Taking part in a clinical trial may be the best treatment choice for some acute lymphoblastic leukemia (ALL) patients. Clinical trials are under way to develop treatments that cure patients of all ages and ALL subtypes. Today's standard treatments for cancer are based on earlier clinical trials. The Leukemia & Lymphoma Society continues to invest funds in ALL research.
To find better treatments, researchers are studying:
- the causes of ALL
- the cell changes that make ALL cells resistant to treatment
- the criteria for identifying disease subtypes, such as chromosome abnormalities
- approaches that will permit patients to get the least toxic therapies without compromising treatment goals
- better ways to manage treatment side effects
Clinical trials can involve new drugs, new combinations of drugs or approved drugs being studied to treat patients in new ways such as new drug doses or new schedules to administer the drugs. Clinical trials are conducted worldwide under rigorous guidelines to help doctors find out whether new cancer treatments are safe and effective or better than the standard treatment.
Current ALL Research and Clinical Trials
Scientists are conducting research strategies and clinical trials that hold the promise of increasing remission and cure rates of ALL patients. These are some of the types of research and trials under way:
- Leukemia-specific therapy. Scientists are studying the unique characteristics of leukemia cells in different subtypes, such as chromosome changes. This could lead to being able to examine a patient's ALL cells to determine the type of induction and consolidation therapy that would work best.
- Drug resistance. Drugs used to kill ALL cells may work in some people but not in others. When the drugs don't work, it's called drug resistance. Scientists are trying to understand why some ALL cells are resistant to the effects of chemotherapy. So far, researchers have found certain mechanisms in leukemia cells that protect them from chemotherapy - a step toward developing better treatments.
- Immunotherapy. Scientists continue to study immunotherapy, looking for more ways to boost the body's natural defenses to kill or prevent the growth of ALL cells. One approach is radioimmunotherapy, when manufactured antibodies are combined with radioactive particles and injected into the patient to target and destroy leukemia cells. Another approach is to use lymphocytes that have been made immune to cancerous cells. This allows the lymphocytes to recognize and attack ALL cells.
- Blood cell growth factors. Researchers are studying a class of drugs called blood cell growth factors to help restore normal blood cells during ALL treatment.
- Oncogenes. Mutated genes that cause cancer are called oncogenes. Scientists are studying the exact genetic changes in oncogenes that cause a normal cell to become an ALL cell. This research is leading to the development of new therapies that block the effects of oncogenes.
- Gene expression profiling. Gene expression profiling is a research method that can help design specific treatments for the different types of leukemia. By analyzing certain characteristics in our genes, doctors will be better able to predict patients' response to targeted treatments for ALL.
- Drug therapies for high-risk ALL. Clinical trials are under way to study drugs, such as nilotinib (Tasigna®), to be used alone or in combination with other drugs for patients with high-risk ALL who can't tolerate Gleevec® and Sprycel®. High-risk types of ALL include Ph-positive ALL, T-cell ALL, infant ALL and adult ALL.
- Reduced-intensity transplantation. Doctors are studying a type of stem cell transplant, also called a nonmyeloablative stem cell transplant, that may help some patients such as those who are older and those who have poor overall health better tolerate stem cell transplantation. Unlike standard transplantation, reduced-intensity transplantation doesn't completely destroy the patients' diseased marrow and relies on donor immune cells to fight the disease.