Taking part in a clinical trial may be the best treatment choice for some acute lymphoblastic leukemia (ALL) patients. Clinical trials are under way for patients at every treatment stage and for patients in remission. Today's standard treatments for cancer are based on earlier clinical trials. The Leukemia & Lymphoma Society continues to invest funds in ALL research.
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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. Here are examples (and some descriptions) of specific agents under study in clinical trials for ALL. L.
- Bortezomib (Velcade®) - This drug, approved to treat myeloma and some types of lymphoma, is now being studied in combination with other drugs such as belinostat for the treatment of relapsed or refractory ALL. It is also being studied for treating newly diagnosed pediatric patients with T-cell ALL.
- Clofarabine (Clolar®) - Already approved to treat pediatric ALL, clofarabine is now showing promising results in studies of adults with ALL. It is also being studied in combination with other drugs such as mitoxantrone in clinical trials for the treatment of children whose ALL is relapsed or refractory.
- Nelarabine (Arranon®) - This drug, a type of antimetabolite drug, is approved for patients who have relapsed T-cell ALL. It is now being studied in clinical trials in combination with other agents for the treatment of relapsed or refractory T-cell ALL. It is also being evaluated in combination with other drugs as part of an induction regimen for untreated T-cell ALL.
Janus kinase (JAK) Inhibitor
- Ruxolitinib (Jakafi®) - Already approved to treat myelofibrosis and polycythemia vera patients, it is being studied in clinical trials in the treatment of pediatric refractory and relapsed ALL. It is also being studied in combination with several chemotherapy drugs in the treatment of children with Ph-like ALL and CRLF2 and JAK mutations.
Special Chemotherapy Combination
- Augmented Hyper-CVAD - The hyper-CVAD combination (cyclophosphamide, vincristine, doxorubicin and dexamethasone) is a well-established regimen for ALL. The augmented hyper-CVAD formulation was designed in 2011 and it includes intensified doses of vincristine, dexamethasone and asparaginase. Researchers are studying the efficacy of this combination for ALL treatment.
- Monoclonal antibodies rituximab (Rituxan®), alemtuzumab (Campath®), ofatumumab (Arzerra®) - These drugs are already approved in the treatment of other blood cancers. They are currently being studied for their use in combination with chemotherapy in clinical trials for untreated and relapsed/ refractory ALL.
- Blinatumomab (Blincyto®) - This drug is a bispecific, anti-CD19, CD3 T-cell engager, approved for the treatment of relapsed or refractory Ph-negative B-cell precursor ALL. It is being studied in current trials for the treatment of refractory and relapsed ALL and also as therapy for older patients with newly diagnosed disease.
- Inotuzumab ozogamicin - This drug is an anti-CD22 monoclonal antibody that is bound to a toxic drug called calicheamicin. It is being studied, as part of a regimen with combination chemotherapy, in the treatment of relapsed and refractory ALL.
- Chimeric antigen receptor (CAR) T-cell therapy - This is a type of immunotherapy that consists of engineering patients’ own immune cells first to recognize and then to attack cancerous tumors. This approach has shown very promising results in patients with blood cancers. The T cells are genetically engineered to produce receptors on their surface called “chimeric antigen receptors” (CARs). These receptors recognize and bind to a specific target found on the cancerous cells. Clinical trials are studying the use of CAR T-cell therapy in the treatment of chemotherapy-resistant or refractory ALL in both adults and children. To read more about this treatment, please click here.