J. Joshua Smith, MD, PhD, FACS

I received my MD degree from the University of Texas Medical School at Houston and my PhD degree in Cell and Developmental Biology from Vanderbilt University Medical Center, where I also completed my residency.

In 2013, I joined Memorial Sloan Kettering Cancer Center (MSK) as a fellow in complex surgical oncology. I served as Chief Administrative Fellow for the Department of Surgery from 2014 to 2015. At MSK I have been a co-leader on the topic of watch-and-wait after clinical complete response to neoadjuvant therapy for rectal cancer patients on our Colorectal Disease Management Team. I am actively working to improve our understanding of this management strategy for rectal cancer patients on and off trial. Currently, I am a co-investigator on Dr. Paul Rommesser’s novel trial in rectal cancer patients. Additionally, I serve on the Rectal-Anal Task Force of the National Cancer Institute’s Gastrointestinal Steering Committee and serve on the Alliance for Clinical Trials GI Surgery Working Group.

While I focus on caring for people with rectal and colon cancer,I also research how to improve responses to standard treatments for these diseases. I spend significant time doing basic and translational research in the laboratory of Charles Sawyers. My focus there is to develop better models to study rectal cancer and to uncover targeted treatments for people with rectal and colon cancer who do not respond to standard treatments. This type of research requires that I investigate the basic mechanisms and predictive markers that we can assess in the tumors of our patients with colorectal cancer. In particular, I study Smad4 loss to identify people at risk for their cancer returning.

In the past four years, I have been heavily involved with Dr. Garcia-Aguilar in administration of his National Institutes of Health funded trial, Organ Preservation in Rectal Adenocarcinoma, for which I am an active site co-lead. We are looking into the molecular mechanisms of poor response to standard neoadjuvant chemoradiation in locally advanced rectal cancer. Furthermore, we have proposed a novel method of assessing response. We are examining this in a prospective manner to find a more precise and individualized approach to caring for people with rectal cancer.