Reprogramming Cancer from Within

I'm Daniel Levine, and this is the Bio Report. Leukemia once threatened Aaron Vinnie's life, but now it defines his mission. Diagnosed with acute lymphoblastic leukemia as a college student, he survived chemotherapy, central nervous system relapse, and an allogeneic stem cell transplant from his younger brother, an experience that made him aware of both the power and toxicity of conventional cancer care. Today, as a hematologist oncologist and laboratory researcher at Columbia University, Vinny is helping reimagine how we treat blood cancers by shifting from blunt cell killing approaches to precision strategies that rewire malignant cells in their ecosystems. We spoke to Vinny, assistant professor of medicine at Columbia University, Vageles College of Physicians and Surgeons, about the case for thinking of hematological cancers as regulatory problems rather than focusing on genetic mutations, the potential for looking at epigenetic activators and deactivators of genes to treat them, and how he's harnessing new technology to look at cell surface proteins to distinguish regenerating marrow from refractory leukemia. Aaron, thanks for joining us. Glad to be here. We're gonna talk about hematological cancers, traditional therapeutic approaches to developing therapies that kill cancers and the case for reframing that approach to these diseases by seeking to rewire or reprogram cancer cells. I'd like to start with your own history. You were diagnosed with acute lymphoblastic leukemia more than twenty years ago. What happened? Yeah. I guess that's one way to just kinda dive right into it. Sure. So, I love the framing of killing cancer cells with with essentially poisons and and dichotomizing that from trying to reprogram and rewire cancer cells, which has been a lot of the effort of some of our research focus. But personally, yes, indeed. I was diagnosed with acute lymphoblastic leukemia, when I was 20 years old. I was a junior in college. And this is a disease that is, prevalent, rather uniquely both across, young children, older adults, and also in people who are kind of termed the adolescent and young adult stage. So I was an AYA patient, with a disease that's largely been classified and thought of as a pediatric leukemia, which which creates, some additional layers of of complexity. And so, you know, what leukemia is at its core, and I think this will be relevant for some of our discussions later, is you have these important stem cells in your bone marrow, and all of the stem cells that you're ever gonna have, you're born with. Those stem cells, mostly remain, dormant and, quiescent. And only a small population of those stem cells at any given time are the ones that are repopulating your blood. They're making the red blood cells that carry oxygen. They're making the white blood cells that help fight infection, and they're making the platelets that help you clot the blood if you have any tissue injury. And importantly, they also have the ability to self renew. And so over your lifetime of, say, eighty to a …