Systems medicine paves the way for improved treatment for leukemia patients

A multi-disciplinary team of researchers at the Institute for Molecular Medicine Finland, FIMM, and the Helsinki University Central Hospital has developed a novel individualized systems medicine (ISM) strategy which enables selection of potentially effective cancer therapies for individual patients. Furthermore, this strategy helps in understanding and predicting drug resistance and may pave a path for individualized optimization of patient therapies in the clinic for various types of cancers.

Many novel targeted drugs have been introduced to the clinic for cancer therapy, often guided by genomic clues on disease pathogenesis. Clinical treatment of cancer patients is, however, challenged by the fact that genomics is often not informative in selecting therapies to individual patients. Patients also often develop resistance to therapies that were initially effective. Furthermore, tumor heterogeneity and clonal evolution over time within an individual patient make it difficult to apply cancer genomics as a guide to patient therapy.

ISM combines genomics with comprehensive drug sensitivity testing of patient cells to facilitate optimization of safe and efficacious cancer therapies for individual patients. Furthermore, the ISM strategy aids in understanding and predicting how drug resistance evolves and how it may be prevented.

Results achieved by applying this strategy to 28 patient samples have been recently published in the Cancer Discovery journal.

Most of the patients studied had chemoresistant adult acute myeloid leukemia (AML), a disease characterized by poor prognosis. AML is today largely treated by the same chemotherapeutic agents as applied 30-50 years ago. Here, the researchers measured the response of patients' cells to a panel of 202 cancer drugs covering all approved and many emerging cancer drugs. A list of the most likely effective and ineffective drugs was created for each individual patient and passed on to the treating physician to consider.

Several patients benefited from the therapy selected based on the drug sensitivity testing results. For example, one patient previously unresponsive to three rounds of chemotherapy achieved complete clinical remission with a treatment optimized with the ISM platform.

Leukemia facts Leukemia is a cancer of the blood cells.

While the exact cause(s) of leukemia is not known, risk factors have been identified.

Leukemias are grouped by how quickly the disease develops (acute or chronic) as well as by the type of blood cell that is affected (lymphocytes or myelocytes). The four main types of leukemia include acute lymphocytic leukemia (ALL), chronic lymphocytic leukemia (CLL), acute myelocytic leukemia (AML), and chronic myelocytic leukemia (CML).

People with leukemia are at significantly increased risk for developing infections, anemia, and bleeding. Other symptoms and signs include easy bruising, weight loss, night sweats, and unexplained fevers.