There have been staggering improvements in survival rates for the most common form of childhood cancer, acute lymphoblastic leukaemia (ALL). But 60 years ago, it was practically a death sentence. It’s been thanks to rigorous clinical trials in many different countries that have tested the most effective combinations, intensity and timing of chemotherapy drugs that now nine out of 10 children survive for at least five years, and most children will be considered ‘cured’.
During this time, the results of coordinated clinical trial groups in the UK, US, Japan and mainland Europe, especially Germany, Austria, Netherlands, France and Italy, have all influenced the design of each other’s subsequent studies. The gains in survival or the reduction in relapses achieved by a new treatment protocol from one trial group, have been incorporated by trial groups in other countries and then further refined. This was formalised in the mid-1990s by the formation of the International Acute Lymphoblastic Leukemia Working Group, which includes researchers from all major countries involved in trials for this disease. This is designed to share data and ideas to develop common strategies for the prevention and reduction of treatment toxicity.
The UK, and research studies supported by Bloodwise in particular, have been instrumental in identifying genetic risk predictors and developing a test to detect residual leukaemia cells with incredible sensitivity. These developments have allowed doctors to tailor the intensity of treatment to individual patients – meaning children receive just the right amount of treatment without compromising chances of a cure. This approach is now embedded in the clinic in all major developed countries.
What we’re doing
We’re now funding the current national trial for childhood ALL, which is aiming to further refine the use of testing for residual disease and to reduce the intensity of treatment when it’s safe to do so. We’re also continuing to fund a major programme to explore the next generation of cutting edge DNA sequencing technology to further refine genetic risk predictors for childhood ALL. These results will undoubtedly shape the global approach to treating this disease.
Our researchers are also conducting a key laboratory project as part of a trial called IntReALL: it’s the largest ever clinical trial for children with relapsed ALL. It’s comparing a number of new drugs to the drugs that are already available, with the aim of standardising treatment and boosting survival. The trial involves more than 1,000 children from 19 countries – so it really does have the potential to help us towards our goal of making sure that no child dies from this disease again, right across the world.