Where Are They Now? Anita Kumar, MD
When did you become interested in the study of lymphoma?
I did my internal medicine training at the Brigham and Women’s Hospital in Boston, initially thinking I wanted to pursue a career in cardiology. The two biggest programs there were cardiology and oncology. I started my intern year on the oncology service with Dr. Ann LaCasce, who is a lymphoma specialist at the Dana-Farber Cancer Institute and Chair-Elect of the Lymphoma Research Foundation’s Scientific Advisory Board (SAB). She was such an inspiring teacher, mentor, and clinician—a compassionate doctor who cared deeply for all of the patients and a talented teacher in the field of hematologic malignancies. I feel so lucky I met her earlier in my career and benefited from her guidance. She remains an important role model to me and is definitely one of the biggest reasons I decided to study lymphoma.
I conducted a subsequent research project with Dr. LaCasce and Dr. Gregory Abel at Dana-Farber, looking at central nervous system (CNS) prophylaxis in diffuse large B cell lymphoma (DLBCL) using the National Comprehensive Cancer Network (NCCN) database. Because of that research, I was mentored by Dr. Craig Moskowitz, a lymphoma specialist and leading investigator in the field of Hodgkin lymphoma (HL), when I began my fellowship at Memorial Sloan Kettering Cancer Center (MSK). Dr. Moskowitz is also a past member of the LRF SAB and current member of the LRF Mantle Cell Lymphoma Consortium (MCLC). Similarly, he was a wonderful role model—such a caring physician, an inspiring clinical researcher, and a talented mentor who really believed in the success of his mentees, supporting our development and celebrating our successes.
I also enjoyed seeing lymphoma patients. Of course, the disease biology is interesting. It’s clinically and biologically heterogeneous; there are many different subtypes of lymphoma. It can be curable. It can also be manageable over the course of a lifetime. When I started my career about 10 years ago, there were a number of new therapies being developed. And since then, there’s been an explosion in terms of the research and the advances in the field.
At what point in your career did you receive funding from LRF? What kind of grant did you receive?
I first received funding from the LRF Lymphoma Scientific Research Mentoring Program (LSRMP). That was a great program during my fellowship at MSK, where I submitted a project I’d been working on with Dr. Moskowitz for a novel treatment program of brentuximab vedotin (Adcetris) and AVD (doxorubicin [Adriamycin], vinblastine [Velban], and dacarbazine) chemotherapy for early-stage, unfavorable-risk HL patients. My time in the LSRMP was tremendous. The Scholar class came together for a week-long intensive workshop with incredible mentors across the field of lymphoma from many different institutions. I received specific feedback on my LRF research project, which was valuable because I was writing the protocol and designing the clinical trial. But there was also a curriculum that offered general advice about how to build a successful career in the field of lymphoma. I remember many leaders in the field gave such great talks about how to support a research program, how to receive funding, and how to publish successfully in top peer-reviewed journals. I found that advice and mentorship so valuable.
What were you hoping to achieve with your LRF research grant?
My LRF research grant studied a novel combination of an antibody drug conjugate for brentuximab vedotin that targeted CD30 and is linked to monomethyl auristatin E (MMAE), in conjunction with a standard AVD chemotherapy. The purpose of using this combination was to see whether we could potentially reduce or limit the extent of radiation required for patients who presented with bulky mediastinal early-stage HL to limit the long-term side effects of treatment.
Was the grant funding you received from LRF vital to advancing your career in studying the disease and treating people with lymphoma?
Absolutely! The Lymphoma Research Foundation has been such a tremendous support during my career. I feel so grateful to LRF for the way in which it helped introduce me to important leaders in the field to gain helpful advice and guidance about how to develop a successful academic or research career. That began in the LSRMP. But I was also fortunate to receive an additional grant from LRF, a clinical career development award (CDA) for a clinical trial studying ibrutinib (Imbruvica) in T-cell lymphoma.
The treatment was not successful in the sense that we did not further develop the use of ibrutinib in T-cell lymphoma because it did not have a high level of activity in that disease. But we did learn that ibrutinib alone is not a viable option to treat the disease. Nevertheless, garnering that research support and being a part of the LRF community has been tremendously valuable in terms of learning how to successfully write a grant and design and execute a clinical trial. In addition, through LRF I’ve learned how to successfully write up the results from a study, even if they’re negative results, and what you can learn from a study that can help you gain new insights into developing a better treatment. And then how do you also collaborate with others, not only for ongoing mentorship, but also for collaboration, for correlative science and for multicenter efforts? All of those things I’ve taken away from my funding and support from the LRF have been tremendously valuable.
How has your LSRMP and CDA research impacted the work you do today?
Although I’ve shifted from HL and T-cell lymphomas, the support I received from LRF through my participation in the LSRMP and CDA helped to set the stage in my work in mantle cell lymphoma (MCL), where I currently lead the Mantle Cell Lymphoma Research Program at MSK. Many of the principles and themes I learned in the context of the LSRMP program and workshop and ongoing leadership and training, as well as the skills I developed, have helped build a strong foundation for developing a successful research career more broadly.
Recently, my LSRMP Scholar class got together again, and we continue to maintain those professional ties. I continue to get great advice from and continue to touch base with my mentors from the program. Being part of that broader lymphoma family across the country, and even beyond, has been so valuable. Many questions we can’t answer alone at our own institutions, and many of the diseases we treat are rare diseases. So, we need those collaborations and that network. We need those connections to be able to answer the most important questions for our patients.
Much progress has been made in the development of targeted therapies to treat lymphoma/chronic lymphocytic leukemia (CLL). Can you describe your work in the realm of targeted therapies? Why are these therapies important and why do they represent a new frontier in the treatment of lymphoma?
The concept with targeted therapies is that each case of lymphoma is unique. And if we understand the disease biology and its molecular underpinnings, we can potentially design more individualized therapies that allow us to target the pathways or the mutations most critical for the survival of that lymphoma. For example, genomic profiling of many of our patients with lymphomas can help us understand the pattern of mutations in each specific patient. Then, we can try to use that information to understand what’s driving that cancer cell to grow and how we can target this at a molecular level.
And there have been a number of targeted therapies. For example, Bruton’s tyrosine kinase (BTK) inhibitors have been an important treatment development in the field of lymphoma and CLL that have revolutionized the treatment for patients with MCL, because we understand there’s chronic activation of the B cell receptor pathway and BTK sits within that pathway. Targeting that site can be very effective to treat MCL patients. Similarly, we continue to learn more about the mutational profiles and the molecular underpinnings of the different histologies and subsets within lymphoma to try to personalize therapy for our patients.
How has your involvement with LRF evolved since receiving an early career grant?
I continue to be involved with LRF in a variety of educational programs. The Foundation has great programming for our [MSK] patients in New Jersey and in New York. And as speaking faculty for their education programs, I’ve been able to help engage with other patients and their loved ones on topics like clinical trials and the basics of lymphoma. It’s important to educate not only at a one-to-one level with our own patients, but also more broadly within the lymphoma community. LRF has also proven to be a wonderful leader in the scientific and academic clinical community. It hosts a number of different scientific workshops that allow us to get together as a scientific community and collaborate.
Why is LRF’s mission and focus on lymphoma-specific research and research programming so important? How would the lymphoma community be impacted if there was no LRF?
The Lymphoma Research Foundation helps in so many different ways. It helps advance life-saving research, helping fund crucial clinical trials and research endeavors that have contributed to many FDA approvals and advancement in the field. And it has contributed to supporting many of our research and clinical careers. It also serves as a vital source of education and counseling. It brings patients together who have similar experiences, so they can support each other. It also provides patients with actual resources, whether it’s financial support or just connection, psychosocial support, or community. All of those dimensions are important.
It brings the lymphoma experts closer to individual patients. We know only a fraction of patients can receive their care in a medical or academic center. But LRF democratizes that type of expertise. So, you have many lymphoma experts who will come together for the “Ask the Doctor” patient education series, where patients living in smaller cities, towns, and communities can ask specific questions about new treatments and research in their disease area.
What research or projects are you currently pursuing that you would like to share with our readers?
One of the most important is the BOVen study, which is a combination of zanubrutinib (Brukinsa), obinutuzumab (Gazyva), and venetoclax (Venclexta), for high-risk MCL patients. We know patients with P53 mutant MCL do poorly with current chemo immunotherapy or standard chemo immunotherapy programs. This is a novel combination of targeted therapies, which we believe has strong biologic rationale for having a higher degree of activity in patients with high-risk MCL. And this is a clinical trial open here at MSK and at Mass General Hospital in Boston. It is a rare subset of an already rare disease, so we are trying to get the word out about this trial because we’ve seen exciting activity thus far. We believe it represents an unmet need within the field of MCL.
What are you most excited about in the field of lymphoma research today? Why?
One of the things that makes me very excited, especially in the field of MCL research, is that we’re moving away from a one-size-fits-all approach. There’s an interest in learning as much as we can about a patient’s individual disease profile, their specific biologic and clinical characteristics, so we can tailor our treatment programs based on a patient’s disease biology and their clinical features. This way, patients have received treatments that have the highest likelihood of having excellent clinical activity, but also consider maintaining a patient’s quality of life and minimizing toxicities. Just because we have a hammer, doesn’t mean everyone needs to receive the same “hammer.”
Having individualized treatment planning based on a strong understanding of a specific disease biology is the
next frontier and what makes me really excited about the work we’re doing in the field of lymphoma.
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Pulse is a publication of the Lymphoma Research Foundation, providing the latest updates on the Foundation and its focus on lymphoma and chronic lymphocytic leukemia (CLL) research, awareness, and education