SEATTLE — Nine years ago, Bellevue attorney Jane Graham got a telephone call from her physician who began the conversation by saying, "I hate giving news like this."
The news: Graham, a 37-year-old mother of two young boys, had a rare kind of blood cancer known as chronic myelogenous leukemia, or CML. Her doctor said a bone marrow transplant was the only chance for survival.
"That was scary enough, but as time passed I learned that although I was living 10 minutes from the world's best transplant center (Fred Hutchinson Cancer Research Center), I did not have a matched donor," Graham recalled. She was told she had only a few years to live.
Graham was given daily injections of the drug interferon, which slowed the disease's progression but left her with anemia, depression, skin problems and chronic flu-like symptoms. Looking for some shred of hope, she turned to a patient support group on the Internet — and found a scientist in Oregon.
"Almost all our patients came to us through the Internet," said Dr. Brian Druker, now a renowned oncologist at the Oregon Health & Science University in Portland.
Druker had moved from Boston to the Pacific Northwest in 1993 largely because his superiors at Harvard University told him his particular avenue of inquiry in cancer research "wasn't going to amount to much." A soft-spoken but persistent man, he decided to switch coasts rather than research interests.
Druker's persistence, which also included a few battles with the drug industry, paid off with a drug called Gleevec. It's a largely non-toxic, new type of anti-cancer drug that has saved the lives of many with CML, including Graham.
"I lead a completely normal life now," she said. "I travel, I hike, I ski. Best of all, I've watched my sons grow up. Now I'm looking forward to grandchildren, but hopefully not too soon."
Graham, who has been in remission now for three years, will be among those honoring Druker today at the annual dinner of the Northwest Association for Biomedical Research — an organization that seeks to educate the public about the value of such research.
"The enormous success of Gleevec has been a real boost to cancer investigators," said Dr. Fred Appelbaum, director of clinical research at Fred Hutchinson.
Appelbaum said Druker's work showed that you could use the powerful new tools of molecular biology to identify a particular biochemical malfunction in a cancer, work backward from there to identify its genetic cause and design a drug to fix it.
"It always seemed very straightforward to me," said Druker, who was recently inducted into the prestigious Institute of Medicine of the National Academy of Sciences. In CML, he explained, it was clear that the cancer was caused by an enzyme gone bad and what was needed was a drug that simply shut down this enzyme. "When I began looking at this, people argued it would be impossible and that I was wasting my time," Druker said.
Later, when he began to show in animals that the approach could work, new obstacles arose.
CML is a relatively rare cancer, and the drug industry had little interest in a disease with such a small market. Druker pushed for years, ultimately demanding that he be given the license for the drug if the big companies didn't want it — prompting industry to approve a trial.
"I knew with our first trial that if we didn't show amazing results right away, that it was over," he said. "But I was facing patients who were dying of CML and had no hope. I could accept that we might fail to find a drug, but I couldn't accept not trying."
Druker's research was a stunning success. And his novel approach has encouraged other scientists to pursue this more targeted "genomics" strategy to identifying cancer therapies.
"There are similar enzymes for other cancers," Appelbaum noted. But in many cases, he said, the solutions may not be a single target as in CML. Many cancers, Appelbaum said, are the products of multiple mutations or chemical malfunctions.
Patients on Gleevec need to take the drug for as long as they live, he added. The evidence so far indicates that few patients with CML can totally rid their body of the cancer, Appelbaum said, but the drug is almost without toxicity. Whether it will remain effective for a person's lifetime, he said, isn't yet clear.
Some patients on Gleevec see the cancer return and eventually need bone marrow transplants, Appelbaum said. Young people with CML and a good marrow match opt for the transplant over Gleevec, he said, since the procedure cures the disease.