Choosing an effective leukemia treatment is an educated guess based largely on decades-old diagnostic methods. Dr. Jerald Radich calls it “the biology of luck.”
Radich, a molecular biologist in the Clinical Research Division at Fred Hutch, is working to improve the odds. His research is helping doctors decide what therapy is likely to produce a lasting response and determine early on whether a patient in remission is likely to relapse so they can intervene sooner rather than later.
“Everyone has a story about someone who was expected to do well after treatment but relapsed, and someone who wasn’t expected to do well but stayed in remission,” Radich said. “If we can predict response, we won’t waste time on treatments that are going to fail and can try other approaches.”
Radich’s research has led to important breakthroughs in leukemia detection and treatment since he came to the Hutch 25 years ago. His work involves sniffing out tiny numbers of cancer cells based on their genetic signature. “It’s all about finding the needle in the haystack,” Radich said.
Radich was part of a team that developed a test that can detect extremely small numbers of cancer cells in chronic myeloid leukemia patients following treatment. The test involves a technique known as polymerase chain reaction that is thousands of times more sensitive than previous methods. By measuring even tiny traces of cancer, the test helps doctors gauge a patient’s risk of relapse and start an alternative treatment before the disease progresses.
Besides helping doctors make better treatment decisions, the test promises to speed development of new treatments. “We can shorten the length of clinical trials because we can have answers in a year rather than waiting five years to see how well a treatment works,” Radich said. In partnership with private industry, Radich built an automated version of the test—an especially useful tool in developing countries because it requires little technical training.
Radich grew up building stuff. “My dad loved to tinker, invent, and rebuild,” he said. “Our garage was filled with welders, an engine lift, everything you needed to build anything out of anything. We used to do things like haul home an abandoned Jeep, tear it apart and rebuild it.”
Radich was leaning towards literature and fiction writing when he went to college. Instead, a molecular biology class ignited a passion for discovery and pointed him toward a career in medicine. After graduating from medical school at the University of California Davis, he continued his training at University of Washington and the Hutchinson Center before joining Fred Hutch in 1990.
“I knew when I started medical school that I wanted to specialize in cancer because it was the best opportunity to use my molecular biology training to help desperately ill people,” Radich said. “Nothing is more rewarding than seeing patients come back to the Hutch cured of their disease.”
Radich is currently leading a national study of acute myeloid leukemia patients. The study compares those who respond to standard therapy with those who don’t. The goal is to identify the types of cancer cells that resist treatment so doctors can choose therapies that target those specific types of cells.
Radich expects they’ll soon have a test – similar to the CML test – that can quickly tell which AML patients won’t benefit from standard therapy and should instead pursue experimental treatment. By better understanding the biology behind poor response, Radich is improving the way leukemia is diagnosed and treated – and changing bad luck to good.