Profile:
Marina Kremyanskaya MD, PhD
Icahn School of Medicine, New York, NY, USA
From Bench to Bedside: Dr. Marina Kremyanskaya’s Mission to Revolutionize MPN Treatment
Downplaying a cure
“It is an experimental treatment. There is no doubt about it,” Marina Kremyanskaya MD, PhD, states plainly about a new anti-cancer vaccine for patients with myeloproliferative neoplasms (MPNs). The Associate Professor of Hematology and Medical Oncology at Icahn School of Medicine delivers her pitch with the candor of a salesperson who doesn’t work on commission.
Just beyond the frank, impartial consultation is the opportunity to be among the first to receive a personalized MPN immunotherapy treatment designed to target these rare cancerous cells. Clearly articulating the benefits and risks of a new potential cancer cure is a challenging but necessary part of seeking clinical trial participants.
Dr. Marina Kremyanskaya plays an important role in the treatment landscape, straddling the divide between patient and researchers. In many ways, she is the face of this phase 1 clinical trial (ID#: NCT05025488). The responsibility of explaining not only what a clinical trial is but also the nuanced experience of participation falls on her shoulders. Though frustrating at times, she loves it. “My passion really is clinical medicine,” she professes.
Kremyanskaya acknowledges the apprehension patients may have around clinical trials. Participation in a clinical study comes with the possibility of not obtaining the new medicine or experiencing an unknown adverse effect. Addressing questions about the risks and benefits, she patiently explains, “just how regulated it is and how very, very careful everybody is monitored.”
Kremyanskaya sees the personal attention participants receive as a huge bonus. “In fact, you get many more people on your team than when you’re a patient receiving regular treatment,” she says from experience.
Absent from many clinical trial discussions is a convincing personal perspective from doctors and scientists. When asked if they would enroll in a clinical trial themselves, they consistently respond with a resounding yes. “But, you know, some patients are interested, get excited and want to learn more, and some people say, absolutely not.” All responses are accepted and respected.
What Can You Do with an MD PhD?
At her Mount Sinai clinic in New York, Dr. Marina Kremyanskaya utilizes her dual expertise as an MD and PhD to push the boundaries of treatment for patients with myeloproliferative neoplasms. “As a physician, I hopefully help individual patients as I take care of them and have an impact on their lives and their families,” she notes, reflecting on her clinical work. However, she skillfully integrates her PhD training in experimental research to amplify her impact. “With research, potentially getting a new drug to the clinic has a huge potential to impact thousands, or maybe more, patients.”
The heart of Dr. Kremyanskaya’s work revolves around the concept of transforming laboratory discoveries into tangible treatments for patients. This journey “from bench to bedside” is often fraught with challenges but can lead to significant breakthroughs. She feels that clinical research is “the only way to bring new therapies to patients.”
Dr. Kremyanskaya’s research focuses on the mutation of a protein called calreticulin (CALR), a key player in the development of certain MPNs. She believes the unique surface protein could be effectively targeted with her trial’s vaccine. Through an MPN Research Foundation 2022 Thrive Initiative award, Kremyanskaya aims to harness the human immune system to target MPNs with the mutant CALR protein.
Empathetic Work
Despite the promise, Dr. Kremyanskaya emphasizes the major hurdle that all clinical trial researchers face. “The reality of clinical trial enrollments: we need patients!” An essential part of this effort is the willingness of patients to participate in studies and provide blood or bone marrow samples.
As research advances closer to answering the needs of patients, human samples become essential. While early tests use non-human animals such as mice, researchers must run studies using human cells and tissue before any clinical trial is possible. “The patients also have to be there and be willing to give us the samples. It’s a little bit more complicated than getting samples from mice,” Dr. Kremyanskaya quips.
Luckily, Kremyanskaya’s ability to empathize with patients is a cornerstone of her approach. “I think I’m good at putting myself in other people’s shoes, so to speak, to try to understand where they’re coming from.” This empathy is critical not only in patient care, but also in her united efforts with colleagues to complete this trial.
Kremyanskaya collaborates with scientists to explore the workings behind MPNs. “I think sometimes patients forget that it’s not just me wanting to get the sample,” Kremyanskaya says with a chuckle. She sees herself as a critical link in the chain, collecting samples from patients “to provide them to our scientists so they can do the experiments.”
Dr. Marina Kremyanskaya’s work exemplifies the power of combining clinical practice with rigorous scientific research. Her dedication to bridging the gap between the scientists and patients offers hope for new treatments and improved outcomes for MPN patients. As she, her team, and others across the country continue to explore the potential of targeting the mutated CALR protein, the future of MPN research looks promising, driven by compassion, collaboration, and an unwavering commitment to patient care.