ASH News Daily - Saturday, December 10, 2011 - (Page A-14)
Page A–14
®
ALL
Efficacy and Toxicity — Is There a Sweet Spot in ALL?
By BarBara pro, Md
T
he goal of our fight against
cancer is finding the MELTing
(most-effective-least-toxic)
potion. Thus, moving away from
standard “kill-all” drugs to “spareme”
targeted agents have been most
of the focus of cancer research in the
last few decades. Also, as patients
live longer, we struggle with a number
of issues due to treatment-related
short- and long-term toxicities
and look back and ask ourselves:
How can we make it better? Is there
a sweet spot of increased efficacy
and minimal toxicity? This morning
at 7:30 a.m. and again at 2:00 p.m.
in Elizabeth Ballroom EFGH, Manchester
Grand Hyatt San Diego, Dr.
Adele Fielding, University College
London, will chair an Education Program
session titled “Current Management
Issues in Acute Lymphocytic
Leukemia,” outlining the most
current and pressing issues in the
treatment of ALL.
For pediatric ALL the good news is
that survival has increased dramatically
with five-year rates exceeding
90 percent. The bad news is that success
has come with a price. Chronic
health issues, secondary cancers,
and significant emotional hurdles
for both patients and caregivers are
only a few of the many issues we are
left to deal with. Dr. Leslie Robinson,
St. Jude Children’s Research Hospital,
will present the most current information
on key issues associated
with early morbidity and mortality
in childhood ALL survivors.
Most importantly, based on recent
findings, she will provide recommendations
for screening and new
directions for interventions to improve
long-term outcomes.
What about adult ALL? The good
news is that there are many new
therapies; the bad news is that none
of them are fully effective at control-
JAK2
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the eosinophilic disorders, molecularly
defined as PDGFRA, PDGFRB,
and FGFR1-associated neoplasms.
Dr. James W. Vardiman from the
University of Chicago, indicates
that the promise of future targeted
therapies akin to imatinib played a
role in devising the 2008 WHO Classification
system. While JAK2 mutations
were at once enlightening,
they likely represent just the first
piece of a very elaborate mosaic.
Dr. Landau indicated no relevant
conflicts of interest.
003192_sgn35_adc_and_fa2.indd 1
ling this challenging disease. The development
of monoclonal antibodies
represents one of the greatest success
stories in the treatment of hematologic
malignancies as it is the ideal
targeted therapy. Dr. Dieter Hoelzer,
University of Frankfurt, will discuss
how the introduction of antibodybased
therapies is changing the
outcome for patients with ALL. In
addition to providing the most current
data on the use of traditional
antibodies, Dr. Hoelzer will discuss
the use of the newer humanized
anti-CD20 and bi-specific an-
tibodies in the treatment of ALL.
Some of the challenges related to
the use of antibody-based therapies
in different clinical settings
will also be addressed.
Dr. Fielding will conclude the ses-
sion with an update on the treatment
of Philadelphia-positive (Ph+) ALL.
The Philadelphia chromosome is the
most common cytogenetic abnormality
associated with adult ALL. Before
the introduction of tyrosine kinase
inhibitors (TKIs), Ph+ ALL carried a
poor prognosis with poor response
to chemotherapy and short survival
rates. Treatment with BCR-ABLspecific
TKIs has resulted not only in
higher complete remission rate and
better long-term outcome but also in
minimal toxicity. Dr. Fielding will
review a number of important issues
such as the role of monotherapy with
TKIs in select patients, the role of allogeneic
stem cell transplantation,
and mechanisms of resistance. Results
of ongoing studies with novel
agents will also be presented.
Dr. Pro indicated no relevant conflicts
of interest.
ASH NEWS DAILY
Saturday, December 10, 2011
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