Alan Holtzman felt that an angel was on his shoulder when a chance meeting with another CLL patient directed him to a leading specialist. Watch his story.
Why do I have lung cancer if I’ve never smoked? Dianne Stewart, a stage IV cancer patient, asked herself this question following her diagnosis. Hear about her initial stage of shock and denial and her advice for others.
February 13, 2014
Dr. Leo Gordon, from Northwestern Memorial Hospital, reviews the developing paradigm shift in the way that lymphomas are treated. He talks about the move from aggressive chemotherapy to more targeted treatments and explores how new categories of medicines, such as monoclonal antibodies and targeted small molecule inhibitors, or pills, may allow people to manage their disease as a chronic condition. Overall, Dr. Gordon is overwhelmingly positive about the future of treatment for lymphomas with novel therapies currently in clinical trials and those that are still in the early stages of development.
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Please remember the opinions expressed on Patient Power are not necessarily the views of Northwestern Memorial Hospital, its medical staff or Patient Power. Our discussions are not a substitute for seeking medical advice or care from your own doctor. That’s how you’ll get care that’s most appropriate for you.
Hello and welcome to Patient Power. I'm Andrew Schorr. This program is sponsored by Northwestern
Memorial Hospital, and we're on location in New Orleans, Louisiana, where we're
at the American Society of Hematology meeting.
This is really the world series of discussions about blood-related
cancers, and with us is Dr. Leo Gordon from Northwestern Memorial
Hospital, the Feinberg School of Medicine, the Lurie Comprehensive Cancer
Center. Dr. Gordon, you specialize
in particularly some indolent blood cancers like chronic lymphocytic leukemia,
follicular lymphoma. This is an exciting
meeting for these illnesses and hope for people I would think with these
Sure. This is a very
exciting meeting. We've seen really a
change in paradigm in the way we think about lymphomas in general, low-grade
lymphomas and chronic lymphocytic leukemia in particular, primarily because the
thinking has moved somewhat away from aggressive cytotoxic chemotherapy to—and
it's been doing this for a while—but to much more targeted type of treatment
starting with antibody therapy—drugs like rituximab (Rituxan) and some newer
monoclonal antibodies that are going to be discussed at the meeting today all
the way to much more targeted small-molecule inhibitors of pathways that we're
now understanding to be important in the pathogenesis of these diseases.
Okay. So now we're
talking about when you say small molecules, pills that someone might take, and
that controls their illness better than ever before and hopefully with minimal
That's correct. I mean I
think we are talking about pills. We're
beginning maybe to get to the point where we can think about these diseases as
chronic diseases but in a way that we've been thinking about maybe hypertension
and diabetes as chronic diseases, if in fact these pills fulfill the promise
that we've seen so far. And there are
some very nice examples. There is a drug
called ibrutinib (Imbruvica), which has just been approved for mantle cell
lymphoma, but it's also about to be approved for CLL.
So at Northwestern you help lead research there and you see
patients. So when people sit down with
you have more tools to discuss both approved and in research.
…to see what's right for their specific situation.
That's right. I mean I
think we have the opportunity to do that.
Just being a research institution, we have the opportunity to both take
care of patients and to at least think about novel therapies, therapies that
we're doing clinical trials with and also therapies that we're trying to
develop in the preclinical sense. We've
been working with nanotechnology and nanoparticles and lymphoma especially and
are excited about that prospect.
But there are drugs that are currently in clinical trials. There's a drug from AbbVie, ABT-199, that has
really very potent activity in chronic lymphocytic leukemia. We've seen patients where blood counts will
go from near 300,000 to almost normal within 24, 48 hours with an oral drug. And so those trials are ongoing. We're very excited about those.
We're very excited about drugs like ibrutinib and idelalisib,
drugs which inhibit different components of the pathway down—what we consider
to be downstream—from something called the B-cell receptor, which seems to be
important for B-cell development and B-cell growth, and these are B-cell
malignancies that we're talking about.
One other point I wanted to make is I know some of the data is
suggesting that even people with some of the most aggressive forms of these
diseases, where there was less hope before, these drugs are showing utility for
Absolutely. In CLL, the
patients with 17p deletions, that particular group of patients that have that
molecular abnormality, had a more difficult time. The responses didn't used to last as long,
they weren't as good, and we were really thinking allogeneic stem cell
transplant for those patients. And still that's part of the mix, but I think we
need to see—and it looks very promising so far—what these new drugs bring to
that group of patients, a little more aggressive group.
Dr. Gordon, how you feel about things is sort of a
barometer for patients? So you've been
at this a while. How positive, hopeful
are you feeling today?
I'm positive enough that I wish I could start over again right
now. I mean I think being where I am in
my career, I'd like to be sort at the beginning so I can see these things to
fruition. And I think the next generation of investigators and clinicians are
going to be at a great—kind of a golden era I think. And it's because of the basic research that's
gone on. It's because of our
understanding of the molecular pathways, and it's an even better reason that
funding from NIH, from NCI needs to continue—and needs to not just continue,
needs to increase and we think of funding for the national defense. There is no better national defense than
Okay. So for we patients,
we all have to write our congressmen, let them know.
You need to write your congressman every day, absolutely.
Thank you so much for your leadership at Northwestern, your
devotion to this, and hope you still have a ways to go in your career…
…and you can see this blossom.
Dr. Leo Gordon, thank you so much.
Thank you very much.
…for being with us. It's
really a very encouraging time for those of us affected by these conditions and,
of course, so important to have a dialogue with a specialist such as
Dr. Gordon to see what's right for you.
Thank you for joining us.
I'm Andrew Schorr. Remember,
knowledge can be the best medicine of all.
Dr. Bob Boyd, a former OB-GYN, was diagnosed with advanced cancer after a routine exam. Now, as a survivor, he gives hope to the newly diagnosed and encourages other survivors to do the same. Watch.
Published: November 7, 2013
Could a patient's own immune cells soon be used to fight their cancer? Dr. Laurence Cooper, from MD Anderson Cancer Center, explains exciting developments in gene therapy.
Published: December 19, 2013
New oral medicines are showing increased effectiveness in reducing tumors for patients with certain subtypes of non-Hodgkin lymphoma. Watch now as Dr. Wyndham Wilson of the National Cancer Institute answers questions about why the scientific community is so excited about these study results.
Published: July 6, 2013
By Andrew Schorr