Genomic-led cancer care: Unlocking truly personalised treatment for leukaemia patients

Pharma News: A new project has given researchers insight to better predict outcomes and tailor treatment for young adults living with acute lymphoblastic leukaemia (ALL), a form of aggressive blood cancer.

Led by Professors Deb White and David Yeung from the South Australian Health and Medical Research Institute (SAHMRI), the study involved comprehensive genomic analyses on adolescents and young adults (AYA) newly diagnosed with ALL.

The SAHMRI study was a compendium to a clinical trial run by the Australasian Leukaemia and Lymphoma Group (ALLG), known as the ALL06 study, which established intensive chemotherapy as the standard of care in AYA patients with ALL.

Using state of the art, next generation sequencing facilities at the SAHMRI, Professor White and her team was able to reveal the mutations that were responsible for the development of the leukaemia in 86% of cases based on genomic data. This is a substantial improvement compared to past decades where many cases had no clear genetic driver.

“We’ve shown that detailed genomic information is a critical component of a patient’s treatment plan, when combined with a comprehensive approach including optimised chemotherapy and careful monitoring,” Professor White noted.

This week, AstraZeneca participated in discussions at the Rare Cancers Australia and Australian Genomics Policy Roundtable series, focusing on the practicalities of implementing genomic-led cancer care. Transitioning genomics from research-led applications to standard clinical practice could facilitate faster access to necessary treatments for Australian patients at the time of a cancer diagnosis. AstraZeneca advocates for equitable access to comprehensive genomic profiling, which would help eliminate barriers to biomarker testing and access to precision oncology medicines.

Professor White further added, “We’re now looking to extend these observations to older patients, which will be a major advancement in how we approach ALL.”

This research enhances the understanding of relapse risk, allowing patients and doctors to determine whether additional treatment or monitoring is required. Moreover, it contributes to a deeper understanding of the origins of ALL and the development of targeted inhibitors for treatment. The findings hold particular significance, as AYA patients have often been overlooked in traditional cancer research.

Professor Yeung said the research is transforming the understanding of leukaemia in young adults.

“By better understanding the genetic landscape of ALL, we can tailor treatments to each patient’s needs. This not only optimises their chances of survival but also reduces the potential for unnecessary toxicity,” Prof Yeung explained. “This study gives us hope for more precise, effective and less harmful treatments.”

The research also highlights the growing importance of combining genomic data with early treatment responses, to guide treatment intensification.

Looking ahead, researchers suggest the integration of cutting-edge therapies, like CAR-T cells and personalised approaches will be key to optimising treatment for ALL in young adults.

“The future of leukaemia treatment is precision medicine,” Professor White said.

“By incorporating all available diagnostic data, including genomic, patient-related factors and treatment response information, we can create a truly personalised treatment plan that gives patients the highest probability of success.”

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