Who can enter
- Children with relapsed or refractory acute lymphoblastic leukemia (ALL) and lymphoblastic lymphoma (LBL) with mutations in the MAPK/SRC pathway
- 1 to 21 years
Goal
The goal of this study is to investigate whether the combination of dasatinib and venetoclax is tolerable, safe and effective in combination with dexamethasone, cyclophosphamide and cytarabine. This is tested in patients who have had an inadequate response to previous treatment (refractory) or whose disease has come back (relapse).
Background
Certain changes (mutations) present in leukemia or lymphoma cells are responsible for increased and uncontrolled cell growth. Known changes that act like this are mutations in several genes that are part of the MAPK-SRC signaling pathway.
Certain proteins control the growth of many cancers. These are the so-called tyrosine kinases, and the BCR-ABL and SRC family proteins are examples of tyrosine kinases. The drug dasatinib mainly inhibits the action of BCR-ABL proteins and proteins of the SRC family. This inhibits the division of cells and thus the growth of leukemia or lymphoma cells.
Venetoclax targets a particular enzyme that is increased in leukemia or lymphoma cells and prevents the cancer cells from dying naturally (this protein is called: BCL2 protein). Venetoclax turns off this BCL2 protein, causing the leukemia cells to die.
Dexamethasone, cyclophosphamide and cytarabine are drugs that can cause leukemia and lymphoma cells to die more quickly.