Most of the people with AML that she sees clinically – indeed, most AML patients everywhere – are over the age of 60. While AML can be a devastating diagnosis at any age, older patients often face the worst odds because they tend to have poorer responses to treatments compared to younger patients. With V Foundation funding, Garrett-Bakelman is working to find out why – and find new treatments that may be more effective in older people.
“Several factors contribute to the disparity in outcomes that patients over the age of 60 experience,” said Garrett-Bakelman. “[For example,] many have chronic diseases that can impact what treatment they receive and how well they’ll do with that treatment.”
Another contributor is the fact that almost all AML therapies were originally tested in younger people. Recent studies have suggested that the biology of the disease may actually be different in older people, which may mean they need different treatments.
Garrett-Bakelman and other researchers have shown that monitoring how gene mutations change over time in AML patients can provide important insights into who will respond better to a particular targeted treatment. “We now have several targeted therapies for AML and a better understanding of which patients respond better to particular treatments,” she said. “By monitoring people over time using technology that can assess mutations in their genes, we can modify their treatments and give them a better chance for living as long as possible with the highest quality of life.”
Garrett-Bakelman and colleagues recently published findings from a study examining gene mutations specifically in older AML patients, one of the first studies of its kind.
“We found that the information that we have from younger patients is not always applicable to the older patient population,” said Garrett-Bakelman. “We also found that for certain genetic backgrounds, women do better than men, and we identified certain combinations of gene mutations that can help predict how older AML patients will do over time.”
With additional work, this research could lead to new methods for predicting how older patients with AML will respond to specific treatments in order to guide more personalized treatment decisions. It also could help inform future research into new AML therapies. These advances could make a world of difference to the tens of thousands of people diagnosed with AML in the U.S. each year – whatever their age.
“Victory over cancer to me means that people will live longer and will have a very high quality of life for as long as they can,” said Garrett-Bakelman. “It’s hope for patients and their families that there are treatment options that can be best for them, as opposed to one-size-fits-all, which used to be the case.”