Aaron Logan, MD, PhD, discusses some of the treatment options available for patients with acute lymphoblastic leukemia.
Aaron Logan, MD, PhD, assistant professor of Clinical Medicine, University of California San Francisco, discusses some of the treatment options available for patients with acute lymphoblastic leukemia (ALL).
New therapies such as blinatumomab (Blincyto), inotuzumab (Besponsa), and chimeric antigen receptor (CAR)-T cells, have made the management of patients with ALL both complex and positive. Some agents, including blinatumomab, are even being moved into the frontline setting.
During a session at the National Comprehensive Cancer Network 2022 Annual Meeting: Hematologic Malignancies, experts, including Logan, further discussed the new and best strategies for managing patients with ALL.
Transcription:
0:08 | The management of adults with ALL has become a bit more complex but thankfully more successful due to the availability of agents such as blinatumomab, inotuzumab, and we now have CAR T cells that are approved for adults of all age groups. We are now seeing that some of these agents are being moved to frontline therapy, in particular, blinatumomab, which is actually FDA approved for the management of minimal residual disease [MRD]-positive ALL.
0:40 | The NCCN guidelines now specify that it is an appropriate therapy for patients that have MRD positivity to get blinatumomab and then conventionally followed by an allogeneic stem cell transplant. There are potentially some patients that could remain in a long term remission after blinatumomab without transplant, but we currently are not able to prospectively identify those patients. The plan is generally to do blinatumomab followed by an allogeneic transplant. Then as far as the remainder of consolidation therapy for patients who achieved the milestone of MRD negativity after induction, or at least early in the course of therapy after initial consolidation, there are a few different options, including continuing multi-agent chemotherapy based on what protocol they're on.
1:24 | Their protocol might be a pediatric inspired regimen, such as the CALGB 10403 regimen if they're in the adolescent or young adult group, or it might be hyper-CVAD depending on what institution they're being treated at. Another option per the NCCN guidelines would be to use blinatumomab as consolidation, even for patients who have achieved MRD negativity. That's based on some studies that have already demonstrated that blinatumomab is safe therapy after multi-agent chemotherapy, and is likely associated with long term remissions in that setting.
Darolutamide Becomes Routine Doublet and Triplet Option in Hormone-Sensitive Prostate Cancer
May 6th 2024Darolutamide has been adopted routinely in clinical practice as a component of both doublet and triplet regimens for the treatment of patients with metastatic hormone-sensitive prostate cancer.
Read More
Responders to UGN-101 Have Positive RFS in Upper Tract Urothelial Cancer
May 5th 2024In patients at 15 centers who had upper tract urothelial cancer, those with no evidence of disease after UGN-101 induction had a 68% rate of 3-year recurrence-free survival, and this outcome did not differ based on tumor status, method of instillation, or treatment intent.
Read More
UGN-101 Shows Promise for Upper Tract Urothelial Cancer Durability
May 5th 2024Maintenance UGN-101 therapy demonstrated good durability of response in initial responders with low-grade upper tract urothelial cancer, as evidenced by a low rate of disease progression in a multicenter, longitudinal follow-up study.
Read More