Dr. Sara Hurvitz: Searching for Better Breast Cancer Therapies

When Sara Hurvitz entered medical school, she wasn’t sure what field she wanted to pursue let alone whether or not medicine was her true calling.

But she knew she was in the right place when she heard a lecture the first week of medical school by a professor who treated patients with lymphoma. In this lecture, the oncologist described what it means to be a physician—what an honor it is to be invited into the lives of the sick—to get to intimately know them, to have their trust even before that trust has been earned, and to have an opportunity in some way to heal them, not only through cures and treatments, but through deep connections, compassion and empathy.

Hurvitz knew she had found her calling.
Her pursuit of medicine began in 1990 when she enrolled at the University of California, Irvine, and went on to earn dual degrees in biology and psychology.

She believes that this core education helped shape her personal practice style of blending science and humanity.

“The foundation of the Hippocratic Oath is ‘First, do no harm.’ To do this, one must understand the patient sitting across from them, must know not only their medical history and physical needs, but understand, acknowledge and respect their emotional needs,” Hurvitz said. “I enter the room of each patient with a rough evaluation or treatment plan based on my education, experience and what I know about the patient’s illness. But once I talk with my patient, really listen to them, my plans are molded by their input, goals and priorities. It’s a real collaboration or partnership.”

In 1995, Hurvitz was accepted into medical school at the University of Southern California. In her second year she was highly influenced by the hematology-oncology curriculum. Her lecturers explained that the field of oncology was experiencing the birth of a new era. There was an incredible revolution in the understanding of the molecular underpinnings of cancer that was leading to near-miraculous discoveries in how to treat cancer.

She learned about a recent observation that led to the discovery of the cause of a deadly form of leukemia. This observation led to the development of curative therapy using a form of vitamin A.

Around the same time, a discovery across town at UCLA had been made by Dr. Dennis Slamon, director of clinical/translational research at UCLA’s Jonsson Comprehensive Cancer Center. Slamon had discovered that up to a quarter of patients with breast cancer have a form of the disease that is driven by too many copies of a gene called HER2. He showed that too many copies of this gene leads to too much expression of the HER2 protein on cells. Slamon then showed that patients with tumors that have too much HER2 protein are more likely to die from their cancer.

This knowledge led to the development and approval of a groundbreaking treatment, Herceptin, an antibody that specifically recognizes and binds to HER2.

“I was absolutely fascinated by these sorts of discoveries and knew that oncology was the field I wanted to pursue,” Hurvitz said.

In 2002, Hurvitz completed her internal medicine internship and residency at UCLA and was then selected to be chief resident of internal medicine for a year. Because of the cutting edge research ongoing at UCLA, as well as the world-renowned scientists working at UCLA, she decided to stay on for her hematology/oncology fellowship.

During her fellowship, her research focused on lymphoma and cancer immunology.

“I acquired important basic laboratory skills and was able to complete a rather large project that evaluated how an antibody, rituximab, works against lymphoma,” she said.

Although she envisioned specializing in lymphoma, Slamon offered her a position within UCLA’s Breast Oncology Program. Hurvitz was initially reluctant to take this offer, since her clinical expertise had been in lymphoma.

“He told me, ‘It should be easy to learn breast cancer. After all, there are 35 types of lymphoma, there are only five or so types of breast cancer. So if you learned lymphoma in a year, it should only take you a few weeks to learn breast cancer,” Hurvitz recalled.

She laughs at this now.

“He wasn’t completely honest about the simplicity of understanding or treating breast cancer, but I fell for it,” Hurvitz said. “And today I’m thankful for my naivety because I’ve been involved in some of the most groundbreaking, exciting research the past five years.”

Hurvitz joined the UCLA faculty in 2006 and is now the director of the Breast Oncology Program and co-director of the Santa Monica-UCLA Outpatient Oncology Practice, where she cares for patients with breast cancer two to three days a week in the clinic.

She also serves as the medical director of the Clinical Research Unit for UCLA’s Jonsson Comprehensive Cancer Center. The studies she designs and oversees are testing molecularly targeted therapies that hone in on what’s broken in the cancer cell, sparing the healthy tissue. Many of these new targeted therapies are evaluated in the laboratory at UCLA and are then translated into clinical trials like those Hurvitz is now running.

“I spend a lot of after-hours time working on clinical translational studies,” she said. “For me, it’s important to be involved, so I have a hands-on approach with trials I am developing and running.”

Hurvitz also remains active in the laboratory, evaluating the activity of novel therapies and studying breast cancer tissue from patients who have been treated for breast cancer to better understand routes of resistance to current therapies.

“The science of cancer is really intriguing right now. Our understanding of how cancer starts is rapidly evolving now,” she said. “These changes are affecting how successfully we can treat patients. However, there are still many areas of unmet need in breast oncology, such as triple negative breast cancer, brain metastases from breast cancer and treatment-resistant forms of breast cancer.

“There are also many unanswered questions relating to the optimal treatment approach for breast cancer. Science has advanced tremendously in this field, but there is much work to be done.”

By Shaun Mason, 2013