Thursday, 16 October 2014

Immune Therapy Induces Remission for Many With a Tough-to-Treat Blood Cancer

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But, some advanced acute lymphoblastic leukemia patients relapsed, study finds


WebMD News from HealthDay

By Amy Norton

HealthDay Reporter

WEDNESDAY, Oct. 15, 2014 (HealthDay News) -- An experimental immune-system therapy can often lead to complete remission in leukemia patients who have run out of other options, a new study confirms.

Researchers found that 27 of 30 children and adults with advanced acute lymphoblastic leukemia (ALL) went into full remission after receiving genetically tweaked versions of their own immune system cells.

"Ninety percent of patients who had no options left went into complete remission. That's amazing," said senior researcher Dr. Stephan Grupp, of Children's Hospital of Philadelphia and the University of Pennsylvania.

However, seven patients who went into remission did eventually suffer a relapse, according to the study.

The findings, published Oct. 16 in the New England Journal of Medicine, confirm what smaller studies have suggested: The therapy offers hope to people with ALL that has repeatedly eluded standard treatments.

But while past studies have focused on adults, this study included mostly children.

"It shows the therapy can work just as well in children with ALL, and it's great to see that," said Dr. Michel Sadelain, a researcher at Memorial-Sloan Kettering Cancer Center in New York City who worked on those earlier studies.

But, both Grupp and Sadelain said ongoing studies will have to clarify the therapy's role in treating ALL.

ALL is a cancer of the blood and bone marrow that progresses quickly. It's more common in children than adults, but while children are often cured with chemotherapy, adults have a poorer outlook, Sadelain said.

In the United States, about 6,000 people will be diagnosed with ALL this year, and just over 1,400 will die, according to the American Cancer Society (ACS). Adults will account for 80 percent of those deaths, according to the ACS.

The standard first treatment for ALL is three rounds of chemotherapy drugs, and for many patients that does beat back the cancer. Unfortunately, the disease often returns. At that point, Sadelain explained, the only hope for long-term survival is to have another round of chemotherapy that wipes out the cancer, followed by a stem cell transplant.

But when the cancer recurs, it is likely to be resistant to many chemotherapy drugs. The new therapy takes an entirely different approach -- enlisting the immune system to target specific proteins on ALL cells, according to the researchers.

Doctors take immune system T cells from a patient's blood. Then, they genetically engineer them to express so-called chimeric antigen receptors -- which allow the T cells to recognize and destroy ALL cells. The tweaked cells are infused back into the patient's blood, where they multiply. The researchers dubbed the engineered cells "hunter" cells.

Of the 30 patients treated in the current study, 27 quickly went into complete remission -- meaning they no longer had detectable cancer. Most of the group has been followed for at least six months, and for as long as two years, the researchers said. During that time, 19 remained in remission, while seven died after their cancer relapsed or progressed.



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