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ESH 2016: Prof. Hallek on the Microenvironment in CLL

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I was lucky enough to be invited by Professor Michael Hallek to speak in September 2016 at the ESH (European School of Hematology) 2nd International Conference on New Concepts in B-Cell Malignancies in Estoril, Portugal on the beach near Lisbon.

estoril-portugal

Estoril, Portugal

It was not only a beautiful place to visit; it was an important conference for explaining some of the basic science of chronic lymphocytic leukemia (CLL).

My role was to bring the American patient’s perspective to the mostly European audience of hematologists attending, but I took the opportunity to interview some of the top researchers who were part of the faculty at ESH 2016.

Professor Hallek from the University of Cologne heads up both clinical and basic science research in Germany on CLL.

In this interview, he discusses the role of the microenvironment in CLL and why it is an important target.

Take Away Points:

  • Every tumor, in order to survive, needs the support of surrounding cells.
  • New drugs (kinase or enzyme inhibitors) such as ibrutinib and idelalisib, target not just the cancer cells, but also their environment.
  • Most of the growth of the cancer cells occurs in the bone marrow, lymph nodes and spleen.
  • When we take drugs such as ibrutinib or idelalisib and several others in development, the cancer cells are quickly driven out of their comfort zone into the blood stream, often causing what is usually a transient rise in the lymphocyte count. Only then do they begin to very slowly die though programmed cell death or apoptosis.
  • This clinical observation and other animal studies support the theory that these drugs derive a significant part of their therapeutic benefit indirectly by blocking the communication of the cancer cells with its surrounding support system.
  • New drugs are being developed to target the cells, such as macrophages (immune cells that among other actions, “eat” microbes) and T lymphocyte that support CLL cells.

Professor Hallek is doing important research that helps us understand how to beat CLL.

Please enjoy the interview.

Brian Koffman, MD  11/21/16