David I. Smith, Ph.D.

The laboratory of David I. Smith, Ph.D., uses the most cutting-edge genomic technologies to better understand the molecular alterations that underlie cancer development.

Dr. Smith is also the chairman of the Technology Assessment Committee, which works for the Center for Individualized Medicine at Mayo Clinic. The goal of this committee is to evaluate new technologies that could have a significant impact on research and its clinical translation. Perhaps the most exciting technology has been the recent advancements in DNA sequencing, which now make it possible to completely sequence a person's entire genome for just a few thousand dollars.

Focus areas

There are two major projects ongoing in Dr. Smith's laboratory:

• Oropharyngeal cancer. The first project is the study of oropharyngeal cancer, which is one type of cancer of the head and neck. While most patients with this cancer have a history of smoking and drinking, the fastest growing group of patients developing this cancer does not have these risk factors. The most likely cause of cancer in these patients is the presence of human papillomavirus, the same virus that causes cervical cancer in women. Dr. Smith's laboratory has been using the powerful tool of next-generation DNA sequencing to analyze the precise alterations that occur in different oropharyngeal cancers. The laboratory is also studying the role of large genes that reside in chromosomal regions of profound instability in the development of oropharyngeal cancer. One goal of this work is to determine which molecular alterations are associated with a good versus poor prognosis for patients with this cancer.
• Long noncoding RNA. The second major project in the laboratory is the study of long noncoding RNA. It has recently been found that in addition to the 20,000 known genes that code for different proteins, there are at least 200,000 other RNA transcripts that do not code for protein, but which have important regulatory roles within cells. The laboratory is studying one of these transcripts because it appears to be stress-responsive, and its expression is inactivated in most breast cancers studied.

Significance to patient care

The newest sequencing technologies will soon offer an ability to better understand the precise alterations that occur in a specific cancer, and this will lead to tailored therapies more ideal for each patient. Currently, Dr. Smith's laboratory is focusing on head and neck cancer, and how sequencing will better inform clinicians as to which cancers are more aggressive versus less aggressive. The laboratory is also looking for molecular markers that would help to determine which drugs would be more effective on a specific cancer.