Written by:
Global Head of Multiple Myeloma Clinical Development and Strategy, AstraZeneca
Global Head of Leukaemia Strategy and Clinical Development, AstraZeneca
Blood cancers like multiple myeloma (MM), lymphoma and leukaemia present complex treatment challenges due to their diverse molecular and phenotypic characteristics. Many of these cancers are diagnosed at advanced stages and relapse is common, underscoring the need for a fundamentally reimagined approach to elevate the standards of care.
At AstraZeneca, our vision is to redefine the standards of care in haematology with innovative medicines and novel combination strategies with the aim to address the complexity of blood cancers and reduce the treatment burden for patients.
Advancing Precision Medicine in Multiple Myeloma
The management of MM, a cancer originating in the bone marrow, continues to pose significant challenges. Early diagnosis can be difficult due to non-specific symptoms that are easily overlooked. Even following initial treatment patients face the possibility of disease relapse, resistance to existing therapies, and the physical and emotional burden of prolonged and intensive treatment regimens. While cure currently remains out of reach, advances in immunotherapies and targeted treatments mean that many individuals can live with MM as a chronic condition.
Our scientists and clinicians are focussed on not only developing potentially more effective and more tolerable therapies, but also on delivering options that could reduce the treatment burden – moving away from traditional multiagent, indefinite chemotherapy regimens.
We are pioneering antibody drug conjugates that precisely target and kill cancer cells, while sparing healthy cells. We are also advancing a novel dual-targeting autologous CAR T, designed using our FasTCAR rapid manufacturing platform, which reduces the time it takes to create a personalised cell therapy. This may allow us to deliver a patient’s therapy faster, minimising their chance of disease progression while they await treatment. What’s particularly exciting about cell therapy is the potential to offer a one-time treatment approach, versus patients having to receive multiple doses of treatment over time. We are also investigating blood-based disease assessments that could one day replace invasive biopsies and simplify disease monitoring.
Pioneering Targeted Therapies for Lymphoma
Lymphomas—particularly non-Hodgkin lymphoma (NHL)—are among the most common types of blood cancers. The challenge in treating lymphoma lies in its heterogeneity, with different subtypes of the disease, for example Diffuse large B-cell lymphoma (DLBCL) and follicular lymphoma (FL), requiring distinct treatment strategies. Traditional treatments rely on intensive, multi-agent combinations of chemotherapy however, the landscape is rapidly evolving with the emergence of immunotherapies such as cell therapies and T cell engagers (TCEs).
One of the most promising modalities is TCEs, a bispecific antibody that harness a patient’s own immune response against their cancer. TCEs have shown improved outcomes across some types of blood cancers, however side effects like cytokine release syndrome, a systemic inflammatory response, require careful monitoring and can be dose-limiting. Our teams are exploring different ways to overcome this, with the goal of extending the potential of TCEs to more patients. This includes step-up dosing to gradually prime the patient’s immune system and next-generation TCEs designed to specifically activate cancer-killing immune cells, for enhanced selectivity against cancer.
Looking to the future, our focus is on moving next-generation immunotherapies to earlier lines of treatment and developing chemo-light or chemo-free regimens, with the goal of improved efficacy and tolerability.
Finding New Approaches in Leukaemia Treatment – ALL
Building on our leadership in chronic lymphocytic leukaemia (CLL), we’re continually exploring new avenues across the leukaemia landscape, including a renewed focus on acute lymphoblastic leukaemia (ALL).
ALL is one of the most aggressive blood cancers due to the rapid proliferation of cancerous blood cells that affects both adults and children and there is a need for more tolerable therapies that drive longer periods of remission. Leukaemia can be particularly challenging to eradicate completely. Even after successful treatment, small numbers of cancerous cells known as minimal residual disease (MRD) can remain undetected and cause disease relapse. To address this we are pioneering research to potentially improve MRD testing for enabling earlier disease detection and to develop adaptive treatment strategies.
Our innovative ALL pipeline spans a range of modalities, including ADCs, TCEs and small molecules, with a focus on key targets including CD19 and CD22. However, it’s not just the drugs in our pipeline, but how we develop them in the clinic that matters. We are committed to moving new therapies into the frontline setting as early as possible, to offer potentially more tolerable and more convenient treatment options for people with newly diagnosed ALL. Beyond this, we are incorporating MRD endpoints across our clinical trials, to inform regulatory and clinical decision making, to deliver potential new treatments to people living with ALL faster.
Redefining Standards of Care
By focusing on the distinct needs of diseases like MM, lymphoma and leukaemia, we aim to build a future where blood cancer is no longer a life-limiting diagnosis, but a treatable condition. Our approach is unified by one common goal: to provide patients with more effective, more tolerable and personalised treatments and reduce the burden of disease.
The next generation of blood cancer treatments is about pushing the boundaries of science to provide a holistic approach to care that addresses the complexities of each disease, the individual needs of each patient and the long-term impact on their lives. One approach alone won’t solve the problems faced in blood cancer treatment, which is why we are building a diverse pipeline, leveraging multiple mechanisms of action to target different facets of each disease. With a diverse pipeline, we can also look to create novel targeted combinations which in turn may create deeper and more durable responses. Additionally, we’re looking to leverage new technologies, including measurable residual disease detection, to support earlier diagnosis and interventions.
As we continue to advance research and collaborate with our global partners, we are one step closer to creating a future where haematology care is defined by possibility, precision and transformation.
