Future Perspectives in cGVHD

Future Directions

For therapy sequencing, approaches varied:

• Dr Shaughnessy: Generally switching between agents with brief steroid pulse
• Dr Bishop: Adding new agents to maintain control from multiple mechanisms
• Dr Lee: Cautious about combining without safety data, preferring switching

Future directions the panel is excited about:

• Moving targeted agents to first-line therapy
• Cell therapies for cGVHD (mesenchymal stromal cells as precedent from pediatric acute GVHD)
• Combination therapies in single molecules (eg, ROCK/JAK inhibitor)
• Agents targeting cell migration

Key principles for treatment goals:

• Symptom control and quality of life improvement
• Getting patients off steroids
• Disease stabilization, especially for lung involvement
• Tailoring therapy to organ involvement and tolerability