A researcher at Dartmouth Hitchcock Medical Center has found what may be a way to improve treatment for adults who have a common form of leukemia.
The recently published study shows that two drugs may be better than one.
Chronic Lymphocytic Leukemia, or CLL, accounts for about one third of all leukemia cases in the United States, and about 4500 people die from it every year.
It is a slow growing cancer, which means it is relatively easy to study in human patients.
Alan Eastman, a researcher at Dartmouth Hitchcock, says that when it shows up in blood, it is relatively easy to target with medication. But when it hides out in lymph cells and bone marrow, it can resist treatment. Eastman has found that combining two drugs can help break down that resistance.
“And it’s knowing how the two different drugs work independently and then being able to understand why the cells in that lymph node are resistant. We recognize that drug B, the Gossypol, would actually overcome the resistance that would come from Navitoclax, the other drug,” Eastman explained.
Eastman says both drugs in this one-two punch still need to go through clinical testing. He’s grateful to patients who took part in the research.
One of those is Margarita Pulaski, who was diagnosed with leukemia about eight years ago. At 73, she has started chemotherapy, and she’s hopeful that the lab research done in part with her blood cells will pay off for her and others in a few years.
“Other than sitting there and just giving blood, I really did not know that I would be informed as to how this would end or whether I would be around whenever they came up with whatever they were going to come up with,” Pulaski said. “So you know I did read the study, I read the information that’s been put out and it’s very promising.”
Promising, perhaps, but not yet definitive.
Jeremy Abramson also read Eastman’s study. Abramson directs the Center for Lymphoma at Massachusetts General Hospital in Boston, and he, too, sees value in Eastman’s findings. But Abramson says there may be even more promising drugs in clinical trials. The question is whether they, too, will combat resistance and make cancer cells easier to target.
“And so understanding the mechanisms of resistance and designing clever ways to overcome those mechanisms of resistance at a biological level is really part and parcel of this next phase of developing targeted or personalized medicine for cancer,” Abramson said.
Abramson is not sure that the particular drugs in Eastman’s study will end up being the best ones in an oncologist’s tool box, but he says the Dartmouth research is exciting because it shows that combining drugs can outsmart certain cancer cells.