Mapping Acute Lymphoblastic Leukemia (ALL) Subtypes: An Interview with Todd Druley of Mission Bio (Pt. 1)

Did you know that September is Childhood Cancer Awareness Month? Although September has just passed, it is still important to raise awareness of the many different forms of childhood cancer – and the research being done to assist these patients. For example, a recent article published in Nature Genetics is the first study to offer a thorough and comprehensive view of the co-occurring single cell genetic mutations and protein expression across many subtypes of pediatric acute lymphoblastic leukemia (ALL). 

So how did this study come to be? Well, Mission Bio’s Tapestri™ platform helped researchers from St. Jude Children’s Research Hospital explore combinations of mutations inside and proteins on the surface of individual leukemia cells from particularly troublesome cases that didn’t respond well to standard treatment. The research has the potential to improve the ability to identify who is most at risk of treatment failure, but also what other treatment options may improve outcomes. What if, moving forward, treatments can become more personalized? Can studying the genetic makeup of the cancer in treatment-refractory patients help overcome treatment resistance and other barriers?

I recently sat down with Todd Druley, MD, PhD, the Chief Medical Officer (CMO) of Mission Bio, to discuss the importance of raising awareness, the powerful findings from this study, and the most rewarding – and most challenging – parts of working within this realm.

About Todd Druley, MD, PhD

Todd Druley, MD, PhD, trained as a pediatric oncologist. After earning his bachelor’s degree from the University of Illinois at Urbana-Champaign, Todd went on to the Medical Scientist Training Program (to pursue his MD and PhD) at the University of Illinois in Chicago before moving to Washington University and St. Louis Children’s Hospital to pursue his specialty clinical training in pediatric oncology. 

Todd is a board-certified pediatric oncologist and was previously an Associate Professor of Pediatrics, Genetics and Developmental Biology at St. Louis Children’s Hospital and the Washington University School of Medicine. He oversaw a molecular genomics research laboratory for around 15 years, as well as caring for pediatric cancer patients of all types. He made a transition into industry in 2019, working first as the Chief Medical Officer (CMO) of ArcherDx and ANGLE Biosciences before moving to Mission Bio as its CMO in April 2022. 

His Mission Bio profile explains that:

Todd’s research program focused on improving molecular diagnostics for a variety of cancers, but specifically myeloid leukemia. He has published over 60 peer-reviewed manuscripts, patented error-corrected NGS methods to improve AML MRD detection by next-generation sequencing, and built clinical programs based on genetic predisposition to cancer.

When asked why he chose to focus on pediatric oncology specifically, Todd shared that his cousin’s son passed away from acute myeloid leukemia (AML) in the late 1990s. 

I was in medical school at the time and could see the rapport between my cousin and their pediatric oncologist. It was really profound to me. At the same time, I was doing cancer research and thought that this would be a good line of focus.

Acute Lymphoblastic Leukemia (ALL): An Overview

Also sometimes referred to as acute lymphocytic leukemia, Todd describes acute lymphoblastic leukemia (ALL) as:

A cancer affecting a specific type of white blood cells called lymphocytes. These arise from the bone marrow or from a gland called the thymus. ALL occurs when the body loses control over lymphocytes, allowing them to divide rapidly and indefinitely, and infiltrate areas of the body where they do not belong. Although ALL is relatively rare in patients older than 30, it is the most common pediatric cancer. Pediatric oncologists see ALL quite a bit.

In ALL, immature lymphocytes acquire mutations that transform healthy cells into cancerous lymphoblasts. Risk factors include having a sibling with ALL, previous cancer treatment or radiation exposure, or having certain genetic disorders. Symptoms of acute lymphoblastic leukemia can (but do not always) include:

  • Swollen lymph nodes
  • Fatigue and general weakness
  • Bleeding from the gums
  • Shortness of breath
  • Fever
  • Frequent nosebleeds
  • Bone pain
  • Frequent or recurrent infections
  • Pallor (pale skin) 

There are numerous different forms of treatment, such as radiation, bone marrow transplants, targeted therapy, and chemotherapy. Todd shares that:

Chemotherapy is the main form of treatment, which can be long and harsh. For unclear reasons, boys don’t respond as well as girls to treatment, so boys receive three years of treatment whereas girls are only treated for two. A lot of studies are trying to understand the gender difference but there is no good explanation yet. If they fail their treatment, they move on to bone marrow transplants.

Why Raise Awareness?

It is incredibly crucial to raise awareness about acute lymphoblastic leukemia and other forms of childhood cancer. This is because many people are still unaware of the impact it has. Todd shares:

It’s still surprising when I hear adults say that they didn’t realize that kids could get cancer, or that their family could be affected. I want people to know that this happens. Children can have lifelong effects from cancer. They don’t just go back to normal. I hope that, through sharing my insights and this new data, people will become more engaged and aware of going on and how they might help future children.

Further, Todd hopes that through raising awareness, there will be more research spurred that specifically focuses on childhood cancer, its unique needs, and treatments that lead to the highest quality of life for these patients.

Don’t forget to join us in Part 2 as we discuss Mission Bio, mapping ALL genetic mutations, and the struggles and rewards of oncology.

Jessica Lynn

Jessica Lynn

Jessica Lynn has an educational background in writing and marketing. She firmly believes in the power of writing in amplifying voices, and looks forward to doing so for the rare disease community.

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