First person profile: Ruth M. O’Regan, MD

Abstract

From her start as a young medical intern and resident working in a small research laboratory in Ireland to her current role as chair of medicine and the Charles A. Dewey professor at the University of Rochester (Rochester, New York), Dr Ruth M. O’Regan has traversed a lot of ground and contributed to critical research on the mechanisms behind tamoxifen-resistant breast cancer and triple-negative breast cancer (TNBC). She also has served as a clinician caring for some of the most difficult to treat patients with cancer and as a leader in multiple administrative roles.

In her current role as chair, she oversees 500 faculty members while also serving as the interim associate director of clinical research and associate director of education and mentoring at the Wilmot Cancer Institute at the University of Rochester. In all these capacities, she is focused on fostering an environment that offers faculty time to get involved in research and other academic projects. She thinks a lot about grants and how to promote female oncologists. She is a big proponent of a healthy work–life balance and encourages faculty to work from home when they are able.

Several previous positions helped to hone her leadership abilities. Before her current position, she served as the division chief of hematology, medical oncology, and palliative care in the Department of Medicine and as deputy director at the Carbone Cancer Center at the University of Wisconsin School of Medicine and Public Health. During this time, she also helped to guide the research and scientific mission of the Big Ten Cancer Research Consortium as the chief scientific officer to the consortium and as the vice chair of the National Comprehensive Cancer Network’s board of directors. Her first recruitment into a leadership role was as director of the Glenn Family Breast Cancer Program at the Winship Cancer Institute and as the vice chair of education and director of the Hematology Oncology Fellowship Program in the Department of Hematology and Medical Oncology at Emory University.

While serving in these roles, Dr O’Regan prioritized getting things done through collaboration, fostering cooperation instead of competition, and focusing on what is best for patients.

Sheryl Gabram-Mendola, MD, a professor of oncology at the Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins University, has known Dr O’Regan since 2005. Each was the director of a breast center (two different ones) at the Emory University School of Medicine. She marveled at a “strategy” that Dr O’Regan developed to bring together oncologists throughout the Atlanta region to discuss patient case scenarios and update one another about clinical trials open at their respective institutions. “I thought why would you reach out and gather the competition together?” she says.

However, it worked. “It was about advocating for patients, and in the end, it was the right thing to do from a patient’s perspective. This cadre of medical, surgical, and radiation oncologists would then often refer to each other if appropriate,” she says. “I was in admiration of this strategy, and it speaks to her commitment to high quality patient care.”

Exposure to oncology research as a young medical student led Dr O’Regan to focus on oncology as an intern and resident, first in her home country of Ireland and then in the United States, where she completed her internal medicine residency at the Medical College of Wisconsin and her hematology/oncology fellowship at Northwestern University.

While at Northwestern University, she first began focusing on resistant breast cancer by looking at the mechanisms of tamoxifen resistance; this spawned findings that led to the development of clinical trials for patients with tamoxifen-resistant cancer. Specifically, she evaluated the impact of other selective estrogen receptor (ER) modulators on the growth of endometrial cancer.¹ She was the first to show that raloxifene, an agent used to prevent breast cancer and improve bone density, stimulates the growth of breast and endometrial cancer in mice previously treated with tamoxifen.²

Using this knowledge, she developed and conducted translational breast cancer trials at Emory University and was recruited as the chief of hematology and medical oncology at the Georgia Cancer Center for Excellence at Grady Memorial Hospital.³ During this time, she became interested in another resistant breast cancer, TNBC, which occurs more frequently in Black women. Her laboratory work showed the role of plasticity in the progression of mesenchymal TNBC.⁴ She also became interested in the role of androgen receptors (ARs) in TNBC and demonstrated crosstalk between the AR and the mesenchymal pathways.⁵ During her time at the University of Wisconsin, her laboratory showed that the combination of AR and CDK4/6 inhibition is effective in AR-positive TNBC, and this led to the development of an ongoing clinical trial.

Currently, she is the lead researcher for two active clinical trials. One is an open-label, phase 2 trial examining the efficacy of preoperative neratinib and endocrine therapy with trastuzumab in women with ER-positive and human epidermal growth factor receptor 2 (HER2)–positive breast cancers. The other is an open-label, single-arm, phase 2 trial of ribociclib combined with bicalutamide for advanced AR-positive TNBC.

As the associate director of education and mentoring at the University of Rochester, Dr O’Regan, along with her team, has created a number of programs, including a summer internship for high school students in Rochester that is funded by the National Institutes of Health. She initiated the program in 2021 to expose deaf students to careers in science. Recently, the program received additional funding from the National Cancer Institute to expand the internship to four other national cancer centers, an achievement that Dr O’Regan is particularly excited about.

Another one of her commitments is serving people and populations that may not otherwise have access to education and care. Dr Gabram-Mendola notes that while they worked together at Emory University, she witnessed Dr O’Regan’s focus on this population. “She was a leader in the clinic appropriately overseeing her fellows (trainees) yet being present to guide them in their decision making and opening clinical trials for patients to have access to high-quality clinical care,” she says. “In some of her clinical trials, she had nearly 50% minority representation and was truly a trailblazer in making sure all women had access to her research clinical studies.”

“She was totally ahead of her time,” she adds.