A group of more than 20 Brazilian oncologists traveled to Weill Cornell Medicine and NewYork-Presbyterian Hospital from South America to attend the 2017 Update in Hematologic Malignancies, a two-day interactive educational symposium organized and presented by members of the Weill Cornell Lymphoma Program’s research and clinical faculty.
The meeting, directed by Dr. Sarah Rutherford, featured didactic lectures on chronic lymphocytic leukemia (CLL) and Richter’s Transformation (RT) by Drs. John Allan and Richard Furman, discussions of controversies and challenging cases in mantle cell, follicular and diffuse large B-cell lymphomas (MCL, FL, DLBCL) led by Drs. Rutherford and Peter Martin, a lymphoma-specific hematopathology update from Dr. Amy Chadburn, and a tour of Dr. Leandro Cerchietti’s research laboratory.
Programs like this one foster partnerships that can propel us toward our goal of improving health outcomes for the nearly 100,000 people around the world who are affected by lymphoma. Our team is able to establish collaborative international relationships to teach and learn from medical practitioners of a diverse background, all while solidifying our role as a trusted, global authority on lymphoma research and care.
“The relationship we have established with the Brazilian oncologists is fulfilling for all of us,” says Dr. Rutherford. “We enjoy teaching them and helping to manage complex cases that they face in Brazil. We also remain in touch with them after the conference – providing guidance on patients and even traveling to Brazil to participate in meetings. We look forward to continuing this collaboration given our shared mission of providing the best possible care for patients with lymphoma.”
Histone deacetylase inhibitors (HDACi) are small molecules that alter the function of histones, or proteins that bind to DNA and help to determine chromosome shape and gene activity. In cancer treatment, HDACi are traditionally considered epigenetic drugs because of their capacity to modify gene expression to halt tumor cell division, but new research from the Cerchietti Research Laboratory at Weill Cornell Medicine poses rationale for studying the inhibitors’ biological effects through a different lens – their impact on cell metabolism.
Benet Pera, Ph.D., along with Weill Cornell colleagues, as well as researchers from the Helmholtz Institute of Computational Biology in Germany and the Lady Davis Institute for Medical Research in Canada, conducted the study to improve the efficacy of HDACi in people with B-cell lymphoma, which is relatively low compared to that in T-cell lymphoma. Several HDACi, including vorinostat and romidepsin, have been approved by the United States Food and Drug Administration (FDA) for treatment of certain T-cell lymphoma subtypes.
Contrary to their namesake, histone deacetylase inhibitors are able to affect a long list of non-histone proteins, among them metabolic enzymes. These agents can be more appropriately referred to as lysine deacetylase inhibitors (KDACi). Due to the activity of KDACi in proteins involved in metabolic pathways, Pera et al. investigated the effects of the KDACi panobinostat in the cell metabolism of relapsed/refractory diffuse large B-cell lymphoma (DLBCL) patients enrolled in a phase II trial. Metabolic profiling of the patients’ plasma before and after KDACi-treatment demonstrated that panobinostat prompts DLBCL cells to rely on a certain metabolic pathway, the choline pathway, for survival. The scientists found that in the lab, treating the cancer cells with a choline pathway inhibitor in combination with panobinostat produced superior anti-lymphoma effects in vitro and in animal models.
“We are studying these so-called ‘epigenetic’ drugs from a different angle, hoping that metabolomics might hold the key to improving their clinical efficacy,” says Dr. Pera.
The research data recently published in the open-access journal EBioMedicine help to substantiate the team’s innovative re-application of epigenetic reagents, demonstrating the value and promise of the metabolic mechanisms by which KDACi/HDACi can improve current therapeutic options for people with B-cell lymphoma. The results also highlight the need to explore the unknown biological effects of this class of drugs before they can be successfully implemented in a clinical setting.
The Lymphoma Program’s Dr. John Leonard was granted the prestigious 2017 Miriam G. Wallach Award for Excellence in Humanistic Medical Care at Weill Cornell Medicine and NewYork-Presbyterian Hospital’s Physician of the Year event, as presented by the Department of Nursing. The award honors a physician who exemplifies altruistic and humanistic qualities and displays exceptional dedication to providing outstanding, compassionate patient-centered care.
Dr. Cam Patterson, Senior Vice President and Chief Operating Officer for NewYork-Presbyterian Hospital/Weill Cornell Medicine, helped to introduce Dr. Leonard and present the award. He noted that Dr. Leonard is widely acknowledged by his colleagues both locally and nationally for his stature in the field of lymphoma research and care, especially known for his astuteness in taking on challenging cases, such as treating pregnant women with lymphoma. He is also regarded as a great partner to his nursing colleagues.
“Receiving an award that is reflective of the feelings of the nursing staff is about as good as it gets,” said Dr. Leonard.
In his acceptance remarks, Dr. Leonard described interactions with his patients staying in the hospital the previous evening. Throughout the course of his visits, conversation topics spanned serious, difficult discussions, as well as some of a more lighthearted nature, including doubles tennis and the New York Yankees.
Dr. Leonard explained that making his rounds took only a few minutes, but it was the most fun part of his day, and it made a difference to his patients. He noted that small interactions, such as sitting down to talk and certain intricacies in the way that we connect with one another, have the potential to make a huge difference in our relationships.
“These things that you do on a daily basis and don’t even think of affect patients, colleagues and trainees,” said Dr. Leonard. “If we understand that and deliberately carry it through [to practice], we can make an even greater difference for our patients.”