Hetty Carraway, MD, associate professor of Medicine, the Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, and member, Hematology and Medical Oncology, the Cleveland Clinic, discusses the role of biomarker testing in patients with myelodysplastic syndromes (MDS) and acute myeloid leukemia (AML). 

Identifying relevant genomic information has helped shape treatment options for patients with myeloid malignancies, AML, or MDS, Carraway says. This information has helped physicians better classify a disease’s underlying biology and its drivers to the leukemogenesis and pathogenesis, Carraway explains. The speed of these tests has also improved, allowing for faster identification of the best therapy plan for each patient, Carraway adds.

Oncologists continue to ask if mutations can help to identify resistance pathways to specific drugs, and this has shaped frontline treatment choices, Carraway continues. These tools help evaluate minimal residual disease, plus optimal therapy at diagnosis and during remission, Carraway concludes.

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Hetty Carraway, MD, discusses the role of biomarker testing in patients with myelodysplastic syndromes and acute myeloid leukemia. 


Dr. Carraway on the Importance of Testing for Biomarkers in Patients with MDS and AML

Hetty Carraway, MD, associate professor of medicine, Cleveland Clinic Lerner College of Medicine, Case Western Reserve University, vice chair, Strategy and Enterprise Development, Taussig Cancer Institute, Cleveland Clinic, discusses important considerations for the future of acute myeloid leukemia (AML) regarding mutations and next-generation sequencing.

Mutations in AML are crucial markers of patient prognoses, Carraway says. Sequencing at the time of diagnosis, as well as throughout therapy, can reveal which mutations may be most sensitive to certain therapies, Carraway continues.

Sequencing should not be a static event but rather a way to receive data about refractory and responsive patients and gain more knowledge of resistance pathways, Carraway notes. Thinking about measurable residual disease is an important step toward determining additional treatment options for many patients with AML, Carraway concludes.

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Hetty Carraway, MD, discusses important considerations for the future of acute myeloid leukemia regarding mutations and next-generation sequencing.

Dr. Carraway on Next-Generation Sequencing in AML

Hetty Carraway, MD, oncologist, Cleveland Clinic, discusses predisposition to acute myeloid leukemia (AML).

Research has been done on the presence of mutations in patients who do not possess a hematologic malignancy. This research led to understanding of the presence of mutations and clonal hematopoiesis of indeterminate potential. That work was seminal in leading other research groups to question the development of AML in larger cohorts of patients, says Carrway.

In that research, as many as 150,000 patients who had leukemia were selected. These patients were retrospectively examined via serial samples of blood as far as 10 years prior to their diagnosis to see what happened following the detection of mutations. In that time span, researchers were able to identify differences in the presence of mutations and the variant allele frequency in specific genes that were associated with a higher risk of progression to AML compared to those who did not have those mutations, states Carrway. That work has enabled physicians to think more deeply about changing that trajectory for patients, adds Carrway.

Hetty Carraway, MD

Articles

Dr. Carraway on the Importance of Testing for Biomarkers in Patients with MDS and AML

Dr. Carraway on Next-Generation Sequencing in AML

Dr. Carraway on Predisposition to Acute Myeloid Leukemia