Charting the Course in Myeloma: Durie Keeps Standards, New Goals in Sight

Beth Fand Incollingo @fandincollingo
Published: Monday, Jun 10, 2013
Dr Durie and his wife Susie Novis

Photo courtesy of the International Myeloma Foundation

Dr Durie is chairman of the International Myeloma Foundation while his wife, Susie Novis, left, serves as president.

As one of the world’s top multiple myeloma physicians and researchers, Brian G.M. Durie, MD, can boil his mission down to one simple goal: saving lives. But it was two people the doctor couldn’t save who have most affected his path.

His father died, after a long illness, when Durie was 11.

“In the years leading up to that, the doctor was constantly visiting our house,” recalled Durie, who grew up in a fishing village in Scotland and is now in his 60s. “I became very much familiar with doctors and looked up to the ones who were helping the family. So my desire to become a doctor stemmed from that experience.”

Years after he’d become a driving force in the multiple myeloma community, Durie treated a patient, Brian Novis, who also eventually succumbed to aggressive disease.

During the time they knew each other, Durie and Novis launched the nonprofit International Myeloma Foundation (IMF), meant both to inform patients and to push forward research into new and better treatments.

When Novis died, Durie left a senior post at a London hospital to take over as medical director of the foundation and chairman of its board, working side by side with Novis’s wife, Susie, who moved into the position of president.

Three years later, Durie and Susie Novis were married. Circumstances put the two together, Durie said, and “we connected.”

Today, the couple continues to run the IMF, whose role in changing outcomes for patients with multiple myeloma has grown exponentially.

Durie heads up the foundation’s International Myeloma Working Group, the research arm of the organization. In that role, he has forgone running his own lab for an alternative method of conducting research—collaboratively, with scientists around the world.

“I started my career with a biology lab in myeloma, but as the IMF evolved, I began to contract out sequencing and molecular genetics projects to larger labs with sophisticated equipment that we couldn’t afford to buy,” he said. “Now, one of my functions is to coordinate collaborative projects where research of a certain type is done in one lab—for instance, DNA sequencing in Rotterdam—and then cell biology is done in another lab with expertise in that area. This type of networking in science is a new way forward.”

Since the Working Group has grown to include 160 of the world’s top experts in multiple myeloma, it is able to assess outcomes for very large numbers of patients, and to issue guidelines that “are sensible and based on facts”—including recommendations on risk stratification and maintenance therapy for patients with the disease, Durie said. “It has allowed us to focus on which treatment will work for a patient and which will allow the best quality of life.”

Another recent project, also made possible by the size and reach of the Working Group, identified the key features of the 20% of patients with multiple myeloma likely to attain meaningful longevity by undergoing stem cell transplant.1

“It’s very satisfying to know who should get a recommendation for stem cell transplant,” Durie said. “Although not trivial, the procedure can allow these patients to go off treatment or onto maintenance, function well, and return to their families and their work for many, many years.”

Managing a Full Roster

Durie is also very involved in conducting clinical multiple myeloma research outside of the foundation.

As chairman of the Myeloma Committee within the cooperative SWOG (formerly the Southwest Oncology Group), he is principal investigator for SO777, a phase III, 600-patient trial comparing lenalidomide plus dexamethasone against the two drugs in combination with bortezomib (NCT00644228).

“This is a key question in myeloma right now—whether patients need to be treated with three or more drugs versus maybe just two, while saving the third for later,” Durie said. “This is an important trial, and a lot of people are waiting to see the results.”

Durie is also the founder of the Academic Myeloma Consortium, or AMyC, a group of a dozen investigators across the United States working together to develop trials and enroll patients.

“Our goal is to pick up drugs at phase I and II, assess their effectiveness and toxicity, and try to move them forward into other trials,” Durie said.

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