Articles by Lewis B. Silverman, MD
Dr. Silverman asks Dr. Curran to address how frontline therapy goals have evolved for young adults with ALL in the era of pediatric-inspired regimens (PIRs). Dr. Curran describes a significant paradigm shift: the historical standard in adult oncology held that young, fit patients should achieve remission as a bridge to allogeneic stem cell transplant (allo-SCT), which was considered to offer the best chance of long-term cure. Data supporting PIRs in AYA ALL have fundamentally changed this calculus.
Dr. Lewis Silverman introduces the program on pediatric-inspired asparaginase-based regimens in adolescent and young adult (AYA) ALL, joined by Dr. Emily Curran. The discussion focuses on the 2026 real-world analysis by Freyer and colleagues, which demonstrated significantly higher overall survival in AYAs with ALL treated with guideline-concordant pediatric-inspired regimens compared to adult-inspired regimens. Dr. Curran notes that no randomized trial comparing pediatric-inspired versus adult regimens in the AYA population has been completed to date; the accumulating retrospective and prospective data nonetheless strongly favor pediatric-inspired regimens over historical adult controls.
