3768 Pedaling for a Cure HOUSTON (Ivanhoe Newswire) – Five years ago, Leslie Trudeau’s world came crashing down. At just 22 years old, her son Taylor lost his battle with leukemia. “He was the bravest person I know. He never complained. He never said, ‘Why me?’” Trudeau told Ivanhoe. “I personally don’t want any family to go through what we went through.” That’s why Trudeau is pedaling for a cure. Her son’s fraternity brothers in Pi Kappa Alpha at the University of New Hampshire created Cycle for Life, a fundraising event held on college campuses across the country. Participants pay $10 to ride a stationary bike for half an hour; 100 percent of the donations go towards cancer research. And so far it’s paying off. Last year, Cycle for Life granted Stem Cell Therapist Dean Anthony Lee, MD, PhD, at MD Anderson Cancer Center, $250,000 to start a phase I clinical trial on a new leukemia treatment using immune cells donated by a related family member, called natural killer cells or NK cells. “Their job is to try to kill cancer,” Dr. Lee told Ivanhoe. But chemo not only attacks the cancer, it also kills all the NK cells. Dr. Lee has found a way to grow more NK cells in mass. Using blood from a donor, he takes the NK cells, multiplies them by 30,000 times their original amount and injects them into the patient. “NK cells job are really not to identify a specific target, but really to look at this combination of what’s good and what’s bad about a cell,” Dr. Lee said. “And if a cell has an overall balance of things that look dangerous, that’s when it decides to kill the cell.” IT’S A BEACON OF HOPE FOR TAYLOR’S FRIENDS AND FAMILY. “It’s almost like the phoenix, you know? He passed away but something greater came out of his cause,” Demetri Kouloheras, Taylor’s friend, told Ivanhoe. “He’d be amazed. He would go, ‘Really? For me?’” Trudeau said. For more information about the organization and Dr. Lee’s clinical trial, visit taylorcycleforlife.org. MEDICAL BREAKTHROUGHS RESEARCH SUMMARY TOPIC: REPORT: PEDALING FOR A CURE MB # 3768 BACKGROUND: Leukemia is cancer that starts in blood-forming tissue such as bone marrow and causes large numbers of blood cells to be produced and enter the bloodstream. Most normal blood cells develop from cells in the bone marrow, called stem cells. Bone marrow is the soft material in the center of most bones. Stem cells will develop into different kinds of blood cells each with a specific job. White blood cells fight infection. Red blood cells carry oxygen to tissue throughout the body. Platelets help form blood clots that control bleeding. These cells are made from stem cells as the body needs them. Most blood cells mature in the bone marrow. Then they will move into the blood vessels. When someone has leukemia, their bone marrow makes abnormal white blood cells, called leukemia cells. (Source: www.cancer.gov) RISK FACTORS: The exact cause of leukemia is unknown. Researchers do know that there are certain risk factors that increase the likelihood of developing the disease. They include: • • • • Radiation: people exposed to high levels are more likely to get acute myeloid, chronic myeloid, or acute lymphocytic leukemia. Smoking: cigarettes increase the risk of acute myeloid leukemia. Chemotherapy: cancer patients treated with certain types of drugs sometimes can get acute myeloid leukemia or acute lymphocytic leukemia. Inherited Diseases: Down syndrome, blood disorders, Human T-cell leukemia virus type 1, family history of leukemia, and other inherited diseases increase the risk of developing acute leukemia. (Source: www.cancer.gov) NEW TECHNOLOGY: Dr. Dean Anthony Lee, at MD Anderson Cancer Center, is testing a new way to treat leukemia. He’s studying something called natural killer (NK) cells, which essentially look at cells and determine whether they are considered good or bad. If they encounter a bad cell, they kill it. But because these cells originate in the bone marrow, in patients with leukemia their production is stopped or slowed down. Although they’ve been known about since the 1970s, not much research has been done on their effect. Dr. Lee is currently growing large amounts of these cells, in an effort to determine if they can be used in a treatment or therapy. (Source: Dr. Dean Anthony Lee) FOR MORE INFORMATION, PLEASE CONTACT: Dean Anthony Lee, MD, PhD dalee@mdanderson.org Office: 713-563-5404 If this story or any other Ivanhoe story has impacted your life or prompted you or someone you know to seek or change treatments, please let us know by contacting Marjorie Bekaert Thomas at mthomas@ivanhoe.com Dean A. Lee, M.D., Ph.D. Dean A. Lee, M.D., Ph.D., Associate Professor in the Division of Pediatrics and Cell Therapy Section at the University of Texas MD Anderson Cancer Center, talks about a potential new way for doctors to treat cancer. What are in NK cells? Dr. Lee: So your immune system is really split into two halves. If you think about it as like defending the country: we have this mobilized army and Special Forces and then we have border patrol. I think NK cells are the side that’s more like border patrol. There’s a lot of emphasis put on T cells and B cells in the last 15 to 20 years which are more specific. Like the army and Special Forces, they’re going after specific targets. NK cells’ job are really not to identify a specific target but really to look at this combination of what’s good and what’s bad about a cell and if the cell has an overall balance of things that look dangerous, that’s when it decides to kill the cell. What happens to NK cells in a person with leukemia? Dr. Lee: There are several things that happen to NK cells in patients with leukemia. First of all, NK cells are made in your bone marrow and when leukemia starts to overtake the bone marrow you just can’t make any more. NK cells are, we think, relatively short-lived, most of the time probably only three to four weeks. So you’re going to get some of the numbers go down. But also leukemia actually has several factors that suppress NK cells and make the NK cells a little bit stunned and not able to do their job while they’re in that right environment. What role do NK cells play in the survival of the patient? Dr. Lee: Depending on whether you look at NK cell numbers or the genes that the NK cells have, or whether you’re treating cancer or getting a bone marrow transplant, the NK cells play a different role in each of those different settings. But what we do know now is that certain genes in NK cells can actually make you more or less likely to get leukemia in the first place. They can make you more or less likely to respond to therapy and the numbers that you have and the genes that are present in NK cells can predict whether or not you respond to a transplant as part of therapy. How does chemo affect natural killer cells in leukemia patients? Dr. Lee: So chemotherapy is another way that we actually hurt NK cells for patients with leukemia. NK cells happen to be very sensitive to both chemotherapy and to some of the steroid drugs that we use for some leukemias. So after each cycle of chemotherapy you’ve essentially wiped out all of the NK cells you have admitted they have to regrow. So the various cells we have whose job is to try to kill cancer, we’re actually affecting with the chemotherapy we give. Can you tell me about your lab? Dr. Lee: Our research and lab on NK cells really started with trying to understand whether or not we can just get them to grow, can we get enough of them to actually do therapy in the clinic. That was a finding that we had about five or six years ago. Now that we can actually generate lots of NK cells, the lab has focused on multiple ways of making those cells more effective or finding specific varieties of NK cells that are the best for an individual cancer. What do you do with the cells once you’ve grown them? Dr. Lee: What we do with these cells after we grow them is really in two parts. One is that, although we’ve known about NK cells since the 1970’s, we haven’t been able to really study them very well because we couldn’t grow large enough numbers of them to really do all of those tests. So in the lab we’ll grow large numbers of these cells and then we have lots of different ways that we can test them and look at different versions of NK cells, test what drugs affect them; those kinds of things in the lab. In the clinic we developed a way that we can grow NK cells that can actually be infused in to patients. And how we can infuse those in to patients is really what’s under investigation now with these trials. There’s potential for using them as part of a transplant and making a transplant more effective. There’s potential for infusing them right after chemotherapy to make the chemotherapy more effective or combining them with antibodies and other drugs that healthy NK cells recognize tumor targets. What’s the next step for these cells? Dr. Lee: So I think what’s next for the clinic is currently all the trials we have are taking all NK cells that a person has, growing all of them up and giving all of them back. And what will be next will be to see if we can select the NK cells that are most defective and specifically target those cells to the patient’s tumor. How can patients get involved with your trial? Dr. Lee: If patients want to get involved in one of the NK cell trials they can look either online at clinicaltrials.gov. That’s actually a clearing house for not even just the U.S. but trials all the world and it’s very easy to search for NK cell trials there. They can go on to the MD Anderson website and we have several places there that they can find the NK cell trials that are available. We currently have one that’s open, two more that are very close to opening, and several more coming behind for different diseases. I couldn’t give a specific one because there’s more than one trial. How has the Pi Kappa Alpha Taylor Trudeau Cycle for Life Foundation helps your work? Dr. Lee: The Pi Kappa Alpha Taylor Trudeau Cycle for Life Foundation has really helped get this research from the lab to the clinic. There are a lot of hurdles getting something from the lab to the clinic particularly when you don’t have a pharmaceutical agent that can just be put into a bottle. So their funds are helping us to do all the manufacturing of those NK cells and get the clinical staff that’s necessary to get this trial running.