Taking part in a clinical trial may be a good treatment choice for people with chronic myelomonocytic leukemia (CMML). Clinical trials are under way to help improve treatment, extend survival and improve the quality of life for CMML patients. Today's standard treatments for cancer are based on earlier clinical trials. The Leukemia & Lymphoma Society continues to invest funds in CMML research.
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 CMML Research and Clinical Trials
Below are some examples of clinical trials for new or improved drug therapies currently under study:
Decitabine (Dacogen®) and azacitidine (Vidaza®) are being studied for use in combination with other agents such as hydroxyurea, volasertib, and birinapant for CMML patients who have not responded to treatment or who have relapsed after initial therapy.
Reduced-intensity allogeneic stem cell transplantation (also known as “nonmyeloablative allogeneic stem cell transplantation”) may prove effective for CMML patients who do not respond to drug therapy but are not considered candidates for allogeneic transplant because of older age or other health risks. Patients being conditioned for a reduced-intensity transplant receive lower doses of chemotherapy and/or radiation than those given to patients before a standard stem cell transplantation. Patients also receive immunosuppressive drugs to prevent rejection of the graft.
The engraftment of donor immune cells may allow these cells to attack the disease (graft-versus-leukemia effect). The theory being tested with a reduced-intensity transplant is that by undergoing less-toxic conditioning prior to the transplant, the body will be better able to withstand the procedure but full donor engraftment still takes place, and the desired graft-versus-leukemia effect still occurs. Relapse is one of the major causes of failure of stem cell transplant for CMML, and clinical trials are currently evaluating combination therapy with azacitidine, lenalidomide, and donor lymphocyte infusions.