"Blood cancer is harder to treat than other solid tumors, but it is possible to achieve a cure and even completely graduate from the hospital. Do not be discouraged and hope to stay with the medical staff until the end."
On the 13th, Professor Ko Young-il, a hematology oncologist at Seoul National University Hospital in Jongno District, Seoul, said, "Blood cancer has a low number of patients and interest, but treatment methods are definitely advancing." Professor Ko graduated from Seoul National University College of Medicine and received his master's and doctorate from the same university. He has been seeing patients in hematology oncology since 2013 after training and internal medicine residency at Seoul National University Hospital.
Blood cancer is a type of cancer that occurs in rapidly growing blood cells. Leukemia is a representative type. It occurs when white blood cells in the blood or bone marrow proliferate abnormally. It is divided into acute and chronic forms, among which acute lymphoblastic leukemia (ALL) is fast-progressing and deadly when it occurs in adults. The cancer spreads quickly, making it difficult to categorize it as early or late stage. If not treated within 3 months of onset, it can deteriorate rapidly and lead to death.
Professor Ko noted, "While the cure rate for pediatric ALL patients is high, in the past, only about 30% of adults achieved a cure," and added, "Swift treatment is essential as delaying it can worsen the condition within a few weeks." There are about 300 cases of domestic patients annually, making it rare. The annual incidence accounts for less than 0.4% of all cancers.
While solid tumors in organs are treated with surgery, blood cancer is mainly treated with chemotherapy. A typical treatment method is a three-phase chemotherapy regimen. The first phase is "induction therapy," which reduces cancer cells to one-hundredth of their original size; the next is "consolidation therapy," which reduces the size of cancer cells to a point where they are nearly eradicated; and the last is "maintenance therapy," which prevents relapse over 2 to 3 years.
In the past, hematopoietic stem cell (bone marrow) transplantation was considered the most effective treatment to prevent relapse. However, due to a shortage of donors, options are becoming limited. Professor Ko said, "Finding donors is very difficult now, unlike in the past when there were many siblings," and asserted, "This is an era where transplantation cannot be the only treatment method."
It is known that if even a small amount of cancer cells remain after treatment for leukemia, more than half will relapse within five years. Recently, targeted therapies such as bispecific antibodies and antibody-drug conjugates (ADC) have emerged, opening new pathways for treating acute lymphoblastic leukemia. In particular, bispecific antibody treatments can eliminate cancer cells that remain in such minimal quantities that they are nearly invisible.
Research results have shown that using bispecific antibody treatments on adult patients whose cancer cells have decreased to a point where they are not visible can reduce the risk of relapse by nearly half. Starting in February of this year, bispecific antibody treatments can be administered regardless of whether a minimal amount of cancer cells remains. Professor Ko said, "We have been able to save nearly half as many patients as before."
In addition to patient care, Professor Ko is also dedicated to research aimed at conquering blood cancer. He stated, "Even for the same cancer, each patient has different genetic mutations," and emphasized, "It is important to analyze this to determine personalized treatment directions."
In 2020, a genetic mutation map for Korean patients with acute myeloid leukemia (AML) was constructed, and by the end of last year, a screening method was developed and announced to predict the effectiveness of targeted therapies in advance. It received evaluations for overcoming the limitations of existing treatments that were only effective for specific patients.
Professor Ko founded Novomedicine in 2017 and is also focused on the development of new drugs for blood cancer. Last year, he introduced the blood cancer drug candidate "Poseltinib" from Hanmi Pharmaceutical and is currently conducting Phase 2 clinical trials.
Recently, he has been concentrating on research aimed at uncovering the causes of cancer among those aged 60 and older across all cancer types in preparation for a super-aged society. Professor Ko believes that unraveling the links between aging and cancer could be key to conquering cancer in the future.
Professor Ko noted, "While the development of treatments for blood cancer has been slow, it serves as a 'model cancer type' that helps in the development of innovative therapies for other cancer types." He explained, "Blood cancer cells are easily collected because they are in the blood, and their cell composition is more uniform than that of solid tumors, making them favorable for genetic research. Innovations in next-generation therapies, including bispecific antibodies, ADCs, and CAR (chimeric antigen receptor) T-cells, also began with blood cancer."