Big Ideas

Elli Papaemmanuil, Ph.D.

Thanks to improved treatments and more funding for research, the number of cancer survivors in the U.S. has reached an incredible 17 million and counting. While each of these remarkable individuals has a lot to celebrate, cancer survivors often face continuing health challenges well after their initial battle is over. One such challenge is cancer survivors are more likely to develop leukemia than the general population.

For decades, leukemia was seen as an unfortunate side effect of some cancer treatments that doctors were powerless to predict or protect. However, recent studies have turned that thinking on its head with the discovery that some patients exhibit a mutation associated with leukemias many years before a cancer diagnosis. Dr. Elli Papaemmanuil and colleagues have shown that using existing diagnostic workflows, it may be possible for doctors to identify patients at risk of secondary leukemia, tailor therapies for people with this mutation and help them avoid the anguish of a second cancer diagnosis.

With a background in genetics, Papaemmanuil was always intrigued by how new genomic data and technology might help people with cancer. “My journey has been following a path where we can use new information to inform better diagnoses and treatment decisions for cancer patients,” said Papaemmanuil.

That background has helped inspire her current research. Today, she and her team at Memorial Sloan Kettering Cancer Center are using genetic information to change how we look at cancer survivors who develop leukemia. Papaemmanuil received a translational grant for this work from the V Foundation for Cancer Research in 2019, supported by Bristol Myers Squibb through the Robin Roberts Cancer Thrivership Fund.

The team focuses on clonal hematopoiesis (CH), a family of genetic mutations found in blood cells. They’ve found about one in four cancer patients have these mutations present in their blood – as well as evidence that some cancer treatments may spur the growth of cells that carry specific gene mutations.

“Through our ongoing study, we are understanding which types of cancer therapies promote the growth of certain cells and which therapies don’t,” said Papaemmanuil. “That information will then help reflect the risk of a patient developing a secondary cancer down the line.”

Knowing if a patient has a CH mutation could be powerful knowledge for doctors as they are developing a treatment plan for their patients.

“When an oncologist is with a patient and evaluating their primary tumor, their goal is to best treat that tumor,” said Papaemmanuil. “Even if the tumor can be surgically removed or eradicated with a minimal amount of radiation of chemotherapy, it can be tempting to go further. Sometimes doctors might consider stronger treatment to eliminate any possibility of disease progression or relapse. That conversation might change if we know the patient has a mutation in their blood that would make them more susceptible to leukemia in the future.”

Papaemmanuil is optimistic that her team’s work will not only help researchers better understand the biology of cancer, but pave the way for clinical trials that test whether insights on CH can help give more people a better life after cancer. And this research was made possible by generous support from donors.

“The grant from the V Foundation was instrumental because we need large cohort sizes in order to have statistically meaningful findings and validate them,” said Papaemmanuil. “That means we need a team of interdisciplinary scientists, so the support from the Foundation has allowed us to have the right people and data and perform the studies we would otherwise not have been able to.”

When someone supports cancer research, they want to see their dollars making a difference. It’s important to remember that every single improvement in treatment, detection or prevention moves us closer to our goal of Victory Over Cancer®. With each and every win, together we can make a real difference in people’s lives.

“I think global victory over cancer will come with many small wins,” said Papaemmanuil. “Each win, no matter how small, is fundamental to this transition for improved prevention and detection and optimized therapy.”