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Systemic therapy
Epigenetic & differentiation therapy
Changing how a cancer cell reads its own instructions, rather than killing it outright.
Delivered at a partner unit
What it is
Some cancers are driven less by broken genes than by genes being switched on or off wrongly. Hypomethylating agents, HDAC inhibitors and differentiation agents such as ATRA act on that layer , pushing immature malignant cells to mature, or restoring genes the cancer has silenced.
Acute promyelocytic leukaemia is the landmark case: a disease that was rapidly fatal became one of the most curable, largely without conventional chemotherapy.
When it is used
- Myelodysplastic syndromes and selected AML
- Acute promyelocytic leukaemia
- Some T-cell lymphomas
- Where intensive chemotherapy is not survivable
How the decision is made
- Whether disease control over months is the realistic goal, rather than a rapid response.
- Whether the patient can attend for the repeated dosing schedule these agents require.
- Differentiation syndrome risk and how it will be watched for.
Prescribed and monitored here; infusions at a partner day-care unit.
Who does what
What we handle, and what happens elsewhere
KPCIRC handles
- Diagnosis confirmation with the molecular markers that decide this
- A written treatment schedule and monitoring plan
- Differentiation-syndrome counselling and an escalation route
- Cycle-by-cycle response review
Performed and billed elsewhere
- Drug supply and administration
- Marrow assessment
- Differentiation syndrome, breathlessness, swelling, fever in the first weeks of ATRA-type treatment, is an emergency. You will be told exactly what to watch for.
Questions to ask your own doctor
Take these with you. They work whether or not you are treated here.
- How long before we know whether this is working?
- What is the schedule and how many visits?
- What is differentiation syndrome and what do I do?
- What is the alternative if this fails?
Support that goes with it
Where this is used
Cancers this commonly forms part of
Not sure this is the right option for you?
That is exactly what a second opinion is for. Bring what you have, we will tell you what is missing and what the alternatives actually are, in writing.