Two-Drug Combo May Help Hard-to-Treat Leukemia

Oct. 10, 2011 -- A combination of two drugs -- the chemotherapy drug Fludara and the biologic drug Campath -- may allow people with hard-to-treat chronic lymphocytic leukemia (CLL) to live longer.

One of the most common blood cancers affecting adults in the U.S., CLL is considered incurable. In CLL, there are too many abnormal white blood cells in the blood and bone marrow. About 14,570 new cases of CLL will be diagnosed in the U.S. this year, according to the American Cancer Society. And about 4,380 people will die from the disease.

"There is a tremendous need for new therapies," says Ira Braunschweig, MD, director of the Bone Marrow Transplantation Program at Montefiore Medical Center in the Bronx, N.Y. "This is one of the most common types of leukemia and it is still a deadly disease." Braunschweig reviewed the study for WebMD.

Compared to treatment with Fludara (fludarabine) alone, the new combination increased "progression-free survival" or the length of time in which a person is free from disease after finishing treatment, and prolonged the lives of people who have had a relapse.

The findings are published online in The Lancet Oncology.

How It Works

Chemotherapy drugs like Fludara kill cancer cells. Campath (alemtuzumab) is a monoclonal antibody therapy. It targets a protein called CD52 that is found on the surface of white blood cells. It attaches to the cells and then rallies the immune system to help kill them.

In the study, 168 people with CLL who had relapsed or who did not respond to previous therapy received Fludara plus Campath and 167 received Fludara alone for up to six 28-day cycles. People who received the combination remained progression-free for a median of 23.7 months after treatment (about half remained progression-free for less than 23.7 months, half more), while those who took Fludara alone had a median of 16.5 months of progression-free survival.

The overall survival rate was also higher for people who got both drugs, the study showed. The findings held for older people and people with advanced CLL.

Side effects in both groups included low white blood cell count and an abnormally low number of blood platelets. The risk of serious complications, including infections, was higher in the combination group. That said, a similar number of people from each group stopped treatment because of side effects. In addition, a similar number of people died in both groups.

Researchers say the combination therapy eliminates the need for certain harsh chemotherapy agents used in other combinations. What’s more, the doses required of Fludara plus Campath are lower when the agents are used together. The new combination may also hold a convenience edge. It is given three days per month. The standard treatment is given three times a week for up to 12 weeks.