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VIDEO: Charles G. Mullighan, MBBS (Hons), MSc, MD, reviews treatment options, potential of tyrosine kinase inhibitors in ALL
In this video with Healio.com, Charles G. Mullighan, MBBS (Hons), MSc, MD, of St. Jude Children’s Research Hospital, provides an overview of several molecularly defined subtypes of acute lymphoblastic leukemia and evidence supporting the use of tyrosine kinase inhibitors in this setting.
Mullighan reviews the role of stem cell transplantation in Philadelphia chromosome-positive and BCR-able–positive ALL and how TKI therapy prior to transplant fits into treatment. More research is needed to determine the duration of TKI therapy in this setting, Mullighan said.
Ph-like ALL has been “associated with a poor prognosis, at least in the era of chemotherapy before tyrosine kinase inhibitors were used,” according to Mullighan. Anecdotal reports demonstrate some “spectacular responses” to TKI therapy in patients with refractory disease.
Recent findings in T-lineage ALL suggested that “patients who have high-risk disease might be logically treated with one of these TKIs or signaling pathway inhibitors in a genomically informed way to improve the outcome of therapy.”
While further research is needed to confirm the efficacy of this approach, the use of TKIs such as imatinib (Gleevec, Novartis) and dasatinib (Sprycel; Bristol-Myers Squibb, Otsuka) is “where we are heading in all spheres of ALL management,” Mullighan said.