[ Anglais] An Expert Review of ASH 2018 CML News

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Topics include: Treatments and Understanding

At the  2018 American Society of Hematology (ASH) conference in San Diego, Patient Power host, Lee Swanson, is joined by chronic myelogenous leukemia (CML) expert Dr. Michael Mauro, from Memorial Sloan Kettering Cancer Center, to learn about research developments announced at the meeting. Dr. Mauro discusses developing treatment approaches and research into a deeper understanding of treatment cessation and remission. 

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Please remember the opinions expressed on Patient Power are not necessarily the views of our sponsors, contributors, partners or Patient Power. Our discussions are not a substitute for seeking medical advice or care from your own doctor. That’s how you’ll get care that’s most appropriate for you.

Chronic myeloid leukemia, CML, a lot of news coming out about that at this conference.  What are you excited about?  

Probably one of the most intriguing is combination treatment with TKIs, they are oral drugs for use like nilotinib (Tasigna), with interferon.  There was a session that included a few trials combining nilotinib and interferon and looking at molecular response and probably the ability to move quickly towards more streamlined regimens and getting people to a treatment-free remission.  So I think interferon has always been a good drug in myeloproliferative disease and still looks viable in CML, and I'm encouraged to see that we're still studying it. So I think with we need more time to follow those studies, but those combinations are still being investigated. 

Probably the other thing on the same token is about how do we really characterize these deep remissions, and how can we better characterize who may or may not have success with treatment cessation, and better tools are always a good idea.  So we have better techniques in PCR called digital PCR where instead of doing a reaction and trying to get as much information out of it as you possibly can you divide it into many, many reactions and then collate your responses and all the different reactions and it increases your sensitivity, and that may be a better predictor for patients who are beginning into a treatment-free remission stance and are about to stop treatment.  What's the status of their digital PCR rather than their standard PCR to predict whether they may or may not relapse?  

And then for the tough cases where we have folks with resistance or intolerance to multiple medications, we still have issue with certain mutations such as T315i.  And there's a new drug called asciminib, used to be known by the name ABL-001, which is from Novartis, and they have been performing a Phase I trial which has been reported already showing that it's a safe drug, then we have a safe dose, and we're moving it forward into other trials.  

But at this meeting we're seeing a report on how well does it perform in this T315i mutation setting, which isn't that uncommon and can happen after people have been exposed to multiple drugs.  I think it's active and maybe will require higher doses of the drug asciminib, and a little bit more time is needed, but I think it's really encouraging that we now maybe are saying we might have something that is proving to be worthwhile in that setting.  Because at the moment we have medications to prove like ponatinib, or Iclusig, but there's still safety concerns there.  

So good stories, and I think novel approaches early on, better monitoring and even better things on the back end, if you will, when things get tough and we have certain mutations.  

We'd like to see a higher number of people be able to get into the kind of remission we think is what we call a functional cure or potential functional cure, and we're really trying to think about what happens if that experiment fails.  We have some trials that are opening in the U.S. in the CML consortium, and that group, which I'm part of, is really focused on treatment-free remission and maybe a second treatment-free remission even, so I think a lot of work to be done there too.  But that's a nice chapter we're moving into, treatment-free remission. That's really where we want to be. 

Please remember the opinions expressed on Patient Power are not necessarily the views of our sponsors, contributors, partners or Patient Power. Our discussions are not a substitute for seeking medical advice or care from your own doctor. That’s how you’ll get care that’s most appropriate for you.

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Page last updated on January 17, 2019