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Latest advances and outcomes from the treatment of acute leukemia today Leukemia is a blood cancer that can be identified by the rapid growth of defective blood cells. The marrow of our bone produces most of the blood in our body which is the site of this abnormal growth. Typically, leukemia cells are immature white blood cells. Leukemic cells alter the normal blood cell formation process, leading to various signs and symptoms such as bleeding, infection, and tiredness. There are two kinds of leukemia: acute leukemia and chronic leukemia. Further, the acute type was classified into acute myeloid leukaemia (AML) and acute lymphoblastic leukaemia (ALL). Myeloblasts, or defective white blood cells, are the cause of acute myeloid leukaemia (AML). Acute myelogenous, granulocytic, nonlymphocytic, or myeloblastic leukaemia are other terms for this kind of cancer. However, the overproduction of lymphocytes is caused by acute lymphoblastic leukaemia (ALL). Stem cell transplantation, radiation therapy, and chemotherapy have been the cornerstones of leukaemia treatment. Targeted therapy has also been included in the standard of care for certain kinds of leukaemia within the past 20 years. These medications target the proteins that regulate the growth, division, and metastasis of cancer cells. Different treatment combinations are needed for different forms of leukaemia. For Acute lymphocytic leukemia (ALL), Immunotherapies are being used where many elderly people are unable to handle the severe side effects of the intense chemotherapy therapies required to treat ALL. Compared to chemotherapy, targeted therapies might have fewer adverse effects. Immunotherapies are treatments that enhance the body's ability to fight cancer through the immune system. Currently, four immunotherapies are FDA approved for the treatment of ALL: blinatumomab, inotuzumab ozogamicin, tisagenlecleucel and midostaurin. In ALL, the following immunotherapy techniques are being tested or employed are CAR T-cell therapy and bispecific T-cell engagers (BiTEs). A sort of cancer treatment called CAR T-cell therapy involves genetically modifying the patient & own immune cells. For the treatment of some children and young adults with ALL, one kind of CAR T cell therapy is currently approved. Dosing is based on weight reported at the time of leukapheresis.The use of this type in elderly B-cell ALL patients is now being investigated. Adults with B-cell precursor ALL who have not responded to previous treatment or have returned after treatment have been approved for another course of CAR T-cell therapy. Bispecific T-cell engagers (BiTEs) are another immunotherapy that is being studied for ALL. These medications bind to both cancer and immune cells, drawing the two groups of cells closer together so that the immune cells can locate and eliminate the cancer cells with ease. Recently, it was demonstrated that one such BiTE, blinatumomab, can increase survival for ALL patients in remission following chemotherapy, even in situations where the disease is completely eradicated. Acute myeloid leukaemia (AML) tends to be aggressive and was harder to treat than ALL. However, AML cells sometimes have gene changes that cause the tumors to grow but can be targeted with new drugs. The management of AML involves two phases such as remission induction therapy (first phase of treatment to kill the  leukemia   cells  in the blood and  bone marrow ) and remission continuation therapy (second phase of treatment to kill any remaining leukemia cells). The treatment of AML includes chemotherapy (drugs to stop the growth of cancer cells), radiation therapy (uses high-energy  x-rays  or other types of  radiation  to kill cancer cells), stem cell transplant (to replace the blood-forming cells from the blood or  bone marrow  of the patient) and targeted therapy (drugs or other substances to identify and attack specific cancer cells) or combination of both. Targeted treatments such as Enasidenib, Olutasidenib, Ivosidenib, Venetoclax, Gemtuzumab ozogamicin, Midostaurin, Gilteritinib, Glasdegib, and Quizartinib have recently been approved to treat AML with specific gene alterations. In order to achieve complete remission (CR) from acute leukaemia, standard treatment paradigms have involved high-intensity induction chemotherapy. In certain cases, this was followed by an allogeneic hematopoietic cell transplant (allo-HCT) to eliminate residual disease through the "graft versus leukaemia effect, which is mediated by the immune cells of the donor. Allo-HCT is not recommended for all patients, though, and one of the biggest problems facing the industry at the moment is the lack of viable chemotherapy-based choices for patients who relapse after allo- HCT or who develop chemotherapy-refractory illness. The potential of immunotherapy in the treatment of acute myeloid leukaemia (AML) has been established by the effectiveness of allogeneic stem cell transplantation. Alternative T-cell-based immunotherapies have demonstrated effectiveness, but there is a chance that they could cause on-target off-leukemia hematotoxicity. Currently, the use of adoptive autologous or allogeneic chimeric antigen receptor (CAR) T / natural killer cell treatment as a bridge-to-transplant approach is almost only available in clinical studies. Acute leukaemia used to be nearly always fatal, but now it has a 63% 5-year survival rate in the US. The therapeutic options for acute leukaemia have increased with the introduction of immunotherapy, however, the advancement in AML has been slower. Novel medicines such as ADCs, CAR T cell treatments, and BiTEs continue to show remarkable response rates and favourable toxicity profiles in various disease states every year. Even with these developments, a large number of patients are still not eligible for immunotherapeutic treatments, and relapses following some of the more recent modalities are still linked to extremely poor prognoses. In the future, new medicines with potentially unique mechanisms of action will probably be approved together with the expansion of the indications for currently available medications. References: 1. Leukemia. National Cancer Institute. Available at: https://www.cancer.gov/types/leukemia/hp/adult-aml-treatment-pdq 2. Boyiadzis MM, Aksentijevich I, Arber DA, et al. The Society for Immunotherapy of Cancer (SITC) clinical practice guideline on immunotherapy for the treatment of acute leukemia. Journal for ImmunoTherapy of Cancer. 2020 3. Kantarjian, H., Kadia, T., DiNardo, C. et al. Acute myeloid leukemia: current progress and future directions. Blood Cancer J. 2021 4. Subklewe M, Bücklein V, Sallman D, Daver N. Novel immunotherapies in the treatment of AML: is there hope? Hematology Am Soc Hematol Educ

There are many misunderstandings regarding chemotherapy. It is understandable to be hesitant & anxious about the beginning of chemotherapy treatment. To ensure you are fully informed about the risks and benefits of any therapy, it is crucial that you discuss any particular concerns you may have with your medical oncologist. Check out some of the most widespread misconceptions about chemotherapy to get a sense of the topics you might want to go into further depth with your physician about.     Myth: Chemotherapy causes significant side effects.      Fact: Chemotherapy, is a cocktail of numerous medicines and it was associated with intense nausea and vomiting, and that reputation was well deserved. But, as with so many cancer treatments, advances and research have been made to improve the effectiveness of cancer drugs and reduce their side effects.    Myth: I’m going to be constantly sick from chemotherapy.     Fact: Chemotherapy can sometimes cause nausea – making you feel or be sick. It depends on the type of chemotherapy drug you’ve been prescribed. With advancements and research – most of these side-effects are easily managed and even stopped.     A common misconception is that chemotherapy is only used in situations where there are no viable alternatives.      In reality, chemotherapy can be an effective treatment at different stages of cancer for a wide range of patients.      Myth: Chemotherapy will cause you to lose all your hair.      Fact: While hair loss is a potential side effect of chemotherapy, not all chemotherapy drugs cause hair loss. Some only cause hair loss, while others do not cause hair loss. There are some products that can help reduce your risk of hair loss from chemotherapy. If you experience hair loss from chemotherapy, it is usually only temporary.      Myth: If I get chemo, I’ll need to spend all my time in the hospital getting infusions.      Fact: The duration of your chemotherapy session will depend on the type of chemotherapy you’re receiving and the type of treatment you’re getting. Some chemotherapy is done in an outpatient setting and some is done in an inpatient setting.      Myth: All Chemotherapy is the same.      Fact: Chemotherapy agents come in a wide variety, some of which can continue to be effective after other treatments have failed. Chemotherapy is still a valuable treatment option for most cancers. It is known to enable cure many types of cancers including blood cancer. Immunotherapy and targeted therapy are ground-breaking approaches, but chemotherapy shouldn’t be overlooked. It has effectively eliminated cancer in some cases. Early detection, timely intervention, and collaboration between healthcare teams and patients are key.   As we progress into the future, oncology is witnessing remarkable breakthroughs driven by cutting-edge technologies and innovative approaches. Five key advancements are at the forefront: Artificial Intelligence (A.I.), Genomic Medicine, Next-Generation Cancer Organoids, Nanoparticles, and Pressurized Intraperitoneal Aerosol Chemotherapy (PIPAC). Share: More Posts Send Us A Message

Breast Cancer: Everything You Need to Know, from Diagnosis to Prevention Breast cancer is a significant public health concern, affecting individuals worldwide. In India, the incidence of breast cancer has been steadily increasing in recent years. According to the Indian Council of Medical Research (ICMR), breast cancer is now the most common cancer among Indian women. In fact, recent estimates [1] suggest that approximately 1.5 lakh new cases are diagnosed each year. This data is a stark reminder of the urgency to address this issue and raise awareness about early detection and prevention. Here’s everything you need to know about the condition, along with effective prevention tips and the importance of screening. Symptoms, Diagnosis, and Treatment Options Early detection is crucial for effective breast cancer treatment. Being aware of the common symptoms and seeking medical attention promptly can make a significant difference in treatment outcomes. Remember, breast cancer is successfully treatable when detected and treated early. The symptoms of breast cancer include: Lump(s) or thickening in the breast or underarm Change in the size, shape, or appearance of the breast Unexplained pain in the breast or nipple Nipple discharge other than breast milk Skin changes on the breast, such as redness, dimpling, or scaling If you notice any of these symptoms, you should visit your family physician to discuss the cause of these symptoms further. The diagnosis of breast cancer typically involves a combination of methods, including a clinical breast exam, mammography, ultrasound, and biopsy. Once diagnosed, your treatment options can vary depending on the stage and type of cancer. They may include surgery, chemotherapy, radiation therapy, targeted therapy, Immunotherapy and hormonal therapy. Further, your treatment plan will, most likely, be tailored to your specific diagnosis, and it is crucial to discuss all available options with your medical team to make informed decisions. Screening, and why it is Important Breast cancer, like many other cancers, can be a silent killer. You might not notice symptoms of the disease for several months or years before it is detected. This is why regular screening is imperative to detect cancer early. When detected early, breast cancer is more likely to have successful treatment outcomes and very high cure rates. The goal of screening is to detect cancer before it causes symptoms, making it easier to treat and potentially preventing it from spreading. As per the American Cancer Society, a woman should start screening for breast cancer with mammograms, every year starting at age 40[2]. Women at high risk for breast cancer, such as those individuals with strong family history of breast cancer may need to start screening earlier. While, this is a general recommendation, it is important to talk to your doctor about when you should start screening for breast cancer based on your individual risk factors. The best way to screen for breast cancer is by performing regular breast self-exams and getting a mammogram once every year. But if you notice any of the symptoms mentioned above, you should visit your doctor immediately to get them investigated. Importance of Breast Self-Exams Breast self-exams are a simple yet powerful tool to detect breast cancer early. Conducting regular breast self-exams can help you become familiar with your body, helping you notice any changes as soon as they occur. Here’s a step-by-step guide on how to perform a breast self-exam: Stand in front of a mirror and inspect your breasts for any visible changes, such as dimpling, puckering, or changes in the nipple’s position. Raise your arms above your head and look for the same changes. Lie down and use your opposite hand to feel your breast using a circular motion, checking for lumps or abnormalities. Repeat the process for the other breast. Performing breast self-exams should become a monthly routine, preferably a few days after your menstrual cycle. If you notice any changes or have concerns, consult a healthcare professional for further evaluation. Risk factors: Certain factors can increase your risk of developing breast cancer. Being aware of these risk factors can help you make informed lifestyle choices and consider regular screenings earlier than recommended. Some common risk factors include: Age: The risk of breast cancer increases with age, particularly after 40. Family history: A family history of breast cancer can raise your risk, especially if close relatives have had the disease. Genetic mutations: Inherited genetic mutations, such as BRCA1 and BRCA2, can significantly increase your risk of developing breast cancer. Getting tested for this gene mutation is paramount, especially if you have a family history of the disease. Hormone replacement therapy: Long-term use of hormone replacement therapy may increase your risk of breast cancer as well. It is best to speak to your treating physician about this if you have any concerns. Reproductive factors: Early menstruation, late menopause, and having children at an older age can all raise your risk of developing breast cancer. Excessive alcohol consumption: Regular, heavy alcohol consumption may also increase your risk of breast cancer. Obesity: Being overweight or obese can also raise your risk of developing breast cancer. Having a high amount of body fat or adipose tissue can lead to the release of high levels of estrogen, which has been linked to an increased risk of breast, endometrial, ovarian, and some other cancers. Understanding these risk factors is essential for making lifestyle choices and seeking appropriate screenings, especially if several risk factors apply to you. Tips for prevention: Preventing breast cancer is not always possible, but there are steps you can take to reduce your risk and promote breast health: Maintain a healthy lifestyle: Eating a healthy and nutritious diet, exercising regularly and maintaining a healthy weight can all help prevent or delay the onset of breast cancer. Limit alcohol consumption: If you do drink alcohol, do so in moderation. Breastfeeding: If possible, breastfeed your children, as it can reduce the risk of breast cancer. Get regular screenings: This is especially true if you have any of the above-mentioned risk factors. Even otherwise, you should start