In this installment of the Living a Full Life series, guest editor Jame Abraham, MD, spoke with Aleix Prat, MD, PhD, Head of the Medical Oncology Department, Hospital Clinic of Barcelona. Dr. Prat, a breast cancer researcher, is currently working to identify strategies to tailor treatment for improved outcomes in patients with breast cancer.
On Professor José Baselga: “Dr. Baselga was an incredible mentor and always encouraged me to broaden my career, with activities like pursuing a master’s degree, which I received in molecular oncology....”
On travel: “Traveling is a very important way to get away from the stress of work. I like to visit foreign places and learn the culture, because it broadens me as a person and an oncologist.”
Advice to new medical students: “Consider oncology. It gives you the chance to treat and interact with patients who have cancer, which is the most intimate doctor-patient relationship in all of medicine.”
Dr. Prat was born in Barcelona in 1979. No members of his family were in the medical profession, and during his early school years, Dr. Prat had designs on becoming an architect.
“During high school, I was an exchange student with a host family in South Carolina, which turned out to be an uncomfortable experience in that it was my first time away from home. However, I had a terrific biology teacher who explained the inner workings of the human body, which grabbed my attention and turned my ambitions toward medicine,” said Dr. Prat.
After completing high school in the United States, Dr. Prat returned to Barcelona and applied for medical school at the University of Barcelona. “I was thrilled to be accepted into medical school, which was a 6-year program. Honestly, at that point, I was still very much fixated on the biology of the human body. But by my fifth year, I caught the oncology bug, as it satisfied my interest in biology as well as my desire to pursue a field in which I could make a difference in people’s lives,” he added.
Dr. Prat continued: “At that point, I was accepted to a 1-month summer clerkship program in the hematology oncology department at the Mayo Clinic in Rochester, Minnesota. It was a pivotal experience, during which I decided that I wanted to be a medical oncologist, a career where I could treat patients with cancer and also pursue research. I was looking to do a fellowship in the States, but one of my teachers, Dr. Rubin, suggested I contact Professor José Baselga, who was building a huge department at the Vall d’Hebron Hospital in Barcelona. I met with Dr. Baselga who said that if I did my medical oncology fellowship at Vall d’Hebron, he’d mentor me as a translational clinical scientist, after which I could go to the States for more experience. So, I did my 4-year medical oncology fellowship at Vall d’Hebron. Dr. Baselga was an incredible mentor and always encouraged me to broaden my career, with activities like pursuing a master’s degree, which I received in molecular oncology from CNIO [Spanish National Cancer Research Center] in Madrid.”
A Valuable Mentor at UNC
During his fellowship, it became obvious to Dr. Prat that the road forward in oncology was paved with genomics. So, after completing his fellowship, he spent several weeks in the States, where he visited laboratories at MIT, Berkeley, MD Anderson, and the University of North Carolina (UNC) at Chapel Hill, where he met Charles M. Perou, PhD. Dr. Perou was Co-Director of the UNC Lineberger Breast Cancer Research Program, Professor, Department of Genetics.
“All the other labs were amazing, but Chuck invited me to be a post-doc in his lab, and I stayed in Chapel Hill for 4 years. I’d never done research, so it was a real learning experience; it was formative in my career, as it brought a different perspective of oncology because I was actually seeing breast tumors and how to do genomics, microarray data, and bioinformatics. It opened a whole new world for me in the clinic and the research lab,” said Dr. Prat.
“It is vital for the patient population to understand the benefits of participating in our trial system.”— Aleix Prat, MD, PhD
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Given his experience at UNC, Dr. Prat considered staying in the States, but many exciting opportunities waited back home, so he returned to Barcelona in 2012. “It had been 4 years since I came back to Vall d’Hebron. At that point, José Baselga was already in the States, and Josep Tabernero was, and still is, Head of the Medical Oncology Department at Vall d’Hebron. He gave me an opportunity to work in the breast cancer clinic 1 day a week and spend the rest of the time building my lab and applying for grants. I started with only one technician (Patricia Galván), but with all my connections in the States, such as Chuck Perou, it made things a bit easier for me to grow my lab and research work,” said Dr. Prat.
In 2014, Dr. Prat left Vall d’Hebron and became Head of the Medical Oncology Department of Hospital Clínic Barcelona. “It was another step forward in my career, leading the medical oncology department, where I could see cancer from a deeper and more diverse level. I must thank Hospital Clinic for giving me this opportunity despite my age and lack of prior experience in running a department. I also moved my lab from Vall d’Hebron to IDIBAPS [August Pi i Sunyer Biomedical Research Institute], which is the research center attached to the University of Barcelona, where I’m full Professor. At the same time, I started getting involved with SOLTI [gruposolti.org], which is a nonprofit cooperative group that runs clinical trials, led by José Baselga 25 years ago. I had the chance to join the executive board at the beginning, and now, after several years, I’m the Chair, which is very rewarding,” said Dr. Prat.
A Day in the Life
Dr. Prat stressed that an early start and keeping an organized calendar is key to getting the most out of a super-busy schedule. “My day starts quite early, and I’m at the office, by 7:00 AM. To me, that first period of the day is very important because I’m very productive. I see patients now twice a week and run a department with more than 100 people, 37 medical oncologists, nurses, staff, clinical trials unit, and so on. And then, in the afternoon is when I try to spend time in research. I usually go to SOLTI once a week to go over the studies and other administrative issues. SOLTI now has 57 full-time employees, so as the chair, it keeps me busy. Then, as Professor at the university, I teach classes, which is something I love. My executive assistant, Eva Paradell, helps me keep my tight schedule organized, and without her, I would be lost,” said Dr. Prat.
Jame Abraham, MD, FACP
Jame Abraham, MD, FACP, is Acting Chair of the Taussig Cancer Institute and Chair of the Department of Hematology and Medical Oncology at Cleveland Clinic. He is also Professor of Medicine at Cleveland Clinic Lerner College of Medicine.
Dr. Abraham asked why Europe seems to have better clinical trial accrual rates than the United States, and Dr. Prat responded: “On the one hand, I think the culture of the patient is slightly different here—at least in Spain. I can tell you from experience that patients are really willing to participate in research. Plus, medical oncologists in Europe are more likely to suggest clinical trials for their patients with cancer, as I think the health-care system doesn’t put as many burdens on the process. Then, there’s the proximity of European countries, and that makes international collaboration easier. But that said, we also have our barriers to accrual, so it is vital for the patient population to understand the benefits of participating in our trial system.”
Sports, Children, and Travel
“I used to play soccer in high school,” shared Dr. Prat, “but I tore my ACL. So, I’m strictly a fan now and watch soccer from the safety of the stands or in front of the television. Because our kids are small, the priority is to be with them during my limited free time. However, I play tennis quite often, at least once a week; it really clears my mind. And, prior to the COVID-19 pandemic, traveling, especially, and visiting other countries was also a very important way to get away from the stress of work. I like to visit foreign places and learn the culture, because it broadens me as a person and an oncologist.”
Recruitment Message: Consider Oncology
“Although it is highly challenging, oncology is an amazing specialty that offers an opportunity to engage in cutting-edge research, which translates to better outcomes at the bedside,” Dr. Prat said. “I always encourage our new medical students to consider oncology, as it has so many different fields rolled into one. But, most important, it gives you the chance to treat and interact with patients who have cancer, which is the most intimate doctor-patient relationship in all of medicine. Moreover, oncology is accelerating at an incredible pace, given our growing knowledge of genomics and tumor biology. And, given the rising incidence of cancer, we need new oncologists more than ever.”
DISCLOSURE: Dr. Prat has received fees from NanoString Technologies, Roche, Novartis, AstraZeneca, Foundation Medicine, Oncolytics Biotech, Guardant Health, and Daiichi Sankyo. He is also the founder of Reveal Genomics.