Susan Dent, MD, Honored by International Cardio-Oncology Society
Published
From the Duke Cancer Institute archives. Content may be out of date.
Christine Brezden-Masley, MD, PhD, Susan Dent, MD
On Oct. 6, Susan Dent, MD, was presented with the International Cardio-Oncology Society (IC-OS) Thomas L. Force Pioneer Award in recognition of her achievements in the field.
A professor of medicine, cardio-oncologist, breast oncologist, associate director of Clinical Research, Duke Cancer Institute Breast Cancer Disease Group, and clinical director of the Duke Consortium for Inflammatory Breast Cancer, Dent accepted the award upon delivering the Thomas Force Leadership in Cardio-Oncology Lecture at the 2022 Global Cardio-Oncology Summit held in Toronto. The meeting was hosted by the Canadian Cardiac Oncology Network — a not-for-profit organization devoted to the optimization of cancer care for patients without compromising cardiovascular health — that Dent founded in 2011.
"I really want to thank you personally for all that you've done over the years. And I am so proud that you will accept this award and will be recognized as a pioneer in the International Cardio-Oncology Society," said Daniel Lenihan, MD, founder and past president of IC-OS, in a video produced to recognize Dent with the award.
Dent Came to Duke From Canada
Before she came to Duke four years ago, Dent worked in Canada; where she was born and spent her entire life.
"I can describe Susan as just a wonderful, caring, intelligent, driven, collegial, supportive, a 'mom' of cardio-oncology," said former mentee Christine Brezden-Masley, MD, Ph.D., oncologist and medical director of the Cancer Program, Sinai Health System, Toronto, and director of the Marvelle-Koffler Breast Center.
Dent attended McMaster University Medical School in Hamilton, Ontario, Canada, and completed her residency training in Internal Medicine and Medical Oncology at the Ottawa Hospital, University of Ottawa, Ontario, Canada. She subsequently completed a post-graduate research fellowship in clinical trials at the Canadian Cancer Trials Group in Kingston, Ontario, and was appointed as a staff medical oncologist at the Northwestern Ontario Cancer Center in Thunder Bay, Ontario. In 2001, she returned to Ottawa where she specialized in the treatment of breast cancer.
In 2008, working with her cardiology colleagues, she established a multidisciplinary cardio-oncology clinic in Ottawa — the first of its kind in Canada. Three years later, she went national; founding the Canadian Cardiac Oncology Network. It was the first national network (in Canada) to bring together cardiologists, oncologists, oncologists, physiotherapists, nurses, and radiation oncologists from across Canada and even the U.S. Dent not only developed the network, but she also developed the website.
"There was a real lack of communication between oncologists and cardiologists, and we were really not working together at all. Probably one of the hardest tasks was trying to open up the lines of communication between those two sub-specialties and to try and encourage people to look at a patient, not as an oncology patient or a cardiology patient but as an entire patient," said Dent.
Dent is the fourth person to receive the Thomas Force Pioneer Award. She had the opportunity to meet Force at one of the Canadian Cardiac Oncology Network meetings in Ottawa.
"I invited him and was so proud to have him come and speak," she said. "He was a pioneer in generating knowledge that we are using today to try and better understand the mechanisms of cardiotoxicity associated with cancer treatments."
As noted in JACC: CardioOncology, cardiovascular scientist Thomas Force, MD, "provided unique insights directly relevant to the cardiotoxic effects of targeted therapies. His research demonstrated a critical role for kinase signaling in the cardiovascular system. In 2006, his laboratory published a seminal manuscript in Nature Medicine, which opened the door for using cardio-oncology as a novel platform for basic cardiac investigation." Force began his career at Harvard University Medical School and Massachusetts General Hospital, then moved to Thomas Jefferson Medical College in Philadelphia, Temple University, and Vanderbilt University. The IC-OS established the award in 2018 prior to Force's passing in 2020.
"I'm feeling really honored to be given the Thomas Force Pioneer Award. And even though I'm not a scientist, as a clinician, I'm very grateful to be recognized for my efforts," said Dent.
Dent's colleagues say she's been a leader in integrating cardiology training with oncology and hematology training and getting professional societies engaged in the burgeoning field, including the American Heart Association, the American College of Cardiology, the American Society of Clinical Oncology, and the European Society of Medical Oncology, which have now endorsed the idea of the two fields coming together to help improve patient care.
In 2015, Dent launched the Global Cardio-Oncology Summit, an annual meeting that now attracts oncologists, cardiologists, and allied healthcare providers from more than 23 countries. Cardio-oncology programs are now providing care for our patients globally.
"When I first met Susan it was at a Canadian Cardio-Oncology Society meeting. Susan was leading the meeting and only towards the end, I started to realize that she's in fact an oncologist, which to me was surprising because the meeting wasn’t being driven by a cardiologist," said Dinesh Thavendiranathan, MD, MSc, FRCP, cardiologist and associate professor of medicine at the Peter Munk Cardiac Center and director of the Ted Rogers Program in Cardiotoxicity Prevention at Toronto General Hospital.
Dent is far from done with what's become her life's work and the work isn't done with her.
"There are still a lot of questions around how best to care for patients with cancer who are at risk of or have pre-existing cardiovascular disease. One thing that I feel is very important is ongoing education and research so that we can continue to learn and share our knowledge on the best preventative and treatment strategies for our patients," said Dent.
"She honestly wants to make the cancer journey better for the patient," said Thavendiranathan.
For decades, a diagnosis of metastatic breast cancer has carried a clear message: while treatments can help control the disease and extend life, the disease is generally considered incurable. As a result, treatment strategies have traditionally focused on managing cancer and maintaining quality of life rather than pursuing a cure.New advances in breast cancer therapies are changing that conversation. Research led by Duke Cancer Institute breast surgical oncologist Jennifer Plichta, MD, suggests that some patients with limited metastatic breast cancer may benefit from a more aggressive treatment approach than has traditionally been offered. The findings, published in JAMA Surgery, add to growing evidence that metastatic breast cancer is not the same for every patient and that treatment decisions may need to become more personalized.Plichta's research builds on years of work focused on improving how physicians classify and predict outcomes for patients with breast cancer. Historically, a diagnosis of metastatic, or stage IV, breast cancer, was associated with poor survival. However, the development of targeted therapies and other advances in systemic treatment have dramatically improved outcomes for many patients."Many women with metastatic breast cancer are now living for years and sometimes even a decade after diagnosis," Plichta said. "We've come a long way in terms of treatment options and survival."At the same time, researchers have discovered significant variation among patients with metastatic disease. Some experience aggressive cancer that progresses quickly, while others have relatively limited disease that remains controlled for long periods.This variability led Plichta and her colleagues to ask an important question: Are there certain patients with metastatic breast cancer who could benefit from treatment strategies typically reserved for patients with earlier-stage disease?The study focused on patients with what is known as oligometastatic breast cancer, a form of metastatic disease in which cancer has spread to only a limited number of sites. Researchers believe this group may represent a distinct subset of patients whose disease behaves differently than widespread metastatic cancer.Using data from the National Cancer Database, which captures information on many newly diagnosed breast cancers in the U.S., the team analyzed outcomes among patients with limited metastatic disease. They examined whether patients received treatment directed at the primary breast tumor, treatment directed at metastatic sites, both treatments, or neither.The goal was to determine whether a treatment approach that more closely resembles care for stage III breast cancer—combining systemic therapy with aggressive local treatment—might improve outcomes for selected patients."What stood out was that removing the primary breast tumor seemed to be the factor most strongly associated with improved survival," Plichta said. "Treating the distant sites did not appear to offer the same survival advantage on its own."While previous studies have explored surgery for patients with metastatic breast cancer, results have been mixed. Plichta believes one reason may be that metastatic breast cancer is often treated as a single category, even though patients can have vastly different disease characteristics and prognoses.One of the most significant implications of this research is how clinicians think about treatment goals. Patients with stage III breast cancer are typically treated with curative intent, meaning doctors use every appropriate therapy available, including chemotherapy, surgery, and radiation, in an effort to eliminate the disease. Patients with metastatic breast cancer, by contrast, are usually treated with palliative intent, focusing on disease control rather than cure.But as outcomes improve, the line between those groups may not be as clear as it once was."We're seeing some patients with metastatic disease living longer than patients with locally advanced breast cancer," Plichta said. "That raises important questions about whether some patients with limited metastatic disease should be approached differently."Because the study was retrospective, the results point to an important association that warrants further study. Several clinical trials are now being developed to investigate curative-intent treatment strategies in specific subgroups of metastatic breast cancer patients, including those with HER2-positive disease. Duke hopes to participate in these multi-institutional studies as the field continues to evolve.As breast cancer treatments continue to improve, researchers are gaining a more nuanced understanding of metastatic disease. For Plichta, the study represents an important step toward that goal."I hope this work encourages further research into which patients may benefit from a curative-intent approach," she said. "The ultimate goal is to find the right treatment strategy for the right patient."
For decades, a diagnosis of metastatic breast cancer has carried a clear message: while treatments can help control the disease and extend life, the disease is generally considered incurable. As a result, treatment strategies have traditionally focused on managing cancer and maintaining quality of life rather than pursuing a cure.New advances in breast cancer therapies are changing that conversation. Research led by Duke Cancer Institute breast surgical oncologist Jennifer Plichta, MD, suggests that some patients with limited metastatic breast cancer may benefit from a more aggressive treatment approach than has traditionally been offered. The findings, published in JAMA Surgery, add to growing evidence that metastatic breast cancer is not the same for every patient and that treatment decisions may need to become more personalized.Plichta's research builds on years of work focused on improving how physicians classify and predict outcomes for patients with breast cancer. Historically, a diagnosis of metastatic, or stage IV, breast cancer, was associated with poor survival. However, the development of targeted therapies and other advances in systemic treatment have dramatically improved outcomes for many patients."Many women with metastatic breast cancer are now living for years and sometimes even a decade after diagnosis," Plichta said. "We've come a long way in terms of treatment options and survival."At the same time, researchers have discovered significant variation among patients with metastatic disease. Some experience aggressive cancer that progresses quickly, while others have relatively limited disease that remains controlled for long periods.This variability led Plichta and her colleagues to ask an important question: Are there certain patients with metastatic breast cancer who could benefit from treatment strategies typically reserved for patients with earlier-stage disease?The study focused on patients with what is known as oligometastatic breast cancer, a form of metastatic disease in which cancer has spread to only a limited number of sites. Researchers believe this group may represent a distinct subset of patients whose disease behaves differently than widespread metastatic cancer.Using data from the National Cancer Database, which captures information on many newly diagnosed breast cancers in the U.S., the team analyzed outcomes among patients with limited metastatic disease. They examined whether patients received treatment directed at the primary breast tumor, treatment directed at metastatic sites, both treatments, or neither.The goal was to determine whether a treatment approach that more closely resembles care for stage III breast cancer—combining systemic therapy with aggressive local treatment—might improve outcomes for selected patients."What stood out was that removing the primary breast tumor seemed to be the factor most strongly associated with improved survival," Plichta said. "Treating the distant sites did not appear to offer the same survival advantage on its own."While previous studies have explored surgery for patients with metastatic breast cancer, results have been mixed. Plichta believes one reason may be that metastatic breast cancer is often treated as a single category, even though patients can have vastly different disease characteristics and prognoses.One of the most significant implications of this research is how clinicians think about treatment goals. Patients with stage III breast cancer are typically treated with curative intent, meaning doctors use every appropriate therapy available, including chemotherapy, surgery, and radiation, in an effort to eliminate the disease. Patients with metastatic breast cancer, by contrast, are usually treated with palliative intent, focusing on disease control rather than cure.But as outcomes improve, the line between those groups may not be as clear as it once was."We're seeing some patients with metastatic disease living longer than patients with locally advanced breast cancer," Plichta said. "That raises important questions about whether some patients with limited metastatic disease should be approached differently."Because the study was retrospective, the results point to an important association that warrants further study. Several clinical trials are now being developed to investigate curative-intent treatment strategies in specific subgroups of metastatic breast cancer patients, including those with HER2-positive disease. Duke hopes to participate in these multi-institutional studies as the field continues to evolve.As breast cancer treatments continue to improve, researchers are gaining a more nuanced understanding of metastatic disease. For Plichta, the study represents an important step toward that goal."I hope this work encourages further research into which patients may benefit from a curative-intent approach," she said. "The ultimate goal is to find the right treatment strategy for the right patient."
