Will novel agents for ALL finally change the natural history?

Abstract

Pediatric acute lymphoblastic leukemia (ALL) cure rates have markedly improved over the past years to approximately 85%, but remain at 40%-50% in adults. Redefining current adult chemotherapy regimens is likely to improve the natural course of the disease, but new agents are needed. Immunotherapy approaches for pre-B ALL are in the forefront of research on novel agents; in particular, advances are being made in manipulating autologous T cells either by infusion of a bifunctional antibody (eg, blinatumomab) or by ex vivo genetic modification of chimeric antigen receptors (CARs). The natural course of Philadelphia positive ALL has already improved by targeting ABL/BCR1. Other mutated genes are being discovered and novel small molecules that target their products are being studied in clinical trials. Finally, ALL is a heterogeneous disease and novel agents are likely to impact the natural course of smaller populations of biologically defined ALL subtypes.

• Authors: Dan Douer
• Journal: Best practice & research. Clinical haematology (Best Pract Res Clin Haematol) 2014 Sep-Dec Vol. 27 Issue 3-4 Pg. 247-58 ISSN: 1532-1924 [Electronic] Netherlands
• PMID: 25455274 (Publication Type: Journal Article, Review)
• Copyright: Copyright © 2014 Elsevier Ltd. All rights reserved.

Chemical References

• Antineoplastic Agents
• Fusion Proteins, bcr-abl

Topics

• Adolescent
• Adult
• Antineoplastic Agents (therapeutic use)
• Child
• Child, Preschool
• Drug Delivery Systems (methods)
• Female
• Fusion Proteins, bcr-abl (antagonists & inhibitors, genetics)
• Humans
• Lymphocyte Transfusion
• Male
• Precursor B-Cell Lymphoblastic Leukemia-Lymphoma (genetics, therapy)
• T-Lymphocytes (transplantation)