United against myeloma
Kenneth Anderson, M.D., confers with patient, Ron Burton, former New England Patriots star running back and a strong supporter of Dana-Farber and the Jimmy Fund for nearly two decades. Now an inspirational speaker and director of a nonprofit camp in Hubbardstown, Mass., that provides athletic and academic opportunities for inner-city children, Burton was diagnosed with multiple myeloma in 1999. Accepting the Jimmy Award last year for his dedicated volunteer work, Burton said, "I am standing on my own two feet. Dana-Farber turned my life around."
To visit the Lipper Center is to witness a revolution in the way myeloma is studied and treated. The center — named after Jerome Lipper, a prominent lawyer and Dana-Farber patient who died of multiple myeloma in 1991 — is a group of laboratories in the Louis B. Mayer Building. There, some 14 scientists and postdoctoral fellows from countries as widely dispersed as the United States, India, Japan, Austria, Germany, Taiwan, and Singapore probe the inner workings of myeloma cells in hopes of developing new therapies. The researchers are so diverse that Anderson lightheartedly refers to them as the "United Nations against myeloma."
The focus of their research is worlds removed from traditional chemotherapy. The aim of chemo and radiation therapy — for more than 25 years the standard treatments for multiple myeloma — is to home in on myeloma cells and destroy them. The regimen can extend patients' lives by an average of three or four years, and high doses of chemo can lengthen the time when patients are free of active myeloma, but it doesn't prolong their overall survival.
"The limitations of conventional therapy make clear the need for new approaches," Anderson says. "At Dana-Farber, we've taken a broad perspective that includes, but isn't limited to, myeloma cells themselves."
Although research at the Lipper Center includes dozens of individual studies, the work is moving along four main tracks: investigations of the genetic abnormalities of myeloma cells; studies of the circuitry that enables myeloma cells to grow and resist chemotherapy; efforts to unleash the power of the immune system against myeloma; and explorations of the way myeloma cells interact with their environment in the bone marrow.
"I'm lucky to be alive, in as good shape as I'm in, and to have had good doctors. Ken Anderson certainly leads that list."
— Joseph Schwarz, Ph.D., 17-year cancer survivor
Some of the most exciting projects are in the final category. "We know that chemotherapy works by targeting and destroying myeloma cells," Anderson says. "The aim of our current research is to understand the relationship between myeloma cells and their 'microenvironment,' the bone marrow cells among which they live. Ultimately, we want to develop and test therapies that make the bone marrow inhospitable to myeloma cells — that, in effect, evict myeloma cells from the neighborhood."
One agent that seems able to do that has a familiar, if notorious, name: thalidomide. The drug, which caused thousands of birth defects in the 1950s and '60s when taken during pregnancy, has a potent effect against some cancers (see page 8). At the Lipper Center, investigators have sought to discover how thalidomide achieves its anti-myeloma effect.
"We found that thalidomide works in several ways," says Faith E. Davies, M.D., a postdoctoral fellow at the Lipper Center. "It not only acts on myeloma cells themselves, killing them or causing them to become dormant, but it also acts on their environment, reducing the cells' ability to stay in the marrow."
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