Jennifer K. Litton, MD
Breast cancer specialist Jennifer K. Litton, MD, was born and reared in Leominster, Massachusetts, a small city in the north central part of the state. “I went to parochial schools until seventh grade and then went on to high school in Worcester. Although I enjoyed science early on, I was definitely drawn more to English and history,” said Dr. Litton.
English and History
AFTER GRADUATING high school, Dr. Litton entered Duke University in Durham, North Carolina. She said her father’s friend had strongly suggested Duke, but she was reluctant until she visited the campus and fell in love with the university. It proved to be a fortuitous decision, not only was Duke in the NCAA Final Four each year during Dr. Litton’s time there, but she also met the man who would become her husband. At the time, Dr. Litton was still focused on a career in liberal arts and graduated from Duke University in 1992, with a double major in history and English.
UPON GRADUATING with a liberal arts degree, Dr. Litton was faced with a difficult question: what do I do now? Although she always planned on going to law school, after some deep introspection, she realized she didn’t want to become a lawyer. However, her husband did attend law school in Austin while Dr. Litton remained in New England, struggling with a career direction. “I wish there was some great epiphany, a moment or incident that guided me to medicine, but there wasn’t. I simply woke up one morning and decided to pursue a career in medicine,” she revealed.
Dr. Litton continued: “Harvard had a premed program, so I enrolled and took general chemistry and absolutely loved it. At the time, I was volunteering in the health clinic at a men’s shelter in Boston called the Pine Street Inn. Although I was seriously thinking about a career in medicine, I still wanted to be sure, so I decided to look for a job in the field. After applying at several hospitals, I was offered a position as a clinical trial coordinator at Dana-Farber’s Breast Evaluation Center by former ASCO President Daniel Hayes, MD, FASCO.”
Dr. Litton said that it didn’t take long before she was “hooked” by the excitement of clinical trial work. She spent 2 years at Dana-Farber, during which time she finished her premed work and entered the University of Massachusetts Medical School (UMass), already certain that she wanted to pursue a career in breast cancer research. “UMass was truly a magical experience for me. At that time, you had to be from Massachusetts to attend the medical school, and it cost me only about $3,000 a year for tuition, so when I graduated, I wasn’t buried in debt like so many young doctors are,” she said. “I was part of a group of women in medical school who supported each other, and we continue to support each other throughout our careers to this very day.”
MD Anderson Calls
AFTER SHE RECEIVED her medical degree in 2000, Dr. Litton was not only sure that she wanted to pursue a research career, she was also sure about where: MD Anderson Cancer Center. “I visited the fellowship director at MD Anderson and asked what he’d be looking for in a candidate, and he told me. Armed with that knowledge, I did my clinical internship and residency at Baylor College of Medicine, where I was chosen to be Chief Resident. Then in 2004, I was accepted for a clinical fellowship at MD Anderson,” she added.
“Working with Dr. Hayes on breast cancer trials when I was only 23 years old excited my interest in the field to the degree that when I left Dana-Farber, I knew exactly what I wanted to do.”— Jennifer K. Litton, MD
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Asked what finally cemented her decision to pursue breast cancer research, Dr. Litton praised mentors and those who inspired and helped her career path, such as Dr. Hayes at Dana-Farber. “Working with Dr. Hayes on breast cancer trials when I was only 23 years old excited my interest in the field to the degree that when I left Dana-Farber, I knew exactly what I wanted to do.”
Dr. Litton has been at MD Anderson since she began her clinical fellowship in 2004. “Much of the work I currently do stems from my time at UMass when I was doing a gynecologic rotation. I was supposed to do a project and I asked what happened to pregnant patients with cancer, and no one could give me a satisfactory answer. At that time, the significant research in that challenging clinical setting was being done at MD Anderson. When I came here for my fellowship, I worked with Richard Theriault, DO, and he was a great mentor for me early in my career. We worked on treating pregnant patients, which led to the area that encompasses fertility and genetic heritability issues,” said Dr. Litton. “And that work led to my interest in triple-negative breast cancer.” She noted that she also had the benefit of having multiple incredible mentors at MD Anderson such as Gabriel Hortobagyi, MD, and Banu Arun, MD.
Motherhood and Fellowship
ASKED ABOUT her current work at MD Anderson, Dr. Litton noted that she was recently appointed as Chief of Clinical Research and Drug Development Program in Breast Medical Oncology. “But my life here goes back to when I was doing my fellowship and went on maternity leave after my twins were born prior to starting my fellowship,” she said.
She admitted that at first, it was a difficult juggling act. “I actually thought very seriously about quitting the fellowship and staying as a part-time ER physician, which is what I was doing at the time. My husband fully supported my decision to stay at home, but he reminded me that I took a fellowship spot as only 1 of 12 people from around the world and owed it to MD Anderson to at least give it a try. Two days later, I never looked back. I also reminded my husband that as a first-year fellow, I had to work every weekend. So, he took care of the babies during the weekends and worked during the week and deserves a lot of credit,” Dr. Litton shared.
Focus on Smaller Trials
DR. LITTON has a busy clinical practice during which she sees patients with all stages of breast cancer, plus a separate clinic in which genetic testing and counseling are performed. Most of her current research is dedicated to breast cancer immunotherapy and DNA-damage repair. Recently, Dr. Litton led an international phase III trial on the poly (ADP-ribose) polymerase inhibitor talazoparib, which was published in The New England Journal of Medicine,1 and the patient-reported outcomes were published in the Annals of Oncology.2 “We’ve doing several investigator-initiated trials that will begin soon. We’re looking for different trials for patients with hereditary cancer syndromes and also looking at agents in the curable setting, which hasn’t been done before. I presented research findings on that at the 2018 ASCO Annual Meeting. It was in the neoadjuvant setting, and the results were so significant that we are moving forward with a single-agent multicenter national trial,” noted Dr. Litton.” noted Dr. Litton.
“The single checkpoint is not where we’re going in breast cancer, and I think we’ll have to employ multiple combinations to see results in immunotherapy in breast cancer.”— Jennifer K. Litton, MD
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Dr. Litton revealed that she has a strong body of female colleagues at MD Anderson. “We have an amazing group of women who look out for each other, and I don’t think that is always the case in business or academic medicine. I’m really blessed to be here,” she admitted.
ASKED TO share a closing thought on oncology research moving forward, Dr. Litton responded, “As far as the progress of our clinical trials, we are already seeing a restructuring. The days of putting 1,000 patients on trial are over. There are so many new agents that we need smaller information-rich studies to be able to understand these complex mechanisms.”
According to Dr. Litton, immunotherapy is another exciting development, although she does not consider it a game-changer in breast cancer yet. “The single checkpoint is not where we’re going in breast cancer, and I think we’ll have to employ multiple combinations to see results in immunotherapy in breast cancer. But that said, we’re on the cusp of very exciting times in oncology,” she predicted. ■
DISCLOSURE: Dr. Litton is a consultant/advisor for Pfizer, AstraZeneca, and Medivation/Pfizer; is on the speakers bureau of Medscape, Physician Education Resource, UptoDate, and Med Learning Group; has received (institution) research funding from GlaxoSmithKline, Medivation/Pfizer, Novartis, Bristol-Myers Squibb, Genentech, Pfizer, EMD Serono, and Jounce; has patents/ royalties/other intellectual property from UptoDate; and has received travel/accommodation/expenses from Physician Education Resource, Med Learning Group, and Medscape.
1. Litton JK, Rugo HS, Ettl J, et al: Talazoparib in patients with advanced breast cancer and a germline BRCA mutation. N Engl J Med 379:753-763, 2018.
2. Ettl J, Quek RGW, Lee KH, et al: Quality of life with talazoparib versus physician’s choice of chemotherapy in patients with advanced breast cancer and germline BRCA 1/2 mutation: Patient-reported outcomes from the EMBRACA phase III Trial. Ann Oncol. August 15, 2018 (early release online).