Straight Dope on Medicine: Leukemia Game-Changer

Sometimes you can jump to the moon.

Doesn’t happen all that often.

I’m happy to report that the jump is being made with leukemia. Specifically, relapsed or refractory acute myeloid leukemia (r/r AML).

This is important because relapsed/refractory acute myeloid leukemia (AML) is a devastating disease with a poor prognosis and represents a major unmet medical need. In 2020, 19,940 new cases and 11,180 deaths are estimated in the United States.[i] Despite advances in therapy, prognosis remains poor, with 28% alive at 5 years after diagnosis.[ii] In particular, relapsed/refractory (R/R) AML is associated with dismal outcomes, and up to 57% of patients experience primary refractory AML, relapse after complete remission (CR), or death in the first 12 months after diagnosis.[iii]

These results are phenomenal. Now if only we get in into circulation and the relevant doctors educated. Doctor education is not what it should be. It is sporadic and vexing.

The Human Toll

Three of my five best friends from college died of cancer. It’s terrible.

Warren Gerleman

Visitation for Dr. Warren R. Gerleman 52 of Tower Lakes is from 3-7 PM. Saturday December 29, 2018 at the Kristan Funeral Home PC 219 West Maple Ave. (2 blocks west of Rt. 45 on Rt. 176) Mundelein. Mass of Christian Burial is 11 AM Monday December 31 at St. Wenceslaus Catholic Church, Spillville, Iowa. Interment will follow in the church cemetery. Warren was born October 2, 1966 in Cedar Rapids, Iowa and died Wednesday December 26, 2018 at St. Alexius Hospital, Hoffmann Estates. Warren graduated from Carmel Catholic High School, St. Norbert College and the National Chiropractic College of Lombard. He has been a Chiropractor for the past 27 years. He enjoyed woodworking, collecting family heritage and was a devoted father. Warren was also a member of the Knights of Columbus. He is survived by his son Garrett, parents Clark and Joyce (nee Lechtenberg) Gerleman, his brother Grant Gerleman, sister Kelli (David) Swisher, his nieces and nephews Amanda (Jacob) Carter, Austin and Adam Swisher, Monica Gerleman and his grand nephew William. In lieu of flowers memorials to St. Jude Children’s Research Hospital at www.stjude.org .

Summer Quimby

Passed away December 1, 2019 after a long battle with breast cancer at the age of 52 years. Loving mother of Anne (fiance Nathan Sippel) Mark, John Mark, and Brian Mark. Beloved daughter of David R. Quimby and Phyllis J. Quimby. Dear sister of Heather (David) Schuster, and Jennifer (Ben) Withers. Further survived by nieces, nephews, other relatives and friends.
Visitation on Saturday, December 7, from 10:00AM - 12:00PM at the funeral home chapel. Funeral service at 12:00PM. Interment private. In lieu of flowers, memorials to the Al-Anon Family Groups of Southeastern WI appreciated. www.alanon-wi.org
Our girl Summer was a rock star in so many ways. Kind. Generous of talent, time, and heart. She had a wonderful sense of humor. If things got hard, she sought find the humor and laughter. And/or, she would sing and sing loudly. And sometimes she would sing off key because it’s funny and made it easier to laugh instead of cry.
Summer was super smart. She graduated St. Norbert College with a double major in Math and Computer Science and earned a Masters degree from Purdue in Computer Science. It was at Purdue that she met her ex-husband Scott Mark and they married in the summer of 1992. Early in their marriage were blessed with 3 children, Anne, John, and Brian.
Somehow Summer managed a balancing act of raising her family and doing amazing work. She worked at places where she could make a positive difference in people’s health and the world. Some of these places included Bayer Laboratories, writing and testing software for Glucometers. She also worked at Indiana University Health Proton Center developing software for lasers, apertures, and what she would call neat do-dads or thing-a-ma-jigs when talking to us less knowledgeable. But never in condescending way. She spoke in a kind and fun and inclusive way that made you want to listen and learn more. Summer was diligent, detailed oriented, and her work was top notch. People who worked with her found her a delight. The last project Summer created for Siemens is still running well, and the techs continue to love using it. Someone recently mentioned, “We are using the report formats that Summer designed. They are so well laid out and have garnered praise from the groups who release instruments. Summer had an innate ability to understand what users needed and was
always willing to spend time with them and observe their work to make the programs and reports she produced not only meet their needs, but also reduce the amount of time they had to spend testing.
Her reports have all received praise from managers who are responsible for approving the releases and all appreciated the additional clarity she added by her design and formatting skills. Her work continues to impact the industry she so loved working in.”
Her work ethic extended into her personal life as a volunteer at her kids’ schools, clubs and activities.
Many will likely think of Summer as they purchase poinsettias this year and years to come. She and Scott mentored Mennonite Youth groups for years and kept in touch with many.
She hoped to pass along a strong work ethic to her kids. Sometimes she would bring the kids along for the fun of weeding or planting with groups at the state fair. And sometimes it was fun. Working and helping is a time to connect to others. A time to talk and to laugh and to seed friendships.
Some of Summer’s proudest moments were seeing her children move through milestones of youth.
She was able to see all three graduate high school and move into the next stages of their lives. Anne graduated from University of Madison and was hired at PPD to work in testing and development. John moved to Colorado to start life and work. Brian recently started at the University of Milwaukee. All three have ups and downs, as we all do, and continue to work hard.
Their trials and tribulations of growing into adults and navigating through the world never affected her love or pride of them. Something she somewhat secretly enjoyed doing was imagining what her kids would go on to do, knowing well what they all have inside them to do.
Summer wanted so much for her children and for all of us. She wanted to pass along her love of life, people, and the world. Life is often hard. But still good. People can be or do sucky things. They are human and mostly still good. Work hard, play hard. Spend time with people. Visit places. Learn languages. Get a passport. Use it. Step in the ocean from each coast if you can. Plan trips. Go with people you love. Get snow in your boots during a snowball fight. Pour loved ones hot cocoa or tea. Sit and talk. Laugh. Cry if you need to, it’s okay. Ask for help if you need to, that is okay too, people love you and want to help. Sing while doing the dishes. Admit when you’re wrong. People mess up.
Forgive. Be strong. Know your worth. Light a candle. Help someone light their candle. Enjoy a sunrise. Embrace the sunset. Love some more. Let go.

Kim Cimaglio

PALATINE - Beloved Mother, Daughter, Sister, Aunt, and Local Business Leader With a heavy heart, we announce the passing of Kimberly Ann Cimaglio. Born in 1966, Kim passed away on December 14, 2021, after a courageous and lengthy two-year battle with leukemia. Kim is survived by her daughter Grace, parents, Fred and Judy, brothers, Tim (Kristin) and Chris (Cindy), nephews, Chase, Parker, Zachary (Julia) and Sam, aunts, Jill Stone, Mary Stutz, and Nancy Cimaglio. She is also survived by many beloved uncles, cousins, and friends. Kim had an immense joy for life and was known for her generosity, volunteerism, and kindness. Born in Chicago and raised in Palatine, Kim, and her twin brother, Tim, attended St. Theresa School in Palatine. She then attended Sacred Heart of Mary High School in Rolling Meadows and graduated with a Bachelor of Arts in Communication from St. Norbert College in DePere, Wisconsin. Kim worked in education and development, eventually joining her family's business, Total Marketing Associates, where she ultimately became President of the company in 2017. Kim was an outstanding businesswoman, but more importantly, a wonderful mother, daughter, sister, and friend. On Monday, December 20, 2021, a Memorial Mass will be held at 10:00 AM at St. Theresa Church, 455 N. Benton Street, Palatine. The family requests no flowers. However, donations can be made in Kim's name to the stem cell program at Northwestern. Please make donations online at: https://foundation.nm.org/ Or make donations payable to the: Northwestern Memorial Foundation, PO Box 734985, Chicago, Illinois 60673-4985. 

What is Iomab-B?

It is a targeted radiotherapy.[iv]

AWE Technology

Actinium's Antibody Warhead Enabling (AWE) Technology Platform

Actinium's AWE technology platform is used to produce ARCs or Antibody Radiation Conjugates, a highly potent and selective form of targeted radiotherapy. ARCs enable the precision targeting of the proven therapeutic power of radiation to tumors and its synergistic potential with other therapeutic modalities that cannot be matched by traditional external beam radiation, cytotoxic chemotherapy or biologic therapies. AWE enabled ARCs exploit the use of highly selective targeted biological agents such as monoclonal antibodies that can seek out and bind cancer antigens found on the tumor cell surface to deliver potent radioisotopes that are capable of producing double strand DNA breaks for which there is no known resistance or repair mechanisms.

Through our AWE technology platform we are able to utilize multiple radioisotopes to match the needs of the desired indication. We have demonstrated our ability to label both hematologic and solid tumor targeting agents with isotopes ranging from beta-emitters Iodine-131 (I-131) and Lutetium-177 (Lu-177) to the alpha-emitters such as Actinium-225 (Ac-225).

The SIERRA trial utilized folks 55 and older, a group traditionally consigned to nontreatment or meager intervention due to their age. Now, right now, the Iomab-B results are carrying the moniker, “potentially curative” for this group. Hematologists need to be aware of this to best treat their patients.

Bone Marrow Transplant Induction and Conditioning in One

Iomab-B, Actinium’s lead asset, is being studied in the pivotal Phase 3 SIERRA clinical trial as an induction and conditioning agent in patients over the age of 55 with active relapsed or refractory Acute Myeloid Leukemia (AML) prior to receiving a bone marrow transplant (BMT), also known as a hematopoietic stem cell transplant or HSCT. The SIERRA trial completed patient enrollment in the third quarter of 2021.

Crossover means that the people in the control group were not responding to conventional treatment and engaged their “option” to get the experimental treatment. Sixty percent chose to receive Iomab-B.

CD45 is an antigen widely expressed on all types of blood cancer cells and immune cells.

Iomab-B was developed at the Fred Hutchinson Cancer Research Center where it was studied in several Phase 1 and Phase 2 trials in almost 300 patients in multiple blood cancer indications, including acute myeloid leukemia (AML), myelodysplastic syndrome (MDS), chronic myeloid leukemia (CML), acute lymphoblastic leukemia (ALL), chronic lymphocytic leukemia (CLL), Hodgkin's disease (HD), Non-Hodgkin lymphomas (NHL) and multiple myeloma (MM) and is currently being studied in several ongoing physician trials.[v]

In a Phase 2 clinical study in 58 patients with advanced AML or high-risk myelodysplastic syndrome (MDS) age 50 and older, Iomab-B produced complete remissions in 100% of patients and these patients experienced transplant engraftment at day 28. The overall survival rate of the 36 relapsed or refractory AML patients in the proof of concept study was 30% at one year and approximately 20% at two years.

Conclusion

When you double the rate of survival, people should be convinced and partake of your offering.

[i] Siegel RL, Miller KD, Jemal A. Cancer statistics, 2020. CA Cancer J Clin (2020) 70:7–30. 10.3322/caac.21590

[ii] National Caner Institute . SEER. SEER Cancer Stat Facts: Acute Myeloid Leukemia. https://seer.cancer.gov/statfacts/html/amyl.html Accessed June 27, 2020.

[iii] Walter RB, Othus M, Burnett AK, Löwenberg B, Kantarjian HM, Ossenkoppele GJ, Hills RK, et al.. Resistance prediction in AML: analysis of 4601 patients from MRC/NCRI, HOVON/SAKK, SWOG and MD Anderson Cancer Center. Leukemia (2015) 29:312–20. 10.1038/leu.2014.242

[iv] https://www.actiniumpharma.com/awe-technology

[v] https://www.actiniumpharma.com/product-pipeline/iomab-b