ISAL 2025 | Improving outcomes for young adults with ALL: progress and challenges
Wendy Stock, MD, University of Chicago Medical Centre, Chicago, IL, comments on the challenges and progress in improving outcomes for young adults with acute lymphoblastic leukemia (ALL). Dr Stock addresses issues with patients completing treatment and those with resistant disease. She highlights the potential of novel antibodies in B-cell ALL, but notes that these approaches are not yet available for T-cell ALL. This interview took place at the 19th International Symposium on Acute Leukemias (ISAL XIX) in Munich, Germany.
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Transcript
Some of the things I just talked about in terms of patients’ ability to get through the treatments is number one important because we know that if you don’t complete your treatment, you’re not going to do well. Then there’s the whole issue of resistant disease. And there is a much larger percentage of patients with adverse biology in the young adult population compared to the pediatric population that require novel approaches...
Some of the things I just talked about in terms of patients’ ability to get through the treatments is number one important because we know that if you don’t complete your treatment, you’re not going to do well. Then there’s the whole issue of resistant disease. And there is a much larger percentage of patients with adverse biology in the young adult population compared to the pediatric population that require novel approaches. For B-ALL, as you were alluding to a few moments ago about the incorporation of novel antibodies into frontline treatment, that has become a very big focus of our clinical research studies in the young adult ALL population for patients with B-ALL. And it is clear that the antibodies are going to have a role in frontline treatment, exactly how to structure that addition and which drugs to use when, for how long, remain to be determined and are the challenge for the next generation of trials. For T-ALL, we don’t yet have these novel antibodies, and there are some very unique approaches that are being entertained and about to be tested in the frontline setting to further improve outcomes for these patients. And T-ALL is a disease of young adults. So the predominant population of patients with T-ALL are young adult patients. And so we really need, and they comprise about 30% of our young adult population. So while the antibodies are revolutionizing treatment of B-ALL and are easy to think about incorporating into frontline treatment, we don’t yet have those kind of antibody or immunotherapeutic targeting approaches available for young adults with T-ALL, and so we’re focusing on other agents, including the BH3 mimetics that will sort of sensitize these cells to chemotherapy.
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