Acute Leukemia Takeaways From ASH 2015: New Agents

Farhad Ravandi, MD


December 22, 2015

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This is a very exciting American Society of Hematology (ASH) meeting this year because we are seeing a number of developments in both acute myeloid leukemia (AML) and acute lymphoblastic leukemia (ALL), starting with the plenary presentations reporting survival advantages in both of these diseases with the addition of rituximab in ALL and midostaurin in AML among two specific subgroups of patients with these diseases.[1,2]

It is also exciting because we are now beginning to see the future of therapy in both AML and ALL with a number of new agents that are in development and are likely to be incorporated into our chemotherapy backbone regimens. A number of oral targeted agents are being presented in this meeting, including FMS-like tyrosine kinase 3 (FLT3) inhibitors, isocitrate dehydrogenase (IDH) 1, IDH2, and 1-aminobenzotriazole (ABT) inhibitors that are already being complemented to chemotherapy regimens and are showing significant promise.

Data on monoclonal antibody-based therapies are also being presented; for example, CD33 antibody-drug conjugates, which are of a lot of interest in acute myeloid leukemia, as well as CD19 antibody-drug conjugates, which are of interest in ALL, in the form of inotuzumab ozogamicin, which is being complemented into chemotherapy backbone regimens and has shown significantly improved outcomes for subsets of ALL.

In terms of CD33-based monoclonal antibodies, SGN-CD33A is an interesting and exciting drug that has been presented both as monotherapy as well as in combination with hypomethylating agents.

These are areas that are likely to be of a lot interest to us in the acute leukemia community and would likely improve the outcomes of patients with these diseases.

Other areas of interest include other immunotherapy-based strategies such as chimeric antigen receptor (CAR) T cells, which are still being presented in more complete forms in a number of abstracts and are likely to be of a lot interest in the next couple of years. Similarly, specific antibodies, particularly blinatumomab and other new ones that are in development, are likely to become available in the near future and will complement our strategies and are likely to improve the outcomes in patients with both AML and ALL.

Minimal residual disease assessment has received a lot of interest; in this ASH meeting, we are seeing a number of presentations showing the relevance of treating these patients. Now with the availability of the agents that I mentioned, such as the oral targeted therapies as well as immunoglobulin or antibody-based therapies, we are going to have very effective tools to eradicate minimal residual disease in patients who have already achieved remission with chemotherapy-based regimens. This is going to be another major area that will continue to be explored and presented in future meetings. Thank you.


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