Breakthroughs in Lymphoma and Other Blood Cancers

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Although there are 70,000 new cases of lymphoma diagnosed every year, new treatments are allowing patients to live long, productive lives. Learn about the new drugs and research in the area from Dr. Andrew Evens, a hematologist/oncologist and assistant professor in hematology/oncology at the Robert H. Lurie Comprehensive Cancer Center of Northwestern University. Host Andrew Schorr, a leukemia survivor himself, also provides insight into how blood cancer research is doing wonders for patients.

Dr. Evens, a lymphoma expert, brings back the latest findings from the American Society of Hematology, or ASH, meeting in Orlando. ASH is the annual world-wide meeting where doctors from around the world come together to share research ideas. Andrew and Dr. Evens discuss successes that came from past conferences, as well as the new and exciting drugs becoming available now.

Andrew and Dr. Evens explain the significance of targeted therapies, combination therapies, and clinical trials. Traditional chemotherapy treatment kills not only bad cells but good ones, targeted therapies attack the cancer cells more directly, causing fewer side effects than chemo. This “cruise-missile” type of drug is, according to Dr. Evens, one of the most promising advancements in modern cancer research. Andrew describes the different drugs associated with leukemia treatment, specifically rituximab, which is a targeted treatment for lymphomas as well. They describe how doctors are combining different treatments to give their patients the best chance at remission, and how they test new combinations in clinical trials.

Some types of lymphomas are more aggressive than others, but the median survival rate for lymphomas continues to grow. Even if they aren’t yet curable, many lymphomas are quite treatable. Patients can go into remission for long periods of time, or many may simply go in for more treatments when the cancer returns, making the illness more chronic than fatal. Given this new environment, Dr. Evens talks about the importance of setting goals and understanding what your options are. Listen to this webcast to learn why leaders in the lymphoma research community are encouraged by what they are finding.

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Transcript

Andrew Schorr:

Good morning wherever you may be around the country or on the Internet around the world. I am Andrew Schorr here every week helping you make smarter healthcare decisions. Every week we talk about very significant health problems, and what I try to do is take a look at when there are big medical conventions or conferences, which is where a lot of research gets presented. We the patients, and as our announcer Carline said, I’m a 10-year leukemia survivor. I have no sign of the leukemia now because I got advanced care, and I was in a clinical trial, and we’ll talk about that as we go along, but that cancer could rear its head again. What will be the right treatment for me? So that may be something that’s discussed at one of these meetings because I want to know is there something better and what’s optimal for me with the fewest side effects, the best chance of beating the cancer or certainly beating it back so I can go on with my life.

We had such a medical meeting just in the last week. It’s called the American Society of Hematology or ASH meeting, and that was down in Orlando, Florida at the big convention center there not far from Disney World, and with us today is a cancer expert who can help us understand what happened, and that expert is Dr. Andrew or “Andy” Evens. He’s a hematologist/oncologist and assistant professor in the division of hematology/oncology at the Robert H. Lurie Comprehensive Cancer Center of Northwestern University. Dr. Evens, thanks for being with us.

Dr. Evens:

Thanks. No problem Andrews.

Andrew Schorr:

So you were down at the ASH meeting. Now I know that you’re a specialist in lymphoma, and that’s sort of the most common blood-related cancer, and then there are a number of leukemias that follow as well and multiple myeloma, and I’d like to bring those in as well. First of all, the overall tenor of the meeting; there are about what 20,000 to 30,000 doctors who go?

Dr. Evens:

That’s right. It’s a huge meeting down there, and it really is our big annual world-wide meeting where not just the U.S. but literally everyone from all over the world comes to Orlando and really shares research ideas but in a formal manner where there are oral presentations and you submit ahead of time your research, and really the best of the best or the most important and novel get accepted, and you present them in front of your peers, or we even have poster board presentations where you make a poster and stand by the poster and other doctors come through and you discuss it.

Andrew Schorr:

I like to describe it as sort of the “World Series” of blood-related cancers.

Dr. Evens:

It really is. It’s big. Now, there certainly are smaller meetings throughout the year, but this is kind of the as you said the “World Series” or the “Superbowl” of our hematology meetings.

Andrew Schorr:

Let’s talk about some of developments that have happened in years past. Now the big one was a few years ago. There was actually an anti-cancer pill, if you will, Gleevec. Some people may have heard of it. It was on the cover of all the big news magazines, and that’s a pill that’s allowed people with one sort of leukemia, CML or chronic myelogenous or myeloid leukemia, to take this pill and many people who otherwise would die to live and live a pretty normal life. So that was a, wouldn’t you agree that was a major, major breakthrough that cancer specialists dream about?

Dr. Evens:

It was incredible, and I remember how many years now, it probably was eight years ago or nine years ago when it first came through clinical trials, and at the time that disease CML or chronic myelogenous leukemia, it usually is chronic but sometimes it can become very aggressive, and I remember at the time I was just finishing my training at the time of the clinical trials. There are different types of clinical trials called phase 1 that are at the first step where they’re just trying to find a dose, and then once you find a safe dose phase 2, and usually in phase 1 you don’t see that many patients necessarily getting into remission, but I remember that these were patients who were very sick, and at the time it was really the first of its kind, this targeted cancer therapy as a pill. At the time patients had been getting huge IV chemotherapy, big doses, or bone marrow transplants and coming in very sick. We’d give them a pill, and they would come back two weeks later, unbelievable, feeling great and a few months later in complete remission. It really, really set the standard for not only oncology but I think all of medicine trying to really be more targeted.

Andrew Schorr:

Right and the magic bullet, and I have a friend Jane, and she was a sick puppy, and they were wondering would she need a bone marrow transplant, and she takes those Gleevec pills. Now there is one approved successor or a medicine to help with people who didn’t respond for some reason to Gleevec, and there is another one coming.

Dr. Evens:

That’s right.

Andrew Schorr:

I know there is more research even to look at what they called the, is it the multikinase inhibitors, but looking at were there yet other developmental medications that can round this out so that more people with these conditions can be helped. So I know that’s pretty exciting.

Okay well let’s talk about some of the, now that was kind of a big on the “Today Show” on every news magazine kind of news.

Dr. Evens:

It was huge. Yes it was literally a home run.

Andrew Schorr:

Yes, that was a home run. We wish that that could happen every year in our fight against cancer. That wasn’t this year, but just as an overall tenor of it, was the meeting upbeat?

Dr. Evens:

I think so. It was, and yes it’s hard because we want every new drug to be a home run, but usually in most situations it’s a lot a singles; maybe in a few doubles here and there; but yes, I think with this meeting it was positive. There was really nice progress made in multiple areas. I pay a little bit more attention to the lymphoma but keeping an eye out on some of the leukemias and multiple myeloma really just across the board I think nice progress has been made.

Andrew Schorr:

Now I’ll just give my personal example and how this applies. So my doctor, I was in a clinical trial, is a fellow named Michael Keating who has devoted his life to a condition called chronic lymphocytic leukemia. So as you know there was a pill that people took that was marginally effective called chlorambucil or Leukeran, and people took it around the world.

Dr. Evens:

Right.

Andrew Schorr:

And then they tried a single-agent chemotherapy, fludarabine, and that did better, and then they said well let’s combine that with Cytoxan, another drug used a lot in breast cancer, and then they did better and that research at a program like this at the ASH meeting, and then they said let’s add a monoclonal antibody, a kind of non-chemotherapy, targeted therapy Rituxan, and for me at least being in a clinical trial over almost 6 years now that continues to have worked. So the monoclonal antibodies have been exciting and remain a very important area of research right?

Dr. Evens:

Absolutely. That one in particular was called rituximab, and that targets B-cells, which CLL is; it’s a malignant B-cell disease, and most of lymphomas are B-cells, and thankfully right we’ve learned that this rituximab works in many different lymphomas, different kinds of lymphoma, and also in this CLL, and that’s really the future. The future of oncology is finding targeted medicines hopefully with not a lot of toxicity and certainly along with that hopefully high remission rates.

Andrew Schorr:

Well it worked for me, and the treatment that I received is what many people receive nationwide and some worldwide now. When we come back after the break Andy, what I want to do is discuss lymphoma since that’s really the most common blood-related cancer and what’s going on there.

Welcome back to Patient Power live on HealthRadio Network. Andy we were talking about this American Society of Hematology meeting that ended just about a week ago in Orlando, and you being sort of our news reporter on what happened, and your special area is lymphoma, and that is I guess the most common blood-related cancer. So that’s what 40,000 to 45,000 new cases a year? Is that right?

Dr. Evens:

A little bit more, and it’s that lymphomas probably are going to near 70,000. It’s right around 66,000, and that’s including Hodgkin lymphoma, which used to be known as Hodgkin’s disease, which accounts for about 8,000, and then the non-Hodgkin lymphoma, which is right around 60,000. That’s one thing where we’re dedicating research because it still is increasing in the United States and elsewhere, the incidence. We get asked that a lot; what causes it, why; and the honest answer is still we don’t know. We have some theories, but it’s still a really active area of research as well in addition to treating the disease.

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