Latest Advances in Leukemia Treatment

Introduction

Leukemia is a type of cancer that affects the blood and bone marrow. It starts in the bone marrow, the spongy tissue inside bones, where blood cells are made. There are four main types of leukemia, but the most common types are acute lymphoblastic leukemia (ALL) and acute myeloid leukemia (AML). Treatment for leukemia often involves chemotherapy, radiation therapy, stem cell transplant, or a combination of these. However, in recent years, researchers have been working on developing novel treatments that target cancer cells more specifically and are less toxic to healthy cells. Here are some of the latest advances in the treatment of leukemia.

CAR T Cell Therapy for Relapsed or Refractory B-ALL

CAR T cell therapy is a type of immunotherapy that uses a patient’s immune cells to fight cancer. In this therapy, T cells, a type of white blood cells, are taken from the patient’s blood and then genetically modified in a laboratory to produce chimeric antigen receptors (CARs) on their surface. These CARs can recognize and bind to specific proteins on cancer cells and then kill them.

Recently, a novel anti-CD19 autologous CAR T cell therapy called obecabtagene autoleucel (obe-cel) has shown promising results in treating adults with relapsed or refractory B-ALL, according to a Phase Ib/II FELIX clinical trial. The therapy achieved durable remissions in 40% of patients without a subsequent stem cell transplant (SCT) at a median follow-up of 21.5 months. The 12-month event-free survival and overall survival rates were 49.5% and 61%, respectively.

The persistence of CAR T cells and B-cell aplasia, a condition where anti-CD19 CAR T cells kill CD19-expressing B-lymphocytes causing a patient to have an extremely low B-cell count, both improved event-free survival in patients treated with obe-cel. The median EFS and 12-month EFS rate were identical between those who did and did not receive a SCT, suggesting that SCTs did not offer additional value for these patients. Thus, obe-cel could be considered as a standalone treatment for adults with relapsed or refractory B-ALL who have limited treatment options.

Shorter Duration of Venetoclax for AML

Venetoclax is an oral medication used to treat AML, a type of cancer that affects the blood and bone marrow. It works by inhibiting the activity of B-cell lymphoma-2 (BCL-2), a protein that helps cancer cells survive. However, venetoclax can cause side effects such as low blood cell counts, infection, and nausea.

A retrospective multi-center analysis has shown that a 7-day course of venetoclax is as effective and more tolerable compared to the standard 28-day course for older or chemotherapy-ineligible patients with newly diagnosed AML when combined with azacitidine. The composite complete remission rate was 72% for both groups, and the median OS for the shorter duration cohort was 11.2 months compared with 10.1 months for the longer duration cohort. Importantly, the 8-week mortality rate was significantly higher in the 28-day treatment group compared to the 7-day group at 16% vs 6%, respectively.

The study suggests that shorter courses of venetoclax may help reduce side effects and improve patients’ tolerability of treatment without compromising response rates. It is important to identify treatment options that can produce similar rates of remission and survival for older patients who tend to experience more side effects and often have additional medical issues that increase the risk of serious complications. Researchers are also exploring the use of shorter courses of venetoclax in triplet regimens to treat older or chemotherapy-ineligible patients.

Conclusion

The latest advances in leukemia treatment offer new hope for patients by targeting cancer cells more specifically and producing less toxic side effects compared to traditional treatments. CAR T cell therapy and venetoclax offer promising outcomes for patients with relapsed or refractory B-ALL and newly diagnosed AML, respectively. These treatments may also improve patients’ tolerability of treatment and reduce the risk of serious complications. As researchers continue to make progress in leukemia treatment, patients can look forward to more effective and less toxic treatment options in the future.

Originally Post From https://www.eurekalert.org/news-releases/1046615

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