The Future of Blood Cancers: How Advances Are Improving Care

Sophisticated blood tests now make it possible to find one cancer cell in a field of millions of cells, an important finding for physicians who are caring for patients with blood cancers. Detecting measurable residual disease (MRD), or small numbers of cancer cells that may remain even after treatment, is revolutionizing how doctors monitor patient progress and make treatment decisions.

September is Blood Cancer Awareness Month. Two of the experts from Baptist Health Miami Cancer Institute, Guenther Koehne, M.D., Ph.D., deputy director and chief of hematologic oncology and stem cell transplantation, and Firas El Chaer, M.D., MSHCM, chief of the leukemia service and medical director of infusion services, recently sat down to discuss advances in care.

Hematologic cancer, also known as blood cancer, accounts for roughly 10 percent of all cancers diagnosed. And while survival rates have improved over the years, blood cancers such as leukemia, lymphoma, myeloma, myelodysplastic syndrome and myeloproliferative neoplasm can still be very complex to treat.

More Personalized Approaches to Fighting Blood Cancers

In the last decade, however, treatment has grown increasingly individualized, thanks to a better understanding of the molecular and genetic foundations underlying hematologic malignancies, cutting-edge laboratory techniques and developments in immunotherapy and targeted therapies. Taken together, the advances are leading to a cure for some and longer survival for others.

“In blood cancer such as leukemia, myeloma or lymphoma, we are now able to specifically target mutations, even with oral therapy,” Dr. El Chaer said. “Many of these targeted therapies lack the side effects that we used to see with traditional chemotherapy. It controls the cancer, it provides good quality of life and it prolongs life.”

Promising New Treatments for Blood Cancers

Targeted therapies — drugs that attack specific molecules or pathways that cancer cells depend on to grow — and immunotherapies that harness the body’s own immune system to fight disease, are promising and evolving treatments for blood cancers.

“Years ago, we used to have to tell patients, ‘We gave you all the drugs that we have.’ Now, we have a third line, a fourth line or a fifth line of treatment. We have another option, another alternative to present to the patient,” Dr. Koehne said.

Close monitoring of MRD by very sensitive blood tests also allows physicians to intervene more quickly than in the past, rather than waiting until their disease is in full relapse. “We’re very proud that we’re able to provide our patients with these forefront therapies and latest treatments, whether it’s FDA-approved or in a clinical trial,” Dr. El Chaer said.

CAR T-cell therapy, which essentially turns a patient’s own immune system into a powerful cancer-fighting weapon, is a focus of Dr. Koehne’s. In this innovative approach, doctors remove T-cells, a type of white blood cell, from the patient’s blood and genetically modify them to include a new marker that targets and kills the cancer cells when infused back into the patient.

A New Frontier in Fighting Blood Cancers

Another exciting area of advancement involves dual specific co-stimulatory molecules, which represent a new frontier in enhancing the body’s immune response against blood cancers. These engineered molecules are designed to simultaneously engage two different pathways that activate immune cells, creating a more robust and sustained anti-cancer response than traditional single-target approaches.

“There are different ways for the tumor cell to escape immune recognition. They develop resistance mechanisms,” Dr. Koehne said. “So, there are new strategies now to try to prevent this escape mechanism by targeting two molecules at the same time.”

Physician-scientists are also researching the use of natural killer (NK) cell therapy in blood cancer patients, which involves collecting NK cells from the patient or a donor, enhancing them in the lab and infusing them into the patient. There, they patrol the body looking for abnormal cells and destroy them.

Actively leading clinical trials and research studies is crucial to providing the most advanced care, Dr. Koehne said. “We have exciting treatment approaches, and we now have long-lasting remissions in patients that we could not expect years ago,” he said. “Blood cancers remain among the most complex and rapidly evolving areas of medicine, requiring continuous learning and adaptation. Staying current is critical to delivering the best possible care.”

Guenther Koehne, M.D., Ph.D., deputy director and chief of hematologic oncology and stem cell transplantation at Baptist Health Miami Cancer Institute

Firas El Chaer, M.D., MSHCM, chief of the leukemia service and medical director of infusion services at Baptist Health Miami Cancer Institute