Hi All,
I have been looking to see if anything new or interesting came out of the proceedings of the American Society of Hematologists held in San Diego last December and came across a video online of Dr Mauro post conference, a well known practitioner and researcher based in New York;his review I have sumarised. He indicated that an interesting area still was that of combination therapy and especially that of nilotinib plus interferon and related to trials in this area.For those who are not familiar with interferon alpha prior to the introduction of tkis this was the only treatment offered apart from the possibility of transplants;apparently it was given by injection and led to very uncomfortable flu like side effects-it kept patients alive for a while but when the PCR rose then one knew that the disease would progress to a fatal conclusion.Apparently in a current context when used in combination with a tki it could lead to an immune modification to bring about a deeper and more rapid response.
Dr Mauro the mentioned the development of more sensitive tools of analysis such as the digital PCR that has advantages over current approaches because of its benefits of allowing closer monitoring and also might help as a better prognostic tool especially for those in treatment free remission or when a decision needs to be made to discontinue use of a tki or to reduce it.
The area of study of greatest promise he suggested is the development of a possible new 4th generation tki previously referred to as ABL001 but now labelled as Asciminib.Currently there are various Phase 1 trials being operated across different international locations some with use of single dose Asciminib and others in combination with existing tkis- results might not emerge until 2021 or later and the objective is to ascertain the safety for humans of this new possible treatment.The urgency it seems is because of new mutations such as T315i that for a proportion of patients respond to Ponatinib;in addition this third generation tki has an imperfect safety profile. Previous threads in forum here refer to AL001 and current trials I believe.
The CML Advocates website refers to a summary of a presentation at ASH given by Professor Dragona Milojkovic on treating CML before and during pregnancy and there is a suggested algorithm for the management of issues during this critical period in some patients lives.
As a postscript the other research area of promise is according to Dr Mauro that of immunology and immune based strategies that might be useful post tki in the TFR stage in order to prevent any consequent relapse;googling Dr Mauro s slides will access a number of his power point presentations.
Possibly what I have referred to above is not really new or ground breaking as it has been in the news for a period of time but has anyone found any additional useful outputs related to CML from the ASH proceedings?
Regards
John
