Sunday, February 24, 2013

ASH 2012: Dr. Tom Kipps on Genetics, Epigenetics, and Targeted Therapy

In the third of a four part interview with my CLL doctor, Dr. Tom Kipps out of UCSD, we hear him present a vision of the future of "personalized" cancer therapy in general and CLL in particular.

But he also tells us what targeted therapies are available right now in clinical trials near you.

In CLL, it is less about the genetic code and more about the epigenetics. This crucial and relatively recent understanding has been critical in advancing therapies because the pinpoint DNA damage seen in CML such as the telltale fused Philadelphia chromosome are frustratingly less of a glaring target in CLL. However, when the researchers instead started identifying the overly activated pathways in our clonal B cells, the progress sped up in decoding and quickly thereafter, controlling our disease. Dr. Kipps walks you through the difference in these approaches.

Dr. Sharman talks about this insight in one of my prior post, and here Dr. Kipps makes it all easy to understand. He also explains combination therapies, the importance of the new and old generations mAbs (monoclonal antibodies) including 1st generation rituximab, 2nd generation ofatuzamab, and the promise of the powerful 3rd generation GA-101 or another mouthful of a name, obinutuzumab, all directed at CD20, re-use of some drugs already approved for other cancers, and CAR-T therapy

Eleven minuted well spent. Dr. Kipps breaks it all down into bite size pieces.

Learn and enjoy:

Part Four with Dr. Kipps will be coming soon and I still have Drs. Wiestner and Furman in the video vault. ASH 2012 was an amazing meeting, jam-packed with hope and good news for those of us with CLL.

Personal notes:

I am still waiting for my final bone marrow biopsy report from OSU done Feb 5, 2013. FISH and cytogenetics should be back by now, and I hate the suspense.

Back home from studying hematology for hematologists at the 17th Annual International Congress on Hematologic Malignancies – Focus on Leukemias, Lymphomas, and Myeloma in Manhattan and the MDACC hematology board reviews, so I can be more fluent in speaking about the buzz around small molecules such as ibrutinib, ABT-199 and idelalisib in treating other B-cell lymphomas in particular and blood cancers in general.

I will also return to posting more on the personal and human aspects of dealing with an incurable cancer, but for right now, my priority is to get all the remaining ASH 2012 videos online over the next few weeks.

Next weekend, I am off to Washington DC to lecture to the National Sleep Foundation on "The Sleepy Patient". Then I am home for several weeks in a row. Yeah!

In the spring and fall, I will be flying all over the place again teaching other doctors about anemia (MDS or myelodysplastic syndrome that can be a challenging late complication of CLL and some of the chemotherapy used to treat it), gout and thyroid disease. I will be posting my ASH 2012 interviews with Dr. Steensma on MDS here soon.

For any health care providers reading this blog, and to anyone else interested, for another few weeks until March 6, 2013, at Primary Issues, an online medical journal, you can receive ACCME accredited CME on the recognition and early lab testing of CLL or just learn from my article and interviews with Drs. Wiestner and Kipps done at ASH 2011. That San Diego meeting 14 months ago is where I made the fateful decision to enroll in the clinical trial NCT01217749 at OSU that has served me so well.

My love is teaching and my special love is teaching hematology and making sure that the patients and their providers are teamed together to offer the best possible care for each individual case. That's what I want to do more and more.

I am hoping to find some funding do more of these interviews and news coverage for patients and healthcare providers alike, to expand beyond the big ASH meeting to ASCO and IWCLL and more. Next up will be ASCO at the end of May, where I bet there will be important updates on ibrutinib, idelalisib, ABT-199, obinutuzumab and others.

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Blogger Wayne said...

Hi Brian,

Very good interview with Dr. Kipps. Glad you got into the subject of "off-label" drug use and the possibility it affords,37 Jesseme bringing patients quicker and more targeted therapy choices.

Kipps gave the best short version of why epigenetic research is so important and specific to CLL/SLL.

As a fellow Lab Rat(-; Your focus on patient benefit for considering Clinical Trials at this stage in new drug development is well argued both for advancing research and better treatment outcomes for those who enroll.

For future interviews, I would look forward to a discussion on autoimmune related disorders to include non-hemic as well as the more common hemic disorders of AIHA & ITP.


February 25, 2013 at 2:06 PM  
Blogger Shulamit said...

Brian-- Thanks so much for the interviews with Dr. Kipps. He expresses himself clearly and with underlying passion. It's good for us CLL-ers to learn from all your interviewees that there are so many promising potential treatments in the pipeline.

February 25, 2013 at 3:51 PM  

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