A Road Less Traveled

What routes do new faculty take as they wend their way through post-doctoral training to prepare for where life leads them? In particular, what routes do new Stanford Department of Medicine faculty follow? What leads them to take the fork in the road that ends up on the Stanford campus?

We’ll be asking this question from time to time in the coming months, no doubt uncovering a globe-full of roads to Stanford. We begin this month with Suleiman Massarweh, MD (associate professor, oncology), whose travels began in his native Jordan and followed a path consecutively through Houston, TX; Amman, Jordan; and Lexington, KY, ending in Palo Alto in January 2015.

Following medical school in Jordan, Massarweh went to Baylor for internal medicine residency and oncology fellowship training, ending up with a few years in the lab of Kent Osborne, MD at the Baylor Breast Center, where he began his studies on breast cancer. He returned to Jordan to work for two years at King Hussein Cancer Center in Amman and then accepted a position in Lexington, KY, where he stayed for almost nine years.

“At the Baylor Breast Center,” Massarweh says, “we did quite a bit of work in the area of breast cancer resistance to hormone therapy, which remains a problem still today. “

Hormone therapy is a mainstay of treatment for patients with breast cancer. More than 70-80% of women with breast cancer have the kind that feeds off the hormone estrogen. Being able to block estrogen or its receptor with endocrine therapy, according to Massarweh, “has been tremendous in our ability to treat breast cancer of this kind.”

“Millions of women have benefited from this treatment. It is a very simple therapy. It is nontoxic, preserves quality of life, and is less expensive than the more complicated chemotherapies that can be toxic to patients.”

Q: Why then are some of the more complicated, more expensive, and in some cases newer therapies even needed?

“This is where I come in: not everybody responds to endocrine therapy; many who do respond later develop resistance, and then the disease progresses. So we have to identify what mechanisms lead to resistance and then what new targeted treatments we can use to overcome or delay this resistance and prolong the benefit from endocrine therapy.”

Q: Have there been satisfying advances in the care of patients with breast cancer during your career to date? Are there promising new therapies currently being tested that will make the next phase of your career equally satisfying?

“Over the past 15 years there has been a tremendous growth in the number of clinical trials testing new hypotheses, testing new treatment combinations. And that growth continues, with more discoveries being made in unravelling mechanisms of endocrine resistance. My interest is in designing novel clinical trials to test new targeted agents in endocrine resistance, that may at times challenge existing dogma, but understanding that they have to be on the edge in order to answer these kinds of mechanistic questions and help patients at the same time.”

“I am primarily a clinician, and I collaborate with basic researchers through interdisciplinary translational research to move things back and forth between the clinic and the lab. I believe that ultimately the key in any kind of research we do in medicine is that it has to be relevant to patient care. And, as such, patients are a critical component of translational research.”

Q: And why did you choose to join the faculty at Stanford?

“Stanford is such a special place. Because of the depth of science here, there are unique opportunities to capitalize on the translational potential on campus.  A big part of my role will be to build multidisciplinary research teams centered around the patient care platform.“

“The Stanford breast group that is already in place is excellent, and it is truly exciting to have a division chief like George Sledge (professor and chief, oncology), who is of such high caliber as both a leader and a breast cancer researcher. I want to bring in my passion and my energy to the group. I believe Stanford will do special things in breast cancer. A world class group.”