NEW TARGETED THERAPIES FOR RELAPSED PEDIATRIC LYMPHOBLASTIC LEUKEMIA.

NEW TARGETED THERAPIES FOR RELAPSED PEDIATRIC LYMPHOBLASTIC LEUKEMIA.

Expert Rev Anticancer Ther. 2017 Jun 25;:

Authors: Pierro J, Hogan LE, Bhatla T, Carroll WL

Abstract
INTRODUCTION: The improvement in outcomes for children with acute lymphoblastic leukemia (ALL) is one of the greatest success stories of modern oncology however the prognosis for patients who relapse remains dismal. Recent discoveries by high resolution genomic technologies have characterized the biology of relapsed leukemia, most notably pathways leading to the drug resistant phenotype. These observations open the possibility of targeting such pathways to prevent and/or treat relapse. Likewise, early experiences with new immunotherapeutic approaches have shown great promise. Areas Covered: We performed a literature search on PubMed and recent meeting abstracts using the keywords below. We focus on the biology and clonal evolution of relapsed disease and highlight potential new targets of therapy. We further summarize the results of early trials of the three most prominent immunotherapy agents currently under investigation. Expert Commentary: Discovery of targetable pathways that lead to drug resistance and recent breakthroughs in immunotherapy show great promise towards treating this aggressive disease. The best way to treat relapse, however, is to prevent it which makes incorporation of these new approaches into frontline therapy the best approach. Challenges remain to balance efficacy with toxicity and to prevent the emergence of resistant subclones which is why combining these newer agents with conventional chemotherapy will likely become standard of care.

PMID: 28649891 [PubMed - as supplied by publisher]

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