While reviewing my ASH notes and related posts, I wanted to highlight this paragraph from one of my articles about vaccines and immunotherapies from two weeks ago:
A number of recent studies came to similar conclusions. Taken together, they reiterate what has long been known but not quite grasped in such detail: that even a single cancer patient carries a private ecosystem of pathology within her body, a tropical rain forest of disease. If the old chemotherapies and radioactive treatments worked like napalm to blast away the canopy, the new breed of personalized therapies target only specific plants. For some cancers, the more homogeneous ones, they do the job just fine. For others, though, the approach comes up against the relentless rules of Darwinian selection. Wipe out one subtype of a cancer — the clone that seems most aggressive, say, or the one that’s most prevalent in a biopsy — and you may have slowed the disease or thinned it out. But the cells left behind might represent a fitter strain and fill the niche.
Pay special attention to the part that I’ve highlighted in BOLD. This was the focal point at several large, important oral presentations at ASH; how current novel therapy agents only wipe-out a few types of myeloma cells, leaving clones behind that eventually emerge stronger and more aggressive.
These drug resistant clones are where researchers need to focus their attention. Some are, but as odd and discouraging as it sounds, they are just starting to understand the anatomy of our disease.
As a matter of fact, several seemed pleased with themselves that they are figuring this out. NEWS FLASH: It’s 2013, people! And you’re just learning how myeloma cells act and react now?
What can I say? Better late than never? ARGGGG!
Feel good and keep smiling! Pat
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