SOHO 2026 | Optimizing assessment of treatment resistance and loss of response in CML
Simona Soverini, PhD, University of Bologna, Bologna, Italy, discusses common challenges in assessing treatment resistance and loss of response in chronic myeloid leukemia (CML). She highlights the importance of considering BCR::ABL1 trends, treatment goals, and the individual patient context rather than overinterpreting a single result or narrowly defined treatment milestone, particularly when considering a treatment switch. This interview took place at the 14th Annual Meeting of the Society of Hematologic Oncology (SOHO 2026) in Houston, TX.
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Transcript
Well, I think one of the biggest issues I see is how they define failure and loss of response, because sometimes they are too strict in interpreting the ELN or NCCN recommendations. So in case of slight increases in BCR-ABL transcripts, unconfirmed, or for example in a patient who is a near miss in terms of a molecular response milestone, they sometimes tend to over-interpret the results without looking at the trend, without looking at the perspective of the patients, at the treatment goal, and whether they would do more harm in switching rather than keeping the patient a little bit longer on the same TKI...
Well, I think one of the biggest issues I see is how they define failure and loss of response, because sometimes they are too strict in interpreting the ELN or NCCN recommendations. So in case of slight increases in BCR-ABL transcripts, unconfirmed, or for example in a patient who is a near miss in terms of a molecular response milestone, they sometimes tend to over-interpret the results without looking at the trend, without looking at the perspective of the patients, at the treatment goal, and whether they would do more harm in switching rather than keeping the patient a little bit longer on the same TKI. So sometimes they get too nervous, they are too strictly adhering to the molecular response milestone cutoff, and sometimes they switch when they could wait a little bit longer. And if you run out of your options and switch towards more toxic drugs, of course you can benefit from greater potency, but you never can tell what may happen in the long term in terms of side effects.
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