Back to the top

TARGETING CLONAL HEMATOPOIESIS TO PREVENT AML

This project asks the provocative question, “Is AML preventable by intercepting the progression of its pre-malignant state, clonal hematopoiesis?” Pursuing a novel investigative strategy that brings together clinical trials and laboratory modeling, this TeamLab intends to create a new paradigm for AML management: one based on identifying individuals at greatest risk of developing the disease, and on creating strategies for early detection and prevention.

This project asks the provocative question, “Is AML preventable by intercepting the progression of its pre-malignant state, clonal hematopoiesis?” Pursuing a novel investigative strategy that brings together clinical trials and laboratory modeling, this TeamLab intends to create a new paradigm for AML management: one based on identifying individuals at greatest risk of developing the disease, and on creating strategies for early detection and prevention.

PROJECT HIGHLIGHTS

  • Leveraging the relatively recent discovery of clonal hematopoiesis (CH) as a pre-malignant state for AML and working to create a major new pathway for intervening in the disease’s development.
  • Developing the foundational knowledge of CH needed to create new, effective approaches for early detection and treatment.
  • Establishing a biobank of patient-derived samples and of human cell models—and using the material for deep research on CH biology and pre-clinical testing of potential treatments.
  • Ultimately, pursuing multi-institutional Phase I trials designed to test the feasibility of therapies that could improve blood counts and reduce clonal expansion in patients with high-risk CH.

MEET THE TEAM

The Targeting Clonal Hematopoiesis TeamLab comprises both rising stars and established thought leaders in the fields of hematology, bioinformatics, immunology, and cellular biology. Indeed, many of these researchers were involved in the original discovery of CH and the early investigations into its clinical and biological implications.
Together, they and their institutions have formed a robust clinical, basic science, and translational ecosystem with specific expertise in disease modeling, single cell technology, computational analytics, clinical identification and management of CH patients, community partnership and engagement, and clinical trials. Moreover, a planned collaboration with pharmaceutical industry partners will provide access to novel therapeutics with minimal toxicity for early intervention clinical trials.
We invite you to learn about the institutions and individual investigators driving this pioneering scientific and clinical research collaboration.

AllDana-Farber Cancer InstituteMemorial Sloan Kettering Cancer CenterMIT’s Koch Institute for Integrative Cancer ResearchThe Sidney Kimmel Comprehensive Cancer Center at Johns HopkinsThe University of Texas MD Anderson Cancer Center

MEET THE TEAM

The Targeting Clonal Hematopoiesis TeamLab comprises both rising stars and established thought leaders in the fields of hematology, bioinformatics, immunology, and cellular biology. Indeed, many of these researchers were involved in the original discovery of CH and the early investigations into its clinical and biological implications.
Together, they and their institutions have formed a robust clinical, basic science, and translational ecosystem with specific expertise in disease modeling, single cell technology, computational analytics, clinical identification and management of CH patients, community partnership and engagement, and clinical trials. Moreover, a planned collaboration with pharmaceutical industry partners will provide access to novel therapeutics with minimal toxicity for early intervention clinical trials.
We invite you to learn about the institutions and individual investigators driving this pioneering scientific and clinical research collaboration.

View Team
AllDana-Farber Cancer InstituteMemorial Sloan Kettering Cancer CenterMIT’s Koch Institute for Integrative Cancer ResearchThe Sidney Kimmel Comprehensive Cancer Center at Johns HopkinsThe University of Texas MD Anderson Cancer Center

PROJECT SUMMARY

Much of the progress in decreasing cancer morbidity and mortality has come from early detection and prevention efforts. Detection of clonal hematopoiesis (CH), a pre-malignant state for AML, may offer the potential to identify individuals at greatest risk of developing the disease and to shift the paradigm of AML care towards prevention.
CH is caused by leukemogenic mutations in hematopoietic cells, leading to an expanded clone of blood cells and increased risk for blood cancers, in addition to other inflammatory disorders. Therefore, the team hypothesizes that if scientists can develop ways to halt expansion of—or even eradicate—premalignant clones, then AML risk could be significantly reduced. Residual CH following AML treatment, which is a harbinger of disease relapse, might also be reduced.
There are several hurdles to pursuing those goals. First, most CH-related mutations are not directly targetable for treatment. Second, there are currently no lab models of CH in humans, making it impossible to learn about CH cell biology. Third, researchers have not yet developed clearly defined surrogate endpoints for evaluating the effectiveness of early interventions targeting CH. Finally, there has not previously been a consortium of institutions with sufficiently large numbers of patients to effectively identify suitable candidate drugs for clinical trials.
This project seeks to address these hurdles by expeditiously identifying novel vulnerabilities created by factors such as CH cells’ genomic alterations, micro-environmental interactions, and immunologic signals. The researchers will then use novel lab models of human CH cells to target these vulnerabilities with potential therapeutic interventions intended to prevent AML; and they will leverage the clinical resources of four CH-focused clinical centers to build an effective cohort of patients to participate in powerful clinical trials.

The Targeting Clonal Hematopoiesis TeamLab is pursuing three primary aims.
The first aim focuses on the biology of CH: using genetic engineering technologies in human stem and progenitor cells—as well as an array of scientific approaches pioneered by TeamLab members—to develop and benchmark robust models of CH. The researchers will also use human cell models of CH to perform CRISPR/Cas9 screens that will help identify genetic dependencies in the condition.
The second aim seeks to understand and target immunologic alterations in CH. Building on the investigators’ previous discoveries of aberrant inflammation in CH patients, the project will examine the immune microenvironment in CH, determine immunologic mechanisms essential for CH expansion, and identify clone-specific novel antigens as potential therapeutic targets.
The third aim is to develop the resources necessary to support a Phase I trial of therapeutic intervention in high-risk CH. Leveraging the capacities of the collaborating institutions’ CH clinics, the researchers will prospectively collect samples from a representative population of patients with CH, creating a diverse and deeply annotated biobank. This resource will support validation of CH risk stratification models—as well as the project’s preclinical studies on CH biology and immunologic alternations. Leveraging the results of that work, a planned multi-institutional Phase I trial could determine the feasibility of systemic therapy designed to improve blood counts and to reduce clonal expansion in patients with high-risk CH.
Ultimately, the TeamLab’s pursuit of these aims will bridge critical gaps in the current understanding of the biologic and immunologic dependences of CH clonal evolution. And it will establish a diverse and representative patient cohort to enable the swift translation of preclinical findings into early detection and prevention clinical trials.

MAKE A DIFFERENCE

Break Through Cancer was created in February 2021 with an extraordinary matching gift of $250,000,000. Every gift to the Foundation supports groundbreaking cancer research and helps us to meet our matching commitment.

For questions about giving please email Lisa Schwarz, Chief Philanthropy Officer at LMS@BreakThroughCancer.org

Break Through Cancer
101 Rogers Street
Suite 3A
Cambridge, MA 02142
Info@breakthroughcancer.org
1-800-757-9881