Dr. Frits van Rhee of UAMS discusses Total Therapy, his approach to address high-risk patient needs, and the importance genetic and imaging tests and how these pinpoint prognosis and best treatment path options

Dr. Frits van Rhee, MD, PhD, University of Arkansas for Medical Sciences

Interview date: October 4, 2013

Dr. Frits van Rhee of the University of Arkansas for Medical Sciences shares how Total Therapy is modeled after the approach in childhood acute lymphoblastic leukemia that showed dramatic results (from 5% to 90% remission rates). He describes the importance, and pros and cons of each of the diagnostic tests including cytogenetics, FISH, gene expression profiling and imaging studies. He shares how new disease growth can show up on imaging studies even before they are presented in blood or bone marrow samples. He explains that with the use of the genetic profile test, all UAMS patients are separated into two subgroups - high risk and standard risk. He explains how he tailors treatment for each sub-type and how they are using different approaches for high-risk patients including shortened treatment-free intervals with more frequent, but lower doses of chemotherapy and other combination therapies. He also describes how high-risk patients are being treated in an open study with an immunotherapy, expanded natural killer (NK) cells. He shares his opinion that the highest unmet needs currently in myeloma are treatments for high-risk patients and describes a way to find the low-hanging fruit: finding and using existing therapies effective and available for other cancers with similar genetic profiles. He describes the advantage that UAMS has in the ability to follow their patients over the long-term and how that enables them to see large numbers of patient populations divided into subgroups and better tailor personalized treatment.