A recently published study led by Drs. Mohamed Sorror and Elihu Estey of Fred Hutchinson Cancer Research Center, involving five collaborating institutions, provides a novel model to predict one-year survival rates after beginning treatment for acute myeloid leukemia.
The researchers hope the new study, which included 1,100 patients treated for AML and was published online Sept. 7 in JAMA Oncology, will provide physicians and patients with novel, patient-centered risk-assessment means that could both improve survival and reduce treatment-related health costs by more closely matching patients with therapies most likely to benefit them.
“The AML composite model combines the effects of age and AML aggressiveness together with, for the first time, patients’ objective measure of overall health or comorbidities,” said lead author Sorror, an associate member in the Clinical Research Division.
Physicians can use the online assessment tool to refine decision-making about the modality and intensity of therapy used in treating patients with AML.
Among physicians, Sorror said, there might be some reluctance in offering curative therapy to older patients with newly diagnosed AML — especially those with multiple medical problems.
“The new model allows objective identification of those older patients who might benefit from referral to receive either conventional or investigational AML therapy,” Sorror said. “This is particularly important since AML is more common in older adults, with a median age of 68 at diagnosis.”
Conversely, the AML-composite model could identify patients so unlikely to benefit from certain AML therapies that they could be spared the toxicities and costs of these treatments.
“This model could prove useful to the [U.S.] Food and Drug Administration when monitoring clinical trials to ensure adequate representation and proper evaluation of high-risk patients in these trials and, hence, generalizability of trial results to the whole AML population,” Sorror said.
Sorror and colleagues are using the AML-composite model in an ongoing prospective study to identify those patients who might benefit from allogeneic hematopoietic cell transplantation, typically associated with high mortality risks, as a curative therapy for AML.
Grants from the Patient-Centered Outcome Research Institute and the American Cancer Society funded the research.
— Molly McElroy / Fred Hutch News Service
Dr. Thomas Uldrick will become the new deputy program head of Fred Hutch Global Oncology Dec. 1, joining the program from the National Cancer Institute, where he is a senior clinician and clinical director of the HIV & AIDS Malignancy Branch at the Center for Cancer Research.
“The addition of this new faculty position represents an important investment by Fred Hutch leadership in the growing Global Oncology program,” said Dr. Edus H. “Hootie” Warren, head of Global Oncology. “Tom joins us at an exciting time and will help to propel our activities forward.”
Warren and Dr. Julie McElrath, Fred Hutch senior vice president and director of the Vaccine and Infectious Disease Division, or VIDD, announced Uldrick’s appointment in a recent email to program staff in Seattle and Kampala, Uganda.
“We are truly enthusiastic about Tom’s complementary scientific expertise and strengths in conducting clinical trials, both domestically and internationally,” McElrath said.
A hematologist and oncologist, Uldrick’s research focuses on AIDS-related cancers, particularly Kaposi sarcoma and lymphoma, both of which are key interests of the Global Oncology program. Kaposi sarcoma is caused by infection with herpesvirus 8, but the virus leads to cancer mostly in people who also have a weakened immune system, thus its association with HIV/AIDs.
Uldrick has collaborated with Global Oncology scientists in the National Institutes of Health-sponsored AIDS Malignancy Consortium as well as with the Fred Hutch-based Cancer Immunotherapy Trials Network. With the latter, he is a lead scientist in a multicenter study of pembrolizumab (Keytruda), a type of immunotherapy known as a checkpoint inhibitor, in people with both HIV and cancer.
At a Fred Hutch talk in March, Uldrick discussed his work in southern Africa and his interest in designing clinical trials, including immunotherapy studies, for low-resource countries. That is also a goal of Warren, an oncologist and immunotherapy researcher who became head of Global Oncology in July and wants to finds ways to adapt what scientists are learning about the immune system to improving cancer care worldwide.
The Hutch program, a cross-divisional effort led by VIDD, grew out of a small 2004 research project with the Uganda Cancer Institute, or UCI, in Kampala and was formalized in 2008. In 2015, the state-of-the-art UCI-Fred Hutch Cancer Centre opened in Kampala to house research, training, laboratories, and adult and pediatric outpatient clinical care.
Uldrick will be an associate member of VIDD with pending appointments in the Clinical Research Division and as an associate professor in the Department of Medicine at the University of Washington School of Medicine. He will be based in Seattle with regular travel to Kampala.
— Fred Hutch News Service staff