Dr. Brad Kahl
Dr. Brad Kahl is the Skoronski Chair of Lymphoma Research and Associate Professor of Medicine at the University of Wisconsin School of Medicine and Public Health. He is also Associate Director for Clinical Research at the UW Carbone Cancer Center. Dr. Kahl received his medical degree from Tufts University. He is Chair of the Eastern Cooperative Oncology Group's (ECOG) lymphoma committee. He is also a member of the LRF’s Scientific Advisory Board and of the Mantle Cell Lymphoma Consortium's Executive Committee.
Broadly speaking, Dr. Kahl's current research focus is finding better ways to treat lymphoma patients. Usually, this means testing new drugs. An example of an exciting new drug that he is currently testing is ABT-199. This drug targets a protein called bcl-2, which is overexpressed in many lymphoma subtypes. ABT-199 effectively knocks down the level of bcl-2 inside lymphoma cells, making them more willing to die. In theory, ABT-199 should work best when combined with traditional chemotherapy. As Dr. Kahl puts it, "Sort of a 1-2 punch where we weaken the cell with the bcl-2 inhibitor and then knock it out with chemotherapy." What has been amazing for him to observe, is that ABT-199 is highly effective by itself for CLL/SLL and mantle cell lymphoma patients. In lymphoma subtypes where the single agent activity appears to be more modest, such as follicular lymphoma and diffuse large B cell lymphoma, Dr. Kahl is optimistic that the combination strategy will be an improvement over what we currently do. Those studies are now being designed.
In addition to ABT-199, Kahl notes there are several other tremendously new classes of drugs that target biochemical pathways important to B lymphocytes. Examples include drugs which target Bruton's tyrosine kinase (ibrutinib) and drugs which target PI3 kinase (GS1101, IPI-145). These drugs have the potential to revolutionize the way in which several types of lymphoma are treated. For Dr. Kahl, equally exciting is the growing ability to identify abnormalities in an individual patient's lymphoma and pick treatments armed with that knowledge. "We have a ways to go, but are getting closer and closer to the goal of individualized treatments."
As a member of LRF's Scientific Advisory Board, Dr. Kahl states that the Foundation has helped contribute to his research progress and to his career. "In 2010, the LRF awarded our team a $450,000 grant to study biomarkers that would predict a follicular lymphoma patient's likelihood of responding to single agent rituximab. We have three groups of scientists examining 3 different aspects of the question. Dr. Jim Cerhan, Mayo Clinic, and myself are focusing on Fc receptor polymorphisms. Dr. Erik Ranheim and Dr. David Yang, University of Wisconsin, are focusing on the tumor microenvironment. Dr. Randy Gascoyne, Vancouver, BC, and his group are doing gene expression profiling. We are making nice progress and expect to have completed the analysis of all three aims by the end of the year. This work would not have been possible without the LRF." With regard to his career, he adds that "My involvement with the LRF helps me be a better researcher and a better doctor. I sit on the LRF Scientific Advisory Board and the LRF Mantle Cell Consortium Executive Committee. These are wonderful forums for scientific exchange with colleagues."
Dr. Kahl has a deep, personal connection to the field. After the loss of his father to leukemia when he was 12, he decided to go to medical school and focus on cancer. During his 2nd year medical school hematology course at Tufts University, he found himself particularly drawn to the blood cancers. That summer, he took a research job with the lymphoma specialist at Tufts University/New England Medical Center (Dr. David Schenkein) and Dr. Kahl got to watch him in action. He liked Dr. Schenkein's approach to patients and could see he genuinely cared. The focus on the mix of patient care and research in his practice was very influential and Dr. Kahl he envisioned himself doing something similar. After an initial concern that he may have difficulty handling the emotional rollercoaster of treating cancer patients, Dr. Kahl came to realize he could be good at it someday. This is an area in which he now excels.
Chairing the Eastern Cooperative Oncology Group's lymphoma committee is Dr. Kahl's proudest professional accomplishment. Leading a large research group gives him an opportunity to make a big difference in the lives of lymphoma patients. Since he started in the field 13 years ago, there has been improvement in outcomes for diffuse large B cell lymphoma, follicular lymphoma, CLL/SLL, and Mantle Cell Lymphoma. He believes that, looking forward, we are on the verge of designing more tailored, individual treatment strategies for lymphoma patients and predicts we will soon be accurately identifying who among Hodgkin lymphoma patients will need intensive therapy or radiation treatments and who will not. Envisioning the not too distant future, Dr. Kahl thinks that we are not too far away from having specific treatments for the different molecular subtypes of diffuse large B cell lymphoma. And, that we have tremendously exciting new drugs for CLL/SLL and Mantle Cell Lymphoma, which are likely to have a major impact. In follicular lymphoma, a 2 drug biologic combination (lenalidomide and rituximab) is currently being tested against a chemotherapy combination. This trial could lead to a major paradigm shift in follicular lymphoma. Dr. Kahl believes that the lymphoma world could look very different 5 to 10 years from now. He says, "Currently, the major bottleneck to progress is our ability to rapidly and efficiently conduct appropriate clinical trials in lymphoma." Relieving this bottleneck will require unprecedented US and international collaboration and Kahl plans on spending his energy forging these collaborations.
As an accomplished veteran in the field, we asked Dr. Kahl to share three key pieces of advice that he would give to a researcher just starting out:
Dr. Kahl has this advice for patients recently diagnosed with lymphoma, "There is reason to be hopeful. There is an army of doctors and researchers working day and night to help you. Keep the faith and look for ways to give back by participating in clinical trials, volunteering, or with your donations. We are all in this together."
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