Vision
Our vision for IntReALL 2020 is to improve the survival of all children with relapsed acute lymphoblastic leukaemia (ALL) in Europe by employing targeted and less toxic immunotherapy. The overall aim is to establish an immunotherapeutic arm as standard of care and to provide access to individualized treatment recommendations to all children with relapsed ALL. IntReALL 2020 is made possible by the collaboration of 18 EU member states and 3 non-members which together constitute the largest study group for childhood relapsed ALL in the world.
Rationale
ALL is one of the most common childhood cancers, affecting predominantly children younger than 6 years. Whilst immense progress has been made in the treatment of ALL patients with survival rates currently exceeding 80%, a significant number of patients still experience relapse. Tumour relapse poses a major challenge in nearly all cases and is currently the primary cause of death with a median survival rate of approximately 25%. Standard treatment strategies such as chemotherapy and hematopoietic stem cell transplantation are associated with substantial long-term toxicity. Furthermore, subsets of patients associated with very high-risk features show resistance to these therapies.
IntReALL addresses this problem by introduction of targeted immunotherapy. Immunotherapeutic drugs stimulate the immune system to target and eliminate cancerous cells. This allows for a more specific and much less toxic approach than is possible with chemotherapeutic drugs. Previous trials, including the IntReALL 2010 trial, have already shown promising results in this area. To elaborate on these findings, large randomized-trials will be set up to test the efficacy of promising immunotherapeutic drugs and to provide treatment appropriate to the patient's risk group. For patients with very high-risk features, personalized treatment strategies will be offered upon recommendation of an expert federated relapsed/refractory acute leukaemia (FEDRAL) board. Thus, IntReALL is aimed at all children with relapsed ALL.
