther, who helped me meaningfully as I began my clinical research career.

I was presented with the opportunity to work on a pivotal study at Genentech on a novel therapy (emicizumab) to treat hemophilia A patients who had inhibitors against factor VIII. What ultimately led me to “take the leap” was thinking about how, if safe and efficacious, the molecule could potentially benefit the lives of the two hemophilia A patients with inhibitors whom I cared for at UCSF, as well as many other patients with inhibitors across the world.

I entered Genentech as an associate medical director with two axioms I had recently been told: 1) clinical research in industry is team-based, and 2) the most precious commodity is time, not funding. In my first few months, I leaned on the guidance that my manager and a couple of extremely patient and generous colleagues shared with me. What helped me early on, however, was not being afraid to ask questions whenever an unfamiliar matter presented itself, and working hard to get up to speed and complete assigned tasks in a timely manner. I felt like an intern again, but I was learning a lot and figuring out how clinical research in industry is conducted, working in teams and in a fast-paced environment. It was exciting!

MC: I am a physician-scientist hematologist by training, having completed my MD, PhD, residency, and fellowship at Stanford University. My PhD focused on identifying novel therapeutics targeting cancer stem cells in hematologic malignancies. My postdoctoral work centered on developing novel disease models of acute myeloid leukemia and myeloproliferative neoplasms through the use of induced pluripotent stem cells. Prior to several years ago, I had never considered a transition into industry. Like many in academia, I had my 30-year plan, and at the time of my transition, I would have been looking for faculty positions in academia, running a lab and seeing patients.

My gradual interest in industry was fostered by a desire to conduct translational research that had maximal impact on patients. During my PhD I conducted seminal work identifying a therapeutic antibody targeting a protein called CD47, which had impressive pre-clinical activity across many tumors in pre-clinical models. This led to the clinical development of this antibody, including first-in-class trials conducted with our antibody Hu5F9-G4 at Stanford. About two years ago, a few of us, including my professors Drs. Irving Weissman and Ravi Majeti, and another postdoc in the lab Dr. Jens Volkmer, founded Forty Seven, Inc. to fully explore the clinical potential of Hu5F9-G4. Developing novel therapies based on cutting edge science that have the potential for transformational impact in patients was a dream come true. As I began to understand how drugs are developed and approved, I realized that drug development in industry drives this fundamental process. Thus, I made the decision to join the company full time. It was a difficult decision because my prior career in academia was an environment I loved. My mentors and the leadership at Stanford have been incredibly supportive of my transition, which I have very much appreciated. Ultimately, I know that the door is open to transition back to academia. I feel that the experiences I gain during industry in drug development will only enhance my perspective in patient care.

Forty Seven, Inc. is a small biotech, and I knew that I would have to rapidly learn on the job given the large amount of responsibility given to each individual. I was initially worried about whether there would be adequate mentorship in such a role, but our chief medical officer and my primary mentor in the company, Dr. Chris Takimoto, has been one of a kind. He spent many years in academia before transitioning to industry and has been vested in my development.

Q: Describe your career trajectory since entering industry, and the landscape of entry-level jobs that might be available to interested professionals.

BK: I started out as a medical monitor (on a clinical science team) at Genentech, where I led the writing of a phase III protocol, helped design the data capture forms and questionnaires, worked with the operations team and principal investigators to initiate sites, evaluated adverse events with the safety team, participated in discussions at health authority meetings, and contributed to writing application documents for health authority approval. These experiences prepared me for my current position as senior medical director at BioMarin for BMN 270 (gene transfer for hemophilia). Currently, I serve as a medical monitor, and I oversee a team of clinical scientists as well as various studies that comprise the clinical development plan.

There are numerous functions or teams in industry that one can join based on interests and experience, including, for example, clinical science (design and oversee translational or clinical trials for molecules that have not yet been approved), safety (evaluate and mitigate safety concerns/adverse events), or medical affairs (design and oversee post-approval trials). In general, if you have just graduated from fellowship or are a junior faculty member, you will start as an assistant or associate director (i.e., an individual contributor as opposed to a manager of team members). Promotions are based on achievements, time in the position, ability to be strategic, and available openings.

MC: My position at Forty Seven, Inc. is vice president of clinical development and co-founder of the company. Along with the chief medical officer, I oversee the company's clinical development program and management of our clinical trial programs. Our lead asset, Hu5F9-G4, a monoclonal antibody targeting CD47, is being tested in five clinical trials for a variety of solid tumor and hematologic malignancies. My primary responsibilities include trial oversight, interfacing with clinical investigators and key opinion leaders, and planning our clinical trial strategy and registrational approval paths. For MDs or MD/PhDs coming out of fellowship, or junior faculty; the typical transition to industry involves positions that are at the assistant/associate medical director level, often in large pharma. These positions often serve as the clinical leads for trials and function as the medical monitor, working with a matrixed team of functions to properly execute these trials.

Q: What did you acquire in academia that was useful for your new industry position, and what are the skills that you wish to develop further?

BK: Unlike academia, where finding and developing a niche is important to differentiate yourself and promote your career, industry values the ability to contribute to a variety of different activities and effectively lead teams of individuals (especially in smaller companies). In retrospect, I believe my variegated background helped me contribute to various projects and working group meetings I participated in daily. Leading ward teams as a resident was the closest experience I had to leading cross-functional teams, where one must guide and empower individuals with varying skills and backgrounds to achieve a common goal. A couple of skills that I am currently working on improving include thinking strategically while considering the views and needs of multiple different stakeholders, and communicating with leaders clearly and concisely.

MC: The skill that I have most valued is the ability to think critically about the science and how these insights translate into the clinic. The ability to follow the data is critical to success, in both academic and industry settings. Our company is currently involved in early-phase clinical development where it is necessary to combine pre-clinical/scientific insights with what we are seeing clinically to determine which indications and patients will most benefit from our therapy. This exchange and analysis of data occurs daily. In addition, the ability to interact with multiple stakeholders and people with distinct perspectives has been highly valuable. This has been developed through clinical training, where clinicians interact with diverse groups including patients, trainees, nurses, pharmacists, senior clinicians, and others. As a clinical lead in the company, this ability is invaluable.

Q: What are the most surprising aspects of your industry role?

BK: The idea of moving from being primarily responsible for your own success to that of your team — working strategically, effectively, and expeditiously toward your collective success — was a surprise. Instead of trying to convince others that they should spend their time working on your project, you have multiple people from different functions whose job it is to work on your shared project. For some, independence to determine which research projects you want to participate in as an academician is paramount, while others relish the direct clinical impact an interventional study conducted by industry can have, whether the results are positive or negative.

MC: The most surprising aspect has been the emphasis and necessity on team dynamics. While working on clinical programs, I interface constantly with people from multiple functions including clinical operations, regulatory affairs, research and development, biometrics, business development and others. This model encourages and emphasizes the notion that projects succeed not by the individual but through the combined efforts of the team. To me this is extremely rewarding, given that a group of people come together to achieve far more than the individual parts and are united under a common purpose. We have an incredible team at Forty Seven, Inc. and I have been privileged to work with such people on a daily basis.

Q: What aspects of the academic environment do you miss?

BK: I miss interacting with trainees the most. As a faculty member, you have an opportunity to teach, inspire, and help shape the careers of medical students, residents, and fellows at a time when they are figuring out what direction their career should take and are open to your guidance and support. It is especially rewarding to see trainees’ enthusiasm for learning; watch them complete, present, and publish the findings from their research projects; and eventually go on to pursue their own career goals.

MC: First, I miss interacting with patients. I still maintain a part-time clinic, but I miss directly taking care of them. I especially miss being on the inpatient wards and the intense interaction developed between physician and patient. However, the fact that I am working “behind the scenes” on therapies that could ultimately benefit patients inspires me daily. Second, I miss the frequent interactions and mentorship with trainees. While industry offers some of that opportunity, I find it harder to be able to provide formal mentorship, as ultimately the company’s success is determined by results, which requires bringing in people who can already do the job.

Q: What are some opportunities to expose trainees to industry jobs, and what advice would you give to trainees considering a career in industry?

BK: I believe trainees get very little exposure to conducting clinical research in industry. Fortunately, there are a variety of ways to learn more. Several companies have fellowship programs, including Genentech’s Clinical Research Fellowship Program (www.gene.com/careers/university-and-early-career/clinical-fellows), in which fellows can spend some or all of their time working on a research team and/or project at the company. I think participating in an immersive fellowship program gives fellows a unique, under-the-hood look into how clinical research is performed in industry. Participating as a sub-investigator on clinical trials with your mentor can be a helpful introduction, but you might not be able to see how companies make decisions. At minimum, you should speak with physicians who have previously made the transition to industry.

When trying to decide on a career in academia versus industry, first think of what gets you excited enough to put in the extra time and effort needed to complete a project. What factors do you value most in your career? What type of environment and manager/mentor do you want to work for? Answering these questions will help you figure out the direction of your internal compass and evaluate the career or position that fits you best.

MC: I think this is incredibly important, especially given the number of opportunities in industry. During my training, my exposure to industry opportunities was quite limited. I think that educational opportunities to explore industry paths could be made more evident during fellowship training. My ability to gather information on a potential transition to industry was informed by interactions with other people who had made the transition (i.e., other trainees) or in discussion with my mentors who had spun out biotech companies in the past. For people thinking about such a transition, it is important to talk to multiple people who have made the same transition. In addition, formal training programs such as internships at large pharma during fellowship (i.e. Genentech has such a program) can also be invaluable. Lastly, for those who are interested in learning more, I recommend connecting with biotech/pharma companies who are hiring. Interactions and interviews with such companies provide a helpful perspective on what daily life in industry can look like.