Talking Hope: Clinical trials are unlocking new possibilities in cancer treatment

“Our job is to create the new standard of care.”

Research is what powers cancer science forward and leads to new treatment options for patients. In this episode, we discuss the importance and impact of clinical trials with one of the top cancer experts in the nation, Edward S. Kim, M.D., M.B.A., Physician in Chief for City of Hope Orange County, Vice Physician-in-Chief for City of Hope National Medical Center, and System Director, Clinical Trials, City of Hope. Dr. Kim was recognized as a 2024 Giant of Cancer Care, one of only 15 oncologists from around the world inducted into that class. Additionally, Dr. Kim has been widely recognized for his advocacy for diversity, equity, and inclusion in cancer research. City of Hope offers more cancer-focused clinical trials than anywhere else in California, and many physicians at City of Hope have open clinical trials for cancer treatments they have designed.

 


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Darrin Godin: Well, hello and welcome to Talking Hope. I'm your host, Darrin Godin. Today I'm pleased to be speaking with one of the top cancer experts in the nation, Dr. Edward S. Kim, physician-in-chief for City of Hope Orange County and vice physician-in-chief for City of Hope National Medical Center, and the system director for clinical trials. Dr. Kim was recognized as a 2024 giant of cancer care, one of only 15 oncologists from around the world inducted into that class. Dr. Kim leads the team of renowned physician scientists at City of Hope Orange County. He is one of the country's foremost experts in molecular prognostication for lung, head and neck cancers, and he is the leader behind the Cherng Family Center for Integrative Oncology at City of Hope, a first of its kind national integrative oncology program that brings together eastern medicine and western medicine to offer evidence-based benefits to patients and their families. Additionally, Dr. Kim has been widely recognized for his advocacy for diversity, equity, and inclusion in cancer research. He has made it his mission to assist Orange County's diverse communities in improving cancer screening rates and accessing advanced cancer research and treatment.

Welcome, Dr. Kim. We're so glad to have you on the podcast today.

Dr. Edward S. Kim: Thanks, Darrin. That's a mouthful you just got there, so it's good.

Darrin Godin: You've got a lot of behind you and a lot of expertise and we're so excited to have you on the podcast today because of that. There's a lot for us to talk about, so let's start with clinical trials. Can you tell us about your work in this area and really why it is so important?

Dr. Edward S. Kim: Yeah. Clinical trials are really the backbone of everything we do in oncology. In order to have standard treatments, they must go through the scientific and research process, and that means clinical trials are really leading to our next standard of care. From a patient standpoint, this is so vitally important because it represents opportunity, something potentially better than what we can deliver today, and really getting a look into the future of what drug development and what types of drugs we have. And these drugs are not only more potent, but many times have less side effects or different side effects. So many pluses. We know that not every clinical trial makes it, but we know that we're at least giving the patient the standard and we're trying to add something beneficial.

My role here is to really position City of Hope as an enterprise to be able to deliver clinical trials across the nation. And that's not been done before. We've had centers that are local and have some network sites. You have groups across the country that are affiliate sites and have those types of associations. But City of Hope now with its very broad footprint in southern California, with 30 plus sites, now with sites and campuses in Chicago, Atlanta, and Phoenix, how can we really be a singular entity that moves the needle even faster for clinical trials, opportunities, enrollments, and really testing the cutting edge? That's what the work needs to be done and that's what I was tasked with about a year ago.

Darrin Godin: And Dr. Kim, you mentioned standard of care. Can you say a little bit more about what exactly is standard of care? And when you say that clinical trials go beyond standard of care, what does that actually mean for a patient who's participating on a clinical trial?

Dr. Edward S. Kim: The standard of care are usually listed in guidelines. They're the standard treatment as we would say it, the baseline treatment. So if somebody was diagnosed with a cancer, and depending on what stage and type, the standard of care could be surgery if it's an early stage. It could be radiation if it's an intermediate stage. And many times, unfortunately in the advanced stage of most cancers, we have to offer chemotherapy, or right now, if we use lung cancer as an example, it would be chemotherapy plus an immunotherapy. These are what appear on guidelines like NCCN and others, and that's what we would expect at the very minimum, as long as the patient could tolerate that therapy as the therapy they would receive.

What clinical trials do is continue to add or try to increase the benefit without increasing the toxicity. I still remember in the early 2000s before immunotherapy, the standard of care for frontline metastatic non-small cell lung cancer was two types of chemotherapy and that's it. And many clinical trials attempted to add a third chemotherapy or a third biologic, and we saw some mixed successes, but not really moving the needle much. It wasn't until we got into personalized therapy with targeted therapy. And instead of just focusing on the drugs, we focused on the person. And the person, each person has a unique type of cancer footprint. And what we found was that there were certain mutations that existed in these cancers that allowed us to tailor the treatment a lot more simply and a lot more specifically. And when you can do that, now you can actually use less treatment to get a magnitude effect. And so we were able to use pills, single pill a day that was more effective than any of our chemotherapy regimens. And instead of patients living months with a lot of side effects, they were living years with less side effects.

It's been a combination of science in all directions. I can tell you the first time somebody said, "Wow, you're going to take a pill instead of two drug chemotherapy." You don't feel like you're getting treated at the standard of care. But when we found it works so much more effectively. We can see that looking at both the person and the treatment is the best way to find the personalized therapy

Darrin Godin: And the level of research being done here at City of Hope is pretty unique. You've had experience across the country with different organizations. Talk to us about the amount of research being done here at City of Hope specific to cancer and why that makes City of Hope a standout for this region.

Dr. Edward S. Kim: City of Hope is one of the few standalone cancer institutions in the country, and that alone starts making it unique because that's what we eat, live, breathe, is cancer. We have everything from our basic scientists looking for new drugs, new mechanisms of action, new pathways to try and target in the human cancer realm. And then we have multiple clinical scientists who are testing new drugs and new therapies in the clinic, trying to see how patients are affected and whether these are better treatments.

We have over 800 clinical trials that we run. We run them now all across the country, and this just powers the science that we have forward to try and really make a difference, increase lives saved, try and cure more folks. We won't stop until we can cure these people. But being City of Hope, a top five cancer center, we expect this. We are working nonstop, both in the clinic and in the labs, to try and make a difference in research and move the field forward.

Darrin Godin: And you mentioned our 800 clinical trials. I think it's also appropriate to mention over a thousand researchers in addition to over 600 physicians, all focused on that singular task, finding those cures and how important that is. How does that compare to other organizations across the country?

Dr. Edward S. Kim: Darrin, I don't like to compare us to many places across the country. I like to always focus on the job that we have in hand in front of us. What makes us unique is that we have more people doing lung cancer here than maybe most oncology departments in many hospitals. And that's just the power of what happens when you can focus on a singular entity. We're not delivering babies. We're not fixing knees or hips. There are great places to go do that. We focus on cancer. And so our bench is deep, our scientific knowledge is deep, our curiosity is high, and we have a singular mission, is to improve the lives of patients. And so it is very powerful when you have this and City of 
Hope is very unique in that sense.

Darrin Godin: Well, thank you, Dr. Kim. Let's switch gears here a little. Let's talk about the recent Nixon National Cancer Conference, which was held at the Richard Nixon Presidential Library right here in Orange County, and you and other experts from City of Hope participated in that. What makes that conference special and why is it important for us to have conferences such as the Nixon National Cancer Conference?

Dr. Edward S. Kim: It's tough to be the president. I wouldn't know, but we can only look from afar and see that Richard Nixon was very progressive in many ways, and one of the things he did that really shaped the lives of many people across the world was to sign the National Cancer Act in 1971. This really galvanized the country toward a common enemy. That was cancer. It started federal funding. It started a real revolution toward trying to cure cancer. Yeah, we're 50 years in. It's still a battle, but we've made so many strides.

Each year now, the Nixon Library hosts the Nixon Conference Cancer Conference, and it's a wonderful event. It brings in experts from all across the country, and we have robust discussions around different topics. This year, I served as a moderator on a panel that discussed our trust in science and why there is deepening mistrust out there and misinformation. This is not unique to science. We're seeing it in other areas as well, but it particularly hits home with science and healthcare because people are constantly trying to find ways to get rid of disease, get rid of ailments, and sometimes you're desperate and will listen to whatever is out there in social media, from centers, from other countries. And it's a challenge right now. We know our history in science, especially some of the experiments that were run in the 1960s and '70s targeting certain minorities were not done what we would consider ethically right now.

So I feel there's been a long journey toward regaining the trust. I think the medical progress we've seen has been remarkable, but it only takes a few instances, especially when we saw during the pandemic, the amount of misinformation or maybe too early information that went out before we could validate science. And that's just confusing the public and not good from a healthcare standpoint.

Darrin Godin: Yeah, I was in attendance at the conference this year and one thing that really struck me is the different institutions that came together from around the country, as well as right here in the Orange County area, and you said it best, cancer is the common enemy. Cancer is our competition. We're all working together to do the same thing, which is to bring an end to this terrible disease. And I found it promising that so many bright minds were coming together to say, "This is what we want to focus on and this is how we want to make a difference in people's lives." So thank you for participating in that and thanks for that recap.

Dr. Edward S. Kim: Amen, brother.

Darrin Godin: I want to shift the gear a little bit more to you as well as just some personal reasons why you are a physician and why you chose to specialize in cancer. Can you tell us about what drew you to become a physician and make this your specialty, your life's work?

Dr. Edward S. Kim: Yeah. I share this every January now. It's only taken me about 20 plus years to be able to talk about it, but there were no physicians in my family. I know I'm a typical stereotypical Asian male, but my father was a finance professor. My mom was an artist. There was no model and no real push for me to become a doctor, even though that's counter to what many stereotypes are. I was actually thinking more engineering and design. That's what I love. I have a creative mind that way.

I have a brother who is two years younger than me, and unfortunately very tragically, he passed away at age 12. I was age 14. Nothing harder than watching your parents really grieve over a lost child. That's just not the natural order of how life is supposed to go, this circle of life. You're supposed to bury your parents and so on. So that was a very traumatic period of time. It certainly has shaped my entire life, that event. At that point, I pursued medicine because I wanted answers and I still want answers. I feel like we haven't found all the answers yet, but that's what science does. Science brings curiosity, brings determination, and that's why I never feel that there's a flame or a fire that's going to be extinguished because that's something very personal to me, and it's why I push very hard on certain objectives to try and change, as we've discussed before, Darrin, the standard of care, what people are used to doing well. That's just not good enough in many situations, especially in healthcare.

And so that's something that I keep very closely. I'm much more comfortable sharing it these days. Someone I would've loved to have seen grow up and see what they're doing today, but that's in the past. We have to remember our past, but use it to move forward. And that's why I married a psychiatrist. She keeps me sane and my meds on a good schedule, but yeah, everybody has a story and we're all in this for a reason. You yourself are here for a lot of those reasons. And whatever draws people to medicine, to healthcare, just take that inspiration and take it with you each day.

Darrin Godin: Well, thank you for sharing your story. We know that many of our colleagues are here for very personal reasons. And this work is not just to do the work. It's really to leave a legacy and make a change for our fellow humans.

Dr. Kim, what does the concept of hope mean to you?

Dr. Edward S. Kim: I think it's all context, and that's why something like cancer is so powerful or any type of deadly disease. When you feel like there's a desperate situation, when you're that person who's facing that crisis, the wildfires just happened here in Southern California, and we know so many people who are evacuated, displaced in their homes and lost their homes, hope is that feeling where, yes, if you can make it through today or make it through tomorrow, that things are going to get better. And you're not sure when they're going to get better, but you have that feeling, that inspiration that it'll get better.

And with City of Hope, it's in our name. It's in our name because of our long history of treating those people who had no place to go for starting with tuberculosis in the... We were a sanatorium in the early-1900s. We took in people who were left to die in the streets because of this deadly disease. And Sam Golter established a couple tents in a desert city, and people started their migration to this place in the desert thinking that there was hope there, and thus the name City of Hope evolved. Now we've become a center where people come because they need help with their cancer treatments or their diabetes treatments, and they know we're constantly pushing the envelope and trying to change the standard of care.

As I've directed many of the people I've hired and people I surround myself with, our job is not to practice the standard of care. Our job is to create the new standards of care. And that is something we have to continue to think about because minute we're comfortable with something, we're losing opportunities to improve it. So hope can mean a lot of things, but hope is very symbolic in our name. It's very symbolic in our mission, and I think it represents the population that we serve, is that they are hoping for a better tomorrow or a better future. And it's our job to try and lead them down a path that can at least improve their overall health.

Darrin Godin: And what gives you hope specifically for cancer right here in Orange County?

Dr. Edward S. Kim: I think Orange County is a remarkable place. It's a very large county with a lot of different populations. I'm excited that City of Hope, top five cancer center, decided to come and build a presence in Orange County. There are certainly other hospital systems that cater to a lot of the folks, but as we've seen, both you and I, Darrin, as we've been here for the last five years, there's too much business, too many patients here. We certainly can see them coming through the door. They need help. And I'm glad we can be part of the environment, part of the neighborhood to offer that help, that hope, that additional expertise so that we can give that option to patients, the people in Orange County, and City Hope is doing that based on our campus size, our volumes, the people who are contacting us. It feels very gratifying to be able to help these people.

Darrin Godin: Well, thank you Dr. Kim. As you know, many of our listeners might be patients or family members, even other physicians, others who are helping to take care of patients. So I want to just give you a moment. Any closing thoughts, anything else you'd like to say to our listeners today?

Dr. Edward S. Kim: Yeah, I think it's really important to reach out if you need help. You can be a colleague, a patient, a family member, a neighbor, a resident. Let us help you answer your questions. We know the journey toward making things cancer-free starts with prevention and screening, and it goes all the way up through not just treating the cancer, but of the patient. And so we know there can be side effects that are residual afterwards. This is why we started the Integrative Oncology Program, the Turing Family Center, because people need to be cared for on both ends.
And I always use this example, we like to treat them on one side, we like to treat them on the backside, and that really gives us a big hug around the patient. And so we really want to make sure that we can prevent the cancers. That's the best case scenario. But if we have cancer already diagnosed, then we need to cure it and then help people really survive the cancer mentally, spiritually, and physically. So that's the type of care we want to deliver. We will advise you. You can come see us. It doesn't matter. We're here to help for whatever you do.

Darrin Godin: Well, Dr. Kim, my friend, my colleague, thank you for joining us on the podcast today. We really appreciate you taking the time to talk to us, and we appreciate all the work that you're doing here in Orange County.

Dr. Edward S. Kim: Well, thanks, Darrin. Thanks for having me, and it's always my pleasure.

Darrin Godin: Well, as Dr. Kim said, when it comes to cancer, you have hope. City of Hope is top five ranked cancer care in the nation right here in Orange County. Breakthrough science on your side, Orange County's most advanced comprehensive cancer center, and Orange County's only specialty cancer hospital opening right here in 2025. 

If you need more information or if we can be of service to you or a loved one, please visit us at cityofhope.org/OC to learn more, or call us at (888) 333-HOPE. That's (888) 333-4673. 

Again, I'm Darrin Godin. Thank you for joining us on Talking Hope and we'll see you next time.