New Chapter

Mayo Clinic was a family affair for David Kurtz, M.D., Ph.D. (MED ’09). He followed his brother to Mayo, and their sister followed them. After medical school at Mayo, Dr. Kurtz went to Stanford for residency, fellowship and a Ph.D. He’s focused on applying science to patient-centric translational medicine and wants to play a role in changing screening and treatment of cancer — particularly, to find cancers early to allow intervention before patients have widespread disease.

“My years at Mayo were some of the happiest of my life and one of the most important periods of my education. It was a transformative experience. I learned how to approach problems and that the needs of the patient come first.”

How did you become interested in medicine?

My mom is a pharmacist, and my dad is a chemist, so we had a lot of science and life science influences in our household. I did my undergraduate studies in chemistry at Caltech (California Institute of Technology) and planned to pursue a Ph.D. in chemistry and basic science. My first two years at Caltech, I worked in a chemistry lab on fundamental science and, I have to say, I really didn’t like it. It just wasn’t a good fit for me. I didn’t see the applications and how they would impact people. It was difficult to motivate myself to work on the problems. I wanted to work on something more applicable to people’s day-to-day lives. It’s not common to into medicine from Caltech, but that’s the path I chose.

What led you to Mayo Clinic for medical school?

My older brother, Chris Kurtz, M.D. (MED ’04, I ’07), went to Mayo Clinic for medical school and internal medicine residency, and my sister, Angela Kurtz, M.D. (FM ’09), came to Mayo for family medicine residency. We were all there at the same time for a few years. I lived with each of them during my time in Rochester.

I wanted the strongest possible clinical training, and Mayo Clinic is the place for that. My years at Mayo were some of the happiest of my life and one of the most important periods of my education. It was a transformative experience. I learned how to approach problems and that the needs of the patient come first.

Ultimately, my path took me back into the lab and science, but the idea of being patient-centric is a founding principle for me. I think about it every day.

Where did you go after medical school?

After medical school, I thought about where I could make the biggest impact in medicine and medical science. I realized pretty early at Mayo that I was a scientist at heart. I wanted to understand problems and make an impact by furthering knowledge and innovation. I sought a residency with strong clinical training and lab-based translational science. Stanford’s internal medicine training had a short-track research pathway — two years of internal medicine training and an extended hematology/oncology fellowship to focus on laboratory research. Stanford also has a unique program called ARTS — Advanced Residency Training at Stanford — that allows residents or fellows to get a Ph.D. with their clinical training. It’s a dedicated path for residents and fellows to get a Ph.D. Between 2009 and 2017, I completed an internship, residency, fellowship and Ph.D. in bioengineering.

I’ve been in the lab ever since then.

What drew you to oncology?

I was drawn to oncology during medical school. It seemed like the area with the most need in terms of understanding the disease, and the most opportunity to apply new methods and discoveries. When I went to Mayo Clinic in 2005, genomics was emerging, and oncology was on the cusp of applying data and genomics to better understand the disease. Applying science to patient-centered questions is my interest area.

Tell us what you do.

The primary disease I work on is diffuse large B-cell lymphoma (DLBCL). We can cure 60 percent of patients. Most of my clinical time is spent treating and helping people through that process.

My research interests are focused on developing novel methods for detecting, monitoring and treating malignancies, particularly non-Hodgkin lymphomas. I aim to create tools to rapidly detect and quantify tumors and their response to chemotherapy and immunotherapy, enabling personalized therapies. You might be familiar with this field as liquid biopsies — basically, emerging methods to detect and track cancers in the blood.

I previously applied high-throughput sequencing of the immunoglobulin genes from plasma cell-free DNA for detection of DLBCL. While this approach served as a proof-of-principle for liquid biopsies in lymphoma, unfortunately it hasn’t been sensitive enough for routine use in the clinic. Therefore, I developed Cancer Personal Profiling by Deep Sequencing (CAPP-Seq) for circulating tumor DNA (ctDNA) detection in non-Hodgkin lymphoma for disease detection, genotyping and response monitoring. By studying the dynamics of ctDNA over 200 patients with DLBCL, I defined molecular response criteria for DLBCL, capable of predicting patient outcomes as early as 21 days into systemic therapy.

The hope is that by detecting response (or nonresponse) early, we will be able to change paradigms of how patients are treated in the clinic and ultimately cure more people. Furthermore, by defining the genomic changes that drive a patient’s cancer, we hope to not only identify that a current therapy is not working but also determine which alternate therapy might be a better choice.

What’s your career goal?

In 20 years, I’d like to look back at what we were doing to care for patients in 2018 and think it was antiquated. “Wow, I can’t believe we were doing invasive surgeries to biopsy cancer patients and doing PET-CT scans every three months to see if patients were responding to treatment.”

Genomics and novel diagnostics will change how we think about and treat cancer. My goal is to be a successful physician-scientist who performs translational science in a lab-based setting, focused on designing and developing novel techniques that make a difference in the clinic. I’d like to play a role in changing how we treat patients with cancer as well as how we screen patients to find cancers early so we can intervene before patients have widespread disease.

How does Mayo Clinic influence you?

When I start a new project or new research questions, I think about it from the perspective of how it will help physicians in the clinic or patients with cancer to get better treatment, to understand the disease better, to prevent a cancer diagnosis. My Mayo training informs my science and what I choose to work on.

What are you most asked about Mayo Clinic?

“Is it true they wear suits every day at Mayo? You must have had a lot of suits.” Stanford is West Coast and pretty informal.

There’s also a lot of interest in how Mayo Clinic operates. It’s a model of efficiency — how to do comprehensive executive physicals in a cost-effective manner in the 21st century. Patients have a two-day itinerary that includes three scans and visits with five physicians. Mayo’s systems make for a unique patient experience. That doesn’t happen as often at other places. You could say optimizing the patient experience is in Mayo Clinic’s DNA!

What has life after training been like?

Life after training looks a lot like life during training. I’m still in the lab 90 percent of the time, developing new tests to detect and measure cancers noninvasively in the blood. I spend a half a day each week treating lymphoma patients and helping them through diagnosis, treatment, recovery and survivorship.

What are you most proud of on your CV?

I’m most proud of getting my Ph.D. in bioengineering. It was a difficult decision to pursue a Ph.D. after my clinical training, and it was a feat of willpower.

The accomplishment that has had the biggest impact is a recent paper in the Journal of Clinical Oncology, “Circulating Tumor DNA Measurements as Early Outcome Predictors in Diffuse Large B-Cell Lymphoma.” That’s the contribution to science that I’m most proud of.

How do you achieve work-life balance?

I married another physician, and we have a 6-month-old daughter, Arden. Before I got married, work was always No. 1, No. 2 and No.3. Having a child has been a big change. Being home with my daughter and taking care of her is one of the first things I like more than being in the lab.

I’m trying to work smarter, not harder. I’m working on developing better habits to work more efficiently. I have good collaborators and students who can help push projects forward. Medical science isn’t done in isolation — many hands and many collaborators can help take the pressure off and help with work-life balance.

What do you do in your spare time?

I enjoy family time. We enjoyed going to Sonoma and Napa and restaurants, but that’s all in the past for now due to the baby!

What advice do you have for medical students and trainees?

There are many paths you can take with a medical degree and many ways to make an impact. Clinical care is overwhelmingly important. Many others with medical degrees work in research, health policy and epidemiology. How we execute and deliver health care is really important too.

See past New Chapter stories here.