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Targeted therapy for acute lymphocytic leukemia
Some people with acute lymphocytic leukemia (ALL) have targeted therapy. It uses drugs to target specific molecules (such as proteins) on the surface of cancer cells. These molecules help send signals that tell cells to grow or divide. By targeting these molecules, the drugs stop the growth and spread of cancer cells while limiting harm to normal cells. Targeted therapy may also be called molecular targeted therapy.
You may have targeted therapy added to the chemotherapy regimen if you have leukemia cells with the Philadelphia chromosome (called Ph+ ALL). You may also have targeted therapy if you have precursor B - ALL without the Philadelphia chromosome (called Ph- ALL) that comes back (relapses, or recurs) after treatment or doesn’t respond to other treatments (called refractory disease).
Your healthcare team will consider your personal needs to plan the drugs, doses and schedules of targeted therapy. You may also receive other treatments.
Targeted therapy drugs commonly used for ALL
The most common targeted therapy drug used is imatinib (Gleevec). It is a type of tyrosine kinase inhibitor.
Other tyrosine kinase inhibitors are most often used to treat other types of leukemia, but they may also be used to treat ALL. These drugs include dasatinib (Sprycel), nilotinib (Tasigna), bosutinib (Bosulif) and ponatinib (Iclusig). They are used most often for relapsed ALL if imatinib was part of previous treatment or if other targeted therapy drugs cause severe side effects. Doctors may switch you to one of these drugs because ALL can sometimes become resistant to imatinib.
Blinatumomab (Blincyto) is another targeted therapy drug. It may be used to treat relapsed or refractory relapsed or refractory precursor B-cell Ph- and PH+ ALL.
Inotuzumab ozogamicin (Besponsa) may be used to treat relapsed or refractory CD22-positve B-cell precursor ALL.
Side effects can happen with any type of treatment for ALL but everyone’s experience is different. Some people have many side effects. Other people have few or none at all.
Targeted therapy doesn’t usually damage healthy cells, so it tends to cause fewer and less severe side effects than chemotherapy and radiation therapy. Chemotherapy and radiation therapy can damage healthy cells along with cancer cells.
If side effects develop with targeted therapy, they can happen any time during, immediately after or a few days or weeks after targeted therapy. Sometimes late side effects develop months or years after targeted therapy. Most side effects go away on their own or can be treated, but some side effects may last a long time or become permanent.
Side effects of targeted therapy will depend mainly on the type of drug, the dose and your overall health. Some common side effects of targeted therapy for ALL are:
- flu-like symptoms, such as fever and chills
- nausea and vomiting
- skin problems, including redness, itching and dryness
- muscle and joint pain
- fluid buildup in the arms, legs and around the eyes
- low blood cell counts (called bone marrow suppression)
- tumour lysis syndrome
Tell your healthcare team if you have these side effects or others you think might be from targeted therapy. The sooner you tell them of any problems, the sooner they can suggest ways to help you deal with them.
Information about specific cancer drugs
Details on specific drugs change quite regularly. Find out more about sources of drug information and where to get details on specific drugs.
Questions to ask about targeted therapy
A drug that blocks the actions of the enzyme tyrosine kinase, which helps transmit the signals that occur after a growth factor binds to its receptor. Tyrosine kinase is involved in cell communication, development, division and growth.
Tyrosine kinase inhibitors are a type of growth factor inhibitor therapy. They may be used to help prevent tumour growth.