New drug combination gives hope for acute myeloid leukaemia treatment

A new trial in the US hopes to marry a new pair of drugs as a combination treatment for acute myeloid leukaemia (AML), with research suggesting that utilising the drugs in tandem will maximise their effectiveness in killing cancer cells.

The trial, which will be carried out at the University of Maryland Greenebaum Comprehensive Cancer Center, Fox Chase Cancer Center and University of Southern California, will combine investigational PARP inhibitor talazoparib with DNA methyltransferase (DNMT) inhibitor decitabine. AML is often preceded by myelodysplastic syndrome (MDS), for which decitabine is already an FDA-approved treatment.

Recent research indicates that PARP and DMNT inhibitors boost each other’s effects when used in combination. "Long-term survival with AML is quite poor and, unfortunately, our arsenal for treating it has remained largely unchanged for decades," said Professor Feyruz Rassool, member of the VARI-SU2C Epigenetics Dream Team. "Combination therapies, such as talazoparib and decitabine together, allow us to attack cancer from multiple angles at the most basic level for a greater potential effect."

Stephen Baylin, co-leader the team, explained: "The trick with PARP is that it has to arrive at the site of the damage, fix it, and then go away. If it gets trapped there, it kills the cell. The same goes for molecules called DNA methyltransferases, which are important for regulating how genetic instructions are read and acted upon. We found that the DNA methyltransferase actually increases the time that PARP gets trapped at the sites of DNA damage, increasing the effectiveness of the PARP inhibitor."

The trial hopes to produce an alternative treatment for the disease to be made available in clinics. AML is a serious disease which affects around 20,000 in the US alone and is known to kill around 75% of sufferers within five years.

The team is also optimistic that the research will lead to expanded applications of the treatment in other forms of cancer: "Our work also shows promise in ovarian cancer and breast cancer, particularly triple-negative breast cancer, which is notoriously difficult to treat," Rassool added. "If this first clinical trial is successful, we hope to expand our studies to help more patients."