Dr. Cutler on Remaining Challenges in GVHD

Corey S. Cutler, MD, MPH, FRCPC, medical director, Adult Stem Cell Transplantation Program, director of Clinical Research, Stem Cell Transplantation, director, Stem Cell Transplantation Survivorship Program, institute physician, Dana-Farber Cancer Institute, and associate professor of medicine, Harvard Medical School, discusses remaining challenges in graft-versus-host disease (GVHD).

Early identification of patients with GVHD who are unlikely to respond well to corticosteroids remains a clinical need, says Cutler. Additionally, understanding which patients require augmented therapy up front compared with those who can receive de-escalated treatment require more study.

While biomarkers for chronic GVHD are less developed, biomarkers for acute GVHD (aGVHD) could aid in identifying these patients, explains Cutler.

The randomized phase 2 BMT CTN 1501 trial showed that single-agent sirolimus (Rapamune) is a viable option for patients with standard-risk aGVHD and is associated with reduced steroid exposure, greater immune suppression discontinuation, and improved quality of life compared with prednisone, concludes Cutler.