Every year the ASCO, the American Society of Clinical Oncology, on the occasion of the annual congress held in Chicago awards with its highest recognition, the David Karnofsky Award, the person who has distinguished himself over the years for having made a decisive contribution to the fight against cancer. This year the prestigious award – named after one of the pioneers of oncology thanks to the development of the first chemotherapy drugs in the 1940s – went to Hagop Kantarjian of the MD Anderson Cancer Center in Houston. To him the merit of having laid the foundations for the development of various therapies capable of changing the history of many blood cancers, leukemia in primis. But that’s not all: with the Karnofsky Award, ASCO wanted to reward Kantarjian’s commitment to guaranteeing access to medicines for everyone, regardless of social status. A subject, this of accessibility, which concerns us more closely than we might think.
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Da Beirut a Houston
Lebanese from Beirut, after graduating in medicine from the American University in Lebanon, Kantarjian made the decision to move to the United States for a period of study at MD Anderson in Houston. His, as he explained during the award ceremony, was an intuition: “I immediately had the impression – he says – that that place would become one of the most avant-garde centers in the world for anticancer treatments”. An intuition that became reality thanks also to Kantarjian.
Early research on chronic leukemia
He joined the staff of the Texan hospital permanently in 1983, those were the years in which chronic leukemias – chronic lymphatic and chronic myeloid, typical adult neoplasms – had very low cure rates: only 20-30% of people could be successfully treated. A situation destined to change radically thanks to research which has identified the Achilles heel of leukemia cells in tyrosine kinase proteins. It was precisely in those years that MD Anderson began to test the first therapies with tyrosine kinase inhibitors such as imatinib, dasatinib, nilotinib, bosutinib, ponatinib and, more recently, olverembatinib. Kantarjian had the merit of developing therapeutic regimens capable of combining different approaches, leading over the years to cure chronic leukemia with very high success rates. Today, thanks to his research, diseases such as chronic myeloid leukemia can be successfully tackled.
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Treatments without chemo for acute leukemia
ASCO also recognized the great contribution to the development of new treatments for acute forms of leukemia to the Lebanese scientist. In fact, in 2017, thanks to the studies of his research group, he helped to develop a treatment protocol without chemotherapy consisting of the use of ponatinib and blinatumomab for Philadelphia positive acute lymphoblastic leukemia. Updated data for this combination indicates a 4-year survival rate of over 90%, a remarkable achievement. And it is precisely on the acute forms that Kantarjian is now concentrating his efforts. The basic idea that is animating the activity of his group is that of ever less recourse to chemotherapy. “In acute lymphoblastic leukemia – explains the expert – we are promoting the concept of an ever shorter and less toxic chemotherapy. A possible goal thanks to the development of new trispecific antibodies. The ultimate goal is the abandonment of chemotherapy or its very limited use in order to increasingly improve the quality of life of the patients”.
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The commitment to equitable access to care
But for ASCO Kantarjian’s contribution does not stop at research alone. In parallel with the development of new drugs, the Lebanese scientist over the years has become increasingly interested in the question of access to therapies and in particular the devastating effect of the lack of treatment due to the high prices of anticancer drugs. “When we developed the first tyrosine kinase inhibitor, imatinib, in 2000, the cost of the drug was $32,000 a year. In 2012, it increased to 120 thousand. This is a common trend for many cancer drugs and more,” Kantarjian explained.
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An unacceptable situation that has led him in recent years to firmly engage in the fight against rising prices and to raise awareness of the need for accessible and universal health care. However, woe to think that Kantarjian’s “battle” concerns only the healthcare model of the United States. Thanks to the development of increasingly sophisticated molecules, the prices of anticancer treatments have increased considerably throughout the world over the years, undermining the sustainability of many national health systems, including ours. That’s why Kantarjian’s commitment concerns us closely.
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