Susan M. O’Brien, MD, Embraces the Challenge of Balancing Patient Care With Clinical Trial Investigation

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One of my current goals is to help find ways in which the collaborative efforts of academia and the pharmaceutical industry can expedite the drug development and approval process.
— Susan M. O’Brien, MD

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Susan M. O’Brien, MD, one of the nation’s foremost leukemia experts, told The ASCO Post that she wanted to become a doctor since her earliest memories. “The idea of being able to help sick people always appealed to me,” said Dr. O’Brien, who was born in Manhattan but spent her formative years in New Jersey.

After high school, Dr. O’Brien entered Mt. Holyoke College, in South Hadley, New Jersey, receiving a degree in biochemistry in 1976. She then entered the University of Medicine & Dentistry of New Jersey Medical School, in Newark, now Rutgers University. “It was predominantly an inner-city hospital, and as anyone who has trained in that environment will tell you, it is truly a hands-on learning experience. I’ve always had the bias that people who come out of that kind of training tend to become very good doctors, as they learn to think on their feet and problem solve in difficult situations,” shared Dr. O’Brien.

Motivated by Mother’s Lung Cancer

When Dr. O’Brien was in her first year of internship, her mother was diagnosed with lung cancer at the age of 50. “My mother had raised six kids and was just at the point in her life when she could start thinking about enjoying herself after so many years of caring for me and my five siblings. Her diagnosis actually came serendipitously,” she revealed.

Dr. O’Brien continued: “She was on an investigative regimen for rheumatoid arthritis and had a spot on a chest x-ray, which turned out to be a very small adenocarcinoma. We were extremely optimistic that she would be cured by surgery. But within a year, my mother had developed widespread metastatic disease, and it became clear there was very little to offer her. It made me think about how much room for improvement there was in the field of oncology.”

In 1980, Dr. O’Brien received her MD from the University of Medicine & Dentistry of New Jersey Medical School and from 1980 to 1983 did her residency in internal medicine at the same institution, serving as Instructor in Medicine until 1984. “By then, I had decided on a career in oncology. I looked around for opportunities, and, given that I had grown up in the metropolitan area, most people thought that Memorial Sloan Kettering Cancer Center would be my first choice,” admitted Dr. O’Brien.

MD Anderson: Love at First Sight

“Memorial is a terrific hospital, but I went down to MD Anderson and just fell in love with the place,” said Dr. O’Brien. She explained that at that time, a lot of people referred to MD as “cowboy” because it was on the cutting edge of cancer treatment, taking calculated risks and pushing the envelop of standard treatments. “I loved that attitude. I wanted to be among those who found new and better treatments for cancer patients. You could come up with the most offbeat approach, but as long as you could defend its value, you were free to try it, even as a fellow,” admitted Dr. O’Brien.

In 1985, Dr. O’Brien began her training as a fellow at MD Anderson. Her first rotation was in leukemia, and she said that she immediately fell in love with hematology as a discipline. “The attendings I worked with were simply terrific. And the members of the leukemia group at MD Anderson were probably the cowboys of the cowboys, which sealed the deal for me as far as my career path,” she said.

Dr. O’Brien added: “When I first got there, I mentioned to one of my attendings that I was giving standard-of-care treatment, to which he said, ‘But if it only cures 20% of the patients, how can it be standard of care?’ And he was right. We didn’t really have a standard of care, so we needed to develop one. But it was those kinds of challenging moments at MD Anderson that made the experience so rich,” she revealed.

Asked whether she liked the Houston, Texas, area itself, Dr. O’Brien responded, “Heck no. Moving from the Northeast to Houston was a mega culture shock. However, there were things I appreciated about Houston, one being its cost of living. For a major metropolitan city, the value for your dollar was amazing. I’d take hot weather over cold any day, but in Texas, you’re hermetically sealed in air-conditioned spaces for 6 months a year. In fact, you could go anywhere in MD Anderson without stepping outside. There were even bridges built so you could cross the street without going outside.”

From Texas to California

In 2015, after 30 years at MD Anderson, where Dr. O’Brien was the Ashbel Smith Professor in the Department of Leukemia, Division of Cancer Medicine, and principal investigator for more than 40 funded clinical research protocols, she accepted a position at the University of California, Irvine Medical Center, Chao Family Comprehensive Cancer Center (CFCCC).

Asked about her decision to leave, arguably, the world’s premier cancer center, she said, “Although I’d been involved in cutting-edge work in drug development, I’d grown tired of Houston. More important, at MD Anderson, my impact on how the institution would evolve was limited; the University of California, Irvine Medical Center, CFCCC was poised to take off, and the position I was offered had the potential to move the institution forward in a way that I never would have had at MD Anderson.”

Dr. O’Brien pointed out that the University of California, Irvine Medical Center, CFCCC is the only National Cancer Institute–designated comprehensive cancer center in all of Orange County, which is the sixth most populous U.S. county and home to more than 1% of the nation’s people.

Optimistic About Challenges in Oncology

Dr. O’Brien, who serves as the Cancer Center’s Associate Director for Clinical Sciences and Medical Center’s Medical Director of the Sue and Ralph Stern Center for Cancer Clinical Trials and Research, explained that she has a multifaceted role, seeing patients and serving as a clinical investigator on drug trials and overseeing cancer clinical trials at UC Irvine. “One of my current goals is to help find ways in which the collaborative efforts of academia and the pharmaceutical industry can expedite the drug development and approval process,” shared Dr. O’Brien.

Despite the ongoing challenges in oncology, Dr. O’Brien is fiercely optimistic. “During my career, I was most involved in the research and treatment of chronic lymphocytic leukemia (CLL); there have been four new drugs approved for this disease in the past 4 years. In the previous 25 years before that, there were five drugs approved for CLL. So that gives you a sense of where we were and where we’re going. This progress has largely been because of the advent of targeted therapies and gene sequencing. And the explosion of our scientific advances will yield more and more treaments, which will ultimately bring better outcomes for our patients.”

Dr. O’Brien is a hematology member of the Southwest Oncology Group Executive Committee.

To decompress from her challenging career, Dr. O’Brien said: “I love to read and play tennis. I go to the gym also, but I hate it. It’s just a necessity of life to keep up the maintenance.”

When asked if she had any regrets, She answered: “Just one. I wish I was younger so I could engage in the truly exciting times ahead in the world of oncology.” ■

Disclosure: Dr. O’Brien reported no potential conflicts of interest.