Wales

Wales

We are supporting research at Cardiff University, which is developing diagnostic tests that could help doctors decide when and how best to treat a person newly diagnosed with chronic lymphoblastic leukaemia (CLL). Our researchers are also looking at new ways to target AML by targeting molecules called reactive oxygen species (ROS), which are found in high levels with in AML cells. Two of our clinical trials are based in Cardiff. The MONOCLE trial is looking for kinder and more effective treatments for people with chronic myelomonocytic leukaemia (CMML). And the LI-1 Trial is finding ways to boost the effectiveness of chemotherapy called cytarabine in people with AML and high risk MDS who are over the age of 60.

Cardiff University

Research at Cardiff University is focussed on developing a diagnostic test that can predict the outcome of people with CLL, and finding new treatment targets for AML. We are also supporting a clinical trial that wants to find better treatments for people with CMML. And the LI-1 Trial is finding ways to boost the effectiveness of chemotherapy in people with AML and high risk MDS who are over the age of 60.

Treatment for CLL depends on how fast the disease develops. Some people develop CLL quickly and feel unwell so will need immediate treatment, others may never need treatment because they have no symptoms. Dr Duncan Baird and his team have developed a test that can predict the outcome for a person with CLL, allowing researchers to identify those who will require treatment early, and those who will not. The test can also predict how people with CLL will respond to treatments. The team now want to develop this test further through a facility in South Wales, and if successful, it could be used to help doctors decide when and how best to treat a person newly diagnosed with CLL. Work from this group has already developed a similar test that has been used to predict the outcome of people with myelodysplastic syndromes (MDS) or myeloma. 

Acute myeloid leukaemia (AML) still has poor outcome, and there is still a lack of targeted therapies for this type of blood cancer. Professor Richard Darley and Dr Alex Tonks have identified an abnormality that is commonly found in people with AML, which is the over-production of highly reactive molecules called reactive oxygen species (ROS). Although ROS is a natural by-product left over from when the cell uses up oxygen, a build-up can cause damage to the cell, and even cell death. Conversely, AML cells have developed resistance to ROS, and depend on them for growth. The team aim to use two approaches to exploit ROS in AML. Firstly, they will deprive the AML cells of ROS to reduce their growth, and the second will be to sensitise AML cells to the damaging effects of ROS. If successful, these two strategies will be refined for testing in a clinical trial.  

Chronic myelomonocytic leukaemia (CMML) is a blood cancer that develops slowly, and causes the bone marrow to produce abnormal blood cells that have not matured enough to function properly. Because the bone marrow becomes crowded with the abnormal cells, there isn’t enough room for the other types of blood cells. The low numbers of normal blood cells in the bloodstream eventually cause symptoms. People with CMML are mainly treated to manage their symptoms using therapies the boost the levels of blood cells, and chemotherapy may also be given if symptoms get worse. But the only true cure for CMML is a stem cell transplant. CMML mostly affects older people, and people who've already had some types of cancer treatment. This means that most people with CMML are unsuitable for stem cell transplants, and there are currently limited treatment options beyond this. Dr Steve Knapper is leading the MONOCLE trial, which aims to see if a targeted treatment called tefinostat can help people with CMML. Because tefinostat is a targeted drug, it could offer a less harsh treatment option than chemotherapy. 

We are also supporting another trial that is looking to boost the effectiveness of AML treatment in people with AML and high risk MDS who are over the age of 60. This group of people are usually given a type of chemotherapy called cytarabine, which is given at a lower dose than intensive chemotherapy. The LI-1 Trial is being led by Dr Mike Dennis, who wants to know if cytarabine's effectiveness can be increased by giving the drug alongside newer chemotherapies or biological drugs.

Developing a new test to predict the outcome of people with CLL

Lead researcher - Professor Duncan Baird, Cardiff University
Leukaemia Chronic lymphocytic leukaemia (CLL)
Telomeric prognostics
Our research led by Professor Baird has shown that the length of telomeres – the protective caps at the end of chromosomes – in CLL cells is a good predictor of whether the disease is likely to be aggressive or not. The team now will turn these findings into a quick and cheap diagnostic test, which would help doctors decide when and how best to treat a person newly diagnosed with CLL.

MONOCLE trial

Chief investigator - Dr Steve Knapper, Cardiff University
Chronic myelomonocytic leukaemia (CMML)
A phase 2 study of the monocyte-targeted histone deacetylase inhibitor tefinostat (CHR-2845) in chronic myelomonocytic leukaemia (CMML)
Chronic myelomonocytic leukaemia (CMML) mainly affects older people, so most people are unsuitable for bone marrow transplant therapy, and there are currently very few other treatment options. The MONOCLE trial aims to see if a targeted treatment called tefinostat can help people with CMML. 

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