Clinical Research Division, Fred Hutch
Kurt Enslein Endowed Chair
Dr. Jerald Radich is a medical oncologist who specializes in the molecular genetics of leukemia. He studies genes and other molecules that signal treatment response, progression and relapse. Dr. Radich specializes in developing methods to improve the detection and treatment of chronic and acute myeloid leukemias, or CMLs and AMLs. His team studies how specific genetic variants influence treatment responses and outcomes. Understanding these variants could help in the development of new drugs or enhance doctors’ ability to choose the best treatments for individual patients.
He also directs Fred Hutch’s Molecular Oncology Lab, which provides high-quality molecular testing for clinical cancer researchers at Fred Hutch and around the world.
University of Washington School of Medicine
B.A., Biology with Honors, University of California, San Diego, 1976
M.A., M.S., Epidemiology, School of Public Health, Harvard University, 1979
M.D., University of California Davis, 1983
Internship, Internal Medicine, University of Washington Affiliated Hospitals, 1984
Residency, Internal Medicine, University of Washington Affiliated Hospitals, 1986
Chief Medical Resident, Veterans Administration Medical Center Affiliated Hospitals, 1987
Fellowship, Medical Oncology, University of Washington and the Fred Hutchinson Cancer Research Center, 1990
Conceptually, Dr. Radich studies “the genetics of luck;” i.e. why patients do or don’t respond after therapy. His research focuses on the molecular underpinnings of therapy response, resistance and relapse in hematological malignancies, performing gene expression and mutation analyses on cases that are refractory to therapy versus those that realize long-term remissions. The Radich team uses cutting-edge molecular methods, including microfluidic platforms for very large-scale analysis of rare genetic events and techniques for measuring gene expression and mutations in single cells. They continue developing diagnostic tests to distinguish biologically distinct cancer subtypes and to help identify particular therapies that are most likely to be effective for individual patients.
The Radich laboratory was one of the first to document that monitoring levels of the abnormal, CML-promoting “BCR-ABL” fusion protein can be used to detect “minimal residual disease” and predict relapse before CML cells can be detected by previously standard tests. Based on this expertise, Dr. Radich and colleagues served as the U.S. and Canadian reference lab for several large clinical trials of anti-CML tyrosine kinase inhibitor drugs (imatinib/Gleevec®, dasatinib/Sprycel®, and nilotinib/Tasigna®), all now FDA-approved for CML patients. The team helped establish the International Scale for BCR-ABL testing and worked with the company, Cepheid, to develop the first automated assay for BCR-ABL.
Dr. Radich runs the Molecular Oncology Lab, a certified diagnostics lab performing rapid genetic tests for CML and acute myeloid leukemia (AML) patients of all ages who are enrolled on national and international clinical trials. He also oversees a research laboratory that is currently focused on multiple scientific areas:
Studies of “outlier responses” in leukemia. These studies focus on CML and AML cases with especially poor versus great clinical responses. The goal is to understand the genetic pathways responsible for response versus refractory disease and relapse. The hope is that the findings will allow doctors to accurately predict which patients will respond (or not) to standard treatments, as well as uncover new molecular targets for drug therapies that could turn a refractory case into a responder.
Deciphering “clonal evolution” in CML and AML. A “clone” is a group of cells that all share one or more distinctive genetic mutation that first occurred in their ancestor cell. Researchers have learned that cancers are usually made up of multiple clones that evolve with a sequence of mutations and other abnormalities, some of which provide a “selective advantage” to the cancer, including when exposed to a particular therapy. The Radich team is using their highly sensitive genetic tests to characterize these time-dependent changes in many different leukemia cases. Understanding clonal evolution will provide important, additional clues as to how best to treat individual patients.
Developing methods to make molecular diagnostic assays inexpensive. These tests are critically needed in poor resource areas. At present the work is with CML patients, in partnership with the Max Foundation and the iCMLf.
—Dr. Jerald Radich