September is Blood Cancer Awareness Month, a global event to help raise awareness of one of the world’s most prevalent and dangerous cancers. Accordingly, we examine advances in research that have the potential to improve treatments and outcomes.
What is Blood Cancer?
Blood cancer is a broad term for any cancer that affects the blood, lymphatic system, or bone marrow. These cancers occur when something goes wrong as blood cells develop, which means they all originate in the bone marrow. When considered as a group, blood cancers account for approximately one million new diagnoses per year globally, and 185,000 in the US alone.
The main types of blood cancer are leukemia, lymphoma, myeloma, myelodysplastic syndromes (MDS), and myeloproliferative neoplasms (MPN). These may be further broken down into a wide range of subtypes, as well as associated disorders.
While the average survival rate for all types of blood cancer currently hovers near 70%, this may vary significantly by subtype. According to the Leukemia & Lymphoma Society, “Leukemia, lymphoma and myeloma are expected to cause the deaths of an estimated 57,380 people in the US in 2023. These diseases are expected to account for 9.4 percent of the deaths from cancer in 2023, based on the estimated total of 609,820 cancer deaths.”
Advances in Treatment
As with other cancers, treatment can take many forms, including chemotherapy, targeted therapies, radiotherapy, immunotherapy, and stem cell transplants. Essentially, the type of cancer, along with a host of variables surrounding the patient, determines the treatment.
Although CAR-T cell therapy has been approved for a handful of blood cancers, each has been individually developed for specific targets related to a particular type of cancer. According to Saar Gill, MD, PhD, an associate professor of hematology-oncology at the Hospital of the University of Pennsylvania, “Up to this point, we haven’t had the tools to create a targeted cell therapy approach that could work across all different forms of blood and bone marrow cancers.”
That may be about to change.
The University of Pennsylvania recently announced that scientists in its Perelman School of Medicine have completed a preclinical, proof-of-concept study that offers hope for treating all types of blood cancer with CAR-T cell therapy. Currently, CAR-T cell therapy has been approved for just five subtypes of blood cancer.
For this study, researchers used engineered CAR-T cells to target CD45, a marker found on the surface of nearly all blood cells, not just blood cancer cells. They altered a small piece of the CD45 structure, or epitope, such that it still works but remains similar enough to the original that anti-CD45 CAR-T cells do not attack it.
In addition, because this approach results in replacing the stem cells that generate new blood cells, it may offer other advantages. For example, it could potentially be used as an alternative to chemotherapy conditioning, a regimen given to patients to prepare them for a bone marrow transplant.
The Penn Medicine study, published in Science Translational Medicine, has demonstrated the potential effectiveness of this new “epitome-editing” approach. Now this proof-of-concept must transition to further toxicology and modeling studies in order to prepare for an investigational new drug application. If the application is approved, the therapy can move into Phase I trials.
Conclusion
Historically, blood cancers have proven challenging to treat because unlike a solid tumor, it flows throughout the body. However, advances in immunotherapy and targeted therapies have helped dramatically improve survivability rates, as noted below.
Among the various types of blood cancers, the National Cancer Institute says five-year survivability has increased from 1990 to 2018, from:
45 percent to 65.7 percent for leukemia
51 percent to 73.8 percent for non-Hodgkin lymphoma
29 percent to 57.9 percent for multiple myeloma
Research such as the Penn Medicine study referenced above continue to demonstrate the potential for improvement in treatment options, outcomes, and outlook.
Read the Penn Medicine press release HERE.
Read the results of the study in Science Translational Medicine HERE.
Learn about Blood Cancer Month HERE.
The following sources were used as reference material for this article:
https://bloodcancer.org.uk/understanding-blood-cancer/
https://www.cancercenter.com/blood-cancers
https://www.lls.org/facts-and-statistics/facts-and-statistics-overview
https://www.science.org/doi/10.1126/scitranslmed.adi1145
https://www.cancercenter.com/community/blog/2023/04/blood-cancer-treatment-breakthroughs