Arti Hurria, MD, remembered as ‘true giant’ in oncology, tireless advocate for patients

Arti Hurria

Arti Hurria, MD, felt she found her perfect fit in the field of geriatric oncology.

The colleagues who feel an overwhelming sense of personal and professional loss after her death last week wholeheartedly agree.

“She was a tireless advocate for patients, specifically the elderly with cancer,” Suresh S. Ramalingam, MD, FASCO, deputy director of Winship Cancer Institute at Emory University School of Medicine, told HemOnc Today. “We have lost a great leader, an excellent researcher and a dear friend.”

Hurria — who served as George Tsai family chair in geriatric oncology, director of Center for Cancer and Aging, and co-leader of the cancer control and population sciences program at City of Hope — died Nov. 7 in a motor vehicle accident in California. She was 48.

‘A true giant’

Hurria, who served as HemOnc Today’s geriatric oncology section editor, was a trained geriatrician and oncologist.

Although she had a particular interest in breast cancers, she specialized in treating individuals aged 65 years or older.

“She deserves a huge share of credit for defining ‘geriatric oncology’ as a specialty of its own,” said Ramalingam, who knew Hurria since her fellowship days.

Approximately 60% of Americans living with cancer are aged older than 65 years; however, that age group accounts for only 30% of clinical trial enrollment in the United States. In addition, older adults who enroll in trials are typically healthy and fit, so evidence is lacking on how older adults who are frail and in poorer health will respond to cancer treatments.

Hurria understood that chronological age alone cannot sufficiently predict survival outcomes or risk for adverse events among older adults.

She led research efforts to develop a comprehensive geriatric assessment tool that incorporates physical and mental health, nutrition, social support and other variables to identify older individuals at risk for side effects of cancer treatment, as well as those at risk for earlier mortality due to health problems unrelated to cancer.

These assessments are now used in the clinical setting and in oncology trials.

“She recognized before anyone else that age is just a number, and these other variables are extremely important,” Andrea B. Apolo, MD, Lasker clinical research scholar in the Genitourinary Malignancies Branch at NCI’s Center for Cancer Research and a HemOnc Today Next Gen Innovator, said in an interview. “She was a pioneer in terms of bringing this knowledge to our field. She was a true giant.”

Hurria was an attending physician on the breast cancer service at Memorial Sloan Kettering Cancer Center when Apolo began her medical oncology fellowship there.

“She was a wonderful teacher and a tremendously caring oncologist,” Apolo told HemOnc Today. “She made a genuine effort to get to know her patients and really considered it a privilege to be let into their lives. To see that from someone you look up to is so important. Her example reinforced that we aren’t just treating a disease or a tumor. We are treating a person.”

‘Love your patients’

Born in Brooklyn, Hurria grew up in Southern California.

In a 2016 interview, Hurria told HemOnc Today she wanted to be a doctor from an early age.

“I grew up around doctors, so it was almost like I didn’t know anything else,” she said. “Both my parents are physicians. My mom is a radiation oncologist. Watching her experience with taking care of patients with cancer was very inspiring to me and it laid the foundation for me to go into hematology/oncology. ... Perhaps I have found my perfect fit.”

Hurria completed a 7-year combined program at Northwestern University and Northwestern Medical School, followed by an internship at Beth Israel Medical Center and residency at Beth Israel Deaconess Medical Center. She completed a geriatrics fellowship at Harvard University and an oncology fellowship at Memorial Sloan Kettering Cancer Center.

She joined the breast medicine service at Memorial Sloan Kettering, serving as a clinical assistant physician from 2002 to 2004, and as assistant member from 2004 to 2006.

She returned to California in 2006 to lead City of Hope’s Center for Cancer and Aging.

In the HemOnc Today profile, Hurria described geriatric oncology as a field that yielded “rewards [that] are so much greater than the effort.”

She offered the following advice to those about to enter the field: “Love your patients as much as you can. Give them as much as you can with all of your heart. They are in a vulnerable place, and kindness and compassion goes such a long way.”

Hurria took over as HemOnc Today’s geriatric oncology section editor in 2014, accepting the nomination from Derek Raghavan, MD, PhD, HemOnc Today’s Chief Medical Editor for Oncology, and John Sweetenham, MD, the publication’s Chief Medical Editor for Hematology.

“I simply cannot comprehend the loss of Arti, who was such a dynamic and vibrant leader and friend, and at the peak of a stellar career,” said Raghavan, president of Levine Cancer Institute (LCI) at Atrium Health. “I will always remember her empathy for people at both ends of the age spectrum — her mentorship of young colleagues, including our LCI geriatric oncologists, Daniel E. Haggstrom, MD, and Raghava R. Induru, MD, and her innovations in care of the elderly.

“John Sweetenham and I so appreciated her leadership role in geriatric oncology for HemOnc Today,” Raghavan added. “We all will truly miss her and we share her family’s grief.”

‘So much more to give’

Hurria demonstrated an “immense” commitment to the field of geriatric oncology, according to William Dale, MD, PhD, the Arthur M. Coppola family chair in supportive care medicine at City of Hope.

“There is no organization that is relevant for the field of cancer and aging [in which] she hasn’t played a leading role,” Dale told HemOnc Today.

Hurria served on ASCO’s board of directors and received several accolades from the society, including a Young Investigator Award in 2002 and a Career Development Award in 2005 from the society’s Conquer Cancer Foundation. In 2013, she was presented with the B.J. Kennedy Award and Lecture for Scientific Excellence in Geriatric Oncology at the society’s annual meeting.

The society has endowed a Young Investigator Award in Geriatric Oncology in Hurria’s memory to recognize her contributions as a clinician, researcher and mentor.

“Everyone here at ASCO recognizes this as an appropriate way to honor her,” ASCO CEO Clifford A. Hudis, MD, FACP, FASCO, told HemOnc Today.

Hurria also served as founding editor of Journal of Geriatric Oncology, received the Paul Calabresi Award from International Society of Geriatric Oncology in 2017 for her contributions to the specialty, and was past president of International Society of Clinical Oncology.

“It is almost impossible to believe that this force of nature is gone,” Dale said. “Her presence has been ubiquitous, and her influence on the field will be felt for many, many years. The only thing that was larger than her contributions to date was the contributions she was going to make. She had so much more to give.”

Dale said Hurria’s vision and the promise of creating a world-class program that embraced the mission of caring for older adults with cancer convinced him to leave The University of Chicago to join City of Hope.

He summarized the excitement and progress of working with her for the past 18 months in one word: Incredible.

“Perhaps most amazing to observe up-close was the style and grace with which she worked to achieve her many goals,” Dale said. “Always armed with a pleasant smile, a quick laugh and a supporting comment, when she was with you, she made you feel like the only person in the room. She somehow always knew the right thing to say to smooth over a disagreement or a challenging situation.”

In the midst of intense professional demands, she demonstrated even greater commitment to her family — including her husband, Dr. Thomas Lee, and her teenage daughter, Serena.

“I can only hope to channel some of the lessons I’ve learned about leadership, scholarship and life from her into the future, helping to build a better world for older adults with cancer that she envisioned and largely achieved, but didn’t get to see blossom into the world,” Dale said.

‘A mentor to mentors’

Sumanta Kumar Pal, MD, associate clinical professor in the department of medical oncology and therapeutics research at City of Hope, as well as co-director of the institution’s kidney cancer program, joined the institution in 2009, the same year as Hurria.

“I am always cautious to use the term ‘perfect’ for my colleagues in academic medicine,” Pal told HemOnc Today. “Some might excel in clinical medicine, but lack in research expertise. Some may excel in hospital politics, but they lack interpersonal skills that guide day-to-day interactions with peers. Dr. Hurria was flawless. She was perfect in every way.”

Patients from around the world sought her expertise, said Pal, a HemOnc Today Editorial Board member.

So did her colleagues.

“At City of Hope, she was the doctor that every fellow and junior faculty clamored to work with,” Pal said. “Even though I am now 10 years out of training, I still turned to her for advice. She was a mentor to mentors, if you will.”

Hurria cared deeply about everyone with whom she interacted and sincerely conveyed interest in their well-being, Pal added.

“We will create programs to foster individuals who will follow in her footsteps and, to be clear, I think we should,” Pal said. “But we should also realize that there will never, ever be anyone like her. She is irreplaceable. She is perfection.” – by Mark Leiser and John DeRosier