Meet Elizabeth Mittendorf, a leader in immunology and breast cancer vaccines

Elizabeth Mittendorf’s first year in medical school didn’t bode well for a career as a doctor. During one of her early encounters with a patient, she fainted. And it wasn’t due to blood or gore.

It was the pain of a patient with a broken wrist.

“My face hit the counter, and I became the patient,’’ says Mittendorf, M.D., Ph.D., associate professor in Breast Surgical Oncology.

At the time, Mittendorf had been questioning her career choice. But that experience, ironically, convinced her to continue pursuing medicine.

“Surprisingly, my reaction to suffering revealed my compassion for patients. The human side of that struck me,’’ she says.

A light bulb moment

Still, Mittendorf had a hard time seeing patients in pain. The first day of her surgery rotation, she worried she’d be proven a fraud.

But the operating room’s sterile, clinical environment calmed her nerves. The unconscious patient, draped in blue, needed to be healed.

“Something clicked in me, that what we were doing was going to help this person,’’ she says. “This isn’t something everybody can do, but I can. It was like a light bulb moment, and I decided to become a surgeon.’’

A few years later, the bulb flickered again while she was an attending surgeon staffing the breast clinic at Walter Reed National Military Medical Center in Bethesda, Maryland. There she met a patient whose breast cancer had returned 15 years after being treated.

“That got me thinking something had gone wrong. Her immune system apparently hadn’t done its job.’’

Mittendorf had to explore why.

A focus on immunology

With a fresh passion for research, she began working in the lab of now-retired military surgeon and scientist George Peoples, M.D., founder of the Cancer Vaccine Development Program.

“George inspired me with his vision,’’ she says.

After coming to MD Anderson in 2005, Mittendorf continued to perform surgery while also working in immunotherapy and the molecular biology lab. She decided to pursue a Ph.D. in immunology to acquire the scientific rigor and legitimacy to lead in that field. She obtained her doctorate in four years.

Using cancer vaccines to end breast cancer

Now a surgeon and researcher, Mittendorf hopes her work will one day help to eliminate, and possibly prevent, breast cancer.

Much of her research focuses on vaccines to stimulate an immune response in breast cancer patients. She has eight breast cancer vaccine clinical trials underway or in planning stages.

The vaccine furthest along in testing, called NeuVax, has stimulated an immune response in women who had both high and low levels of HER2, a tumor protein present in nearly 80% of breast cancers. Mittendorf and her team are evaluating the vaccine in combination with trastuzumab, a monoclonal antibody that targets the HER2 protein.

Her team also has developed a novel breast cancer staging system called Neo-Bioscore, which includes the tumor’s HER2 status.

“With this tool, I can give my patients the precise information they’re looking for — a more refined prognosis,” Mittendorf says. “Hopefully, these findings will result in more informed conversations between doctor and patient.”

Sacrificing for future generations

Mittendorf’s achievements haven’t gone unnoticed. She was named an inaugural R. Lee Clark Fellow in 2014, a Faculty Scholar in 2016, and one of only five members of the Parker Institute for Cancer Immunotherapy at MD Anderson, created in spring 2016.

She doesn’t like being singled out, as she credits teamwork across MD Anderson for her patients’ success.

“Many of our patients are struck by how passionate everyone is, from the valet to the physician, to the nurse, to the patient services coordinator … how they all do what they can to make the patient experience positive,” she says.

She also applauds the generosity of patients who often make sacrifices to participate in clinical trials, knowing it may not benefit them.

“Breast cancer patients are very altruistic,” Mittendorf says. “They have daughters, sisters, nieces … They want us to learn as much as we can so that subsequent generations won’t have to experience what they’re going through.”

She’s confident one day that will happen.

“I’d like to see every breast cancer patient have a chance to beat cancer. And I’d like to see MD Anderson be the world leader in defining how that will happen.”

A longer version of this blog post originally appeared in Messenger, MD Anderson’s bimonthly employee publication.