patients in much better shape.” The hypothesis turned out to be true.
Later improvements in treatment such as a “tandem” transplant technique in which patients receive two smaller, more easily tolerated doses of chemotherapy to kill the cancer cells rather than a more toxic single dose, helped reduce the mortality rate even further. Before stem cell transplants, only five percent of myeloma patients lived 10 years beyond their diagnosis. Now 50 percent live 10 years or longer, and about 15 percent show no evidence of the disease progressing after 14 years of follow-up.
“The next step—not only to get patients in remission, not only to help them survive 10 years, but really going for the cure—needs to come from an interaction of basic science with clinical work,” says Tricot. “That’s why I’ve come to HCI. I want to work in a place where physicians interact with basic researchers, where people can cooperate and collaborate,” he says.
Tricot’s ongoing clinical research involves the microenvironment in the bone marrow. As myeloma cells grow, they shift the environment in the bone marrow so it favors their own growth instead of supporting normal blood- forming cells. Even after chemotherapy, the altered microenvironment allows some myeloma cells to survive. Initial studies using chemotherapy
Patients from all over the world are treated in Huntsman Cancer Institute's Myeloma Program, including James Rollings from Virginia.
drugs that not only killed the myeloma cells but shifted the microenvironment back to normal are proving effective, especially in patients with the most deadly kinds of myeloma.
In patients whose myeloma recurs after treatment, the tumor cells that come back are often resistant, or less sensitive, to chemotherapy. The myeloma cells have found ways to keep the chemotherapy drug from getting inside, or they may excrete it quickly before it damages them. Tricot’s research investigates immunological therapies that recognize the cancer cell from the features of its outer membrane. “We’re working
on immunotherapies that can tell which cells ‘don’t belong’ to remove any populations of myeloma cells that remain after transplantation,” Tricot says.
Investigating, developing, and testing these techniques will create the unique new treatments that draw myeloma patients from around the world. It’s one example of HCI’s philosophy of linking the laboratory to the clinic.
2007 Annual Report 3
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