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Dana-Farber clinic to focus on blood cancer precursor conditions
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Dana-Farber Cancer Institute opened a new clinic designed to improve clinical care and monitoring for individuals with precursor conditions that can progress to blood cancers.
The Center for the Prevention of Progression (CPOP) also will help scientists develop targeted therapies that could prevent these conditions from progressing to malignancy.
“For most precursors of hematologic malignancies, health care professionals tend to tell patients to ‘watch and wait’ and do nothing until symptoms arise,” Irene Ghobrial, MD, DFCI, director of CPOP and professor of medicine at Dana-Farber Cancer Institute, told HemOnc Today. “These patients don’t really receive follow-up care until they have symptoms. We decided to start this center in response.”
Precursor blood conditions include smoldering multiple myeloma, smoldering Waldenström macroglobulinemia, early myelodysplastic syndrome and monoclonal gammopathy of undetermined significance. In many cases, these conditions progress to leukemia, myeloma or myelodysplastic syndrome.
In 2015, Dana-Farber launched PCROWD — an online crowd-sourcing effort — to collect tissue samples and clinical data from individuals diagnosed with these precursor conditions and identify predictors of progression to cancer. PCROWD now includes sequential samples from more than 2,000 people worldwide, with a goal of collecting samples from 50,000 people.
CPOP will expand on that effort by emphasizing early detection of progression from precursor conditions to malignancy, as well as identification of biomarkers that may help predict which patients are most likely to progress.
Clinical trials will assess strategies to prevent precursor conditions from progressing to overt cancer. The clinic also will serve healthy but high-risk individuals who have close relatives with blood cancers, as well as those with germline or inherited predispositions.
“People with precursor conditions are a population that is growing and will continue to grow as the population ages and as more patients survive therapy for solid tumors,” David Steensma, MD, clinical director of CPOP, said in a press release. “There are now tools that may prevent complications that deserve testing. We are pleased to provide our colleagues across the institute and our collaborative sites a place to refer these patients.”
Individuals with precursor conditions who want to be part of CPOP must complete consent and medical history forms. CPOP then mails a collection kit for patients to take to a lab technician for a courtesy sample. Once drawn, the sample is packaged and shipped to Dana-Farber.
Patients with precursor conditions who receive treatment at CPOP will be seen by physicians who specialize in hematologic malignancies. Consultations also can be arranged with cardiologists, genetic counselors, social workers, psychologists and other practitioners who can manage relevant conditions.
CPOP may be only a first step toward improved understanding of these conditions and greater collaboration to improve outcomes, Ghobrial said.
“Other centers are starting to wake up to the possibilities that result from a center like ours,” Ghobrial told HemOnc Today. “We’ve sent other institutions information on how we've put together CPOP and PCROWD. We would love to have multiple centers of prevention working together to develop a consortium for prevention of hematologic malignancies and other cancers.” – by Joe Gramigna
For more information:
Irene Ghobrial, MD, DFCI, can be reached at Dana-Farber Cancer Institute, 450 Brookline Ave., HIM 240, Boston, MA 02115; email: irene_ghobrial@dfci.harvard.edu.
Disclosure: Ghobrial reports honoraria from, consultant/advisory roles with, or travel, accommodations or expenses from Amgen, Bristol-Myers Squibb, Celgene, Janssen, Novartis and Takeda.