Singapore faces a stable increase in blood cancer patients. Promisingly, a chance of better treatment for such incidents emerges from the developments in cancer research and technology.
In a virtual open dialogue, senior consultants specializing in hematology at Parkway Cancer Centre (PCC) in Singapore highlighted the progress in blood cancer treatments, particularly the possibilities of making them individualized.
Most blood cancer patients during the mid-1960s to mid-1990s experienced poor outcomes with the treatments. But from the mid-1990s up to now, “there’s been a lot of exciting and revolutionary advances,” said Dr. Teo Cheng Peng.
Dr. Colin Phipps Diong talked about leukemia and introduced the Chimeric Antigen Receptor T-cell (CAR T-cell) therapy which involves taking a patient’s T-cells and modifying the cells in the laboratory to make them recognize certain targets on certain cancers. Those cells would be given back to the patient through an infusion.
While effective, such a therapy is expensive. Early clinical trials also saw the therapy “killed so many leukemia cells all at once; when [the leukemia cells] died in the body, they release a lot of the toxic stuff inside the cells, and that overwhelmed certain patients,” Dr. Diong said.
“Thankfully, we now know how to deal with these complications, and how to preemptively — or you can say preventively — treat so that these severe complications that cause death are minimized,” he said.
Moreover, CAR T-cell is a targeted therapy which means it cannot be used for all cancer types.
“The two approved indications for CAR T-cell therapy in Singapore at this point [are] against the B-cell acute lymphoblastic leukemia and large B-cell lymphoma,” Dr. Diong said.
“As yet, we do not know what is the best way to target acute myeloid leukemia or T-cell lymphoma with CAR T-cells. There is still a lot of development that needs to happen in the CAR T-cell therapy,” he added.
Dr. Dawn Mya discussed multiple myeloma, a cancer originating from plasma cells. Since multiple myeloma remains incurable, she said that they concentrate on achieving remission with treatment.
“Our treatment is mainly focusing on symptom control, at the same time trying to improve the quality of life; together with prolonged remission as much as possible while trying to delay the time to relapse,” said Dr. Mya.
She divided the treatment into definitive treatment (usually combination therapy) and supportive care.
Dr. Mya also shared new advancements in multiple myeloma treatments like several classes of drugs for medical therapy. There are also immunotherapy and other specific therapies such as bispecific T-cell engagers and cell therapy like the CAR T-cells, which are in clinical trials and may be available soon.
As for lymphoma or the type of blood cancer involving the lymphatic system, Dr. Lee Yuh Shan said that its various subtypes have a different treatment approach.
Developments on lymphoma treatments are also on the horizon, said Dr. Shan. These are immunochemotherapy and BCL-2 inhibitor, new bispecific antibody, and the CAR T-cells.
“Treatment outcomes [are] improving over the years with the new agents, which are more effective,” Dr. Shan observed.
“Personalized treatment is very important,” he added. “We have to take into consideration the tumor type, the disease status, the mutation of the tumor, as well as the fitness of the patient to improve the outcome of this patient with lymphoma.”
For inquiries, please contact Parkway Hospitals Singapore – Manila office located at G/F-B, Marco Polo Hotel, Meralco Avenue and Sapphire Street, Ortigas Center, Pasig City 1600; email
manila.ph@parkwaypantai.com; or call 0917-526-7576. Visit parkwaycancercentre.com/ph/home and CanHope Manila’s Facebook page for more information.
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