It’s In My Blood – Nina Shah, Global Head of Multiple Myeloma Clinical Development and Strategy, Oncology at AstraZeneca

In the third edition of the ‘It’s In My Blood’ interview series, I had the pleasure of speaking with my new colleague, Nina Shah, Global Head of Multiple Myeloma Clinical Development and Strategy, Haematology R&D, Oncology R&D, AstraZeneca, to learn more about multiple myeloma (MM) clinical care, research, and the wealth of expertise she brings to our team.

?Nina, it’s great to have you as a part of our team and this series. Before we delve into strategy and science, who inspired your career path??

It's great to be featured. Three key people have inspired my career path. The first, from residency, is Dr. Gwen Nichols, an inspirational lymphoma expert and oncologist who is always equally focused on science and the patient.?Second is my fellowship mentor, Dr. Elizabeth J. Shpall, a world-renowned cellular therapy expert, who taught me to always visualize what you can do and how you can do it, not how it can’t be done. Finally, the person who has shaped my career most recently is my myeloma mentor, Dr. Tom Martin, who taught me that the key ingredients to success are thinking outside the box and maintaining healthy, respectful, and openhearted relationships.?

Wonderful to see how your mentors have helped shape your career. As you know, this is an exciting time for our team as we further develop and refine our focus on MM. In your opinion, what challenges are associated with the diagnosis and treatment of MM and how can we address them??

As far as diagnosis goes, one of the challenges is finding blood-based diagnostics and techniques.1 I want a future where minimally invasive blood-based tests replace bone marrow biopsies for these patients. Additionally, MM is incurable, but we know that people live with it for a long time as a chronic disease with chronic treatment.2 So, minimizing the number of treatments patients need to take is a clear unmet need.?

It’s clear that combinations are becoming increasingly important in cancer care and there’s a large investment in immuno- and cellular therapies in research. How could these therapies change treatment for people living with MM? ?

Immuno- and cellular therapies are exciting and could change how we treat MM. For example, CAR T-cell therapy is designed as a one-time treatment – patients receive one dose of a CAR T and then may be in remission for years.3 Also, immuno-therapies are teaching us that we don't necessarily need chronic steroids. Since steroids have traditionally been one of the backbones of myeloma regimens, patients with MM receive them for years and have to deal with the subsequent toxicities.2,4 I'd love to see a steroid-free regimen in the future – and I think it’s possible with the novel immunotherapies, which generally try to omit steroids from the treatment plan. ?

I agree. Focusing on sustainable, one-time treatments for this patient population is integral.?What opportunities for drug development and innovation do you see in this space??

One of the things we have to think about is how we make treatments more accessible and tolerable for patients. There are many ways that advances in digital and mobile health can be used to help deliver therapies. For example, home-centered therapy administration with remote MD visits will allow more patients to receive the care they need, such as second and third-line treatment — which many patients are not getting.5 Advances in drug development, such as different drug formulations and comprehensive systems to digitally track administration, symptoms and clinical data could potentially enable greater patient access and help get therapies to underrepresented communities.?

It's inspiring to see our innovations come to life with the potential to change patients' lives. Do you have advice for people entering oncology today? ?

I always tell people, particularly women, thinking about going into medicine that oncology is the perfect field. It combines science, innovation, clinical practice, and the personal aspects of being a physician, which can translate into an industry career – if that’s what they are interested in pursuing. Every person who goes into oncology has the opportunity to explore different focus areas and carve his or her own path. Keep an open mind and gravitate towards the things that make oncology enjoyable so you can find success from something you love doing, and that will always lead to success.?

That's great advice, Nina. Last question that I ask all my guests – what was the last thing you watched (or read)??

The last thing I watched was the nightly news with my family because I think that's one of the best ways to stay informed. The last thing I read, although I haven't quite finished yet, is The First 90 Days, a book on career transitions and what you should try to achieve within the first 90 days of your new job.?

Thanks for joining me today, and we all look forward to seeing your work here come to life.

?

References:

1. Cancer.Net. Multiple Myeloma: Diagnosis. Available at: https://www.cancer.net/cancer-types/multiple-myeloma/diagnosis. Accessed September 2022.

2. Cancer.Net. Multiple Myeloma: Types of Treatment. Available at: https://www.cancer.net/cancer-types/multiple-myeloma/types-treatment. Accessed September 2022.

3. Huang, R., Li, X., He, Y.?et al.?Recent advances in CAR-T cell engineering.?J Hematol Oncol.2020; 13;86.

4. Soekojo CY, Ooi M, de Mel S, Chng WJ. Immunotherapy in Multiple Myeloma. Cells. 2020; 3;9(3):601.

5. Cancer.Net. How People With Cancer Can Make the Most of Televisits. Available at: https://www.cancer.net/blog/2020-12/how-people-with-cancer-can-make-most-televisits. Accessed September 2022.?

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