Improving survival for patients with acute leukaemia
Leukaemia is one of Australia’s deadliest types of cancer. However, as Steven Lane knows, it’s not just one type—it’s hundreds of different types, each with its own genetic fingerprint.
This variation means some types of leukaemia are treatable, whereas others quickly develop resistance. Today, 85 per cent of children with leukaemia can be cured, but the outlook for patients over 60 is bleak—only 10 per cent survive beyond one year.
Steven wants to change that outlook. Together with his team at the QIMR Berghofer Medical Research Institute in Brisbane, he has developed the capacity to rapidly profile the genetics of leukaemia types and model them in the lab.
He’s been awarded an inaugural CSL Centenary Fellowship to begin tailoring treatments to individual patients. Specifically, he’ll use the support to identify new drug pathways and explore repurposing existing drugs to target resistant leukaemia types.
Resistance to standard chemotherapy treatments occurs in most patients with Acute Myeloid Leukaemia (AML), and it is particularly common in those patients over 60 years of age. Steven’s previous research discovered that rare leukemic stem cells allow the cancer to weather the storm of treatment then later grow out, driving the relapse in these patients.
The problem is, new treatments for leukaemia are usually tested in clinical trials. These trials may exclude patients who show resistance and therefore fail to deliver treatments that work for them. This is often the case with older patients, whose health may be affected by other factors that could bias a trial.
To get around this, Steven is using primary AML cells derived from human patients with resistant cancers. These are grown in the lab before being tested against novel chemotherapies. This allows Steven to work with many leukaemia types simultaneously, providing a cheaper, faster and more accurate model of AML that reflects the different genetic fingerprints.
He’s also genetically engineered mice to develop human leukaemia. Once identified, the mouse cancer cells and their genes can be targeted for treatments and tracked closely to see how they respond. This means Steven can map the effectiveness of individual chemotherapy treatments against the genomes of individual cancers.
The powerful suite of techniques that has led Steven to identify the unique genomes of leukaemic stem cell that drive resistance may hold the clues to unravelling their treatment. His lab has already developed and piloted a novel treatment in mice, finding substantial improvements in survival that were predicted by the cancer’s own genes.
He now wants to enhance this predictive power. He’ll use his Fellowship to focus on two key aims: identifying recurrent pathways of chemotherapy resistance and improving understanding of a new type of treatment called hypomethylating agents that are particularly useful in older patients with leukaemia.
The CSL Centenary Fellowship solidifies Steven Lane’s reputation as one of Australia’s most innovative haematologists. His career in medicine began at the University of Queensland (UQ), followed by a fellowship at Harvard Medical School in Boston, USA and a PhD supervised at UQ.
Hopefully, with the support of CSL, he’ll soon have better news to bring from his bench to the bedside.
Associate Professor Steven Lane
QIMR Berghofer Medical Research Institute
2017 CSL Centenary Fellow