Meet five women who are making a difference in Memphis.
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St. Jude Children's Research Hospital
As she unlocks the mysteries of how individual genes interact with medicines, this Phoenix transplant is making life easier for countless young cancer patients.
In choosing her field of college study, Mary Relling settled on pharmacy at the University of Arizona at Tucson. “I was really an English or history major type,” she says, “but I had also discovered I was pretty good at chemistry.” With a degree in pharmacy, she explains, “I could apply chemistry to practical problems.” That decision has been literally life-saving for many children at St. Jude Children’s Research Hospital, where Relling is chair of the pharmacy department. Since she joined the staff as a postdoctoral fellow in 1985, her research has helped boost cure rates, decreased the side effects of certain medicines, and broken new ground in the field of pharmacogenetics.
When she was nearing completion of her doctorate of pharmacy and realized she wanted to focus on pediatric cancer, her colleagues informed her, “There’s only one place to go: St. Jude.” So the Phoenix native headed to Memphis to work with Dr. Bill Evans, who is now the hospital’s CEO and Relling’s husband of 23 years. With a joint interest in pharmacogenetics — which explores the role genes play in a medicine’s effect — the couple has seen projects they started years ago result in beneficial changes. Their marriage also benefits from their professional partnership: “Our work is so integral to who we are; we don’t have to stop and explain anything.”
In their studies, Relling and her colleagues have learned that genetic variances identify patients who are at high risk for side effects. “But it’s one thing to study genetics in the laboratory and make discoveries,” she says. “It’s another thing entirely to say, ‘How come when Joan goes in to see her doctor, nobody does a DNA test to decide what medicine and what dose she should have?’ So we’re sort of putting together all the world’s literature on how genetics should be used to change the way we give medications, applying the knowledge to day-to-day care.”
Relling, whose lab receives $2.9 million in annual funding from the National Institutes of Health grants, explains what motivates her studies. “I’m not one of those scientists driven by an insatiable curiosity of how biology works. We need scientists like that and St. Jude has a lot of them. But for me it’s about how we can better care for our patients and improve their lives. Everything I do is driven by that.”
Sometimes that drive leads to exciting moments when a solid discovery in the laboratory has implications for change. “Those moments don’t happen every day,” she says, “so when they do, they’re special.” As an example, she tells of an analysis her lab conducted of anti-seizure medications. “We suspected that some medicines were revving up the livers of certain patients and making their bodies rid the anti-cancer medicines too quickly,” she says. “The study showed exactly who got the medicine and who didn’t. From that we could show what patients had a higher leukemia relapse rate after receiving those medicines.”
That finding led to recommendations that have altered the way doctors around the country administer the drugs. “So while I make new discoveries, a huge chunk of my efforts is implementation science,” says Relling. “That means I take what’s been discovered and validate it. I get calls and emails every day from people wanting us to share exact procedures on how to use genetics to give better medications. In other words, if a patient has gene A, give him drug B. If he has gene B, give him drug X.” She and her colleagues are writing the rules as a guide for clinicians. “If we don’t do it at St. Jude,” she asks, “who will?”
Relling hopes to see genetics incorporated into a universal healthcare system. “If we had a universal system for at least tracking and dispensing medications on each patient,” she says, “then making the leap to genetic testing would not be so unthinkable.”
One of only a handful of Tennesseans named to the prestigious Institute of Medicine, Relling’s also a stepmother and grandmother and a satisfied Memphis transplant. “I like downtown, all the good restaurants and the music,” she says. “And I really love St. Jude and its international flavor. We’ve met a lot of great people here.” — Marilyn Sadler