“Fortunately, the problems we are studying affect a minority of CML patients, but still this leaves some patients with no good treatment option at all,” said Thomas O’Hare, PhD, an HCI investigator and co-senior author of the study. He is also a research associate professor of Internal Medicine, Division of Hematology and Hematologic Malignancies. “Our goal is to have a TKI option for every patient.”
“We were able to sequence about 100 clinical samples, which gave us a very large body of data to shed light on the number of compound mutations and how they develop,” said Michael Deininger, MD, PhD, co-senior author of the study, a professor of Internal Medicine, and an HCI investigator. “One key finding was that compound mutations containing an already known mutation called T315I tend to confer complete resistance to all available TKIs.”
Working with HCI computational chemist Nadeem Vellore, PhD, the research team modeled at the molecular level why the drugs do not bind to certain BCR-ABL compound mutants. “This puts us in position to evaluate new drug candidates and work toward developing new treatments,” said O’Hare. “Computational analysis was one of the most interesting parts of the study. It not only confirmed what we found but showed the reason behind it,” said Matthew Zabriskie, BS, co-lead author of the study. “We’ve established what the next level of TKI resistance is going to entail.”
According to O’Hare, it is only a matter of time until analogous compound mutations emerge in many other cancers, including non-small cell lung cancer (NSCLC) and acute myeloid leukemia (AML). In these diseases, scientists and clinicians are still learning how to control single mutation-based resistance. “Our findings in CML will provide a blueprint for contending with resistance in these highly aggressive diseases as well,” he said.
In addition to Zabriskie, Deininger, and O’Hare, the study’s authors included 39 other researchers representing HCI, the University of Utah, and 22 other institutions worldwide. The article was dedicated to the legacy of Professor John M. Goldman of Imperial College London, whose work and mentorship made a major mark on the field of CML. “His passing in December 2013 left a very big gap in the CML community,” said Deininger. This study was supported by the Leukemia & Lymphoma Society, the American Society of Hematology, Howard Hughes Medical Institute, Huntsman Cancer Foundation, and the National Institutes of Health/National Cancer Institute grants P30 CA042014 and R01 CA178397. # # #
About Huntsman Cancer Institute at the University of UtahHuntsman Cancer Institute (HCI) is one of the world’s top academic research and cancer treatment centers. HCI manages the Utah Population Database - the largest genetic database in the world, with more than 16 million records linked to genealogies, health records, and vital statistics. Using this data, HCI researchers have identified cancer-causing genes, including the genes responsible for melanoma, colon and breast cancer, and paraganglioma. HCI is a member of the National Comprehensive Cancer Network (a 23-member alliance of the world's leading cancer centers) and is a National Cancer Institute-Designated Cancer Center. HCI treats patients with all forms of cancer and operates several high-risk clinics that focus on melanoma and breast, colon, and pancreas cancers. The HCI Cancer Learning Center for patient and public education contains one of the nation's largest collections of cancer-related publications. The institute is named after Jon M. Huntsman, Sr., a Utah philanthropist, industrialist, and cancer survivor.