ASH 2024 | New approaches to upfront therapy in Ph+ ALL
Marlise Luskin, MD, MSCE, Dana-Farber Cancer Institute, Boston, MA, discusses her presentation on new approaches to upfront therapy in Philadelphia chromosome-positive (Ph+) acute lymphoblastic leukemia (ALL), highlighting the advancements made in the treatment of this disease. These include using novel potent tyrosine kinase inhibitors (TKIs), combination therapies with blinatumomab, and using measurable residual disease (MRD) to monitor patients’ response to treatment. This interview took place at the 66th ASH Annual Meeting and Exposition, held in San Diego, CA.
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Transcript (AI-generated)
It’s really an exciting opportunity for me to present a talk in the education session of ASH this year on Philadelphia chromosome-positive ALL. In this talk I’ll be really focusing on the initial upfront treatment of this disease in adult patients. This is a really exciting opportunity to give this talk because there’s been so much advancement in the field of Philadelphia chromosome-positive ALL over the last couple of years...
It’s really an exciting opportunity for me to present a talk in the education session of ASH this year on Philadelphia chromosome-positive ALL. In this talk I’ll be really focusing on the initial upfront treatment of this disease in adult patients. This is a really exciting opportunity to give this talk because there’s been so much advancement in the field of Philadelphia chromosome-positive ALL over the last couple of years. What I endeavor to do in this talk is to summarize those advancements and really make this accessible to all those clinicians and practitioners taking care of these patients to really make sure they understand what we’ve learned and what we still need to learn more about.
So, in this talk, I’ll talk about a brief history of Ph+ ALL but really focusing on the future directions. And I’ll talk about the role of different components of therapy for Philadelphia chromosome-positive ALL, including tyrosine kinase inhibitors, data on new and more potent tyrosine kinase inhibitors. And I’ll talk about also the best way to combine tyrosine kinase inhibitors with other components of therapy, including the role of blinatumomab, a bispecific T-cell engager immunotherapy that we’re learning increasingly more about as it’s combined with tyrosine kinase inhibitors, as well as the evolving role of allogeneic stem cell transplant as we improve our medical therapy with TKIs and blinatumomab.
Also something I’ll cover in this talk is how we monitor response, something called measurable residual disease or MRD, which we’ve traditionally done with monitoring of BCR-ABL transcripts. That’s still obviously a very valuable tool, but we’re also learning that there are cases where this is not the most precise way to monitor treatment response and so-called next generation sequencing approaches can help us understand how patients are responding when they have types of ALL called multi-lineage Ph+ ALL. So overall, I sort of summarized how I treat patients with Philadelphia chromosome positive ALL currently, as well as also allude and highlight ongoing trials that are going to help us refine our treatments even further.
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