The WorldCare Wire – Fall 2023
Welcome to this edition of The WorldCare quarterly e-newsletter, where you’ll learn how a medical second opinion (MSO) can inform you and your doctor about new treatment options and clinical trials. You’ll also learn about leukemia and research insights from The WorldCare Consortium® providers.
For Your Health: MSOs Help Identify New Treatment Options and Clinical Trials
A WorldCare MSO goes beyond ensuring your diagnosis is correct. It recommends a treatment plan with the best approach possible, including the latest available treatment options and clinical trials of new therapies under investigation for your consideration.
The WorldCare Consortium® members are at the forefront of advancing clinical research into new treatments for the serious and complex conditions they specialize in. They have deep knowledge of new options recently approved or under investigation and understand variations in illnesses and how to optimize the response to new treatment approaches.
In fact, 75% of WorldCare MSOs change the recommended treatment — by suggesting an entirely different treatment or modifying the existing treatment approach, for example, with additional drugs or therapies.
Health IQ: Leukemia
Leukemia is a cancer of blood-forming stem cells. Different types are defined as fast growing (acute) or slow growing (chronic), and whether the cancer begins in lymphoid or myeloid cells.1
The main types of leukemia are:2
• Acute lymphocytic leukemia (ALL). Also called acute lymphoblastic leukemia, ALL is the most common type of leukemia in children but can also occur in adults.
• Acute myeloid leukemia (AML). AML is the most common acute leukemia in adults. It can also occur in children.
• Chronic lymphocytic leukemia (CLL). CLL is the most common chronic leukemia in adults. People with CLL may feel well for years without needing treatment.
• Chronic myeloid leukemia (CML). CML mainly occurs in adults. There may be few or no symptoms for a long time before the cancer cells spread.
Common Leukemia Symptoms
Leukemia symptoms may be vague and similar to flu or other common illnesses. Typical signs and symptoms may include:
• Fever or chills
• Persistent fatigue or weakness
• Frequent or severe infections
• Unexplained weight loss
• Swollen lymph nodes, enlarged liver or spleen
• Easy bruising or bleeding
• Recurring nosebleeds
• Tiny red spots in the skin, called petechiae
• Excessive night sweats
• Bone pain or tenderness
Leukemia Causes and Risk Factors:2
Leukemia arises when blood-forming cells acquire gene mutations that tell the cells to keep growing and dividing. There is no known exact cause. Scientists think it develops from a combination of environmental and genetic factors.
The following may increase your risk of developing leukemia:
• Previous chemotherapy or radiation treatment for cancer
• Genetic disorders, such as Down syndrome
• Exposure to certain chemicals, such as benzene, found in gasoline
• Smoking cigarettes
• A family history of leukemia
Remember that most people with these risk factors do not get leukemia, and many people diagnosed with leukemia have no known risk factors.
WorldCare Consortium® Research Update: UCLA Health is conducting clinical trials of a new class of drugs for AML
Menin inhibitors are a new class of drugs showing promise for treating advanced AML, one of the most challenging leukemias to treat.3
Menin inhibitors block the interaction between the protein menin and genes expressing specific mutations that drive cancer cell growth, turning the leukemia cells into normal blood cells or killing them.3
UCLA Health is currently conducting two first-in-human clinical trials of oral menin inhibitors for adults ages 18 and older with advanced AML that has not responded to standard therapies:
• A Phase 1/2 study of ziftomenib. Phase 1 will assess the highest dose that can be given safely. Phase 2 will continue evaluating the drug in patients with a specific gene mutation called nucleophosmin 1 (NPM1).
• A Phase 1 study of BMF-219 in adults with advanced AML, ALL with specific gene mutations, diffuse large B cell lymphoma, multiple myeloma, and CLL/small lymphocytic leukemia. The study will evaluate the optimal dose that can be given safely and the incidence of adverse events.
1 Leukemia. American Cancer Society. Accessed at https://www.cancer.org/cancer/types/leukemia.html
2 Leukemia. Mayo Clinic. Accessed at https://www.mayoclinic.org/diseases-conditions/leukemia/symptoms-causes/syc-20374373
3 National Cancer Institute. Revumenib Shows Promise in Treating Advanced Acute Myeloid Leukemia. Accessed at https://www.cancer.gov/news-events/cancer-currents-blog/2023/revumenib-menin-inhibitor-advanced-aml
WorldCare Consortium® Provider Research News
Personalized Immunotherapy for Glioblastoma
Jefferson Health is participating in a Phase 2b clinical trial for adults with newly diagnosed glioblastoma brain tumors. Living tumor cells from the patient are removed, and then combined with a drug in small chambers that are implanted back into the patient’s brain for two days. When the tumor cells die, they release particles that train their immune system to attack the tumor.
Phase 1 studies showed that this treatment strategy was safe and well tolerated, with promising improvements in survival, tumor response, and immune system response.
Jefferson Health neurosurgeon Dr. David Andrews worked with a biotechnology company to develop this innovative treatment approach. The Phase 2b trial will be conducted at 25 hospitals, including Jefferson Health, and they are aiming to recruit over 90 participants.
Reseachers Discover Important Clues About the Source of Arrhythmia
Researchers at UCLA Health recently discovered that scar-forming cells called fibroblasts found in the heart play a direct role in promoting an irregular heartbeat rhythm, known as arrhythmia. Their groundbreaking finding was published recently in the journal, Science.
Arrhythmia is an underlying cause of most cases of sudden cardiac death in the United States. Having more cardiac fibroblasts had previously been linked to an increased risk of arrhythmia. The new study found the fibroblasts generate an electrical field and communicate directly with cardiac muscle cells, actively promoting excitability and generating arrhythmias in mouse models.
The current therapy for treating arrhythmias related to scar-tissue formation in the heart is to destroy muscle cells in the scar tissue in a procedure called ablation. It is highly effective, but arrhythmia recurs in half of patients within a year, potentially driven by an increase in fibroblasts caused by the ablation. The investigators are continuing their work to learn more about how fibroblasts and cardiac muscle cells communicate, with a view to developing new strategies to help prevent sudden cardiac death caused by arrhythmia in the future.
Our Member MSO Experience
“We were very pleased with the level of service that the WorldCare team provided us. You have all made a very scary, worrisome experience, much better. The help that the team has provided is truly immeasurable, and we can’t thank you enough. Our experience has been positive, professional, empathetic, and informative. We truly appreciate all of the information and answering our many questions in a timely fashion.”
— Member
Alberta, Canada
As a covered member, if you or a loved one is diagnosed with a serious or complex condition, contact WorldCare.
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