Advances in Hematologic Malignancies
Issue 11, Fall 2019
Why did you decide to work in oncology?
I have been interested in cancer biology since my time as an undergraduate student, but what ultimately convinced me to become an oncologist was my rotations on the inpatient oncology services during my internal medicine residency at Brigham and Women's
Hospital. I formed close relationships with my patients on those services, and was struck by how quickly the field of cancer medicine was changing. Even over the course of my three-year residency, new targeted therapies and immunotherapies were developed
that changed the treatment approach and outcomes for many patients.
Tell us about the condition(s) you specialize in. Why is this an area of interest to you? What led you to focus here?
I specialize in caring for patients with lymphoma. Lymphoid malignancies are an incredibly diverse set of cancers, affecting men and women of all ages and ranging from very indolent to extremely aggressive diseases. This
diversity makes each clinic day interesting and always different from the one before. We have excellent treatments for many types of lymphoma, and it is so rewarding to guide many patients from an unexpected diagnosis of cancer to a long-term remission.
However, for many lymphoma patients, treatment options are limited, which provides constant motivation to study and develop new lymphoma therapies that can improve outcomes for my patients.
What are the main challenges in this area? How do you address these challenges with patients/families?
Given the diversity of lymphoma, it's not surprising that we face a number of different challenges depending on the patient or the specific lymphoma subtype. In each visit, I prioritize patient education, because I believe that a better understanding
of one's disease and treatment is empowering for patients.
For example, young patients who are diagnosed with lymphoma may still be in school or beginning their career, or may be thinking about starting a family. As an institution, we have support networks to help make decisions about taking time off from school
or work and considering fertility preservation for patients who hope to have children after their cancer treatment.
Patients with indolent lymphomas also face unique challenges. In many cases, these patients don't require immediate treatment for their lymphoma; observation without treatment can generate anxiety for patients and family members. In these situations,
I reassure patients that watchful waiting is an effective approach for their lymphoma and that even without treatment, they will be followed closely and supported.
Describe your research work. Why is this an area of interest for you?
I am interested in designing clinical trials, with a particular interest in immune-based treatments, like immune checkpoint agents and cellular therapies. Immune checkpoint agents targeting the PD-1 receptor (like nivolumab and pembrolizumab) have dramatically
improved treatment options for patients with classical Hodgkin lymphoma. Through close collaboration with basic science labs at Dana-Farber, I hope to identify and test novel immunotherapy strategies in Hodgkin lymphoma
and other lymphoma subtypes.
What are you most excited about in lymphoma? What holds promise for patients?
There are so many exciting new advances in lymphoma. Chimeric antigen receptor (CAR) T cells have already dramatically changed the treatment landscape for patients with relapsed or refractory
diffuse large B-cell lymphoma, and PD-1 inhibitors are having a similar effect for patients with Hodgkin lymphoma. I am also excited about rapid improvement in prognostic markers, which may help us to better tailor therapies for individual patients.
Most lymphoma patients have small amounts of circulating tumor DNA in their blood, and by looking at changes in the amount of circulating tumor DNA, it may be possible to determine earlier, less invasively, and more accurately which patients are responding
What do you like to do when you're not caring for patients/doing research? What do you do for fun?
Whenever possible, I like to hike and be outdoors. I also love to travel, play tennis, and spend time with friends and family.
Learn more about Dr. Merryman