Novel agents for treatment of CML

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Published: 5 Aug 2010
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Prof John Goldman, Imperial College London, UK
Prof Goldman discusses the recent developments in the treatment of chronic myeloid leukaemia, specifically the results of using 2nd generation tyrosine kinase inhibitors for treatment of chronic phase CML.

EHA 2010 Annual Meeting, 10-13th June 2010, Barcelona

 

Professor John Goldman (Imperial College, London, UK)

 

Novel agents for treatment of CML

 

I’m Professor John Goldman, I’m now an Emeritus Professor of Haematology at Imperial College in London and I have a very long-standing interest in leukaemia, particularly chronic myeloid leukaemia.

 

What have been the recent advances in chronic myeloid leukaemia?

 

In chronic myeloid leukaemia the most exciting thing in the last year is the denouement, the unravelling if you like, of the results of using second generation tyrosine kinase inhibitors as initial therapy for chronic phase chronic myeloid leukaemia. We’ve known now for ten years, or even longer, that Imatinib Gleevec is a very effective drug in controlling the chronic phase, two-thirds of patients do very well and remain in good remission, good complete cytogenetic response or major molecular response on Imatinib but that means that one-third don’t do so very well. One-third are off treatment with the Imatinib by the end of five or seven years. The question is what can you do for them? And we’ve known now for three or four years that the use of second generation tyrosine kinase inhibitors, by which I mean Nilotinib or Dasatinib, are very effective in rescuing some of the patients who fail Imatinib.

 

Well now we begin to see the results of initial therapy of chronic phase CML with Dasatinib and Nilotinib and they’re very spectacularly good. It looks as if the high proportion of those who fail the Imatinib and are rescued with second generation TKI, now if they start with the second generation tyrosine kinase inhibitors will do extremely well.

 

What new developments do you expect to see?

 

I think that’s really the main thing, that we’ll see the clinical results of using these new agents up front. We’ll also see that the combination of Imatinib with Interferon Alpha seems to give better results for chronic phase CML than Imatinib alone. Those will be the two major developments, I think, for this year so far.