Not long ago, a diagnosis of multiple myeloma — a cancer of the bone marrow — carried with it a very poor prognosis, with median survival estimates of just two to three years. Now, thanks in large part to research and treatment advances at Dana-Farber/Brigham and Women’s Cancer Center (DF/BWCC), this disease is for many patients a chronic, and more manageable disease, with prognosis now improved to median survivals of seven to ten years.
Here is a look at how DF/BWCC physician-scientists and patients have helped lead the way toward improved treatment for multiple myeloma over the past three decades.
In prostate cancer – the most common cancer in men aside from skin cancer – scientists are working to answer some of the most basic questions about the disease while developing an array of new treatments.
Using the prostate-specific antigen (PSA) blood test, doctors are often able to detect prostate cancer at an early stage. But it remains difficult to determine which prostate cancers are likely to spread – and therefore require aggressive treatment – and which are either idle or slow-growing, and can be dealt with by “observation or active surveillance.” This uncertainty could result in unnecessary treatment for some patients.
Immunotherapy – stimulating the body’s defenses to recognize and destroy disease-causing cells and proteins – was dubbed the “breakthrough of the year” in 2013 by Science magazine. Dana-Farber researchers have contributed many important discoveries over the years about how the immune system works. Now, they are building on these insights to develop immunotherapy against tumors – known as immuno-oncology.
In 2005 Dana-Farber established the Cancer Vaccine Center (CVC) under the leadership of Ellis Reinherz, MD, Jerome Ritz, MD, and Glenn Dranoff, MD. The mission of the CVC is to translate the promising insights from basic immunology into therapeutics that benefit cancer patients. The CVC undertook a series of clinical trials exploring the biologic activity of autologous tumor cell vaccines and antibodies targeting negative immunoregulatory pathways in patients. These investigations contributed to the foundation underlying the FDA approval of the first therapeutic cancer vaccine (Provenege) and the first antibody antagonizing a negative T cell checkpoint (ipilimumab).
When cancer develops in someone with other diseases, it can be more serious, according to a recent annual report from several national cancer organizations.
“Cancer does not occur in isolation,” says Lawrence Shulman, MD, in commenting on the report. “It occurs in a human being, who may have other medical problems.”
For about 70 years, the standard treatment for patients with advanced prostate cancer was drugs that blocked male hormones feeding the tumor. If that stopped working and the disease progressed, oncologists turned to chemotherapy to kill the cancer cells.
This timetable is about to change. Results of a clinical trial led by a Dana-Farber researcher revealed that such patients lived longer if started on both a hormone blocker and a chemotherapy drug at the same time. The government-sponsored trial found that 69 percent of men receiving both treatments were alive at three years, compared with 52.5 percent of men who initially got just the hormone blocker. The advantage was so striking – especially for patients with greater degrees of cancer spread – that the National Cancer Institute publicized the findings ahead of schedule to alert doctors and patients.
“The results of this study are practice-changing for some patients,” says Christopher Sweeney, MBBS, clinical director of Dana-Farber’s Lank Center for Genitourinary Cancer, who headed the trial. We asked him to explain:
Ann LaCasce, MD, a medical oncologist in the Dana-Farber/Brigham and Women’s Cancer Center Adult Lymphoma Program, answered a variety of questions about Hodgkin and non-Hodgkin lymphoma during a live web chat hosted by Dana-Farber last month.
Experts with the U.S. Preventive Services Task Force (USPSTF) have recommended that current smokers and former-smokers who recently quit should undergo an annual low-dose CT scan to screen for lung cancer.