OncoInfluencers: Dialogue with Tony Mok, hosted by Gevorg Tamamyan

Join us for an exciting new episode of “OncoInfluencers,” hosted by Dr. Gevorg Tamamyan. In this episode, we have the honor of featuring Tony Mok, who is a world-renowned medical oncologist from Hong Kong. Dr. Mok focuses on biomarkers and molecular-targeted therapy in lung cancer. He co-founded the Lung Cancer Research Group.

In his discussion, Dr. Mok talks about his interesting career in oncology, his present work activities, cancer research, the future of oncology, shares the key to success and gives some advice for young oncologists.

Tony S.K. Mok holds the esteemed position of Li Shu Fan Professor and Chairman of the Department of Clinical Oncology at the Chinese University of Hong Kong. Also, he is the Associate Editor in Thoracic Oncology for the Journal of Clinical Oncology.

Previously Dr. Mok was the President and Treasurer of the International Association for the Study of Lung Cancer (IASLC) and a Member of the Board of Directors for prestigious organizations such as ASCO, AstraZeneca, Aurora Tele-Oncology, Sanomics, Hutchison Chi-Med, and St. Stephen’s College and Preparatory School.

His active involvement in international education initiatives and substantial contributions to renowned organizations like AACR, ASCO, CSCO, and ESMO underscore his commitment to advancing oncology on a global scale.

Prof. Mok has contributed to over 250 articles in international peer-reviewed journals. Mainly his research is centered around biomarkers and molecular targeted therapy in lung cancer.

He was the Principal investigator of the IPASS study, which marked a milestone in precision medicine application for advanced lung cancer.

His dedication to precision medicine extends to clinical research on oncogene-driven lung cancer and immunotherapy.

The host, Dr. Gevorg Tamamyan is the Editor-in-chief of OncoDaily, Head of the Pediatric Cancer and Blood Disorders Center of Armenia, Chairman and Professor of the Department of Hematology and Pediatric Oncology at Yerevan State Medical University, CEO of the Immune Oncology Research Institute, President-Elect of the Pediatric Oncology East and Mediterranean (POEM) Group, Chairman of the Board of the Institute of Cancer and Crisis.

Recently Dr. Tamamyan has been selected as the President-Elect for SIOP Asia 2024.

OncoInfluencers: Dialogue with Tony Mok, hosted by Gevorg Tamamyan

0:15 Introduction
0:36 Why did Dr. Pasi A. Jänne suggest him for an interview?
2:21 Why does Dr. Mok have an unusual bio?
5:46 How would Dr. Mok describe himself in one sentence?
8:23 What is the thing that makes Dr. Mok most proud?
10:18 Not academically-wise
12:13 Most important award
14:09 Dr. Mok is also on the board of a preparatory school
15:14 How can we improve cancer research infrastructure?
19:49 How does Dr. Mok see the future of oncology?
21:45 The key to success
24:05 Advice for young oncologists
25:58 Who should we interview next?

The transcript of OncoInfluencers: Dialogue with Tony Mok, hosted by Gevorg Tamamyan

Gevorg Tamamyan: Hi everyone, and welcome back to OncoDaily. Today, with our Oncoinfluencers, is Professor Tony Mok, a world-known medical oncologist from Hong Kong.

Thank you very much for having the time for today’s interview. And it’s a great honor and pleasure for us.

Tony Mok: Thank you for the invitation. Thank you.

Gevorg Tamamyan: Thank you. So recently I was interviewing Pasi Jänne, and he suggested that the next one I should interview you. Why? What do you think?

Tony Mok: Well, because it’s actually my Western brother who worked in Boston, so basically we have been collaborating for over 20 years. I can tell you one little story that how we met.

We were actually together at a quote unquote young investigator for a lung cancer training course organized by AstraZeneca more than 20 years ago.

It’s a three annual event, in different parts of the world. And so we have been kind of, say, collaborating since we were quote unquote young investigators till now.

So, yes, it has been a long and deep relationship And we both focused on EGFR mutation and now on other, targeted therapy as well. And, together we have done a lot of good work.

Gevorg Tamamyan: Yeah. And when I emailed you, you said he’s also your collaborator on food and wine.

Tony Mok: Oh, that is a more important collaboration. So, you know, we go to meetings and then we have this formal dinner here, formal dinner there.

But every time, you know, at a conference, we find one evening, together with a few other good friends, sometimes lunch part, with Solange Peters, sometimes others that we just get together, talk about everything else except oncology. 

Which is a good friend enjoying fine and companionship together and then doing some gossip. So just like any normal human being would have wine and dine together, that is what we like to do and look forward to in ASCO and ESMO.

Gevorg Tamamyan: Wonderful. Then your bio starts, when I read your bio, it starts a bit different than usual bios. It starts. “Doctor Mook was trained at the University of Alberta and completed later on fellowship in medical oncology.” So you basically start from like from this part. But usually the usual Bios are different. Why?

Tony Mok: Right. It is an interesting story, I don’t mind to share. So I finished my medical training, in Princess Margaret, which is a high academic center, in Toronto. At that time I considered doing academic medicine.

However, my son was born and it was very poor to do a Canadian fellowship in the laboratory. And then I don’t want to do too much lowc.

So I decided, okay, what I have let me just do, community oncology. So which I did, I end up in Scarborough, which is a suburban area, a lot of Chinese living there. I was the only Chinese speaking oncology in that area, so I become really quite busy very soon, as a community oncology. And I thought that I would spend the rest of my life as a commercial oncology at that time. But coincidentally, in 1994 95, I was in ASCO.

I met someone from Hong Kong when he was presenting a poster. I see a Chinese name, I see a poster on XCC. I just go up and speak in Cantonese. And so we just kind of, you know, get to know each other and then, you know, the exchange called, the phone number. And so 1995 Christmas, I returned home to visit my family in Hong Kong.

I take the opportunity to visit him at the Chinese University. And on behold, his boss, Philip Johnson at that time offered me a job two days later. So at that moment, I have no academic credential serial publication. I was a commercial oncologist. Just because I can speak Chinese and I’m a fully certified oncologist. They wanted me to join them. So that’s how I started my career.

But you may also want to ask, why did I make the decision to give up my big practice in Toronto and go back to Hong Kong? And actually, it took me two weeks to think about it. Of course, there are a lot of factors to consider, but to boil it down, there are two points.

One is that if I stay in Toronto as a community oncologist, that is quite a bit of certainty. I know that I would do well. I know that I continue to have a lot of patients and etc. but then it is quite certain what as compared when I come back to Hong Kong, is uncertain. I don’t know what will happen to me and my life. So between certainty and uncertainty, I chose uncertainty at that time. So that’s one point.

And second, that was 1996. And as it turned out, that 1997 Hong Kong will return to China. So I thought that would be an excellent opportunity for me to work with China. And so I did that. I came back to Hong Kong in 1996 and then 1997 Hong Kong became part of China. In 1998, I started working with China.

And so my career, a lot of my work is built in collaboration with China. So those are the two main reasons that drove my decision of coming back to Hong Kong, the uncertainty and then working with China.

Gevorg Tamamyan: Wonderful. if you describe Tony Mok with one sentence, how would you describe, like if you write your bio, but there is a limit one sentence.

Tony Mok: Well, no, no, this is like writing my obituary. What would I say in my obituary?

Gevorg Tamamyan: No no no.

Tony Mok: Right? So when I, when I’m that I want people to remember that this is an oncologist with a funny hairdo or with spiky hair and with a love of food and wine, but actually make a slight difference in the management of lung cancer during his lifetime.

Gevorg Tamamyan: Wonderful. why you decided to become an oncologist?

Tony Mok: Oh, another good story. I actually got a lot of this story. Like that. So, that was back in 1986. Yeah.

So I finished my medical school in 84, and then I did three years of general medicine. So at that time I kind of say, like gastroenterology the reason is that there’s a lot of new Gidget at that time, you know, in a way of the endoscope and those new, new new things that you can play with, with the GI.

And then I also like oncology in a way, is the fact that there is actually, facing life and death. And at that time, there’s really nothing too much you know that you can do with oncology. So my vision is that the thing that you got nothing to do with? There must be something you can do in the future. So those are the two areas that can attract me.

So I was in Alberta, which is a middle of nowhere. It’s very cold. And then I decided to go to the top center in Canada to get the extra training. So the best GI training at that time is Queen’s University, which is in Kingston, Ontario. And the oncology is the Princess Margaret in Toronto.

So I flew over a red eye flight. I got interviewed in both places in Queen’s University and also in, Princess Margaret and I got accepted both to GI and oncology. So how do I choose? It’s actually very easy.

There is a Chinatown in Toronto, but there’s no Chinatown in Queens, so you know that is as quickly as that I can’t, I need my Chinese food. So I got to have a Chinatown close by. So that’s how I ended up with oncology.

Gevorg Tamamyan: Yeah. what’s the thing you are most proud of are?

Tony Mok: So academic wise? You mean? Or anything?

Gevorg Tamamyan: I mean, you can answer both.

Tony Mok: Okay. So academic wise is that, you know, I’m fortunate enough to be able to contribute to the development of modern psychotherapy from the early on, in a way, that I was in the right place at the right time. You know, back to Hong Kong in 1997, 96 and I started to build up the so-called the study group, in Asia.

And then the EGFR story broke out in 2004, and EGFR turned out to be more common among the Asian population. So all the sudden, the focus will be the development of the EGFR targeted treatment and Asia become the hot place to do that.

And I was just right in the right seat to be able to coordinate and help to the development. So the whole movement of the target therapy, I can be part of it. So this is one thing I’m proud of because not because of the personal treatment, but rather the fact that I can see how this transformed the patient’s life.

You know, in a way, that you have to develop the drug, but at the same time, in the clinic, you see how the patient benefit the drug. Previously, lung cancer patient died very quickly. But now I do have patients who bring back the Christmas chocolate year after year, after years.

So one of my longest survivor is now in the 15 years since the start. That is one of my first research patient. So this is how amazing it is, is that you will be able how often that you can do something and able to help the mankind a little bit. So this is one thing that I’m quite proud of. 

Gevorg Tamamyan: Wonderful and not academic wise.

Tony Mok: Not academic way is that, in a way is that I’m not excellent in anything, but I can be good in a lot of things. So in a way of the diversity of things that I do. So, yes, lung cancer research, but I can also be a doctor. I very much, you know, do a lot of our drug development.

So I sit on the board of directors of AstraZeneca and a couple of other companies, so in the commercial sense, I have actually some experience. I also had a start up company that which I developed in 2015. And then I, developed and then so just recently. I also write columns for newspapers. I also have a TV show.

So it’s just my life is very diverse and rich that I got a bit of everything not good at, not excellent at everything, but kind of a bit of good in everything.

Gevorg Tamamyan: What’s your TV show about?

Tony Mok: What’s that again?

Gevorg Tamamyan: What’s your TV show about?

Tony Mok: Oh, the TV show started off as a health show because I was a doctor. So they want me to talk about general health problems. So we did it for two seasons that I, we got a bit bored the third season.

I say, why don’t we do food and health? But it turned out to become totally a food show rather than a health show. So people see me as a host for a food show in Hong Kong. So it’s a tough job. I have to go around different restaurants with three beautiful lady, including Miss Hong Kong, and then eat and talk. You know, I mean, it’s a tough job.

Gevorg Tamamyan: Oh very tough. Everyone is going to be jealous once we publish this interview.

You have a lot of awards and. But which one is the most important for you?

Tony Mok: So each one got it’s meaning, but one that submade the meeting. Two that submade the meeting.

Well, one is the ESMO life Achievement award. I’m most honored. you know, in a sense, is that being recognized by a major international organization of my overall achievement in that? So that is a so called a what I call the submission price. In a way, it’s a life achievement award.

The other one is actually the red one. You see on the on my background, that is actually the, China National Science and Technology Prize. So it is actually a, China government, and presented a prize. You go to the major city hall in Beijing and presented by the leadership of China.

And remember, my objective is to come back to work for with China and then being able to have this award together with Helen Wu is a co-shared between me and Wu just kind of stay the fact that my vision of coming back to China is a realized. So those are the two, to me, the, you know, most impactful.

Yeah. And also one other small one, that is actually, you know, also in the background, that is one of the best TV show award. Let me see. Yes. This one, this one is a, one of the best TV show award. So I think it’s unusual for oncologists to get a TV show award.

Gevorg Tamamyan: Yeah, that’s nice. I think that once we’re interviewing Robert Peter Gale and he got Emmy.

Tony Mok: No. Wow. Yeah, that I can’t do.

Gevorg Tamamyan: Who knows? Maybe 

Tony Mok: It’s a very local TV show.

Gevorg Tamamyan: So you are also on the board of preparatory school. So I mean, on the community where you are very active. Right.

Tony Mok: Yeah. So, that is actually my alma mater. And so it is actually a very nice boarding school, in Stanley, Hong Kong. It’s a very British style. I went there as a form four to form one to form four student meaning from my age, 12 to age 16. So basically I developed myself in the four years of boarding school there. More than anything else in my life, you learn how to communicate with people. You learn how to live with people you know how to discipline.

And then I start to find my vision and then to find my goal of life in those four years in the boarding school. So I really love the school. So when I got an opportunity, they invited me to be one of the board of directors. I immediately say, yes.

Yes, it does take some time, but hey, serving your alma mater. I think this is actually, you know, something very important to do.

Gevorg Tamamyan: You work on developing the clinical research infrastructure in China and in Asia. And, I mean, you said it’s a very challenging and very rewarding work. But what do you think?

I mean, in general, there is a very huge disparity globally in the clinical research infrastructures. And recently there was also an Asco policy paper about it. So I mean, what’s your vision, how we can improve more this, I mean, make it, better place for or like friendly place for clinical research worldwide. Because it’s a different story in Canada, in Hong Kong and in other places.

Tony Mok: Yes. It’s different between countries. But one common point is the fact that it has to be a close collaboration with a pharmaceutical company. The way I see research, clinical research is like this.

It is to address some scientific question that is the objective of a clinical scientist or investigator. But then there are two other parties. We have to take care. One is the patient. Patient wants the best care and the best drug possible.

And then there is the pharmaceutical company who needs to have a commercialization. Otherwise they cannot sponsor the trial. So when we develop clinical trials, we have to put all three parties’ interests in place and then have a balance.

So I can share with you the story about the Ipass study.

The Ipass study is the randomized study of futility versus chemotherapy in a selected population trying to prove EGFR as the biomarker. Now, at that time, juvederm was excluded from FDA. So they cannot get kicked out by the FDA, in short. So they can only develop the drug in Asia or Europe. The story is a bit complicated. But then in short, is that they had the so-called temporary registration, but then the ISO study, a third line study failed.

So therefore FDA terminated the registration. So when they come to Asia, we need to do study for registration in Japan and China. Obviously, those are the two biggest countries. And then at that time, China actually did not have too much infrastructure to do a clinical trial. So one of my jobs is to be able to help to develop those clinical trial structures.

It takes a lot of resources. But then the drug company had incentive of doing that, the investment to build this structure so that they can do the clinical trial properly and so that they can get registration in the country. So doing that turn out that in China, if I remember correctly, there are about 20 to 30 centers. Some start off with good center, because already those are the major centers. Like we don’t center, but there are some centers that are actually not very good.

But in the process, because of this trial, it’s important registration trial for AstraZeneca. We actually go to different centers, help them to do GCP, help them to find a nurse, help them to do the infrastructure and then make them into good condition. And so the trial was done. And it turned out the quality of the trial was very good.

But what happened after that? What happened is that this 20 some centers in China, after this study, they grouped together and became Sitong Chinese Thoracic Oncology Group. Now it has become 46 centers and become one of the major productions of the multinational, multicenter, randomized study from China. So their infrastructure originated from the building of a major multinational trial, but they carry on with the infrastructure and grow from it.

So I think it can happen to any country. It can happen to India. It can happen to, you know, Turkey, I mean, you know basically as long as there is an incentive doing it and there’s sufficient so-called support to develop the infrastructure, it can be done. But then there has to be sufficient incentive for people to invest in that.

Gevorg Tamamyan: Yeah. and how do you see the future of I mean, I think it’s a popular question, but the future of oncology when we see this AI and a lot of developments right now, what’s your vision about the future of oncology?

Tony Mok: Oh, I think we are in a very exciting time because we have two waves of success with the molecule targeted therapy. And then with the immunotherapy, both are actually very success in lung cancer. And then both for the patients’ care with the improvement of survival as well as financial success for the drug industry.

So riding on these two waves, there will be the third and fourth wave. So one of this is already happening is the ADC. Another new technology platform. Some success. may not be such a big wave as we like it for the time being, but then there is further modification of the ADC to make it better in the future.

So I think the ADC wave can ride on even further. And then there is another wave that’s coming. is similar to that is bispecific. so there’s already one bispecific successful and we want to map. But I think there will be a few more bispecific is going to come along the line.

And then there’s another whole separate category is the cell therapy and the cancer vaccine. And then all these you know will evolve AI involve new technology like the cancer vaccine. They have to use AI to interrogate the genome data to identify which is the new antigen.

So all these are kind of technology integrated and turned into a technological based, treatment platform. And I think this wave is going to make a difference to cancer care as well in the coming decade.

Gevorg Tamamyan: Thank you. So one more question. What’s your key for success?

Tony Mok: Oh, suppose first of all, I don’t know how to define success. You know, I never see myself as quote unquote success or not success. I like to Life. And then, if I can make a difference, that may already be a success. And that gives me joy and satisfaction to see, you know, give the patient talk or therapy, the tumor shrinks, the pleural effusion disappears.

That gives me happiness. And so, in a sense, is that you collect that piece of happiness and put it in your pocket.

One scenario that I always like to share with my younger colleague is that, I think I’m like, Super Mario Super Mario, start with a journey. And over the journey he jumps over a barrier, kicks off the dragon and collects coins. And to me, it’s just collecting coin contacting Moment of happiness. Enough coin. Eventually you got a score.

It’s a successful score, now it doesn’t matter as long as I collect enough coins of happiness. That will be the objective of my life.

Gevorg Tamamyan: Wonderful. what? What are your top, top books that you would recommend?

Tony Mok: Reason or whatever. Okay. reason one. Reason one, I read the book by Mokichi. Is that The Song of Cells. I really enjoyed it. Okay. It is because he was able. 

He’s an oncologist himself, but he’s a terrific writer and he was able to get the history of how the cell integrated into health with quite a bit of oncology involved. And then inside the book there are people that I know. So it’s a, you know, a very, very enjoyable to read, you know, the story that, you know, you kind of part of the development as well. The song of cells.

Gevorg Tamamyan: Wonderful what advice you would give to young oncologists.

Tony Mok: Okay. Well, my motto always is work hard, play hard. But that’s generic. Everybody should. But again, for the young oncologists, that’s just rather than talking about what advice I gave them. Let me just talk. What are the barriers that they may face?

Okay. Now, my era of development, you know, from a younger one to the older oncologist, is slightly different because we basically have little to start with. So any achievement can be perceived as something very big. But now the overall achievement is bigger. So they may have to make bigger achievements. So for them to carry on, I think that there’s a couple of so-called important attitudes

One is curiosity. So sometimes as oncologists, we’re quite settled on what we are being told as that this is a standard of treatment. But I think it’s important to keep up the curiosity to say, hey, every day so-called, clinical scenario, there’s a potential challenge and always ask the question why?

And being curious, why does this happen? Why won’t this happen? Why did this patient survived for so long? Why would this patient progress so quickly? Giving up that curiosity is important for you to find the next new thing, to have the breakthrough. So that would be one of the so-called advisors I would suggest to the younger generation.

Gevorg Tamamyan: Thank you so much. And, the last question, what I mean is who we should interview next. What would be your advice.

Tony Mok: Okay, so which part of the world?

Gevorg Tamamyan: Anywhere.

Tony Mok: Anywhere. Lung cancer wise, have you interviewed Solang Peter?

Gevorg Tamamyan: Pasi A. Jänne already suggested, so I sent an email. I haven’t got a response, but I’m sure she will. We will interview.

Tony Mok: So you have interviewed the brother and sister from Europe, United States and Asia. So you have this Trinity. You have to complete this triangle with that.

But then I think it may be interesting for you to interview Professor Yong Wu. He is my Chinese brother, and he is really the top lung cancer person in China. And he is very influential. I think you should interview him to see his, Well, we kind of grew together, so a lot of stories we share. But then he also got his inside story on the development of China.

Gevorg Tamamyan: Yeah, that would be wonderful. I will email him and ask for an interview. Thank you so much. It was wonderful, interviewing you. And it was very, very interesting for me and very motivational. And I’m sure people are going to like it. Thank you very much.

Tony Mok: Thank you so much for the opportunity. And, you know, I mean, it’s great to share my experience with you and your audience as well. Thank you.

Gevorg Tamamyan: Thank you very much.

Tony Mok: Thank you. Ciao. Bye bye.

Previous episodes of OncoInfluencers

Episode 1: OncoInfluencers: Dialogue with Françoise Meunier

Episode 2: OncoInfluencers: Dialogue with Dean Crowe

Episode 3: OncoInfluencers: Dialogue with Nagashree Seetharamu

Episode 4: OncoInfluencers: Dialogue with Julie Gralow

Episode 5: OncoInfluencers: Dialogue with Lillian L. Siu

Episode 6: OncoInfluencers: Dialogue with Douglas Flora

Episode 7: OncoInfluencers: Dialogue with Pasi Jänne