Tailoring the treatment of Chronic Myeloid Leukaemia patients

Targeted treatment for Chronic Myeloid Leukemia (CML) can greatly extend the survival time of patients, but not all patients respond to therapy.

Dr Naranie Shanmuganathan is uncovering genetic markers at the time of diagnosis which can predict how patients will respond to therapy and which treatment option is best.

“Those patients that get into those deep molecular responses sooner are usually the same patients that are able to stop therapy sooner rather than later,” said Dr Shanmuganathan.

A changed landscape

Tyrosine kinase inhibitors (TKIs) are a class of drugs that block the action of the abnormal protein that signals cancer cells to multiply. The development of TKIs has resulted in a near-full expected lifespan for people with CML.

“From a disease that was fatal, CML has now turned into a chronic disease,” said Dr Shanmuganathan.

However, there remains a small proportion of patients who are resistant to TKIs and progress to the more advanced stages of CML.

Dr Shanmuganathan is leading a new wave of clinical trials to better understand how to best use new TKIs, either alone or in combination.

“If we can treat these high-risk CML patients with more potent drugs up front, does that cancel out the additional risk? Early results suggest that it is perhaps the case,” she said.

“Our pivotal studies have enabled the TGA listing of Asciminib. They have enabled it to be brought into Australia outside of clinical trials.” Dr Naranie Shanmuganathan.

For CML patient, Lisa McNeil, participating in one of Dr Shanmuganathan’s clinical trials was a life-changing decision.

“The symptoms of CML have been really tough. Bringing up two children and running my own business, I had a lot on my plate. Being hit with this, and the early drugs, really impacted my life,” she said.

“I started on Asciminib in the Phase I clinical trial. It has made a world of difference. It took me 12 months to decide to do it, but in hindsight, it was a good decision.”