When John Byrd, MD, first began research in 1991 into treatments for chronic lymphocytic leukemia, a CLL diagnosis was like a death sentence.
"There was a chemotherapy drug then that could treat CLL, but patients' immune systems were obliterated," says Byrd, a cancer researcher at The Ohio State University Comprehensive Cancer Center – Arthur G. James Cancer Hospital and Richard J. Solove Research Institute.
“Before these innovative breakthroughs, the conversations doctors everywhere had with CLL patients were about how their lives would be shortened. Now, they get to tell patients they’re going to be survivors.” Click to tweet this story
"One of my patients at the time died not from CLL, but from pneumonia. I remember looking at his X-ray and thinking, 'We have to do better than this.'"
By 1996, Byrd's team had begun its first preclinical trials focused on prolonging CLL patients' survival with targeted therapy, which differs from chemotherapy by going after cancer cells without attacking the entire body.
Just nine years later, the Ohio State researchers published evidence of the first-ever treatment to prolong survival in patients with CLL, combining a newer, immune-based drug called rituximab with chemotherapy.
But the researchers wanted to do better. They continued the hunt for a targeted therapy that could be effective on its own.
"Everyone said this couldn't be done with CLL because the disease didn't have a common genetic mutation to target," Byrd says.
That was until his research team concentrated on an enzyme in CLL tumor cells that allowed cancer cells to multiply and create havoc. The enzyme could be blocked by the drug ibrutinib.
The first ibrutinib studies worked "phenomenally," Byrd says.
"Of the study's patients in 2010, virtually all had no treatment options remaining, but their bodies responded to ibrutinib."