Dr. Danelle James has been working to understand the role of the tumor microenvironment in CLL. Her goal is to define and develop novel therapeutic strategies that target the leukemia cell interaction with the non-tumor accessory cells in the CLL microenvironment. Dr. James has spent extensive time in the lab and has pursued formal training and education in clinical research. Therefore, Dr. James is well poised to bring new therapies to patient with CLL.

In the body, CLL cells are resistant to dying even in the setting of chemotherapy. The Kipps lab has shown that nurse-like cells, found in the lymph organs of patients with CLL attract CLL cells and protect them from spontaneous or drug induced cell death in-vitro. Nurse-like cells and other accessory cells in the CLL microenvironment likely play a similar role in supporting the survival of leukemia cells in the body.

Dr. James believes, “Targeting the microenvironment in CLL and low grade lymphomas might lead to the development of curative therapies.” The CLL Research Consortium will be instituting a multi-center national phase II study to evaluate the combination of Revlimid and Rituximab for the frontline therapy of CLL. Revlimid is an immunomodulating agent that has impressive clinical activity in relapsed CLL and likely works by targeting the tumor microenvironment.

The clinical study is designed to have companion biologic corollary work to better understand how this agent works in CLL and to see if we can predict those who are more likely to respond to this therapy. The Revlimid and Rituximab trial will open for enrollment before the end of this year.