Better prognosis for blood cancer

The diagnosis of cancer is a shocking turning point in the lives of those affected. However, the diagnosis of blood cancer is particularly dramatic. Although the chances of recovery are good today, relapses can occur. Researchers led by Thorsten Zenz are working intensively to reduce the risk of recurrence.

The latest figures from the Swiss Cancer League speak for themselves: every year, a good 1200 people in Switzerland are diagnosed with blood cancer (leukemia), which corresponds to 2.7 percent of all cancer cases. Men fall ill slightly more often than women (60 versus 40 percent). Leukemia is the most common type of cancer in children. Little is known today about the exact causes of leukemia. However, it is known that in a healthy person, blood cells are formed in exactly the amount that the body needs. In leukemia, however, the precursor cells of the red and white blood cells or platelets are not fully developed, yet they multiply in the blood and block the functions of healthy blood cells.

Broad Range of Treatments

Thorsten Zenz, UZH Professor of Hematology, treats patients with blood cancer and lymphoma at the University Hospital Zurich. Lymphoma is characterized by the uncontrolled growth of white blood cells, known as lymphocytes. Zenz can use modern therapies for his patients. "The prognosis for first-time sufferers is much better today than it used to be," says the doctor. There is a wide range of treatments available for children and adults - from intensive chemotherapy as a standard method to novel cancer immunotherapies such as stem cell transplantation or CAR-T cell therapy (Chimeric Antigen Receptor). "Thanks to these therapies, the treatment results for patients have improved significantly. Many leave our clinic cured," reports Zenz.

Relatively High Recidivism Rate

And yet the physician is concerned about a recurring problem: for some patients, the treatment does not work or the cancer returns after a certain time. The relapse rate can vary considerably depending on the type of leukemia. Three years ago, Thorsten Zenz launched the «INTeRCePT» research project to gain a better understanding of why some patients respond well to the therapy and others do not. The scientists of the research consortium, including: Burkhard Becher (UZH), Nico Beerenwinkel (ETHZ), Jean-Pierre Bourquin (KISPI/UZH), Wolfgang Huber (EMBL), Andreas Moor (ETHZ), Berend Snijder (ETHZ) and Stefanie Kreutmair (USZ/UZH), are primarily investigating non-Hodgkin's lymphomas. These are malignant diseases of the lymphatic tissue. The lymph nodes are most commonly affected in this disease, but other organs such as the lungs, liver, bone marrow or spleen can also be affected - especially in advanced stages of the disease.

Clinical Trial in Summer 2024

The researchers want to gain a better understanding of which drugs or therapies work best for whom and thus curb relapses. "For example, we don't know exactly how the cells of a lymphoma are structured and which therapy is best to combat them". INTeRCePT is designed to take into account the individual requirements of those affected and thus follows the precision medicine approach. The research study includes patients who did not respond to the first treatment or whose disease has relapsed. The INTeRCePT project is scheduled to run for five years. In the first three years, the focus was on basic research before the clinical trial starts in summer 2024. So far, tissue and blood samples have been analyzed in the laboratory. The researchers tested various drugs and how they affect the tissue. The analysis was carried out down to individual cell level. "For the first three years, we generated as much data as possible and included over 200 patients in the study," says Zenz, explaining how important the time factor was to the researchers. "We tested how quickly the immune cells and tumor cells react to drugs".

Assessing the relapse

In a follow-up study, which will also start this summer, Zenz and his research group will work with high-risk patients who receive CAR T-cell therapy and additional treatments. This randomized study is planned with 50 patients, with 25 patients receiving the standard therapy; the other 25 will receive a risk assessment tailored to them and then - if necessary - an appropriate therapy based on the cell analyses. "This is based on highly complex diagnostics that help us to put together the right mix of medication and treatments and also to learn for the future in which cases there is a risk of relapse and in which cases there is not," says Zenz. The scientists will analyze data and draw a detailed map of the drug response at the individual cell level. From this, they will be able to derive a more widely applicable method for treating blood cancer in the future. The aim is to increase the response rate by 50 percent.

Author: Marita Fuchs

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