Lymphoma expert Larry Kwak speaks on precision medicine's great promise

December 3, 2015 | by Letisia Marquez

A cancer cell grows uncontrollably and undergoes as many as 200 mutations. The challenge for cancer researchers is figuring out which changes are causing the cancer cell to grow and which are inconsequential.

“What we’re trying to understand is which of these mutations are the ‘driver’ changes versus the ‘passenger’ changes,” said Larry W. Kwak, M.D., Ph.D., the Tim Nesvig Lymphoma Research Fellow at City of Hope, director of City of Hope’s Toni Stephenson Lymphoma Center, and associate director for developmental therapeutics and translational research for the institution’s comprehensive cancer center.

“In other words, which are the changes that are driving the cancer cell growth so we can target them,” Kwak said.

Once researchers unlock that puzzle, they can develop molecularly targeted therapies to stop cancer cells from multiplying. These targeted therapies, referred to as “precision medicine,” are considered the treatment goal for a host of currently difficult-to-treat cancers. Some precision medicines currently exist; more are needed.

Kwak, the Dr. Michael Friedman Professor in Translational Medicine, will speak about the search for targeted therapies for blood cancers at a symposium Dec. 4 in Orlando, Florida. The symposium will occur the day before the American Society of Hematology’s Annual Meeting, held Dec. 5 to 8. The current research is very exciting, he said, giving scientists greater understanding of the genetic changes within a cancer cell.

“We have tools now that we didn’t have 10 or even five years ago to study how, for instance, each subtype of leukemia has its own unique genetic changes,” he added.

Kwak’s research focuses on follicular lymphoma, the most common type of lymphoma in the western world. His work found that follicular lymphoma’s growth is fueled by changes in the normal cell surrounding the cancer cell.

“The analogy we use is seed and soil, so the seed is the cancer cell and the soil is the microenvironment that’s needed for the cell to survive,” Kwak said. “In this soil, there are normal cells that are being recruited by cancer cells, known as myeloid suppressor cells, to sustain their growth.”

These suppressor cells also shut down an immune response against cancer. Kwak has identified a marker that identifies the myeloid suppressor cells, and also developed a therapeutic antibody to target and eliminate them.

He hopes to test the antibody at City of Hope within the next two years.

“We already have a few drugs that will target some of the most common cancer cell mutations in lung and colon cancer, but we are largely in the discovery phase for other cancers,” Kwak said. “However, the science is changing rapidly, and we’re working every day on creating more drugs that target a larger number of cancers.”

Learn more about City of Hope's lymphoma treatments and research. If you are looking for a second opinion about your diagnosis or consultation about your treatment, request an appointment online or contact us at 800-826-HOPE. Please visit Making Your First Appointment for more information.
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