20 Famous Men Who Have Had Prostate Cancer
Current And Breakthrough Treatments For Chronic Lymphocytic Leukemia (CLL)
Chronic lymphocytic leukemia (CLL) is a slow-growing cancer of the immune system. Because it's slow-growing, many people with CLL won't need to start treatment for many years after their diagnosis.
Once the cancer begins to grow, there are many available treatment options that can help people achieve remission. This means people can experience long periods of time when there's no sign of cancer in their bodies.
The exact treatment option that you'll receive depends on a variety of factors. This includes:
While there's no cure for CLL yet, breakthroughs in the field are on the horizon.
Doctors typically stage CLL using a system called the Rai system. Low risk CLL describes people who fall in "stage 0" under the Rai system.
In stage 0, the lymph nodes, spleen, and liver are not enlarged. Red blood cell and platelet counts are also near normal.
If you have low risk CLL, your doctor (usually a hematologist or oncologist) will likely advise you to "watch and wait" for symptoms. This approach is also called active surveillance.
Someone with low risk CLL may not need further treatment for many years. Some people will never need treatment. You'll still need to see a doctor for regular checkups and lab tests.
Intermediate risk CLL describes people with stage 1 to stage 2 CLL, according to the Rai system. People with stage 1 or 2 CLL have enlarged lymph nodes and potentially an enlarged spleen and liver but close to normal red blood cell and platelet counts.
High risk CLL describes patients with stage 3 or stage 4 cancer. This means you may have an enlarged spleen, liver, or lymph nodes. Low red blood cell counts are also common. In the highest stage, platelet counts may be low as well.
If you have intermediate or high risk CLL, your doctor will likely recommend that you start treatment right away.
Chemotherapy and immunotherapyIn the past, the standard treatment for CLL included a combination of chemotherapy and immunotherapy agents, such as:
Over the last few years, a better understanding of the biology of CLL has led to a number of more targeted therapies. These drugs are called targeted therapies because they're directed at specific proteins that help CLL cells grow.
Examples of targeted drugs for CLL include:
Monoclonal antibody therapies are a type of treatment in which proteins are made in a laboratory and designed to target certain antigens. They help jolt your immune system into attacking the cancer cells.
There are several monoclonal antibody treatments approved for treating CLL by targeting the antigens CD20 and CD52:
You may need to receive intravenous (IV) blood transfusions to increase blood cell counts.
RadiationRadiation therapy uses high-energy particles or waves to help kill cancer cells and shrink painful, enlarged lymph nodes. Radiation therapy is rarely used in CLL treatment.
Stem cell and bone marrow transplantsYour doctor may recommend a stem cell transplant if your cancer doesn't respond to other treatments. A stem cell transplant allows you to receive higher doses of chemotherapy to kill more cancer cells.
Higher doses of chemotherapy can cause damage to your bone marrow. To replace these cells, you'll need to receive additional stem cells or bone marrow from a healthy donor.
A large number of approaches are under investigation to treat people with CLL. Some have been recently approved by the FDA.
Drug combinationsIn May 2019, the FDA approved venetoclax (Venclexta) in combination with obinutuzumab (Gazyva) to treat people with previously untreated CLL as a chemotherapy-free option.
In April 2020, the FDA approved a combination therapy of rituximab (Rituxan) and ibrutinib (Imbruvica) for adult patients with chronic CLL.
These combinations make it more likely that people may be able to do without chemotherapy altogether in the future. Nonchemotherapy treatment regimens are essential for those who can't tolerate harsh chemotherapy-related side effects.
CAR T-cell therapyOne of the most promising future treatment options for CLL is CAR T-cell therapy. CAR T-cell therapy, which stands for chimeric antigen receptor T-cell therapy, uses a person's own immune system cells to fight cancer.
The procedure involves extracting and altering a person's immune cells to better recognize and destroy cancer cells. The cells are then put back into the body to multiply and fight off the cancer.
CAR T-cell therapy research is still ongoing. In September 2023, researchers reported a possible "universal" CAR T-cell treatment that may be effective in all types of blood cancers.
CAR T-cell therapies are promising, but they do carry risks. One risk is a condition called cytokine release syndrome. This is an inflammatory response caused by the infused CAR T-cells. Some people can experience severe reactions that may lead to death if not quickly treated.
Other drugs under investigationSome other targeted drugs currently being evaluated in clinical trials for CLL include:
Once clinical trials are completed, some of these drugs may be approved for treating CLL. Talk with a doctor about joining a clinical trial, especially if current treatment options aren't working for you.
Clinical trials evaluate the efficacy of new drugs as well as combinations of already approved drugs. These new treatments may work better for you than the ones currently available. Hundreds of clinical trials are ongoing for CLL.
Many people who receive a diagnosis of CLL won't actually need to start treatment right away. Once the disease starts to progress, you have many treatment options available.
There's also a wide range of clinical trials to choose from that are investigating new treatments and combination therapies.
Bispecific Antibodies 'Change The Landscape' Of Lymphoma Treatment
Experts look back on the year in the news regarding bispecific antibodies for the treatment of B-cell lymphomas including CLL and SLL.
The biggest news of 2023 for patients with lymphoma and provers has been the rise of bispecific antibody treatment options, as one expert tells CURE®.
"I think these drugs as single agents in combination are going to change the landscape of indolent and aggressive B-cell lymphomas, including CLL (chronic lymphocytic leukemia) and SLL (small lymphocytic lymphoma)," Dr. Juan Alderuccio, associate professor of medicine and clinical site disease group leader in the lymphoma section at the University of Miami Sylvester Comprehensive Cancer Center, told CURE®. "And I think we will start to see when we start to obtain the data of the currently ongoing clinical trials, we will see that these therapies are going to be used in early lines of therapy and hopefully, will significantly improve the outcome of these patients."
Bispecific antibodies, which bond to two targets on lymphoma cells at once, work to activate the immune system and help the patient's body fight the disease.
LEARN MORE: New Horizons for Diffuse Large B-Cell Lymphoma
The Food and Drug Administration (FDA) approved Lunsumio (mosunetuzumab-axgb) — a CD20xCD3 T-cell engaging bispecific antibody touted by Genentech, the manufacturer of the drug, as a new class of fixed-duration cancer immunotherapy — in December 2022 to treat adults with relapsed or refractory follicular lymphoma.
This was followed by the FDA granting accelerated approval for Epkinly (epcoritamab-bysp) — a bispecific CD20-directed CD3 T-cell engager — for the treatment of patients with relapsed or refractory diffuse large B-cell lymphoma (DLBCL) in May, an approval which also included patients with DLBCL occurring as a result of indolent lymphoma and high-grade B-cell lymphoma after two or more lines of systemic therapy, according to the FDA's release.
Then, when the agency approved Columvi (glofitamab-gxbm) for the treatment of adults with relapsed or refractory diffuse large B-cell lymphoma (DLBCL) or those with large B-cell lymphoma resulting from follicular lymphoma after two or more lines of therapy in June, it made Columvi the first bispecific antibody with a fixed-duration treatment for this patient population, according to Columvi manufacturer Genetech.
"We're seeing a whole variety of new immunotherapies to treat primarily lymphomas," Lee Greenberger, chief scientific officer of the Leukemia and Lymphoma Society, told CURE® earlier this year as part of our Speaking Out® video series.
"In particular, there are new bispecific antibodies," Greenberger said. "And what that means is a bispecific antibody, what that does is it's a molecule that can bind to the T-cells and bring the T-cells to the tumor cells. So, it's got two binding sites, and when you bring T-cells to the tumors, it's capable, in the name of the T-cells, to kill the tumors.
"And so we've seen approval (in December 2022) for (Lunsumio [mosunetuzumab]) for follicular lymphoma, and there's two other bispecific antibodies that are approved for large B-cell lymphomas, that means diffuse large B-cell lymphoma and advanced cases of follicular lymphoma. So bispecifics, and in general immunotherapy … (and) engaging T-cells to kill tumors has been really a big advancement in the field, really now approved since 2017 but now we're seeing a wave of bispecifics come through."
For more news on cancer updates, research and education, don't forget to subscribe to CURE®'s newsletters here.
What To Know About Leukemia Survival Rates
Life expectancy for leukemia can depend on a person's age, the type of leukemia, and other factors. While leukemia is currently not curable, it is possible to treat the cancer to help improve outlook.
For children with acute lymphocytic leukemia (ALL), the 5-year survival rate is now around 90%, according to the American Cancer Society. For other types, however, the chance of living 5 years or more with leukemia may be lower.
There are many different types of leukemia. Which type a person develops depends on which white blood cells are affected, as well as some other factors. Leukemia can prevent white blood cells from fighting infections and cause them to multiply uncontrollably. This overgrowth can cause overcrowding of the healthy blood cells, leading to severe problems throughout the body.
Leukemia can either be acute or chronic. Acute describes when white blood cells are less mature, develop quickly, and become dysfunctional cells known as blasts. Chronic refers to when the white blood cells develop slower, which can result in symptoms not being noticeable for many years.
This article discusses the survival rate of leukemia, including factors that may impact the rate.
Unlike many other cancers, doctors do not use standard staging methods, such as the TNM system, to stage leukemia. Instead, a doctor will first determine the subtype of leukemia through diagnostic tests and then use a unique system for each subtype. The staging is as follows:
The latest figures show that the 5-year survival rate for all subtypes of leukemia is 65.7%. A 5-year survival rate looks at how many people are still alive 5 years after their diagnosis.
Leukemia is most common in older adults, with incidence rates rising sharply from around 55 years. In the United Kingdom, between 2016–2018, roughly 4 in 10 new cases were in individuals aged 75 and over. The highest rates occur in people in the 85–89 age group.
It is also one of the most common cancers for people under age 20. The survival rate is higher for younger people.
According to the National Cancer Institute, the percentage of deaths by age group are as follows:
A range of factors may affect a person's chance of surviving leukemia. These include:
While there is currently no cure for leukemia, it is possible to treat the cancer to prevent it from coming back.
Treatment success depends on a range of factors. Treatment can include:
Treatment can last several months or even years, depending on the type and severity of the condition.
Receiving a leukemia diagnosis is life changing and challenging for both an individual and their loved ones.
It is common to feel a mixture of emotions after a cancer diagnosis, but everybody reacts differently in these situations. Some may try to put on a brave appearance to protect their loved ones, while others will openly seek support.
It is essential to remember that support is available for everyone from a wide range of sources, including:
There may also be local charities and online resources that can help a person understand and manage their condition.
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