Groundbreaking Breast Cancer Researcher Shares a World of Knowledge

Hope Rugo, MD, FASCO

Other little girls may have had their eyes on dollhouses or dresses, but a young Hope Rugo saved up her S&H Green Stamps to buy a children’s chemistry set from a Sears catalog. At the age of 8, Rugo knew she wanted to be a scientist. A few years later, she realized she wanted to be a medical scientist.

Around the age of 10, she hurt her knee and was taken to a children’s hospital in Boston, Massachusetts. Her curiosity was piqued, and after receiving a fluoroscopy on her leg, she was hooked. “I left that appointment and said, ‘I want to be a doctor.’ I just thought the whole thing was fascinating,” she said.

Hope Rugo, MD, FASCO, would go on to become a professor of medicine and the director of the Breast Oncology and Clinical Trials Education program at the University of California San Francisco (UCSF) Helen Diller Family Comprehensive Cancer Center—and one of the most impressive and influential people in breast oncology.

But decades ago, people were doubtful about her becoming a doctor. Not only was medicine an extraordinarily difficult field requiring years of expensive education but it was an unusual path for a woman. “Everybody was saying, ‘It’s a long road. Are you sure that’s what you want to do?’” Rugo recalled.

Pursuing Her Dream

Luckily Rugo had the support of her mother, a retired English teacher, and her father, a biophysicist.

“They instilled in me the idea that we could, and we should, work to do what we wanted to do,” Rugo said. “And there wasn’t a limit to that or a box that you need to fit into.”

Rugo’s parents motivated her to pursue her dream career in medicine, and the world of cancer is far better for it. She traded her toy chemistry set for a real one and went on to earn a bachelor’s degree in chemistry from Tufts University in Boston and then her medical degree from the University of Pennsylvania School of Medicine in Philadelphia in 1983. She would go on to lead groundbreaking research, from immunotherapy and other novel agents in breast cancer to adverse event (AE) management like pioneering the use of cold caps for chemotherapy-related alopecia.

To help pay for medical school at the University of Pennsylvania, Rugo applied for, and was awarded, a 2-year scholarship from the National Health Service Corps, which covered a portion of her schooling in exchange for work in a medically underserved area. “During what would have been my fourth year of medical school, I decided to focus on global health by applying for a scholarship with the Henry Luce Foundation, which allowed me to live in the Philippines on the island of Mindanao,” Rugo said.

After finishing medical school, she went to the United Kingdom, where she worked at the Royal Brompton Hospital in London. In 1984, she moved back to the United States to start her residency in internal medicine at UCSF. Initially, she thought she would kick off her career as a primary care physician and then go into infectious diseases. But during rotations in the oncology ward, she found her calling.

“I really became fascinated with oncology,” Rugo said, emphasizing that she was particularly interested in the immune system and transplants.

“Oncology was a perfect match between taking care of the whole patient, as opposed to an organ system, and bringing science into the clinic.”

Loss as Motivation

Rugo’s work as an oncologist became personal when physicians discovered that her mother’s breast cancer—originally diagnosed as stage I while Rugo was in Asia—was actually metastatic. She suddenly found herself starting her career, tending to 2 small children, and caring for her mother on a daily basis.

“It was a rather dark time of life and very difficult,” she said. “And interestingly, times when you really have to reach [into] yourself, that’s what gives you the most meaning and what’s go-ing to be the most important looking forward.”

Rugo said that her mother was her best friend and that losing her served as motivation for a career change. “During that period, I thought I really wanted to work in breast cancer. I loved the work I did in hematology, but I just really needed to make a change.”

In 1999, a position became available on the breast cancer team at UCSF. Rugo made the lateral move and never looked back. Since then, she has dedicated her life to improving both the outcomes and quality of life for patients with breast cancer. Rugo has been, and continues to be, successful in that endeavor.

While she moved from 1 oncology specialty to another, Rugo’s interest in the immune system never wavered. She was a primary investigator in the IMpassion130 trial, which led to the March 2019 FDA approval of atezolizumab (Tecentriq) plus nab-paclitaxel (Abraxane) for patients with unresectable, locally advanced PD-L1–positive triple-negative breast cancer. This was a huge milestone for patients with the disease, as it was the first immune checkpoint inhibitor to be approved in the breast cancer space.