Published on September 3, 2020
When will there be a cure for Waldenstrom Macroglobulinemia?
What does the future hold for Waldenstrom's macroglobulinemia patients? How far have we come in the treatment for Waldenstrom? Dr. Stephen Ansell, professor of medicine, Department of Hematology, and chair of Lymphoma Group, Mayo Clinic, joins Patient Power co-founder Andrew Schorr to provide comprehensive answers to these questions. Dr. Ansell also explains targeted therapies and the micro-environments of cancer cells. This program is an overview of Dr. Ansell’s recent presentation at the IWMF conference.
Watch the full discussion.
Transcript | Will There Be a Cure For Waldenstrom Macroglobulinemia?
Hello, and welcome to Patient Power. I'm Andrew Schorr in Southern California. Joining me from the Mayo Clinic in Rochester, Minnesota, is Dr. Stephen Ansell, Professor of Medicine there and a leading researcher. Dr. Ansell, thanks for being with us on Patient Power.
Oh, my pleasure. Thank you for having me.
So, people living with Waldenstrom's want to know, is there research progressing that could someday lead to a cure?
Is there hope for a Waldenstrom's cure?
If one casts your mind back 10 years, maybe even 15, and you said, "What did we know about Waldenstrom's 15 years ago?" The answer was, "Very little." We basically had borrowed much of our knowledge from other diseases. Myeloma, some lymphoma, some CLL. But really, very little specific work had been done in Waldenstrom's macroglobulinemia itself.
Since then, a dramatic change has happened. That change has come from good understanding of the biology of Waldenstrom's, a greater understanding of the genetics, really understanding what drives the whole malignant process, and a lot of work done on the microenvironments in which these malignant cells live that really is fostering the growth and success of the cells and the production of this IgM protein.
So, that has really then led to targeted therapies that are really effective in switching off this malignant cell, shutting down its production of IgM, making the environment unfavorable for its growth. And that has now resulted in very effective therapies and substantial improvement in patient outcome. If you really think back to what we knew about Waldenstrom's and how long patients lived, it's almost tripled, even more potentially than that, over the course of 15 to 20 years, purely because of the research that's got in. So, we haven't got to the cure yet, but if you look at that trajectory, one is pretty optimistic that you're going to see, in the next five to 10 years, potential cures for this disease.
So, we've heard so much over the last few years about targeted therapy going right for the cancer cell, but you're talking about this world that the cancer cell lives in and gets its strength from. So, you're kind of treating the whole forest and not just the individual trees, right?
Correct. So, I think there's real merit in targeting the cancer cell. That's true. But I think one of the things that drives home to me, this concept of microenvironment, is if you take a Waldenstrom's cell out of the bone marrow and you put it in a dish and try and get it to grow, it's extremely difficult. And in fact, these cells almost never grow. They clearly need an environment that is favorable and helps them grow.
And I think, again, Waldenstrom's macroglobulinemia is very interesting because it likes the bone marrow. For whatever reason, it really seems to grow very well there. We've learned there are lots of proteins and cytokines and other immune-active ligands, all of which really promote the growth and success of those cancer cells.
So, it's a little bit like the analogy of a nasty neighborhood that really facilitates bad actors. If you suddenly come in and police that neighborhood and take care of things and move out the troublemakers, often that neighborhood then becomes much more favorable and fewer of those bad elements succeed. That's really what we're trying to do when we're changing the microenvironment, is to make it good for good cells and bad for bad ones.
The Importance of Clinical Trials
So, how could patients help you? You're a researcher. Is it, be in trials? What'll help you move further to that goal of a cure, faster?
So, I think your point is exactly right. The thing that we need to do is to test out what we're finding in lab work, in patients. Because often what works in the lab doesn't work for patients, and I think what's really important is to test things in clinical trials. So, as new therapies become available, building on that basic research, patients can really help by participating in the trials.
But sometimes even when you're at universities or other kind of academic centers, you can participate in studies where you provide patient specimens, bone marrow specimen, blood work, et cetera, which can be used for some of the basic research. So, there are two ways I think in which people can really help. That is, providing their tissue and providing themselves in clinical trials.
You as a researcher, for patients, you're very optimistic?
Correct. So I think again, and I'm not just talking just to talk, I think we can look back over a history of fantastic progress made in Waldenstrom's. And if I was to draw a graph from where we were to where we are now, that's a line straight up. And if I say, if we can keep that trajectory going, I would anticipate that we would see even greater success as we look five, 10 years down the line.
Dr. Stephen Ansell, from the Mayo Clinic in Rochester, Minnesota, thanks so much for an upbeat message.
Well, thank you.
I'm Andrew Schorr. Remember, knowledge can be the best medicine of all.