Doctors and patients gathered in Portland this weekend for a conference on blood cancers, organized by the Northwest chapter of the Leukemia and Lymphoma Society.
Roughly 1.3 million people in the United States are living with or are in remission from leukemia, lymphoma and myeloma, and leukemia remains the most common form of cancer in children and teenagers.
A team at the OHSU Knight Cancer Institute recently announced an initiative to develop treatments for a particularly complex and difficult to treat form of blood cancer: AML, or acute myeloid leukemia. Patients with AML have high numbers of abnormal immature white blood cells, which crowd out healthy cells in the blood stream and the bone marrow. The initiative is called “Beat AML.”
Doctors used to think of AML as a single disease, but Dr. Elie Traer, an oncologist at OHSU, says research has found dozens of different strains of AML. Each strain of the cancer is associated with a unique set of genetic mutations. The team at OHSU is collecting blood samples from 900 AML patients and is planning to sequence the genomes of their cancer cells.
“The real goal is to try to understand what are the genetic changes that cause a certain leukemia to be sensitive to a certain drug,” Traer said.
Traer says at present, genomic testing for AML patients is mostly used to identify which strain of the cancer they have and to predict whether or not they’re likely to survive. The team at OHSU hopes to identify a suite of drugs that will target the specific genetic driver of each type of AML.
“(That’s) opposed to what we do now, which is where we treat all acute myeloid leukemia patients with the exact same chemotherapy, even though we know they all respond differently. We just don’t have a better approach right now,” said Traer.
The research is funded by a grant from the Leukemia and Lymphoma Society, and made possible by the falling cost of sequencing DNA. In 2008, it cost about a million dollars to sequence the genome of a cancer cell; today, it costs less than $5,000.
OHSU is partnering with Intel and several biotech companies to analyze the data from the gene sequences they are gathering.
The genomes of cancer-causing cells are made up of about 3 trillion tiny building blocks called base pairs. Mutations can be large — involving hundreds of thousands of base pairs — or tiny, involving just one or two base pairs. Further complicating the picture, some mutations are actually harmless, making it challenging for researchers to pinpoint which ones cause cancer.
“Intel is working with us basically to work on the computing side of all this. They’ve been interested in this as a computational problem,“ says Traer.
The “Beat AML” team hopes to finish gathering genomic data and identifying potentially successful drugs within three years, and then to develop clinical trials after that.
Dr. Brian Druker, the director of the Knight Cancer Institute, is leading the initiative. Druker is known for his contribution to the development of Imatanib, one of the first drugs capable of targeting and blocking the action of a cancer-causing protein. The drug, marketed as Gleevac, has revolutionized the treatment of several types of leukemia.