Skip to Navigation Skip to Search Skip to Content
Search All Centers

How Gene Testing and Epigenetics Are Influencing MPN Treatment Approaches

Read Transcript Download/Print Transcript
View next

Published on July 14, 2014

As part of a roundtable discussion from the 2014 American Society of Clinical Oncology (ASCO) meeting, Dr. Ross Levine from Memorial Sloan Kettering Cancer Center discusses how the discovery of various gene mutations are affecting treatment of MPNs as well as the influence of epigenetics on the approach to treatment.

Sponsored by Incyte Corporation.

Featuring

Transcript | How Gene Testing and Epigenetics Are Influencing MPN Treatment Approaches

Please remember the opinions expressed on Patient Power are not necessarily the views of our sponsors, contributors, partners 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.

Dr. Levine:

There’s two immediate goals we should have. The first is exactly what you said, Srdan, which is that there are definitely some mutations, genes like ASXL1 or SRSF2 or IDH that we know, in every study that I’ve seen, really predict for patients that are going to do poorly.

And I think we need to rapidly make sure that we’re testing for those and probably, more importantly as you suggest. Srdan, figure out what we’re going to do about it—because it’s one thing to tell a patient, you know, this mutation suggests you’re not going to do well. But if they then say to you, what are you going to do differently? And they go, well, I don’t really have another approach, that’s not a very satisfying interaction, and it’s not a satisfying outcome for the patient. So I think we do need to think about whether transplant is an option for some of these high-risk patients.

Two really exciting things that I think, when the patient asks any of us, what’s coming, to me, there’s two really exciting things. And one of these we’re starting to see, and the other, I think we’re going to see. The first is that some of these new drugs, for example, the target IDH, or panobinostat, may affect things that are called epigenetics. And what is epigenetics?

Epigenetics is what tells a cell to be a blood cell or to be a cell in your hair or to be a cell in your hand even though you have the same DNA.

It really controls what we call cell fate or cell decisions. A cell is born, and it has to decide what part of your body to be. And it turns out that a lot of these drugs affect this black box called epigenetics, and what I like to call it is they’re reeducating the cancer cell.

You’re not killing the myeloproliferative cell. You’re not getting rid of it. You’re actually reprogramming it. You’re telling it to behave normally again. And there are a couple of things these drugs actually do. They actually restore those cells to normal functionality, and I think that’s an exciting concept that you’ve never seen before in these diseases.

We’ve seen a few leukemias where we can reprogram, educate them, but those are very rare successes. We’re going to broaden that out. The other area which I haven’t seen any data yet, but at least in my crystal ball, I think we’re about to see, is going to be the immune system. And every cancer at this meeting, except for leukemias, the exciting thing are all these new drugs, antibodies, small molecules that use the person’s own immune system to turn back on the disease they have.

And I think we haven’t seen the data yet, but, obviously, that’s the immediate question we all have, and I think our patients really want us to figure out how to use their own immune system beyond transplantation to do that. So there’s no data yet. But if patients ask me, what am I excited about seeing in six months to 12 months, it’s those two concepts.

Please remember the opinions expressed on Patient Power are not necessarily the views of our sponsors, contributors, partners 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.

View next