The research efforts of Rafat Abonour, MD, Professor of Medicine in the Division of Hematology/Oncology and Associate Dean for Clinical Research at Indiana University School of Medicine, Indianapolis, and a physician/researcher at the Indiana University Melvin and Bren Simon Cancer Center, focus on finding less toxic and more efficacious remedies to fight B-cell malignancies, especially in such incurable cancers as multiple myeloma. Last year, Dr. Abonour became Chairman of the Hoosier Oncology Group, an organization whose goal is to bring together researcher/clinicians from academic institutions and community hospitals and patients to make personalized medicine a reality for every patient with cancer.

The NCI named Dr. Abonour one of its recipients of the Cancer Clinical Investigator Team Leadership Award. The 2-year award provides $50,000 in funding for cancer research programs and clinical trials at NCI-designated cancer centers. The ASCO Post talked with Dr. Abonour about his current and future research plans and how his award will help him further his goals.

Research Objectives

Much of your research centers on gene therapy in B-cell cancers, specifically in multiple myeloma. What are you hoping to achieve?

What we are trying to do is twofold. One goal is to identify the marker of the disease that will help us better assign the right treatment for our patients. Today, one of the obstacles in the treatment of patients with multiple myeloma is the one-size-fits-all approach. But the disease is quite heterogeneous, so one of our efforts is to identify biomarkers, specifically those that will help identify patients at increased risk of bone disease, which is the major morbidity of these patients.

We’re also trying to find molecules that will help change the behavior of the disease and prevent the development of bone lesions and destruction of the bone. That’s the area that we’re focusing on at this point.

Finding these molecules will allow you to extend the length of remission, making the disease more chronic?

Yes. Although patients are living longer, there is still no cure for multiple myeloma. In addition, those with smoldering multiple myeloma have no standard treatment, and we’re not addressing the issue of bone disease and the potential for developing pathologic fractures in these folks. So our goal is to try to prevent this morbidity and improve quality of life.

Role of Bisphosphonates

Isn’t the potential for bone disease ameliorated by the use of bisphosphonates?

Bisphosphonates are not a home run. They have helped reduce the occurrence of bone disease by 50% in symptomatic disease, however, their role in smoldering disease is less clear. And one of the issues with these medications is that they work on one pathway, which really only inhibits osteoclast activity against the bone. Also, they have some risk of renal toxicity and osteonecrosis of the jaw, so it will be important to come up with a molecule that will not only enhance osteoclast activity, but also improve bone building and remodeling and have less toxicity. And we’re exploring some of these molecules in the clinic.

Impact of Funding

How will you use the NCI Cancer Clinical Investigator Team Leadership Award to achieve your research priorities?

Last year, I became Chairman of the Hoosier Oncology Group, which has been around for 25 years. The group started with the collaboration between clinicians in the community and academics in Indiana University School of Medicine, and it’s been successful in trying to bring new molecules to patients across Indiana and beyond. But my goal as Chairman is to transform the organization from another phase II or phase III trial-driven organization to one that is driven by a more molecular-specific plan, to achieve personalized medicine. What I’d like to be able to do is start looking at the biomarkers of all types of cancer and investigate why certain cancers respond to certain treatments and others don’t, as well as why certain patients develop toxicities while they’re receiving treatment and other patients don’t.

The $50,000 in funding from the award provides me with the protected time I need to coordinate these efforts. I’m reaching out to oncologists across Indiana and working with our investigators at the Simon Cancer Center to come up with the tools to recruit patients, collect tissue samples for biomarkers, and help design the clinical research needed to facilitate those goals.

I’m excited about the activity that we have at our institution, and I’m really excited about the buy-in from the community oncologists to participate in this kind of research, to both help reduce drug toxicities and increase the efficacy of our current chemotherapies for all cancers. ■

Financial Disclosure: Dr. Abonour reported no potential conflicts of interest.