Yale Cancer Study Announced Combination Therapy Results

Yale cancer center study of immune checkpoint inhibition in patients with myeloid malignancies

red blood cells

Yale Cancer Center (YCC) and Smilow Cancer Hospital researchers located in Orlando, Florida, announced promising results using checkpoint inhibitors for patients with myeloid cancers. 

This new study was presented today at the 61st American Society of Hematology (ASH) meeting in Orlando, Florida. Amer Zeidan, MBBS, MHS, associate professor of medicine at YCC, is leading the research study using the chemotherapy drug azacitidine.

Azacitidine is a standard treatment for patients with acute myeloid leukemia (AML) who are unfit for intensive chemotherapy as well as those with higher-risk myelodysplastic syndromes (MDS). 

Pre-clinical research had suggested that azacitidine might prove more effective when combined with a checkpoint inhibitor drug such as durvalumab, which inhibits the PD-L1 protein that cancer cells may use to hold off immune system attacks. 

This theory was tested by Dr. Zeidan and colleagues in a large, international randomized phase 2 clinical trial of first-line treatments for both groups of 213 patients, which compared azacitidine alone versus azacitidine combined with durvalumab.

“The final results showed no significant improvement in response rate or survival of patients with the combination therapy in either cohort,” said Dr. Zeidan, in a press release.

‘While the hypomethylating activity of AZA on PD-L1 gene was confirmed, no treatment-mediated induction of PD-L1 surface expression was observed on myeloid blasts.’

“But this study was the 1st randomized trial of immune checkpoint inhibition, a form of immune therapy which provided impressive results in patients with some forms of advanced solid tumors, in patients with myeloid malignancies.” 

Zeidan added the trial is also expected to yield additional laboratory results that improve the understanding of immune changes in these blood cancers and might inform the design of future trials with these agents.

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Blood cancers affect the production and function of your blood cells, says Hematology.org. 

Most of these cancers start in your bone marrow where blood is produced. Stem cells in your bone marrow mature and develop into three types of blood cells: red blood cells, white blood cells, or platelets. 

In most blood cancers, the normal blood cell development process is interrupted by the uncontrolled growth of an abnormal type of blood cell. 

These abnormal blood cells, or cancerous cells, prevent your blood from performing many of its functions, like fighting off infections or preventing serious bleeding.

There are 3 main types of blood cancers:

  • Leukemia, a type of cancer found in your blood and bone marrow, is caused by the rapid production of abnormal white blood cells. The high number of abnormal white blood cells are not able to fight infection, and they impair the ability of the bone marrow to produce red blood cells and platelets.
  • Lymphoma is a type of blood cancer that affects the lymphatic system, which removes excess fluids from your body and produces immune cells. Lymphocytes are a type of white blood cell that fights infection. Abnormal lymphocytes become lymphoma cells, which multiply and collect in your lymph nodes and other tissues. Over time, these cancerous cells impair your immune system.
  • Myeloma is a cancer of the plasma cells. Plasma cells are white blood cells that produce disease- and infection-fighting antibodies in your body. Myeloma cells prevent the normal production of antibodies, leaving your body's immune system weakened and susceptible to infection.

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